WorldWideScience

Sample records for incident command medical

  1. Literature review on medical incident command.

    Science.gov (United States)

    Rimstad, Rune; Braut, Geir Sverre

    2015-04-01

    It is not known what constitutes the optimal emergency management system, nor is there a consensus on how effectiveness and efficiency in emergency response should be measured or evaluated. Literature on the role and tasks of commanders in the prehospital emergency services in the setting of mass-casualty incidents has not been summarized and published. This comprehensive literature review addresses some of the needs for future research in emergency management through three research questions: (1) What are the basic assumptions underlying incident command systems (ICSs)? (2) What are the tasks of ambulance and medical commanders in the field? And (3) How can field commanders' performances be measured and assessed? A systematic literature search in MEDLINE, PubMed, PsycINFO, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, ISI Web of Science, Scopus, International Security & Counter Terrorism Reference Center, Current Controlled Trials, and PROSPERO covering January 1, 1990 through March 1, 2014 was conducted. Reference lists of included literature were hand searched. Included papers were analyzed using Framework synthesis. The literature search identified 6,049 unique records, of which, 76 articles and books where included in qualitative synthesis. Most ICSs are described commonly as hierarchical, bureaucratic, and based on military principles. These assumptions are contested strongly, as is the applicability of such systems. Linking of the chains of command in cooperating agencies is a basic difficulty. Incident command systems are flexible in the sense that the organization may be expanded as needed. Commanders may command by direction, by planning, or by influence. Commanders' tasks may be summarized as: conducting scene assessment, developing an action plan, distributing resources, monitoring operations, and making decisions. There is considerable variation between authors in nomenclature and what tasks are included or highlighted

  2. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

    Science.gov (United States)

    Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

    2017-01-01

    This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

  3. 32 CFR 724.406 - Commander, Naval Medical Command.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Commander, Naval Medical Command. 724.406 Section 724.406 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NAVAL DISCHARGE REVIEW BOARD Principal Elements of the Navy Department Discharge Review System § 724.406 Commander...

  4. Incident Command System - Environmental Unit responsibilities

    International Nuclear Information System (INIS)

    Hillman, S. O.

    1997-01-01

    The Incident Command System (ICS) for crisis management, used for response to oil spills by the Alyeska Pipeline Service Company throughout its facilities, including the Trans Alaska Pipeline and the Valdez Marine Terminal, was described. Special attention was given to the Environmental Unit within the ICS which functions as a primary support unit for the Incident Operations Section. Details of the Unit's function were provided. These include the collection, evaluation and dissemination of information on all environmental issues concerning the crisis, provision of advice and direction on environmental aspects, and up-front agency interaction. A checklist of tasks is included. 7 refs

  5. Incident command linkup: the vital key for CBRN response

    International Nuclear Information System (INIS)

    Smith, D.

    2009-01-01

    The most vital element for responding emergency personnel to a CBRN attack is the incident command linkup and dissemination of information. Incident Command, the basic foundation of the National Incident Management System (NIMS), is the first thing that must be effectively established when a response is required in any emergency. When initial evaluation of the scene determines that the incident involves CBRN, specialized resources from a wide array of assets must be activated quickly to mitigate the hazards. In this paper, we examine the information that the Incident Commander must be prepared to convey to those specialized assets responding. We will also look at what questions those specialized resources may ask while en route and upon arrival. Another key element that will be discussed is the placement of those resources in the hierarchy of the National Incident Management System. The information that the Incident Commander (IC) must be prepared to convey to those specialized assets responding is crucial for an efficient response and effective deployment. What questions might those specialized CBRN resources ask while en route and upon arrival? At a bare minimum, the four basic questions of who is in charge of the incident, where is the incident located, what transpired to trigger a response, and when did the incident occur must be answered. These questions should be answered while en route to the scene so that the Commander of the responding CBRN unit can formulate a plan on the move and prepare his response accordingly. While in transit, the CBRN responders should maintain contact with a representative of the Incident Command at the scene so that the latest information is available. Discussions should include anticipated logistical requirements such as personal protective equipment (PPE), decon requirements, communications protocols, and medical care issues. The CBRN Commander will need to know if the site is secure, has it been cleared of explosive hazards

  6. An incident command system in practice and reality

    International Nuclear Information System (INIS)

    Spitzer, J.D.

    1992-01-01

    The basic organizational problems and options for forming a pollution response organization are described. Problems with multi-agency response organizations include poor coordination and lack of accountability. Alternatives to autonomous organizations operating with minimal coordination are the multi-agency/organization teams working under a controlling organization, and organizations formed into a single response organization (the incident command system or ICS). Design criteria for an ICS include flexibility as to the jurisdiction and agency, adaptable organizational structure, capability to expand in a logical manner, and uniform elements in terminology, organization, and procedures. ICS in practice is illustrated both by the CANUSLAK exercise undertaken in August 1990 and a real incident that occurred several days after the exercise was finished. CANUSLAK involved the US Coast Guard and its Canadian and Michigan counterparts in a simulated incident in the St. Clair river. The real incident was the explosion of the gasoline-carrying tank vessel Jupiter in the Saginaw River. In both instances, ICS combined many organizations into one team with a single incident commander. The eight basic components of ICS are common terminology, modular organization, integrated communications, unified command structure, consolidated action plan, manageable span of control, designated incident facilities, and comprehensive resource management. ICS has been tailored to a wide range of applications and is not only used in major disasters but as a part of routine operations. 18 refs., 5 figs

  7. Successful emergency operations and the Incident Command System

    International Nuclear Information System (INIS)

    Montgomery, M.

    1994-01-01

    The Incident Command System (ICS) was developed to provide an ''all-risk'' system of effective emergency scene management. The Cy-Fair Volunteer Fire Department (CFVFD) has made ICS an integral part of their operations since 1987. On January 26, 1993, CFVFD was called to investigate a petroleum odor and possible spill near State Highway 6 and Jackrabbit Road in northwest Harris County. Over the next six-hour period, the dispatch center received over 100 calls an hour regarding this incident. Personnel from CFVFD, the oil company, mutual aid fire departments, and private contractors worked around the dock to successfully contain, clean and reduce the effects of a 25,000 gallon crude oil spill next to a 141-foot diameter oil storage tank at the Satsuma Station. Among the keys to success was proper use of the Incident Command System (ICS). Problems overcome included the lack of a readily available water source, limited foam supplies, time of day, and incident duration

  8. L-037: EPR-First Responders: Action Guides commander of incident response

    International Nuclear Information System (INIS)

    2011-01-01

    This conference is about the main action guides responses implemented by the incident commander in a radiological emergency. The public exposure, the contamination, the radioactive sources and suspicious material are important aspects to be considered by the first responders

  9. NHD, riverspill, and the development of the incident command tool for drinking water protection.

    Science.gov (United States)

    William B. Samuels; Rakesh Bahadur; Michael C. Monteith; David E. Amstutz; Jonathan M. Pickus; Katherine Parker; Douglas. Ryan

    2006-01-01

    This project involved the development of an information tool that gives Incident Commanders the critical information they need to make informed decisions regarding the consequences of threats to public water supply intakes.

  10. 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.

  11. Unified Medical Command and Control in the Department of Defense

    Science.gov (United States)

    2012-03-22

    This is the Joint Task Force – Capital Medical (JTF CAPMED ) model, in which organizations, resources, and personnel are aligned under a single...This was demonstrated in the formation of the JTF- CAPMED , designed as a 3-star level command controlling military medical activities in the National...used ground vehicles, helicopters and fixed wing aircraft for strategic casualty evacuation (CASEVAC). Enroute care is standard and critical in

  12. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  13. 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...

  14. A day in the life of a volunteer incident commander: errors, pressures and mitigating strategies.

    Science.gov (United States)

    Bearman, Christopher; Bremner, Peter A

    2013-05-01

    To meet an identified gap in the literature this paper investigates the tasks that a volunteer incident commander needs to carry out during an incident, the errors that can be made and the way that errors are managed. In addition, pressure from goal seduction and situation aversion were also examined. Volunteer incident commanders participated in a two-part interview consisting of a critical decision method interview and discussions about a hierarchical task analysis constructed by the authors. A SHERPA analysis was conducted to further identify potential errors. The results identified the key tasks, errors with extreme risk, pressures from strong situations and mitigating strategies for errors and pressures. The errors and pressures provide a basic set of issues that need to be managed by both volunteer incident commanders and fire agencies. The mitigating strategies identified here suggest some ways that this can be done. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  15. Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

    Science.gov (United States)

    Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

    2011-08-01

    Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

  16. Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Yarmohammadian

    2011-01-01

    Full Text Available Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS. Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational, barriers (internal and external of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

  17. From the incident command center oil spills from Hurricanes Katrina and Rita

    Energy Technology Data Exchange (ETDEWEB)

    Guidry, R.J. [Lousiana Oil Spill Coordinator' s Office, Baton Rouge, LA (United States)

    2006-07-01

    Approximately 30.2 million litres of oil were discharged during Hurricanes Katrina and Rita. A total of 230 incidents were reported to the state's spill response community, including ruptured pipelines, damaged and moved storage tanks, refineries, and sunken vessels. By January 2006, industry had reported the recovery of 14.7 million litres of oil. After Hurricane Rita, a further 234 off- and onshore incidents were reported. This paper presented a chronology from August 26 2005 through to June 2006 of clean-up activities for both hurricanes, with specific reference to logistic and communications issues associated with working in environments that are difficult to access due to damaged transportation infrastructure. An outline of the Louisiana Oil Spill Coordinator's Office's role in the incidents was presented, as well as an overview of the Louisiana State Contingency Plan. It was noted that the lack of communications systems caused considerable difficulties for responders. It was concluded that responses to hurricanes can be made more effective by having all response communities incident command structure (ICS)-trained with a thorough knowledge of the National Response Plan as it relates to the National Contingency Plan. Ensuring that plans are operational, having clear lines of authority on all hurricane-related issues, and having a robust communications plan were recommended, as well as the ability to respond without communications.

  18. From the incident command center oil spills from Hurricanes Katrina and Rita

    International Nuclear Information System (INIS)

    Guidry, R.J.

    2006-01-01

    Approximately 30.2 million litres of oil were discharged during Hurricanes Katrina and Rita. A total of 230 incidents were reported to the state's spill response community, including ruptured pipelines, damaged and moved storage tanks, refineries, and sunken vessels. By January 2006, industry had reported the recovery of 14.7 million litres of oil. After Hurricane Rita, a further 234 off- and onshore incidents were reported. This paper presented a chronology from August 26 2005 through to June 2006 of clean-up activities for both hurricanes, with specific reference to logistic and communications issues associated with working in environments that are difficult to access due to damaged transportation infrastructure. An outline of the Louisiana Oil Spill Coordinator's Office's role in the incidents was presented, as well as an overview of the Louisiana State Contingency Plan. It was noted that the lack of communications systems caused considerable difficulties for responders. It was concluded that responses to hurricanes can be made more effective by having all response communities incident command structure (ICS)-trained with a thorough knowledge of the National Response Plan as it relates to the National Contingency Plan. Ensuring that plans are operational, having clear lines of authority on all hurricane-related issues, and having a robust communications plan were recommended, as well as the ability to respond without communications

  19. Decrease in medical command errors with use of a "standing orders" protocol system.

    Science.gov (United States)

    Holliman, C J; Wuerz, R C; Meador, S A

    1994-05-01

    The purpose of this study was to determine the physician medical command error rates and paramedic error rates after implementation of a "standing orders" protocol system for medical command. These patient-care error rates were compared with the previously reported rates for a "required call-in" medical command system (Ann Emerg Med 1992; 21(4):347-350). A secondary aim of the study was to determine if the on-scene time interval was increased by the standing orders system. Prospectively conducted audit of prehospital advanced life support (ALS) trip sheets was made at an urban ALS paramedic service with on-line physician medical command from three local hospitals. All ALS run sheets from the start time of the standing orders system (April 1, 1991) for a 1-year period ending on March 30, 1992 were reviewed as part of an ongoing quality assurance program. Cases were identified as nonjustifiably deviating from regional emergency medical services (EMS) protocols as judged by agreement of three physician reviewers (the same methodology as a previously reported command error study in the same ALS system). Medical command and paramedic errors were identified from the prehospital ALS run sheets and categorized. Two thousand one ALS runs were reviewed; 24 physician errors (1.2% of the 1,928 "command" runs) and eight paramedic errors (0.4% of runs) were identified. The physician error rate was decreased from the 2.6% rate in the previous study (P < .0001 by chi 2 analysis). The on-scene time interval did not increase with the "standing orders" system.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. 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...

  1. 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)

  2. 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

  3. 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.

  4. 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....

  5. On a Clear Day, You Can See ICS: The Dying Art of Incident Command and the Normal Accident of NIMS - A Policy Analysis

    Science.gov (United States)

    2013-03-01

    Commander ICS Incident Command System IMT Incident Management Team MACC Multi-Agency Coordination System MACS Multi-Agency Coordination System NIMS...as a nation to respond to the big (and little) ones. I do not propose that these three policy options are all-inclusive, as there are many more...Giuliani rose to the occasion and became known as “America’s Mayor” for his leadership during the events ( Economist , 2005). The city of New York

  6. 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.

  7. Implementation of the National Incident Management System (NIMS)/Incident Command System (ICS) in the Federal Radiological Monitoring and Assessment Center(FRMAC) - Emergency Phase

    International Nuclear Information System (INIS)

    NSTec Environmental Restoration

    2007-01-01

    Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS

  8. 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.

  9. 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.

  10. 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

  11. 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...

  12. Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model.

    Science.gov (United States)

    Yu, Wenya; Lv, Yipeng; Hu, Chaoqun; Liu, Xu; Chen, Haiping; Xue, Chen; Zhang, Lulu

    2018-01-01

    Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For large-scale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise.

  13. 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)

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. A Case Study in the Identification of Critical Factors Leading to Successful Implementation of the Hospital Incident Command System

    Science.gov (United States)

    2015-06-01

    additional eight patients were inbound to the emergency department, and by 4:30 pm, a total of 35 patients...Information Officer  Marketing Director  Patient Relations  Risk Management  Chief Information Officer  Community Relations  Chief Executive...192 Ibid. 128 The HICS 202 Incident Objectives:193 1. Confirm staffing/competencies 2. Confirm capacity 3. Confirm inbound 4. Complete

  6. 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...

  7. 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 ...

  8. 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...

  9. 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.

  10. Standardization and Implementation of a Standard Emergency Code Call System within Estern Region Medical Command

    Science.gov (United States)

    2009-03-01

    ACHs) exist the same way that Kaiser has established different levels of services within a geographical region ( Hawaii : Hilo , Kona, Honolulu, Maui...California, Hawaii , etc., the Army MHS is divided into regions. Within these regions, Army Medical Centers (MEDCENSs) and Army Community Hospitals

  11. 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...

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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...

  20. 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

  1. 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

  2. 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

  3. 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/

  4. 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.

  5. 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...

  6. 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.

  7. 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...

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. Incidence of and sequels to medical problems discovered in medical students during study-related activities

    NARCIS (Netherlands)

    Pols, J; Boendermaker, PM; Muntinghe, H

    2003-01-01

    Purpose Students often act as subjects during practical and clinical skills training sessions. This routine seems to be quite acceptable for them but may present side-effects. Disorders, sometimes of a serious nature, have been discovered in medical students during clinical skills training. Because

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

  18. 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.

  19. 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.

  20. 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...

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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)

  11. 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.

  12. 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)...

  13. 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

  14. 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.

  15. 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.

  16. [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.

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. 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

  2. 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....

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. Survey of the incidence and effect of major life events on graduate medical education trainees

    Directory of Open Access Journals (Sweden)

    Lars J. Grimm

    2015-06-01

    Full Text Available Purpose: This study aims to assess the incidence of major life events during graduate medical education (GME training and to establish any associations with modifiable activities and career planning. Methods: The authors surveyed graduating GME trainees from their parent institution in June 2013. Demographic information (clinical department, gender, training duration and major life events (marriage, children, death/illness, home purchase, legal troubles, property loss were surveyed. Respondents were queried about the relationship between life events and career planning. A multivariable logistic regression model tested for associations. Results: A total of 53.2% (166/312 of graduates responded to the survey. 50% (83/166 of respondents were female. Major life events occurred in 96.4% (160/166 of respondents. Male trainees were more likely (56.1% [46/82] vs. 30.1% [25/83] to have a child during training (p=0.01. A total of 41.6% (69/166 of responders consciously engaged or avoided activities during GME training, while 31.9% (53/166 of responders reported that life events influenced their career plans. Trainees in lifestyle residencies (p=0.02, those who experienced the death or illness of a close associate (p=0.01, and those with legal troubles (p=0.04 were significantly more likely to consciously control life events. Conclusion: Major life events are very common and changed career plans in nearly a third of GME trainees. Furthermore, many trainees consciously avoided activities due to their responsibilities during training. GME training programs should closely assess the institutional support systems available to trainees during this difficult time.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. Electromagnetic interference from radio frequency identification inducing potentially hazardous incidents in critical care medical equipment

    NARCIS (Netherlands)

    Togt, R. van der; Lieshout, E.J. van; Hensbroek, R.; Beinat, E.; Binnekade, J.M.; Bakker, P.J.M.

    2008-01-01

    Context: Health care applications of autoidentification technologies, such as radio frequency identification (RFID), have been proposed to improve patient safety and also the tracking and tracing of medical equipment. However, electromagnetic interference (EMI) by RFID on medical devices has never

  14. 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.

  15. Medication-Related Fall Incidents in an Older, Ambulant Population: The B-PROOF Study

    NARCIS (Netherlands)

    Ham, Annelies C.; Swart, Karin M. A.; Enneman, Anke W.; van Dijk, Suzanne C.; Oliai Araghi, Sadaf; van Wijngaarden, Janneke P.; van der Zwaluw, Nikita L.; Brouwer-Brolsma, Elske M.; Dhonukshe-Rutten, Rosalie A. M.; van Schoor, Natasja M.; van der Cammen, Tischa J. M.; Lips, Paul; de Groot, Lisette C. P. G. M.; Uitterlinden, André G.; Witkamp, Renger F.; Stricker, Bruno H.; van der Velde, Nathalie

    2014-01-01

    Background Medication use is a potentially modifiable risk factor for falling; psychotropic and cardiovascular drugs have been indicated as main drug groups that increase fall risk. However, evidence is mainly based on studies that recorded falls retrospectively and/or did not determine medication

  16. 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.

  17. [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.

  18. 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

  19. 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

  20. Medical and Psychological Risk Factors for Incident Hypertension in Type 1 Diabetic African-Americans

    Directory of Open Access Journals (Sweden)

    Monique S. Roy

    2011-01-01

    Conclusions. The development of hypertension in African-Americans living with type 1 diabetes appears to be multifactorial and includes both medical (overt proteinuria as well as psychological (high hostility risk factors.

  1. 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.

  2. 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

  3. 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

  4. 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...

  5. Medical SisRadiologia: a new software tool for analysis of radiological accidents and incidents in medical radiology

    International Nuclear Information System (INIS)

    Lima, Camila M. Araujo; Silva, Francisco C.A. da; Araujo, Rilton A.; Pelegrineli, Samuel Q.

    2013-01-01

    The man's exposure to ionizing radiation in health are has increased considerably due not only the great request of medical examinations as well as the improvement of the techniques used in diagnostic imaging, for example, equipment for conventional X-rays, CT scans, mammography, hemodynamic and others. Although the benefits of using of radiology techniques are unquestionable, the lack of training in radiation protection of the workers, associated with procedure errors, have been responsible for the increasing number of radiation overexposures of these workers. Sometimes these high doses are real and there is a true radiological accident. The radiation workers, named occupationally Exposed Individual (IOE), must comply with two national regulations: Governmental Decree 453/1998 of the National Agency of Sanitary Surveillance (Portaria 453/1998 ANVISA Agencia Nacional de Vigilancia Sanitaria), which establishes the basic guidelines for radiation protection in medial and dental radiology and; the Governmental Decree NR-32/2002 of the Ministry of Labour and Employment (Ministerio do Trabalho e Emprego), which establishes the basic guidelines for the worker's health. The two mandatory regulations postulate a detailed investigation in the event of radiation overexposure of an IOE. In order to advice the diagnostic institution to perform an efficient analysis, investigation and report of high doses, it is proposed the use of a computational tool named 'Medical SisRadiologia'. This software tool enables the compilation and record of radiological abnormal data occurred in a diagnostic institution. It will also facilitate the detailed analysis of the event and will increase the effectiveness and development of work performed by the Radiation Protection Service. At the end, a technical report is issued, in accordance with the regulations of the technical regulations, which could also be used as training tool to avoid another event in the future. (author)

  6. Medical SisRadiologia: a new software tool for analysis of radiological accidents and incidents in medical radiology

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Camila M. Araujo; Silva, Francisco C.A. da, E-mail: araujocamila@yahoo.com.br, E-mail: dasilva@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Araujo, Rilton A.; Pelegrineli, Samuel Q., E-mail: consultoria@maximindustrial.com.br, E-mail: samuelfisica@maximindustrial.com.br [Maxim Industrial, Rio de Janeiro, RJ (Brazil)

    2013-07-01

    The man's exposure to ionizing radiation in health are has increased considerably due not only the great request of medical examinations as well as the improvement of the techniques used in diagnostic imaging, for example, equipment for conventional X-rays, CT scans, mammography, hemodynamic and others. Although the benefits of using of radiology techniques are unquestionable, the lack of training in radiation protection of the workers, associated with procedure errors, have been responsible for the increasing number of radiation overexposures of these workers. Sometimes these high doses are real and there is a true radiological accident. The radiation workers, named occupationally Exposed Individual (IOE), must comply with two national regulations: Governmental Decree 453/1998 of the National Agency of Sanitary Surveillance (Portaria 453/1998 ANVISA Agencia Nacional de Vigilancia Sanitaria), which establishes the basic guidelines for radiation protection in medial and dental radiology and; the Governmental Decree NR-32/2002 of the Ministry of Labour and Employment (Ministerio do Trabalho e Emprego), which establishes the basic guidelines for the worker's health. The two mandatory regulations postulate a detailed investigation in the event of radiation overexposure of an IOE. In order to advice the diagnostic institution to perform an efficient analysis, investigation and report of high doses, it is proposed the use of a computational tool named 'Medical SisRadiologia'. This software tool enables the compilation and record of radiological abnormal data occurred in a diagnostic institution. It will also facilitate the detailed analysis of the event and will increase the effectiveness and development of work performed by the Radiation Protection Service. At the end, a technical report is issued, in accordance with the regulations of the technical regulations, which could also be used as training tool to avoid another event in the future. (author)

  7. 77 FR 52746 - Medical Countermeasures for a Burn Mass Casualty Incident

    Science.gov (United States)

    2012-08-30

    ... Building 1 where routine security check procedures will be performed. For parking and security information... telephone number. Those without Internet access should contact Suzanne Schwartz to register (see Contact... Internet at http://www.fda.gov/MedicalDevices/NewsEvents/WorkshopsConferences/default.htm . (Select this...

  8. 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.

  9. 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.

  10. Childhood accidents: the relationship of family size to incidence, supervision, and rapidity of seeking medical care.

    Science.gov (United States)

    Schwartz, Shepard; Eidelman, Arthur I; Zeidan, Amin; Applebaum, David; Raveh, David

    2005-09-01

    Large family size may be a risk factor for childhood accidents. A possible association with quality of child supervision and rapidity of seeking medical care has not been fully evaluated. To determine whether children with multiple siblings are at increased risk for accidents, to assess whether quality of child supervision varies with family size, and to evaluate the relationship of family size with the rapidity of seeking medical care after an accident. We prospectively studied 333 childhood accidents treated at TEREM (emergency care station) or the Shaare Zedek Medical Center. Details on family composition and the accident were obtained through parental interview. Family size of the study population was compared with that of the Jerusalem population. Families with one to three children (Group 1) and four or more children (Group 2) were compared with regard to type of supervision and different "Gap times" - the time interval from when the accident occurred until medical assistance was sought ("Gap 1"), the time from that medical contact until arrival at Shaare Zedek ("Gap 2"), and the time from the accident until arrival at Shaare Zedek for those children for whom interim medical assistance either was ("Gap 3A") or was not ("Gap 3B") sought. Children from families with 1, 2, 3, 4 and > or =5 children comprised 7.2%, 18.3%, 14.4%, 18.6% and 41.4% of our sample compared to 20.4%, 21.8%, 18.4%, 14.7% and 24.7% in the general population respectively. Children from Group 2 were less often attended to by an adult (44.5% vs. 62.0%) and more often were in the presence only of other children at the time of the accident (27.0% vs. 10.5%). Gaps 1, 2 and 3A in Group 2 (6.3 hours, 16.5 hours, 27.8 hours respectively) were longer than for Group 1 (2.7, 10.7, 13.3 hours respectively). The risk for accidents is increased among children from families with four or more children. The adequacy of child supervision in large families is impaired. There is a relative delay from the time

  11. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

    Directory of Open Access Journals (Sweden)

    Huber-Wagner S

    2009-12-01

    Full Text Available Abstract Background Hospitals have a critically important role in the management of mass causality incidents (MCI, yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%, pelvic injuries (11.5%, thoracic injuries (5.0% and major amputations (3.1%. The mean cut to suture time was 130 min (IQR 65-165 min. Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00, ISS ≥ 35 (OR 2,94, hemoglobin level ≤ 8 mg/dL (OR 1,40, pulse rate on hospital admission 120/min (OR 1,39, blood pressure on hospital admission Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.

  12. 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.)

  13. Incidence, characteristics and management of pain in one operational area of medical emergency teams.

    Science.gov (United States)

    Kosiński, Sylweriusz; Bryja, Magdalena; Wojtaszowicz, Rafał; Górka, Andrzej

    2014-01-01

    Experience of pain associated with both chronic as well as acute medical conditions is a main cause for call for ambulance. The aim of this study was to establish both frequency and characteristics of pain reported by patients treated in pre-hospital environment in a single operational area. The supplementary goal was an analysis of methods of pain alleviation applied by medical personnel in the above described scenario. The written documentation of 6 months of year 2009 provided by doctor-manned as well as paramedic-only ambulances operating in Tatra county, Małopolska, Poland was analyzed. Medical personnel inquired about pain experienced in 57.4% of cases, 10-point numerical rating scale was used in 22.3% of patients. Pain was reported by 43.8% of patients, the most frequent reasons of experienced pain were trauma and cardiovascular diseases. In almost half of the cases pain was referred to the areas of chest and abdomen. Non-traumatic pain was reported by 47.7% of patients, post-traumatic in 41.3% of cases, 11% of subjects reported ischemic chest pain. 42.3% of pain-reporting patients received some form of analgesia, yet only 3% of subjects in this group received opiates. Personnel of paramedic-only ambulances tended to use pain intensity scale more often (P < 0.01), yet administered pain alleviating drugs noticeably less often than the doctor-manned teams (P < 0.01). The use of pain alleviating drugs, opiates especially, was inadequate in proportion to frequency and intensity of pain reported by patients. General, nation-wide standards of pain measurement and treatment in pre-hospital rescue are suggested as a means to improve the efficacy of pain reduction treatment.

  14. Marine Corps Counterterrorism: Determining Medical Supply Needs for the Chemical Biological Incident Response Force

    Science.gov (United States)

    2004-03-04

    80.33 6505009269197 Ipecac Syrup USP 7% 30ml 1 BT 0.01 0.30 $0.93 0.01 0.3 $0.93 6505001326904 Isoniazid Tablets USP 300 Mg 100s...Administer Appropriate Medication 6505000648724 Acetazolamide Sodium Sterile USP 500mg Vial 0.5 VI 29 6505001009985 Aspirin Tablets USP 0.324gm 100s...6505012149062 Ibuprofen Tablets USP 800 Mg 500 Tablets Per Bottle 1 EA 7 6515013448487 Injector Tube Reusable 1ml & 2ml Ndl Units 1 EA

  15. 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

  16. Medical incidents in developing countries: A few case studies from Nigeria.

    Science.gov (United States)

    Chukwuneke, F N

    2015-12-01

    The moral worth of a clinician's, action in patients' management depends exclusively on the moral acceptability of the rule of obligation to duty on which the clinician acts. Since every rational being thinks of him or herself as an end, all people must act in such a way that they treat humanity, whether in their own person or in the person of another, always as an end and never simply as a means. A duty of care is, therefore, paramount in the relationship between clinician and patient. While litigation in healthcare system is rapidly increasing globally, which affords individual explanation and compensation for perceived wrong diagnosis and treatment; it is still rudimentary in Nigeria. This default position has made most health care providers indifferent in the presence of gross clinical negligence and medical errors. Though most Nigerians may be aware of their rights to institute legal action in situations such as, negligence with serious harm or death, but, the socioeconomic factors, cultural, and religious notions among other reasons within the society often makes litigation impossible for an individual. Attributing every medical adverse event in the course of treatment as "God's Will" and the saying "It's God's Time" for every death among most African people has also become a great impediment to curbing clinical negligence in our environment. This paper presents a few case studies from author's experience and complaints from patients during clinical practice.

  17. 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

  18. 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.

  19. 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.

  20. 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…

  1. 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...

  2. The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

    Directory of Open Access Journals (Sweden)

    Norakhoda Sadeghifard

    2010-10-01

    Full Text Available Clostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P

  3. EmerLoc: location-based services for emergency medical incidents.

    Science.gov (United States)

    Maglogiannis, I; Hadjiefthymiades, S

    2007-10-01

    Recent developments in positioning systems and telecommunications have provided the technology needed for the development of location aware medical applications. We developed a system, named EmerLoc, which is based upon this technology and uses a set of sensors that are attached to the patient's body, a micro-computing unit which is responsible for processing the sensor readings and a central monitoring unit, which coordinates the data flow. To demonstrate that the proposed system is technically feasible and acceptable for the potential users. Transmission speed is assessed mostly by means of transmission of DICOM compliant images in various operational scenarios. The positioning functionality was established both outdoor using GPS and indoor using the UCLA Nibble system. User acceptability was assessed in a hospital setting by 15 physicians who filled in a questionnaire after having used the system in an experimental setting. Transmission speeds ranged from 88kB/s for a IEEE 802.11 infrastructure to 2.5kB/s for a GSM/GPRS scenario. Positioning accuracy based on GPS was 5-10m. The physicians rated the technical aspects on average above 3 on a 5-point scale. Only the data presentation was assessed to be not satisfactory (2.81 on a 5-point scale). The reported results prove the feasibility of the proposed architecture and its alignment with widely established practices and standards, while the reaction of potential users who evaluated the system is quite positive.

  4. The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

    Directory of Open Access Journals (Sweden)

    Norakhoda Sadeghifard

    2010-09-01

    Full Text Available "nClostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P<0.05. Among the wards of selected hospitals, in gastroenterology of Children clinical center, Toxigenic C. difficile was isolated from patients most frequently. The sensitivity of isolates to vancomycin, Chloramphenicol and ceftriaxone were higher than other antibiotics. Toxigenic C. difficile is a common hospital-acquired infection. The organism was found in 6.1% hospitalized patients. Further studies to evaluate the rate and role of toxigenic C. difficile in nosocomial diarrheal processes, ecological and pathogenic terms are suggested.

  5. [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.

  6. [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.

  7. 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

  8. 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

  9. Effect of prophylactic topical hypotensive medications in reducing the incidence of postoperative ocular hypertension after phacoemulsification in dogs.

    Science.gov (United States)

    Dees, D Dustin; Spahn, Kate J; Wagner, Lynsey Smith; Greller, Andrew; Paglia, Danielle; Armour, Micki D; Madsen, Richard

    2017-11-01

    To determine whether topical hypotensive medications prevent postoperative ocular hypertension (POH) after phacoemulsification. 52 client-owned dogs (88 eyes). Diabetic and nondiabetic dogs having undergone phacoemulsification were included in this retrospective study. The control group received no ocular hypotensive medications. The treatment groups received latanoprost, dorzolamide, or dorzolamide/timolol, beginning immediately after surgery, for 2-week duration. IOPs were obtained at initial examination followed by 4 h, 24 h, 7 days, and 14 days postoperatively. POH was defined as an IOP above 20 mmHg (POH20) or 25 mmHg (POH25). POH20 occurred in 33 of 87 eyes (37.93%), including 11 of 21 eyes (52.38%) in the control group, three of 23 eyes (13.04%) in the latanoprost group, eight of 15 eyes (53.33%) in the dorzolamide group, and 11 of 28 eyes (39.29%) in the dorzolamide/timolol group. Active treatment groups were compared to the control group, and the overall group effect was not significant (P = 0.11). POH25 occurred in 22 of 86 eyes (25.58%), including seven of 21 eyes (33.33%) in the control group, two of 23 eyes (8.70%) in the latanoprost group, five of 15 eyes (33.33%) in the dorzolamide group, and eight of 27 eyes (29.63%) in the dorzolamide/timolol group. Active treatment groups were compared to the control group, and the overall group effect was not significant (P = 0.31). Intraoperative use of intracameral tissue plasminogen activator significantly decreased the chances of POH25 (P = 0.0063). The latanoprost group had a substantially lower percentage of POH 20 and POH25 compared to the control and other active treatment groups, although statistical significance was not achieved. Intraoperative intracameral tissue plasminogen activator decreased the incidence of POH25. © 2017 American College of Veterinary Ophthalmologists.

  10. 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...

  11. 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

  12. 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....

  13. 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

  14. 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...

  15. Drug-Gene Interactions of Antihypertensive Medications and Risk of Incident Cardiovascular Disease: A Pharmacogenomics Study from the CHARGE Consortium.

    Directory of Open Access Journals (Sweden)

    Joshua C Bis

    antihypertensive therapy meta-analyses (Pinteraction > 5.0×10-8. Similarly, findings were null for meta-analyses restricted to 66 SNPs with significant main effects on coronary artery disease or blood pressure from large published genome-wide association studies (Pinteraction ≥ 0.01. Our results suggest that there are no major pharmacogenetic influences of common SNPs on the relationship between blood pressure medications and the risk of incident CVD.

  16. Factor VII and incidence of myocardial infarction in a Japanese population: The Jichi Medical School Cohort Study.

    Science.gov (United States)

    Shiraishi, Takuya; Ishikawa, Shizukiyo; Kario, Kazuomi; Kayaba, Kazunori; Kajii, Eiji

    2017-11-01

    The role of factor VII (FVII) as a risk factor in myocardial infarction (MI) has been the subject of numerous studies. However, it remains uncertain whether the FVII levels are associated with development of MI. The subjects were 4142 men and women whose activated FVII (FVIIa) and FVII coagulant (FVIIc) levels were measured in the Jichi Medical School Cohort Study. Subjects were divided into tertiles by FVIIa and FVIIc levels, and Cox's proportional hazard model was used to calculate hazard ratios (HRs) for MI. The multivariate-adjusted HRs (95% confidential interval [CI]) for FVIIa in men were 0.67 (0.67-1.78) in tertile 2 (T2), and 0.52 (0.17-1.60) in T3. In women, the multivariate-adjusted HRs (95% CI) were 0.18 (0.02-1.60) in T2, and 0.39 (0.07-2.20) in T3. The multivariate-adjusted HRs (95% CI) for FVIIc in men were 0.54 (0.21-1.36) in T2, and 0.20 (0.04-0.91) in T3. In women, the multivariate-adjusted HRs (95% CI) were 0.44 (0.07-2.85) in T2, and 0.35 (0.06-2.22) in T3. We used T1 as a reference for all measures. Our findings revealed a significant association between low FVIIc level and incidence of MI in men. The FVIIa and FVIIc levels were inversely related to increased MI risk, but did not reach statistical significance. Future studies are needed to confirm this association. © 2017 Wiley Periodicals, Inc.

  17. Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities

    International Nuclear Information System (INIS)

    Fondevila, Damian; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Monica; Dosoretz, Bernardo

    2008-01-01

    Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (α max ) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining α max , which is a function of the thickness of the barrier (t E ) and the equilibrium tenth-value layer (TVL e ) of the shielding material for the nominal energy of the beam. It can be seen that α max increases for increasing TVL e (hence, beam energy) and decreases for increasing t E , with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation

  18. Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities.

    Science.gov (United States)

    Fondevila, Damián; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Mónica; Dosoretz, Bernardo

    2008-05-01

    Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (alpha(max)) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining alpha(max), which is a function of the thickness of the barrier (t(E)) and the equilibrium tenth-value layer (TVL(e)) of the shielding material for the nominal energy of the beam. It can be seen that alpha(max) increases for increasing TVL(e) (hence, beam energy) and decreases for increasing t(E), with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation.

  19. ٍ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.

  20. 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

  1. 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.

  2. 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

  3. 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....

  4. 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.

  5. 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.

  6. 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.

  7. Medical procedures in the event of nuclear power plant accidents. Guidelines for: Medical consultants for emergency response commander; physicians in emergency care centres; physicians in outpatient and inpatient care

    International Nuclear Information System (INIS)

    Genkel, Simone

    2008-01-01

    The author of the contribution under consideration reports on medical procedures in the event of nuclear power plant accidents. This contribution consists of the following sections: protective measures, tasks of radiation protection physicians, emergency care centres. It has been pointed out that differentiation of the hospitals is acquired which accept radiation accident patients. However, only a small number of hospitals will be able to professionally treat patients with suspected gastrointestinal or pronounced (muco)cutaneous type of hospitals with haemotological-oncological departments. Thus they should be able to treat patients who have been exposed to radiation doses between 1 and 6 Gy without any difficulties. Even larger is the number of hospitals which can accept patients who were exposed to a radiation dose of less than 1 Gy, but suffer from other complicating diseases (injuries, general diseases)

  8. 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...

  9. 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.

  10. 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

  11. Changing trends in the incidence of juvenile nasopharyngeal angiofibroma: seven decades of experience at King George's Medical University, Lucknow, India.

    Science.gov (United States)

    Mishra, A; Mishra, S C

    2016-04-01

    The occurrence of juvenile nasopharyngeal angiofibroma is reportedly higher in India than in some other parts of the world, and our centre has seen a four-fold increase in its occurrence across seven decades. This paper reports a retrospective archival analysis of 701 juvenile nasopharyngeal angiofibroma cases from 1958 to 2013, and considers probable environmental factors in an Indian context that may affect its biology and the global distribution, as reported in the literature. A continuously progressive increase in occurrence was evident, but the rapid rise observed in the current decade was alarming. The world map of juvenile nasopharyngeal angiofibroma incidence does not reflect true global distribution given the paucity of reporting. Our centre has dealt with approximately 400 cases in the last 24 years. With the alarming increase in juvenile nasopharyngeal angiofibroma incidence, there is a need for a registry to define its epidemiology. The world literature needs to reflect the status of juvenile nasopharyngeal angiofibroma incidence in the third world as well. Environmental factors known for hormone disruptive actions may influence its occurrence. Such aspects need to be considered to plan specific prevention policies.

  12. 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...

  13. 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...

  14. 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...

  15. Strategic Global Climate Command?

    Science.gov (United States)

    Long, J. C. S.

    2016-12-01

    Researchers have been exploring geoengineering because Anthropogenic GHG emissions could drive the globe towards unihabitability for people, wildlife and vegetation. Potential global deployment of these technologies is inherently strategic. For example, solar radiation management to reflect more sunlight might be strategically useful during a period of time where the population completes an effort to cease emissions and carbon removal technologies might then be strategically deployed to move the atmospheric concentrations back to a safer level. Consequently, deployment of these global technologies requires the ability to think and act strategically on the part of the planet's governments. Such capacity most definitely does not exist today but it behooves scientists and engineers to be involved in thinking through how global command might develop because the way they do the research could support the development of a capacity to deploy intervention rationally -- or irrationally. Internationalizing research would get countries used to working together. Organizing the research in a step-wise manner where at each step scientists become skilled at explaining what they have learned, the quality of the information they have, what they don't know and what more they can do to reduce or handle uncertainty, etc. Such a process can increase societal confidence in being able to make wise decisions about deployment. Global capacity will also be enhanced if the sceintific establishment reinvents misssion driven research so that the programs will identify the systemic issues invovled in any proposed technology and systematically address them with research while still encouraging individual creativity. Geoengineering will diverge from climate science in that geoengineering research needs to design interventions for some publically desirable goal and investigates whether a proposed intervention will acheive desired outcomes. The effort must be a systems-engineering design problem

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

    NARCIS (Netherlands)

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

    Purpose Our study aimed to investigate the association between prenatal exposure to reactive intermediate (RI)-inducing drugs and the initiation of psychotropic medications among children. Methods We designed a cohort study using a pharmacy prescription database. Pregnant women were considered

  17. Incidence of Decompression Illness and Other Diving Related Medical Problems Amongst Royal Navy Divers 1995-1999

    Science.gov (United States)

    1999-01-01

    conditions hypobares ou hyperbares ] To order the complete compilation report, use: ADA395680 The component part is provided here to allow users access to...following report: TITLE: Operational Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux...Navy diving accidents, and with the assistance of the British Hyperbaric Association (BHA) all civilian cases of decompression illness treated by member

  18. 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...

  19. Plagiarism in submitted manuscripts: incidence, characteristics and optimization of screening-case study in a major specialty medical journal.

    Science.gov (United States)

    Higgins, Janet R; Lin, Feng-Chang; Evans, James P

    2016-01-01

    Plagiarism is common and threatens the integrity of the scientific literature. However, its detection is time consuming and difficult, presenting challenges to editors and publishers who are entrusted with ensuring the integrity of published literature. In this study, the extent of plagiarism in manuscripts submitted to a major specialty medical journal was documented. We manually curated submitted manuscripts and deemed an article contained plagiarism if one sentence had 80 % of the words copied from another published paper. Commercial plagiarism detection software was utilized and its use was optimized. In 400 consecutively submitted manuscripts, 17 % of submissions contained unacceptable levels of plagiarized material with 82 % of plagiarized manuscripts submitted from countries where English was not an official language. Using the most commonly employed commercial plagiarism detection software, sensitivity and specificity were studied with regard to the generated plagiarism score. The cutoff score maximizing both sensitivity and specificity was 15 % (sensitivity 84.8 % and specificity 80.5 %). Plagiarism was a common occurrence among manuscripts submitted for publication to a major American specialty medical journal and most manuscripts with plagiarized material were submitted from countries in which English was not an official language. The use of commercial plagiarism detection software can be optimized by selecting a cutoff score that reflects desired sensitivity and specificity.

  20. Boxing injury epidemiology in the Great Britain team: a 5-year surveillance study of medically diagnosed injury incidence and outcome.

    Science.gov (United States)

    Loosemore, Michael; Lightfoot, Joseph; Palmer-Green, Deborah; Gatt, Ian; Bilzon, James; Beardsley, Chris

    2015-09-01

    There has been no comprehensive injury report of elite-level amateur boxers in competition and training. We reviewed injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2009. Longitudinal, prospective injury surveillance over 5 years of the GB boxing squad from 2005 to 2009. 66 boxers passed through the squad. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training, and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 h. More injuries affected the hand than any other body location. This was the case overall, in training and competition individually, and for both new and recurrent injuries. More injuries occurred during training than during competition, and most injuries were new rather than recurrent. Total injury rate during competition was 828 per 1000 h and hand injury rate in competition was 302 injuries per 1000 h. Hand injury rate in competition was significantly higher than at the other locations. The incidence of concussion is comparatively low. Injury prevention should aim to protect the hands and wrists of elite amateur boxers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. 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...

  2. [Discussion of the Roles of Medical Social Workers in the Response to the Explosion Incident at Formosa Fun Coast].

    Science.gov (United States)

    Yueh, Hsin-Tien; Sung, Hsien-Yi; Wu, Chia-Feng

    2016-02-01

    Medical social workers apply the theories of "person in the environment" (PIE) and "ecological perspective" as practical foundations. Furthermore, they emphasize the people, the environment, and the interactions between these two. When burn patients from the explosion at Formosa Fun Coast were sent to hospitals, social workers not only provided care and assessed the impact on burn patients but also assisted in supporting the family members of these patients. This article discusses the various roles of social workers within different systems. In the individual system, we use Eric Erickson's theory of psychosocial development to evaluate the patient's crisis and the tasks of social workers. Secondly, in the systems of family, school, and work, we assess the relationships between a patient, his/her significant others, and caregivers as well as the interactions among sub-systems in the family. In the community and cultural systems, we focus on the social resources that may be utilized by the burn patients after discharge. Moreover, we add a time frame to examine our major tasks, including the initial stage, the middle stage, and the preparation-for-discharge stage. We explore the roles of social workers, the applicable theories, and the goals for each stage.

  3. 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

  4. 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

  5. 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.

  6. The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system.

    Science.gov (United States)

    Mortaro, Alberto; Pascu, Diana; Zerman, Tamara; Vallaperta, Enrico; Schönsberg, Alberto; Tardivo, Stefano; Pancheri, Serena; Romano, Gabriele; Moretti, Francesca

    2015-07-01

    The role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives. An ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010. During the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population. Despite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a "learning organization" and improve both efficacy and safety of first aid care.

  7. 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...

  8. 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

  9. 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...

  10. 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...

  11. 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...

  12. 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

  13. 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...

  14. Design of a medical record review study on the incidence and preventability of adverse events requiring a higher level of care in Belgian hospitals

    Directory of Open Access Journals (Sweden)

    Vlayen Annemie

    2012-08-01

    Full Text Available Abstract Background Adverse events are unintended patient injuries that arise from healthcare management resulting in disability, prolonged hospital stay or death. Adverse events that require intensive care admission imply a considerable financial burden to the healthcare system. The epidemiology of adverse events in Belgian hospitals has never been assessed systematically. Findings A multistage retrospective review study of patients requiring a transfer to a higher level of care will be conducted in six hospitals in the province of Limburg. Patient records are reviewed starting from January 2012 by a clinical team consisting of a research nurse, a physician and a clinical pharmacist. Besides the incidence and the level of causation and preventability, also the type of adverse events and their consequences (patient harm, mortality and length of stay will be assessed. Moreover, the adequacy of the patient records and quality/usefulness of the method of medical record review will be evaluated. Discussion This paper describes the rationale for a retrospective review study of adverse events that necessitate a higher level of care. More specifically, we are particularly interested in increasing our understanding in the preventability and root causes of these events in order to implement improvement strategies. Attention is paid to the strengths and limitations of the study design.

  15. Commanders of the Great Victory

    Directory of Open Access Journals (Sweden)

    Anatoly Dmitriyevich Borshchov

    2015-01-01

    Full Text Available The honorary title of «commander» as well as the «admiral» is granted to a military or naval figure on the basis of public recognition of his personal contribution to the success of actions. Generals are usually individuals with creative thinking, the ability to foresee the development of military events. Generals usually have such personality traits as a strong will and determination, rich combat experience, credibility and high organizational skills. In an article dedicated to the 70th anniversary of the Soviet victory in the Great War examines the experience of formation and practice of the most talent-ed Soviet military leaders.

  16. 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...

  17. 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...

  18. 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...

  19. 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

  20. 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...

  1. Command and Service Module Communications

    Science.gov (United States)

    Interbartolo, Michael

    2009-01-01

    This viewgraph presentation examines Command and Service Module (CSM) Communications. The communication system's capabilities are defined, including CSM-Earth, CSM-Lunar Module and CSM-Extravehicular crewman communications. An overview is provided for S-band communications, including data transmission and receiving rates, operating frequencies and major system components (pre-modulation processors, unified S-band electronics, S-band power amplifier and S-band antennas). Additionally, data transmission rates, operating frequencies and the capabilities of VHF communications are described. Major VHF components, including transmitters and receivers, and the VHF multiplexer and antennas are also highlighted. Finally, communications during pre-launch, ascent, in-flight and entry are discussed. Overall, the CSM communication system was rated highly by flight controllers and crew. The system was mostly autonomous for both crew and flight controllers and no major issues were encountered during flight.

  2. Command and Control Software Development

    Science.gov (United States)

    Wallace, Michael

    2018-01-01

    The future of the National Aeronautics and Space Administration (NASA) depends on its innovation and efficiency in the coming years. With ambitious goals to reach Mars and explore the vast universe, correct steps must be taken to ensure our space program reaches its destination safely. The interns in the Exploration Systems and Operations Division at the Kennedy Space Center (KSC) have been tasked with building command line tools to ease the process of managing and testing the data being produced by the ground control systems while its recording system is not in use. While working alongside full-time engineers, we were able to create multiple programs that reduce the cost and time it takes to test the subsystems that launch rockets to outer space.

  3. 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...

  4. 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

  5. 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.

  6. 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.

  7. 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...

  8. Wheelchair incidents

    NARCIS (Netherlands)

    Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

    2002-01-01

    This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. The role of patient simulation and incident reporting in the development and evaluation of medical devices and the training of their users

    DEFF Research Database (Denmark)

    Dieckmann, P; Rall, M; Østergaard, Doris

    2009-01-01

    incident report. Simulation can serve as a laboratory to analyse such cases and to create relevant and effective training scenarios based on such analyses. We will describe a methodological framework for analysing simulation scenarios in a way that allows discovering and discussing mismatches between...... conceptual models of the device design and mental models users hold about the device and its use. We further describe how incident reporting systems can be used as one source of data to conduct the necessary needs analyses - both for training and further needs for closer analysis of specific devices or some...

  1. 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...

  2. 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...

  3. Incidence and nature of medication errors in neonatal intensive care with strategies to improve safety - A review of the current literature

    NARCIS (Netherlands)

    Chedoe, Indra; Molendijk, Harry A.; Dittrich, Suzanne T. A. M.; Jansman, Frank G. A.; Harting, Johannes W.; Brouwers, Jacobus R. B. J.; Taxis, Katja

    2007-01-01

    Neonates are highly vulnerable to medication errors because of their extensive exposure to medications in the neonatal intensive care unit (NICU), the general lack of evidence on pharmacotherapeutic interventions in neonates and the lack of neonate-specific formulations. We searched PubMed and

  4. 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...

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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)

  10. 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...

  11. 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...

  12. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

  13. Incidents analysis

    Energy Technology Data Exchange (ETDEWEB)

    Francois, P

    1997-12-31

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs.

  14. 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.

  15. 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...

  16. 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...

  17. 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

  18. 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.

  19. 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

  20. 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)

  1. 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.

  2. Temporal changes in incidence and pattern of central nervous system relapses in children with acute lymphoblastic leukaemia treated on four consecutive Medical Research Council Trials, 1985–2001

    Science.gov (United States)

    Krishnan, Shekhar; Wade, Rachel; Moorman, Anthony V; Mitchell, Chris; Kinsey, Sally E; Eden, TOB; Parker, Catriona; Vora, Ajay; Richards, Sue; Saha, Vaskar

    2009-01-01

    Despite the success of contemporary treatment protocols in childhood acute lymphoblastic leukaemia (ALL), relapse within the central nervous system (CNS) remains a challenge. To better understand this phenomenon, we have analysed the changes in incidence and pattern of CNS relapses in 5564 children enrolled on four successive MRC-ALL trials between 1985 and 2001. Changes in the incidence and pattern of CNS relapses were examined and the relationship with patient characteristics assessed. Factors affecting post-relapse outcome were determined. Overall, relapses declined by 49%. Decreases occurred primarily in non-CNS and combined relapses with a progressive shift towards later (≥30 months from diagnosis) relapses (p<0·0001). Although isolated CNS relapses declined, the proportional incidence and timing of relapse remained unchanged. Age and presenting white cell count were risk factors for CNS relapse. On multivariate analysis, the time to relapse and the trial period influenced post-relapse outcomes. Relapse trends differed within biological subtypes. In ETV6-RUNX1 ALL, relapse patterns mirrored overall trends while in High Hyperdiploidy ALL, these appear to have plateaued over the latter two trial periods. Intensive systemic and intrathecal chemotherapy have decreased the overall CNS relapse rates and changed the patterns of recurrence. The heterogeneity of therapeutic response in the biological subtypes suggests room for further optimisation using currently available chemotherapy. PMID:20016529

  3. 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...

  4. 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

  5. Using medical imaging for the detection of adverse events ("incidents") during the utilization of left ventricular assist devices in adult patients with advanced heart failure.

    Science.gov (United States)

    Kaufmann, Friedrich; Krabatsch, Thomas

    2016-05-01

    Ventricular assist devices (VAD) are used for mechanical support of the terminally failing heart. Failure of these life supporting systems can be fatal. Early and reliable detection of any upcoming problems is mandatory and is crucial for the outcome. Medical imaging methods are described within this review, which are not only essential for diagnosis of typically VAD-related complications but also for the detection or verification of technical issues. Within this review the utilization of medical imaging equipment for the diagnosis of technical malfunctions or damages of implanted system components is discussed. A newly developed specialized acoustic imaging method for pump thrombosis detection will also be described along with the most common VAD-related medical complications and their respective imaging methods and the limitations induced by the use of the VAD-system.

  6. 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.

  7. 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.

  8. Army Medical Research and Materiel Command Resident Research Associateship Program

    Science.gov (United States)

    2017-05-01

    submitted four papers related to sleep and performance/sleep resiliency and genetics (2 published; 2 under review): Journal of Strength & Conditioning...study looking at genetic markers related to sleep resiliency and performance and performance maintenance with caffeine administration. This study is...muscle clock, Biochimie; 132:161-165 Brager, AJ; Hammer SB; Capaldi V; Campbell B, 2017, In search of adaptive homeostasis in ultra-marathon runners

  9. Army National Guard Medical Readiness Training Exercises in Southern Command

    Science.gov (United States)

    1994-06-03

    pulled , the number of people in a health education class, or the number of procedures performed in order to assess the success of the program...the dental set was configured for general dentistry, but the missions often entailed pulling teeth rather than restoration of teeth. The staff...participating units’ level would benefit the academic world and may reveal valuable clues as to how to modify the program. The goali and objectives

  10. The Anthrax Vaccine Debate: A Medical Review for Commanders

    National Research Council Canada - National Science Library

    Hersack, Richard

    2001-01-01

    .... The policy decision to vaccinate is based on an assessment of relative risk. The risk to an individual of developing side effects and complications after vaccination versus, the risk that Defense Department (DoD...

  11. Army Medical Research and Materiel Command Resident Research Associateship Program

    Science.gov (United States)

    2018-05-01

    Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT During this reporting period, the NRC promoted research opportunities at AMRMC institutes through a... productivity of these Associates is listed in the technical report. 15. SUBJECT TERMS- Associateship program, post-doc, awards 16. SECURITY CLASSIFICATION OF...following activities in support of the subject contract: Outreach and Promotion The promotional schedule to advertise the NRC Research Associateship

  12. 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)

  13. 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...

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. Age-, sex-, and diagnosis-specific incidence rate of medically certified long-term sick leave among private sector employees: The Japan Epidemiology Collaboration on Occupational Health (J-ECOH) study.

    Science.gov (United States)

    Nishiura, Chihiro; Nanri, Akiko; Kashino, Ikuko; Hori, Ai; Kinugawa, Chihiro; Endo, Motoki; Kato, Noritada; Tomizawa, Aki; Uehara, Akihiko; Yamamoto, Makoto; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Imai, Teppei; Okino, Akiko; Miyamoto, Toshiaki; Sasaki, Naoko; Tomita, Kentaro; Nagahama, Satsue; Kochi, Takeshi; Eguchi, Masafumi; Okazaki, Hiroko; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

    2017-12-01

    Long-term sick-leave is a major public health problem, but data on its incidence in Japan are scarce. We aimed to present reference data for long-term sick-leave among private sector employees in Japan. The study population comprised employees of 12 companies that participated in the Japan Epidemiology Collaboration on Occupational Health Study. Details on medically certified sick-leave lasting ≥30 days were collected from each company. Age- and sex-specific incidence rate of sick-leave was calculated for the period of April 2012 to March 2014. A total of 1422 spells in men and 289 in women occurred during 162,989 and 30,645 person-years of observation, respectively. The three leading causes of sick-leave (percentage of total spells) were mental disorders (52%), neoplasms (12%), and injury (8%) for men; and mental disorders (35%), neoplasms (20%), and pregnancy-related disease (14%) for women. Incidence rate of sick-leave due to mental disorders was relatively high among men in their 20s-40s but tended to decrease with age among women. Incidence rate of sick-leave due to neoplasms started to increase after age 50 in men and after age 40 in women, making neoplasms the leading cause of sick-leave after age 50 for women and after age 60 for men and the second leading cause after age 40 for women and after age 50 for men. Pregnancy-related disease was the second leading cause of sick-leave among women aged 20-39 years. These results suggest that mental disorder, neoplasms, and pregnancy-related disease are the major causes of long-term sick-leave among private sector employees in Japan. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  19. Incidence of acute otitis media in children below 6 years of age seen in medical practices in five East European countries.

    Science.gov (United States)

    Usonis, Vytautas; Jackowska, Teresa; Petraitiene, Sigita; Sapala, Alicja; Neculau, Andrea; Stryjewska, Izabella; Devadiga, Raghavendra; Tafalla, Monica; Holl, Katsiaryna

    2016-07-26

    Although acute otitis media (AOM) remains a major public health problem worldwide and brings economic burden on health care system and caregivers, little information is available about its epidemiology in Eastern Europe. We conducted an epidemiological, prospective, observational, multi-centre cohort study (NCT01365390) in five East European countries (Estonia, Lithuania, Poland, Romania and Slovenia) between June 2011 and January 2013 to determine the incidence and clinical characteristics of AOM among children aged children and a higher risk in those attending school/childcare or with allergies. AOM required 521 visits to the doctor. Antibiotics were prescribed for 276 (74.8 %) episodes with the lowest prescription rate in Estonia (51.4 %) and the highest in Romania (83.7 %). Complications were rare and hospitalisations occurred in 2 % of the cases. The disease burden of AOM in Eastern Europe is relevant and public health initiatives to reduce it should be considered. ClinicalTrial.gov NCT01365390 .

  20. 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.

  1. 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

  2. Commandants' Managerial Capacity and Workers Productivity in ...

    African Journals Online (AJOL)

    The purpose of this study is to evaluate the commandant's managerial capacity as if relates to workers productivity with a view to determining whether their calling to the education terrain has been justified and to correct certain areas in need of improvement in the Nigeria Police Education set up. In doing this, the study took ...

  3. 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

  4. RELATIONSHIP BETWEEN LINGUISTIC UNITS AND MOTOR COMMANDS.

    Science.gov (United States)

    FROMKIN, VICTORIA A.

    ASSUMING THAT SPEECH IS THE RESULT OF A NUMBER OF DISCRETE NEUROMUSCULAR EVENTS AND THAT THE BRAIN CAN STORE ONLY A LIMITED NUMBER OF MOTOR COMMANDS WITH WHICH TO CONTROL THESE EVENTS, THE RESEARCH REPORTED IN THIS PAPER WAS DIRECTED TO A DETERMINATION OF THE SIZE AND NATURE OF THE STORED ITEMS AND AN EXPLANATION OF HOW SPEAKERS ENCODE A SEQUENCE…

  5. 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.

  6. 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....

  7. 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...

  8. '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 ...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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)

  15. Economic burden of gastrointestinal cancer under the protection of the New Rural Cooperative Medical Scheme in a region of rural China with high incidence of oesophageal cancer: cross-sectional survey.

    Science.gov (United States)

    Li, Xiang; Cai, Hong; Wang, Chaoyi; Guo, Chuanhai; He, Zhonghu; Ke, Yang

    2016-07-01

    To evaluate the financial burden of oesophageal cancer under the protection of the new Rural Cooperative Medical Scheme (NCMS) and to provide evidence and suggestions to policymakers in a high-incidence region in China. We analysed inpatient claim data for oesophageal cancer, gastric cancer and colorectal cancer from 1 January to 31 December 2013. The data were extracted from the NCMS management system of Hua County, Henan Province, a typical high-risk region for oesophageal cancer in China. Cancer-specific health economic indicators were calculated to evaluate the financial burden under the protection of the local NCMS. The total cost of oesophageal cancer was 2.7-3.6 times higher than that of gastric cancer and colorectal cancer, respectively, due to high incidence of oesophageal cancer. For each hospitalisation to treat oesophageal cancer, the average total cost and out-of-pocket expenses after reimbursement equalled an entire year's gross domestic product per capita and per capita disposable income, respectively, for the local area. The average total cost per hospitalisation for oesophageal cancer increased monotonically with hospital level for surgical hospitalisations, and it increased more rapidly for non-surgical hospitalisations (from $301 to $2589, 860%) than for gastric cancer (from $289 to $1453, 503%) and colorectal cancer (from $359 to $1610, 448%). Vulnerable groups with less access to high-level hospitals were found in different gender and age groups. Oesophageal cancer imposes serious financial burdens on communities and patients' households in this high-incidence region, and no preferential policy from the local NCMS has been designed to address this issue. A special supportive policy should be developed on the basis of local disease profiles and population characteristics to alleviate the financial burden of populations at high risk for certain high-cost diseases. © 2016 John Wiley & Sons Ltd.

  16. [The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI)--a case report].

    Science.gov (United States)

    Gałazkowski, Robert; Wejnarski, Arkadiusz; Baumberg, Ignacy; Świeżewski, Stanisław; Timler, Dariusz

    2014-01-01

    In 2013 a fire broke out in the Nursing Home (NH) in the Henryszew village 5 km away from the district hospital in Zyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI). Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary.

  17. The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI – A case report

    Directory of Open Access Journals (Sweden)

    Robert Gałązkowski

    2014-04-01

    Full Text Available In 2013 a fire broke out in the Nursing Home (NH in the Henryszew village 5 km away from the district hospital in Żyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI. Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary. Med Pr 2014;65(2:289–295

  18. 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...

  19. 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...

  20. 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

  1. 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...

  2. 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.

  3. 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...

  4. Commanders’ Perception of Risk: Enabling Boldness

    Science.gov (United States)

    2008-04-01

    individual. Soldiers are trained over time to employ their weapon systems tinder a variety of conditions in, realistic simulations and scenarios, thus...from ground combat the specialty is, where th~ leader provides the same support in combat that he would in garrison with no direct relationship to an...34 safety paperwork and activities. 73 Senior commanders must aggressively search for means to communicate their intent and the relationship between

  5. 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

  6. Jimmy Doolittle: The Commander behind the Legend

    Science.gov (United States)

    2015-02-01

    was 35 percent and that, although luxury items were cheap, food and other necessities were expensive. He speculated that everyone in Germany...British Spitfire groups, one troop-carrier group, one light-bombardment group, and three medium-bombardment groups.123 He later observed, “I was a brand ...a very popular commander, Ira Eaker, was perhaps the first. Eaker had served in the Eighth since its incep- tion and led its first independent attack

  7. 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.

  8. Auftragstaktik: The Basis for Modern Military Command?

    Science.gov (United States)

    2012-12-06

    Pauli’s Nachf, 1892. Showalter, Dennis. The Wars of German Unification. London: Hodder Education , 2004. Simpkin, Richard. Race to the Swift. London...to the bourgeois class again, making education , not social position, the deciding factor for obtaining a commission.15 The army created a system of...only reflected the increased education and capability of the new officer corps, but also the reality of commanding an army in the Napoleonic era

  9. Mission Command In A Communications Denied Environment

    Science.gov (United States)

    2017-02-16

    the mutual trust between the echelons.8 In the United States armed forces, the Joint Chiefs have understood the value of...without being over controlling or micromanaging.12 During the execution phase the commander is the free to choose his position on the battlefield to... the Air Force Association Convention, National Harbor, MD, September 16, 2009, accessed at http://www.defenselink.mil/ speeches

  10. Naval Meteorology and Oceanography Command exhibit entrance

    Science.gov (United States)

    2000-01-01

    StenniSphere at NASA's John C. Stennis Space Center in Hancock County, Miss., invites visitors to discover why America comes to Stennis Space Center before going into space. Designed to entertain while educating, StenniSphere includes informative displays and exhibits from NASA and other agencies located at Stennis, such as this one from the Naval Meteorology and Oceanography Command. Visitors can 'travel' three-dimensionally under the sea and check on the weather back home in the Weather Center.

  11. Naval Meteorology and Oceanography Command exhibit

    Science.gov (United States)

    2000-01-01

    Designed to entertain while educating, StenniSphere at the John C. Stennis Space Center in Hancock County, Miss., includes informative displays and exhibits from NASA and other agencies located at Stennis, such as this one from the Naval Meteorology and Oceanography Command. Visitors can 'travel' three-dimensionally under the sea and check on the weather back home in the Weather Center. StenniSphere is open free of charge from 9 a.m. to 5 p.m. daily.

  12. Contaminated Mexican steel incident

    International Nuclear Information System (INIS)

    1985-01-01

    This report documents the circumstances contributing to the inadvertent melting of cobalt 60 (Co-60) contaminated scrap metal in two Mexican steel foundries and the subsequent distribution of contaminated steel products into the United States. The report addresses mainly those actions taken by US Federal and state agencies to protect the US population from radiation risks associated with the incident. Mexico had much more serious radiation exposure and contamination problems to manage. The United States Government maintained a standing offer to provide technical and medical assistance to the Mexican Government. The report covers the tracing of the source to its origin, response actions to recover radioactive steel in the United States, and return of the contaminated materials to Mexico. The incident resulted in significant radiation exposures within Mexico, but no known significant exposure within the United States. Response to the incident required the combined efforts of the Nuclear Regulatory Commission (NRC), Department of Energy, Department of Transportation, Department of State, and US Customs Service (Department of Treasury) personnel at the Federal level and representatives of all 50 State Radiation Control Programs and, in some instances, local and county government personnel. The response also required a diplomatic interface with the Mexican Government and cooperation of numerous commercial establishments and members of the general public. The report describes the factual information associated with the event and may serve as information for subsequent recommendations and actions by the NRC. 8 figures

  13. 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.

  14. 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...

  15. 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...

  16. 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)

  17. Estudo de incidência de eventos adversos hospitalares, Rio de Janeiro, Brasil: avaliação da qualidade do prontuário do paciente Incidence of in-hospital adverse events in the State of Rio de Janeiro, Brazil: Evaluation of patient medical record

    Directory of Open Access Journals (Sweden)

    Ana Luiza Braz Pavão

    2011-12-01

    Full Text Available OBJETIVO: Avaliar a qualidade da informação dos prontuários de três hospitais de ensino do Estado do Rio de Janeiro, participantes do estudo de base para a estimativa da incidência de eventos adversos (EA. MATERIAL E MÉTODOS: Estudo descritivo, baseado em informações coletadas na revisão de prontuários do estudo de base. Foi aplicado escore de completitude, medido pela proporção de informação ignorada, composto pelos graus de avaliação: excelente (menor que 5%, bom (5% - 10%, regular (11% - 20%, ruim (21% - 50% e muito ruim (mais de 50%. Foram calculados proporções e intervalos de confiança de 95%, para cada informação do prontuário. A análise foi realizada para o conjunto dos pacientes, para os três hospitais e para pacientes com e sem EA. Foram calculadas médias na análise do conjunto de variáveis e, para fins de comparação, foi realizado o teste t de Student. Foi aplicado o teste qui-quadrado e a estatística de Fisher na análise comparativa entre pacientes com e sem EA. RESULTADOS: A qualidade dos prontuários foi considerada ruim, no conjunto dos pacientes. As variáveis que apresentaram maior proporção de ausência de informação foram: "Avaliação inicial da enfermagem" (63,9% e "Avaliação do paciente pelo assistente social" (80%. O hospital 3 apresentou melhor qualidade dos prontuários e o hospital 1 apresentou o pior resultado. Os pacientes com EA apresentaram melhor qualidade dos prontuários do que aqueles sem EA. CONCLUSÕES: Informações indispensáveis ao cuidado apresentaram baixo registro. Ressalta-se a importância da elaboração de medidas que visem melhorias na qualidade do prontuário, que irão refletir na qualidade da assistência ao paciente.OBJECTIVE: To evaluate the quality of information obtained from medical records of three teaching hospitals in the State of Rio de Janeiro, Brazil, which participated in a previous study on the incidence of adverse events (AE. METHODS: Descriptive

  18. 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

  19. OFFICER AND COMMANDER IN ASYMMETRIC WARFARE OPERATIONS

    Directory of Open Access Journals (Sweden)

    Giuseppe CAFORIO

    2013-01-01

    Full Text Available Starting from the data of a field research conducted among soldiers with asymmetric warfare experiences from nine different countries, the author seeks to identify and shed light on the various problems that officers with command responsibilities had to face during their missions. A picture emerges of feelings and experiences relating to their first impression upon arriving in the theatre, relations with local armed forces, relations with the local population and local authorities, relations with NGOs, relations with other armies, the impact of the rules of engagement (ROEs, training and education, and operational experiences. The paper ends with a discussion of the lessons learned.

  20. Spaceport Command and Control System Automation Testing

    Science.gov (United States)

    Hwang, Andrew

    2017-01-01

    The Spaceport Command and Control System (SCCS) is the National Aeronautics and Space Administrations (NASA) launch control system for the Orion capsule and Space Launch System, the next generation manned rocket currently in development. This large system requires high quality testing that will properly measure the capabilities of the system. Automating the test procedures would save the project time and money. Therefore, the Electrical Engineering Division at Kennedy Space Center (KSC) has recruited interns for the past two years to work alongside full-time engineers to develop these automated tests, as well as innovate upon the current automation process.

  1. 24 Command Fire Improvement Action Program Plan

    International Nuclear Information System (INIS)

    GRIFFIN, G.B.

    2000-01-01

    Fluor Hanford (FH) is responsible for providing support to the Department of Energy Richland Operations Office (RL) in the implementation of the Hanford Emergency Preparedness (EP) program. During fiscal year 2000, a number of program improvements were identified from various sources including a major range fire (24 Command Fire). Evaluations of the emergency preparedness program have confirmed that it currently meets all requirements and that performance of personnel involved is good, however the desire to effect continuous improvement resulted in the development of this improvement program plan. This program plan defines the activities that will be performed in order to achieve the desired performance improvements

  2. Spaceport Command and Control System Automation Testing

    Science.gov (United States)

    Plano, Tom

    2017-01-01

    The goal of automated testing is to create and maintain a cohesive infrastructure of robust tests that could be run independently on a software package in its entirety. To that end, the Spaceport Command and Control System (SCCS) project at the National Aeronautics and Space Administration's (NASA) Kennedy Space Center (KSC) has brought in a large group of interns to work side-by-side with full time employees to do just this work. Thus, our job is to implement the tests that will put SCCS through its paces.

  3. Spaceport Command and Control System Automated Testing

    Science.gov (United States)

    Stein, Meriel

    2017-01-01

    The Spaceport Command and Control System (SCCS) is the National Aeronautics and Space Administrations (NASA) launch control system for the Orion capsule and Space Launch System, the next generation manned rocket currently in development. This large system requires high quality testing that will properly measure the capabilities of the system. Automating the test procedures would save the project time and money. Therefore, the Electrical Engineering Division at Kennedy Space Center (KSC) has recruited interns for the past two years to work alongside full-time engineers to develop these automated tests, as well as innovate upon the current automation process.

  4. 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.

  5. 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.

  6. 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…

  7. 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

  8. 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.

  9. 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.

  10. incidence of occupational stress among medical radiographers

    African Journals Online (AJOL)

    which future studies in view of the on going health sector reform in Nigeria could be compared. Key Words: ... disturbing individual's well being physically and mentally (Akpa and .... not only mental health but also the ... Stressors and employee.

  11. incidence of occupational stress among medical radiographers

    African Journals Online (AJOL)

    Job satisfaction rating was 61.3% and anxiety level was 45.3%. This study has provided a baseline stress level and prevalence among ... theoretical terms predisposes the individual to increased ... checked, burnout ensures. Burnout is an individual's reaction to chronic stress .... neurovegetative functioning of the mental but.

  12. 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

  13. 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...

  14. 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.

  15. 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...

  16. Deductive Sensemaking Principles Using Personal Constructs of the Field Commanders

    National Research Council Canada - National Science Library

    Ntuen, Celestine A; Leedom, Dennis

    2007-01-01

    .... It is assumed that the expert commander constructs diverse and asynchronous sensemaking models when confronted with asymmetric situations-evolving and changing dynamics of the battlefield information...

  17. Contractor Support on the Battlefield -- Increased Reliance Requires Commander's Attention

    National Research Council Canada - National Science Library

    Maloney, Kathy J

    2006-01-01

    .... Department of Defense initiatives to adopt a leaner business strategy, increase efficiency, and reduce expenditures have exposed the battlefield commander to additional operational risk centered...

  18. 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...

  19. Human Systems Integration Assessment of Network Centric Command and Control

    National Research Council Canada - National Science Library

    Quashnock, Dee; Kelly, Richard T; Dunaway, John; Smillie, Robert J

    2004-01-01

    .... FORCEnet is the operational construct and architectural framework for Naval Network Centric Warfare in the information age that integrates warriors, sensors, networks, command and control, platforms...

  20. 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...

  1. 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).

  2. 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.

  3. A spacecraft computer repairable via command.

    Science.gov (United States)

    Fimmel, R. O.; Baker, T. E.

    1971-01-01

    The MULTIPAC is a central data system developed for deep-space probes with the distinctive feature that it may be repaired during flight via command and telemetry links by reprogramming around the failed unit. The computer organization uses pools of identical modules which the program organizes into one or more computers called processors. The interaction of these modules is dynamically controlled by the program rather than hardware. In the event of a failure, new programs are entered which reorganize the central data system with a somewhat reduced total processing capability aboard the spacecraft. Emphasis is placed on the evolution of the system architecture and the final overall system design rather than the specific logic design.

  4. Post-Soviet nuclear command and security

    International Nuclear Information System (INIS)

    Garwin, R.L.

    1992-01-01

    Traditionally, any nuclear command system must reckon with conflicting requirements. The system must ensure that weapons will be launched reliably when ordered, a goal known as positive control. But negative control, ensuring that the weapons will not be used without an authentic order, is also essential. These goals are often in tension; steps to make it more difficult to launch without authorization can make it less certain that weapons will be launched when desired, and vice versa. The balance struck between the two naturally shifts, with increased emphasis on negative control in peacetime, and on positive control in a major crisis. Under present circumstances, with virtually no threat of deliberate nuclear attack, both the US and Russia should be putting their emphasis overwhelmingly on ensuring negative control

  5. Policy Options to Address Crucial Communication Gaps in the Incident Command System

    Science.gov (United States)

    2012-09-01

    knife and study their husbands’ necks. Anything can happen.12 Raymond Chandler , Red Wind, A. CHAPTER INTRODUCTION This chapter describes the...Santa Barbara, moving southward towards Ventura, 12 Raymond Chandler , “Red Wind.” Available at http...front of the Alfred P. Murrah Federal Building. Government and other responders were on the scene minutes after a massive truck bomb destroyed a federal

  6. 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

  7. 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)

  8. 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 ...

  9. 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...

  10. 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

  11. 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

  12. 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 ...

  13. 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

  14. 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...

  15. 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

  16. 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

  17. 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)

  18. 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

  19. 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

  20. Modelling of command and control agility

    CSIR Research Space (South Africa)

    Oosthuizen, R

    2014-06-01

    Full Text Available . Therefore, the stock of information decays over time. Situation Awareness is developed through processing and interpretation of information. This leads to decisions on action to be taken by own forces in reaction to incidents. The understanding..., collective dynamics, and adaptation (Cil & Mala 2010, Beyerchen 1992, Clausewitz 1976). The C2 system support designing courses of action through problem solving within a military context as well as controlling their execution. The purpose of C2, as a force...

  1. 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).

  2. [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).

  3. 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

  4. 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...

  5. 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.

  6. 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)

  7. 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.

  8. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  9. 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...

  10. Command History, 1969. Volume 2. Sanitized

    Science.gov (United States)

    1969-01-01

    approvrtl in Vebrtlary for ’J.., 4,t d4ttto*nd Ope,.’.., Sntties t| ot the r1t0-l stt-d 10, 44-1, broIl uti lm’,ght tlhr VNN autlo•kirted fttiet-, v...Education and Welfare. (C) On 9 Mar, the MOD directed the eallup, by name, of 226 doctors, pharmacists , den- tists, veterin":’ans, and medical...training capability. The mission of this school was to train regular medical officers, pharmacists , and dentists. The school had moved to S-igun in 1954 and

  11. 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...

  12. Architecting Joint Command and Control System of System Capability Certifications

    National Research Council Canada - National Science Library

    Acosta, Jacob; Hoesly, Scot; Huseth, Scott; Krider, Steven; Lamb, Jeremy; Martin, Calvin; Medina, Vince; Medina, Jorge; Nguyen, Michael; Patel, Jaykant

    2007-01-01

    Command, Control, Communications, Computers, and Intelligence (C4I) systems, each originally designed to address a single warfighting function, have been assembled into an interdependent C4I System of Systems (SoS...

  13. 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...

  14. The Big Issue: Command and Combat in the Information Age

    National Research Council Canada - National Science Library

    Potts, David

    2003-01-01

    This Occasional Paper considers command and combat in the information age. A small team in the British Army's conceptual "think tank," the Directorate General Development and Doctrine, worked together on this issue for 18 months...

  15. 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...

  16. 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

  17. Contract Claims Experience at the Naval Air Systems Command

    National Research Council Canada - National Science Library

    Carty, John

    1999-01-01

    ...) experienced at the Naval Air Systems Command (NAVAIR) between January 1997 and December 1998 as a means to identify areas of potential improvement in management practices which could result in reduced numbers of claims being submitted...

  18. Measuring, Monitoring, and Managing Knowledge in Command and Control Organizations

    National Research Council Canada - National Science Library

    Freeman, Jared; Weil, Shawn A; Hess, Kathleen P

    2006-01-01

    .... Iconography and interaction standards for such displays are well defined. Less attention has been paid to representing non-geographical information, such as information about the state of knowledge and decision making in a command staff...

  19. Intelligent Tutoring System for Teaching Battlefield Command Reasoning Skills

    National Research Council Canada - National Science Library

    Domeshek, Eric

    2002-01-01

    ... (ITS) for high-level battlefield command reasoning skills. The ultimate goal of this research is to develop new ITS techniques and technology for teaching skills that cannot he taught as simple methods and procedures to he followed...

  20. 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...

  1. 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...

  2. Opening the Aperture... Ending Service "Branding" of US Unified Commands

    National Research Council Canada - National Science Library

    Handy, Russell

    2003-01-01

    .... It asserts that over tine, the defense establishment runs the risk of establishing a cultural identity in the command that limits perspectives to aground-, sea-, or air and space-centric viewpoint...

  3. The International Criminal Court: Considerations for the Joint Force Commander

    National Research Council Canada - National Science Library

    Sutton, Michael

    2003-01-01

    An analysis of the issues and remedies a Joint Force Commander should be concerned about because of the relationship between the United States and the newly-created International Criminal Court (ICC...

  4. 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...

  5. Should the Department of Defense Establish a Joint Corrections Command

    National Research Council Canada - National Science Library

    Evans, Thomas P

    2008-01-01

    ... and control element at the combatant command level. The military and the Coalition Provisional Authority's ability to establish a national penal system, conduct standardized training and effective prison operations to rebuild the Iraqi penal system...

  6. Joint Forward Operating Base Elements of Command and Control

    National Research Council Canada - National Science Library

    Summers, William

    2002-01-01

    ... and its associated leadership, command of air assets at a joint forward operating base lacks guidance. Today, the United States prosecutes an air war over Afghanistan from bases in Uzbekistan, Pakistan, and Afghanistan...

  7. 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

  8. Systems Engineering Management Training at Naval Air Systems Command

    National Research Council Canada - National Science Library

    Rebel, James

    2000-01-01

    Within the past few years, the Naval Air Systems Command (NAVAIR) has undergone several major changes including an engineering reorganization from a matrix organization to an Integrated Program Team/Competency Aligned Organization (IPT/CAO...

  9. Public Affairs Capacity Building: A Soft Tool for Combatant Commanders

    National Research Council Canada - National Science Library

    Salata, Jason P

    2008-01-01

    Public affairs capacity building is a valuable soft component of the Combatant Commander's Theater Campaign Plan that builds habitual relationships, fosters transparency, and enhances the ability to shape the AOR...

  10. 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...

  11. 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

  12. 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

  13. 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

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. Generating Control Commands From Gestures Sensed by EMG

    Science.gov (United States)

    Wheeler, Kevin R.; Jorgensen, Charles

    2006-01-01

    An effort is under way to develop noninvasive neuro-electric interfaces through which human operators could control systems as diverse as simple mechanical devices, computers, aircraft, and even spacecraft. The basic idea is to use electrodes on the surface of the skin to acquire electromyographic (EMG) signals associated with gestures, digitize and process the EMG signals to recognize the gestures, and generate digital commands to perform the actions signified by the gestures. In an experimental prototype of such an interface, the EMG signals associated with hand gestures are acquired by use of several pairs of electrodes mounted in sleeves on a subject s forearm (see figure). The EMG signals are sampled and digitized. The resulting time-series data are fed as input to pattern-recognition software that has been trained to distinguish gestures from a given gesture set. The software implements, among other things, hidden Markov models, which are used to recognize the gestures as they are being performed in real time. Thus far, two experiments have been performed on the prototype interface to demonstrate feasibility: an experiment in synthesizing the output of a joystick and an experiment in synthesizing the output of a computer or typewriter keyboard. In the joystick experiment, the EMG signals were processed into joystick commands for a realistic flight simulator for an airplane. The acting pilot reached out into the air, grabbed an imaginary joystick, and pretended to manipulate the joystick to achieve left and right banks and up and down pitches of the simulated airplane. In the keyboard experiment, the subject pretended to type on a numerical keypad, and the EMG signals were processed into keystrokes. The results of the experiments demonstrate the basic feasibility of this method while indicating the need for further research to reduce the incidence of errors (including confusion among gestures). Topics that must be addressed include the numbers and arrangements

  19. 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.

  20. Command and Data Handling Branch Internship

    Science.gov (United States)

    Billings, Rachel Mae

    2016-01-01

    Modular Integrated Stackable Layers (MISL) is a computer system designed for simple, fast, and cost effective flexible reconfiguration in space environments such as the ISS and Orion projects for various uses. Existing applications include wireless and wired communications, data acquisition and instrumentation, and camera systems, and potential applications include bus protocol converters and subsystem control. MISL is based on Texas Instruments (TI)' MSP430 16-bit ultra-low-power microcontroller device. The purpose of my project was to integrate the MISL system with a liquid crystal display (LCD) touchscreen. The LCD, manufactured by Crystalfontz and part number CFAF320240F-035T-TS, is a 320 by 240 RGB resistive color screen including an optional carrier board. The vast majority of the project was done with Altium Designer, a tool for printed circuit board (PCB) schematic capture, 3D design, and FPGA (Field Programmable Gate Array) development. The new PCB was to allow the LCD to directly stack to the rest of MISL. Research was done with datasheets for the TI microcontroller and touchscreen display in order to meet desired hardware specifications. Documentation on prior MISL projects was also utilized. The initial step was to create a schematic for the LCD, power bus, and data bus connections between components. A layout was then designed with the required physical dimensions, routed traces and vias, power and ground planes, layer stacks, and other specified design rules such as plane clearance and hole size. Multiple consultation sessions were held with Hester Yim, the technical discipline lead for the Command and Data Handling Branch, and Christy Herring, the lead PCB layout designer in the Electronic Design and Manufacturing Branch in order to ensure proper configuration. At the moment, the PCB is awaiting revision by the latter-mentioned branch. Afterwards, the board will begin to undergo the manufacturing and testing process. Throughout the internship at

  1. 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) ...

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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 ...

  8. 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

  9. Cancer incidence among waiters

    DEFF Research Database (Denmark)

    Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

    2015-01-01

    AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were...... diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined...... INCIDENCE IN SOME CANCER SITES CAN LIKELY BE EXPLAINED BY HIGHER ALCOHOL CONSUMPTION, THE PREVALENCE OF SMOKING AND OCCUPATIONAL EXPOSURE TO TOBACCO SMOKE HOPEFULLY, THE INCIDENCE OF CANCER AMONG WAITERS WILL DECREASE IN THE FUTURE, DUE TO THE BANNING OF TOBACCO SMOKING IN RESTAURANTS AND BARS IN THE NORDIC...

  10. Radiological incidents in radiotherapy

    International Nuclear Information System (INIS)

    Hobzova, L.; Novotny, J.

    2008-01-01

    In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. [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.

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. [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.

  6. Police Incident Blotter (Archive)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Police Blotter Archive contains crime incident data after it has been validated and processed to meet Uniform Crime Reporting (UCR) standards, published on a...

  7. 2011 Japanese Nuclear Incident

    Science.gov (United States)

    EPA’s RadNet system monitored the environmental radiation levels in the United States and parts of the Pacific following the Japanese Nuclear Incident. Learn about EPA’s response and view historical laboratory data and news releases.

  8. Prediction of Safety Incidents

    Data.gov (United States)

    National Aeronautics and Space Administration — Safety incidents, including injuries, property damage and mission failures, cost NASA and contractors thousands of dollars in direct and indirect costs. This project...

  9. Marine Animal Incident Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Large whale stranding, death, ship strike and entanglement incidents are all recorded to monitor the health of each population and track anthropogenic factors that...

  10. Acute incidents during anaesthesia

    African Journals Online (AJOL)

    management of acute incidents and the prevention of ... High or total (complete) spinal blocks in obstetric .... Pain and opioid analgesics lead to delayed ... Step up postoperative care and use ... recognise suprasternal and supraclavicular.

  11. 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.

  12. 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 ...

  13. 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).

  14. 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.

  15. Investigative report, science committee of Aggregate corporation Radiological technologist society of the Oita prefecture. Questionnaires research on security control of department of radiological technology of medical facilities in the Oita prefecture. The second report. Research on high risk incident measures

    International Nuclear Information System (INIS)

    Eto, Yoshihiro; Mano, Isao; Takagi, Ikuya; Murakami, Yasunori; Sueyoshi, Seiji; Yoshimoto, Asahi

    2007-01-01

    Oita association of radiological technologists carried out the questionnaires about the measures against high lisk incidental in department of radiological technology at the medical facilities in Oita. We distributed the questionnaire to 102 facilities, which are worked by the technologists (member), and got response from 91 facilities (89%). Research contents are Patient verification method'' ''Input and verification of patient attribute'' ''Infection in hospital'' ''Stumbles and falls of patient'' Contrast enhancement CT'' ''Something related to pacemaker'' ''MRI inspection and the magnetic substance'' ''Remedy mistake'' and ''Risk management''. The Result, Low level recognition contents of medical accident measures are ''Contrast enhancement CT'' ''Stumbles and falls of patient'' Risk management of department of radiological technology''. (author)

  16. US Africa Command (AFRICOM) and Nigeria's National Security ...

    African Journals Online (AJOL)

    The US decision to establish a unified combatant command (AFRICOM) in African has raised numerous questions, particularly in Africa, regarding its possible security implications for the continent. The article narrows itself to the concern for unraveling the national security implications of Nigeria's opposition to the location of

  17. Commander in chief : FDR's battle with Churchill, 1943

    NARCIS (Netherlands)

    Hamilton, Charles Nigel

    2016-01-01

    Commander in Chief is een deelbiografie van president Franklin Delano Roosevelt waarin Roosevelts rol als opperbevelhebber van de gewapende strijdkrachten van de Verenigde Staten in de Tweede Wereldoorlog het hoofdthema is. Het boek concentreert zich op het jaar 1943: een jaar waaraan biografen van

  18. Interagency Cooperation for Irregular Warfare at the Combatant Command

    Science.gov (United States)

    2009-01-01

    enemy’s command capability.16 Salamoni argued that the term “irregular warfare” belies an ethnocentric perspective of conflict that will limit military...duty military staffing to form the nucleus of the organization, which would receive augmentation from additional assigned reservists and interagency

  19. Zenith-100 Microcomputer Network for Air Command and Staff College.

    Science.gov (United States)

    1987-04-01

    34 AD-A182 495 ZENI T-ipo ml CROCOMFUT E NET WOR( FOR AIR COMAND AND h SAFF CoLLG (U) AIl COMMAND ANDCSTAFF COLL MAX(WELL AFS "CAL W L GALWAY El AL...processing of documents by eliminating the time required to physically move the documents from one office to the next. Reproduction Savings. Information

  20. 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

  1. Commander’s Handbook on Military and Civilian Law. Revision

    Science.gov (United States)

    1992-01-01

    Cuminal Law Divio 23-8 Commander’s Handbook The accused’s possession must be knowing and conscious. Therefore, if the accused didn’t know he or she...of violence and neglect in families, for example, experiencing or witnessing abuse as a child or the stress a family experiences due to the member’s

  2. Principles of Mission Command Applied to Civil Military Relationships

    Science.gov (United States)

    2017-05-25

    to prevent tension and promote cohesive teams. While historians trace civil-military theory to Sun Tzu and Carl von Clausewitz, the beginning of...Conclusion – A Mission Command Approach .............................................................................. 34 Bibliography ...Civil-Military Relations,” Monograph, (School of Advanced Military Studies, Fort Leavenworth, KS, 2010): 3. 64 Bennett, 3. 36 Bibliography

  3. Satellite Telemetry and Command using Big LEO Mobile Telecommunications Systems

    Science.gov (United States)

    Huegel, Fred

    1998-01-01

    Various issues associated with satellite telemetry and command using Big LEO mobile telecommunications systems are presented in viewgraph form. Specific topics include: 1) Commercial Satellite system overviews: Globalstar, ICO, and Iridium; 2) System capabilities and cost reduction; 3) Satellite constellations and contact limitations; 4) Capabilities of Globalstar, ICO and Iridium with emphasis on Globalstar; and 5) Flight transceiver issues and security.

  4. Command and Control Across Space and Cyberspace Domains

    Science.gov (United States)

    2016-02-16

    debilitating impact on security, national economic security, national public health or safety, or any combination of those matters.”16).17 From Joint...Third, push control (if not command) to the theater or operational level. Returning to the inbound ICBM scenario proposed by Maj Gen Zabel and detailed

  5. TGIN language reference manual: NAMMU and MATDIF commands

    International Nuclear Information System (INIS)

    Cliffe, K.A.; Herbert, A.W.

    1992-03-01

    NAMMU is a finite-element program for modelling groundwater flow and transport. The matrix diffusion option models the transport of radionuclides including the effects of rock-matrix diffusion. It uses the free-format structured-input TGIN. This report describes the commands in the TGIN language for running the NAMMU and MATDIF package. (author)

  6. 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)

  7. STS-32 Commander Brandenstein adjusts IMAX camera during training session

    Science.gov (United States)

    1989-01-01

    STS-32 Commander Daniel C. Brandenstein adjusts IMAX camera setting during briefing and training session as technician looks on. The session was conducted in the JSC Mockup and Integration Laboratory (MAIL) Bldg 9B. The IMAX camera will be used onboard Columbia, Orbiter Vehicle (OV) 102, during the STS-32 mission.

  8. 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.

  9. 78 FR 24694 - Family Advocacy Command Assistance Team (FACAT)

    Science.gov (United States)

    2013-04-26

    ... be composed of personnel from appropriate disciplines, including, medicine, psychology, and child... in all allegations of child abuse and neglect. DATES: Comments must be received by June 25, 2013... multi-disciplinary Family Advocacy Command Assistant Team to respond to allegations of child sexual...

  10. 32 CFR 536.7 - Responsibilities of the Commander USARCS.

    Science.gov (United States)

    2010-07-01

    .... (s) Serve as proponent for the database management systems for torts, personnel and affirmative... ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.7 Responsibilities of the Commander... Department of Justice (DOJ) and the SA's designee is authorized. (h) Operate the “receiving State office” for...

  11. 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)

  12. Company Level Commander Development In The US Army

    Science.gov (United States)

    2013-12-01

    pedagogy and andragogy in instruction can have a significant positive impact on developing combat arms officers to be successful company level commanders...Recommendations to achieve these improvements using andragogy are discussed. In the United States (US) Army, when an officer...use Malcom Knowles’ andragogy framework for understanding adults as learners in order to analyze the trainees and maximize the training outcomes for

  13. 32 CFR 884.17 - Commander's instruction letter to member.

    Science.gov (United States)

    2010-07-01

    ... instruction letter to member. Subject: Instructions in Case of Release on Bail or Personal Recognizance 1. You... 32 National Defense 6 2010-07-01 2010-07-01 false Commander's instruction letter to member. 884.17... civilian custody on bail or on your own recognizance, report immediately in person or by telephone to the...

  14. Naval Sea Systems Command > Home > Warfare Centers > NSWC Corona

    Science.gov (United States)

    . Richard A. Braunbeck III Capt. Stephen H. Murray, left, salutes his relief, Capt. Richard A. Braunbeck III -321 NORCO, Calif. (Dec. 7, 2016) Capt. Stephen H. Murray, commanding officer of Naval Surface... https ): Dewin Andujar (Virtual Reality); Nicholas Manning (Maritime Capture the Flag); Stephen O'Grady

  15. 32 CFR 536.3 - Command and organizational relationships.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Command and organizational relationships. 536.3 Section 536.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND... relationships. (a) The Secretary of the Army. The Secretary of the Army (SA) heads the Army Claims System and...

  16. 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...

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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...

  3. A Coast Guard Commander's Quick Reference Manual for Legal Issues

    National Research Council Canada - National Science Library

    1997-01-01

    ...). ̂ Following an alcohol incident, review the member's security clearance lAW COMDTlNST M5510.16. ̂ Review the status of members involved in alcohol abuse incidents and take appropriate disciplinary, remedial, educational and I or...

  4. FOCUS-PDCA循环管理在降低肠外营养不合理医嘱发生率中的应用%Application of FOCUS-PDCA Cycle Management in Reducing the Incidence of Irrational Medical Orders of Parenteral Nutrition

    Institute of Scientific and Technical Information of China (English)

    贺银丽; 封卫毅; 施秉银; 罗秦英; 董乐乐; 庞成森; 鲁会侠; 张亚婷; 张晓霞; 董卫华; 王曙逢

    2017-01-01

    目的:降低我院肠外营养不合理医嘱的发生率,促进肠外营养的合理使用.方法:收集我院普通外科2016年第一季度的肠外营养医嘱,统计其不合理医嘱数量及发生类型,然后运用FOCUS-PDCA(Find-organize-clarify-understand-select-plan-do-check-act)循环管理对肠外营养医嘱开具过程中存在的问题进行分析和改善,再收集改善后(2016年第三季度)的肠外营养医嘱对其不合理医嘱数量及发生类型进行统计,评价管理效果.结果:我院通过采取成立营养支持小组、加强对医护人员的培训与沟通、在医院信息系统中加入肠外营养审方模块等多项措施进行持续改进,使普通外科肠外营养的不合理医嘱发生率由改善前的48.25%(1433/2970)下降至改善后的5.67%(120/2118),不合理类型中阳离子超量、遴选药品不适宜、配伍不适宜发生率降为0.结论:采用FOCUS-PDCA循环管理可降低肠外营养不合理医嘱发生率,促进医院肠外营养的合理使用.%OBJECTIVE:To reduce the incidence of irrational medical orders for parenteral nutrition,and promote the rational use of parenteral nutrition. METHODS:The medical orders for parenteral nutrition of the first quarter of 2016 in general surgery de-partment of our hospital were collected,and the number and types of its irrational medical orders were summed up. Then FO-CUS-PDCA(Find-organize-clarify-understand-select-plan-do-check-act)cycle management was adopted to analyze and improve the existing problems in issuing medical orders for parenteral nutrition. The improved(the third quarter of 2016)medical orders for par-enteral nutrition were collected,the number and types of its irrational medical orders were summed up,and management effect was evaluated. RESULTS:Establishing nutrition support group,strengthening the training and communication of medical staff,adding prescription evaluation module for parenteral nutrition in hospital information system and a

  5. Hazmat Yearly Incident Summary Reports

    Data.gov (United States)

    Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

  6. A critical incident reporting system in anaesthesia.

    Science.gov (United States)

    Madzimbamuto, F D; Chiware, R

    2001-01-01

    To audit the recently established Critical Incident Reporting System in the Department of Anaesthesia and Critical Care Medicine, University of Zimbabwe Medical School. The system was set up with the purpose of improving the quality of care delivered by the department. Cross sectional study. A critical incident was defined as 'any adverse and reversible event in theatre, during or immediately after surgery that if it persisted without correction would cause harm to the patient'. The anaesthetic or recovery room staff filled a critical incident form anonymously. Data was collected from critical incident reporting forms for analysis. The anaesthetic service in the two teaching hospitals of Harare Central and Parirenyatwa General Hospitals. Between May and October 2000, 62 completed critical incident forms were collected. The nature of the incident and the monitoring used were recorded, the cause was classified as human, equipment or monitoring failure and the outcome for each patient reported. There was no formal system for reminding staff to fill in their critical incident forms. A total of 14,165 operations were performed over the reporting period: 62 critical incident forms were collected, reporting 130 incidents, giving a rate of 0.92% (130/14,165). Of these, 42 patients were emergencies and 20 elective. The incidents were hypotension, hypoxia, bradycardia, ECG changes, aspiration, laryngospasm, high spinal, and cardiac arrest. Monitoring present on patients who had critical incidents was: capnography 57%, oxymetry 90% and ECG 100%. Other monitors are not reported. Human error contributed in 32/62 of patients and equipment failure in 31/62 of patients. Patient outcome showed 15% died, 23% were unplanned admissions to HDU while 62% were discharged to the ward with little or no adverse outcome. Despite some under reporting, the critical incident rate was within the range reported in the literature. Supervision of juniors is not adequate, especially on call. The

  7. Joint Force Headquarters - Global Strike: Preserving, Advancing, and Accelerating Operational Art for the Joint Force Commander

    National Research Council Canada - National Science Library

    Kruse, Jeffrey

    2004-01-01

    ... combatant commanders. It can be viewed as infringing upon theater unity of command, a potential avenue for increased national level control and interference, and a competitor for finite warfighting resources...

  8. 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...

  9. 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...

  10. 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...

  11. 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.

  12. 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...

  13. 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

  14. 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

  15. 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...

  16. 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…

  17. 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.

  18. An extended SPSS extension command for generating random data

    Directory of Open Access Journals (Sweden)

    Harding, Bradley

    2015-10-01

    Full Text Available The GRD extension command for SPSS (Harding & Cousineau, 2014 has been used in a variety of applications since its inception. Ranging from a teaching tool to demonstrate statistical analyses, to an inferential tool used to find critical values instead of looking into a z-table, GRD has been very well received. However, some users have requested other data generation components that would make GRD a more complete extension command: the possibility to add contaminants to the generated dataset as well as the ability to generate correlated variables. Another component we added is a graphical user interface (or GUI that makes GRD accessible through the drop-down menus in the SPSS Data Editor window. This GUI allows users to generate a simple dataset by entering parameters in dedicated fields rather than writing out the full script. Finally, we devised a small series of exercises to help users get acquainted with the new subcommands and GUI.

  19. Using LTE Networks for UAV Command and Control Link

    DEFF Research Database (Denmark)

    Nguyen, Huan Cong; Amorim, Rafhael Medeiros de; Wigard, Jeroen

    2017-01-01

    In this paper we investigate the ability of Long-Term Evolution (LTE) network to provide coverage for Unmanned Aerial Vehicles (UAVs) in a rural area, in particular for the Command and Control (C2) downlink. The study takes into consideration the dependency of the large-scale path loss on the hei......In this paper we investigate the ability of Long-Term Evolution (LTE) network to provide coverage for Unmanned Aerial Vehicles (UAVs) in a rural area, in particular for the Command and Control (C2) downlink. The study takes into consideration the dependency of the large-scale path loss...... on the height of the UAV, which is derived from actual measurements, and a real-world cellular network layout and configuration. The results indicate that interference is the dominant factor limiting the cellular coverage for UAVs in the downlink: outage level increases from 4.2% at 1.5 m height to 51.7% at 120...

  20. Plann: A command-line application for annotating plastome sequences.

    Science.gov (United States)

    Huang, Daisie I; Cronk, Quentin C B

    2015-08-01

    Plann automates the process of annotating a plastome sequence in GenBank format for either downstream processing or for GenBank submission by annotating a new plastome based on a similar, well-annotated plastome. Plann is a Perl script to be executed on the command line. Plann compares a new plastome sequence to the features annotated in a reference plastome and then shifts the intervals of any matching features to the locations in the new plastome. Plann's output can be used in the National Center for Biotechnology Information's tbl2asn to create a Sequin file for GenBank submission. Unlike Web-based annotation packages, Plann is a locally executable script that will accurately annotate a plastome sequence to a locally specified reference plastome. Because it executes from the command line, it is ready to use in other software pipelines and can be easily rerun as a draft plastome is improved.

  1. Lightning incidents in Mongolia

    Directory of Open Access Journals (Sweden)

    Myagmar Doljinsuren

    2015-11-01

    Full Text Available This is one of the first studies that has been conducted in Mongolia on the distribution of lightning incidents. The study covers a 10-year period from 2004 to 2013. The country records a human death rate of 15.4 deaths per 10 million people per year, which is much higher than that of many countries with similar isokeraunic level. The reason may be the low-grown vegetation observed in most rural areas of Mongolia, a surface topography, typical to steppe climate. We suggest modifications to Gomes–Kadir equation for such countries, as it predicts a much lower annual death rate for Mongolia. The lightning incidents spread over the period from May to August with the peak of the number of incidents occurring in July. The worst lightning affected region in the country is the central part. Compared with impacts of other convective disasters such as squalls, thunderstorms and hail, lightning stands as the second highest in the number of incidents, human deaths and animal deaths. Economic losses due to lightning is only about 1% of the total losses due to the four extreme weather phenomena. However, unless precautionary measures are not promoted among the public, this figure of losses may significantly increase with time as the country is undergoing rapid industrialization at present.

  2. 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)

  3. The Supreme Allied Commander’s Operational Approach

    Science.gov (United States)

    2014-05-22

    the Seine below Paris , and then began converging toward the northern line of march just below the first. A third line broke off from the second in a...toward the Seine Basin and Paris .” Therefore, in the aftermath of Goodwood Eisenhower felt both disappointed and deceived. After Goodwood, Eisenhower...command. Simultaneously, Bradley’s armies were to “[capture] Brest , [protect] the southern flank of the

  4. Spaceport Command and Control System User Interface Testing

    Science.gov (United States)

    Huesman, Jacob

    2016-01-01

    The Spaceport Command and Control System will be the National Aeronautics and Space Administration's newest system for launching commercial and government owned spacecraft. It's a large system with many parts all in need of testing. To improve upon testing already done by NASA engineers, the Engineering Directorate, Electrical Division (NE-E) of Kennedy Space Center has hired a group of interns each of the last few semesters to develop novel ways of improving the testing process.

  5. Deception Recognition: Rethinking the Operational Commander’s Approach

    Science.gov (United States)

    2010-10-27

    Understanding this cultural relativism gives us insight into intent. Social norms tend to be tacitly established and maintained through body...the concept of ―face‖ in dealing with people in a personal or professional relationship is first and foremost in the Chinese culture . The western... morality ,‖5 the operational commander can be and usually is directly affected by both political deception and MILDEC and must be able to recognize and

  6. Manual command component with tactile and/or kinesthetic feedback

    International Nuclear Information System (INIS)

    Foumier, R.

    1995-01-01

    The invention concerns a manual command component designed to be use by a human hand in order to control a slave system, with a tactile and/or kinesthetic feedback. It is composed by a handle and by piece(s) for the feedback. The handle contains a captor to signalize the move and the speed. The signals are transmitted to the slave system. The later send feedbacks which are transformed in a couple for the handle. (TEC)

  7. Measuring Command Post Operations in a Decisive Action Training Environment

    Science.gov (United States)

    2017-05-01

    constantly changing information requirements. Having established procedures in place to handle these challenges would seem requisite for units...maintain the continuous and rapid execution of command post operations. According to FM 3-90.2, the SOPs established and rehearsed for each CP...a rehearsed plan for a possible attack on the CP, and a rehearsed plan to move the CP. The Follow Up section emphasized the necessity of debriefing

  8. Mission Command: Making it work at Battalion Level

    Science.gov (United States)

    2013-04-01

    National Training Center, CA, February 2012. 29 Litwin, G.H., and R.A.Stringer, Motivation & Organizational Climate , Harvard University Press...for Joint Land Operations, Washington, DC: Joint Staff, 29 June 2010. Litwin, George H., and Robert A. Stringer Jr., Motivation & Organizational ...interact with one another, and develop leadership competencies that strengthen the organization. Mission command as a philosophy, a system and a

  9. Benefits Of Mission Command: Balance Of Philosophy And System

    Science.gov (United States)

    2016-05-26

    Seminar Leader Charles T. Lombardo, COL ___________________________________, Director, School of Advanced Military Studies Henry A. Arnold III...Battle of Tora Bora was convoluted. Hank Crumpton, Berntsen’s supervisor at the CIA recalls speaking to Berntsen daily and to the specific request...science of mission command in execution. It has expanded to fifteen total problems with thirteen recommended solutions being material based, while twenty

  10. Empowering Globally Integrated Operations and Mission Command: Revisiting Key West

    Science.gov (United States)

    2013-03-01

    depended on coordination between commanders. Examples include Captain Thomas McDonough’s 4 U.S...Hedgehog Concept In his book, Good to Great, which describes how good organizations become great ones, Jim Collins borrows an example from an Isaiah ...that it executes with perfection—curling into a ball with its spikes outward. 62 In the words of Archilochus (first line in quotes), Isaiah Berlin

  11. A chemical reaction in the movie The Ten Commandments

    Directory of Open Access Journals (Sweden)

    López Pérez, José Pedro;

    2012-04-01

    Full Text Available The study of natural sciences in the second year of Secondary Education must be complemented with a visit to the laboratory, where experiments should be permormed. The curriculum emphasizes the initial basis of Chemistry and the study of reactions. In this paper we describe a laboratory experience, useful for understanding the concept of chemical change. Also, we present the hypothesis that a chemical reaction was used in the classic movie The Ten Commandments.

  12. Airborne Intelligence, Surveillance, and Reconnaissance: Mission Command and Centralized Control

    Science.gov (United States)

    2014-12-10

    short stint in Texas, Stuart reported to Fort Leavenworth, where he began his career as a cavalryman and found himself confronted with the torrent of...found themselves back at the War Department in a meeting with Secretary Floyd and President James Buchanan.50 The Secretary of War placed Lee in command...and Aldie. Those fights were tactical victories for the Union cavalry and Stuart had lost 500 men , but his cavalry had served its operational

  13. Headquarters, Special Operations Command, Africa Stuttgart, Germany (redacted)

    Science.gov (United States)

    2016-08-09

    make sure the boss is not stepping over the line in te1ms of reprisal." - documented that conversation on November 4, 2011, in an MFR. stated that...play nice and wait until I’m gone. Smile . Act like you’re going to work ... but ifyou continue to unde1mine my authority as a commander, I’m going to

  14. Deja vu: The Unified Command Plan of the Future Revisited

    Science.gov (United States)

    2011-05-19

    Approved for Public Release; Distribution is Unlimited Déjà vu : The Unified Command Plan of the Future Revisited A Monograph by Lieutenant...DD-MM-YYYY) 19-05-2011 2. REPORT TYPE Monograph 3. DATES COVERED (From - To) JUL 2010 – MAY 2011 4. TITLE AND SUBTITLE Déjà vu : The Unified...i SCHOOL OF ADVANCED MILITARY STUDIES MONOGRAPH APPROVAL Lieutenant Colonel Edward Francis Martignetti Title of Monograph: Déjà vu : The Unified

  15. One Among Many: Building Partner Capacity in a Multinational Command

    Science.gov (United States)

    2012-03-20

    initiative-life/ (accessed March 10, 2012). UNESCO defines literacy as “The ability to read and write with understanding a simple statement related...Nations Educational, Scientific, and Cultural Organization, “ UNESCO Institute for Statistics Glossary,” 2006, http://glossary.uis.unesco.org/glossary...Command Brief, briefing slides, Fort Polk, LA , February 8, 2012 and MAJ John A. Redford, Brigade Operations Officer, 162d Infantry Brigade, Fort

  16. Disagreement, Cognitive Command, and the Indexicality of Moral Truth

    Directory of Open Access Journals (Sweden)

    Reichardt Bastian

    2015-09-01

    Full Text Available Moral Relativism can be considered an attractive alternative to realism because relativists can make good sense of cultural and societal disagreements by seeing them as faultless. However, we can show that this advantage is made possible by systematically disagreeing with moral phenomenology. Relativists make a substantial distinction between intercultural and intracultural discourses which turns out to be incoherent. This can be shown by making use of Crispin Wright’s notion of Cognitive Command.

  17. 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

  18. 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.

  19. 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.

  20. Incidents with hazardous radiation sources

    International Nuclear Information System (INIS)

    Schoenhacker, Stefan

    2016-01-01

    Incidents with hazardous radiation sources can occur in any country, even those without nuclear facilities. Preparedness for such incidents is supposed to fulfill globally agreed minimum standards. Incidents are categorized in incidents with licensed handling of radiation sources as for material testing, transport accidents of hazardous radiation sources, incidents with radionuclide batteries, incidents with satellites containing radioactive inventory, incidents wit not licensed handling of illegally acquired hazardous radiation sources. The emergency planning in Austria includes a differentiation according to the consequences: incidents with release of radioactive materials resulting in restricted contamination, incidents with release of radioactive materials resulting in local contamination, and incidents with the hazard of e@nhanced exposure due to the radiation source.

  1. 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...

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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...

  7. Maximum Credible Incidents

    CERN Document Server

    Strait, J

    2009-01-01

    Following the incident in sector 34, considerable effort has been made to improve the systems for detecting similar faults and to improve the safety systems to limit the damage if a similar incident should occur. Nevertheless, even after the consolidation and repairs are completed, other faults may still occur in the superconducting magnet systems, which could result in damage to the LHC. Such faults include both direct failures of a particular component or system, or an incorrect response to a “normal” upset condition, for example a quench. I will review a range of faults which could be reasonably expected to occur in the superconducting magnet systems, and which could result in substantial damage and down-time to the LHC. I will evaluate the probability and the consequences of such faults, and suggest what mitigations, if any, are possible to protect against each.

  8. 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...

  9. 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.

  10. Committee on Medical Aspects of Radiation in the Environment (COMARE) 4. report. The incidence of cancer and leukaemia in young people in the vicinity of the Sellafield site, West Cumbria: Further studies and an update of the situation since the publication of the report of the Black Advisory Group in 1984

    Energy Technology Data Exchange (ETDEWEB)

    Bridges, B.A.

    1996-12-31

    The Fourth Report of the Committee on Medical Aspects of Radiation in the Environment (COMARE) updates the information on the incidence of cancer and leukaemia in young people in the vicinity of the Sellafield site since the publication of the Black Advisory Group report in 1984. Data are reviewed on radiation exposure and the risk of radiation-induced leukaemia and cancer in young people living in Seascale; possible effects of paternal preconception irradiation in cancer; exposure to chemicals used at and discharged from the Sellafield site and the risk to the general population and offspring of site workers; and the infectious aetiology of childhood cancer. The history of the Royal Ordnance Factories sited at Sellafield and Drigg in the 1940s and a historical review of childhood cancer in Seascale is also given. (UK).

  11. Committee on Medical Aspects of Radiation in the Environment (COMARE) 4. report. The incidence of cancer and leukaemia in young people in the vicinity of the Sellafield site, West Cumbria: Further studies and an update of the situation since the publication of the report of the Black Advisory Group in 1984

    International Nuclear Information System (INIS)

    Bridges, B.A.

    1996-01-01

    The Fourth Report of the Committee on Medical Aspects of Radiation in the Environment (COMARE) updates the information on the incidence of cancer and leukaemia in young people in the vicinity of the Sellafield site since the publication of the Black Advisory Group report in 1984. Data are reviewed on radiation exposure and the risk of radiation-induced leukaemia and cancer in young people living in Seascale; possible effects of paternal preconception irradiation in cancer; exposure to chemicals used at and discharged from the Sellafield site and the risk to the general population and offspring of site workers; and the infectious aetiology of childhood cancer. The history of the Royal Ordnance Factories sited at Sellafield and Drigg in the 1940s and a historical review of childhood cancer in Seascale is also given. (UK)

  12. 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.

  13. 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...

  14. 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)

  15. Long-term results of high-dose conformal radiotherapy for patients with medically inoperable T1-3N0 non-small-cell lung cancer: Is low incidence of regional failure due to incidental nodal irradiation?

    International Nuclear Information System (INIS)

    Chen Ming; Hayman, James A.; Haken, Randall K. ten; Tatro, Daniel; Fernando, Shaneli; Kong, F.-M.

    2006-01-01

    Purpose: To report the results of high-dose conformal irradiation and examine incidental nodal irradiation and nodal failure in patients with inoperable early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: This analysis included patients with inoperable CT-staged T1-3N0M0 NSCLC treated on our prospective dose-escalation trial. Patients were treated with radiation alone (total dose, 63-102.9 Gy in 2.1-Gy daily fractions) with a three-dimensional conformal technique without intentional nodal irradiation. Bilateral highest mediastinal and upper/lower paratracheal, prevascular and retrotracheal, sub- and para-aortic, subcarinal, paraesophageal, and ipsilateral hilar regions were delineated individually. Nodal failure and doses of incidental irradiation were studied. Results: The potential median follow-up was 104 months. For patients who completed protocol treatment, median survival was 31 months. The actuarial overall survival rate was 86%, 61%, 43%, and 21% and the cause-specific survival rate was 89%, 70%, 53%, and 35% at 1, 2, 3, and 5 years, respectively. Weight loss (p = 0.008) and radiation dose in Gy (p = 0.013) were significantly associated with overall survival. In only 22% and 13% of patients examined did ipsilateral hilar and paratracheal (and subaortic for left-sided tumor) nodal regions receive a dose of ≥40 Gy, respectively. Less than 10% of all other nodal regions received a dose of ≥40 Gy. No patients failed initially at nodal sites. Conclusions: Radiation dose is positively associated with overall survival in patients with medically inoperable T1-3N0 NSCLC, though long-term results remain poor. The nodal failure rate is low and does not seem to be due to high-dose incidental irradiation

  16. The Role of a Commander in Military Lessons Learned Systems

    Directory of Open Access Journals (Sweden)

    Zenon Waliński

    2015-06-01

    Full Text Available The aim of the paper is to investigate the role of a commander in military Lessons Learned systems. In order to achieve the aim, the paper presents (1 the architecture of the Lessons Learned capabilities in the U.S. Army, NATO and the Polish Armed Forces, (2 the commander’s role in the Lessons Learned process (3 the commander’s role in fostering Lessons Learned organisation culture. The paper is based on multiple case study analysis including Lessons Learned systems in NATO, the U.S. Army and the Polish Armed Forces.

  17. Command History. 1972-1973. Volume 2. Sanitized

    Science.gov (United States)

    1973-07-15

    was de - ing processing Army DEROS flights, transporting veloped to handle the anticipated large number of baggage to and from the flight lines, and...VOLUME 11 B CIA IFIED CY 1 PAC F0 IG D EMN 0 EXE TED IF AMA NERA DE LASSIF A N EXEM E SY CINC CC \\’ opy ot󈨤 Cop~ies Iys BTAG pT ’’, 00- d 6,,’ 83-6 6-24...it nocoaam7 &WE Identity by black aiimiiw) Logistica , Support of RVNAF. Communications-Electronics, VNAF Support, Command Activities, The New Agencies

  18. Location of Microbial Ecology Evaluation Device in Apollo Command Module

    Science.gov (United States)

    1971-01-01

    The location of the Microbial Ecology Evaluation Device (MEED) installed on the open hatch of the Apollo Command Module is illustrated in this photograph. The MEED, equipment of the Microbial Response in Space Environment experiment, will house a selection of microbial systems. The MEED will be deployed during the extravehicular activity on the transearth coast phase of the Aopllo 16 lunar landing mission. The purpose of the experiment will be to measure the effects of certain space environmental parameters on the microbial test systems.

  19. India's nuclear command and control: perspectives from organisation theory

    International Nuclear Information System (INIS)

    Sasikumar, Shanmugasundaram

    2010-01-01

    Command and control of nuclear weapons was the edifice upon which great power nuclear strategy was based. Empirical Cold War research later proved that this edifice was, in fact, only a power keg. Therefore, US non-proliferation-minded analysts propounded logical reasons for their claim that new nuclear nations will be unable to demonstrate prudence in nuclear weapons management. The unique Indian case, pronounced from the organisation theory perspective, proves to the contrary. India's nuclear organisation is not a static entity; its unique strategic culture together with a political standard operating procedure for nuclear weapons management reduces the exaggerated possibility of any catastrophe. (author)

  20. Transforming Airborne Command and Control and Intelligence, Surveillance, and Reconnaissance

    Science.gov (United States)

    2012-06-01

    the US Government, Department of Defense, the United States Air Force, or Air University. In accordance with Air Force Instruction 51-303, it is not...Staff level. Lt Col Roger “Charlie” Brown offered key perspective at the Major Command level. Lt Col Herb “Weed” Maraman, Sqn Ldr Mike Lyttle...studied the feasibility of using space-based radar (SBR) platforms as well as large manned aircraft like the E-10A to meet USAF C2 and ISR operational