WorldWideScience

Sample records for incident management simulation

  1. Simulation analysis of route diversion strategies for freeway incident management : final report.

    Science.gov (United States)

    1995-02-01

    The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...

  2. 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.

  3. Traffic incident management resource management.

    Science.gov (United States)

    2009-01-01

    The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...

  4. Critical incident stress management.

    Science.gov (United States)

    Lim, J J; Childs, J; Gonsalves, K

    2000-10-01

    Recent studies have indicated implementation of the CISM Program has impacted and reduced the cost of workers' compensation claims for stress related conditions and the number of lost work days (Ott, 1997; Western Management Consultants, 1996). Occupational health professionals need to be ready to develop and implement a comprehensive critical incident stress management process in anticipation of a major event. The ability to organize, lead, or administer critical incident stress debriefings for affected employees is a key role for the occupational health professional. Familiarity with these concepts and the ability to identify a critical incident enhances value to the business by mitigating the stress and impact to the workplace. Critical Incident Stress Management Systems have the potential for decreasing stress and restoring employees to normal life function--a win/win situation for both the employees and the organization.

  5. Information Security Incident Management

    Directory of Open Access Journals (Sweden)

    D. I. Persanov

    2010-03-01

    Full Text Available The present report highlights the points of information security incident management in an enterprise. Some aspects of the incident and event classification are given. The author presents his view of the process scheme over the monitoring and processing information security events. Also, the report determines a few critical points of the listed process and gives the practical recommendations over its development and optimization.

  6. 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…

  7. Improving freight crash incident management.

    Science.gov (United States)

    2015-06-01

    The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

  8. Modelling and Simulation for Major Incidents

    Directory of Open Access Journals (Sweden)

    Eleonora Pacciani

    2015-11-01

    Full Text Available In recent years, there has been a rise in Major Incidents with big impact on the citizens health and the society. Without the possibility of conducting live experiments when it comes to physical and/or toxic trauma, only an accurate in silico reconstruction allows us to identify organizational solutions with the best possible chance of success, in correlation with the limitations on available resources (e.g. medical team, first responders, treatments, transports, and hospitals availability and with the variability of the characteristic of event (e.g. type of incident, severity of the event and type of lesions. Utilizing modelling and simulation techniques, a simplified mathematical model of physiological evolution for patients involved in physical and toxic trauma incident scenarios has been developed and implemented. The model formalizes the dynamics, operating standards and practices of medical response and the main emergency service in the chain of emergency management during a Major Incident.

  9. Information sharing for traffic incident management.

    Science.gov (United States)

    2009-01-01

    Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

  10. Information Security Incident Management Practical Aspects

    Directory of Open Access Journals (Sweden)

    A. B. Kostina

    2010-03-01

    Full Text Available The information security incident management process model (ISIMP is developed; the role of this process in the information security management system is established. Input and output data of the process are determined. Key practical aspects of incident management are determined.

  11. Bronchoaspiration: incidence, consequences and management.

    Science.gov (United States)

    Beck-Schimmer, Beatrice; Bonvini, John M

    2011-02-01

    Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the lower respiratory tract. Upon injury, epithelial cells and alveolar macrophages secrete chemical mediators, attracting and activating neutrophils, which in turn release proteases and reactive oxygen species, degrading the alveolocapillary unit. Aspiration can lead to a range of diseases such as infectious pneumonia, chemical pneumonitis or respiratory distress syndrome with significant morbidity and mortality. It occurs in approximately 3-10 per 10 000 operations with an increased incidence in obstetric and paediatric anaesthesia. Patients are most at risk during induction of anaesthesia and extubation, in particular in emergency situations. The likelihood of significant aspiration can be reduced by fasting, pharmacological intervention and correct anaesthetic management using a rapid sequence induction. Treatment of acid aspiration is by suctioning after witnessed aspiration; antibiotics are indicated in patients with aspiration pneumonia only. Steroids are not proven to improve outcome or reduce mortality. Patients with acute lung injury requiring mechanical ventilation should be ventilated using lung protective strategies with low tidal volumes and low plateau pressure values, attempting to limit peak lung distension and end-expiratory collapse.

  12. 49 CFR 1542.307 - Incident management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...

  13. Traffic management simulation development.

    Science.gov (United States)

    2011-01-03

    Microscopic simulation can provide significant support to traffic management center (TMC) operations. However, traffic simulation applications require data that are expensive and time-consuming to collect. Data collected by TMCs can be used as a prim...

  14. Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-06-01

    Kentucky s Highway Incident Management Strategic Plan consists of a mission statement, 4 goals, 16 objectives, and 49 action strategies. The action strategies are arranged by priority and recommended time frame for implementation. When implemented...

  15. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

    In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

  16. Risk Management and Simulation

    DEFF Research Database (Denmark)

    Skovmand, David

    2014-01-01

    Review of: Risk Management and Simulation / Aparna Gupta. Boca Raton, FL: CRC Press, 2013, xxix + 491 pp., $99.95(H), ISBN: 978-1-4398-3594-4.......Review of: Risk Management and Simulation / Aparna Gupta. Boca Raton, FL: CRC Press, 2013, xxix + 491 pp., $99.95(H), ISBN: 978-1-4398-3594-4....

  17. Incident Management Organization succession planning stakeholder feedback

    Science.gov (United States)

    Anne E. Black

    2013-01-01

    This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...

  18. Simulator configuration management system

    International Nuclear Information System (INIS)

    Faulent, J.; Brooks, J.G.

    1990-01-01

    The proposed revisions to ANS 3.5-1985 (Section 5) require Utilities to establish a simulator Configuration Management System (CMS). The proposed CMS must be capable of: Establishing and maintaining a simulator design database. Identifying and documenting differences between the simulator and its reference plant. Tracking the resolution of identified differences. Recording data to support simulator certification, testing and maintenance. This paper discusses a CMS capable of meeting the proposed requirements contained in ANS 3.5. The system will utilize a personal computer and a relational database management software to construct a simulator design database. The database will contain records to all reference nuclear plant data used in designing the simulator, as well as records identifying all the software, hardware and documentation making up the simulator. Using the relational powers of the database management software, reports will be generated identifying the impact of reference plant changes on the operation of the simulator. These reports can then be evaluated in terms of training needs to determine if changes are required for the simulator. If a change is authorized, the CMS will track the change through to its resolution and then incorporate the change into the simulator design database

  19. IT Security Vulnerability and Incident Response Management

    NARCIS (Netherlands)

    Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.

    2006-01-01

    This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer

  20. Evaluating and improving incident management using historical incident data : case studies at Texas transportation management centers.

    Science.gov (United States)

    2009-08-01

    The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...

  1. Traffic management simulation development : summary.

    Science.gov (United States)

    2011-01-01

    Increasingly, Florida traffic is monitored electronically by components of the Intelligent Traffic System (ITS), which send data to regional traffic management centers and assist management of traffic flows and incident response using software called...

  2. Computer incident response and forensics team management conducting a successful incident response

    CERN Document Server

    Johnson, Leighton

    2013-01-01

    Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

  3. New York integrated incident management system evaluation project final report

    Science.gov (United States)

    2007-03-23

    The Integrated Incident Management System (IIMS) enables incident response personnel to transmit data about an incident to other responders and dispatchers on a real-time basis. When an incident is entered into IIMS, the system uses GPS to identify t...

  4. Incident Management in Academic Information System using ITIL Framework

    Science.gov (United States)

    Palilingan, V. R.; Batmetan, J. R.

    2018-02-01

    Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

  5. Development of Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-05-01

    ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...

  6. Program for accident and incident management support, AIMS

    International Nuclear Information System (INIS)

    Putra, M.A.

    1993-12-01

    A prototype of an advisory computer program is presented which could be used in monitoring and analyzing an ongoing incident in a nuclear power plant. The advisory computer program, called the Accident and Incident Management Support (AIMS), focuses on processing a set of data that is to be transmitted from a nuclear power plant to a national or regional emergency center during an incident. The AIMS program will assess the reactor conditions by processing the measured plant parameters. The applied model of the power plant contains a level of complexity that is comparable with the simplified plant model that the power plant operator uses. A standardized decay heat function and a steam water property library is used in the integral balance equations for mass and energy. A simulation of the station blackout accident of the Borssele plant is used to test the program. The program predicts successively: (1) the time of dryout of the steam generators, (2) the time of saturation of the primary system, and (3) the onset of core uncovery. The coolant system with the actual water levels will be displayed on the screen. (orig./HP)

  7. 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.

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

    International Nuclear Information System (INIS)

    Ali, F. R.; Lear, J. T.

    2012-01-01

    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

  9. Pro-active Management of Traffic Incidents Using Novel Technologies

    NARCIS (Netherlands)

    Nitsche, P.; Olstam, J.; Taylor, N.; Reinthaler, M.; Ponweiser, W.; Bernhardsson, V.; Mocanu, I.; Uittenbogaard, J.; Dam, E. van

    2016-01-01

    This paper presents the results of the assessment phase of the project PRIMA (Pro-Active Incident Management), where the benefits, costs and risks of novel traffic incident management techniques are investigated. The project targets the enhancement of current state-of-the-art measures for handling

  10. Current approaches to managing aggressive incidents among in ...

    African Journals Online (AJOL)

    Background: Aggressive behavior and incidents in psychiatric wards are commonplace and management approaches should be evidencebased. This audit aims to review the management of violent incidents and aggressive behaviour in the acute wards of the Federal Neuropsychiatric Hospital Calabar against the NICE ...

  11. A New Model For Understanding Incident Management

    Science.gov (United States)

    2016-12-01

    emergency management agencies and practitioners. Additionally, NEMA seeks to improve and create “ strategic partnerships, innovative programs, and...formulated, and revised administrative responsibilities for emergency management .”33 Several scholarly journals , academic papers, and practitioner articles... management as a profession, David T. Crews states, “In their primary and ‘ strategic ’ roles, emergency managers must analyze the threat to economic

  12. Sports Related Injuries: Incidence, Management and Prevention

    OpenAIRE

    Stanger, Michael A.

    1982-01-01

    The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

  13. Safer travel, improved economic productivity : incident management systems

    Science.gov (United States)

    1999-01-01

    This brochure gives an overview of how incident management technologies can be used to reduce incident-related congestion and increase road safety. It focuses on the need for interagency cooperation and the benefits that can be derived from the coope...

  14. Wildfire incidence and management in the forest transition zone of ...

    African Journals Online (AJOL)

    A survey was conducted in eight communities in the forest transition zone to assess the perceptions of farmers on farming-related wildfire incidences, specific activities in farming associated with incidence of wildfires and coping measures being used by farmers to manage wildfires. Farmers in the studied settlements hold ...

  15. Defining Incident Management Processes for CSIRTs: A Work in Progress

    National Research Council Canada - National Science Library

    Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark

    2004-01-01

    .... Workflow diagrams and descriptions are provided for each of these processes. One advantage of the model is that it enables examination of incident management processes that cross organizational boundaries, both internally and externally...

  16. Air quality evaluation of Rhode Island's incident management program

    Science.gov (United States)

    1997-09-01

    The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...

  17. Changing Incidence, Outcome and Management of Myelomeningocele

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-07-01

    Full Text Available Pediatric neurosurgeons at Children’s Memorial Hospital, Chicago, review their long-term experience and the evolution of the etiology, diagnosis and management of patients born with myelomeningocele (MM in 1975-1979 and followed for 25 years in a multi-disciplinary spina bifida clinic.

  18. Congenital clinical malaria: Incidence, management and outcome ...

    African Journals Online (AJOL)

    Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...

  19. Management of adult spontaneous spondylodiscitis and its rising incidence.

    Science.gov (United States)

    Sur, A; Tsang, K; Brown, M; Tzerakis, N

    2015-09-01

    Spondylodiscitis refers to the infection of the intervertebral disc and osteomyelitis of the adjacent endplates, and it is uncommon in the developed world. Broad consensus indicates its incidence is on the rise. The aim of this retrospective study was twofold. First, we sought to give an up-to-date incidence estimate by comparing case presentation over two time periods (1995-1999 and 2008-2011). Data from the England and Wales census in 2001 and 2011 were used for incidence estimation. The second part of this study aimed to generate management guidance from data from medical and radiographic records of the 2008-2011 patient cohort. The incidence of adult spontaneous spondylodiscitis in the local region between 2008 and 2011 was 3.67/100,000 per year, representing a 150% increase from the incidence in 1995-1999. Our data demonstrate that methicillin sensitive Staphylococcus aureus remains the most common offending pathogen of spontaneous spondylodiscitis. The mean C-reactive protein (CRP) level remained at >30mg/l after a month of starting antibiotic treatment in both medically and surgically managed groups. Evidence suggests that the incidence of spondylodiscitis is on the rise. A review of our case series has demonstrated the effectiveness of intravenous antibiotic therapy. While no official guidance exists for when to switch from intravenous to oral antibiotics, our study shows that CRP at 1 month is >30mg/l and we recommend 6 weeks of intravenous therapy, followed by 6 further weeks of oral therapy.

  20. Early identification and management of critical incident stress.

    Science.gov (United States)

    Caine, Randy M; Ter-Bagdasarian, Levon

    2003-02-01

    Everyone experiences stress. That stress may be related to work (internal), community (external), or family; it may be cumulative or related to a particular critical incident. The cost related to treating acute stress is staggering, both to individuals and to organizations. Critical care nurses are well educated in the physiological responses to the stress of acute illness. Recognizing the emotional impact of stress and the techniques to manage it in themselves and in those with whom they work is equally as important. CISD is widely advocated as an intervention after critical incidents. Although debriefing in and of itself is effective, a single-session semistructured crisis intervention will not prevent posttraumatic stress; thus, the use of CISD as part of a comprehensive multifaceted approach to the management of acute stress related to a critical incident is recommended.

  1. Incidence and management of postoperative bile leaks: A ...

    African Journals Online (AJOL)

    Incidence and management of postoperative bile leaks: A prospective cohort analysis of 467 liver resections. A.J. Dell, J.E.J. Krige, E. Jonas, S.R. Thomson, S.J. Beningfield, U.K. Kotze, S.A. Tromp, S. Burmeister, M.M. Bernon, P.C. Bornman ...

  2. Safety Incident Management Team Report for NIMLT Case 50796

    LENUS (Irish Health Repository)

    2017-01-17

    This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\

  3. 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

  4. 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.

  5. Obstetric anal sphincter injury: incidence, risk factors, and management.

    Science.gov (United States)

    Dudding, Thomas C; Vaizey, Carolynne J; Kamm, Michael A

    2008-02-01

    Obstetric sphincter damage is the most common cause of fecal incontinence in women. This review aimed to survey the literature, and reach a consensus, on its incidence, risk factors, and management. This systematic review identified relevant studies from the following sources: Medline, Cochrane database, cross referencing from identified articles, conference abstracts and proceedings, and guidelines published by the National Institute of Clinical Excellence (United Kingdom), Royal College of Obstetricians and Gynaecologists (United Kingdom), and American College of Obstetricians and Gynecologists. A total of 451 articles and abstracts were reviewed. There was a wide variation in the reported incidence of anal sphincter muscle injury from childbirth, with the true incidence likely to be approximately 11% of postpartum women. Risk factors for injury included instrumental delivery, prolonged second stage of labor, birth weight greater than 4 kg, fetal occipitoposterior presentation, and episiotomy. First vaginal delivery, induction of labor, epidural anesthesia, early pushing, and active restraint of the fetal head during delivery may be associated with an increased risk of sphincter trauma. The majority of sphincter tears can be identified clinically by a suitably trained clinician. In those with recognized tears at the time of delivery repair should be performed using long-term absorbable sutures. Patients presenting later with fecal incontinence may be managed successfully using antidiarrheal drugs and biofeedback. In those who fail conservative treatment, and who have a substantial sphincter disruption, elective repair may be attempted. The results of primary and elective repair may deteriorate with time. Sacral nerve stimulation may be an appropriate alternative treatment modality. Obstetric anal sphincter damage, and related fecal incontinence, are common. Risk factors for such trauma are well recognized, and should allow for reduction of injury by proactive

  6. Persistent perineal sinus. Incidence, pathogenesis, risk factors, and management

    International Nuclear Information System (INIS)

    Lohsiriwat, V.

    2009-01-01

    This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)

  7. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes.

    Science.gov (United States)

    Murphy, C; Livingstone, I; Foot, B; Murgatroyd, H; MacEwen, C J

    2014-11-01

    Orbital cellulitis is a potentially blinding and life-threatening condition. There are little published data on the incidence of orbital cellulitis and little is known about the differences between children and adults affected. The purpose of this study was to identify the incidence, aetiology, management and outcome of orbital cellulitis in children and adults in Scotland. This study was a 1-year prospective observational study using the Scottish Ophthalmic Surveillance Unit reporting system among Scottish ophthalmologists. The response rate from ophthalmologists was 66.4%. There were 15 children and 5 adults reported giving an incidence of 1.6 per 100 000 and 0.1 per 100 000 in children and adults, respectively. 47% of children had a preceding upper respiratory tract infection with 87% having radiological evidence of sinus disease. Within the adult group, there was preceding immunosuppression and trauma. Streptococcus (66%) and Haemophilus (46%) species were the most commonly isolated pathogens in children. Respiratory pathogens were less predictable in adults. All patients were treated with intravenous antibiotics. All children with orbital and subperiosteal abscesses had surgery; one adult with orbital abscess did not have surgery. There were two cases of series morbidity: one intracranial spread of infection and one evisceration. The incidence of orbital cellulitis is higher in children than in adults. In children, it commonly follows upper respiratory infection and sinus disease; however, in adults, preceding illness and trauma are more common. Respiratory pathogens are common in affected children. Intravenous antibiotics and surgical treatment of abscesses remain the preferred management. 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.

  8. Management of response to the polonium-210 incident in London

    International Nuclear Information System (INIS)

    Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger

    2008-01-01

    On the 23 November 2006, Alexander Litvinenko died in London allegedly from poisoning by 210 Po, an alpha particle emitter. The spread of radioactive contamination, arising from the poisoning and the events leading up to it, involved many locations in London. The potential for intakes of 210 Po arising from the contamination posed a public health risk and generated significant public concern. The scale of the event required a multi-agency response, including top level UK Government emergency response management arrangements. The Health Protection Agency (HPA) had a leading role in co-ordinating and managing the public health response. This paper reviews the management of the incident response and the issues involved. The fatal poisoning of Mr Litvinenko with 210 Po, and the associated public health hazard from the spread of contamination to many locations across London, was an unprecedented event. Fortunately, no one else is known to have suffered any acute effects. Results from the programme of individual monitoring showed that whilst more than 100 people had measurable intakes of 210 Po, only 17 had assessed doses in excess of 6 mSv. The highest dose of about 100 mSv gives rise to an increased risk of fatal cancer of about 0.5%, compared with the natural incidence of about 25%. The incident required a co-ordinated and sustained multi-agency emergency response. The Health Protection Agency, as the lead on public health matters played a significant role in this. Whilst inevitably some lessons have been identified, the response is considered to have been very effective and to have benefited from the wide spectrum of experience and expertise developed through normal work, together with the effort put into emergency preparedness and the various emergency response. (author)

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

    Science.gov (United States)

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

    2013-09-01

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

  10. [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.

  11. Towards Incidence Management in 5G Based on Situational Awareness

    Directory of Open Access Journals (Sweden)

    Lorena Isabel Barona López

    2017-01-01

    Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.

  12. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  13. Improvements to information management systems simulator

    Science.gov (United States)

    Bilek, R. W.

    1972-01-01

    The performance of personnel in the augmentation and improvement of the interactive IMSIM information management simulation model is summarized. With this augmented model, NASA now has even greater capabilities for the simulation of computer system configurations, data processing loads imposed on these configurations, and executive software to control system operations. Through these simulations, NASA has an extremely cost effective capability for the design and analysis of computer-based data management systems.

  14. Simulation of Solar Radiation Incident on Horizontal and Inclined Surfaces

    Directory of Open Access Journals (Sweden)

    MA Basunia

    2012-12-01

    Full Text Available A computer model was developed to simulate the hourly, daily and monthly average of daily solar radiation on horizontal and inclined surfaces. The measured hourly and daily solar radiation was compared with simulated radiation, and favourable agreement was observed for the measured and predicted values on clear days. The measured and simulated monthly averages of total (diffuse and beam daily solar radiation were compared and a reasonable agreement was observed for a number of stations in Japan. The simulation showed that during the rice harvesting season, September to October, there is a daily average of 14.7 MJ/m2 of solar irradiation on a horizontal surface in Matsuyama, Japan. There is a similar amount of solar radiation on a horizontal surface during the major rice harvesting season, November to December, in Bangladesh. This radiation can be effectively utilized for drying rough rice and other farm crops.

  15. Lessons Learnt from the Improvement of Customer Support Processes: A Case Study on Incident Management

    Science.gov (United States)

    Jäntti, Marko

    IT Infrastructure Library (ITIL) is the most widely used IT service management framework that provides guidelines how to create, manage and support IT services. Service support processes, such as incident management and problem management, are among the first ITIL processes that organizations start to implement. However, several challenges may exist in the process implementation. The research question of this study is: which issues are important in establishing an ITIL-based incident management process? The main contribution of this paper is to present lessons learnt from an ITIL-based process improvement project that focused on establishing an incident management process in an IS department of a university hospital. Our results show that key issues in implementing incident management are to 1) define the basic concepts of incident management with concrete examples and 2) define process interfaces between incident management and other support processes.

  16. Human factors simulation in construction management education

    Science.gov (United States)

    Jaeger, M.; Adair, D.

    2010-06-01

    Successful construction management depends primarily on the representatives of the involved construction project parties. In addition to effective application of construction management tools and concepts, human factors impact significantly on the processes of any construction management endeavour. How can human factors in construction management be taught effectively? Although simulations are applied in construction management education, they have not incorporated human factors sufficiently. The focus on human factors as part of the simulation of construction management situations increases students' learning effectiveness within a cross-cultural teaching setting. This paper shows the development of discrete-event human factors in construction management simulation. A description of the source code is given. Learning effectiveness in a cross-cultural education setting was analysed by evaluating data obtained through student questionnaire surveys. The mean score obtained by the students using the simulator was 32% better than those not exposed to the simulator. The spread of results was noticeably greater for the students not exposed to the simulator. The human factors simulation provides an effective means to teach students the complexities and dynamics of interpersonal relationships in construction management.

  17. Simulation of the Paks-2 incident. The CODEX-CT-1 experiment

    International Nuclear Information System (INIS)

    Windberg, P.; Hozer, Z.; Nagy, I.; Vimi, A.

    2006-01-01

    The Paks-2 cleaning tank incident was simulated with an electrically heated fuel bundle in the CODEX facility. The test conditions included seven hours of oxidation in hydrogen rich steam and final water quenching of the brittle fuel rods. The final state of the bundle showed similar picture that was observed after the incident at the power plant in 2003. (author)

  18. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

    Science.gov (United States)

    Naradko, Anthony M.

    2017-01-01

    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  19. Sensitivity analysis for oblique incidence reflectometry using Monte Carlo simulations

    DEFF Research Database (Denmark)

    Kamran, Faisal; Andersen, Peter E.

    2015-01-01

    profiles. This article presents a sensitivity analysis of the technique in turbid media. Monte Carlo simulations are used to investigate the technique and its potential to distinguish the small changes between different levels of scattering. We present various regions of the dynamic range of optical...

  20. Non-medical aspects of civilian-military collaboration in management of major incidents.

    Science.gov (United States)

    Khorram-Manesh, A; Lönroth, H; Rotter, P; Wilhelmsson, M; Aremyr, J; Berner, A; Andersson, A Nero; Carlström, E

    2017-10-01

    Disasters and major incidents demand a multidisciplinary management. Recent experiences from terrorist attacks worldwide have resulted in a search for better assessment of the needs, resources, and knowledge in the medical and non-medical management of these incidents and also actualized the need for collaboration between civilian and military healthcare. The aim of this study was to evaluate the impact of the civilian-military collaboration in a Swedish context with the main focus on its non-medical management. An exercise, simulating a foreign military attack centrally on Swedish soil, was designed, initiated, and conducted by a team consisting of civilian and military staff. Data were collected prospectively and evaluated by an expert team. Specific practical and technical issues were presented in collaboration between civilian and military staffs. In addition, shortcomings in decision-making, follow-up, communication, and collaboration due to prominent lack of training and exercising the tasks and positions in all managerial levels of the hospital were identified. Current social and political unrests and terror attacks worldwide necessitate civilian-military collaboration. Such collaboration, however, needs to be synchronized and adjusted to avoid preventable medical and non-medical consequences. Simulation exercises might be one important source to improve such collaboration.

  1. Simulation modeling for the health care manager.

    Science.gov (United States)

    Kennedy, Michael H

    2009-01-01

    This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

  2. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

    2017-01-01

    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  3. In situ simulation: Taking reported critical incidents and adverse events back to the clinic

    DEFF Research Database (Denmark)

    Juul, Jonas; Paltved, Charlotte; Krogh, Kristian

    2014-01-01

    improve patient safety if coupled with training and organisational support2. Insight into the nature of reported critical incidents and adverse events can be used in writing in situ simulation scenarios and thus lead to interventions that enhance patient safety. The patient safety literature emphasises...... well-developed non-technical skills in preventing medical errors3. Furthermore, critical incidents and adverse events reporting systems comprise a knowledgebase to gain in-depth insights into patient safety issues. This study explores the use of critical incidents and adverse events reports to inform...... in situ simulation to improve patient safety. Design and purpose The study uses a case study design of in situ simulation training tailored to two emergency departments in the Central Denmark Region. We aim to: - Develop a model that integrates critical incidents and adverse events, a contextual needs...

  4. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...

  5. monetary policy and macroeconomic management: a simulation ...

    African Journals Online (AJOL)

    Admin

    Endogenous. Xa. Agricultural export. Endogenous. Lma. Capital goods import. Endogenous. Lmb. Consumer goods import. Exogenous. Ms money supply. Exogenous. Cremn. Credit to manufacturing sector. Exogenous. MONETARY POLICY AND MACROECONOMIC MANAGEMENT: A SIMULATION EXPERIMENT. 5 ...

  6. Buffer Management Simulation in ATM Networks

    Science.gov (United States)

    Yaprak, E.; Xiao, Y.; Chronopoulos, A.; Chow, E.; Anneberg, L.

    1998-01-01

    This paper presents a simulation of a new dynamic buffer allocation management scheme in ATM networks. To achieve this objective, an algorithm that detects congestion and updates the dynamic buffer allocation scheme was developed for the OPNET simulation package via the creation of a new ATM module.

  7. Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management.

    Science.gov (United States)

    Fang, Fang; Sun, Hongwei; Wang, Zuowei; Ren, Ming; Calabrese, Joseph R; Gao, Keming

    2016-09-01

    Somnolence is a common side effect of antipsychotics. To assess the incidence of this side effect, we performed a MEDLINE search for randomized, double-blinded, placebo- or active-controlled studies of adult patients treated with antipsychotics for schizophrenia, mania, bipolar depression, or bipolar disorder. We extracted rates of somnolence from original publications and pooled them based on the dose of each antipsychotic in the same psychiatric condition, then estimated the absolute risk increase (ARI) and the number needed to harm (NNH) of an antipsychotic relative to placebo or an active comparator in the same psychiatric condition. According to the ARI in acute schizophrenia, bipolar mania, and bipolar depression, antipsychotics can be classified as high somnolence (clozapine), moderate somnolence (olanzapine, perphenazine, quetiapine, risperidone, ziprasidone), and low somnolence (aripiprazole, asenapine, haloperidol, lurasidone, paliperidone, cariprazine). The risk of somnolence with blonanserin, brexpiprazole, chlorpromazine, iloperidone, sertindole, and zotepine needs further investigation. The rates of somnolence were positively correlated to dose and duration for some antipsychotics, but not for others. Many factors, including antipsychotic per se, the method used to measure somnolence, patient population, study design, and dosing schedule, might affect the incidence of antipsychotic-induced somnolence. The mechanisms of antipsychotic-induced somnolence are likely multifactorial, although the blockade of histamine 1 receptors and α1 receptors may play a major role. The management of antipsychotic-induced somnolence should include sleep hygiene education, choosing an antipsychotic with a lower risk for somnolence, starting at a lower dose with a slower titration based on psychiatric diagnoses, adjusting doses when necessary, and minimizing concurrent somnolence-prone agents. Since most cases of somnolence were mild to moderate, allowing tolerance to

  8. STUDY OF INCIDENCE & MANAGEMENT OF PARA PHARYNGEAL TUMORS

    Directory of Open Access Journals (Sweden)

    Aruna Kumari

    2015-11-01

    Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less

  9. 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.

  10. Structural Composites Corrosive Management by Computational Simulation

    Science.gov (United States)

    Chamis, Christos C.; Minnetyan, Levon

    2006-01-01

    A simulation of corrosive management on polymer composites durability is presented. The corrosive environment is assumed to manage the polymer composite degradation on a ply-by-ply basis. The degradation is correlated with a measured Ph factor and is represented by voids, temperature, and moisture which vary parabolically for voids and linearly for temperature and moisture through the laminate thickness. The simulation is performed by a computational composite mechanics computer code which includes micro, macro, combined stress failure, and laminate theories. This accounts for starting the simulation from constitutive material properties and up to the laminate scale which exposes the laminate to the corrosive environment. Results obtained for one laminate indicate that the ply-by-ply managed degradation degrades the laminate to the last one or the last several plies. Results also demonstrate that the simulation is applicable to other polymer composite systems as well.

  11. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges.

    Science.gov (United States)

    Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J

    2017-12-01

    To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.

  12. Policies for managing emergency medical services in mass casualty incidents.

    Science.gov (United States)

    Adini, B; Bodas, M; Nilsson, H; Peleg, K

    2017-09-01

    Diverse decision-making is needed in managing mass casualty incidents (MCIs), by emergency medical services (EMS). The aim of the study was to review consensus among international experts concerning policies of EMS management during MCIs. Applicability of 21 EMS policies was tested through a 2-cycle modified e-Delphi process, in which 38 multi-disciplinary experts from 10 countries participated. Threshold for approving proposed solutions was defined as consensus of >80%. Policies that did not achieve the targeted consensus were reviewed to detect variability according to respondents' origin country. 16 policies were endorsed in the first cycle including collaboration between ambulance service providers; implementing a unified mode of operation; preparing criteria for ground versus aerial evacuation; and, developing support systems for caregivers exposed to violence. An additional policy which proposed that senior EMS officers should not necessarily act as on-site MCI commanders was endorsed in the second cycle. Demographic breakdown of views concerning non-consensual policies revealed differences according to countries of origin. Assigning ambulances to off-duty team members was highly endorsed by experts from Israel and South Africa and strongly rejected by European respondents. Avoiding entry to risk areas until declared safe was endorsed by European, Asian and Oceanic experts, but rejected by Israeli, South African and North American experts. Despite uniqueness of countries and EMS agencies, solutions to most dilemmas were applicable to all organizations, regardless of location or affiliation. Cultural diversity was found concerning readiness to implement military-civilian collaboration in MCIs and a rigid separation between work-leisure responsibilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Management practices associated with the incidence rate of clinical mastitis.

    Science.gov (United States)

    Barkema, H W; Schukken, Y H; Lam, T J; Beiboer, M L; Benedictus, G; Brand, A

    1999-08-01

    Risk factors for the incidence rate of clinical mastitis were studied in 274 Dutch dairy herds. Variables that were associated with resistance to disease were the feeding, housing, and milking machine factors. Variables that were associated with exposure were grazing, combined housing of dry cows and heifers, and calving area hygiene. Postmilking teat disinfection in herds with a low bulk milk somatic cell count and years of practicing dry cow therapy were positively associated with the incidence rate of clinical mastitis. Herds with a low bulk milk somatic cell count and in which postmilking teat disinfection was not used had lower incidence rates of clinical mastitis than did other herds. The incidence rate of clinical mastitis caused by Escherichia coli was mostly related to housing conditions, hygiene, and machine milking. The incidence rate of clinical mastitis caused by Staphylococcus aureus was mostly related to factors associated with bulk milk somatic cell count and factors that might be due to cause and effect reversal. A strong positive correlation existed between the incidence rate of clinical mastitis caused by Streptococcus dysgalactiae and the incidence rate of clinical mastitis caused by Staph. aureus. The incidence rate of clinical mastitis caused by Streptococcus dysgalactiae was related to nutrition, milking technique, and machine milking. The incidence rate of clinical mastitis caused by Streptococcus uberis was associated with factors related to housing, nutrition, and machine milking.

  14. Simulation of the effect of incline incident angle in DMD Maskless Lithography

    Science.gov (United States)

    Liang, L. W.; Zhou, J. Y.; Xiang, L. L.; Wang, B.; Wen, K. H.; Lei, L.

    2017-06-01

    The aim of this study is to provide a simulation method for investigation of the intensity fluctuation caused by the inclined incident angle in DMD (digital micromirror device) maskless lithography. The simulation consists of eight main processes involving the simplification of the DMD aperture function and light propagation utilizing the non-parallel angular spectrum method. These processes provide a possibility of co-simulation in the spatial frequency domain, which combines the microlens array and DMD in the maskless lithography system. The simulation provided the spot shape and illumination distribution. These two parameters are crucial in determining the exposure dose in the existing maskless lithography system.

  15. Incidence, diagnosis and management of eye affections in dogs ...

    African Journals Online (AJOL)

    A retrospective study of ocular affections in dogs was conducted at some selected clinics and hospitals in Southwest Nigeria between 2003 and, 2013 to determine the incidence, pattern of distribution, methods of diagnosis and treatment modalities using descriptive statistical tool. Overall incidence of eye affection in dogs ...

  16. The World Trade Center attack. Helping the helpers: the role of critical incident stress management.

    Science.gov (United States)

    Hammond, J; Brooks, J

    2001-12-01

    Healthcare and prehospital workers involved in disaster response are susceptible to a variety of stress-related psychological and physical sequelae. Critical incident stress management, of which critical incident stress debriefing is a component, can mitigate the response to these stressors. Critical incident stress debriefing is a peer-driven, therapist-guided, structured, group intervention designed to accelerate the recovery of personnel. The attack on the World Trade Center, and the impact it may have on rescue, prehospital, and healthcare workers, should urge us to incorporate critical incident stress management into disaster management plans.

  17. Major incident medical management and support the practical approach at the scene

    CERN Document Server

    Advanced Life Support Group

    2012-01-01

    Major Incident Medical Management and Support (MIMMS) is the coursebook for the Advanced Life Support Group's internationally taught training for health care professionals responding to major incidents. The practical approach employed in MIMMS has proved an invaluable aid to both civilian and military doctors, nurses and paramedics working in disaster management worldwide.

  18. Project managing your simulator DCS upgrade

    International Nuclear Information System (INIS)

    Carr, S.

    2006-01-01

    The intention of this paper is to provide helpful information and tips for the purchaser with regard to the project management of a DCS upgrade for an existing nuclear power station operator-training simulator. This paper was written shortly after STS Powergen completed two nuclear power station simulator DCS projects in the USA. Areas covered by this paper are: - Contractual documents and arrangements; - Licence and Escrow agreements; - Liquidated damages; - Project management; - Project schedules and resources; - Monitoring progress; - Defect reporting; - DCS automation code; - Access to proprietary information; - Tips for project meetings; - Testing; - Cultural issues; - Training

  19. Use of simulators in severe accident management

    International Nuclear Information System (INIS)

    Evans, R.C.

    1994-01-01

    The U.S. nuclear utility industry is moving in a deliberate fashion through a coordinated industry severe accident working group to study and augment, where appropriate, the existing utility organizational and emergency planning structure to address accident and severe accident management. Full-scope simulators are used extensively to train licensed operators for their initial license examinations and continually thereafter in licensed operator requalification training and yearly examinations. The goal of the training (both initial and requalification) is to ensure that operators possess adequate knowledge, skills and abilities to prevent an event from progressing to core damage. The use of full-scope simulators in severe accident management training is in large part viewed by the industry as being premature. The working group study has not progressed to the point where the decision to employ full-scope simulators can be logically considered. It is not however premature to consider part-task or work station simulators as invaluable research tools to support the industry's study. These simulators could be employed, subject to limitations in the current state of knowledge regarding severe accident progression and phenomenological responses, in the validation and verification (V and V) of severe accident models or codes as they are developed. The U.S. nuclear utility industry has made substantial strides in the past 12 years in the accident prevention, mitigation and management arena. These strides are a product of the industry's preference for a logical and systematic approach to change. (orig.)

  20. A remotely piloted aircraft system in major incident management: concept and pilot, feasibility study.

    Science.gov (United States)

    Abrahamsen, Håkon B

    2015-06-10

    Major incidents are complex, dynamic and bewildering task environments characterised by simultaneous, rapidly changing events, uncertainty and ill-structured problems. Efficient management, communication, decision-making and allocation of scarce medical resources at the chaotic scene of a major incident is challenging and often relies on sparse information and data. Communication and information sharing is primarily voice-to-voice through phone or radio on specified radio frequencies. Visual cues are abundant and difficult to communicate between teams and team members that are not co-located. The aim was to assess the concept and feasibility of using a remotely piloted aircraft (RPA) system to support remote sensing in simulated major incident exercises. We carried out an experimental, pilot feasibility study. A custom-made, remotely controlled, multirotor unmanned aerial vehicle with vertical take-off and landing was equipped with digital colour- and thermal imaging cameras, a laser beam, a mechanical gripper arm and an avalanche transceiver. We collected data in five simulated exercises: 1) mass casualty traffic accident, 2) mountain rescue, 3) avalanche with buried victims, 4) fisherman through thin ice and 5) search for casualties in the dark. The unmanned aerial vehicle was remotely controlled, with high precision, in close proximity to air space obstacles at very low levels without compromising work on the ground. Payload capacity and tolerance to wind and turbulence were limited. Aerial video, shot from different altitudes, and remote aerial avalanche beacon search were streamed wirelessly in real time to a monitor at a ground base. Electromagnetic interference disturbed signal reception in the ground monitor. A small remotely piloted aircraft can be used as an effective tool carrier, although limited by its payload capacity, wind speed and flight endurance. Remote sensing using already existing remotely piloted aircraft technology in pre

  1. Walk the talk: leaders' enacted priority of safety, incident reporting, and error management.

    Science.gov (United States)

    Van Dyck, Cathy; Dimitrova, Nicoletta G; de Korne, Dirk F; Hiddema, Frans

    2013-01-01

    The main goal of the current research was to investigate whether and how leaders in health care organizations can stimulate incident reporting and error management by "walking the safety talk" (enacted priority of safety). Open interviews (N = 26) and a cross-sectional questionnaire (N = 183) were conducted at the Rotterdam Eye Hospital (REH) in The Netherlands. As hypothesized, leaders' enacted priority of safety was positively related to incident reporting and error management, and the relation between leaders' enacted priority of safety and error management was mediated by incident reporting. The interviews yielded rich data on (near) incidents, the leaders' role in (non)reporting, and error management, grounding quantitative findings in concrete case descriptions. We support previous theorizing by providing empirical evidence showing that (1) enacted priority of safety has a stronger relationship with incident reporting than espoused priority of safety and (2) the previously implied positive link between incident reporting and error management indeed exists. Moreover, our findings extend our understanding of behavioral integrity for safety and the mechanisms through which it operates in medical settings. Our findings indicate that for the promotion of incident reporting and error management, active reinforcement of priority of safety by leaders is crucial. Social sciences researchers, health care researchers and health care practitioners can utilize the findings of the current paper in order to help leaders create health care systems characterized by higher incident reporting and more constructive error handling.

  2. Virtual engine management simulator for educational purposes

    Science.gov (United States)

    Drosescu, R.

    2017-10-01

    This simulator was conceived as a software program capable of generating complex control signals, identical to those in the electronic management systems of modern spark ignition or diesel engines. Speed in rpm and engine load percentage defined by throttle opening angle represent the input variables in the simulation program and are graphically entered by two-meter instruments from the simulator central block diagram. The output signals are divided into four categories: synchronization and position of each cylinder, spark pulses for spark ignition engines, injection pulses and, signals for generating the knock window for each cylinder in the case of a spark ignition engine. The simulation program runs in real-time so each signal evolution reflects the real behavior on a physically thermal engine. In this way, the generated signals (ignition or injection pulses) can be used with additionally drivers to control an engine on the test bench.

  3. Management of resources at major incidents and disasters in relation to patient outcome: a pilot study of an educational model.

    Science.gov (United States)

    Nilsson, Heléne; Rüter, Anders

    2008-06-01

    Organizations involved in disaster response often have a defined operative level of management (command and control) that can take the overall decisions regarding the mobilization and distribution of resources and distribution of casualties. This level of management can be referred to as strategic management. The aim of this pilot study was to show the possibility, in simulation exercises, to relate decisions made regarding resources to patient outcome. The simulation system used measures to determine if lifesaving interventions are performed in time or not in relation to patient outcome. Evaluation was made with sets of performance indicators as templates and all management groups were evaluated not only as to how the decisions were made (management skills), but also how staff work was performed (staff procedure skills). Owing to inadequate response and insufficient distribution of patients to hospitals, 11 'patients' died in the simulated incident, a fire at a football stand with subsequent collapse. The strategic level of management received 16 points out of a possible 22 according to a predesigned template of performance indicators. The pilot study demonstrated the possibility to, in simulation exercises, relate decisions made regarding resources to patient outcome. This training technique could possibly lead to increased knowledge in what decisions are crucial to make in an early phase to minimize mortality and morbidity.

  4. Acute Appendicitis: Incidence and Management in Nigeria | Alatise ...

    African Journals Online (AJOL)

    Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life.

  5. The Critical Incident Technique in Library and Information Management Research.

    Science.gov (United States)

    Fisher, Shelagh; Oulton, Tony

    1999-01-01

    Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…

  6. Incidence, Pattern and Management of Ovarian Cancer at a Tertiary ...

    African Journals Online (AJOL)

    Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku‑Ozalla 1Department of. Histopathology, University of ... ovarian cancer giving an incidence rate of 1/405 gynecological admissions per year or 0.3% (95% .... not found in the records. Follow up of patients was by clinical examination and.

  7. Interactive simulation of technology management foresight

    DEFF Research Database (Denmark)

    Hansen, Mette Sanne; Rasmussen, Lauge Baungaard; Jacobsen, Peter

    2013-01-01

    Two of the main foresight challenges are how to handle complexity and uncertainty of evolving technology tracks, which may merge and create new challenges for the management of a company in order to avoid sub- optimization. Complexity refers to the difficulty of identifying and quantifying causal...... as a number of intervening stakeholders at different levels of technology management in an organization. Uncertainty comprises lack of knowledge in addition to variable responses of management to identical technological tracks. The purpose of this paper is to identify and reflect on the obstacles...... and possibilities of using the combination of narrative and numerical simulation to explore uncertainties and complexities of technology development and implementation in companies. Foresight as a method to develop technology management strategies can hardly be organized as a separated step by step procedure...

  8. Partially coherent X-ray wavefront propagation simulations including grazing-incidence focusing optics.

    Science.gov (United States)

    Canestrari, Niccolo; Chubar, Oleg; Reininger, Ruben

    2014-09-01

    X-ray beamlines in modern synchrotron radiation sources make extensive use of grazing-incidence reflective optics, in particular Kirkpatrick-Baez elliptical mirror systems. These systems can focus the incoming X-rays down to nanometer-scale spot sizes while maintaining relatively large acceptance apertures and high flux in the focused radiation spots. In low-emittance storage rings and in free-electron lasers such systems are used with partially or even nearly fully coherent X-ray beams and often target diffraction-limited resolution. Therefore, their accurate simulation and modeling has to be performed within the framework of wave optics. Here the implementation and benchmarking of a wave-optics method for the simulation of grazing-incidence mirrors based on the local stationary-phase approximation or, in other words, the local propagation of the radiation electric field along geometrical rays, is described. The proposed method is CPU-efficient and fully compatible with the numerical methods of Fourier optics. It has been implemented in the Synchrotron Radiation Workshop (SRW) computer code and extensively tested against the geometrical ray-tracing code SHADOW. The test simulations have been performed for cases without and with diffraction at mirror apertures, including cases where the grazing-incidence mirrors can be hardly approximated by ideal lenses. Good agreement between the SRW and SHADOW simulation results is observed in the cases without diffraction. The differences between the simulation results obtained by the two codes in diffraction-dominated cases for illumination with fully or partially coherent radiation are analyzed and interpreted. The application of the new method for the simulation of wavefront propagation through a high-resolution X-ray microspectroscopy beamline at the National Synchrotron Light Source II (Brookhaven National Laboratory, USA) is demonstrated.

  9. Incident angle dependence of reactions between graphene and hydrogen atom by molecular dynamics simulation

    International Nuclear Information System (INIS)

    Saito, Seiki; Nakamura, Hiroaki; Ito, Atsushi

    2010-01-01

    Incident angle dependence of reactions between graphene and hydrogen atoms are obtained qualitatively by classical molecular dynamics simulation under the NVE condition with modified Brenner reactive empirical bond order (REBO) potential. Chemical reaction depends on two parameters, i.e., polar angle θ and azimuthal angle φ of the incident hydrogen. From the simulation results, it is found that the reaction rates strongly depend on polar angle θ. Reflection rate becomes larger with increasing θ, and the θ dependence of adsorption rate is also found. The θ dependence is caused by three dimensional structure of the small potential barrier which covers adsorption sites. φ dependence of penetration rate is also found for large θ. (author)

  10. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection and han...

  11. Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

    Science.gov (United States)

    Brunton, Margaret Ann; Jeffrey, Lynn Maud

    2010-01-01

    This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

  12. Integrated Simulation Of Supply Chain Management

    Directory of Open Access Journals (Sweden)

    N.Manikandan

    2013-06-01

    Full Text Available Nowadays, manufacturers face the challenge of reducing manufacturing cycle time, delivery lead time and inventory reduction. Every organization has its own objectives and its own way of decision making processes. Because of the conflictions among the objectives of each organization and non-integrated decision making processes, there has been a need for a new mechanism, which help to resolve those conflictions and to integrate processes. In the early 1990s, management is a process of integrating and utilizing suppliers, manufacturers, warehouses and retailers, so that goods are produced and delivered at the right quantities and at the right time while minimizing costs as well as satisfying customer requirements. Managing the entire supply chain becomes a key factor for the successful business. Organizations now realize that non-integrated manufacturing processes, nonintegrated distribution processes and poor relationships with suppliers and customers are in adequate for their success. The supply chain areas are affected by the organization’s plan. The organization plan’s impact on the supply chain areas cannot be predicted before its execution. Simulation paves way to evaluate the performance of plans before the execution of the plan. This paper describes the effort of developing a simulation model for the supply chain management in an industry. This article discusses the requirement of supply chain simulation modeling.

  13. Managing Macroeconomic Risks by Using Statistical Simulation

    Directory of Open Access Journals (Sweden)

    Merkaš Zvonko

    2017-06-01

    Full Text Available The paper analyzes the possibilities of using statistical simulation in the macroeconomic risks measurement. At the level of the whole world, macroeconomic risks are, due to the excessive imbalance, significantly increased. Using analytical statistical methods and Monte Carlo simulation, the authors interpret the collected data sets, compare and analyze them in order to mitigate potential risks. The empirical part of the study is a qualitative case study that uses statistical methods and Monte Carlo simulation for managing macroeconomic risks, which is the central theme of this work. Application of statistical simulation is necessary because the system, for which it is necessary to specify the model, is too complex for an analytical approach. The objective of the paper is to point out the previous need for consideration of significant macroeconomic risks, particularly in terms of the number of the unemployed in the society, the movement of gross domestic product and the country’s credit rating, and the use of data previously processed by statistical methods, through statistical simulation, to analyze the existing model of managing the macroeconomic risks and suggest elements for a management model development that will allow, with the lowest possible probability and consequences, the emergence of the recent macroeconomic risks. The stochastic characteristics of the system, defined by random variables as input values defined by probability distributions, require the performance of a large number of iterations on which to record the output of the model and calculate the mathematical expectations. The paper expounds the basic procedures and techniques of discrete statistical simulation applied to systems that can be characterized by a number of events which represent a set of circumstances that have caused a change in the system’s state and the possibility of its application in the field of assessment of macroeconomic risks. The method has no

  14. 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

  15. Agent-Based Simulations for Project Management

    Science.gov (United States)

    White, J. Chris; Sholtes, Robert M.

    2011-01-01

    Currently, the most common approach used in project planning tools is the Critical Path Method (CPM). While this method was a great improvement over the basic Gantt chart technique being used at the time, it now suffers from three primary flaws: (1) task duration is an input, (2) productivity impacts are not considered , and (3) management corrective actions are not included. Today, computers have exceptional computational power to handle complex simulations of task e)(eculion and project management activities (e.g ., dynamically changing the number of resources assigned to a task when it is behind schedule). Through research under a Department of Defense contract, the author and the ViaSim team have developed a project simulation tool that enables more realistic cost and schedule estimates by using a resource-based model that literally turns the current duration-based CPM approach "on its head." The approach represents a fundamental paradigm shift in estimating projects, managing schedules, and reducing risk through innovative predictive techniques.

  16. Simulation Data Management - Requirements and Design Specification

    Energy Technology Data Exchange (ETDEWEB)

    Clay, Robert L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Friedman-Hill, Ernest J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gibson, Marcus J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hoffman, Edward L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Olson, Kevin H. [Science Applications International Corporation (SAIC), Reston, VA (United States); Laney, Daniel [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-11-01

    Simulation Data Management (SDM), the ability to securely organize, archive, and share analysis models and the artifacts used to create them, is a fundamental requirement for modern engineering analysis based on computational simulation. We have worked separately to provide secure, network SDM services to engineers and scientists at our respective laboratories for over a decade. We propose to leverage our experience and lessons learned to help develop and deploy a next-generation SDM service as part of a multi-laboratory team. This service will be portable across multiple sites and platforms, and will be accessible via a range of command-line tools and well-documented APIs. In this document, we’ll review our high-level and low-level requirements for such a system, review one existing system, and briefly discuss our proposed implementation.

  17. Large data management and systematization of simulation

    International Nuclear Information System (INIS)

    Ueshima, Yutaka; Saitho, Kanji; Koga, James; Isogai, Kentaro

    2004-01-01

    In the advanced photon research large-scale simulations are powerful tools. In the numerical experiments, real-time visualization and steering system are thought as hopeful methods of data analysis. This approach is valid in the stereotype analysis at one time or short-cycle simulation. In the research for an unknown problem, it is necessary that the output data can be analyzed many times because profitable analysis is difficult at the first time. Consequently, output data should be filed to refer and analyze at any time. To support the research, we need the followed automatic functions, transporting data files from data generator to data storage, analyzing data, tracking history of data handling, and so on. The Large Data Management system will be functional Problem Solving Environment distributed system. (author)

  18. Incidence and management of biliary leakage after hepaticojejunostomy

    NARCIS (Netherlands)

    de Castro, Steve M. M.; Kuhlmann, Koert F. D.; Busch, Olivier R. C.; van Delden, Otto M.; Laméris, Johan S.; van Gulik, Thomas M.; Obertop, Hugo; Gouma, Dirk J.

    2005-01-01

    This study analyzes the change in the management of biliary leakage after hepaticojejunostomy. Between 1993 and 2003 all patients (n = 1033) were studied with a hepaticojejunostomv as part of a pancreatoduodenectomy (n = 486), proximal bile duct resection (without liver resection) (n = 35), and

  19. Experimental simulation of the Paks-2 cleaning tank incident through separate effect and integral tests

    Energy Technology Data Exchange (ETDEWEB)

    Hozer, Z., E-mail: hozer@aeki.kfki.h [Hungarian Academy of Sciences KFKI Atomic Energy Research Institute, H-1525 Budapest, P.O. Box 49 (Hungary); Horvath, M.; Kunstar, M.; Matus, L.; Nagy, I.; Novotny, T.; Perez-Fero, E.; Pinter-Csordas, A.; Ver, N.; Vimi, A.; Windberg, P. [Hungarian Academy of Sciences KFKI Atomic Energy Research Institute, H-1525 Budapest, P.O. Box 49 (Hungary)

    2011-03-15

    Following the ex-core cleaning of VVER type fuel assemblies, a severe fuel damage took place at the Paks NPP. Assemblies with high decay heat remained without cooling for 7 h. As a common result of high temperature oxidation and final water quenching the assemblies were broken and the fuel rods fragmented. In order to improve the understanding of the phenomena that took place during the Paks-2 incident, several series of separate effect and integral tests have been carried out. The separate effect tests investigated the phenomena related to the upward shift of fuel assemblies, to the role of the spacer grid and the spring in the loss of cladding integrity, and to the importance of high hydrogen content in the vessel's atmosphere on the embrittlement of zirconium. Integral tests were carried out in the CODEX facility to simulate the whole scenario of the incident using electrically heated fuel rods.

  20. 76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

    Science.gov (United States)

    2011-10-04

    ...). 11. Division/Group Supervisor. 12. Unit Leader. 13. Strike Team/Task Force Leader. 14. Technical... Teams AGENCY: Federal Emergency Management Agency; DHS. ACTION: Notice of availability; request for comments. SUMMARY: The All-Hazard Position Task Books for Type 3 Incident Management Teams were developed...

  1. [Preclinical and intrahospital management of mass casualties and terrorist incidents].

    Science.gov (United States)

    Franke, A; Bieler, D; Friemert, B; Kollig, E; Flohe, S

    2017-10-01

    Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care. There is a need to adapt the known established medical structure for a conventional mass casualty situation to the special requirements that are raised by this new kind of terrorist threat to our social life. It is the aim of this article, from a surgical point of view, to depict the tactics and challenges of preclinical care of the special kind of terrorist attack-related injuries from the site of the incident, via the advanced medical post or casualty collecting point, to the triage point at the hospital. The special needs of medical care and organizational aspects of the primary treatment in the hospital are highlighted and possible decisional options and different approaches are discussed.

  2. Hanford solid waste management system simulation

    International Nuclear Information System (INIS)

    Shaver, S.R.; Armacost, L.L.; Konynenbelt, H.S.; Wehrman, R.R.

    1994-12-01

    This paper describes systems analysis and simulation model development for a proposed solid waste management system at a U.S. Department of Energy Site. The proposed system will include a central storage facility, four treatment facilities, and three disposal sites. The material managed by this system will include radioactive, hazardous, and mixed radioactive and hazardous wastes. The objective of the modeling effort is to provide a means of evaluating throughput and capacity requirements for the proposed treatment, storage, and disposal facilities. The model is used to evaluate alternative system configurations and the effect on the alternatives of changing waste stream characteristics and receipt schedules. An iterative modeling and analysis approach is used that provides macro-level models early in the project and establishes credibility with the customer. The results from the analyses based on the macro models influence system design decisions and provide information that helps focus subsequent model development. Modeling and simulation of alternative system configurations and operating strategies yield a better understanding of the solid waste system requirements. The model effectively integrates information obtained through systems analysis and waste characterization to provide a consistent basis for system and facility planning

  3. Cognitive simulation of incident risks in the structure of loading and transport enterprise

    Science.gov (United States)

    Shishkina, S. V.; Pristupa, Yu D.; Pavlova, L. D.; Fryanov, V. N.

    2017-09-01

    Organizational and technical system of a manufacturing enterprise was identified, which includes three subsystems: main production, industrial and social infrastructure. Based on the results of cognitive modeling, significant system concepts were identified that reduce the risks of incidents. The internal control influences formed in accordance with level of competence of heads of services, departments, sections, dispatchers, acting on the basis of regulations, job profiles. The second concept influencing the enterprise management system is personnel, which is assessed by the compliance of competencies of crane operators, loader operators, slingers, loaders, and acceptance/delivery agents to job responsibilities and labor functions. At a low level of professional competencies, the personnel does not fully comply with job duties and labor functions, the risk of an incident is maximal. The application of cognitive modeling allows us to identify the essential elements that ensure stable functioning of the system as a whole.

  4. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment

    Science.gov (United States)

    2017-12-01

    Traffic incidents have long been recognized as the main contributor to congestion in highway networks. Thus, contending with non-recurrent congestion has been a priority task for most highway agencies over the past decades. Under most incident scenar...

  5. Control systems, personnel policies and management initiatives to limit pollution incidents

    International Nuclear Information System (INIS)

    Martin, B.F.

    1991-01-01

    After the regulatory requirements are met, an important collateral step in the continuing Hazardous Waste/Environmental Management cycle of activities is to minimize the possibility of a pollution incident, spill, contamination, mislabeling, mishandling or exposure, since this minimizes a major contingent liability of the company. Human failure accounts for 88% of accidents, 10% occur from mechanical failure and only 2% are unpreventable force majeure. This implies that fully 98% of all accidents can be prevented or minimized. Good engineering, production, management and educational practices can be formulated to minimize the occurrence and effects of accidental pollution incidents. Hazardous Material/Environmental Management tends to focus on technical and regulatory objectives, a reactionary mode caused in part by the rapidly changing regulatory environment and the need to continually adapt to these changes. Management functions such as personnel management and situational management get shortchanged in research and in practice. What is needed is a system that incorporates change readily, adapts personnel to change easily and mobilizes all the human resources of a company in meeting environmental and regulatory goals in the same way other goals of the company are met. Feedback Loop/Control System concepts have been applied to management practice in the popular Management By Objectives School as well as other schools of management practice. An Environmental Management program is proposed which incorporates feedback loop/ control systems to facilitate operations and training objectives and requirements. By incorporating Environmental and Hazardous Waste goals with other management goals in a system involving all levels of management and workers on the same team, the proposed system will reduce the probability of accidental pollution incidents and thus the contingent liability of a spill or other incident

  6. Air Force Critical Incident Stress Management outreach with Pentagon staff after the terrorist attack.

    Science.gov (United States)

    Rowan, Anderson B

    2002-09-01

    This article describes the Critical Incident Stress Management outreach to Pentagon staff conducted after the terrorist attack by a team of Air Force mental health and chaplain personnel. Also discussed are lessons learned from the author's experience while leading the mental health component and working in a larger tri-service outreach. Finally, the observed impacts of the outreach effort are examined along with recommendations for future postcritical incident outreach efforts.

  7. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  8. An open source simulator for water management

    Science.gov (United States)

    Knox, Stephen; Meier, Philipp; Selby, Philip; Mohammed, Khaled; Khadem, Majed; Padula, Silvia; Harou, Julien; Rosenberg, David; Rheinheimer, David

    2015-04-01

    Descriptive modelling of water resource systems requires the representation of different aspects in one model: the physical system including hydrological inputs and engineered infrastructure, and human management, including social, economic and institutional behaviours and constraints. Although most water resource systems share some characteristics such as the ability to represent them as a network of nodes and links, geographical, institutional and other differences mean that invariably each water system functions in a unique way. A diverse group is developing an open source simulation framework which will allow model developers to build generalised water management models that are customised to the institutional, physical and economical components they are seeking to model. The framework will allow the simulation of complex individual and institutional behaviour required for the assessment of real-world resource systems. It supports the spatial and hierarchical structures commonly found in water resource systems. The individual infrastructures can be operated by different actors while policies are defined at a regional level by one or more institutional actors. The framework enables building multi-agent system simulators in which developers can define their own agent types and add their own decision making code. Developers using the framework have two main tasks: (i) Extend the core classes to represent the aspects of their particular system, and (ii) write model structure files. Both are done in Python. For task one, users must either write new decision making code for each class or link to an existing code base to provide functionality to each of these extension classes. The model structure file links these extension classes in a standardised way to the network topology. The framework will be open-source and written in Python and is to be available directly for download through standard installer packages. Many water management model developers are unfamiliar

  9. Managing shoreline assessment data during the Lake Wabamun incident

    Energy Technology Data Exchange (ETDEWEB)

    Lamarche, A. [Environmental Performance and Decision Support, Montreal, PQ (Canada); Martin, V. [Eastern Canada Response Corp. Ltd., Vercheres, PQ (Canada)

    2009-07-01

    A freight train derailed near the shore of Lake Wabamun near Edmonton in August 2003, spilling about 750 m{sup 3} of heavy Bunker C oil on the lakeshore. The nature and extent of oiling was assessed over a period of 3 consecutive summers using a variety of techniques. Surface oiling along the shore was evaluated using the Shoreline Cleanup Assessment Team (SCAT) approach, with some modifications to consider local conditions. Oiling conditions of the submerged tar ball oil in the shallow near shore waters was evaluated in the summer of 2006. Several computerized functions were developed in order to provide reports and maps of the submerged oil conditions, so that the treatment team could remove most of the oil before the next reed growing season. The location of all observations were recorded using GPS. Lake Wabamun includes the following along its shores: industry which uses the lake water for cooling purposes; a provincial park; a First-nations reservation; and private residences. Since all survey data was made available to the general public, it had to be detailed and easy to understand. This paper described how some of the data management issues were addressed within the framework of the shoreline assessment organization. 6 refs., 3 tabs., 13 figs.

  10. A computerized business simulation for dental practice management.

    Science.gov (United States)

    Willis, D O; Smith, J R; Golden, P

    1997-10-01

    Computerized simulations have been used for many years for teaching principles of management in business schools. This paper describes the development of a computerized business simulation for use in dental school practice management courses. The simulation is in a competitive game format. It requires students to formulate strategies and to implement management decisions that reinforce and fulfill that strategy. Participants use the outcomes of these decisions to formulate new management decisions for the upcoming period. Student response to participation in the simulation has been positive, with students indicating that participation is valuable for developing better understanding of analytical business management techniques and interpersonal techniques such as group process and leadership skills.

  11. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  12. Simulation as a hospital management support tool

    Directory of Open Access Journals (Sweden)

    Nemesio Rodrigues Capocci

    2017-07-01

    Full Text Available This study aims to demonstrate the use of the discrete event simulation technique as a hospital management support tool, as well as all complex processes existing in a health unit. There must be an analysis of the system as a whole from the perspective of service level provided to patients regarding waiting times. The role of this technique is to show the behavior of a given system. Data were collected from employees of a public Polyclinic, located in a city of the greater São Paulo, by means of interviews which questions were prepared to determine the time spent in the processes of the service system. Such data were inserted in the software Arena in flowchart format for analysis and identification of the problem. Since the person responsible for the screening process was overloaded, thus causing longer waiting times for patients submitted for screening, some changes were made in the model in order to propose an improvement, to balance the occupancy levels of the health unit’s staff and, at the same time, reach a shorter withdrawal period of patients throughout the system. Results showed a significant improvement in the performance of the Polyclinic’s system, as well as a subsequent improvement in the level of service provided to patients. Based on this study, one can note that simulation allows for evaluating scenarios and projecting changes that will impact the behavior of a certain system with no physical changes, thus preventing the lack of scientific basis when making management decisions and allowing for improvements.

  13. Business Simulations in Financial Management Courses: Implications for Higher Education

    Science.gov (United States)

    Wolmarans, H. P.

    2006-01-01

    Business simulations provide a teaching method that typically yields (1) more hands-on experience, (2) a higher level of excitement, (3) a higher noise level (and yet a lower incidence of problems), and (4) more commitment than traditional methods of teaching (McLure 1997, 3). Business simulations are experiential learning opportunities that have…

  14. Simulation of the impact of dangerous road incidents on driver’s loss of time on express roads

    Directory of Open Access Journals (Sweden)

    Strzebrakowska Barbara

    2017-01-01

    Full Text Available Incidents on roads are an important factor in traffic flow disruption and a consequent loss of time for drivers. Disruptions can be the result of unexpected road incidents or planned repair works after an incident. These situations differ in the availability of information about the incidents and the resulting rerouting undertaken by drivers. The first part of the paper presents a literature review on the impact of road incidents on traffic and driver’s loss of time modelling. Statistical analysis of the database of road incidents on motorways and express roads in the region of Pomorskie was conducted. The average time of arrival of emergency services to a scene and the average time of the rescue action were determined. Simulation research on road incidents was performed for different scenarios with modifications of traffic volume, duration of the road incidents and the degree of road section capacity limitations in various options. The simulation was performed by PTV VISUM software, with the DUE (Dynamic User Equilibrium module for dynamic traffic modelling. The result of the research is the estimation of the average loss of time for the different variants of the incident, which enabled building a model of the driver’s loss of time for specified event parameters.

  15. Two incidents that changed quality management in the Australian livestock export industry

    Directory of Open Access Journals (Sweden)

    Peter R. Stinson

    2008-03-01

    Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  16. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

    Science.gov (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

    2014-07-01

    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Cardiac measures of nuclear power plant operator stress during simulated incident and accident scenarios.

    Science.gov (United States)

    Pakarinen, Satu; Korpela, Jussi; Torniainen, Jari; Laarni, Jari; Karvonen, Hannu

    2018-03-01

    Maintaining optimal performance in demanding situations is challenged by stress-induced alterations in performance. Here, we quantified the stress of nuclear power plant (NPP) operators (N = 20) during a full-scale simulator training for incident and accident scenarios. We compared the ambulatory electrocardiography measurements of heart rate (HR) and heart rate variability (HRV), and self-reported stress during baselines and simulated scenarios. Perceived (scale 0-10) and physiologically measured stress were low during baseline after the scenarios and normal NPP operation (means 1.8-2.2, mean HR 75-80 bpm). During a cognitively challenging scenario simulating a sensor malfunction, the operators' stress was mild to moderate (mean 3.4; HR + 12% from baseline). During simulations of severe accidents of fire and radioactive steam leakage, the experienced stress and cardiac activity were on a moderate to high level (means 4.2 and 4.6; HR + 23% and + 14% from baseline, respectively). Cardiac activity paralleled the self-reported stress: correlation of self-reported stress to HR was 0.61 (p < .001) and to HRV features RMSSD, HF, LF/HF, SD1, and SD1/SD2 were -0.26, -0.28, 0.35, -0.40, and -0.39 (p < .01), respectively. The low shared variance (22%) between HR and physical activity further support the interpretation that the cardiac activity was strongly linked to the experience of stress and not accountable by operators' movement within the simulator. Cardiac measurements in naturalistic settings can thus reveal relevant information on acute stress with the benefit of not interrupting the primary task. © 2018 The Authors. Psychophysiology published by Wiley Periodicals, Inc. on behalf of Society for Psychophysiological Research.

  18. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  19. Automated input data management in manufacturing process simulation

    OpenAIRE

    Ettefaghian, Alireza

    2015-01-01

    Input Data Management (IDM) is a time consuming and costly process for Discrete Event Simulation (DES) projects. Input Data Management is considered as the basis of real-time process simulation (Bergmann, Stelzer and Strassburger, 2011). According to Bengtsson et al. (2009), data input phase constitutes on the average about 31% of the time of an entire simulation project. Moreover, the lack of interoperability between manufacturing applications and simulation software leads to a high cost to ...

  20. Using immersive simulation for training first responders for mass casualty incidents.

    Science.gov (United States)

    Wilkerson, William; Avstreih, Dan; Gruppen, Larry; Beier, Klaus-Peter; Woolliscroft, James

    2008-11-01

    A descriptive study was performed to better understand the possible utility of immersive virtual reality simulation for training first responders in a mass casualty event. Utilizing a virtual reality cave automatic virtual environment (CAVE) and high-fidelity human patient simulator (HPS), a group of experts modeled a football stadium that experienced a terrorist explosion during a football game. Avatars (virtual patients) were developed by expert consensus that demonstrated a spectrum of injuries ranging from death to minor lacerations. A group of paramedics was assessed by observation for decisions made and action taken. A critical action checklist was created and used for direct observation and viewing videotaped recordings. Of the 12 participants, only 35.7% identified the type of incident they encountered. None identified a secondary device that was easily visible. All participants were enthusiastic about the simulation and provided valuable comments and insights. Learner feedback and expert performance review suggests that immersive training in a virtual environment has the potential to be a powerful tool to train first responders for high-acuity, low-frequency events, such as a terrorist attack.

  1. Drones at the service for training on mass casualty incident: A simulation study.

    Science.gov (United States)

    Fernandez-Pacheco, Antonio Nieto; Rodriguez, Laura Juguera; Price, Mariana Ferrandini; Perez, Ana Belen Garcia; Alonso, Nuria Perez; Rios, Manuel Pardo

    2017-06-01

    Mass casualty incidents (MCI) are characterized by a large number of victims with respect to the resources available. In this study, we aimed to analyze the changes produced in the self-perception of students who were able to visualize aerial views of a simulation of a MCI. A simulation study, mixed method, was performed to compare the results from an ad hoc questionnaire. The 35 students from the Emergency Nursing Master from the UCAM completed a questionnaire before and after watching an MCI video with 40 victims in which they had participated. The main variable measured was the change in self-perception (CSP). The CSP occurred in 80% (28/35) of the students (P = .001). Students improved their individual (P = .001) and group (P = .006) scores. They also described that their personal performance had better results than the group performance (P = .047). The main conclusion of this study is that drones could lead to CSP and appraisal of the MCI simulation participants.

  2. Analysis of performance and stress caused by a simulation of a mass casualty incident.

    Science.gov (United States)

    Nieto Fernández-Pacheco, Antonio; Castro Delgado, Rafael; Arcos González, Pedro; Navarro Fernández, José Luis; Cerón Madrigal, José Joaquín; Juguera Rodriguez, Laura; Perez Alonso, Nuria; Armero-Barranco, David; Lidon López Iborra, María; Damian, Escribano Tortosa; Pardo Rios, Manuel

    2018-03-01

    To determine the stress that is potentially produced in professional health workers due to a mass casualty incident (MCI) simulated exercise, and its relation to prior academic training and the role played in the simulation. Observational study of stress in a MCI. For this work, two MCI drills comprised of 40 victims each were conducted. Two randomized groups of 36 students each were created: Master's Students Group (MSG) and Undergraduate Student Group (USG). The role performed by each student (triage or sectorization) was assessed. The stress level was determined by prior and subsequent measurements of alpha-amylase (αA), HR, SBP and DBP. The percentage of victims that were correctly triaged was 88.6%, 91.84% for MSG and 83.76% for the USG (p=0.004). The basal αA was 97,107.50±72,182.67IU/L and the subsequent αA was 136,195.55±90,176.46±IU/L (pperformed the triage and those who performed sectorization but there were no differences between undergraduate and Masters' students. Conducting a simulated exercise caused stress in personnel involved in the MCI, with a greater impact on participants who performed triage, although it was not influenced by their prior academic level. The stress level in our case did not affect or determine the performance of acquired skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  4. Applying the concept of network enabled capabilities to incident management in the Netherlands

    NARCIS (Netherlands)

    Immers, L.H.; Huisken, G.

    2008-01-01

    The application of Incident Management to the Dutch road network suffers from serious problems in terms of availability of accurate and up-to-date information. In this paper we present an approach aimed at diminishing the occurrence of misunderstandings. This approach is based on the concept of

  5. Smothering in UK free-range flocks. Part 1: incidence, location, timing and management.

    Science.gov (United States)

    Barrett, J; Rayner, A C; Gill, R; Willings, T H; Bright, A

    2014-07-05

    Smothering in poultry is an economic and welfare-related concern. This study presents the first results from a questionnaire addressing the incidence, location, timing and management of smothering of free-range farm managers from two commercial egg companies (representing 35 per cent of the UK free-range egg supply). Overall, nearly 60 per cent of farm mangers experienced smothering in their last flock, with an average of 25.5 birds lost per incidence, although per cent mortality due to smothering was low (x̄=1.6 per cent). The majority of farm managers also reported that over 50 per cent of all their flocks placed had been affected by smothering. The location and timing of smothering (excluding smothering in nest boxes) tended to be unpredictable and varied between farms. Blocking off corners/nest boxes and walking birds more frequently were identified as popular smothering reduction measures, although there was a wide variety of reduction measures reported overall. The motivation to implement reduction measures was related to a farm manager's previous experience of smothering. To our knowledge, this is the first study to provide a representative industry estimate on the incidence, location, timing and management of smothering. The results suggest that smothering is a common problem, unpredictable between flocks with no clear, effective reduction strategies. A follow-up study will investigate the correlations among smothering, disease and other welfare problems and may shed further light on management solutions. British Veterinary Association.

  6. Errors in the management of cardiac arrests: an observational study of patient safety incidents in England.

    Science.gov (United States)

    Panesar, Sukhmeet S; Ignatowicz, Agnieszka M; Donaldson, Liam J

    2014-12-01

    The aim of this qualitative study is to better understand the types of error occurring during the management of cardiac arrests that led to a death. All patient safety incidents involving management of cardiac arrests and resulting in death which were reported to a national patient safety database over a 17-month period were analysed. Structured data from each report were extracted and these together with the free text, were subjected to content analysis which was inductive, with the coding scheme emerged from continuous reading and re-reading of incidents. There were 30 patient safety incidents involving management of cardiac arrests and resulting in death. The reviewers identified a main shortfall in the management of each cardiac arrest and this resulted in 12 different factors being documented. These were grouped into four themes that highlighted systemic weaknesses: miscommunication involving crash number (4/30, 13%), shortfalls in staff attending the arrest (4/30, 13%), equipment deficits (11/30, 36%), and poor application of knowledge and skills (11/30, 37%). The factors identified represent serious shortfalls in the quality of response to cardiac arrests resulting in death in hospital. No firm conclusion can be drawn about how many deaths in the study population would have been averted if the emergency had been managed to a high standard. The effective management of cardiac arrests should be considered as one of the markers of safe care within a healthcare organisation.

  7. Computers in radiology. The sedation, analgesia, and contrast media computerized simulator: a new approach to train and evaluate radiologists' responses to critical incidents

    Energy Technology Data Exchange (ETDEWEB)

    Medina, L.S.; Racadio, J.M. [Dept. of Radiology, Children' s Hospital Medical Center, Cincinnati, OH (United States); Schwid, H.A. [Dept. of Anesthesia, Veterans Administration Medical Center, University of Washington, Seattle, WA (United States)

    2000-05-01

    Background. Awareness and preparedness to handle sedation, analgesia, and contrast-media complications are key in the daily radiology practice. Objective. The purpose is to create a computerized simulator (PC-Windows-based) that uses a graphical interface to reproduce critical incidents in pediatric and adult patients undergoing a wide spectrum of radiologic sedation, analgesia and contrast media complications. Materials and methods. The computerized simulator has a comprehensive set of physiologic and pharmacologic models that predict patient response to management of sedation, analgesia, and contrast-media complications. Photorealistic images, real-time monitors, and mouse-driven information demonstrate in a virtual-reality fashion the behavior of the patient in crisis. Results. Thirteen pediatric and adult radiology scenarios are illustrated encompassing areas such as pediatric radiology, neuroradiology, interventional radiology, and body imaging. The multiple case scenarios evaluate randomly the diagnostic and management performance of the radiologist in critical incidents such as oversedation, anaphylaxis, aspiration, airway obstruction, apnea, agitation, bronchospasm, hypotension, hypertension, cardiac arrest, bradycardia, tachycardia, and myocardial ischemia. The user must control the airway, breathing and circulation, and administer medications in a timely manner to save the simulated patient. On-line help is available in the program to suggest diagnostic and treatment steps to save the patient, and provide information about the medications. A printout of the case management can be obtained for evaluation or educational purposes. Conclusion. The interactive computerized simulator is a new approach to train and evaluate radiologists' responses to critical incidents encountered during radiologic sedation, analgesia, and contrast-media administration. (orig.)

  8. Computers in radiology. The sedation, analgesia, and contrast media computerized simulator: a new approach to train and evaluate radiologists' responses to critical incidents

    International Nuclear Information System (INIS)

    Medina, L.S.; Racadio, J.M.; Schwid, H.A.

    2000-01-01

    Background. Awareness and preparedness to handle sedation, analgesia, and contrast-media complications are key in the daily radiology practice. Objective. The purpose is to create a computerized simulator (PC-Windows-based) that uses a graphical interface to reproduce critical incidents in pediatric and adult patients undergoing a wide spectrum of radiologic sedation, analgesia and contrast media complications. Materials and methods. The computerized simulator has a comprehensive set of physiologic and pharmacologic models that predict patient response to management of sedation, analgesia, and contrast-media complications. Photorealistic images, real-time monitors, and mouse-driven information demonstrate in a virtual-reality fashion the behavior of the patient in crisis. Results. Thirteen pediatric and adult radiology scenarios are illustrated encompassing areas such as pediatric radiology, neuroradiology, interventional radiology, and body imaging. The multiple case scenarios evaluate randomly the diagnostic and management performance of the radiologist in critical incidents such as oversedation, anaphylaxis, aspiration, airway obstruction, apnea, agitation, bronchospasm, hypotension, hypertension, cardiac arrest, bradycardia, tachycardia, and myocardial ischemia. The user must control the airway, breathing and circulation, and administer medications in a timely manner to save the simulated patient. On-line help is available in the program to suggest diagnostic and treatment steps to save the patient, and provide information about the medications. A printout of the case management can be obtained for evaluation or educational purposes. Conclusion. The interactive computerized simulator is a new approach to train and evaluate radiologists' responses to critical incidents encountered during radiologic sedation, analgesia, and contrast-media administration. (orig.)

  9. 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.

  10. 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.

  11. Analysis of Incident and Accident Reports and Risk Management in Spine Surgery.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Morozumi, Masayoshi; Nishida, Yoshihiro; Nagao, Yoshimasa; Ishiguro, Naoki

    2017-08-01

    A review of accident and incident reports. To analyze prevalence, characteristics, and details of perioperative incidents and accidents in patients receiving spine surgery. In our institution, a clinical error that potentially results in an adverse event is usually submitted as an incident or accident report through a web database, to ensure anonymous and blame-free reporting. All reports are analyzed by a medical safety management group. These reports contain valuable data for management of medical safety, but there have been no studies evaluating such data for spine surgery. A total of 320 incidents and accidents that occurred perioperatively in 172 of 415 spine surgeries were included in the study. Incidents were defined as events that were "problematic, but with no damage to the patient," and accidents as events "with damage to the patient." The details of these events were analyzed. There were 278 incidents in 137 surgeries and 42 accidents in 35 surgeries, giving prevalence of 33% (137/415) and 8% (35/415), respectively. The proportion of accidents among all events was significantly higher for doctors than non-doctors [68.0% (17/25) vs. 8.5% (25/295), P < 0.01] and in the operating room compared with outside the operating room [40.5% (15/37) vs. 9.5% (27/283), P < 0.01]. There was no significant difference in years of experience among personnel involved in all events. The major types of events were medication-related, line and tube problems, and falls and slips. Accidents also occurred because of a long-term prone position, with complications such as laryngeal edema, ulnar nerve palsy, and tooth damage. Surgery and procedures in the operating room always have a risk of complications. Therefore, a particular effort is needed to establish safe management of this environment and to provide advice on risk to the doctor and medical care team. 4.

  12. [Incidence and management of ectopic pregnancy in Iceland 2000-2009].

    Science.gov (United States)

    Baldvinsdottir, Áslaug; Gudmundsson, Jens A; Geirsson, Reynir Tómas

    2013-12-01

    Ectopic pregnancy can be life-threatening. Its treatment has changed radically during the last two decades. The study objective was to evaluate incidence and treatment of ectopic pregnancy in the Icelandic population during the decade 2000-2009. Information was collected about all diagnosed cases, place and method of treatment and admissions. The annual incidence was calculated with reference to number of pregnancies (n/1000), number of women aged 15-44 years (n/10 000) and by 5-year age groups, comparing the periods 2000-2004 and 2005-2009. The number of ectopic pregnancies during these 10 years was 836, or 444 during the years 2000-2004 and 392 during 2005-2009. The average annual incidence was 15.6/1000 pregnancies and 12.9/10 000 women. There was an annual incidence reduction from 17.3 to 14.1/1000 pregnancies (ptreatment for 94.9% of women, methotrexate in 3.2% and expectant management in 1.9%. Surgical management decreased from 98.0% to 91.3% between 5-year periods as medical treatment increased (0.4% to 6.4%; pectopic pregnancy is comparable to the development in neighbouring countries. Management has changed with increased use of laparoscopic surgery, medical and expectant treatment.

  13. Study and Simulation of the Density of the Incident Solar Flux on the Walls of a Building in Adrar, Algeria

    Directory of Open Access Journals (Sweden)

    A. Oudrane

    2017-10-01

    Full Text Available In this work, we studied the effect of external climatic conditions on the evolution of the daily solar flux incident on the walls of a building located at Adrar region in the South of Algeria. This building is designed for heating or air conditioning applications. Numerical simulations allowed to compare the variation of the incident solar flux over a full day on the south, east, north and west walls of the building to the values of the solar flux on a horizontal wall (the outer ceiling. The horizontal global solar flux is calculated using a Gaussian sinusoidal function. The simulations were carried out in the case of a building located in a desert zone. The results of the numerical simulation showed the effect of the orientation of the building on the evolution of the incident daily solar flux.

  14. A Framework for Understanding Learning from Management Simulations.

    Science.gov (United States)

    Tonks, David; Armitage, S.

    1997-01-01

    Proposes a framework for understanding aspects of learning from computer-based management simulations based on research with MBA (Masters of Business Administration) students in three European business schools that identified students' perceptions of learning outcomes from experience using computer-based management simulations. Learning style and…

  15. PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

    Directory of Open Access Journals (Sweden)

    Vjeran Strahonja

    2007-06-01

    Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.

  16. Human Factors Simulation in Construction Management Education

    Science.gov (United States)

    Jaeger, M.; Adair, D.

    2010-01-01

    Successful construction management depends primarily on the representatives of the involved construction project parties. In addition to effective application of construction management tools and concepts, human factors impact significantly on the processes of any construction management endeavour. How can human factors in construction management…

  17. A Dynamic Simulation Game (UNIGAME) for Strategic University Management.

    Science.gov (United States)

    Barlas, Yaman; Diker, Vedat Guclu

    2000-01-01

    Presents an interactive simulation model on which the academic aspects of university management can be analyzed and alternative management strategies tested. Focuses specifically on long-term, dynamic, strategic management problems and yields performance measures about the fundamental activities in a university that can support strategic…

  18. Applied simulation to the project management: a review

    Directory of Open Access Journals (Sweden)

    Leonardo Rosas Leal

    2011-05-01

    Full Text Available The objective of this article is to show a literature review of Applied Simulation to the Project Management as for the last twenty years. This article reviews the main Simulation methodologies, as well as some of their properties, that have stimulated the application of Simulation in project management. Besides that, a review of historical marks is presented, since the Monte Carlo Simulation proposal as a solution to PERT/CPM methodology limitations. In addition, this work intends to outline the theme through stratifications in order to offer a holistic overview of the theme. As a result, there will be the possibility of realize some important connections and tendencies in relation to the stratifications, as the application of the Discrete Event Simulation and Monte Carlo Simulation methodologies for the schedule and cost risk management. Such applications are mainly related with high level risk projects, such as civil projects, software development, design Engineering and Oil & gas projects.

  19. Medical simulation: Overview, and application to wound modelling and management

    Directory of Open Access Journals (Sweden)

    Dinker R Pai

    2012-01-01

    Full Text Available Simulation in medical education is progressing in leaps and bounds. The need for simulation in medical education and training is increasing because of a overall increase in the number of medical students vis-à-vis the availability of patients; b increasing awareness among patients of their rights and consequent increase in litigations and c tremendous improvement in simulation technology which makes simulation more and more realistic. Simulation in wound care can be divided into use of simulation in wound modelling (to test the effect of projectiles on the body and simulation for training in wound management. Though this science is still in its infancy, more and more researchers are now devising both low-technology and high-technology (virtual reality simulators in this field. It is believed that simulator training will eventually translate into better wound care in real patients, though this will be the subject of further research.

  20. NeuroManager: A workflow analysis based simulation management engine for computational neuroscience

    Directory of Open Access Journals (Sweden)

    David Bruce Stockton

    2015-10-01

    Full Text Available We developed NeuroManager, an object-oriented simulation management software engine for computational neuroscience. NeuroManager automates the workflow of simulation job submissions when using heterogeneous computational resources, simulators, and simulation tasks. The object-oriented approach 1 provides flexibility to adapt to a variety of neuroscience simulators, 2 simplifies the use of heterogeneous computational resources, from desktops to super computer clusters, and 3 improves tracking of simulator/simulation evolution. We implemented NeuroManager in Matlab, a widely used engineering and scientific language, for its signal and image processing tools, prevalence in electrophysiology analysis, and increasing use in college Biology education. To design and develop NeuroManager we analyzed the workflow of simulation submission for a variety of simulators, operating systems, and computational resources, including the handling of input parameters, data, models, results, and analyses. This resulted in twenty-two stages of simulation submission workflow. The software incorporates progress notification, automatic organization, labeling, and time-stamping of data and results, and integrated access to Matlab's analysis and visualization tools. NeuroManager provides users with the tools to automate daily tasks, and assists principal investigators in tracking and recreating the evolution of research projects performed by multiple people. Overall, NeuroManager provides the infrastructure needed to improve workflow, manage multiple simultaneous simulations, and maintain provenance of the potentially large amounts of data produced during the course of a research project.

  1. Development of severe accident management advisory and training simulator (SAMAT)

    International Nuclear Information System (INIS)

    Jeong, K.-S.; Kim, K.-R.; Jung, W.-D.; Ha, J.-J.

    2002-01-01

    The most operator support systems including the training simulator have been developed to assist the operator and they cover from normal operation to emergency operation. For the severe accident, the overall architecture for severe accident management is being developed in some developed countries according to the development of severe accident management guidelines which are the skeleton of severe accident management architecture. In Korea, the severe accident management guideline for KSNP was recently developed and it is expected to be a central axis of logical flow for severe accident management. There are a lot of uncertainties in the severe accident phenomena and scenarios and one of the major issues for developing a operator support system for a severe accident is the reduction of these uncertainties. In this paper, the severe accident management advisory system with training simulator, SAMAT, is developed as all available information for a severe accident are re-organized and provided to the management staff in order to reduce the uncertainties. The developed system includes the graphical display for plant and equipment status, the previous research results by knowledge-base technique, and the expected plant behavior using the severe accident training simulator. The plant model used in this paper is oriented to severe accident phenomena and thus can simulate the plant behavior for a severe accident. Therefore, the developed system may make a central role of the information source for decision-making for a severe accident management, and will be used as the training simulator for severe accident management

  2. Execution Management Solutions for Geographically Distributed Simulations

    NARCIS (Netherlands)

    Berg, T.W. van den; Jansen, H.G.M.; Jansen, R.E.J.; Prins, L.M.

    2009-01-01

    Managing the initialization, execution control and monitoring of HLA federates is not always straightforward, especially for a geographically distributed time managed federation. Issues include pre and post run-time data distribution and run-time data collection; starting, stopping and monitoring

  3. Nexus: A modular workflow management system for quantum simulation codes

    Science.gov (United States)

    Krogel, Jaron T.

    2016-01-01

    The management of simulation workflows represents a significant task for the individual computational researcher. Automation of the required tasks involved in simulation work can decrease the overall time to solution and reduce sources of human error. A new simulation workflow management system, Nexus, is presented to address these issues. Nexus is capable of automated job management on workstations and resources at several major supercomputing centers. Its modular design allows many quantum simulation codes to be supported within the same framework. Current support includes quantum Monte Carlo calculations with QMCPACK, density functional theory calculations with Quantum Espresso or VASP, and quantum chemical calculations with GAMESS. Users can compose workflows through a transparent, text-based interface, resembling the input file of a typical simulation code. A usage example is provided to illustrate the process.

  4. Harris Simulator Design Description for Adaptive Distributed Network Management System

    National Research Council Canada - National Science Library

    1986-01-01

    ... (ADNMS), Naval Research Laboratory (NRL). The document describes the Harris Simulator used to support the development and test of a first generation network management algorithm for a typical SDI communications network...

  5. Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis

    Science.gov (United States)

    Carter, Holly; Amlôt, Richard

    2016-01-01

    Introduction: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents. The review focuses on five psychosocial aspects of incident management: likely public behaviour; responder management style; communication strategy; privacy/ modesty concerns; and vulnerable groups. Methods: Two structured literature reviews were carried out; one to identify decontamination guidance documents for first responders, and another to identify evidence which is relevant to the understanding of the psychosocial aspects of mass decontamination.  The guidance documents and relevant research were reviewed to identify whether the guidance documents contain information relating to psychosocial issues and where it exists, that the guidance is consistent with the existing evidence-base. Results: Psychosocial aspects of incident management receive limited attention in current decontamination guidance.  In addition, our review has identified a number of gaps and inconsistencies between guidance and research evidence.  For each of the five areas we identify: what is currently presented in guidance documents, to what extent this is consistent with the existing research evidence and where it diverges.  We present a series of evidence-based recommendations for updating decontamination guidance to address the psychosocial aspects of mass decontamination. Conclusions: Effective communication and respect for casualties’ needs are critical in ensuring

  6. Simulation Modeling of a Facility Layout in Operations Management Classes

    Science.gov (United States)

    Yazici, Hulya Julie

    2006-01-01

    Teaching quantitative courses can be challenging. Similarly, layout modeling and lean production concepts can be difficult to grasp in an introductory OM (operations management) class. This article describes a simulation model developed in PROMODEL to facilitate the learning of layout modeling and lean manufacturing. Simulation allows for the…

  7. Simulation-based modeling of building complexes construction management

    Science.gov (United States)

    Shepelev, Aleksandr; Severova, Galina; Potashova, Irina

    2018-03-01

    The study reported here examines the experience in the development and implementation of business simulation games based on network planning and management of high-rise construction. Appropriate network models of different types and levels of detail have been developed; a simulation model including 51 blocks (11 stages combined in 4 units) is proposed.

  8. The Impact of a Simulation Game on Operations Management Education

    Science.gov (United States)

    Pasin, Federico; Giroux, Helene

    2011-01-01

    This study presents a new simulation game and analyzes its impact on operations management education. The proposed simulation was empirically tested by comparing the number of mistakes during the first and second halves of the game. Data were gathered from 100 teams of four or five undergraduate students in business administration, taking their…

  9. Theoretical and computational foundations of management class simulation

    Science.gov (United States)

    Denie Gerold

    1978-01-01

    Investigations on complicated, complex, and not well-ordered systems are possible only with the aid of mathematical methods and electronic data processing. Simulation as a method of operations research is particularly suitable for this purpose. Theoretical and computational foundations of management class simulation must be integrated into the planning systems of...

  10. EDUCATIONAL PERSPECTIVES ON SIMULATED LEARNING IN WOUND MANAGEMENT

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    Aim: The aim was to explore whether simulated learning is useful in relation to wound management among undergraduate student nurses. Methods: A key element in simulated learning is to create an authentic environment. The pur-pose of establishing collaboration with a private company was to keep...

  11. Business simulations in financial management courses: Implications ...

    African Journals Online (AJOL)

    Business simulations are experiential learning opportunities that have been successfully used for higher education in a wide range of disciplines. They are also ideally suited for use in adult education, where the focus is more on facilitating learning than traditional methods of knowledge transfer are. This article reports on a ...

  12. 12 CFR 250.181 - Reports of change in control of bank management incident to a merger.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Reports of change in control of bank management... change in control of bank management incident to a merger. (a) A State member bank has inquired whether Pub. L. 88-593 (78 Stat. 940) requires reports of change in control of bank management in situations...

  13. Mathematical model as means of optimization of the automation system of the process of incidents of information security management

    Directory of Open Access Journals (Sweden)

    Yulia G. Krasnozhon

    2018-03-01

    Full Text Available Modern information technologies have an increasing importance for development dynamics and management structure of an enterprise. The management efficiency of implementation of modern information technologies directly related to the quality of information security incident management. However, issues of assessment of the impact of information security incidents management on quality and efficiency of the enterprise management system are not sufficiently highlighted neither in Russian nor in foreign literature. The main direction to approach these problems is the optimization of the process automation system of the information security incident management. Today a special attention is paid to IT-technologies while dealing with information security incidents at mission-critical facilities in Russian Federation such as the Federal Tax Service of Russia (FTS. It is proposed to use the mathematical apparatus of queueing theory in order to build a mathematical model of the system optimization. The developed model allows to estimate quality of the management taking into account the rules and restrictions imposed on the system by the effects of information security incidents. Here an example is given in order to demonstrate the system in work. The obtained statistical data are shown. An implementation of the system discussed here will improve the quality of the Russian FTS services and make responses to information security incidents faster.

  14. On the Appropriateness of Incident Management Systems in Developing Countries: A Case from the UAE

    Directory of Open Access Journals (Sweden)

    Faouzi Kamoun

    2010-12-01

    Full Text Available Road traffic incidents are eliciting growing public concerns due to their devastating social, economical, and environmental impacts. The severity of these random events is particularly alarming in developing countries, where the situation is just worsening. Recently, Incident Management Systems (IMSs have been proposed as powerful tools to enhance the coordination and management of rescue operations during traffic accidents. However, most of the available commercial IMS solutions are designed for large metropolitan cities and within the contexts of developed nations. This paper explores the issues of appropriateness and customization of IMS solutions in developing countries through an exploratory inquiry consisting of a case study from the United Arab Emirates (UAE. The paper also explores the important issues related to managing the organizational changes that an IMS introduces to the operations of the command and control room. This contribution calls for the development of more comprehensive theoretical frameworks that can guide towards the implementation of appropriate IMS solutions in developing countries. Our research highlights the need for developing countries to acquire appropriate IMS solutions that are tailored to the local organizational work context in which these systems will be used. The experience reported herein can also inspire other public safety agencies in developing countries to consider the option of developing customized IMS solutions that best suit their needs.

  15. European Clearinghouse. Incidents related to reactivity management. Contributing factors, failure modes and corrective actions

    International Nuclear Information System (INIS)

    Bruynooghe, Christiane; Noel, Marc

    2009-01-01

    This work is part of the European Clearinghouse on Nuclear Power Plant Operational Experience Feedback (NPP-OEF) activity carried out at the Joint Research Centre/Institute for Energy (JRC/IE) with the participation of nine EU Regulatory Authorities. It investigates the 1999 Shika-1 criticality event together with other shortcomings in reactivity management reported to the IAE4 Incident Reporting System in the period 1981-2008. The aim of the work was to identify reactivity control failure modes, reactor status and corrective actions. Initiating factors and associated root causes were also analysed. Five of the 7 factors identified for all events were present in the 1999 Shika-1 event where criticality has been unexpectedly reached and maintained during 15 minutes. Most of the events resulted in changes in procedures, material or staff and management training. The analysis carried out put in evidence that in several instances appropriate communication based on operational experience feedback would have prevented incident to occur. This paper also summarises the action taken at power plants and by the regulatory bodies in different countries to avoid repetition of similar events. It identifies insights that might be useful to reduce the likelihood of operational events caused by shortcomings in reactivity management. (orig.)

  16. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-04-01

    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

  18. A fire management simulation model using stochastic arrival times

    Science.gov (United States)

    Eric L. Smith

    1987-01-01

    Fire management simulation models are used to predict the impact of changes in the fire management program on fire outcomes. As with all models, the goal is to abstract reality without seriously distorting relationships between variables of interest. One important variable of fire organization performance is the length of time it takes to get suppression units to the...

  19. Simulation as a tool for managing Ebola infection

    Directory of Open Access Journals (Sweden)

    Somsri Wiwanitkit

    2015-06-01

    Full Text Available Ebola virus disease is the present deadly infection. The outbreak in Africa becomes the great concern globally. Several attempts have been launched to manage the problem since its first appearance in Africa. The use of simulations as a tool to manage the problem is very interesting. In this short article, the author briefly summarizes and discusses on this topic.

  20. Coordinating a multiple casualty Critical Incident Stress Management (CISM) response within a medical/surgical hospital setting.

    Science.gov (United States)

    Morrow, H E

    2001-01-01

    The medical/surgical hospital environment presents numerous challenges to a Critical Incident Stress Management (CISM) Team Coordinator responsible for implementing a psychological crisis intervention. Often this person is responsible for managing a response to a large in-house multiple-casualty incident, sometimes involving fatalities. Many mental health professionals have not had the opportunity to work in a medical/surgical healthcare facility and consequently are not familiar with the environment (and agency culture) that exists within these employment settings. This article will review important factors to be considered during the initial assessment of a critical incident in a hospital setting, logistical concerns that are unique to this setting, and the subsequent planning of the Critical Incident Stress Management Team crisis management response.

  1. Critical incident stress management in a school setting following police shooting of an adolescent.

    Science.gov (United States)

    Miller, Ronald L; Grueninger, Carl E

    2010-01-01

    Cincinnati Public Schools Critical Incident Stress Management Team responded when a teenager who was in possession of a pellet gun was killed by police. The themes that emerged had more to do with rage than typical bereavement or trauma responses. The primary objective was the prevention of school and community violence. Strategic planning was critical in preventing violence and responding to the changing needs of students, staff and families during the weeks following this tragedy. Team members had to consider cultural differences related to interpretation of events, grieving rituals, and expectations for appropriate behavior when planning and providing interventions.

  2. Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.

    LENUS (Irish Health Repository)

    Hargrove, M

    2012-02-03

    The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

  3. Simulation: A Complementary Method for Teaching Health Services Strategic Management

    Science.gov (United States)

    Reddick, W. T.

    1990-01-01

    Rapid change in the health care environment mandates a more comprehensive approach to the education of future health administrators. The area of consideration in this study is that of health care strategic management. A comprehensive literature review suggests microcomputer-based simulation as an appropriate vehicle for addressing the needs of both educators and students. Seven strategic management software packages are reviewed and rated with an instrument adapted from the Infoworld review format. The author concludes that a primary concern is the paucity of health care specific strategic management simulations.

  4. Monetary policy and macroeconomic management: A simulation ...

    African Journals Online (AJOL)

    The dynamic nexus between money supply, fiscal deficit, inflation, output and exchange rate management has generated much debate in economic literature in Nigeria in recent times. To contribute to this debate, this ... Thus, the study concludes that there is a trade off between higher GDP growth and inflation in Nigeria.

  5. Cognitive Simulation Driven Domestic Heating Energy Management

    NARCIS (Netherlands)

    Thilakarathne, D.J.; Treur, J.

    2016-01-01

    Energy management for domestic heating is a non trivial research challenge, especially given the dynamics associated to indoor and outdoor air temperatures, required comfortable temperature set points over time, parameters of the heating source and system, and energy loss rate and capacity of a

  6. A new vision of management competencies built in Business Simulations

    Directory of Open Access Journals (Sweden)

    Gabriel Vianna Schlatter

    2015-09-01

    Full Text Available This paper presents a survey conducted on users of an online business simulation for an undergraduate Business Administration course. Previous research on the use of business simulations described the validity of this resource as a method for developing managerial skills, as well as the perceptions of students about the experience. However, few studies sought to directly assess which management competencies are built through the use of simulators. In this study, students expressed their perception of the management competencies developed by participating in the simulation. The survey was structured according to the macro-competencies proposed by the Tuning Latin America Project and identified those with higher and lower perceived development.  It was found that the simulation was useful in building up competencies related to the use of information to support decision-making, management of company resources at the operational level and the identification and management of business risks. Moreover, it was possible to determine through factor analysis that the construction of various competencies occurred simultaneously, creating more elaborate assemblies. Five sets, composed of several competencies, have been identified and described as: carrying out undertakings based on data and facts; managing organization´s processes and projects; developing their own planning process; acting primarily with social responsibility; and, managing change risks through teamwork.

  7. Data-intensive management and analysis for scientifc simulations.

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, R.; Norris, J.; Reid, L. B.; Cal Jordan IV, G.; Weide, K.; Papka, M. E. (CLS-CI); ( MCS); (Western Australian Geothemal Centre of Excellence, CSIRO); (School of Environmental Systems Engineering, University of Western Australia)

    2011-01-01

    Scientific simulations can produce enormous amounts of data, making the analysis of results and management of files a difficult task for scientists. The simulation management and analysis system (Smaash) described here is designed to allow scientists to easily capture, store, organize, monitor, and analyze simulation results. The system is automatic, standardized, and secure. Smaash was built using open-source tools and modularized to be independent of the scientific simulation. The web-based front-end allows the scientist to easily interact with the data, and has proved its usefulness in improving the efficiency of a scientific team's workflow. High performance parallel computing allows scientists to solve complex physical problems through computer simulation. However, the massive amounts of data generated and the complex computing environment can create additional complications. A recent review by Ludaescher et al.(2009) describes how scientific workflows can assist scientists in extracting knowledge from these data-intensive operations by automating components within pipelines. Within the fusion community, Klasky et al.(2008) and colleagues have developed a system that handles the storage management, data movement, metadata generation and management, and a means to analyze the results. In response to scientists needs, a simulation management and analysis system (Smaash) was developed at the University of Chicago and Argonne National Laboratory (USA). Smaash provides an integrated way to monitor simulations and analyze computational results; catalog, store, and retrieve simulations; and prepare output for publications. The system is independent of the particular simulation code, accessible from many HPC and browser-based platforms, and built around open-source software tools. Data security and provenance is considered throughout. The analysis components are hidden behind a web-based front end, enabling scientists to focus on their results and not get bogged

  8. A pharmacy business management simulation exercise as a practical application of business management material and principles.

    Science.gov (United States)

    Rollins, Brent L; Gunturi, Rahul; Sullivan, Donald

    2014-04-17

    To implement a pharmacy business management simulation exercise as a practical application of business management material and principles and assess students' perceived value. As part of a pharmacy management and administration course, students made various calculations and management decisions in the global categories of hours of operation, inventory, pricing, and personnel. The students entered the data into simulation software and a realistic community pharmacy marketplace was modeled. Course topics included accounting, economics, finance, human resources, management, marketing, and leadership. An 18-item posttest survey was administered. Students' slightly to moderately agreed the pharmacy simulation program enhanced their knowledge and understanding, particularly of inventory management, cash flow statements, balance sheets, and income statements. Overall attitudes toward the pharmacy simulation program were also slightly positive and students also slightly agreed the pharmacy simulation program enhanced their learning of pharmacy business management. Inventory management was the only area in which students felt they had at least "some" exposure to the assessed business management topics during IPPEs/internship, while all other areas of experience ranged from "not at all" to "a little." The pharmacy simulation program is an effective active-learning exercise and enhanced students' knowledge and understanding of the business management topics covered.

  9. [Incidence of acute agitation and variation in acute agitation management by emergency services].

    Science.gov (United States)

    Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio

    2017-07-01

    To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

  10. Municipality Level Simulations of Dengue Fever Incidence in Puerto Rico Using Ground Based and Remotely Sensed Climate Data

    Science.gov (United States)

    Quattrochi, Dale A.; Morin, Cory

    2015-01-01

    Dengue fever (DF) is caused by a virus transmitted between humans and Aedes genus mosquitoes through blood feeding. In recent decades incidence of the disease has drastically increased in the tropical Americas, culminating with the Pan American outbreak in 2010 which resulted in 1.7 million reported cases. In Puerto Rico dengue is endemic, however, there is significant inter-annual, intraannual, and spatial variability in case loads. Variability in climate and the environment, herd immunity and virus genetics, and demographic characteristics may all contribute to differing patterns of transmission both spatially and temporally. Knowledge of climate influences on dengue incidence could facilitate development of early warning systems allowing public health workers to implement appropriate transmission intervention strategies. In this study, we simulate dengue incidence in several municipalities in Puerto Rico using population and meteorological data derived from ground based stations and remote sensing instruments. This data was used to drive a process based model of vector population development and virus transmission. Model parameter values for container composition, vector characteristics, and incubation period were chosen by employing a Monte Carlo approach. Multiple simulations were performed for each municipality and the results were compared with reported dengue cases. The best performing simulations were retained and their parameter values and meteorological input were compared between years and municipalities. Parameter values varied by municipality and year illustrating the complexity and sensitivity of the disease system. Local characteristics including the natural and built environment impact transmission dynamics and produce varying responses to meteorological conditions.

  11. Tick bite anaphylaxis: incidence and management in an Australian emergency department.

    Science.gov (United States)

    Rappo, Tristan B; Cottee, Alice M; Ratchford, Andrew M; Burns, Brian J

    2013-08-01

    Ticks are endemic to the eastern coastline of Australia. The aim of the present study is to describe the incidence of tick bites in such an area, the seasonal and geographical distribution, the incidence of anaphylaxis due to tick bite and its management. We retrospectively analysed emergency presentations of patients with tick bites to Mona Vale Hospital on Sydney's Northern Beaches over a 2 year period from 1 January 2007 to 1 January 2009. We recorded the geographical and seasonal distribution of tick bites as well as the symptoms from tick bite and its emergency management. We report over 500 cases of tick bites presenting to a single New South Wales hospital over a 2 year period, of which 34 resulted in anaphylaxis. Cutaneous symptoms were the most common feature associated with anaphylaxis (32/34, 94%). Forty per cent (13/34) of patients with tick bite anaphylaxis had a history of allergy or previous anaphylaxis. Seventy-six per cent (26/34) of patients were administered adrenaline either prior to presenting or in the ED, while 97% (33/34) were treated with steroids. Fifty-three per cent were referred to an immunologist and only one-quarter were discharged with an adrenaline auto-injector. We report 34 cases of tick bite anaphylaxis over a 2 year period at a single hospital in a tick endemic area. The variation in the presenting symptoms and signs, as well as in management highlights the need for increased awareness for tick bite management in tick endemic areas. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. A qualitative analysis of bus simulator training on transit incidents : a case study in Florida. [Summary].

    Science.gov (United States)

    2013-01-01

    The simulator was once a very expensive, large-scale mechanical device for training military pilots or astronauts. Modern computers, linking sophisticated software and large-screen displays, have yielded simulators for the desktop or configured as sm...

  13. [Risk management in the operation room. Results of a pilot project of interdisciplinary "incident reporting"].

    Science.gov (United States)

    Horstmann, R; Hofinger, G; Mäder, M; Gaidzik, P W; Waleczek, H

    2006-08-01

    Methods for error analysis are suitable to increase patients' safety as well as staff satisfaction and may avoid, in a sense of process control, financial damage to the hospital. The aim of the presented pilot study was to establish and evaluate an incident reporting system as a first step towards a new safety culture. In June 2003 an incident reporting system was introduced in the central surgical suite, in which the surgical and anaesthesiologic departments took part as well medical and nursing staff. Besides conceiving a report form, a "board of confidence" was elected, kick-off meetings were held and a baseline study on the basis of industrial psychological knowledge was initialised. The process of creating confidence is arduous and depends elementarily on sincere cooperation of management staff, especially of the heads of the departments. The exclusive participation of only two medical departments led to conflicts. Therefore, after finishing the pilot study, the system was expanded to the whole surgical suite including all operating departments. In order to increase the motivation for the strictly voluntarily participation, the frequency of regular echoes to the staff was optimised. To achieve high acceptance in the whole staff, the board of confidence needs a clearly defined position within the system of quality management. For the first time in Germany an incident reporting system under participation of several medical departments has been installed. After finishing the pilot project, in future we will be able to evaluate changes caused by this system. Simultaneously an electronic database for reported adverse events and strategies to avoid them are being developed based on similar systems in aviation industry. In near future, the system will be of increasing importance likewise for inpatient units and non-operative departments.

  14. The results of the simulation process management

    OpenAIRE

    E.B. Mazurin; I.I. Lapushkin; A.L. Lazarev

    2014-01-01

    The aim of the article. The goal of the article is to discuss the model of the management of main production processes (in particular case of projects in the company). The results of the analysis. As a subject of the study it is offered to use a substantial part of the process of decision-making. Scientific novelty of research is in consideration of decision-making process from the point of view of information flow interaction of regulated process with the information flow from implementat...

  15. Process simulation and parametric modeling for strategic project management

    CERN Document Server

    Morales, Peter J

    2013-01-01

    Process Simulation and Parametric Modeling for Strategic Project Management will offer CIOs, CTOs and Software Development Managers, IT Graduate Students an introduction to a set of technologies that will help them understand how to better plan software development projects, manage risk and have better insight into the complexities of the software development process.A novel methodology will be introduced that allows a software development manager to better plan and access risks in the early planning of a project.  By providing a better model for early software development estimation and softw

  16. Cyber crisis management: a decision-support framework for disclosing security incident information

    NARCIS (Netherlands)

    Kulikova, Olga; Heil, Ronald; van den Berg, Jan; Pieters, Wolter

    2012-01-01

    The growing sophistication and frequency of cyber attacks force modern companies to be prepared beforehand for potential cyber security incidents and data leaks. A proper incident disclosure strategy can significantly improve timeliness and effectiveness of incident response activities, reduce legal

  17. Developing an incident management system to support Ebola response -- Liberia, July-August 2014.

    Science.gov (United States)

    Pillai, Satish K; Nyenswah, Tolbert; Rouse, Edward; Arwady, M Allison; Forrester, Joseph D; Hunter, Jennifer C; Matanock, Almea; Ayscue, Patrick; Monroe, Benjamin; Schafer, Ilana J; Poblano, Luis; Neatherlin, John; Montgomery, Joel M; De Cock, Kevin M

    2014-10-17

    The ongoing Ebola virus disease (Ebola) outbreak in West Africa is the largest and most sustained Ebola epidemic recorded, with 6,574 cases. Among the five affected countries of West Africa (Liberia, Sierra Leone, Guinea, Nigeria, and Senegal), Liberia has had the highest number cases (3,458). This epidemic has severely strained the public health and health care infrastructure of Liberia, has resulted in restrictions in civil liberties, and has disrupted international travel. As part of the initial response, the Liberian Ministry of Health and Social Welfare (MOHSW) developed a national task force and technical expert committee to oversee the management of the Ebola-related activities. During the third week of July 2014, CDC deployed a team of epidemiologists, data management specialists, emergency management specialists, and health communicators to assist MOHSW in its response to the growing Ebola epidemic. One aspect of CDC's response was to work with MOHSW in instituting incident management system (IMS) principles to enhance the organization of the response. This report describes MOHSW's Ebola response structure as of mid-July, the plans made during the initial assessment of the response structure, the implementation of interventions aimed at improving the system, and plans for further development of the response structure for the Ebola epidemic in Liberia.

  18. Burnup management simulator for small and medium sized reactors

    International Nuclear Information System (INIS)

    Krishna Kumar, P.T.; Takeda, Toshikazu

    2011-01-01

    Highlights: → Burn up management simulator. → Small and medium Sized reactors. → Optimum choice of Fuel Cycle Length for minimum loss of burn up for the entire reactor. → Long Fuel Cycle Length makes the nuclear power plant availability factor high. - Abstract: We propose a novel burn up management simulator scheme which would maximize the discharge burn up of Small and Medium Sized Reactors (SMR) by optimum choice of Fuel Cycle Length (FCL). In this simulator, the objective being to maximize the burn up of all the subassemblies of the reactor so that burn up loss in them is a minimum and the plant availability factor is maximized. The simulator can be used both for the conventional batch refueling as well as the once through cycle schemes. Further, the designer has the option to choose a particular FCL depending upon the percentage loss in burn up.

  19. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law

  20. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  1. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  2. Development of exercise design, development and implementation protocol in the utilization of simulators for response management training

    International Nuclear Information System (INIS)

    Giesen, J. H.

    1997-01-01

    Development and operation of a marine oil spill management simulator system at Texas A and M University's Galveston Center for Marine Training and Safety was described. The Spill Management Simulator is a multi-year joint program between the U. S. Coast Guard and the Center. Essentially, it is a a computer-based modelling and scenario generator for conducting and evaluating incident management training. An independent evaluation group has been set up by the U.S.Coast Guard to evaluate the Galveston and similar programs established under the same legislation throughout the United States. This paper discusses the creation of a development and implementation protocol for Spill Management Team simulation as a foundation upon which to integrate available and future technology and for making it available to the response community as a whole. 12 refs.,1 tab., 4 figs

  3. Incidence and management of N-acetylcysteine-related anaphylactoid reactions during the management of acute paracetamol overdose.

    Science.gov (United States)

    Yamamoto, Takahiro; Spencer, Tanya; Dargan, Paul I; Wood, David M

    2014-02-01

    Adverse drug reactions (ADRs) to N-acetylcysteine (NAC) treatment for paracetamol overdose are typically anaphylactoid in origin and occur in 2-48% of treated patients. We explored the incidence and management of NAC ADR in our unit. Case notes of patients who presented with paracetamol overdose and had ADR to NAC between February 2005 and June 2011 were reviewed. A total of 1648 patients presented with suspected paracetamol overdose and 660 received NAC treatment. Within this group, 82 patients had documented NAC-related ADR. ADR developed in 12.4% (82/660) of patients receiving intravenous NAC and 59 had full documentation available and were included in this study (34 women, 25 men). ADR occurred in the 15-min (150 mg/kg) bag in 36 cases (61%), 22 in the 4-h (50 mg/kg) bag (37%) and one in the 16-h (100 mg/kg) bag (2%). Symptoms were classified as minimal (n=16, 27%), moderate (n=26, 44%) and severe (n=17, 29%). Asthma and female sex, which are reported risk factors for ADR, did not lead to the development of more severe ADR (P=0.771 and 0.330, respectively). Treatments administered included stopping the NAC infusion (n=32, 54%), administration of antiemetics (n=36, 61%), H1 antihistamines (n=26, 44%), steroids (n=16, 27%), inhaled B2 agonists (n=6, 10%) and adrenaline (n=3, 5%). The incidence of ADR to NAC was comparable with published studies, although there was no association of severity with asthma or female sex. The management of ADRs is variable, with frequent, inappropriate use of steroids. Education about the pathophysiology of these ADRs may improve management.

  4. An MCNP simulation for API applications to waste management issues

    International Nuclear Information System (INIS)

    Tunnell, L.N.

    1994-01-01

    Issues associated with waste management have increasingly become a focal point of attention for both the government and private sector since the end of the cold war. The problem are difficult to solve; the solutions are expensive to implement. Consequently, the development of a data simulation system capable of predicting the performance of a real system can save many thousands of dollars in travel expenses, optimization of experimental parameters, etc.. In this effort, computer codes were developed to simulate the production of associated particle imaging data so that its performance in a typical waste management application can be assessed

  5. Water management simulation games and the construction of knowledge

    Directory of Open Access Journals (Sweden)

    M. Rusca

    2012-08-01

    Full Text Available In recent years, simulations have become an important part of teaching activities. The reasons behind the popularity of simulation games are twofold. On the one hand, emerging theories on how people learn have called for an experienced-based learning approach. On the other hand, the demand for water management professionals has changed. Three important developments are having considerable consequences for water management programmes, which educate and train these professionals. These developments are the increasing emphasis on integration in water management, the characteristics and speed of reforms in the public sector and the shifting state-society relations in many countries. In response to these developments, demand from the labour market is oriented toward water professionals who need to have both a specialist in-depth knowledge in their own field, as well as the ability to understand and interact with other disciplines and interests. In this context, skills in negotiating, consensus building and working in teams are considered essential for all professionals. In this paper, we argue that simulation games have an important role to play in (actively educating students and training the new generation of water professionals to respond to the above-mentioned challenges. At the same time, simulations are not a panacea for learners and teachers. Challenges of using simulation games include the demands it places on the teacher. Setting up the simulation game, facilitating the delivery and ensuring that learning objectives are achieved require considerable knowledge and experience as well as considerable time-inputs of the teacher. Moreover, simulation games usually incorporate a case-based learning model, which may neglect or underemphasize theories and conceptualizations. For simulations to be effective, they have to be embedded in this larger theoretical and conceptual framework. Simulations, therefore, complement rather than substitute

  6. Water management simulation games and the construction of knowledge

    Science.gov (United States)

    Rusca, M.; Heun, J.; Schwartz, K.

    2012-08-01

    In recent years, simulations have become an important part of teaching activities. The reasons behind the popularity of simulation games are twofold. On the one hand, emerging theories on how people learn have called for an experienced-based learning approach. On the other hand, the demand for water management professionals has changed. Three important developments are having considerable consequences for water management programmes, which educate and train these professionals. These developments are the increasing emphasis on integration in water management, the characteristics and speed of reforms in the public sector and the shifting state-society relations in many countries. In response to these developments, demand from the labour market is oriented toward water professionals who need to have both a specialist in-depth knowledge in their own field, as well as the ability to understand and interact with other disciplines and interests. In this context, skills in negotiating, consensus building and working in teams are considered essential for all professionals. In this paper, we argue that simulation games have an important role to play in (actively) educating students and training the new generation of water professionals to respond to the above-mentioned challenges. At the same time, simulations are not a panacea for learners and teachers. Challenges of using simulation games include the demands it places on the teacher. Setting up the simulation game, facilitating the delivery and ensuring that learning objectives are achieved require considerable knowledge and experience as well as considerable time-inputs of the teacher. Moreover, simulation games usually incorporate a case-based learning model, which may neglect or underemphasize theories and conceptualizations. For simulations to be effective, they have to be embedded in this larger theoretical and conceptual framework. Simulations, therefore, complement rather than substitute traditional teaching

  7. Fuel management simulation for CANFLEX-RU in CANDU 6

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Chang Joon; Suk, Ho Chun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1997-12-31

    Fuel management simulations have been performed for CANFLEX-09% RU fuel in the CANDU 6 reactor. In this study, the bi-directional 4-bundle shift fuelling scheme was assumed. The lattice cell and time-average calculation were carried out. The refuelling simulation calculations were performed for 600 full power days. Time-averaged results show good axial power profile with the CANFLEX-RU fuel. During the simulation period, the maximum channel and bundle power were maintained below the licensing limit of CANDU 6 reactor. 7 refs., 4 figs. (Author)

  8. Sustainable construction building performance simulation and asset and maintenance management

    CERN Document Server

    2016-01-01

    This book presents a collection of recent research works that highlight best practice solutions, case studies and practical advice on the implementation of sustainable construction techniques. It includes a set of new developments in the field of building performance simulation, building sustainability assessment, sustainable management, asset and maintenance management and service-life prediction. Accordingly, the book will appeal to a broad readership of professionals, scientists, students, practitioners, lecturers and other interested parties.

  9. Energy Crisis Management Simulation for the State of California

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, M.A.

    1982-08-01

    The Rand Corporation hosted an energy crisis management workshop on January 27-29, 1982. The workshop was sponsored by the California Energy Commission and was designed to give participants experience in managing an energy emergency. The vehicle for providing this experience was a gaming exercise that simulated an international energy emergency. The structure of the game used in the workshop and the game results are documented.

  10. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  11. Development of the KOSMS management simulation training system and its application

    Science.gov (United States)

    Takatsu, Yoshiki

    The use of games which simulate actual corporate management has recently become more common and is now utilized in various ways for in-house corporate training courses. KOSMS (Kobe Steel Management Simulation System), a training system designed to help improve the management skills of senior management staff, is a unique management simulation training system in which the participants, using personal computers, must make decisions concerning a variety of management activities, in simulated competition with other corporations. This report outlines the KOSMS system, and describes the basic structure and detailed contents of the management simulation models, and actual application of the KOSMS management simulation training.

  12. Lithiasis in 1,313 kidney transplants: incidence, diagnosis, and management.

    Science.gov (United States)

    Ferreira Cassini, M; Cologna, A J; Ferreira Andrade, M; Lima, G J; Medeiros Albuquerque, U; Pereira Martins, A C; Tucci Junior, S

    2012-10-01

    Renal transplantation remains the optimal treatment of patients with end-stage renal disease. Urinary lithiasis represents an unusual urologic complication in renal transplantation, with an incidence of lithiasis, which does not occur in patients from living donors, owing to screening with computerized tomography. The aim of this study was to evaluate the incidence, diagnosis, and therapeutic management of renal lithiasis in transplanted kidneys at a single institution. We reviewed the medical records for 1,313 patients who underwent kidney transplantation from February 1968 to February 2011. Among the grafts, 17 patients (1.29%) had nephrolithiasis: 9 women and 8 men. Ages ranged from 32 to 63 years (mean = 45.6 years). Fifteen patients received kidneys from cadaveric and only 2 from living related donors. Two stones, both located inside the ureter, were identified during transplant surgery (11.7%). Three instances of lithiasis were incidentally diagnosed by ultrasound during graft evaluation, within 7 days after surgery (17.6%); all 3 were in the calyces. The 12 remaining patients had the stones diagnosed later (70.58%): 6 in the calyces, 3 in the renal pelvis, and 3 inside the ureter. Urinary lithiasis is a rare complication in renal transplantation. In most patients the condition occurs without pain. The diagnosis and treatment options for graft urolithiasis are similar to those patients with nephrolithiasis in the general population. Extracorporeal shock wave lithotripsy (ESWL) was the most common treatment method. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease.

    Science.gov (United States)

    Lin, C Huie; Hegde, Sanjeet; Marshall, Audrey C; Porras, Diego; Gauvreau, Kimberlee; Balzer, David T; Beekman, Robert H; Torres, Alejandro; Vincent, Julie A; Moore, John W; Holzer, Ralf; Armsby, Laurie; Bergersen, Lisa

    2014-01-01

    Continued advancements in congenital cardiac catheterization and interventions have resulted in increased patient and procedural complexity. Anticipation of life-threatening events and required rescue measures is a critical component to preprocedural preparation. We sought to determine the incidence and nature of life-threatening adverse events in congenital and pediatric cardiac catheterization, risk factors, and resources necessary to anticipate and manage events. Data from 8905 cases performed at the 8 participating institutions of the Congenital Cardiac Catheterization Project on Outcomes were captured between 2007 and 2010 [median 1,095/site (range 133-3,802)]. The incidence of all life-threatening events was 2.1 % [95 % confidence interval (CI) 1.8-2.4 %], whereas mortality was 0.28 % (95 % CI 0.18-0.41 %). Fifty-seven life-threatening events required cardiopulmonary resuscitation, whereas 9 % required extracorporeal membrane oxygenation. Use of a risk adjustment model showed that age events. Using this model, standardized life-threatening event ratios were calculated, thus showing that one institution had a life-threatening event rate greater than expected. Congenital cardiac catheterization and intervention can be performed safely with a low rate of life-threatening events and mortality; preprocedural evaluation of risk may optimize preparation of emergency rescue and bailout procedures. Risk predictors (age < 1, hemodynamic vulnerability, and procedure risk category) can enhance preprocedural patient risk stratification and planning.

  14. Incidence and management of chemotherapy-induced nausea and vomiting in women with breast cancer

    Directory of Open Access Journals (Sweden)

    Thais de Oliveira Gozzo

    Full Text Available The objective of this study was to analyze the incidence of chemotherapy-induced nausea and vomiting in women with breast cancer and identify strategies used by them to control these signs and symptoms. Data for this cross-sectional study were collected through interviews during the last cycle of chemotherapy, between August 2011 and March 2012, in a university hospital in the State of São Paulo. The sample consisted of 22 women between the ages of 31 and 70, of whom 77.3% reported nausea and 50% vomiting during treatment. Regarding symptom management, 82% of the women reported having received some information centered on the use of prescribed medication. However, 27.3% did not know what medication they had taken. We concluded that there is a lack of systematic care and institutional protocol to guide professionals in providing standardized information to women so they can better control nausea and vomiting.

  15. Simulation and management games for training command and control in emergencies.

    Science.gov (United States)

    Levi, Leon; Bregman, David

    2003-01-01

    The aim of our project was to introduce and implement simulation techniques in a problematic field of increasing health care system preparedness for disasters. This field was chosen as knowledge is gained by few experienced staff members who need to disperse it to others during the busy routine work of the system personnel. Knowledge management techniques ranging from classifying the current data, centralized organizational knowledge storage and using it for decision making and dispersing it through the organization--were used in this project. In the first stage we analyzed the current system of building a preparedness protocol (set of orders). We identified the pitfalls of changing personnel and loosing knowledge gained through lessons from local and national experience. For this stage we developed a database of resources and objects (casualties) to be used in the simulation in different possibilities. One of those was the differentiation between drills with trainer and those in front of computers enable to set the needed solution. The model rules for different scenarios of multi-casualty incidents from conventional warfare trauma to combined chemical/toxicological as well as, levels of care pre and inside hospitals--were incorporated to the database management system (we used Microsoft Access' DBMS). The hardware for management game was comprised of serial computers with network and possibility of projection of scenes. For prehospital phase the possibility of portable PC's and connections to central server was used to assess bidirectional flow of information. Simulation software (ARENA) and graphical interfase (Visual Basic, GUI) as shown in the attached figure. We hereby conclude that our system provides solutions which are in use in different levels of healthcare system to assess and improve management command and control for different scenarios of multi-casualty incidents.

  16. Simulating Variation in Order to Learn Classroom Management

    Science.gov (United States)

    Ragnemalm, Eva L.; Samuelsson, Marcus

    2016-01-01

    Classroom management is an important part of learning to be a teacher. The variation theory of learning provides the insight that it is important to vary the critical aspects of any task or subject that is to be learned. Simulation technology is useful in order to provide a controlled environment for that variation, and text as a medium gives the…

  17. Management of Wood Products Manufacturing Using Simulation/Animation

    Science.gov (United States)

    D. Earl Kline; J.K. Wiedenbeck; Philip A. Araman

    1992-01-01

    Managers of hardwood processing facilities need timely information on which to base important decisions such as when to add costly equipment or how to improve profitability subject to time-varying demands. The overall purpose of this paper is to introduce a method that can effectively provide such timely information. A simulation/animation modeling procedure is...

  18. Utilizing a Simulation Exercise to Illustrate Critical Inventory Management Concepts

    Science.gov (United States)

    Umble, Elisabeth; Umble, Michael

    2013-01-01

    Most undergraduate business students simply do not appreciate the elegant mathematical beauty of inventory models. So how does an instructor capture students' interest and keep them engaged in the learning process when teaching inventory management concepts? This paper describes a competitive and energizing in-class simulation game that introduces…

  19. Hepatic adenoma: incidence and management between the year 2002-2006 Hospital R. Calderon Guardia

    International Nuclear Information System (INIS)

    Pages Zamora, Alberto

    2008-01-01

    The incidence and management of hepatic adenoma at the Hospital Calderon Guardia are analyzed between the years 2002-2006. The main hepatic pathologies diagnosed by biopsy are shown. The relationship of hepatic adenoma with the above risk factors and presentation of each case of hepatic adenoma found are analyzed. The media diagnosed in this type of pathology were investigated. The evolution and control of each case of hepatic adenoma have been studied. The results of the management of each case are compared with the recommended in literature. The ideal management of this type of pathology is analyzed. Among the conclusions is given benign liver pathology as the most frequent cause of liver biopsy in the Hospital Calderon Guardia. Metastatic disease of the digestive tract has been the primary neoplastic disease at the hepatic level. Focal nodular hyperplasia has been the biopsy of benign tumor that is performed more frequently. Hepatic adenoma has been a rare entity, but with significant mortality rates. All cases were presented as solitary lesions. It is more common in women of childbearing age but can occur also in older people and in men. A close relationship has existed between the use of oral gestagens and the incidence of hepatic adenoma. Hepatic adenomas and its complications have been related to its size. Most cases of hepatic adenoma were presented with symptoms. The preoperative studies have shown high sensitivity in the detection of lesions, but little specificity. A protocol for the study of hepatic masses is required. A relationship between the size of the adenoma and possible complications was demonstrated. The reason for surgery in most cases has been the possibility of malignancy in the liver injury. The correlation between preoperative diagnosis and the end was unsuccessful in 75 percent of cases. The mortality related to the procedures did not exist, but if a case of morbidity. The study of liver masses should be more exhaustive to improve

  20. [Incidence and management of monozygotic twin conceived by assisted reproductive techniques].

    Science.gov (United States)

    Mo, Lijing; Jin, Congcong; Wu, Yonggen; Wang, Peiyu; Lin, Jia; Zhao, Junzhao

    2015-08-01

    To analysis the incidence and management of monozygotic twin (MZT) conceived by assisted reproductive techniques (ART). A retrospective analysis of clinical pregnancies and MZT that resulted from ART was performed in Reproductive Medical Center, the First Affiliated Hospital, Wenzhou Medical University between January 2011 and January 2014. A total of 5 908 pregnancies were diagnosed: 2 012 twins, 157 high-order multiple pregnancy (HOMP), including 4 quadruplets. Overall, 51 MZT pregnancies were identified of them including 32 cases HOMP and 19 cases MZT. The incidence of MZT resulting from cleavage-stage embryo transfer was similar to blastocyst transfer (P = 0.960). The percent of MZT resulting from in vitro fertilization [0.93% (28/3 022)], frozen-thawed embryo transfer [0.87% (13/1 502)] and intracytoplamic sperm injection [0.72% (10/1 384)] did not show statistical significance (P = 0.794). The expectantly managed MZT was associated with a significantly greater likelihood of miscarriage [6/19 vs 5.11% (101/1 976)], and low birth weight infant [73.91% (17/23) vs 42.89% (1 453/3 388), P < 0.01], when compared with dizygotic twin (DZT) did not undergo selective embryo reduction (SER). In monozygotic (MZ)-triplets with SER to 2 fetuses or to 1 fetus, there was no cases of preterm birth or low birth weight infant observed in MZ-triplets with SER to 1 fetus; when compared with MZ-triplets with SER to 2 fetuses, the low birth weight infant [56.00% (14/25), P = 0.021] has statistical significance. The likelihood of the survival of two babies was lower in MZ-triplets with SER to 2 fetuses when compared with non-MZ triplets with SER to 2 fetuses [42.86% (9/21) vs 75.21% (91/121), P = 0.003]. The incidence of MZT pregnancies following ART is high. It plays a significant role in the occurrence of HOMP. MZT pregnancies are at an increased risk of adverse outcomes, it should transform to a single embryo thansfer (SET) program to reduce them incideuce. Reduction of MZT

  1. Simulating and Communicating Outcomes in Disaster Management Situations

    Directory of Open Access Journals (Sweden)

    Michal Lichter

    2015-09-01

    Full Text Available An important, but overlooked component of disaster managment is raising the awareness and preparedness of potential stakeholders. We show how recent advances in agent-based modeling and geo-information analytics can be combined to this effect. Using a dynamic simulation model, we estimate the long run outcomes of two very different urban disasters with severe consequences: an earthquake and a missile attack. These differ in terms of duration, intensity, permanence, and focal points. These hypothetical shocks are simulated for the downtown area of Jerusalem. Outcomes are compared in terms of their potential for disaster mitigation. The spatial and temporal dynamics of the simulation yield rich outputs. Web-based mapping is used to visualize these results and communicate risk to policy makers, planners, and the informed public. The components and design of this application are described. Implications for participatory disaster management and planning are discussed.

  2. A qualitative analysis of bus simulator training on transit incidents : a case study in Florida.

    Science.gov (United States)

    2013-06-01

    The purpose of this research was to track and observe three Florida public transit agencies as they incorporated and integrated computer-based transit bus simulators into their existing bus operator training programs. In addition to the three Florida...

  3. Bleeding complications after oral surgery in outpatients with compromised haemostasis: incidence and management.

    Science.gov (United States)

    Reich, Waldemar; Kriwalsky, Marcus S; Wolf, Hans H; Schubert, Johannes

    2009-06-01

    PURPOSE AND RESULTS: The aim of this prospective study was to determine the incidence of postoperative bleeding after oral surgery under local anaesthesia performed in outpatients with haemostatic disorders within a 5-year period (2003-2007). One hundred twenty one (70 males, 51 females) out of 2,056 outpatients with different haemostatic disorders (acquired or hereditary) were included in this study. The following data were recorded: medical history and general condition; medications; indication for the surgical procedure; specification of local anaesthesia; applied surgical techniques, considering the kind of haemostatic disorder; and peri- or postoperative bleeding complications. Postoperative bleeding was observed in 12 patients (9.9%). In three cases, inpatient treatment became necessary. The management of two patients with a haemostatic disorder (von Willebrand s disease and haemophilia A) is presented in short case reports. In a heterogeneous group of 121 outpatients with known haemostatic disorders, a combination of a few haemostatic agents with appropriate operative technique enables an effective wound management. In cases of failed local interventions after postoperative bleeding, further diagnostic investigations are required.

  4. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  5. Managing health care decisions and improvement through simulation modeling.

    Science.gov (United States)

    Forsberg, Helena Hvitfeldt; Aronsson, Håkan; Keller, Christina; Lindblad, Staffan

    2011-01-01

    Simulation modeling is a way to test changes in a computerized environment to give ideas for improvements before implementation. This article reviews research literature on simulation modeling as support for health care decision making. The aim is to investigate the experience and potential value of such decision support and quality of articles retrieved. A literature search was conducted, and the selection criteria yielded 59 articles derived from diverse applications and methods. Most met the stated research-quality criteria. This review identified how simulation can facilitate decision making and that it may induce learning. Furthermore, simulation offers immediate feedback about proposed changes, allows analysis of scenarios, and promotes communication on building a shared system view and understanding of how a complex system works. However, only 14 of the 59 articles reported on implementation experiences, including how decision making was supported. On the basis of these articles, we proposed steps essential for the success of simulation projects, not just in the computer, but also in clinical reality. We also presented a novel concept combining simulation modeling with the established plan-do-study-act cycle for improvement. Future scientific inquiries concerning implementation, impact, and the value for health care management are needed to realize the full potential of simulation modeling.

  6. Final Documentation: Incident Management And Probabilities Courses of action Tool (IMPACT).

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Donna M.; Ray, Jaideep; Tucker, Mark D.; Whetzel, Jonathan; Cauthen, Katherine Regina

    2018-03-01

    This report pulls together the documentation produced for the IMPACT tool, a software-based decision support tool that provides situational awareness, incident characterization, and guidance on public health and environmental response strategies for an unfolding bio-terrorism incident.

  7. Incidental intracardiac thromboemboli during liver transplantation: incidence, risk factors, and management.

    Science.gov (United States)

    Xia, Victor W; Ho, Jonathan K; Nourmand, Hamid; Wray, Christopher; Busuttil, Ronald W; Steadman, Randolph H

    2010-12-01

    Even though numerous cases of massive thromboemboli have been reported in the literature, intracardiac thromboemboli (ICTs) incidentally found during orthotopic liver transplantation (OLT) have not been examined. In this study, we retrospectively examined the incidence, risk factors, and management of incidental ICTs during OLT. After institutional review board approval, adult patients who underwent OLT between January 2004 and December 2008 at our center were reviewed. ICTs were identified and confirmed by the examination of OLT datasheets, anesthesia records, and recorded transesophageal echocardiography (TEE) clips. The clinical presentation, management, and outcomes of the patients with ICTs were reviewed. Risk factors were analyzed by multivariate logistic regression. During the study period, 426 of the 936 adult OLT patients (45.5%) underwent intraoperative TEE monitoring. Incidental ICTs were identified in 8 of these 426 patients (1.9%). Two ICTs occurred before reperfusion, and 6 ICTs occurred after reperfusion. The treatment was at the discretion of the treating physicians; however, none of the patients received an anticoagulant or thrombolytics. Multivariate analysis identified 2 independent risk factors for intraoperative incidental ICTs: the presence of symptomatic or surgically treated portal hypertension (a history of gastrointestinal bleeding, a transjugular intrahepatic portosystemic shunt procedure, or portocaval shunt surgery) before OLT and intraoperative hemodialysis (odds ratios of 4.05 and 7.29, respectively; P ICTs during OLT occurred at a rate of 1.9% and were associated with several preoperative and intraoperative risk factors. The use of TEE allows early identification, which may be important. Our management for incidental ICTs is described; however, no conclusions can be made about the optimal therapy. Copyright © 2010 American Association for the Study of Liver Diseases.

  8. Simulation Games: The Future of Water Resources Education and Management?

    Science.gov (United States)

    Castilla Rho, J. C.; Mariethoz, G.; Rojas, R. F.; Andersen, M. S.; Kelly, B. F.; Holley, C.

    2014-12-01

    Scientists rely on models of the water cycle to describe and predict problems of water scarcity in a changing climate, and to suggest adaptation strategies for securing future water needs. Yet these models are too often complicated for managers, the general public and for students to understand. Simpler modelling environments will help with finding solutions by engaging a broader segment of the population. Such environments will enable education at the earliest stages and collective action. I propose that simulation games can be an effective communication platform between scientists and 'non-experts' and that such games will shed light on problems of pollution and overuse of water resources. In the same way as pilots use flight simulators to become proficient at flying aircraft, simulation games—if underpinned by good science—can be used to educate the public, students and managers about how to best manage our water resources. I aim to motivate young scientists to think about using games to advance water education and management.

  9. Vertebral artery injury during foraminal decompression in "low-risk" cervical spine surgery: incidence and management.

    Science.gov (United States)

    Obermüller, Thomas; Wostrack, Maria; Shiban, Ehab; Pape, Haiko; Harmening, Kathrin; Friedrich, Benjamin; Prothmann, Sascha; Meyer, Bernhard; Ringel, Florian

    2015-11-01

    Vertebral artery injury (VAI) during foraminal decompression in cervical spine surgery in the absence of repositioning or screw stabilization is rare. Without immediate recognition and treatment, it may have disastrous consequences. We aimed to describe the incidence and management of iatrogenic VAI in low-risk cervical spine surgery. The records of all patients who underwent surgical procedures of the cervical spine between January 2007 and May 2012 were retrospectively consecutively evaluated. Anterior cervical discectomy and fusion or arthroplasty as well as dorsal foraminal decompression through the Frykholm approach in degenerative diseases were defined as low-risk surgeries (n = 992). VAI occurred in 0.3 % (n = 3) of 992 procedures: in one case during a dorsal foraminal decompression, and in two cases during the anterior cervical discectomy and fusion (ACDF) of two or four levels, respectively. In the first case, the VAI was intraoperatively misdiagnosed. Despite an initially uneventful course, the patient suffered hemorrhage from a pseudoaneurysm of the injured VA 1 month after surgery. The aneurysm was successfully occluded by endovascular coiling. In both ACDF cases, angiography and endovascular stenting of the lacerated segment proceeded immediately after the surgery. All three patients suffered no permanent deterioration. In a high-volume surgical center, the incidence of VAI during low-risk cervical spine surgery is extremely low, comprising 0.3 % of all cases. The major risks are delayed sequels of the vessel wall laceration. In cases of VAI, immediate angiographic diagnostics and generous indications for endovascular treatment are obligatory.

  10. 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.

  11. The incidence and management of infusion reactions to infliximab: a large center experience.

    Science.gov (United States)

    Cheifetz, Adam; Smedley, Michelle; Martin, Sara; Reiter, Monica; Leone, Grace; Mayer, Lloyd; Plevy, Scott

    2003-06-01

    To assess the incidence and management of infusion reactions to infliximab, a chimeric monoclonal antibody that targets human tumor necrosis factor-alpha, in patients with Crohn's disease treated at a large infusion center. A total of 165 consecutive patients who received 479 infliximab infusions in the Division of Clinical Immunology Infusion Center at Mount Sinai Medical Center from July, 1998 to January, 2001 were evaluated. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. The overall incidence of infusion reactions to infliximab was 6.1% (29 of 479) of infusions, affecting 9.7% (16 of 165) of patients. Mild, moderate, or severe acute reactions occurred in 3.1% (15 of 479), 1.2% (six of 479), and 1.0% (five of 479) of infliximab infusions, respectively. Use of treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With the prophylaxis protocol, all patients who experienced an initial mild or moderate acute reaction were able to receive additional infusions. Four patients experienced a total of five severe acute reactions. Three patients were retreated: two patients had no further problems, whereas one patient had a second severe acute reaction that rapidly resolved with treatment. Suggesting that acute infusion reactions are not type I hypersensitivity reactions, in 11 patients who experienced 14 acute infusion reactions, serum tryptase levels were normal. Delayed infusion reactions occurred in 0.6% (three of 479) of infusions. Infliximab infusions were accompanied by acute reactions in approximately 5% of infusions. These reactions did not seem to be true IgE-mediated type I hypersensitivity events. Using appropriate treatment protocols, these reactions were effectively treated and prevented upon retreatment in nearly all patients. Delayed reactions were rare, occurring in <1% of infusions.

  12. Analysis of Chlorine Gas Incident Simulation and Dispersion Within a Complex and Populated Urban Area Via Computation Fluid Dynamics

    Directory of Open Access Journals (Sweden)

    Eslam Kashi

    2015-04-01

    Full Text Available In some instances, it is inevitable that large amounts of potentially hazardous chemicals like chlorine gas are stored and used in facilities in densely populated areas. In such cases, all safety issues must be carefully considered. To reach this goal, it is important to have accurate information concerning chlorine gas behaviors and how it is dispersed in dense urban areas. Furthermore, maintaining adequate air movement and the ability to purge ambient from potential toxic and dangerous chemicals like chlorine gas could be helpful. These are among the most important actions to be taken toward the improvement of safety in a big metropolis like Tehran. This paper investigates and analyzes chlorine gas leakage scenarios, including its dispersion and natural air ventilation  effects on how it might be geographically spread in a city, using computational  fluid dynamic (CFD. Simulations of possible hazardous events and solutions for preventing or reducing their probability are presented to gain a better insight into the incidents. These investigations are done by considering hypothetical scenarios which consist of chlorine gas leakages from pipelines or storage tanks under different conditions. These CFD simulation results are used to investigate and analyze chlorine gas behaviors, dispersion, distribution, accumulation, and other possible hazards by means of a simplified CAD model of an urban area near a water-treatment facility. Possible hazards as well as some prevention and post incident solutions are also suggested.

  13. Applying Resilience Concepts in Forest Management: A Retrospective Simulation Approach

    Directory of Open Access Journals (Sweden)

    Caren C. Dymond

    2015-12-01

    Full Text Available Increasing the resilience of ecological and sociological systems has been proposed as an option to adapt to changing future climatic conditions. However, few studies test the applicability of those strategies to forest management. This paper uses a real forest health incident to assess the ability of forest management strategies to affect ecological and economic resilience of the forest. Two landscape scale strategies are compared to business as usual management for their ability to increase resilience to a climate-change induced mountain pine beetle outbreak in the Kamloops Timber Supply Area, British Columbia, Canada for the period 1980 to 2060. Proactive management to reduce high risk species while maintaining or increasing diversity through reforestation was found to be more resilient in terms of the metrics: post-disturbance growing stock, improved volume and stability of timber flow, and net revenue. However, landscape-scale indicators of diversity were little affected by management. Our results were robust to uncertainty in tree growth rates and timber value and show that adapting to climate change through improving the resilience of forested landscapes is an economically viable option.

  14. Applications of a simulation model to decisions in mallard management

    Science.gov (United States)

    Cowardin, L.M.; Johnson, D.H.; Shaffer, T.L.; Sparling, D.W.

    1988-01-01

    A system comprising simulation models and data bases for habitat availability and nest success rates was used to predict results from a mallard (Anas platyrhynchos) management plan and to compare six management methods with a control. Individual treatments in the applications included land purchase for waterfowl production, wetland easement purchase, lease of uplands for waterfowl management, cropland retirement, use of no-till winter wheat, delayed cutting of alfalfa, installation of nest baskets, nesting island construction, and use of predator-resistant fencing.The simulations predicted that implementation of the management plan would increase recruits by 24%. Nest baskets were the most effective treatment, accounting for 20.4% of the recruits. No-till winter wheat was the second most effective, accounting for 5.9% of the recruits. Wetland loss due to drainage would cause an 11% loss of breeding population in 10 years.The models were modified to account for migrational homing. The modification indicated that migrational homing would enhance the effects of management. Nest success rates were critical contributions to individual management methods. The most effective treatments, such as nest baskets, had high success rates and affected a large portion of the breeding population.Economic analyses indicated that nest baskets would be the most economical of the three techniques tested. The applications indicated that the system is a useful tool to aid management decisions, but data are scarce for several important variables. Basic research will be required to adequately model the effect of migrational homing and density dependence on production. The comprehensive nature of predictions desired by managers will also require that production models like the one described here be extended to encompass the entire annual cycle of waterfowl.

  15. Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

    Directory of Open Access Journals (Sweden)

    Brian O'Leary

    2015-08-01

    Full Text Available Subclavian vein stenosis is a common, but usually asymptomatic, complication following cardiac device placement. In addition to reviewing the literature on incidence, pathogenesis and management options for this important clinical problem, we describe two cases of symptomatic subclavian vein occlusion following pacemaker/defibrillator placement and successful treatment with venoplasty and stenting.

  16. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children

    NARCIS (Netherlands)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    BACKGROUND: Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. METHODS: In this prospective observational cohort study, the incidence of artifacts in

  17. A Data Management System for International Space Station Simulation Tools

    Science.gov (United States)

    Betts, Bradley J.; DelMundo, Rommel; Elcott, Sharif; McIntosh, Dawn; Niehaus, Brian; Papasin, Richard; Mah, Robert W.; Clancy, Daniel (Technical Monitor)

    2002-01-01

    Groups associated with the design, operational, and training aspects of the International Space Station make extensive use of modeling and simulation tools. Users of these tools often need to access and manipulate large quantities of data associated with the station, ranging from design documents to wiring diagrams. Retrieving and manipulating this data directly within the simulation and modeling environment can provide substantial benefit to users. An approach for providing these kinds of data management services, including a database schema and class structure, is presented. Implementation details are also provided as a data management system is integrated into the Intelligent Virtual Station, a modeling and simulation tool developed by the NASA Ames Smart Systems Research Laboratory. One use of the Intelligent Virtual Station is generating station-related training procedures in a virtual environment, The data management component allows users to quickly and easily retrieve information related to objects on the station, enhancing their ability to generate accurate procedures. Users can associate new information with objects and have that information stored in a database.

  18. 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

  19. Delayed Chemotherapy-Induced Nausea and Vomiting: Pathogenesis, Incidence, and Current Management.

    Science.gov (United States)

    Rapoport, Bernardo L

    2017-01-01

    Even when chemotherapy-induced nausea and vomiting (CINV) can be effectively controlled in the acute phase, it may still occur in the delayed phase. Identifying at-risk patients is complex and requires consideration of clinical, personal, demographic, and behavioral factors. Delayed CINV has a significant detrimental effect on patients' daily life and is responsible for significant healthcare resource utilization. Patients who do not experience acute CINV are not necessarily exempt from delayed CINV, and healthcare professionals have been shown to underestimate the incidence of delayed CINV. Failure to protect against CINV during the first cycle of chemotherapy is the most significant independent risk factor for delayed CINV during subsequent cycles. Addition of a neurokinin-1 receptor antagonist to antiemetic prophylactic regimens involving a 5-hydroxytryptamine type 3 receptor antagonist and a corticosteroid helps to ameliorate delayed CINV, particularly vomiting. Netupitant and rolapitant are second-generation neurokinin-1 receptor antagonists that provide effective prophylaxis against delayed chemotherapy-induced vomiting and also have an antinausea benefit. All of the neurokinin-1 receptor antagonists with the exception of rolapitant inhibit or induce cytochrome P450 3A4 (CYP3A4), and a reduced dose of dexamethasone (a CYP3A4 substrate) should be administered with aprepitant or netupitant; by contrast, this is not necessary with rolapitant. Here we review specific challenges associated with delayed CINV, its pathophysiology, epidemiology, treatment, and outcomes relative to acute CINV, and its management within the larger context of overall CINV.

  20. Acute ureterolithiasis: Incidence of secondary signs on unenhanced helical CT and influence on patient management

    Energy Technology Data Exchange (ETDEWEB)

    Ege, G. E-mail: gurkanege@yahoo.com; Akman, H.; Kuzucu, K.; Yildiz, S

    2003-12-01

    AIM: The purpose of this study was to determine the incidence of secondary signs associated with ureteral stones on unenhanced helical computed tomography (CT) of patients with acute renal colic, and to correlate these with patient management and outcome. MATERIALS AND METHODS: One hundred and ten patients with ureterolithiasis were evaluated prospectively for the secondary signs of obstruction on unenhanced helical CT. Our attention was focused primarily on the presence or absence of seven secondary signs on unenhanced helical CT, including hydronephrosis, unilateral renal enlargement, perinephric oedema, unilateral absence of the white pyramid, hydroureter, periureteral oedema and lateroconal fascial thickening. RESULTS: Of the 110 patients, 91 (82.7%) had hydroureter, 88 (80%) had hydronephrosis, 65 (59%) had periureteric oedema and 63 (57.2%) had unilateral renal enlargement. Ninety stones passed spontaneously and 21 required intervention. CONCLUSION: Secondary signs of urinary tract obstruction are useful and supportive findings in interpretation of the CT examination. In our experience, the most reliable signs indicating ureteral obstruction are hydroureter, hydronephrosis, periureteral oedema and unilateral renal enlargement, respectively. In addition, stones larger than 6 mm, located within the proximal two thirds of the ureter, and seen associated with five or more the secondary signs of obstruction, are more likely to require endoscopic removal and/or lithotripsy.

  1. Incidence, risk factors and management of severe post-transsphenoidal epistaxis.

    Science.gov (United States)

    De Los Reyes, Kenneth M; Gross, Bradley A; Frerichs, Kai U; Dunn, Ian F; Lin, Ning; Rincon-Torroella, Jordina; Annino, Donald J; Laws, Edward R

    2015-01-01

    Among the major complications of transsphenoidal surgery, less attention has been given to severe postoperative epistaxis, which can lead to devastating consequences. In this study, we reviewed 551 consecutive patients treated over a 4 year period by the senior author to evaluate the incidence, risk factors, etiology and management of immediate and delayed post-transsphenoidal epistaxis. Eighteen patients (3.3%) developed significant postoperative epistaxis - six immediately and 12 delayed (mean postoperative day 10.8). Fourteen patients harbored macroadenomas (78%) and 11 of 18 (61.1%) had complex nasal/sphenoid anatomy. In the immediate epistaxis group, 33% had acute postoperative hypertension. In the delayed group, one had an anterior ethmoidal pseudoaneurysm, and one had restarted anticoagulation on postoperative day 3. We treated the immediate epistaxis group with bedside nasal packing followed by operative re-exploration if conservative measures were unsuccessful. The delayed group underwent bedside nasal hemostasis; if unsuccessful, angiographic embolization was performed. After definitive treatment, no patients had recurrent epistaxis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Contemporary, age-based trends in the incidence and management of patients with early-stage kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S

    2015-01-01

    Although kidney cancer incidence and nephrectomy rates have risen in tandem, clinical advances have generated new uncertainty regarding the optimal management of patients with small renal tumors, especially the elderly. To clarify existing practice patterns, we assessed contemporary trends in the incidence and management of patients with early-stage kidney cancer. Using Surveillance, Epidemiology, and End Results data, we identified adult patients diagnosed with T1aN0M0 kidney cancer from 2000 to 2010. We determined age-adjusted and age-specific incidence and management rates (i.e., nonoperative, ablation, partial nephrectomy [PN], and radical nephrectomy) per 100,000 adults and determined the average annual percent change (AAPC). Finally, we compared management groups using multinomial logistic regression accounting for patient characteristics, cancer information, and county-level measures for health. From 2000 to 2010, we identified 41,645 adults diagnosed with T1aN0M0 kidney cancer. Overall incidence increased from 3.7 to 7.0 per 100,000 adults (AAPC = 7.0%, Pmanagement and ablation approached nephrectomy rates for those aged 75 to 84 years and became the predominant strategy for patients older than 84 years. Adjusting for clinical, oncological, and environmental factors, older patients less frequently underwent PN and more often received ablative or nonoperative management (P<0.001). As the incidence of early-stage kidney cancer rises, patients are increasingly treated with nonoperative and nephron-sparing strategies, especially among the most elderly. The broader array of treatment options suggests opportunities to better personalize kidney cancer care for seniors. Published by Elsevier Inc.

  3. Data collection in a live mass casualty incident simulation: automated RFID technology versus manually recorded system.

    Science.gov (United States)

    Ingrassia, Pier Luigi; Carenzo, Luca; Barra, Federico Lorenzo; Colombo, Davide; Ragazzoni, Luca; Tengattini, Marco; Prato, Federico; Geddo, Alessandro; Della Corte, Francesco

    2012-02-01

    To demonstrate the applicability and the reliability of a radio frequency identification (RFID) system to collect data during a live exercise. A rooftop collapse of a crowded building was simulated. Fifty-three volunteers were trained to perform as smart victims, simulating clinical conditions, using dynamic data cards, and capturing delay times and triage codes. Every victim was also equipped with a RFID tag. RFID antenna was placed at the entrance of the advanced medical post (AMP) and emergency department (ED) and recorded casualties entering the hospital. A total of 12 victims entered AMP and 31 victims were directly transferred to the ED. 100% (12 of 12 and 31 of 31) of the time cards reported a manually written hospital admission time. No failures occurred in tag reading or data transfers. A correlation analysis was performed between the two methods plotting the paired RFID and manual times and resulted in a r=0.977 for the AMP and r=0.986 for the ED with a P value of less than 0.001. We confirmed the applicability of RFID system to the collection of time delays. Its use should be investigated in every aspect of data collection (triage, treatments) during a disaster exercise.

  4. The incidence and management of postoperative chylothorax after pulmonary resection and thoracic mediastinal lymph node dissection.

    Science.gov (United States)

    Bryant, Ayesha S; Minnich, Douglas J; Wei, Benjamin; Cerfolio, Robert James

    2014-07-01

    Our objective was to determine the incidence and optimal management of chylothorax after pulmonary resection with complete thoracic mediastinal lymph node dissection (MLND). This is a retrospective review of patients who underwent pulmonary resection with MLND. Between January 2000 and December 2012, 2,838 patients underwent pulmonary resection with MLND by one surgeon (RJC). Forty-one (1.4%) of these patients experienced a chylothorax. Univariate analysis showed that lobectomy (p<0.001), a robotic approach (p=0.03), right-sided operations (p<0.001), and pathologic N2 disease (p=0.007) were significantly associated with the development of chylothorax. Multivariate analysis showed that lobectomy (p=0.011), a robotic approach (p=0.032), and pathologic N2 disease (p=0.027) remained predictors. All patients were initially treated with cessation of oral intake and 200 μg subcutaneous somatostatin every 8 hours. If after 48 hours the chest tube output was less than 450 mL/day and the effluent was clear, patients was given a medium-chain triglyceride (MCT) diet and were observed for 48 hours in the hospital. If the chest tube output remained below 450 mL/day, the chest tube was removed, they were discharged home with directions to continue the MCT diet and to return in 2 weeks. Patients were instructed to consume a high-fat meal 24 hours before their clinic appointment. If the patient's chest roentgenogram was clear at that time, they were considered "treated." This approach was successful in 37 (90%) patients. The 4 patients in whom the initial treatment was unsuccessful underwent reoperation with pleurodesis and duct ligation. Chylothorax after pulmonary resection and MLND occurred in 1.4% of patients. Its incidence was higher in those with pathologic N2 disease and those who underwent robotic resection. Nonoperative therapy is almost always effective. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Advanced Simulation Capability for Environmental Management (ASCEM): Early Site Demonstration

    International Nuclear Information System (INIS)

    Meza, Juan; Hubbard, Susan; Freshley, Mark D.; Gorton, Ian; Moulton, David; Denham, Miles E.

    2011-01-01

    The U.S. Department of Energy Office of Environmental Management, Technology Innovation and Development (EM-32), is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high performance computing tool will facilitate integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. As part of the initial development process, a series of demonstrations were defined to test ASCEM components and provide feedback to developers, engage end users in applications, and lead to an outcome that would benefit the sites. The demonstration was implemented for a sub-region of the Savannah River Site General Separations Area that includes the F-Area Seepage Basins. The physical domain included the unsaturated and saturated zones in the vicinity of the seepage basins and Fourmile Branch, using an unstructured mesh fit to the hydrostratigraphy and topography of the site. The calculations modeled variably saturated flow and the resulting flow field was used in simulations of the advection of non-reactive species and the reactive-transport of uranium. As part of the demonstrations, a new set of data management, visualization, and uncertainty quantification tools were developed to analyze simulation results and existing site data. These new tools can be used to provide summary statistics, including information on which simulation parameters were most important in the prediction of uncertainty and to visualize the relationships between model input and output.

  6. Advances in Integrated Vehicle Thermal Management and Numerical Simulation

    Directory of Open Access Journals (Sweden)

    Yan Wang

    2017-10-01

    Full Text Available With the increasing demands for vehicle dynamic performance, economy, safety and comfort, and with ever stricter laws concerning energy conservation and emissions, vehicle power systems are becoming much more complex. To pursue high efficiency and light weight in automobile design, the power system and its vehicle integrated thermal management (VITM system have attracted widespread attention as the major components of modern vehicle technology. Regarding the internal combustion engine vehicle (ICEV, its integrated thermal management (ITM mainly contains internal combustion engine (ICE cooling, turbo-charged cooling, exhaust gas recirculation (EGR cooling, lubrication cooling and air conditioning (AC or heat pump (HP. As for electric vehicles (EVs, the ITM mainly includes battery cooling/preheating, electric machines (EM cooling and AC or HP. With the rational effective and comprehensive control over the mentioned dynamic devices and thermal components, the modern VITM can realize collaborative optimization of multiple thermodynamic processes from the aspect of system integration. Furthermore, the computer-aided calculation and numerical simulation have been the significant design methods, especially for complex VITM. The 1D programming can correlate multi-thermal components and the 3D simulating can develop structuralized and modularized design. Additionally, co-simulations can virtualize simulation of various thermo-hydraulic behaviors under the vehicle transient operational conditions. This article reviews relevant researching work and current advances in the ever broadening field of modern vehicle thermal management (VTM. Based on the systematic summaries of the design methods and applications of ITM, future tasks and proposals are presented. This article aims to promote innovation of ITM, strengthen the precise control and the performance predictable ability, furthermore, to enhance the level of research and development (R&D.

  7. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children.

    Science.gov (United States)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    2018-02-01

    Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. In this prospective observational cohort study, the incidence of artifacts in anesthesia information management system data was investigated in children undergoing anesthesia for noncardiac procedures. Secondary outcomes included the incidence of artifacts among deviating and nondeviating values, among the anesthesia phases, and among different anesthetic techniques. We included 136 anesthetics representing 10,236 min of anesthesia time. The incidence of artifacts was 0.5% for heart rate (95% CI: 0.4 to 0.7%), 1.3% for oxygen saturation (1.1 to 1.5%), 7.5% for end-tidal carbon dioxide (6.9 to 8.0%), 5.0% for noninvasive blood pressure (4.0 to 6.0%), and 7.3% for invasive blood pressure (5.9 to 8.8%). The incidence of artifacts among deviating values was 3.1% for heart rate (2.1 to 4.4%), 10.8% for oxygen saturation (7.6 to 14.8%), 14.1% for end-tidal carbon dioxide (13.0 to 15.2%), 14.4% for noninvasive blood pressure (10.3 to 19.4%), and 38.4% for invasive blood pressure (30.3 to 47.1%). Not all values in anesthesia information management systems are valid. The incidence of artifacts stored in the present pediatric anesthesia practice was low for heart rate and oxygen saturation, whereas noninvasive and invasive blood pressure and end-tidal carbon dioxide had higher artifact incidences. Deviating values are more often artifacts than values in a normal range, and artifacts are associated with the phase of anesthesia and anesthetic technique. Development of (automatic) data validation systems or solutions to deal with artifacts in data is warranted.

  8. Analysis and Numerical Simulations of a Stochastic SEIQR Epidemic System with Quarantine-Adjusted Incidence and Imperfect Vaccination

    Directory of Open Access Journals (Sweden)

    Fei Li

    2018-01-01

    Full Text Available This paper considers a high-dimensional stochastic SEIQR (susceptible-exposed-infected-quarantined-recovered epidemic model with quarantine-adjusted incidence and the imperfect vaccination. The main aim of this study is to investigate stochastic effects on the SEIQR epidemic model and obtain its thresholds. We first obtain the sufficient condition for extinction of the disease of the stochastic system. Then, by using the theory of Hasminskii and the Lyapunov analysis methods, we show there is a unique stationary distribution of the stochastic system and it has an ergodic property, which means the infectious disease is prevalent. This implies that the stochastic disturbance is conducive to epidemic diseases control. At last, computer numerical simulations are carried out to illustrate our theoretical results.

  9. Analysis of eighty-four commercial aviation incidents - Implications for a resource management approach to crew training

    Science.gov (United States)

    Murphy, M. R.

    1980-01-01

    A resource management approach to aircrew performance is defined and utilized in structuring an analysis of 84 exemplary incidents from the NASA Aviation Safety Reporting System. The distribution of enabling and associated (evolutionary) and recovery factors between and within five analytic categories suggests that resource management training be concentrated on: (1) interpersonal communications, with air traffic control information of major concern; (2) task management, mainly setting priorities and appropriately allocating tasks under varying workload levels; and (3) planning, coordination, and decisionmaking concerned with preventing and recovering from potentially unsafe situations in certain aircraft maneuvers.

  10. Nonlinearity management and diffraction management for the ...

    Indian Academy of Sciences (India)

    Variational equations and partial differential equation have been simulated numerically. Analytical and numerical studies have shown that nonlinearity management and diffraction management stabilize the pulse against decay or collapse providing undisturbed propagation even for larger energies of the incident beam.

  11. Advance simulation capability for environmental management (ASCEM) - 59065

    International Nuclear Information System (INIS)

    Dixon, Paul; Keating, Elizabeth; Moulton, David; Williamson, Mark; Collazo, Yvette; Gerdes, Kurt; Freshley, Mark; Gorton, Ian; Meza, Juan

    2012-01-01

    The United States Department Energy (DOE) Office of Environmental Management (EM) determined that uniform application of advanced modeling in the subsurface could help reduce the cost and risks associated with its environmental cleanup mission. In response to this determination, the EM Office of Technology Innovation and Development (OTID), Groundwater and Soil Remediation (GW and S) began the program Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for integrating data and scientific understanding to enable prediction of contaminant fate and transport in natural and engineered systems. This initiative supports the reduction of uncertainties and risks associated with EM?s environmental cleanup and closure programs through better understanding and quantifying the subsurface flow and contaminant transport behavior in complex geological systems. This involves the long-term performance of engineered components, including cementitious materials in nuclear waste disposal facilities that may be sources for future contamination of the subsurface. This paper describes the ASCEM tools and approach and the ASCEM programmatic accomplishments completed in 2010 including recent advances and technology transfer. The US Department of Energy Office of Environmental Management has begun development of an Advanced Simulation Capability for Environmental Management, (ASCEM). This program will provide predictions of the end states of contaminated areas allowing for cost and risk reduction of EM remedial activities. ASCEM will provide the tools and approaches necessary to standardize risk and performance assessments across the DOE complex. Through its Phase One demonstration, the ASCEM team has shown value to the EM community in the areas of High Performance Computing, Data Management, Visualization, and Uncertainty Quantification. In 2012, ASCEM will provide an initial limited release of a community code for

  12. Dynamic information architecture system (DIAS) : multiple model simulation management.

    Energy Technology Data Exchange (ETDEWEB)

    Simunich, K. L.; Sydelko, P.; Dolph, J.; Christiansen, J.

    2002-05-13

    Dynamic Information Architecture System (DIAS) is a flexible, extensible, object-based framework for developing and maintaining complex multidisciplinary simulations of a wide variety of application contexts. The modeling domain of a specific DIAS-based simulation is determined by (1) software Entity (domain-specific) objects that represent the real-world entities that comprise the problem space (atmosphere, watershed, human), and (2) simulation models and other data processing applications that express the dynamic behaviors of the domain entities. In DIAS, models communicate only with Entity objects, never with each other. Each Entity object has a number of Parameter and Aspect (of behavior) objects associated with it. The Parameter objects contain the state properties of the Entity object. The Aspect objects represent the behaviors of the Entity object and how it interacts with other objects. DIAS extends the ''Object'' paradigm by abstraction of the object's dynamic behaviors, separating the ''WHAT'' from the ''HOW.'' DIAS object class definitions contain an abstract description of the various aspects of the object's behavior (the WHAT), but no implementation details (the HOW). Separate DIAS models/applications carry the implementation of object behaviors (the HOW). Any model deemed appropriate, including existing legacy-type models written in other languages, can drive entity object behavior. The DIAS design promotes plug-and-play of alternative models, with minimal recoding of existing applications. The DIAS Context Builder object builds a constructs or scenario for the simulation, based on developer specification and user inputs. Because DIAS is a discrete event simulation system, there is a Simulation Manager object with which all events are processed. Any class that registers to receive events must implement an event handler (method) to process the event during execution. Event handlers

  13. Dynamic information architecture system (DIAS) : multiple model simulation management

    International Nuclear Information System (INIS)

    Simunich, K. L.; Sydelko, P.; Dolph, J.; Christiansen, J.

    2002-01-01

    Dynamic Information Architecture System (DIAS) is a flexible, extensible, object-based framework for developing and maintaining complex multidisciplinary simulations of a wide variety of application contexts. The modeling domain of a specific DIAS-based simulation is determined by (1) software Entity (domain-specific) objects that represent the real-world entities that comprise the problem space (atmosphere, watershed, human), and (2) simulation models and other data processing applications that express the dynamic behaviors of the domain entities. In DIAS, models communicate only with Entity objects, never with each other. Each Entity object has a number of Parameter and Aspect (of behavior) objects associated with it. The Parameter objects contain the state properties of the Entity object. The Aspect objects represent the behaviors of the Entity object and how it interacts with other objects. DIAS extends the ''Object'' paradigm by abstraction of the object's dynamic behaviors, separating the ''WHAT'' from the ''HOW.'' DIAS object class definitions contain an abstract description of the various aspects of the object's behavior (the WHAT), but no implementation details (the HOW). Separate DIAS models/applications carry the implementation of object behaviors (the HOW). Any model deemed appropriate, including existing legacy-type models written in other languages, can drive entity object behavior. The DIAS design promotes plug-and-play of alternative models, with minimal recoding of existing applications. The DIAS Context Builder object builds a constructs or scenario for the simulation, based on developer specification and user inputs. Because DIAS is a discrete event simulation system, there is a Simulation Manager object with which all events are processed. Any class that registers to receive events must implement an event handler (method) to process the event during execution. Event handlers can schedule other events; create or remove Entities from the

  14. Incidental durotomy in lumbar spine surgery - incidence, risk factors and management

    Directory of Open Access Journals (Sweden)

    Adam D.

    2015-03-01

    Full Text Available Incidental durotomy is a common complication of lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra and postoperative management, there is no consensus. Our objective was to report our experience with incidental durotomy in patients who were operated on for lumbar disc herniation, lumbar spinal stenosis and revision surgeries. Between 2009 and 2012, 1259 patients were operated on for degenerative lumbar disorders. For primary operations, the surgical approach was mino-open, interlamar, uni- or bilateral, as for recurrences, the removal of the compressive element was intended: the epidural scar and the disc fragment. 863 patients (67,7% were operated on for lumbar disc herniation, 344 patients (27,3% were operated on for lumbar spinal stenosis and 52 patients (5% were operated for recurrences. The operations were performed by neurosurgeons with the same professional degree but with different operative volume. Unintentional durotomy occurred in 20 (2,3% of the patients with herniated disc, in 14 (4,07% of the patients with lumbar spinal stenosis and in 12 (23% of the patients who were operated on for recurrences. The most frequent risk factors were: obesity, revised surgery and the physician’s low operative volume. Intraoperative dural fissures were repaired through suture (8 cases, by applying muscle, fat graft or by applying curaspon, tachosil. There existed 4 CSF fistulas which were repaired at reoperation. Incidental dural fissures during operations for degenerative lumbar disorders must be recognized and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased medical costs. Preventing, identifying and treating unintentional durotomies can be best achieved by respecting a neat surgical technique and a standardized treatment protocol.

  15. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management.

    Science.gov (United States)

    Baillot, Richard; Fréchette, Éric; Cloutier, Daniel; Rodès-Cabau, Josep; Doyle, Daniel; Charbonneau, Éric; Mohammadi, Siamak; Dumont, Éric

    2012-11-13

    The present study was undertaken to examine the incidence and management of surgical site infection (SSI) in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI). From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES) at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ) as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Five (3.2%) patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI) and were considered as organ/space SSI's based on Center for Disease Control criteria (CDC). Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099) than the other patients in the cohort. While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major muscle were used successfully in these patients.

  16. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management

    Directory of Open Access Journals (Sweden)

    Baillot Richard

    2012-11-01

    Full Text Available Abstract Objective The present study was undertaken to examine the incidence and management of surgical site infection (SSI in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI. Methods From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Results Five (3.2% patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI and were considered as organ/space SSI’s based on Center for Disease Control criteria (CDC. Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099 than the other patients in the cohort. Conclusions While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major

  17. Incidence, management, and course of cancer in patients with inflammatory bowel disease.

    Science.gov (United States)

    Algaba, Alicia; Guerra, Iván; Marín-Jiménez, Ignacio; Quintanilla, Elvira; López-Serrano, Pilar; García-Sánchez, María Concepción; Casis, Begoña; Taxonera, Carlos; Moral, Ignacio; Chaparro, María; Martín-Rodríguez, Daniel; Martín-Arranz, María Dolores; Manceñido, Noemí; Menchén, Luis; López-Sanromán, Antonio; Castaño, Ángel; Bermejo, Fernando

    2015-04-01

    Patients with inflammatory bowel disease [IBD] are at increased risk for developing some types of neoplasia. Our aims were to determin the risk for cancer in patients with IBD and to describe the relationship with immunosuppressive therapies and clinical management after tumor diagnosis. Retrospective, multicenter, observational, 5-year follow-up, cohort study. Relative risk [RR] of cancer in the IBD cohort and the background population, therapeutic strategies, and cancer evolution were analyzed. A total of 145 cancers were diagnosed in 133 of 9100 patients with IBD (global cumulative incidence 1.6% vs 2.4% in local population; RR = 0.67; 95% confidence interval [CI]: 0.57-0.78). Patients with IBD had a significantly increased RR of non-melanoma skin cancer [RR = 3.85; 2.53-5.80] and small bowel cancer [RR = 3.70; 1.23-11.13]. After cancer diagnosis, IBD treatment was maintained in 13 of 27 [48.1%] patients on thiopurines, in 2 of 3 on methotrexate [66.6%], none on anti-TNF-α monotherapy [n = 6] and 4 of 12 [33.3%] patients on combined therapy. Rate of death and cancer remission during follow-up did not differ [p > 0.05] between patients who maintained the treatment compared with patients who withdrew [5% vs 8% and 95% vs 74%, respectively]. An association between thiopurines [p = 0.20] or anti-TNF-α drugs [p = 0.77] and cancer was not found. Patients with IBD have an increased risk for non-melanoma skin cancer and small bowel cancer. Immunosuppresive therapy is not related to a higher overall risk for cancer or worse tumor evolution in patients who maintain these drugs after cancer diagnosis. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  18. Numerical simulation of incidence and sweep effects on delta wing vortex breakdown

    Science.gov (United States)

    Ekaterinaris, J. A.; Schiff, Lewis B.

    1994-01-01

    The structure of the vortical flowfield over delta wings at high angles of attack was investigated. Three-dimensional Navier-Stokes numerical simulations were carried out to predict the complex leeward-side flowfield characteristics, including leading-edge separation, secondary separation, and vortex breakdown. Flows over a 75- and a 63-deg sweep delta wing with sharp leading edges were investigated and compared with available experimental data. The effect of variation of circumferential grid resolution grid resolution in the vicinity of the wing leading edge on the accuracy of the solutions was addressed. Furthermore, the effect of turbulence modeling on the solutions was investigated. The effects of variation of angle of attack on the computed vortical flow structure for the 75-deg sweep delta wing were examined. At moderate angles of attack no vortex breakdown was observed. When a critical angle of attack was reached, bubble-type vortex breakdown was found. With further increase in angle of attack, a change from bubble-type breakdown to spiral-type vortex breakdown was predicted by the numerical solution. The effects of variation of sweep angle and freestream Mach number were addressed with the solutions on a 63-deg sweep delta wing.

  19. A PROSPECTIVE STUDY ON INCIDENCE, AETIOPATHOGENESIS, CLINICAL PRESENTATION, MANAGEMENT AND PROGNOSIS OF LIVER ABSCESS

    Directory of Open Access Journals (Sweden)

    Geetha Danasekaran

    2017-05-01

    Full Text Available BACKGROUND Liver abscess continues to be a major diagnostic and therapeutic challenge to the medical fraternity. It is a life-threatening and a potentially serious condition if left untreated. Therefore, it is very important for prompt diagnosis and appropriate management at the earliest. This study was conducted to assess the incidence, aetiology, clinical presentation, management and prognosis of liver abscess in patients attending a tertiary care referral hospital. MATERIALS AND METHODS This study was conducted in Madurai Medical College Hospital, Madurai, from March 2015 to August 2016. The study population consists of patients admitted in General Surgery Wards of Madurai Medical College and Hospital, Madurai, with features suggestive of liver abscess. RESULTS Liver abscess was more commonly seen in the age group of 41-50 years. Male predominance 97.9% was seen in liver abscess. Nearly, two thirds of cases of liver abscess had a history of alcohol intake. Majority of liver abscess were amoebic and nearly 10% were pyogenic. Escherichia coli was the commonest organism causing pyogenic liver abscess. Abdominal pain was the commonest symptom of liver abscess followed by abdominal distension and fever. Right hypochondrial tenderness and intercostal tenderness were the common clinical signs in liver abscess. There was a predominant involvement of the right lobe of the liver. Percutaneous aspiration of abscess with antiamoebic and antibiotics forms the mainstay of treatment. Percutaneous catheter drainage is method of choice in failed aspiration and laparoscopic drainage or laparotomy and drainage is indicated in ruptured liver abscess. CONCLUSION Liver abscess was more commonly seen in the age group of 41-50 years. Male predominance 97.9% was seen in liver abscess. Nearly, two-thirds of cases of liver abscess had a history of alcohol intake. Majority of liver abscess were amoebic and nearly 10% were pyogenic. Escherichia coli was the commonest

  20. Application of Real-Time Automated Traffic Incident Response Plan Management System: A Web Structure for the Regional Highway Network in China

    Directory of Open Access Journals (Sweden)

    Yongfeng Ma

    2014-01-01

    Full Text Available Traffic incidents, caused by various factors, may lead to heavy traffic delay and be harmful to traffic capacity of downstream sections. Traffic incident management (TIM systems have been developed widely to respond to traffic incidents intelligently and reduce the losses. Traffic incident response plans, as an important component of TIM, can effectively guide responders as to what and how to do in traffic incidents. In the paper, a real-time automated traffic incident response plan management system was developed, which could generate and manage traffic incident response plans timely and automatically. A web application structure and a physical structure were designed to implement and show these functions. A standard framework of data storage was also developed to save information about traffic incidents and generated response plans. Furthermore, a conformation survey and case-based reasoning (CBR were introduced to identify traffic incident and generate traffic incident response plans automatically, respectively. Twenty-three traffic crash-related incidents were selected and three indicators were used to measure the system performance. Results showed that 20 of 23 cases could be retrieved effectively and accurately. The system is practicable to generate traffic incident response plans and has been implemented in China.

  1. Management of Industrial Performance Indicators: Regression Analysis and Simulation

    Directory of Open Access Journals (Sweden)

    Walter Roberto Hernandez Vergara

    2017-11-01

    Full Text Available Stochastic methods can be used in problem solving and explanation of natural phenomena through the application of statistical procedures. The article aims to associate the regression analysis and systems simulation, in order to facilitate the practical understanding of data analysis. The algorithms were developed in Microsoft Office Excel software, using statistical techniques such as regression theory, ANOVA and Cholesky Factorization, which made it possible to create models of single and multiple systems with up to five independent variables. For the analysis of these models, the Monte Carlo simulation and analysis of industrial performance indicators were used, resulting in numerical indices that aim to improve the goals’ management for compliance indicators, by identifying systems’ instability, correlation and anomalies. The analytical models presented in the survey indicated satisfactory results with numerous possibilities for industrial and academic applications, as well as the potential for deployment in new analytical techniques.

  2. DCMS: A data analytics and management system for molecular simulation.

    Science.gov (United States)

    Kumar, Anand; Grupcev, Vladimir; Berrada, Meryem; Fogarty, Joseph C; Tu, Yi-Cheng; Zhu, Xingquan; Pandit, Sagar A; Xia, Yuni

    Molecular Simulation (MS) is a powerful tool for studying physical/chemical features of large systems and has seen applications in many scientific and engineering domains. During the simulation process, the experiments generate a very large number of atoms and intend to observe their spatial and temporal relationships for scientific analysis. The sheer data volumes and their intensive interactions impose significant challenges for data accessing, managing, and analysis. To date, existing MS software systems fall short on storage and handling of MS data, mainly because of the missing of a platform to support applications that involve intensive data access and analytical process. In this paper, we present the database-centric molecular simulation (DCMS) system our team developed in the past few years. The main idea behind DCMS is to store MS data in a relational database management system (DBMS) to take advantage of the declarative query interface ( i.e. , SQL), data access methods, query processing, and optimization mechanisms of modern DBMSs. A unique challenge is to handle the analytical queries that are often compute-intensive. For that, we developed novel indexing and query processing strategies (including algorithms running on modern co-processors) as integrated components of the DBMS. As a result, researchers can upload and analyze their data using efficient functions implemented inside the DBMS. Index structures are generated to store analysis results that may be interesting to other users, so that the results are readily available without duplicating the analysis. We have developed a prototype of DCMS based on the PostgreSQL system and experiments using real MS data and workload show that DCMS significantly outperforms existing MS software systems. We also used it as a platform to test other data management issues such as security and compression.

  3. 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

    We describe how simulation and incident reporting can be used in combination to make the interaction between people, (medical) technology and organisation safer for patients and users. We provide the background rationale for our conceptual ideas and apply the concepts to the analysis of an actual...... 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...

  4. Modelling and simulating retail management practices: a first approach

    OpenAIRE

    Siebers, Peer-Olaf; Aickelin, Uwe; Celia, Helen; Clegg, Chris

    2010-01-01

    Multi-agent systems offer a new and exciting way of understanding the world of work. We apply agent-based modeling and simulation to investigate a set of problems\\ud in a retail context. Specifically, we are working to understand the relationship between people management practices on the shop-floor and retail performance. Despite the fact we are working within a relatively novel and complex domain, it is clear that using an agent-based approach offers great potential for improving organizati...

  5. Medication errors in prehospital management of simulated pediatric anaphylaxis.

    Science.gov (United States)

    Lammers, Richard; Willoughby-Byrwa, Maria; Fales, William

    2014-01-01

    Systematic evaluation of the performances of prehospital providers during actual pediatric anaphylaxis cases has never been reported. Epinephrine medication errors in pediatric resuscitation are common, but the root causes of these errors are not fully understood. The primary objective of this study was to identify underlying causes of prehospital medication errors that were observed during a simulated pediatric anaphylaxis reaction. Two- and 4-person emergency medical services crews from eight geographically diverse agencies participated in a 20-minute simulation of a 5-year old child with progressive respiratory distress and hypotension from an anaphylactic reaction. Crews used their own equipment and drugs. A checklist-based scoring protocol was developed to help identify errors. A trained facilitator conducted a structured debriefing, supplemented by playback of video recordings, immediately after the simulated event to elicit underlying causes of errors. Errors were analyzed with mixed quantitative and qualitative methods. One hundred forty-two subjects participated in 62 simulation sessions. Ninety-five percent of crews (59/62) gave epinephrine, but 27 of those crews (46%) delivered the correct dose of epinephrine in an appropriate concentration and route. Twelve crews (20%) gave a dose that was ≥5 times the correct dose; 8 crews (14%) bolused epinephrine intravenously. Among the 55 crews who gave diphenhydramine, 4 delivered the protocol-based dose. Three crews provided an intravenous steroid, and 1 used the protocol-based dose. Underlying causes of errors were categorized into eight themes: faulty reasoning, weight estimation errors, faulty recall of medication dosages, problematic references, calculation errors, dose estimation, communication errors, and medication delivery errors. Simulation, followed by a structured debriefing, identified multiple, underlying causes of medication errors in the prehospital management of pediatric anaphylactic reactions

  6. A review and discussion of flight management system incidents reported to the Aviation Safety Reporting System

    Science.gov (United States)

    1992-02-01

    This report covers the activities related to the description, classification and : analysis of the types and kinds of flight crew errors, incidents and actions, as : reported to the Aviation Safety Reporting System (ASRS) database, that can occur as ...

  7. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records.

    Science.gov (United States)

    Cashmore, Aaron W; Indig, Devon; Hampton, Stephen E; Hegney, Desley G; Jalaludin, Bin B

    2012-08-09

    Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as 'high risk' work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury - there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical abuse. The most incidents of workplace

  8. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Directory of Open Access Journals (Sweden)

    Cashmore Aaron W

    2012-08-01

    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  9. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Science.gov (United States)

    2012-01-01

    Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical

  10. Intra-operative periprosthetic fractures associated with press fit stems in revision total knee arthroplasty: incidence, management, and outcomes.

    Science.gov (United States)

    Cipriano, Cara A; Brown, Nicholas M; Della Valle, Craig J; Moric, Mario; Sporer, Scott M

    2013-09-01

    The purpose of this study is to report the incidence, management, and outcomes of periprosthetic fractures associated with the insertion of press-fit stems during revision total knee arthroplasty (TKA). Immediate and six week post-operative radiographs from 634 stemmed implants (307 femoral, 327 tibial) from 420 consecutive revision TKAs were reviewed. Sixteen tibial (4.9%) and 3 femoral (1%) fractures (combined incidence 3.0%) were identified. All healed uneventfully without operative intervention, with no evidence of implant loosening at a mean of 23 months (range 12 to 47 months). The technique of tightly press fitting stems into the diaphysis is associated with a small rate (3%) of periprosthetic fractures; most were non or minimally displaced, all healed uneventfully with non-operative management and were not associated with implant loosening. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Influence of occupational safety management on the incidence rate of occupational accidents in the Spanish industrial and ornamental stone mining.

    Science.gov (United States)

    Sanmiquel, Lluís; Rossell, Josep M; Vintró, Carla; Freijo, Modesto

    2014-01-01

    Mines are hazardous and workers can suffer many types of accidents caused by fire, flood, explosion or collapse. Injury incidence rates in mining are considerably higher than those registered by other economic sectors. One of the main reasons for this high-level incidence rate is the existence of a large number of dangerous workplaces. This work analyzes the influence that occupational safety management had on the accidents that took place in Spanish mining of industrial and ornamental stone during the period 2007-2008. Primary data sources are: (a) Results from a statistical study of the occupational health and safety management practices of 71 quarries defined by a questionnaire of 41 items; and (b) Occupational accidents registered in the Spanish industrial and ornamental stone mining throughout the period 2007-2008. The obtained results indicate that workplaces with a low average score in the analysis of occupational safety management have a higher incidence rate of accidents. Studies on mining workplaces are very important to help detect occupational safety concerns. Results from this study help raise awareness and will encourage the adoption of appropriate measures to improve safety.

  12. Advanced Simulation Capability for Environmental Management: Development and Demonstrations - 12532

    Energy Technology Data Exchange (ETDEWEB)

    Freshley, Mark D.; Freedman, Vicky; Gorton, Ian [Pacific Northwest National Laboratory, MSIN K9-33, P.O. Box 999, Richland, WA 99352 (United States); Hubbard, Susan S. [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, MS 50B-4230, Berkeley, CA 94720 (United States); Moulton, J. David; Dixon, Paul [Los Alamos National Laboratory, MS B284, P.O. Box 1663, Los Alamos, NM 87544 (United States)

    2012-07-01

    The U.S. Department of Energy Office of Environmental Management (EM), Technology Innovation and Development is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high-performance computing tool facilitates integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of capabilities, which are organized into Platform and Integrated Tool-sets and a High-Performance Computing Multi-process Simulator. The Platform capabilities target a level of functionality to allow end-to-end model development, starting with definition of the conceptual model and management of data for model input. The High-Performance Computing capabilities target increased functionality of process model representations, tool-sets for interaction with Platform, and verification and model confidence testing. The new capabilities are demonstrated through working groups, including one focused on the Hanford Site Deep Vadose Zone. The ASCEM program focused on planning during the first year and executing a prototype tool-set for an early demonstration of individual components. Subsequently, ASCEM has focused on developing and demonstrating an integrated set of capabilities, making progress toward a version of the capabilities that can be used to engage end users. Demonstration of capabilities continues to be implemented through working groups. Three different working groups, one focused on EM problems in the deep vadose zone, another investigating attenuation mechanisms for metals and radionuclides, and a third focusing on waste tank performance assessment, continue to make progress. The project

  13. ADAM: An Accident Diagnostic,Analysis and Management System - Applications to Severe Accident Simulation and Management

    International Nuclear Information System (INIS)

    Zavisca, M.J.; Khatib-Rahbar, M.; Esmaili, H.; Schulz, R.

    2002-01-01

    The Accident Diagnostic, Analysis and Management (ADAM) computer code has been developed as a tool for on-line applications to accident diagnostics, simulation, management and training. ADAM's severe accident simulation capabilities incorporate a balance of mechanistic, phenomenologically based models with simple parametric approaches for elements including (but not limited to) thermal hydraulics; heat transfer; fuel heatup, meltdown, and relocation; fission product release and transport; combustible gas generation and combustion; and core-concrete interaction. The overall model is defined by a relatively coarse spatial nodalization of the reactor coolant and containment systems and is advanced explicitly in time. The result is to enable much faster than real time (i.e., 100 to 1000 times faster than real time on a personal computer) applications to on-line investigations and/or accident management training. Other features of the simulation module include provision for activation of water injection, including the Engineered Safety Features, as well as other mechanisms for the assessment of accident management and recovery strategies and the evaluation of PSA success criteria. The accident diagnostics module of ADAM uses on-line access to selected plant parameters (as measured by plant sensors) to compute the thermodynamic state of the plant, and to predict various margins to safety (e.g., times to pressure vessel saturation and steam generator dryout). Rule-based logic is employed to classify the measured data as belonging to one of a number of likely scenarios based on symptoms, and a number of 'alarms' are generated to signal the state of the reactor and containment. This paper will address the features and limitations of ADAM with particular focus on accident simulation and management. (authors)

  14. 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

  15. Simulating Harvest Schedule for Timber Management and Multipurpose Management in Teak Plantations

    Directory of Open Access Journals (Sweden)

    Tatang Tiryana

    2016-04-01

    Full Text Available Sustainable management of teak plantations in Java requires an improvement of the existing yield regulation method to optimize multiple benefits of the plantations at risk of stand destruction. This study was therefore aimed to formulate an alternative harvest scheduling model that integrates risk of stand destruction for supporting multipurpose management of teak plantations. The proposed model used a state-space planning model to simulate the dynamic of plantations due to timber harvesting and stand destruction, and then sought optimal solutions for 2 management scenarios, i.e. timber management that optimized total harvest volume and multipurpose management that optimized net present value (NPV while increasing carbon stocks. Using a case study on a typical teak plantation, this study confirmed that increasing destruction rates reduced harvest volumes, NPV, carbon stocks, and resulted in imbalanced ending age-class structures. Reducing cutting-age limit increased harvest volumes and NPV, but it also reduced carbon stocks of the plantations. Although the multipurpose management generated lower financial benefit, it maintained carbon stocks and produced better ending age-class structures compared to timber management. The proposed harvest scheduling model provides a useful planning tool for managing teak plantations.

  16. Nipple Pain Incidence, the Predisposing Factors, the Recovery Period After Care Management, and the Exclusive Breastfeeding Outcome.

    Science.gov (United States)

    Puapornpong, Pawin; Paritakul, Panwara; Suksamarnwong, Maysita; Srisuwan, Siriwan; Ketsuwan, Sukwadee

    2017-04-01

    Nipple pain is the most common complaint of breastfeeding mothers during the immediate postpartum period. Persistent nipple pain is associated with low breastfeeding rate at 6 months postpartum. To further explore the incidence of nipple pain, associated predisposing factors, time for recovery after management, and the impact on exclusive breastfeeding rates. Included in this study were 1,649 singleton, pregnant women who delivered and had their 1-week follow-up at the breastfeeding clinic during the period of January 2013 to December 2015. The mothers who experienced nipple pain were analyzed for the incidence, the predisposing factors, and the recovery period after care management. The breastfeeding outcome comparison of both, mothers with and without pain, was measured by the exclusive breastfeeding rate at the sixth week postpartum. The incidence of nipple pain was at 9.6% by day 7. A predisposing factor of nipple pain was primiparity (relative risk = 1.8, 95% confidence interval 1.3-2.5). The reasons for nipple pain were inappropriate positioning and latching (72.3%), tongue-tie (23.2%), and oversupply (4.4%). The recovery period after care management was 1-2 weeks. There were no statistically significant differences between the 6-week exclusive breastfeeding rates of the mothers with nipple pain with treatment and the mothers without nipple pain. Persistent nipple pain was a common problem. The active management, including early detection and treatment, would help the mothers recover within a 2-week period and there was no significant difference of exclusive breastfeeding rates between the mothers who had early care management and the mothers without nipple pain.

  17. Error-Based Accidents and Security Incidents in Nuclear Materials Management

    International Nuclear Information System (INIS)

    Pond, Daniel J.; Greitzer, Frank L.

    2005-01-01

    Hazard and risk assessments, along with human error analysis and mitigation techniques, have long been mainstays of effective safety programs. These tools have revealed that worker errors contributing to or resulting in accidents are often the consequence of ineffective system conditions, process features, or individual employee characteristics. At Los Alamos National Laboratory (LANL), security, safety, human error, and organizational analysts determined that the system-induced human errors that make accidents more likely also are contributing to security incidents. A similar set of system conditions has been found to underlie deliberate, non-malevolent deviations from proper security practices - termed breaches - that also can result in a security incident. In fiscal-year (FY) 2002, LANL's Security Division therefore established the ESTHER (Enhanced Security Through Human Error Reduction) program to identify and reduce the influence of the factors that underlie employee errors and breaches and, in turn, security incidents. Recognizing the potential benefits of this program and approach, in FY2004 the Department of Energy (DOE) Office of Security Policy (DOE-SO) funded an expansion of ESTHER implementation to the causal assessment and reporting of security incidents at other DOE sites. This presentation will focus on three applications of error/breach assessment and mitigation techniques. One use is proactive, accomplished through the elimination of contributors to error, whereas two are reactive, implemented in response to accidents or security incidents as well as to near misses, to prevent recurrence. The human performance and safety bases of these techniques will be detailed. Associated tools - including computer-based assessment training and web-based incident reporting modules developed by Pacific Northwest National Laboratory - will be discussed

  18. The impact of critical event checklists on medical management and teamwork during simulated crises in a surgical daycare facility.

    Science.gov (United States)

    Everett, T C; Morgan, P J; Brydges, R; Kurrek, M; Tregunno, D; Cunningham, L; Chan, A; Forde, D; Tarshis, J

    2017-03-01

    Although the incidence of major adverse events in surgical daycare centres is low, these critical events may not be managed optimally due to the absence of resources that exist in larger hospitals. We aimed to study the impact of operating theatre critical event checklists on medical management and teamwork during whole-team operating theatre crisis simulations staged in a surgical daycare facility. We studied 56 simulation encounters (without and with a checklist available) divided between an initial session and then a retention session several months later. Medical management and teamwork were quantified via percentage adherence to key processes and the Team Emergency Assessment Measure, respectively. In the initial session, medical management was not improved by the presence of a checklist (56% without checklist vs. 62% with checklist; p = 0.50). In the retention session, teams performed significantly worse without the checklists (36% without checklist vs. 60% with checklist; p = 0.04). We did not observe a change in non-technical skills in the presence of a checklist in either the initial or retention sessions (68% without checklist vs. 69% with checklist (p = 0.94) and 69% without checklist vs. 65% with checklist (p = 0.36), respectively). Critical events checklists do not improve medical management or teamwork during simulated operating theatre crises in an ambulatory surgical daycare setting. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

  19. Tackling TB in low-incidence countries: improving diagnosis and management in vulnerable populations

    Directory of Open Access Journals (Sweden)

    C.C. Heuvelings

    2017-03-01

    Full Text Available In low tuberculosis incidence regions, tuberculosis is mainly concentrated among hard-to-reach populations like migrants, homeless people, drug or alcohol abusers, prisoners and people living with HIV. To be able to eliminate tuberculosis from these low incidence regions tuberculosis screening and treatment programs should focus on these hard-to-reach populations. Here we discuss the barriers and facilitators of health care-seeking, interventions improving tuberculosis screening uptake and interventions improving treatment adherence in these hard-to-reach populations.

  20. Characterization of post-disaster environmental management for Hazardous Materials Incidents: Lessons learnt from the Tianjin warehouse explosion, China.

    Science.gov (United States)

    Zhang, Hui; Duan, Huabo; Zuo, Jian; Song, MingWei; Zhang, Yukui; Yang, Bo; Niu, Yongning

    2017-09-01

    Hazardous Materials Incidents (HMIs) have attracted a growing public concern worldwide. The health risks and environmental implications associated with HMIs are almost invariably severe, and underscore the urgency for sound management. Hazardous Materials Explosion incidents (HMEIs) belong to a category of extremely serious HMIs. Existing studies placed focuses predominately on the promptness and efficiency of emergency responses to HMIs and HMEIs. By contrast, post-disaster environmental management has been largely overlooked. Very few studies attempted to examine the post-disaster environmental management plan particularly its effectiveness and sufficiency. In the event of the Tianjin warehouse explosion (TWE), apart from the immediate emergency response, the post-disaster environmental management systems (P-EMSs) have been reported to be effective and sufficient in dealing with the environmental concerns. Therefore, this study aims to critically investigate the P-EMSs for the TWE, and consequently to propose a framework and procedures for P-EMSs in general for HMIs, particularly for HMEIs. These findings provide a useful reference to develop P-EMSs for HMIs in the future, not only in China but also other countries. Copyright © 2017. Published by Elsevier Ltd.

  1. Food risk management quality: Consumer evaluations of past and emerging food safety incidents

    NARCIS (Netherlands)

    Kleef, van E.; Ueland, O.; Theodoridis, G.; Rowe, G.; Pfenning, U.; Houghton, J.R.; Dijk, van H.; Chryssochoidis, G.; Frewer, L.J.

    2009-01-01

    In European countries, there has been growing consumer distrust regarding the motives of food safety regulators and other actors in the food chain, partly as a result of recent food safety incidents. If consumer confidence in food safety is to be improved, a systematic understanding of what

  2. Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

    Directory of Open Access Journals (Sweden)

    M. Riga

    2011-01-01

    Full Text Available Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies. Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library. Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms. Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients.

  3. Major incident preparation for acute hospitals: current state-of-the-art, training needs analysis, and the role of novel virtual worlds simulation technologies.

    Science.gov (United States)

    Cohen, Daniel C; Sevdalis, Nick; Patel, Vishal; Taylor, David; Batrick, Nicola; Darzi, Ara W

    2012-12-01

    There is growing evidence that health systems in developed countries are poorly prepared to deal with major incidents. This study aimed to determine the skills required for successful major incident response, the factors that contribute to a successful major incident exercise, and whether there is a role for using novel simulation training (virtual worlds) in preparing for major incidents. This was a qualitative semi-structured interview study. Fourteen health care staff with experience of major incident planning and training in the United Kingdom were recruited. Interviews were content-analyzed to identify emergent themes. The aims and benefits of current exercises were categorized into three major themes: Organizational, Interpersonal, and Cognitive. Participants felt that the main objective of current exercises is to see how a major incident plan is implemented, rather than training individual staff. Communications was the most frequently commented-on area requiring improvement. Participants felt that lack of constructive feedback reduced the effectiveness of the exercises. All participants commented that virtual worlds technology could be successfully utilized for training. The creation of an immersive environment, increased training opportunity, and improved participant feedback were thought to be amongst the greatest benefits. There are clear deficiencies with current major incident preparation. Utilizing virtual worlds technology as an adjunct to existing exercises could improve training and response in the future. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Assessment and management of serotonin syndrome in a simulated patient study of Australian community pharmacies

    Directory of Open Access Journals (Sweden)

    MacFarlane B

    2016-06-01

    Full Text Available Background: The incidence of serotonin syndrome is increasing due to the widening use of serotonergic drugs. Identification of serotonin syndrome is challenging as the manifestations are diverse. Misdiagnosis can lead to delay in care and inappropriate treatment. Objectives: The objectives of this study were to determine if staff of community pharmacies in Australia could identify the symptoms of serotonin syndrome in simulated patients and recommend an appropriate course of action. Methods: Agents acting on behalf of a simulated patient were trained on a patient scenario that reflected possible serotonin syndrome due to an interaction between duloxetine and recently prescribed tramadol. They entered 148 community pharmacies in Australia to ask for advice about a 60 year old male simulated patient who was ‘not feeling well’. The interaction was audio recorded and analysed for degree of access to the pharmacist, information gathered by pharmacy staff, management advice given and pharmacotherapy recommended. Results: The simulated patient’s agent was consulted by a pharmacist in 94.0% (139/148 of cases. The potential for serotonin syndrome was identified by 35.1% (52/148 of pharmacies. Other suggested causes of the simulated patient’s symptoms were viral (16.9%; 25/148 and cardiac (15.5%; 23/148. A total of 33.8% (50/148 of pharmacies recommended that the simulated patient should cease taking tramadol. This advice always came from the pharmacist. Immediate cessation of tramadol was advised by 94.2% (49/52 of pharmacists correctly identifying serotonin syndrome. The simulated patient was advised to seek urgent medical care in 14.2% (21/148 of cases and follow up with a doctor when possible in 68.2% (101/148 of cases. The majority of pharmacies (87.8%; 130/148 did not recommend non-prescription medicines. Conclusion: While not identifying the cause of the simulated patient’s symptoms in the majority of cases, community pharmacies

  5. Simulation of empty container logistic management at depot

    Science.gov (United States)

    Sze, San-Nah; Sek, Siaw-Ying Doreen; Chiew, Kang-Leng; Tiong, Wei-King

    2017-07-01

    This study focuses on the empty container management problem in a deficit regional area. Deficit area is the area having more export activities than the import activities, which always have a shortage of empty container. This environment has challenged the trading companies in the decision making in distributing the empty containers. A simulation model that fit to the environment is developed. Besides, a simple heuristic algorithm with some hard and soft constraints consideration are proposed to plan the logistic of empty container supply. Then, the feasible route with the minimum cost will be determined by applying the proposed heuristic algorithm. The heuristic algorithm can be divided into three main phases which are data sorting, data assigning and time window updating.

  6. Data acquisition and management system for a nuclear processes simulator

    International Nuclear Information System (INIS)

    Gonzalez M, J.A.; Santiago C, J.

    2003-01-01

    In the development of this work (Data acquisition and management system for a simulator of nuclear processes (SAMAD)), is important to mention the main modules that involve the operation of the same one. At the beginning it was necessary to contemplate the possible programming languages, as well as the compatibility and handling easiness among them. The used languages to be able to land the contemplated ideas are: C ++ , PHP, HTML, as well as the My SQL database manager. After this it was designed the database (DB), which contains the tables of each one of the components, this according to the enter file type of the RELAP5 code that will be use for each simulation, as well as, tables that will allow us to relate and to maintain the control of the information supplied to the DB. Once created the database is interacting with it through an application program based on PHP (Preprocessor). The application basically consists, in extracting the data from each one of the components to work in that moment, that is to say, to obtain the data of the enter file, as well as, to depurate the data, excluding comments. The preprocessor gives bigger easiness to place the data in the DB. Also, it was developed an graphic interface that allows to register variables to the DB, depending from the unfolding to visualize. Another application that has been implemented is the Data Collector that has as function, to obtain in a direct way the data of the display variables of the RELAP5 code, with the purpose of storing them in the DB, this will be carry out in real time and it was updated in a very small time period. (Author)

  7. Simulation of demand management and grid balancing with electric vehicles

    Science.gov (United States)

    Druitt, James; Früh, Wolf-Gerrit

    2012-10-01

    This study investigates the potential role of electric vehicles in an electricity network with a high contribution from variable generation such as wind power. Electric vehicles are modelled to provide demand management through flexible charging requirements and energy balancing for the network. Balancing applications include both demand balancing and vehicle-to-grid discharging. This study is configured to represent the UK grid with balancing requirements derived from wind generation calculated from weather station wind speeds on the supply side and National Grid data from on the demand side. The simulation models 1000 individual vehicle entities to represent the behaviour of larger numbers of vehicles. A stochastic trip generation profile is used to generate realistic journey characteristics, whilst a market pricing model allows charging and balancing decisions to be based on realistic market price conditions. The simulation has been tested with wind generation capacities representing up to 30% of UK consumption. Results show significant improvements to load following conditions with the introduction of electric vehicles, suggesting that they could substantially facilitate the uptake of intermittent renewable generation. Electric vehicle owners would benefit from flexible charging and selling tariffs, with the majority of revenue derived from vehicle-to-grid participation in balancing markets.

  8. A 2D simulation model for urban flood management

    Science.gov (United States)

    Price, Roland; van der Wielen, Jonathan; Velickov, Slavco; Galvao, Diogo

    2014-05-01

    The European Floods Directive, which came into force on 26 November 2007, requires member states to assess all their water courses and coast lines for risk of flooding, to map flood extents and assets and humans at risk, and to take adequate and coordinated measures to reduce the flood risk in consultation with the public. Flood Risk Management Plans are to be in place by 2015. There are a number of reasons for the promotion of this Directive, not least because there has been much urban and other infrastructural development in flood plains, which puts many at risk of flooding along with vital societal assets. In addition there is growing awareness that the changing climate appears to be inducing more frequent extremes of rainfall with a consequent increases in the frequency of flooding. Thirdly, the growing urban populations in Europe, and especially in the developing countries, means that more people are being put at risk from a greater frequency of urban flooding in particular. There are urgent needs therefore to assess flood risk accurately and consistently, to reduce this risk where it is important to do so or where the benefit is greater than the damage cost, to improve flood forecasting and warning, to provide where necessary (and possible) flood insurance cover, and to involve all stakeholders in decision making affecting flood protection and flood risk management plans. Key data for assessing risk are water levels achieved or forecasted during a flood. Such levels should of course be monitored, but they also need to be predicted, whether for design or simulation. A 2D simulation model (PriceXD) solving the shallow water wave equations is presented specifically for determining flood risk, assessing flood defense schemes and generating flood forecasts and warnings. The simulation model is required to have a number of important properties: -Solve the full shallow water wave equations using a range of possible solutions; -Automatically adjust the time step and

  9. Advanced Simulation Capability for Environmental Management (ASCEM) Phase II Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Freshley, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hubbard, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Flach, G. [Savannah River National Lab. (SRNL), Aiken, SC (United States); Freedman, V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Agarwal, D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Andre, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bott, Y. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chen, X. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Davis, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faybishenko, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gorton, I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Murray, C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Moulton, D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Meyer, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rockhold, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Shoshani, A. [LBNL; Steefel, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wainwright, H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Waichler, S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2012-09-28

    In 2009, the National Academies of Science (NAS) reviewed and validated the U.S. Department of Energy Office of Environmental Management (EM) Technology Program in its publication, Advice on the Department of Energy’s Cleanup Technology Roadmap: Gaps and Bridges. The NAS report outlined prioritization needs for the Groundwater and Soil Remediation Roadmap, concluded that contaminant behavior in the subsurface is poorly understood, and recommended further research in this area as a high priority. To address this NAS concern, the EM Office of Site Restoration began supporting the development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific approach that uses an integration of toolsets for understanding and predicting contaminant fate and transport in natural and engineered systems. The ASCEM modeling toolset is modular and open source. It is divided into three thrust areas: Multi-Process High Performance Computing (HPC), Platform and Integrated Toolsets, and Site Applications. The ASCEM toolsets will facilitate integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. During fiscal year 2012, the ASCEM project continued to make significant progress in capabilities development. Capability development occurred in both the Platform and Integrated Toolsets and Multi-Process HPC Simulator areas. The new Platform and Integrated Toolsets capabilities provide the user an interface and the tools necessary for end-to-end model development that includes conceptual model definition, data management for model input, model calibration and uncertainty analysis, and model output processing including visualization. The new HPC Simulator capabilities target increased functionality of process model representations, toolsets for interaction with the Platform, and model confidence testing and verification for

  10. Vuosaari Harbour Road Tunnel Traffic Management and Incident Detection System Design Issues

    Directory of Open Access Journals (Sweden)

    Caj Holm

    2006-11-01

    Full Text Available Helsinki is constructing in Vuosaari a new modem and effectivecargo harbour. All cargo harbour activities will be concentratedthere. The total project includes the harbour, a logisticsarea, traffic connections (road, railway and fairway and aBusiness Park. The road connection goes through the Porvarinlahtiroad tunnel. The harbour will commence operatingin 2008. This paper gives an oveTView of the tunnel design phasefunctional studies and risk analysis tunnel incident detectionsystem design issues and some specific environmental featuresof the tunnel.

  11. Simulation training for a mass casualty incident: two-year experience at the Army Trauma Training Center.

    Science.gov (United States)

    King, David R; Patel, Mayur B; Feinstein, Ara J; Earle, Steven A; Topp, Raymond F; Proctor, Kenneth G

    2006-10-01

    Civilian and military mass casualty incidents (MCI) are an unfortunate reality in the 21st century, but there are few situational training exercises (STX) to prepare for them. To fill this gap, we developed a MCI STX for U.S. Army Forward Surgical Teams (FST) in conjunction with the U.S. Army Trauma Training Center. After a standardized briefing, each FST has 60 minutes to unpack, setup, and organize a standard equipment cache into an emergency room, operating room, and intensive care unit. In an adjacent room, five anesthetized swine are prepared with standardized, combat-relevant injuries. The number and acuity of the total casualties are unknown to the FST and arrive in waves and without warning. A realistic combat environment is simulated by creating resource limitations, power outages, security breaches, and other stressors. The STX concludes when all casualties have died or are successfully treated. FSTs complete a teamwork self-assessment card, while staff and FST surgeons evaluate organization, resource allocation, communication, treatment, and overall performance. Feedback from each FST can be incorporated into an updated design for the next STX. From 2003-2005, 16 FSTs have completed the STX. All FSTs have had collapses in situational triage, primary/ secondary surveys, and/or ATLS principles (basic ABCs), resulting in approximately 20% preventable deaths. We concluded (1) a MCI can overwhelm even combat- experienced FSTs; (2) adherence to basic principles of emergency trauma care by all FST members is essential to effectively and efficiently respond to this MCI; (3) by prospectively identifying deficiencies, future military or civilian performance during an actual MCI may be improved; and (4) this MCI STX could provide a template for similar programs to develop, train, and evaluate civilian surgical disaster response teams.

  12. Decision making for wildfires: A guide for applying a risk management process at the incident level

    Science.gov (United States)

    Mary A. Taber; Lisa M. Elenz; Paul G. Langowski

    2013-01-01

    This publication focuses on the thought processes and considerations surrounding a risk management process for decision making on wildfires. The publication introduces a six element risk management cycle designed to encourage sound risk-informed decision making in accordance with Federal wildland fire policy, although the process is equally applicable to non-Federal...

  13. Incidence and Management of Thrombotic and Thromboembolic Complications Following the Norwood Procedure: A Systematic Review.

    Science.gov (United States)

    Agarwal, Arnav; Firdouse, Mohammed; Brar, Nishaan; Yang, Andy; Lambiris, Panos; Chan, Anthony K; Mondal, Tapas K

    2017-11-01

    The stage 1 Norwood procedure and its variants represent the first step of palliation for hypoplastic left heart syndrome. Although appropriate postoperative thromboprophylaxis is integral, significant variance remains across institutional practices. The purpose of this systematic review is to estimate the incidence of thrombosis and thromboembolism following the Norwood or modified Blalock-Taussig shunt procedure and examine current thromboprophylaxis regimens. Ovid MEDLINE and Embase were searched from January 2000 to June 2016 for primary studies explicitly reporting incidence of thrombosis, thromboembolism (strokes and pulmonary embolisms), or shunt occlusion in neonates, infants, and children undergoing the Norwood procedure or any variant. All-cause mortality was a secondary outcome of interest. Of 887 identified articles, 15 cohort studies were deemed eligible, the majority including modified Blalock-Taussig shunt patients. Reported incidence of thrombosis ranged from 0% to 40%; thromboembolic events were rarely reported. Overall mortality ranged from 4.5% to 31.3% across studies. Although most studies involved the long-term acetylsalicylic acid use, thromboprophylaxis strategies varied across studies. Due to substantial variability in event rates, no correlation was identified with thrombotic complications. Clinical practice guidelines recommend that patients receive intraoperative unfractionated heparin therapy and either aspirin or no antithrombotic therapy postoperatively. Our findings suggest a substantial risk of thrombosis and thromboembolism and demonstrate substantial variation in thromboprophylaxis practices. Although postoperative thromboprophylaxis seems optimal, it remains controversial whether the long-term aspirin use is most effective. Our findings highlight the lack of a gold-standard thromboprophylaxis strategy and emphasize the need for more consistency.

  14. Simulating long-term effectiveness and efficiency of management scenarios for an invasive grass

    OpenAIRE

    Catherine S. Jarnevich; Tracy R. Holcombe; Catherine Cullinane Thomas; Leonardo Frid; Aaryn Olsson

    2015-01-01

    Resource managers are often faced with trade-offs in allocating limited resources to manage plant invasions. These decisions must often be made with uncertainty about the location of infestations, their rate of spread and effectiveness of management actions. Landscape level simulation tools such as state-and-transition simulation models (STSMs) can be used to evaluate the potential long term consequences of alternative management strategies and help identify those strategies that make efficie...

  15. Crisis management during the SOCATRI incident in July 2008: lessons learned by the IRSN

    International Nuclear Information System (INIS)

    Champion, D.

    2010-01-01

    This report describes the successive events which occurred in July 2008 in the SOCATRI plant where a uranium-bearing solution was accidentally released, causing a temporary pollution of two rivers. Then, he reports how this event has been managed, firstly through a mobilization of public authorities and early decisions, secondly through sampling and measurements performed by the IRSN (the management of the obtained results is also commented), thirdly through expertise investigations by the IRSN, fourthly through relationship with local authorities, and finally through media and public information. For each of these aspects, the author discusses the lessons learned, and proposes ways to improve the management of such an accident

  16. Waste Management Decision-Making Process During a Homeland Security Incident Response

    Science.gov (United States)

    A step-by-step guide on how to make waste management-related decisions including how waste can be minimized, collected and treated, as well as where waste can be sent for staging, storage and final disposal.

  17. Incidents in Czechoslovakian "Socialist Management" between 1956 and 1989. Conflict and Reconciliation

    Czech Academy of Sciences Publication Activity Database

    Vilímek, Tomáš; Tůma, Oldřich

    42/43, Spring-Summer (2016), s. 187-240 ISSN 1310-9456 Institutional support: RVO:68378114 Keywords : socialist management * centrally planned economy * Czechoslovakia 1956-1989 Subject RIV: AB - History

  18. Appreciating the Complexity of Project Management Execution: Using Simulation in the Classroom

    Science.gov (United States)

    Hartman, Nathan S.; Watts, Charles A.; Treleven, Mark D.

    2013-01-01

    As the popularity and importance of project management increase, so does the need for well-prepared project managers. This article discusses our experiences using a project management simulation in undergraduate and MBA classes to help students better grasp the complexity of project management. This approach gives students hands-on experience with…

  19. A Real-Time Expert System Approach To Freeway Incident Management

    OpenAIRE

    Ritchie, Stephen G.; Prosser, Neil A.

    1992-01-01

    Fundamental to the operation of most Intelligent Vehicle-Highway System (IVHS) projects are advanced systems for surveillance, control and management of integrated freeway and arterial networks. A Major concern in the development of such Smart Roads, and the focus of this paper, is the provision of decision support for traffic management center personnel, particularly for addressing non-recurring congestion in large or complex networks. Decision support for control room staff is necessary to ...

  20. International Commission for Mountain Emergency Medicine Consensus Guidelines for On-Site Management and Transport of Patients in Canyoning Incidents.

    Science.gov (United States)

    Strapazzon, Giacomo; Reisten, Oliver; Argenone, Fabien; Zafren, Ken; Zen-Ruffinen, Greg; Larsen, Gordon L; Soteras, Inigo

    2018-02-13

    Canyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  1. Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate: Cumulative Incidence and Outcome of the Management.

    Science.gov (United States)

    Ungkanont, Kitirat; Boonyabut, Panrasee; Komoltri, Chulaluk; Tanphaichitr, Archwin; Vathanophas, Vannipa

    2018-04-01

    To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Retrospective cohort study in the tertiary care center. Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

  2. Incidence and management of hip dislocation in tumour patients with a modular prosthesis of the proximal femur.

    Science.gov (United States)

    Puchner, Stephan E; Funovics, Philipp T; Hipfl, Christian; Dominkus, Martin; Windhager, Reinhard; Hofstaetter, Jochen G

    2014-08-01

    Little data is available about the incidence and especially the management of hip dislocation following the implantation of modular tumor prostheses of the proximal femur. In this retrospective single-centre study we assessed the incidence of hip dislocation following implantation of a proximal femoral modular prosthesis as well as the success of the subsequent surgical or non-surgical treatment in tumor patients. Between 1982 and 2008, 166 tumor patients received a modular prosthesis of the proximal femur at our institution. The average age at the time of surgery was 50 ± 20 years (range, six to 84 years). An additional pelvic reconstruction was done in 14 patients. An artificial band for soft tissue reconstruction of the hip was used in 19 patients. The average time of follow-up was 46 ± 64 months (range, one to 277 months). The overall dislocation rate after proximal femoral replacement was 13% after a mean time of seven ± eight months (range, 0.3-33 months) after surgery. Between 1982 and 1986 the dislocation rate was 33% and declined to 9% in subsequent years (1987-2008). Patients who had received an additional pelvic reconstruction had a three fold higher dislocation rate (p prosthesis of the proximal femur is a common complication, especially in cases with additional pelvic resection with extensive bone and soft-tissue defects. Open surgical management may be more effective in preventing re-dislocation than closed reduction and bracing alone.

  3. Incidence and management of leukopenia/neutropenia in 233 kidney transplant patients following single dose alemtuzumab induction.

    Science.gov (United States)

    Smith, A; Couvillion, R; Zhang, R; Killackey, M; Buell, J; Lee, B; Saggi, B H; Paramesh, A S

    2014-12-01

    The purpose of this study was to determine the incidence and management strategies for post-transplant leukopenia/neutropenia in kidney recipients receiving alemtuzumab induction during the first year following transplantation. We prospectively identified 233 adult patients who underwent kidney transplantation with alemtuzumab induction at a single institution. The incidence and severity of leukopenia (white blood cell count [WBC] ≤2500/mm(3)) and neutropenia (absolute neutrophil count [ANC] ≤500/mm(3)) were evaluated at 1, 3, 6, and 12 months post-transplantation. We determined any association with cytomegalovirus (CMV) infection, graft rejection, and infections requiring hospitalization. We also reviewed interventions performed, including medication adjustments, treatment with granulocyte stimulating factor, and hospitalization. The combined incidence of either leukopenia or neutropenia was 47.5% (n = 114/233) with an average WBC nadir of 1700 ± 50/mm(3) at 131.0 ± 8.5 days and an average ANC nadir of 1500 ± 100/mm(3) at 130.4 ± 9.6 days. No significant difference in graft rejection, CMV infection, or infections requiring hospitalization was found in the leukopenia/neutropenia group vs the normal WBC group (P = .3). The most common intervention performed for leukopenia/neutropenia group was prophylactic medication adjustment. Six patients (5.2%) required a change in >1 medication. The majority of these patients also required granulocyte stimulating factor (61.5%; 32/52), with an average of 2.5 doses given. A total of 25 patients (21.9%) required hospitalization due to leukopenia/neutropenia with an average length of stay of 6 days. Kidney transplant patients receiving alemtuzumab induction required significant interventions due to leukopenia/neutropenia in the first year post-transplantation. These results suggest the need for additional studies aimed at defining the optimum management strategies of leukopenia/neutropenia in this population

  4. Simulator testing of the Westinghouse aware alarm management system

    International Nuclear Information System (INIS)

    Carrera, J.P.; Easter, J.R.; Roth, E.M.

    1997-01-01

    Over the last year, Westinghouse engineers and operators from the Beznau nuclear power station (KKB), owned by the Nordostschweizerische Krafwerke AG of Baden, Switzerland, have been installing and testing the Westinghouse AWARE Alarm Management System in Beznau/SNUPPS operator training simulator, owned and operated by the Westinghouse Electric Corp., in Waltz Mill, PA, USA. The testing has focused primarily on validating the trigger logic data base and on familiarizing the utility's training department with the operation of the system in a real-time environment. Some of the tests have included plant process scenarios in which the computerized Emergency Procedures were available and used through the COMPRO (COMputerized PROcedures) System in conjunction with the AWARE System. While the results to date are qualitative from the perspective of system performance and improvement in message presentation, the tests have generally confirmed the expectations of the design. There is a large reduction in the number of messages that the control room staff must deal with during major process abnormalities, yet at times of relative minor disturbances, some additional messages are available which add clarification, e.g., ''Pump Trouble'' messages. The ''flow'' of an abnormality as it progresses from one part of the plant's processes to another is quite visible. Timing of the messages and the lack of message avalanching is proving to give the operators additional time to respond to messages. Generally, the anxiety level to ''do something'' immediately upon a reactor trip appears to be reduced. (author). 8 refs

  5. Temporal trends in outpatient management of incident pulmonary embolism and associated mortality.

    Science.gov (United States)

    Klil-Drori, Adi J; Coulombe, Janie; Suissa, Samy; Hirsch, Andrew; Tagalakis, Vicky

    2018-01-01

    In clinical trial settings, outpatient management of pulmonary embolism (PE) is feasible and safe, but less is known on its use in routine care. We determined trends in outpatient management of PE and associated mortality in a large non-select patient population. All residents of Quebec, Canada with a first-ever work-up for suspected PE in the emergency department (ED) over 10years were included. Patients could transition to outpatient management and from unconfirmed to confirmed PE in a time-varying fashion. Comparing the years 2005-9 with 2000-4, we assessed the odds ratio (OR) for outpatient management, and relative risk (RR) for all-cause mortality, readmissions for PE, and major bleeding in 30days. We adjusted the RR for a mortality risk score. Of 15,217 patients included, 7583 were outpatients (7.5% confirmed PE) and 7634 were inpatients (60.6% confirmed PE). In all, 10.9% of patients with confirmed PE were outpatients, but outpatient management of confirmed PE was more likely in the latter study period (OR 1.73, 95%CI 1.44-2.09). Among outpatients with confirmed PE, mortality (RR 0.84, 95%CI 0.15-4.61) and readmission (RR 1.25, 95%CI 0.45-3.48) rates were stable, and only 3 major bleeding events were noted. Inpatients with confirmed PE had stable mortality rates (RR 0.95, 95%CI 0.72-1.24). Outpatient PE management increased over 10years while remaining fairly uncommon. Nevertheless, stable mortality and readmission rates indicate this practice is safe in routine care, and add to the growing evidence in support of outpatient PE management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. 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

  7. Simulating human behavior for understanding and managing environmental resource use

    NARCIS (Netherlands)

    Jager, Wander; Mosler, Hans Joachim

    2007-01-01

    Computer simulation allows for the experimental study of dynamic interactions between human behavior and complex environmental systems. Behavioral determinants and processes as identified in social-scientific theory may be formalized in simulated agents to obtain a better understanding of

  8. Learning with a strategic management simulation game: A case study

    OpenAIRE

    Loon, Mark; Evans, Jason; Kerridge, Clive

    2015-01-01

    The use of simulation games as a pedagogic method is well established though its effective use is context-driven. This study adds to the increasing growing body of empirical evidence of the effectiveness of simulation games but more importantly emphasises why by explaining the instructional design implemented reflecting best practices. This multi-method study finds evidence that student learning was enhanced through the use of simulation games, reflected in the two key themes; simulation game...

  9. Comparing Student Perceptions of Coping Strategies and School Interventions in Managing Bullying and Cyberbullying Incidents

    Science.gov (United States)

    Paul, Simone; Smith, Peter K.; Blumberg, Herbert H.

    2012-01-01

    A total of 407 students in a central London secondary school participated in a survey of different approaches to managing traditional bullying and cyberbullying. Student perceptions of individual coping strategies and school interventions for traditional bullying and cyberbullying were measured. Rankings of the strategies for traditional bullying…

  10. Using Simulation to Support Novice Teachers' Classroom Management Skills: Comparing Traditional and Alternative Certification Groups

    Science.gov (United States)

    Pankowski, Jennifer; Walker, Joan T.

    2016-01-01

    Drawing from research on situated cognition and the development of expertise and simulations in professional education, we designed two simulation tasks that provided novice teachers with repeated opportunities to deliberately practice managing a classroom under no-fault conditions. The simulations immersed novices in two perennial classroom…

  11. Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2014-03-01

    Full Text Available OBJECTIVE: To assess the incidence and conditions associated with cesarean section in a cohort of pregnant women with intrauterine fetal death (IUFD, and clinical management to anticipate the childbirth. METHODS: It was a retrospective cohort study with 163 mothers with IUFD, at the second half of pregnancy, who were managed to anticipate childbirth using pharmacological preparations and/or a mechanical method (Foley catheter in a teaching hospital in Rio de Janeiro State, Brazil. Cox regression was used to evaluate the effect of the clinical methods on the kind of delivery. RESULTS: The Subgroups A (misoprostol or Oxytocin, B (misoprostol and Oxytocin, and C (Foley catheter alone or combined with misoprostol and/or Oxytocin were formed according to the applied methods. Nine out of 163 cases ended with cesarean section. The incidence of cesarean section was 3.5 per 1,000 people-hours, meaning that a pregnant woman with IUFD had a 15.6% risk of cesarean section during the first 48 hours of clinical management to anticipate childbirth. The conditions significantly associated with the mode of delivery were placental abruption (HR: 44.97, having two or more previous cesarean deliveries (HR: 10.03, and mechanical method with Foley catheter (HR: 5.01. CONCLUSION: Cesarean section was an essential conduct in this cohort and followed previous cesarean delivery and placental abruption. The effect of the mechanical method on the abdominal route suggests that the Foley catheter method was used in the most difficult cases and that the surgery was performed to ensure maternal health.

  12. Colorectal cancer liver metastases - a population-based study on incidence, management and survival.

    Science.gov (United States)

    Engstrand, Jennie; Nilsson, Henrik; Strömberg, Cecilia; Jonas, Eduard; Freedman, Jacob

    2018-01-15

    Colorectal cancer (CRC) is a leading cause of cancer-associated deaths with liver metastases developing in 25-30% of those affected. Previous data suggest a survival difference between right- and left-sided liver metastatic CRC, even though left-sided cancer has a higher incidence of liver metastases. The aim of the study was to describe the liver metastatic patterns and survival as a function of the characteristics of the primary tumour and different combinations of metastatic disease. A retrospective population-based study was performed on a cohort of patients diagnosed with CRC in the region of Stockholm, Sweden during 2008. Patients were identified through the Swedish National Quality Registry for Colorectal Cancer Treatment (SCRCR) and additional information on intra- and extra-hepatic metastatic pattern and treatment were retrieved from electronic patient records. Patients were followed for 5 years or until death. Factors influencing overall survival (OS) were investigated by means of Cox regression. OS was compared using Kaplan-Meier estimations and the log-rank test. Liver metastases were diagnosed in 272/1026 (26.5%) patients within five years of diagnosis of the primary. Liver and lung metastases were more often diagnosed in left-sided colon cancer compared to right-sided cancer (28.4% versus 22.1%, p = 0.029 and 19.7% versus 13.2%, p = 0.010, respectively) but the extent of liver metastases were more extensive for right-sided cancer as compared to left-sided (p = 0.001). Liver metastatic left-sided cancer, including rectal cancer, was associated with a 44% decreased mortality risk compared to right-sided cancer (HR = 0.56, 95% CI: 0.39-0.79) with a 5-year OS of 16.6% versus 4.3% (p < 0.001). In liver metastatic CRC, the presence of lung metastases did not significantly influence OS as assessed by multivariate analysis (HR = 1.11, 95% CI: 0.80-1.53). The worse survival in liver metastatic right-sided colon cancer could possibly be

  13. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review

    OpenAIRE

    Panelli, Danielle M.; Phillips, Catherine H.; Brady, Paula C.

    2015-01-01

    Background: Ectopic pregnancy is a potentially life-threatening condition occurring in 1-2 % of all pregnancies. The most common ectopic implantation site is the fallopian tube, though 10 % of ectopic pregnancies implant in the cervix, ovary, myometrium, interstitial portion of the fallopian tube, abdominal cavity or within a cesarean section scar. Findings: Diagnosis involves a combination of clinical symptoms, serology, and ultrasound. Medical management is a safe and effective option in mo...

  14. Incidence and management of severe odontogenic infections-a retrospective analysis from 2004 to 2011.

    Science.gov (United States)

    Opitz, Daniel; Camerer, Christian; Camerer, Doris-Maria; Raguse, Jan-Dirk; Menneking, Horst; Hoffmeister, Bodo; Adolphs, Nicolai

    2015-03-01

    The management of odontogenic infections is a typical part of the spectrum of maxillofacial surgery. Normally these infections can be managed in a straight forward way however under certain conditions severe and complicated courses can arise which require interdisciplinary treatment including intensive care. A retrospective analysis of all patients affected by an odontogenic infection that received surgical therapy from 2004 to 2011 under stationary conditions was performed. Surgical treatment consisted in incision and drainage of the abscess supported by additional i.v. antibiotic medication in all patients. Detailed analysis of all patients that required postoperative intensive medical care was additionally performed with respect to special risk factors. During 8 years 814 patients affected by odontogenic infections received surgical treatment under stationary conditions representing 4% of all patients that have been treated during that period (n = 18981). In 14 patients (1.7%) intensive medical therapy after surgery was required, one lethal outcome was documented (0.12%). In all of these 14 patients a history of typical risk factors was present. According to these results two patients per week affected by an odontogenic infection required stationary surgical treatment, about two patients per year were likely to require additional intensive medical care. If well-known risk factors are present in patients affected by odontogenic infection appropriate interdisciplinary management should be considered as early as possible. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Simulation/optimization applications and software for optimal ground-water and conjunctive water management

    OpenAIRE

    Peralta, R. C.

    2001-01-01

    Diverse water management simulation/optimization (S/O) experiences promoted the development of many S/O modeling approaches and models. Several of these are being incorporated within the Simulation/Optimization Modeling System (SOMOS). Non-modeler water scientists or engineers can apply one SOMOS module to optimize field-scale groundwater and conjunctive water management. Experienced groundwater modelers can apply other modules to optimally manage complex heterogeneous aquifer and stream-aqui...

  16. Merging Methods to Manage Uncertainty: Combining Simulation Modeling and Scenario Planning to Inform Resource Management Under Climate Change

    Science.gov (United States)

    Miller, B. W.; Schuurman, G. W.; Symstad, A.; Fisichelli, N. A.; Frid, L.

    2017-12-01

    Managing natural resources in this era of anthropogenic climate change is fraught with uncertainties around how ecosystems will respond to management actions and a changing climate. Scenario planning (oftentimes implemented as a qualitative, participatory exercise for exploring multiple possible futures) is a valuable tool for addressing this challenge. However, this approach may face limits in resolving responses of complex systems to altered climate and management conditions, and may not provide the scientific credibility that managers often require to support actions that depart from current practice. Quantitative information on projected climate changes and ecological responses is rapidly growing and evolving, but this information is often not at a scale or in a form that is `actionable' for resource managers. We describe a project that sought to create usable information for resource managers in the northern Great Plains by combining qualitative and quantitative methods. In particular, researchers, resource managers, and climate adaptation specialists co-produced a simulation model in conjunction with scenario planning workshops to inform natural resource management in southwest South Dakota. Scenario planning for a wide range of resources facilitated open-minded thinking about a set of divergent and challenging, yet relevant and plausible, climate scenarios and management alternatives that could be implemented in the simulation. With stakeholder input throughout the process, we built a simulation of key vegetation types, grazing, exotic plants, fire, and the effects of climate and management on rangeland productivity and composition. By simulating multiple land management jurisdictions, climate scenarios, and management alternatives, the model highlighted important tradeoffs between herd sizes and vegetation composition, and between the short- versus long-term costs of invasive species management. It also identified impactful uncertainties related to the

  17. High Incidence of De Novo and Subclinical Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy and Cardiac Rhythm Management Device.

    Science.gov (United States)

    Wilke, Iris; Witzel, Katrin; Münch, Julia; Pecha, Simon; Blankenberg, Stephan; Reichenspurner, Hermann; Willems, Stephan; Patten, Monica; Aydin, Ali

    2016-07-01

    Atrial fibrillation (AF) is an important prognostic parameter in patients with hypertrophic cardiomyopathy (HCM). Though cardiac rhythm management (CRM) devices (e.g., ICD, pacemaker or implantable loop recorder) can detect subclinical AF, data describing the incidence of AF are rare. We therefore investigated the incidence and clinical impact of de novo and subclinical AF detected by CRM devices in patients with HCM. In our retrospective single-center study, we included patients with HCM and need for CRM devices. The primary endpoint of the study was the incidence of clinical and subclinical de novo AF. During follow-up, patients were screened for adverse events like stroke, ventricular arrhythmia, heart failure, or death. From 192 HCM patients, 44 patients received a CRM device (38 ICDs, 5 pacemakers, 1 implantable loop recorder). In 14 of these patients (32%), AF had been documented before device implantation. Thirty (68%) patients were free from AF at the time of implantation. During a median follow-up of 595 days (interquartile range, 367-890 days), de novo AF was recorded in 16 of these 30 patients (53%). Fourteen (88%) of the 16 patients with de novo AF were free from any clinical symptoms, so these patients were classified to have subclinical AF. In logistic regression analysis, age was the only significant predictor for an increased risk of AF. AF is common in patients with HCM who need a CRM device. More than 50% of these patients develop de novo AF that was predominantly subclinical in our cohort. © 2016 Wiley Periodicals, Inc.

  18. Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors.

    Science.gov (United States)

    Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter

    2012-03-01

    To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.

  19. Incidence of stress on top management and its impact upon health and work area

    Directory of Open Access Journals (Sweden)

    Dana Maria Staňková

    2009-01-01

    Full Text Available Within the frame of this paper the key theoretical knowledge to the selected topic is described, the presentation of partial results and discussion on the issue of the psychological aspects of managerial work, focusing on stress and its manifestations are submitted. The aim of this research was to identify the most frequent stress symptoms in the physiological, emotional and behavioral field and to define the main factors which cause them in work and private life terms. For the purpose of this research of stress effects on health area a questionnaire technology of our own design was chosen. For a deeper understanding of sources of an increased psychological stress in managerial activities a technique of interviews with the top managers was used. Research investigation has showed the action of stress on the senior managers, particularly increased during the current economic recession. The most significant signs of stress are manifested in physiological area, especially by fatigue, headache, digestion problems and sleep disturbances, as in the emotional area by anxiety, excessive concern and overall irritability. At the same time stress impacts also the behavioral area, where it has a negative impact to the work and family life. In the course of processing this subject, an absolutely obvious need occurred for a deeper processing of this large area of work stress, which will be subsequently dealing with, and whose output will be, the methodology of anti-stress strategy for HR (Human Resources managers and Senior Executives of companies to prevent stress, promote health and quality of living conditions in the workplace.

  20. End-stage renal disease in India and Pakistan: incidence, causes, and management.

    Science.gov (United States)

    Sakhuja, Vinay; Kohli, Harbir S

    2006-01-01

    Chronic renal failure is a devastating medical, social, and economic problem for patients and their families in India and Pakistan. Reliable data on the true incidence and prevalence of end-stage renal disease (ESRD) in India and Pakistan are lacking because no national registries exist. Among reported cases, chronic glomerulonephritis is the most common cause, accounting for more than one third of patients, while diabetic nephropathy accounts for approximately 20% of all patients in India. Delayed diagnosis and failure to institute measures to slow the progression of renal failure have resulted in a predominantly young ESRD population, with a median age of 44 years. Because of financial constraints, less than one third of all patients referred to a tertiary care center receive any kind of renal replacement therapy. Most hemodialysis patients who stop treatment and die do so because of cost constraints within the first three months, and approximately 5% of patients are started on ambulatory peritoneal dialysis. Renal transplantation is the cheapest option, but < 10% of all patients with ESRD have a transplant. Cyclosporine, azathioprine, and prednisolone continue to be the backbone of post-transplant immunosuppression, but cyclosporine is stopped in a significant proportion of patients at one year post-transplant to cut down costs. Living related donor transplants constitute 70% of all transplants; two thirds of the donors are females, while more than three fourths of all recipients are males. Spouses account for 20% of donors from within families. Almost 30% of transplanted kidneys are donated by living unrelated donors, while cadaver donors account for only 2%. More resources must be mobilized to care for these patients; early detection of renal disease must be facilitated, and measures to delay ESRD must be implemented.

  1. Incidence and management of Kaposi sarcoma in renal transplant recipients: the Greek experience.

    Science.gov (United States)

    Zavos, G; Moris, D; Vernadakis, S; Bokos, J; Lionaki, S; Mamarelis, G; Panagiotellis, K; Zavvos, V; Boletis, I

    2014-11-01

    One of the most common malignancies in kidney transplant recipients is Kaposi sarcoma. The incidence of Kaposi sarcoma, which develops after renal transplantation, is 400-500 times higher than that in the general population. The aims of this study were to review the experience with Kaposi sarcoma in the highest-volume transplantation Unit in Greece and to analyze clinical characteristics and response to treatment, with respect to both the patients' survival and the renal graft function. The records of 2008 renal graft recipients between March 1983 and December 2012 were retrospectively reviewed. Kaposi sarcoma was diagnosed based on clinical, laboratory, radiological, endoscopic, and histopathologic examinations. The disease was staged according to the classification of Al-Khader et al. The prevalence of Kaposi sarcoma was 1.2% in our renal transplant population. Of these, 1006 recipients underwent living-donor renal transplantation, whereas 1002 received their graft from deceased donors. Post-transplantation malignancy developed in 153 patients, among which, Kaposi sarcoma has been found in 24 cases. Of the 24 cases of Kaposi sarcoma, lesions were mainly cutaneous in 14 cases, visceral and cutaneous in 8, and concomitant visceral and lymph node involvement was observed in 2 patients. With regard to the final outcome, 20 patients (83.3%) showed remission of the disease, whereas 4 patients with visceral involvement (16.6%) did not respond to chemotherapy and discontinuation of immunosuppression and died. Moreover, 8 deaths occurred due to apparently unrelated causes. Kaposi sarcoma is an important part (15.7%) of all post-transplantation neoplasias in our series. Furthermore, our findings confirmed the previously described close association between human herpesvirus-8 and post-transplantation Kaposi sarcoma. Reduction of immunosuppression or discontinuation of calcineurin inhibitors results in remission of the disease in most of the cases. Prognosis in patients with

  2. Airway management in a bronchoscopic simulator based setting

    DEFF Research Database (Denmark)

    Graeser, Karin; Konge, Lars; Kristensen, Michael S

    2014-01-01

    BACKGROUND: Several simulation-based possibilities for training flexible optical intubation have been developed, ranging from non-anatomical phantoms to high-fidelity virtual reality simulators. These teaching devices might also be used to assess the competence of trainees before allowing them...... to practice on patients. OBJECTIVES: To evaluate the validity of airway simulation as an assessment tool for the acquisition of the preclinical basic skills in flexible optical intubation and to investigate anaesthetists' opinion on airway simulation. DESIGN: Observational study. SETTING: International airway...

  3. Effectiveness of a stress management pilot program aimed at reducing the incidence of sports injuries in young football (soccer) players.

    Science.gov (United States)

    Olmedilla-Zafra, Aurelio; Rubio, Victor J; Ortega, Enrique; García-Mas, Alexandre

    2017-03-01

    Several attempts to reduce the incidence of sport injuries using psychosocial interventions produced fruitful, although inconclusive results. This paper presents the effectiveness and implementation issues of a pilot 3-month stress-management and muscle relaxation program aimed at reducing sport injury incidence. Pre-post treatment-non treatment group comparison. The program was administered by a trained psychologist on a once-a-week, 1-h session basis. Seventy-four male soccer players from four National Youth league teams voluntarily participated. Teams were randomly assigned to either treatment/non-treatment group. Injury protocol, Self-monitoring cards, Athletes' satisfaction and commitment survey, Coaches' interview. Group main effect and Time-Group interaction effect were both statistically significant, F(1,60) = 8.30, p = 0.005, η 2 p  = 0.121, with the average number of injuries larger in the post-treatment phase of non-treatment group (p = 0.005, η 2 p  = 0.077). There was a significant decrease in the average number of injuries for the intervention group before and after implementing the program (p sport injuries, with a high level of satisfaction and commitment from the athletes, as well as high acceptance from the coaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. ACE Inhibitor-Induced Angioedema of the Intestine: Case Report, Incidence, Pathophysiology, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Gavin Oudit

    2001-01-01

    Full Text Available A case report of fosinopril-induced angioedema of the intestine with a chronic course accompanied by multiple acute exacerbations is described. Angiotensin-converting enzyme (ACE inhibitor-induced angioedema of the intestine (AIAI occurs in a minority of patients taking an ACE inhibitor. The clinical presentation encompasses acute abdominal symptoms, pronounced bowel edema and ascites with occasional facial and/or oropharyngeal swelling. AIAI is diagnosed based on the temporal relationship between the symptomatic presentation and drug use, absence of alternative diagnoses including other causes of angioedema, and the prompt resolution of symptoms upon discontinuation of the ACE inhibitor. Prompt radiological investigation (abdominal computerized tomography and/or ultrasound is critical in making an early diagnosis and in preventing unnecessary surgical intervention. There is a female predominance of AIAI, which may reflect the interaction of estradiol with the various pathways involved in the pathophysiology of AIAI. Management of AIAI consists mainly of conservative measures and discontinuation of the ACE inhibitor. Angiotensin II receptor antagonists should not be considered as appropriate alternatives. Awareness and knowledge of AIAI are important because of the increasing use of ACE inhibitors, current delays in making the diagnosis, obvious management strategies once the diagnosis is made and the dysutility of alternative diagnoses, which may lead to considerable morbidity. AIAI must be considered in patients taking ACE inhibitors who develop gastrointestinal complaints irrespective of the duration of the therapy.

  5. Simulation of recreational use in backcountry settings: an aid to management planning

    Science.gov (United States)

    David N. Cole

    2002-01-01

    Simulation models of recreation use patterns can be a valuable tool to managers of backcountry areas, such as wilderness areas and national parks. They can help fine-tune existing management programs, particularly in places that ration recreation use or that require the use of designated campsites. They can assist managers in evaluating the likely effects of increasing...

  6. FEMA's Earthquake Incident Journal: A Web-Based Data Integration and Decision Support Tool for Emergency Management

    Science.gov (United States)

    Jones, M.; Pitts, R.

    2017-12-01

    For emergency managers, government officials, and others who must respond to rapidly changing natural disasters, timely access to detailed information related to affected terrain, population and infrastructure is critical for planning, response and recovery operations. Accessing, analyzing and disseminating such disparate information in near real-time are critical decision support components. However, finding a way to handle a variety of informative yet complex datasets poses a challenge when preparing for and responding to disasters. Here, we discuss the implementation of a web-based data integration and decision support tool for earthquakes developed by the Federal Emergency Management Agency (FEMA) as a solution to some of these challenges. While earthquakes are among the most well- monitored and measured of natural hazards, the spatially broad impacts of shaking, ground deformation, landslides, liquefaction, and even tsunamis, are extremely difficult to quantify without accelerated access to data, modeling, and analytics. This web-based application, deemed the "Earthquake Incident Journal", provides real-time access to authoritative and event-specific data from external (e.g. US Geological Survey, NASA, state and local governments, etc.) and internal (FEMA) data sources. The journal includes a GIS-based model for exposure analytics, allowing FEMA to assess the severity of an event, estimate impacts to structures and population in near real-time, and then apply planning factors to exposure estimates to answer questions such as: What geographic areas are impacted? Will federal support be needed? What resources are needed to support survivors? And which infrastructure elements or essential facilities are threatened? This presentation reviews the development of the Earthquake Incident Journal, detailing the data integration solutions, the methodology behind the GIS-based automated exposure model, and the planning factors as well as other analytical advances that

  7. Monte Carlo simulation of electron depth distribution and backscattering for carbon films deposited on aluminium as a function of incidence angle and primary energy

    International Nuclear Information System (INIS)

    Dapor, Maurizio

    2005-01-01

    Carbon films are deposited on various substrates (polymers, polyester fabrics, polyester yarns, metal alloys) both for experimental and technological motivations (medical devices, biocompatible coatings, food package and so on). Computational studies of the penetration of electron beams in supported thin film of carbon are very useful in order to compare the simulated results with analytical techniques data (obtained by scanning electron microscopy and/or Auger electron spectroscopy) and investigate the film characteristics. In the present paper, the few keV electron depth distribution and backscattering coefficient for the special case of film of carbon deposited on aluminium are investigated, by a Monte Carlo simulation, as a function of the incidence angle and primary electron energy. The simulated results can be used as a way to evaluate the carbon film thickness by a set of measurements of the backscattering coefficient

  8. Mitigating Latent Threats Identified through an Embedded In Situ Simulation Program and Their Comparison to Patient Safety Incidents: A Retrospective Review

    Directory of Open Access Journals (Sweden)

    Philip Knight

    2018-02-01

    Full Text Available ObjectiveTo assess the impact of service improvements implemented because of latent threats (LTs detected during in situ simulation.DesignRetrospective review from April 2008 to April 2015.SettingPaediatric Intensive Care Unit in a specialist tertiary hospital.InterventionService improvements from LTs detection during in situ simulation. Action plans from patient safety incidents (PSIs.Main outcome measuresThe quantity, category, and subsequent service improvements for LTs. The quantity, category, and subsequent action plans for PSIs. Similarities between PSIs and LTs before and after service improvements.Results201 Simulated inter-professional team training courses with 1,144 inter-professional participants. 44 LTs were identified (1 LT per 4.6 courses. Incident severity varied: 18 (41% with the potential to cause harm, 20 (46% that would have caused minimal harm, and 6 (13% that would have caused significant temporary harm. Category analysis revealed the majority of LTs were resources (36% and education and training (27%. The remainder consisted of equipment (11%, organizational and strategic (7%, work and environment (7%, medication (7%, and systems and protocols (5%. 43 service improvements were developed: 24 (55% resources/equipment; 9 (21% educational; 6 (14% organizational changes; 2 (5% staff communications; and 2 (5% guidelines. Four (9% service improvements were adopted trust wide. 32 (73% LTs did not recur after service improvements. 24 (1% of 1,946 PSIs were similar to LTs: 7 resource incidents, 7 catastrophic blood loss, 4 hyperkalaemia arrests, 3 emergency buzzer failures, and 3 difficulties contacting staff. 34 LTs (77% were never recorded as PSIs.ConclusionAn in situ simulation program can identify important LTs which traditional reporting systems miss. Subsequent improvements in workplace systems and resources can improve efficiency and remove error traps.

  9. Mitigating Latent Threats Identified through an EmbeddedIn SituSimulation Program and Their Comparison to Patient Safety Incidents: A Retrospective Review.

    Science.gov (United States)

    Knight, Philip; MacGloin, Helen; Lane, Mary; Lofton, Lydia; Desai, Ajay; Haxby, Elizabeth; Macrae, Duncan; Korb, Cecilia; Mortimer, Penny; Burmester, Margarita

    2017-01-01

    To assess the impact of service improvements implemented because of latent threats (LTs) detected during in situ simulation. Retrospective review from April 2008 to April 2015. Paediatric Intensive Care Unit in a specialist tertiary hospital. Service improvements from LTs detection during in situ simulation. Action plans from patient safety incidents (PSIs). The quantity, category, and subsequent service improvements for LTs. The quantity, category, and subsequent action plans for PSIs. Similarities between PSIs and LTs before and after service improvements. 201 Simulated inter-professional team training courses with 1,144 inter-professional participants. 44 LTs were identified (1 LT per 4.6 courses). Incident severity varied: 18 (41%) with the potential to cause harm, 20 (46%) that would have caused minimal harm, and 6 (13%) that would have caused significant temporary harm. Category analysis revealed the majority of LTs were resources (36%) and education and training (27%). The remainder consisted of equipment (11%), organizational and strategic (7%), work and environment (7%), medication (7%), and systems and protocols (5%). 43 service improvements were developed: 24 (55%) resources/equipment; 9 (21%) educational; 6 (14%) organizational changes; 2 (5%) staff communications; and 2 (5%) guidelines. Four (9%) service improvements were adopted trust wide. 32 (73%) LTs did not recur after service improvements. 24 (1%) of 1,946 PSIs were similar to LTs: 7 resource incidents, 7 catastrophic blood loss, 4 hyperkalaemia arrests, 3 emergency buzzer failures, and 3 difficulties contacting staff. 34 LTs (77%) were never recorded as PSIs. An in situ simulation program can identify important LTs which traditional reporting systems miss. Subsequent improvements in workplace systems and resources can improve efficiency and remove error traps.

  10. Trustworthy information sharing for biosecurity incident management - The AU2EU project

    Science.gov (United States)

    Zic, John

    2013-10-01

    Managing sensitive information between partners collaborating to address an exotic disease outbreak is crucial in preserving the medical, economic and social well-being of the affected population (whether it is human, animal or plant). Further, the ability to respond quickly to the outbreak by providing real-time, interactive access to shared (collaborative) information will minimise the impact of an outbreak. The sharing of information must be done carefully, with agreement between the partners and enforced by specific protocols. This paper presents an overview of a new joint project between EU partners and AU partners, total value of around €8.64 million, which is examining the issue of authentication and authorisation required to ensure that collaborative information in such situations is kept within the control of the collaborating partners and that accidental (or deliberate) release to unauthorised partners can be mitigated.

  11. Acute diarrhea in adults consulting a general practitioner in France during winter: incidence, clinical characteristics, management and risk factors.

    Science.gov (United States)

    Arena, Christophe; Amoros, Jean Pierre; Vaillant, Véronique; Ambert-Balay, Katia; Chikhi-Brachet, Roxane; Jourdan-Da Silva, Nathalie; Varesi, Laurent; Arrighi, Jean; Souty, Cécile; Blanchon, Thierry; Falchi, Alessandra; Hanslik, Thomas

    2014-10-30

    Data describing the epidemiology and management of viral acute diarrhea (AD) in adults are scant. The objective of this study was to identify the incidence, clinical characteristics, management and risk factors of winter viral AD in adults. The incidence of AD in adults during two consecutive winters (from December 2010 to April 2011 and from December 2011 to April 2012) was estimated from the French Sentinelles network. During these two winters, a subset of Sentinelles general practitioners (GPs) identified and included adult patients who presented with AD and who filled out a questionnaire and returned a stool specimen for virological examination. All stool specimens were tested for astrovirus, group A rotavirus, human enteric adenovirus, and norovirus of genogroup I and genogroup II. Age- and sex-matched controls were included to permit a case-control analysis with the aim of identifying risk factors for viral AD. During the studied winters, the average incidence of AD in adults was estimated to be 3,158 per 100,000 French adults (95% CI [2,321 - 3,997]). The most reported clinical signs were abdominal pain (91.1%), watery diarrhea (88.5%), and nausea (83.3%). GPs prescribed a treatment in 95% of the patients with AD, and 80% of the working patients with AD could not go to work. Stool examinations were positive for at least one enteric virus in 65% (95% CI [57 - 73]) of patients with AD with a predominance of noroviruses (49%). Having been in contact with a person who has suffered from AD in the last 7 days, whether within or outside the household, and having a job (or being a student) were risk factors significantly associated with acquiring viral AD. During the winter, AD of viral origin is a frequent disease in adults, and noroviruses are most often the cause. No preventable risk factor was identified other than contact with a person with AD. Thus, at the present time, reinforcement of education related to hand hygiene remains the only way to reduce the

  12. Incidence of root rot diseases of soybean in Multan Pakistan and its management by the use of plant growth promoting rhizobacteria

    International Nuclear Information System (INIS)

    Haq, M.I.; Tahir, M.I.; Mahmood, S.

    2012-01-01

    Eight villages in Multan district were surveyed to record incidence of disease and losses of soybean (Glycine max L.) caused by root rot fungi. The root incidence ranged 10-17% and losses ranged 6.75-15.5%. The evaluation of four PGPR isolates was used in combination with organic amendment for the management of root-rot disease incidence and to reduce the population of root pathogenic fungi and to increase the yield in field. This study demonstrated effective biological control by the PGPR isolates tested, thereby indicating the possibility of application of rhizobacteria for control of soil bor ne diseases of soybean in Pakistan and other countries. (author)

  13. Major incident medical management and support: The practical approach at the scene Kevin Mackway-Jones Major Incident Medical Management and Support: The Practical Approach at the Scene Wiley-Blackwell £41.99 196pp 9781405187572 1405187573 [Formula: see text].

    Science.gov (United States)

    2012-06-12

    ALTHOUGH THIS excellent, informative book is intended primarily to be a manual for the pre-major incident medical management and support course, it would be a useful resource in any emergency department and a useful guide for individual nurses who provide care at major incident scenes.

  14. Evaluating the Impact of Classroom Education on the Management of Septic Shock Using Human Patient Simulation.

    Science.gov (United States)

    Lighthall, Geoffrey K; Bahmani, Dona; Gaba, David

    2016-02-01

    Classroom lectures are the mainstay of imparting knowledge in a structured manner and have the additional goals of stimulating critical thinking, lifelong learning, and improvements in patient care. The impact of lectures on patient care is difficult to examine in critical care because of the heterogeneity in patient conditions and personnel as well as confounders such as time pressure, interruptions, fatigue, and nonstandardized observation methods. The critical care environment was recreated in a simulation laboratory using a high-fidelity mannequin simulator, where a mannequin simulator with a standardized script for septic shock was presented to trainees. The reproducibility of this patient and associated conditions allowed the evaluation of "clinical performance" in the management of septic shock. In a previous study, we developed and validated tools for the quantitative analysis of house staff managing septic shock simulations. In the present analysis, we examined whether measures of clinical performance were improved in those cases where a lecture on the management of shock preceded a simulated exercise on the management of septic shock. The administration of the septic shock simulations allowed for performance measurements to be calculated for both medical interns and for subsequent management by a larger resident-led team. The analysis revealed that receiving a lecture on shock before managing a simulated patient with septic shock did not produce scores higher than for those who did not receive the previous lecture. This result was similar for both interns managing the patient and for subsequent management by a resident-led team. We failed to find an immediate impact on clinical performance in simulations of septic shock after a lecture on the management of this syndrome. Lectures are likely not a reliable sole method for improving clinical performance in the management of complex disease processes.

  15. Crisis Management training at nuclear facilities: Simulations in bomb threats

    International Nuclear Information System (INIS)

    Barton, L.

    1993-01-01

    Substantial enhancements to the study of the theoretical and applied foundations of crisis management have been achieved in recent years. Whereas risk managers study 'the probability that a harmful consequence of a particular event will occur during a given time,' crisis management explores unexpected, potentially negative events with short or long-term implications involving injury to life or property. In this regard, crisis management focuses on the mitigation of organizational after-shock; risk management is preventative in scope. While the risk management function of nuclear facilities has been addressed widely in the literature, comparatively little has been written that addresses the myriad, interdisciplinary challenges associated with managing organizational disarray. The issue of crisis management has assumed paramount importance in recent years due to unexpected geopolitical events (e.g., Persian Gulf War), rampant violence facing organizations (e.g., mass shootings in Killeen, Texas and several U.S. Post Offices) and an acceleration of serious crisis impacting large organizations (e.g., Three Mile Island, Chernobyl, Exxon Valdez, NASA Challenger disaster). Without question, the public is increasingly demanding that organizational managers possess a fundamental understanding of crisis management and its principal underpinnings: effective public communication regarding the event and a return to normalcy, employee and public safety and evacuation measures, and other mitigation measures will protect life and property

  16. An advanced configuration management system for full scope power plant simulators

    International Nuclear Information System (INIS)

    Storm, J.; Goemann, A.

    1996-01-01

    In August 1993 KSG Kraftwerks-Simulator-Gesellschaft, Germany, awarded a contract to STN ATLAS Elektronik for the delivery of two full scope replica training simulators for the German BWR plants Isar 1 and Philipsburg 1, known as the double simulator project S30 (S31/S32). For both projects a computer based Configuration Management System (CMS) was required to overcome deficiencies of older simulator systems in terms of limited upgrade and maintenance capabilities and incomplete documentation. The CMS allows complete control over the entire simulator system covering all software- and hardware-items and therewith exceed quality assurance requirements as defined in ISO 9000-3 which gives recommendations for software configuration management only. The system is realized under the project using the UNIX based relational database system EMPRESS and is in use as a development- and maintenance-tool to improve simulator quality and ensure simulator configuration integrity

  17. Simulator as a tool of training to modern equipment management

    Directory of Open Access Journals (Sweden)

    Ahmedyanova Gulnara

    2017-01-01

    Full Text Available In the work, the learning process with the use of a simulator was studied. In this case, both the design and algorithmic content of the simulator, as well as the trainee, must pass their part of the path, only in this case the result of learning is maximized. Theoretically, it is shown that the effectiveness of simulator training is primarily a function of the cognitive-operational and professional-personal aspects of the trainee's competence. The experiment confirmed that, despite the differences above the indicated qualities, the result can be estimated as the sum of their estimates.

  18. The incidence and management of cutaneous adverse events of the epidermal growth factor receptor inhibitors

    Directory of Open Access Journals (Sweden)

    Witold Owczarek

    2017-10-01

    Full Text Available Overexpression of the epidermal growth factor receptor (EGFR is found in many cancers, including those of the head and neck area, non-small-cell lung cancer, and colorectal, cervical, prostate, breast, ovary, stomach, and pancreatic cancer. The EGFR inhibitors are used at present in the treatment of such cancers. Skin lesions that develop during and after cancer treatment may be due to specific cytostatics, molecular-targeted drugs, radiation therapy, complementary therapy, or the cancer itself, and hence knowledge is essential to distinguish between them. The mechanism through which skin toxicity arises during treatment with EGFR inhibitors is not well known, but seems to be due to the modification of the RAS/RAF/MEK/ERK signal path associated with its activation, which results in the similarity between the adverse effects of EGFR inhibitors and the treatment of melanoma with BRAF and MEK inhibitors. The most common side effects are pruritus, xerosis, papulopustular rash, hand-foot skin reaction, alopecia and dystrophy of the hair, and paronychia. This work presents options for prevention and suggestions for managing these adverse events, which are of importance in the care of patients undergoing oncological treatment.

  19. Decontamination and Management of Human Remains Following Incidents of Hazardous Chemical Release

    Energy Technology Data Exchange (ETDEWEB)

    Hauschild, Veronique [U.S. Army Public Health Command; Watson, Annetta Paule [ORNL; Bock, Robert Eldon [ORNL

    2012-01-01

    Abstract Objective: To provide specific procedural guidance and resources for identification, assessment, control, and mitigation of compounds that may contaminate human remains resulting from chemical attack or release. Design: A detailed technical, policy, and regulatory review is summarized. Setting: Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present. Settings would include sites of transportation accidents, natural disasters, terrorist or military operations, mortuary affairs or medical examiner processing and decontamination points, and similar. Patients, Participants: While recommended procedures have not been validated with actual human remains, guidance has been developed from data characterizing controlled experiments with fabrics, materiel, and laboratory animals. Main Outcome Measure(s): Presentation of logic and specific procedures for remains management, protection and decontamination of mortuary affairs personnel, as well as decision criteria for determining when remains are sufficiently decontaminated so as to pose no chemical health hazard. Results: Established procedures and existing equipment/materiel available for decontamination and verification provide appropriate and reasonable means to mitigate chemical hazards from remains. Extensive characterization of issues related to remains decontamination indicates that supra-lethal concentrations of liquid chemical warfare agent VX may prove difficult to decontaminate and verify in a timely fashion. Specialized personnel can and should be called upon to assist with monitoring necessary to clear decontaminated remains for transport and processing. Conclusions: Once appropriate decontamination and verification have been accomplished, normal procedures for remains processing and transport to the decedent s family and the continental United States can be followed.

  20. A CLINICAL STUDY ON THE INCIDENCE AND MANAGEMENT OF BIOLOGICAL COMPLICATIONS IN IMPLANT THERAPY

    Directory of Open Access Journals (Sweden)

    Nicolae VASILE

    2015-09-01

    Full Text Available The scope of the study was to evidence the methods recommended for avoiding, managing and implementing an efficient treatment capable of reducing the biological complications accompanying implant therapies. Materials and method. The study evaluates the patients with prosthesis charged implants - or during their osseointegration period - inserted in the Clinic of The Emergency Military Hospital of Sibiu, over a 5 year period (2009-2014. Retrospective investigation was based on the evaluation of the treatment files and on the imagistic and clinical analyses of the 125 patients to whom 385 implants had been inserted. Results and discussion. The study demonstrates that, when implants are the support of an overdenture, surrounded by either limited keratinized gingiva or mobile tissues, the presence of the bacterial plaque is considerable, the peri-implant pocket exceeds 5 mm, and sensitivity and bleeding are produced on contact with the probe. In susceptible patients, or in those with pathological periodontal antecedents, the re-infection potential has been always higher. The clinical study confirms that, invariably, peri-implantitis is associated with the existence of the bacterial plaque and also with the presence of a peri-implant pocket exceeding 4 mm (8.9%, with partial exposure of the covering screw (4.5% and fixed restaurations without self-cleaning spaces (2%. Conclusions. Out of the post-surgery biological complications, peri-implantitis is the most frequent one, causing a – sometimes total – loss of the alveolar bone around the osseointegrated implant.

  1. Nurses' experiences of managing patient deterioration following a post-registration education programme: A critical incident analysis study.

    Science.gov (United States)

    Butler, Clare

    2018-01-01

    The aim of this study was to explore nurses' experiences assessing and managing deteriorating patients in practice following completion of a relevant post-registration education programme. Recognising the increasing acuity of ward patients, nurses are faced with patients who are at an increased risk of deterioration. Patients who are acutely ill or deteriorating often exhibit periods of physiological deterioration; however there is evidence illustrating that these clinical changes are frequently missed, misinterpreted or mismanaged in practice. In order to prepare nurses to competently assess and manage the deteriorating patient, education as a care initiative is offered to develop the knowledge and skills required. A qualitative study using critical incident analysis was conducted to acquire narrative data from nurses, describing their clinical practice experiences of patient deterioration. Thematic analysis was used to analyse the data. Findings revealed improvements in nurses' abilities to recognise patient deterioration, greater application of the evidence base and an increase in confidence and assertiveness. There was some evidence of applying the knowledge and skills learned, however equally some nurses indicated that they remained ill-prepared to apply the skills in practice. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  2. Adding Value in Construction Design Management by Using Simulation Approach

    OpenAIRE

    Doloi, Hemanta

    2008-01-01

    Simulation modelling has been introduced as a decision support tool for front end planning and design analysis of projects. An integrated approach has been discussed linking project scope, end product or project facility performance and the strategic project objectives at the early stage of projects. The case study example on tram network demonstrates that application of simulation helps assessing performance of project operation and making appropriate investment decisions over life cycle of ...

  3. Management of an incident of failed sterilization of surgical instruments in a dental clinic in Hong Kong

    Directory of Open Access Journals (Sweden)

    Vincent Chi-Chung Cheng

    2013-11-01

    Conclusion: Rapid response is extremely crucial in minimizing the impact of this incident and relieving the anxiety of the affected patients. Proper recording and documentation of autoclave cycles and regular auditing should be enforced to prevent similar incidents.

  4. Habitat complexity influences fine scale hydrological processes and the incidence of stormwater runoff in managed urban ecosystems.

    Science.gov (United States)

    Ossola, Alessandro; Hahs, Amy Kristin; Livesley, Stephen John

    2015-08-15

    Urban ecosystems have traditionally been considered to be pervious features of our cities. Their hydrological properties have largely been investigated at the landscape scale and in comparison with other urban land use types. However, hydrological properties can vary at smaller scales depending upon changes in soil, surface litter and vegetation components. Management practices can directly and indirectly affect each of these components and the overall habitat complexity, ultimately affecting hydrological processes. This study aims to investigate the influence that habitat components and habitat complexity have upon key hydrological processes and the implications for urban habitat management. Using a network of urban parks and remnant nature reserves in Melbourne, Australia, replicate plots representing three types of habitat complexity were established: low-complexity parks, high-complexity parks, and high-complexity remnants. Saturated soil hydraulic conductivity in low-complexity parks was an order of magnitude lower than that measured in the more complex habitat types, due to fewer soil macropores. Conversely, soil water holding capacity in low-complexity parks was significantly higher compared to the two more complex habitat types. Low-complexity parks would generate runoff during modest precipitation events, whereas high-complexity parks and remnants would be able to absorb the vast majority of rainfall events without generating runoff. Litter layers on the soil surface would absorb most of precipitation events in high-complexity parks and high-complexity remnants. To minimize the incidence of stormwater runoff from urban ecosystems, land managers could incrementally increase the complexity of habitat patches, by increasing canopy density and volume, preserving surface litter and maintaining soil macropore structure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Training and learning for crisis management using a virtual simulation/gaming environment

    NARCIS (Netherlands)

    Walker, W.E.; Giddings, J.; Armstrong, S.

    2011-01-01

    Recent advances in computers, networking, and telecommunications offer new opportunities for using simulation and gaming as methodological tools for improving crisis management. It has become easy to develop virtual environments to support games, to have players at distributed workstations

  6. The impact of anti HPV vaccination on cervical cancer incidence and HPV induced cervical lesions: consequences for clinical management.

    Science.gov (United States)

    Brinkman, J A; Caffrey, A S; Muderspach, L I; Roman, L D; Kast, W M

    2005-01-01

    prevent persistent infection with the virus are high and may be implemented in the near future. The consequences for clinical management may include a significant reduction in the frequency of Pap smear screening in the case of prophylactic vaccines, and the availability of less invasive and disfiguring treatment options for women with pre-existing HPV associated lesions in the case of therapeutic vaccines. Implementation of both prophylactic and therapeutic vaccine regimens could result in a significant reduction of health care costs and reduction of worldwide cervical cancer incidence.

  7. Co-producing simulation models to inform resource management: a case study from southwest South Dakota

    Science.gov (United States)

    Miller, Brian W.; Symstad, Amy J.; Frid, Leonardo; Fisichelli, Nicholas A.; Schuurman, Gregor W.

    2017-01-01

    Simulation models can represent complexities of the real world and serve as virtual laboratories for asking “what if…?” questions about how systems might respond to different scenarios. However, simulation models have limited relevance to real-world applications when designed without input from people who could use the simulated scenarios to inform their decisions. Here, we report on a state-and-transition simulation model of vegetation dynamics that was coupled to a scenario planning process and co-produced by researchers, resource managers, local subject-matter experts, and climate change adaptation specialists to explore potential effects of climate scenarios and management alternatives on key resources in southwest South Dakota. Input from management partners and local experts was critical for representing key vegetation types, bison and cattle grazing, exotic plants, fire, and the effects of climate change and management on rangeland productivity and composition given the paucity of published data on many of these topics. By simulating multiple land management jurisdictions, climate scenarios, and management alternatives, the model highlighted important tradeoffs between grazer density and vegetation composition, as well as between the short- and long-term costs of invasive species management. It also pointed to impactful uncertainties related to the effects of fire and grazing on vegetation. More broadly, a scenario-based approach to model co-production bracketed the uncertainty associated with climate change and ensured that the most important (and impactful) uncertainties related to resource management were addressed. This cooperative study demonstrates six opportunities for scientists to engage users throughout the modeling process to improve model utility and relevance: (1) identifying focal dynamics and variables, (2) developing conceptual model(s), (3) parameterizing the simulation, (4) identifying relevant climate scenarios and management

  8. Simulation of demand-response power management in smart city

    Science.gov (United States)

    Kadam, Kshitija

    Smart Grids manage energy efficiently through intelligent monitoring and control of all the components connected to the electrical grid. Advanced digital technology, combined with sensors and power electronics, can greatly improve transmission line efficiency. This thesis proposed a model of a deregulated grid which supplied power to diverse set of consumers and allowed them to participate in decision making process through two-way communication. The deregulated market encourages competition at the generation and distribution levels through communication with the central system operator. A software platform was developed and executed to manage the communication, as well for energy management of the overall system. It also demonstrated self-healing property of the system in case a fault occurs, resulting in an outage. The system not only recovered from the fault but managed to do so in a short time with no/minimum human involvement.

  9. Teaching Supply Chain Management Complexities: A SCOR Model Based Classroom Simulation

    Science.gov (United States)

    Webb, G. Scott; Thomas, Stephanie P.; Liao-Troth, Sara

    2014-01-01

    The SCOR (Supply Chain Operations Reference) Model Supply Chain Classroom Simulation is an in-class experiential learning activity that helps students develop a holistic understanding of the processes and challenges of supply chain management. The simulation has broader learning objectives than other supply chain related activities such as the…

  10. Challenges and needs in fire management: A landscape simulation modeling perspective [chapter 4

    Science.gov (United States)

    Robert E. Keane; Geoffrey J. Cary; Mike D. Flannigan

    2011-01-01

    Fire management will face many challenges in the future from global climate change to protecting people, communities, and values at risk. Simulation modeling will be a vital tool for addressing these challenges but the next generation of simulation models must be spatially explicit to address critical landscape ecology relationships and they must use mechanistic...

  11. Developing Clinical Competency in Crisis Event Management: An Integrated Simulation Problem-Based Learning Activity

    Science.gov (United States)

    Liaw, S. Y.; Chen, F. G.; Klainin, P.; Brammer, J.; O'Brien, A.; Samarasekera, D. D.

    2010-01-01

    This study aimed to evaluate the integration of a simulation based learning activity on nursing students' clinical crisis management performance in a problem-based learning (PBL) curriculum. It was hypothesized that the clinical performance of first year nursing students who participated in a simulated learning activity during the PBL session…

  12. FARSITE: a fire area simulator for fire managers

    Science.gov (United States)

    Mark A. Finney

    1995-01-01

    A fire growth model (FARSITE) has been developed for use on personal computers (PC’s). Because PC’s are commonly used by land and fire managers, this portable platform would be an accustomed means to bring fire growth modeling technology to management applications. The FARSITE model is intended for use in projecting the growth of prescribed natural fires for wilderness...

  13. Simulation of hadron multiple production by cosmic-ray protons in the incident energy region of 1015 eV

    International Nuclear Information System (INIS)

    Takatsuka, Ichiro

    1984-01-01

    The simulation studies of the unusual cosmic ray families found by the experiment at Mt. Chacaltaya were performed. Those families have a larger number of hadrons than the normal families, or are the families with big transverse extension. The former is called Centauro or Mini-centauro, and the latter is called Binocular and Chiron. In the first simulation, the process was calculated, in which the Lorentz transformation of π-meson multiple production (C-jet) in the energy region of 10 14 eV was made, and the jet with raised energy was combined, and the families were formed. The second simulation was made for the energy region more than 300 TeV, in which the nucleon-antinucleon multiple production with large transverse momentum and the B particle multiple production with larger transverse momentum were assumed. The data used were the C-jet data observed at Mt. Chacaltaya. For the simulation, all the primary particles were considered to be protons. The results of the present simulation study showed that the families with strong hadron components observed at Mt. Chacaltaya might be the new type hadron multiple production such as nucleon-antinucleon multiple production or B-particle multiple production. The total energy of all the families increased with the energy of the primary particles. There are a few families having the same extent of energy and spread as the Chiron. (Kato, T.)

  14. Simulating the physician as healthcare manager: An innovative course to train for the manager role.

    Science.gov (United States)

    Gradel, Maximilian; Moder, Stefan; Nicolai, Leo; Pander, Tanja; Hoppe, Boj; Pinilla, Severin; Von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos

    2016-01-01

    During their formal studies medical students acquire extensive medical expertise. However, the medical profession demands additional competencies, such as those involved in efficient resource allocation, business administration, development, organization, and process management in the healthcare system. At present students are not sufficiently prepared for the physician's role as manager. In response, we designed the seminar course, MeCuM-SiGma, to impart basic knowledge about healthcare policy and management to students of medicine. This project report describes our teaching strategies and the initial evaluation of this educational project. In this semester-long, seminar course introduced in 2010, medical students gather experience with the competencies mentioned above as well as learn basic management skills. The course is offered each winter semester, and students sign up to attend voluntarily; course coordination and organization is done on a voluntary basis by physicians and employees of the Mentoring Office (MeCuM-Mentor) at the Medical School of the Ludwig Maximilian University (LMU) in Munich, Germany. The course is open to all students enrolled at the two medical schools in Munich. During the first part of this elective, students learn about the basic principles of the German political and healthcare systems in case-based, problem-based tutorials led by trained tutors and in lectures held by experts. In the second part of the course students take on the roles of the University Hospital's executive board of directors and supervisory board to work on an existing hospital project as a group within the scope of a simulation. This phase of the course is accompanied by workshops conducted in cooperation with university-based and off-campus partners that address the procedural learning objectives (teamwork, project management, negotiation strategies, etc.). A suitable, authentic issue currently facing the hospital is selected in advance by the course organizers

  15. Simulating the physician as healthcare manager: An innovative course to train for the manager role

    Directory of Open Access Journals (Sweden)

    Gradel, Maximilian

    2016-05-01

    Full Text Available Introduction: During their formal studies medical students acquire extensive medical expertise. However, the medical profession demands additional competencies, such as those involved in efficient resource allocation, business administration, development, organization, and process management in the healthcare system. At present students are not sufficiently prepared for the physician’s role as manager. In response, we designed the seminar course, MeCuM-SiGma, to impart basic knowledge about healthcare policy and management to students of medicine. This project report describes our teaching strategies and the initial evaluation of this educational project.Project description: In this semester-long, seminar course introduced in 2010, medical students gather experience with the competencies mentioned above as well as learn basic management skills. The course is offered each winter semester, and students sign up to attend voluntarily; course coordination and organization is done on a voluntary basis by physicians and employees of the Mentoring Office (MeCuM-Mentor at the Medical School of the Ludwig Maximilian University (LMU in Munich, Germany. The course is open to all students enrolled at the two medical schools in Munich.During the first part of this elective, students learn about the basic principles of the German political and healthcare systems in case-based, problem-based tutorials led by trained tutors and in lectures held by experts.In the second part of the course students take on the roles of the University Hospital’s executive board of directors and supervisory board to work on an existing hospital project as a group within the scope of a simulation. This phase of the course is accompanied by workshops conducted in cooperation with university-based and off-campus partners that address the procedural learning objectives (teamwork, project management, negotiation strategies, etc..A suitable, authentic issue currently facing the

  16. Airway management education: simulation based training versus non-simulation based training-A systematic review and meta-analyses.

    Science.gov (United States)

    Sun, Yanxia; Pan, Chuxiong; Li, Tianzuo; Gan, Tong J

    2017-02-01

    Simulation-based training (SBT) has become a standard for medical education. However, the efficacy of simulation based training in airway management education remains unclear. The aim of this study was to evaluate all published evidence comparing the effectiveness of SBT for airway management versus non-simulation based training (NSBT) on learner and patient outcomes. Systematic review with meta-analyses were used. Data were derived from PubMed, EMBASE, CINAHL, Scopus, the Cochrane Controlled Trials Register and Cochrane Database of Systematic Reviews from inception to May 2016. Published comparative trials that evaluated the effect of SBT on airway management training in compared with NSBT were considered. The effect sizes with 95% confidence intervals (CI) were calculated for outcomes measures. Seventeen eligible studies were included. SBT was associated with improved behavior performance [standardized mean difference (SMD):0.30, 95% CI: 0.06 to 0.54] in comparison with NSBT. However, the benefits of SBT were not seen in time-skill (SMD:-0.13, 95% CI: -0.82 to 0.52), written examination score (SMD: 0.39, 95% CI: -0.09 to 0.86) and success rate of procedure completion on patients [relative risk (RR): 1.26, 95% CI: 0.96 to 1.66]. SBT may be not superior to NSBT on airway management training.

  17. Computer simulation for integrated pest management of spruce budworms

    Science.gov (United States)

    Carroll B. Williams; Patrick J. Shea

    1982-01-01

    Some field studies of the effects of various insecticides on the spruce budworm (Choristoneura sp.) and their parasites have shown severe suppression of host (budworm) populations and increased parasitism after treatment. Computer simulation using hypothetical models of spruce budworm-parasite systems based on these field data revealed that (1)...

  18. A Model Management Approach for Co-Simulation Model Evaluation

    NARCIS (Netherlands)

    Zhang, X.C.; Broenink, Johannes F.; Filipe, Joaquim; Kacprzyk, Janusz; Pina, Nuno

    2011-01-01

    Simulating formal models is a common means for validating the correctness of the system design and reduce the time-to-market. In most of the embedded control system design, multiple engineering disciplines and various domain-specific models are often involved, such as mechanical, control, software

  19. Simulating Effects of Forest Management Practices on Pesticide.

    Science.gov (United States)

    M.C. Smith; W.G. Knisel; J.L. Michael; D.G. Neary

    1993-01-01

    The GLEAMS model pesticide component was modified to simulate up to 245 pesticides simultaneously, and the revised model was used to pesticide pesticide application windows for forest site preparation and pine release. Five herbicides were made for soils representing four hydrologic soil groups in four climatic regions of the southeastern United States. Five herbicides...

  20. Business Management Simulations – a detailed industry analysis as well as recommendations for the future

    Directory of Open Access Journals (Sweden)

    Michael Batko

    2016-06-01

    Full Text Available Being exposed to serious games showed that some simulations widely vary in quality and learning outcome. In order to get to the bottom of best practices a detailed review of business management simulation literature was conducted. Additionally, an industry analysis was performed, by interviewing 17 simulation companies, testing a range of full and demo games, and conducting secondary research. The findings from both research efforts were then collated and cross-referenced against each other in order to determine three things: firstly, the practices and features used by simulation companies that have not yet been the subject of academic research; secondly, the most effective features, elements and inclusions within simulations that best assist in the achievement of learning outcomes and enhancement the user experience; and finally, ‘best practices’ in teaching a business management course in a university or company with the assistance of a simulation. Identified gaps in the current research were found to include the effectiveness of avatars, transparent pricing and the benefits of competing the simulation against other teams as opposed to the computer. In relation to the second and third objectives of the research, the findings were used to compile a business plan, with detailed recommendations for companies looking to develop a new simulation, and for instructors implementing and coordinating the use of a simulation in a business management context.

  1. Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents.

    Science.gov (United States)

    Carrillo, Irene; Mira, José Joaquín; Vicente, Maria Asuncion; Fernandez, Cesar; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora

    2016-09-27

    Lack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety. The aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence. The design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA's design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions. BACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003). BACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use.

  2. Comprehensive Simulation Lifecycle Management for High Performance Computing Modeling and Simulation, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — There are significant logistical barriers to entry-level high performance computing (HPC) modeling and simulation (M IllinoisRocstar) sets up the infrastructure for...

  3. Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

    NARCIS (Netherlands)

    Berger, Ferco H.; Körner, Markus; Bernstein, Mark P.; Sodickson, Aaron D.; Beenen, Ludo F.; McLaughlin, Patrick D.; Kool, Digna R.; Bilow, Ronald M.

    2016-01-01

    In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior

  4. Forest growth and timber quality: crown models and simulation methods for sustainable forest management

    Science.gov (United States)

    Dennis P. Dykstra; Robert A. Monserud

    2009-01-01

    The purpose of the international conference from which these proceedings are drawn was to explore relationships between forest management activities and timber quality. Sessions were organized to explore models and simulation methodologies that contribute to an understanding of tree development over time and the ways that management and harvesting activities can...

  5. Treatment of an Anonymous Recipient: Solid-Waste Management Simulation Game

    Science.gov (United States)

    Wu, Ko-Chiu; Huang, Po-Yuan

    2015-01-01

    This study developed a game simulation based on problem solving in the management of urban waste. We then investigated the factors affecting the decisions made by players. During gameplay, the players sought to guide the development of a city via management strategies involving a balance of economic growth and environmental protection. Nature…

  6. Brief introduction to project management of full scope simulator for Qinshan 300 MW Nuclear Power Unit

    International Nuclear Information System (INIS)

    Chen Jie

    1996-01-01

    The key points in development and engineering project management of full scope simulator for Qinshan 300 MW Nuclear Power Unit are briefly introduced. The Gantt chart, some project management methods and experience are presented. The key points analysis along with the project procedure will be useful to the similar project

  7. Spatial optimization of the pattern of fuel management activities and subsequent effects on simulated wildfires

    Science.gov (United States)

    Young-Hwan Kim; Pete Bettinger; Mark Finney

    2009-01-01

    Methods for scheduling forest management activities in a spatial pattern (dispersed, clumped, random, and regular) are presented, with the intent to examine the effects of placement of activities on resulting simulated wildfire behavior. Both operational and fuel reduction management prescriptions are examined, and a heuristic was employed to schedule the activities....

  8. Validating management simulation models and implications for communicating results to stakeholders

    NARCIS (Netherlands)

    Pastoors, M.A.; Poos, J.J.; Kraak, S.B.M.; Machiels, M.A.M.

    2007-01-01

    Simulations of management plans generally aim to demonstrate the robustness of the plans to assumptions about population dynamics and fleet dynamics. Such modelling is characterized by specification of an operating model (OM) representing the underlying truth and a management procedure that mimics

  9. Effects of Crew Resource Management Training on Medical Errors in a Simulated Prehospital Setting

    Science.gov (United States)

    Carhart, Elliot D.

    2012-01-01

    This applied dissertation investigated the effect of crew resource management (CRM) training on medical errors in a simulated prehospital setting. Specific areas addressed by this program included situational awareness, decision making, task management, teamwork, and communication. This study is believed to be the first investigation of CRM…

  10. GIS-based tools to identify tradeoffs between waste management and remediation strategies from radiological dispersal device incidents

    International Nuclear Information System (INIS)

    Lemieux, P.; Wood, J.; Snyder, E.; Boe, T.; Schulthiesz, D.; Peake, T.; Ierardi, M.; Hayes, C.; Rodgers, M.

    2011-01-01

    Management of waste and debris from the detonation of a Radiological Dispersal Device (RDD) will likely comprise a significant portion of the overall remediation effort and possibly contribute to a significant portion of the overall remediation costs. As part of the recent National Level Exercise, Liberty RadEx, that occurred in Philadelphia in April 2010, a methodology was developed by EPA to generate a first-order estimate of a waste inventory for the hypothetical RDD from the exercise scenario. Determination of waste characteristics and whether the generated waste is construction and demolition (C&D) debris, municipal solid waste (MSW), hazardous waste, mixed waste, or low level radioactive waste (LLRW), and characterization of the wastewater that is generated from the incident or subsequent cleanup activities will all influence the cleanup costs and timelines. Decontamination techniques, whether they involve chemical treatment, abrasive removal, or aqueous washing, will also influence the waste generated and associated cleanup costs and timelines. This paper describes the ongoing effort to develop a tool to support RDD planning and response activities by assessing waste quantities and characteristics as a function of potential mitigation strategies and targeted cleanup levels. (author)

  11. Simulating Quantile Models with Applications to Economics and Management

    Science.gov (United States)

    Machado, José A. F.

    2010-05-01

    The massive increase in the speed of computers over the past forty years changed the way that social scientists, applied economists and statisticians approach their trades and also the very nature of the problems that they could feasibly tackle. The new methods that use intensively computer power go by the names of "computer-intensive" or "simulation". My lecture will start with bird's eye view of the uses of simulation in Economics and Statistics. Then I will turn out to my own research on uses of computer- intensive methods. From a methodological point of view the question I address is how to infer marginal distributions having estimated a conditional quantile process, (Counterfactual Decomposition of Changes in Wage Distributions using Quantile Regression," Journal of Applied Econometrics 20, 2005). Illustrations will be provided of the use of the method to perform counterfactual analysis in several different areas of knowledge.

  12. Simulator drills for the management of severe accidents

    International Nuclear Information System (INIS)

    Hoffmann, E.

    1989-01-01

    The present state of deliberations on the simulation of severe accidents is presented and applied to a training philosophy. The special characteristics of 'severe' accidents are addressed and, falling under this category, the 'psychological structure of the man-machine-situation' is examined. The valid rules for drilling 'post-RESA-conduct' (RESA = fast reactor shut down) and the monitoring of safety goals are introduced. 2 figs., 1 tab

  13. Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: A mixed methods evaluation study.

    Science.gov (United States)

    Lavelle, Mary; Attoe, Chris; Tritschler, Christina; Cross, Sean

    2017-12-01

    In the UK, people with severe mental illness die up to 20years earlier than the general population, prompting increased focus on physical health in mental illness. However, training for mental health inpatient staff to meet patients' physical health needs has not received the same attention, with physical health training often being reactive and lacking evidence of effectiveness. To evaluate an interprofessional, in situ, simulation training intervention for managing medical deterioration in mental health settings. Investigating the impact of training on: 1. Participants' knowledge, confidence, and attitudes towards managing medical deterioration; and 2. Incident reporting, as an objective index of incident management. Participants' perceptions of the impact on their practice were qualitatively explored. This evaluation employed a mixed-methods pre-post intervention design. Fifty-three healthcare professionals participated including: mental health nurses, psychiatrists, healthcare assistants, and activity co-ordinators from two busy psychiatric triage wards in South London, UK. The intervention comprised eight half-day sessions delivered weekly across two wards. Structured surveys assessed participants' knowledge, confidence, and attitudes towards medical deterioration pre and post training. Participants' experience of training was qualitatively captured through post-course surveys and focus groups three months post training. Incident reporting rates for seven-month periods pre and post training were compared. Following training, participants showed significant improvement in knowledge (ptraining. Participants' reported improved confidence in managing medical deterioration, better understanding of effective communication, improved self-reflection and team working, and an increased sense of responsibility for patients' physical health. Interprofessional, in situ simulation training for medical deterioration yielded promising outcomes for individuals and teams

  14. Situation awareness in undergraduate nursing students managing simulated patient deterioration.

    Science.gov (United States)

    McKenna, Lisa; Missen, Karen; Cooper, Simon; Bogossian, Fiona; Bucknall, Tracey; Cant, Robyn

    2014-06-01

    Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. The educational process of FIRST(2)ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Clinical laboratories at each of three participating universities. Ninety-seven nursing students from three Australian universities. Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%). Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  15. Simulated Annealing Genetic Algorithm Based Schedule Risk Management of IT Outsourcing Project

    Directory of Open Access Journals (Sweden)

    Fuqiang Lu

    2017-01-01

    Full Text Available IT outsourcing is an effective way to enhance the core competitiveness for many enterprises. But the schedule risk of IT outsourcing project may cause enormous economic loss to enterprise. In this paper, the Distributed Decision Making (DDM theory and the principal-agent theory are used to build a model for schedule risk management of IT outsourcing project. In addition, a hybrid algorithm combining simulated annealing (SA and genetic algorithm (GA is designed, namely, simulated annealing genetic algorithm (SAGA. The effect of the proposed model on the schedule risk management problem is analyzed in the simulation experiment. Meanwhile, the simulation results of the three algorithms GA, SA, and SAGA show that SAGA is the most superior one to the other two algorithms in terms of stability and convergence. Consequently, this paper provides the scientific quantitative proposal for the decision maker who needs to manage the schedule risk of IT outsourcing project.

  16. Design of a simulation environment for laboratory management by robot organizations

    Science.gov (United States)

    Zeigler, Bernard P.; Cellier, Francois E.; Rozenblit, Jerzy W.

    1988-01-01

    This paper describes the basic concepts needed for a simulation environment capable of supporting the design of robot organizations for managing chemical, or similar, laboratories on the planned U.S. Space Station. The environment should facilitate a thorough study of the problems to be encountered in assigning the responsibility of managing a non-life-critical, but mission valuable, process to an organized group of robots. In the first phase of the work, we seek to employ the simulation environment to develop robot cognitive systems and strategies for effective multi-robot management of chemical experiments. Later phases will explore human-robot interaction and development of robot autonomy.

  17. Simulation Evaluation of Controller-Managed Spacing Tools under Realistic Operational Conditions

    Science.gov (United States)

    Callantine, Todd J.; Hunt, Sarah M.; Prevot, Thomas

    2014-01-01

    Controller-Managed Spacing (CMS) tools have been developed to aid air traffic controllers in managing high volumes of arriving aircraft according to a schedule while enabling them to fly efficient descent profiles. The CMS tools are undergoing refinement in preparation for field demonstration as part of NASA's Air Traffic Management (ATM) Technology Demonstration-1 (ATD-1). System-level ATD-1 simulations have been conducted to quantify expected efficiency and capacity gains under realistic operational conditions. This paper presents simulation results with a focus on CMS-tool human factors. The results suggest experienced controllers new to the tools find them acceptable and can use them effectively in ATD-1 operations.

  18. Mission-Driven sensor management analysis, design, implementation and simulation

    NARCIS (Netherlands)

    Bolderheij, F.

    2007-01-01

    The management of sensors onboard of the vessels operated by the Royal Netherlands Navy is becoming increasingly knowledge intensive due to the fact that these vessels are equipped with state-of-the-art sensor systems that provide more functionality and more accurate information at the cost of more

  19. Tragedy of the Commons Fisheries Management Simulation Game

    Science.gov (United States)

    Prothero, W. A.

    2011-12-01

    The goal of the "Fishing Game" is that students will understand some of the issues that occur when multiple stakeholders share, and profit from, common and finite resources. Garrett Hardin described this as "The Tragedy of the Commons." The global fisheries provide a timely example of the over-exploitation of a shared resource. The forests, our water supplies, and atmosphere are other examples of "commons" that we must manage effectively. The "Fishing Game" is loosely based on the "Fishbanks Game" of Dennis Meadows. The student plays against two virtual fishing companies in an effort to make as much money as possible, while exploring the management issues that arise when trying to sustain the fish population for future profits. The player selects each of four realistic management scenarios. These are 1) free for all, 2) limited fishing season, 3) marine reserves, and 4) catch shares. For each scenario the student makes decisions about how many ships to build and how many to send to each of two fishing areas. A simple population model works in the background to determine the catch and number of new fish that are added to the population through birth each year. The student sets the management parameters for each of the scenarios. A modeling tool is used to determine the optimum parameters for each management scenario. The player will quickly find that a single aggressive player whose profit motive trumps concern over the sustainability of the population will almost always win under all scenarios except the 4'th. When the season is limited, everybody fishes harder. With marine reserves, catches will drop, but the population will not disappear completely. Only catch shares sustain the population while providing reasonable long term profit for the fishing companies. For each management scenario, the player is asked a pre and a post play thought question. After all scenarios are played, the student can edit the post versions of the thought questions, plus several added

  20. Crisis Management Simulation: Establishing a Dual Neurosurgery and Anesthesia Training Experience.

    Science.gov (United States)

    Ciporen, Jeremy; Gillham, Haley; Noles, Michele; Dillman, Dawn; Baskerville, Mark; Haley, Caleb; Spight, Donn; Turner, Ryan C; Lucke-Wold, Brandon P

    2018-01-01

    Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis. Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique. Learners were evaluated on communication skills, crisis management algorithms, and implementation of appropriate skill sets at the right time. A preanatomic and postanatomic examination and postsimulation survey was administered to neurosurgery learners. Anesthesia learners provided posttraining evaluation through a tailored realism and teaching survey. Neurosurgery learners' anatomic examination score improved from presimulation (33.89%) to postsimulation (86.11%). No significant difference between learner specialties was observed for situation awareness, decision making, communications and teamwork, or leadership evaluations. Learners reported the simulation realistic, beneficial, and highly instructive. Realistic, first of kind, clinical simulation scenarios were presented to a neurosurgery/anesthesia resident team who worked together to manage an intraoperative crisis. Learners were effectively trained on crisis management, the importance of communication, and how to develop algorithms for future implementation in difficult scenarios. Learners were highly satisfied with the simulation training experience and requested that it be integrated more consistently into their residency training programs.

  1. Shoulder dystocia and postpartum hemorrhage simulations: student confidence in managing these complications.

    Science.gov (United States)

    Andrighetti, Tia P; Knestrick, Joyce M; Marowitz, Amy; Martin, Cheryl; Engstrom, Janet L

    2012-01-01

    Simulation is an effective teaching strategy for educating health professionals. However, little is known about the effectiveness of simulations in midwifery education. The purpose of this project was to determine whether the use of high-fidelity simulations for the obstetric emergencies of shoulder dystocia and postpartum hemorrhage increases student confidence in managing these complications. The participants were registered nurses enrolled in a graduate midwifery education program in the Southeastern United States. Student confidence in learning to manage shoulder dystocia and postpartum hemorrhage was studied in 2 groups of students. The control group (n = 10) received standard teaching methods consisting of discussion, watching a video, and low-fidelity teaching methods. The intervention group (n = 18) received a high-fidelity simulation learning experience. Student confidence was measured before and after each learning experience using a validated, 8-item, Likert-type scale. In the control group, student confidence did not significantly increase after a classroom discussion or low-fidelity simulation experience. Student confidence increased significantly (P shoulder dystocia simulations and a large effect size (1.68) for the postpartum hemorrhage simulations. High-fidelity simulations for shoulder dystocia and postpartum hemorrhage significantly increased student confidence in managing these complications. © 2011 by the American College of Nurse-Midwives.

  2. Grazing Incidence angle X-ray Diffraction of implanted stainless steel: comparison between simulated data and experimental data

    International Nuclear Information System (INIS)

    Dudognon, J.; Vayer, M.; Pineau, A.; Erre, R.

    2006-01-01

    Austenitic stainless steel was implanted with specific elements using specific conditions. The goal of this studies was to compare the predicted structural modifications within the implanted layer with the experimental ones observed by Grazing Incidence angle X-ray Diffraction (GIXD).During ion implantation implanted austenite steel layer undergoes modifications such as austenite lattice expansion, ferrite apparition and structure destruction. The X-ray diffraction austenite peak shape was predicted using the concentration depth profile of implanted element, the information depth profile of diffracted intensity and a linear relationship between implanted element concentration and lattice parameter. Experimental and predicted austenite X-ray diffraction peaks are in good accordance as long as the implanted layer contents mainly austenite. Whatever the nature of implanted element, ferrite appears above a given threshold of incoming energy amount. Moreover, the structure of the implanted layer is destroyed above a given amount of incoming energy

  3. Teaching emergency medical services management skills using a computer simulation exercise.

    Science.gov (United States)

    Hubble, Michael W; Richards, Michael E; Wilfong, Denise

    2011-02-01

    Simulation exercises have long been used to teach management skills in business schools. However, this pedagogical approach has not been reported in emergency medical services (EMS) management education. We sought to develop, deploy, and evaluate a computerized simulation exercise for teaching EMS management skills. Using historical data, a computer simulation model of a regional EMS system was developed. After validation, the simulation was used in an EMS management course. Using historical operational and financial data of the EMS system under study, students designed an EMS system and prepared a budget based on their design. The design of each group was entered into the model that simulated the performance of the EMS system. Students were evaluated on operational and financial performance of their system design and budget accuracy and then surveyed about their experiences with the exercise. The model accurately simulated the performance of the real-world EMS system on which it was based. The exercise helped students identify operational inefficiencies in their system designs and highlighted budget inaccuracies. Most students rated the exercise as moderately or very realistic in ambulance deployment scheduling, budgeting, personnel cost calculations, demand forecasting, system design, and revenue projections. All students indicated the exercise was helpful in gaining a top management perspective, and 89% stated the exercise was helpful in bridging the gap between theory and reality. Preliminary experience with a computer simulator to teach EMS management skills was well received by students in a baccalaureate paramedic program and seems to be a valuable teaching tool. Copyright © 2011 Society for Simulation in Healthcare

  4. Mastery of Status Epilepticus Management via Simulation-Based Learning for Pediatrics Residents

    Science.gov (United States)

    Malakooti, Marcelo R.; McBride, Mary E.; Mobley, Bonnie; Goldstein, Joshua L.; Adler, Mark D.; McGaghie, William C.

    2015-01-01

    Background Management of status epilepticus (SE) in the pediatric population is highly time-sensitive. Failure to follow a standard management algorithm may be due to ineffective provider education, and can lead to unfavorable outcomes. Objective To design a learning module using high-fidelity simulation technology to teach mastery achievement of a hospital algorithm for managing SE. Methods Thirty pediatrics interns were enrolled. Using the Angoff method, an expert panel developed the minimal passing score, which defined mastery. Scoring of simulated performance was done by 2 observers. Sessions were digitally recorded. After the pretest, participants were debriefed on the algorithm and required to repeat the simulation. If mastery (minimal passing score) was not achieved, debriefing and the simulation were repeated until mastery was met. Once mastery was met, participants graded their comfort level in managing SE. Results No participants achieved mastery at pretest. After debriefing and deliberate simulator training, all (n = 30) achieved mastery of the algorithm: 30% achieved mastery after 1 posttest, 63% after a second, and 6.7% after a third. The Krippendorff α was 0.94, indicating strong interrater agreement. Participants reported more self-efficacy in managing SE, a preference for simulation-based education for learning practice-based algorithms of critical conditions, and highly rated the educational intervention. Conclusions A simulation-based mastery learning program using deliberate practice dramatically improves pediatrics residents' execution of a SE management protocol. Participants enjoyed and benefited from simulation education. Future applications include improving adherence to other hospital protocols. PMID:26221431

  5. Introduction to probability and statistics for ecosystem managers simulation and resampling

    CERN Document Server

    Haas, Timothy C

    2013-01-01

    Explores computer-intensive probability and statistics for ecosystem management decision making Simulation is an accessible way to explain probability and stochastic model behavior to beginners. This book introduces probability and statistics to future and practicing ecosystem managers by providing a comprehensive treatment of these two areas. The author presents a self-contained introduction for individuals involved in monitoring, assessing, and managing ecosystems and features intuitive, simulation-based explanations of probabilistic and statistical concepts. Mathematical programming details are provided for estimating ecosystem model parameters with Minimum Distance, a robust and computer-intensive method. The majority of examples illustrate how probability and statistics can be applied to ecosystem management challenges. There are over 50 exercises - making this book suitable for a lecture course in a natural resource and/or wildlife management department, or as the main text in a program of self-stud...

  6. Semantic World Modelling and Data Management in a 4d Forest Simulation and Information System

    Science.gov (United States)

    Roßmann, J.; Hoppen, M.; Bücken, A.

    2013-08-01

    Various types of 3D simulation applications benefit from realistic forest models. They range from flight simulators for entertainment to harvester simulators for training and tree growth simulations for research and planning. Our 4D forest simulation and information system integrates the necessary methods for data extraction, modelling and management. Using modern methods of semantic world modelling, tree data can efficiently be extracted from remote sensing data. The derived forest models contain position, height, crown volume, type and diameter of each tree. This data is modelled using GML-based data models to assure compatibility and exchangeability. A flexible approach for database synchronization is used to manage the data and provide caching, persistence, a central communication hub for change distribution, and a versioning mechanism. Combining various simulation techniques and data versioning, the 4D forest simulation and information system can provide applications with "both directions" of the fourth dimension. Our paper outlines the current state, new developments, and integration of tree extraction, data modelling, and data management. It also shows several applications realized with the system.

  7. Management of Nitrate m Groundwater: A Simulation Study

    Directory of Open Access Journals (Sweden)

    M. Ahmed

    2001-01-01

    Full Text Available Agriculture may cause nitrate and other chemicals to enter into groundwater systems. Nitrate in drinking water is considered a health hazard. A study was conducted to assess the extent of nitrate pollution of groundwater caused by agriculture and to evaluate the possibility of using the LEACHN model to manage nitrate entry into groundwater of agricultural areas of Al-Batinah, which is the most important agricultural region of Oman. Groundwater samples were collected and analyzed to assess the problem and to detect possible trends. Soil sampling and analyses were done to demonstrate the difference in the nitrate concentration in agricultural and non-agricultural soils. A questionnaire survey was conducted to gather information on agricultural practices, fertilizer input, and other possible sources of nitrate pollution. Results from the study show that 23% of groundwater samples have a concentration of nitrate-N concentration of 10 mg/l and 34% samples exceed 8 mg/l. Agricultural soils have higher levels of nitrate compared to non- agricultural soils. Results also demonstrate that nitrate levels in groundwater in Al-Batinah are rising. Application of the ‘LEACHN’ model demonstrated its suitability for use as a management tool to reduce nitrate leaching to groundwater by controlling fertilizer and water input.

  8. Urban Water Cycle Simulation/Management Models: A Review

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Peña-Guzmán

    2017-04-01

    Full Text Available Urban water management is increasingly important given the need to maintain water resources that comply with global and local standards of quantity and quality. The effective management of water resources requires the optimization of financial resources without forsaking social requirements. A number of mathematical models have been developed for this task; such models account for all components of the Urban Water Cycle (UWC and their interactions. The wide range of models entails the need to understand their differences in an effort to identify their applicability, so academic, state, and private sectors can employ them for environmental, economic, and social ends. This article presents a description of the UWC and relevant components, a literature review of different models developed between 1990 and 2015, and an analysis of several case studies (applications. It was found that most applications are focused on new supply sources, mainly rainwater. In brief, this article provides an overview of each model’s use (primarily within academia and potential use as a decision-making tool.

  9. Spatial-Temporal Hotspot Pattern Analysis of Provincial Environmental Pollution Incidents and Related Regional Sustainable Management in China in the Period 1995–2012

    Directory of Open Access Journals (Sweden)

    Lei Ding

    2015-10-01

    Full Text Available Spatial-temporal hotspot pattern analysis of environmental pollution incidents provides an indispensable source of information for the further development of incident prevention measures. In this study, the spatial-temporal patterns of environmental pollution incidents in China in the period of 1995–2012 were analyzed, using the Spatial Getis-Ord statistic and an Improved Prediction Accuracy Index (IAPI. The results show that, in this period, the occurrence of environmental incidents exhibited a dynamic growth pattern but then dropped and continued to drop after the year 2006, which was considered a crucial turning point. Not coincidentally, this corresponds to the year when the State Council issued its National Environmental Emergency Plan, and following the examination of major incidents, special actions were taken to strengthen the control of incidents and emergency responses. The results from Getis-Ord General G statistical analysis show that the spatial agglomeration phenomenon was statistically significant after 1999 and that the level of spatial agglomeration was rising, while the Getis-Ord Gi* statistical analysis reveals that environmental pollution incidents were mainly agglomerated in the Pan Yangtze River Delta and Pan Pearl River Delta regions. Accordingly, the spatial-temporal hotspot pattern based on the IAPI values at the provincial scale could be categorized into: stable hotspots, unstable hotspots, and cold-spot areas. The stable hotspots category was further divided into three subtypes: industrial distribution type, industrial transfer type, and extensive economic growth type. Finally, the corresponding measures for sustainable management were proposed: stable hotspots were classified as essential regions requiring the immediate prevention and control of environmental pollution incidents; unstable hotspots were characterized by their need for ongoing and continual prevention measures, and cold-spots were those areas that

  10. Game-based Learning in Technology Management Education: A Novel Business Simulation

    Directory of Open Access Journals (Sweden)

    Markus Günther

    2011-03-01

    Full Text Available Management games allow students to obtain valuable first-hand experience that is of particular value in a field such as technology management, which usually involves substantial risk as well as significant time lags between a managerial decision and its effects. In drawing from more than fifteen years of experience with management games in higher education, we have developed a management simulation for teaching technology management, a field that is increasingly regarded an important area of study for engineering students. This paper outlines a blended-learning design for a course on technology management, describes the various didactical elements as well as their effects in class, and addresses the technical implementation of the management game as a service-oriented multi-tier application in Java.

  11. 14 CFR Appendix E to Part 60 - Qualification Performance Standards for Quality Management Systems for Flight Simulation Training...

    Science.gov (United States)

    2010-01-01

    ... Quality Management Systems for Flight Simulation Training Devices E Appendix E to Part 60 Aeronautics and...—Qualification Performance Standards for Quality Management Systems for Flight Simulation Training Devices Begin... NSPM a proposed Quality Management System (QMS) program as described in this appendix. The NSPM will...

  12. Computer simulation of nuclear pollutant diffusion from Shimane nuclear power plants and development of an evacuation strategy in the event of a nuclear incident

    International Nuclear Information System (INIS)

    Yakura, Haruna; Kurimasa, Akihiro

    2012-01-01

    Beginning from Tohoku (northeastern) Earthquake on March 11, an accident at the Fukushima Dai-ichi Nuclear Power Plant resulted in a substantial release of radioactivity to the environment. The accident forced a large number of residents to evacuate from surrounding areas. Moreover, the nuclear incident was life-threatening for the elderly and for people with serious illnesses who were confined in hospital or nursing homes. Strikingly, the causes of death were not directly attributed to radiation exposure but to problems encountered during evacuation. Using nuclear diffusion data from the Fukushima incident, we simulated nuclear pollutant dispersion using computer software A2C in an area of Tottori and Shimane Prefectures surrounding the Shimane Nuclear Power Plant. We generated a model for the spread of nuclear pollutants around the Emergency Planning Zone, id est (i.e.) EPZ. From these findings, we proposed evacuation strategies for residents near the power plant to ensure a safe and reliable escape from nuclear pollutants. Our recommendations include: immediate evacuation from PAZ area (within 5 km), securing indoor shelter in the area of the UPZ (from 5 km to 30 km) and preparations to evacuate further outwards from the nuclear plant site, daytime evacuation within a 30 km area after considering wind direction and velocity, and preparation of a planned evacuation strategy that identifies secure facilities for weaker people in the event of a disaster. (author)

  13. Spatiotemporal dynamics of simulated wildfire, forest management, and forest succession in central Oregon, USA

    Directory of Open Access Journals (Sweden)

    Ana M. G. Barros

    2017-03-01

    Full Text Available We use the simulation model Envision to analyze long-term wildfire dynamics and the effects of different fuel management scenarios in central Oregon, USA. We simulated a 50-year future where fuel management activities were increased by doubling and tripling the current area treated while retaining existing treatment strategies in terms of spatial distribution and treatment type. We modeled forest succession using a state-and-transition approach and simulated wildfires based on the contemporary fire regime of the region. We tested for the presence of temporal trends and overall differences in burned area among four fuel management scenarios. Results showed that when the forest was managed to reduce fuels it burned less: over the course of 50 years there was up to a 40% reduction in area burned. However, simulation outputs did not reveal the expected temporal trend, i.e., area burned did not decrease progressively with time, nor did the absence of management lead to its increase. These results can be explained as the consequence of an existing wildfire deficit and vegetation succession paths that led to closed canopy, and heavy fuels forest types that are unlikely to burn under average fire weather. Fire (and management remained relatively rare disturbances and, given our assumptions, were unable to alter long-term vegetation patterns and consequently unable to alter long-term wildfire dynamics. Doubling and tripling current management targets were effective in the near term but not sustainable through time because of a scarcity of stands eligible to treat according to the modeled management constraints. These results provide new insights into the long-term dynamics between fuel management programs and wildfire and demonstrate that treatment prioritization strategies have limited effect on fire activity if they are too narrowly focused on particular forest conditions.

  14. Simulating long-term effectiveness and efficiency of management scenarios for an invasive grass

    Directory of Open Access Journals (Sweden)

    Catherine S. Jarnevich

    2015-05-01

    Full Text Available Resource managers are often faced with trade-offs in allocating limited resources to manage plant invasions. These decisions must often be made with uncertainty about the location of infestations, their rate of spread and effectiveness of management actions. Landscape level simulation tools such as state-and-transition simulation models (STSMs can be used to evaluate the potential long term consequences of alternative management strategies and help identify those strategies that make efficient use of resources. We analyzed alternative management scenarios for African buffelgrass (Pennisetum ciliare syn. Cenchrus ciliaris at Ironwood Forest National Monument, Arizona using a spatially explicit STSM implemented in the Tool for Exploratory Landscape Scenario Analyses (TELSA. Buffelgrass is an invasive grass that is spreading rapidly in the Sonoran Desert, affecting multiple habitats and jurisdictions. This invasion is creating a novel fire risk and transforming natural ecosystems. The model used in this application incorporates buffelgrass dispersal and establishment and management actions and effectiveness including inventory, treatment and post-treatment maintenance. We simulated 11 alternative scenarios developed in consultation with buffelgrass managers and other stakeholders. The scenarios vary according to the total budget allocated for management and the allocation of that budget between different kinds of management actions. Scenario results suggest that to achieve an actual reduction and stabilization of buffelgrass populations, management unconstrained by fiscal restrictions and across all jurisdictions and private lands is required; without broad and aggressive management, buffelgrass populations are expected to increase over time. However, results also suggest that large upfront investments can achieve control results that require relatively minimal spending in the future. Investing the necessary funds upfront to control the invasion

  15. Simulating long-term effectiveness and efficiency of management scenarios for an invasive grass

    Science.gov (United States)

    Jarnevich, Catherine S.; Holcombe, Tracy R.; Cullinane Thomas, Catherine; Frid, Leonardo; Olsson, Aaryn D.

    2015-01-01

    Resource managers are often faced with trade-offs in allocating limited resources to manage plant invasions. These decisions must often be made with uncertainty about the location of infestations, their rate of spread and effectiveness of management actions. Landscape level simulation tools such as state-and-transition simulation models (STSMs) can be used to evaluate the potential long term consequences of alternative management strategies and help identify those strategies that make efficient use of resources. We analyzed alternative management scenarios for African buffelgrass (Pennisetum ciliare syn. Cenchrus ciliaris) at Ironwood Forest National Monument, Arizona using a spatially explicit STSM implemented in the Tool for Exploratory Landscape Scenario Analyses (TELSA). Buffelgrass is an invasive grass that is spreading rapidly in the Sonoran Desert, affecting multiple habitats and jurisdictions. This invasion is creating a novel fire risk and transforming natural ecosystems. The model used in this application incorporates buffelgrass dispersal and establishment and management actions and effectiveness including inventory, treatment and post-treatment maintenance. We simulated 11 alternative scenarios developed in consultation with buffelgrass managers and other stakeholders. The scenarios vary according to the total budget allocated for management and the allocation of that budget between different kinds of management actions. Scenario results suggest that to achieve an actual reduction and stabilization of buffelgrass populations, management unconstrained by fiscal restrictions and across all jurisdictions and private lands is required; without broad and aggressive management, buffelgrass populations are expected to increase over time. However, results also suggest that large upfront investments can achieve control results that require relatively minimal spending in the future. Investing the necessary funds upfront to control the invasion results in the most

  16. Interprofessional simulation training for perioperative management team development and patient safety.

    Science.gov (United States)

    Komasawa, Nobuyasu; Berg, Benjamin W

    2016-11-01

    Establishment of a perioperative management team construct including anaesthesiologists, surgeons, nurses, and other medical staff is essential to optimize safe surgical care. Simulation based education and training provides a unique and effective approach to development of competency and application of relevant technical and non-technical perioperative professional skills such as meta-cognitive ability, caution, shared decision-making, leadership and communication. Development of high functioning perioperative teams can be accomplished through simulation based training. Copyright the Association for Perioperative Practice.

  17. Simulations of Continuous Descent Operations with Arrival-management Automation and Mixed Flight-deck Interval Management Equipage

    Science.gov (United States)

    Callantine, Todd J.; Kupfer, Michael; Martin, Lynne Hazel; Prevot, Thomas

    2013-01-01

    Air traffic management simulations conducted in the Airspace Operations Laboratory at NASA Ames Research Center have addressed the integration of trajectory-based arrival-management automation, controller tools, and Flight-Deck Interval Management avionics to enable Continuous Descent Operations (CDOs) during periods of sustained high traffic demand. The simulations are devoted to maturing the integrated system for field demonstration, and refining the controller tools, clearance phraseology, and procedures specified in the associated concept of operations. The results indicate a variety of factors impact the concept's safety and viability from a controller's perspective, including en-route preconditioning of arrival flows, useable clearance phraseology, and the characteristics of airspace, routes, and traffic-management methods in use at a particular site. Clear understanding of automation behavior and required shifts in roles and responsibilities is important for controller acceptance and realizing potential benefits. This paper discusses the simulations, drawing parallels with results from related European efforts. The most recent study found en-route controllers can effectively precondition arrival flows, which significantly improved route conformance during CDOs. Controllers found the tools acceptable, in line with previous studies.

  18. Equilibrium fuel-management simulations for 1.2% SEU in a CANDU 6

    International Nuclear Information System (INIS)

    Younis, M.H.; Boczar, P.G.

    1989-06-01

    Fuel-management simulations have been performed for 1.2% SEU in a CANDU 6 reactor at equilibrium, for three fuel-management options: axial shuffling; a regular 2-bundling shift with the adjuster rods removed from the core; and a regular 2-bundle shift with the adjuster rods present. Both time-average and time-dependent simulations were performed, from which the physics characteristics of the cores at equilibrium were estimated. Power and power-boost envelopes were derived for both 37-element fuel, and the advanced CANFLEX bundle

  19. Asthma management simulation for children: translating theory, methods, and strategies to effect behavior change.

    Science.gov (United States)

    Shegog, Ross; Bartholomew, L Kay; Gold, Robert S; Pierrel, Elaine; Parcel, Guy S; Sockrider, Marianna M; Czyzewski, Danita I; Fernandez, Maria E; Berlin, Nina J; Abramson, Stuart

    2006-01-01

    Translating behavioral theories, models, and strategies to guide the development and structure of computer-based health applications is well recognized, although a continued challenge for program developers. A stepped approach to translate behavioral theory in the design of simulations to teach chronic disease management to children is described. This includes the translation steps to: 1) define target behaviors and their determinants, 2) identify theoretical methods to optimize behavioral change, and 3) choose educational strategies to effectively apply these methods and combine these into a cohesive computer-based simulation for health education. Asthma is used to exemplify a chronic health management problem and a computer-based asthma management simulation (Watch, Discover, Think and Act) that has been evaluated and shown to effect asthma self-management in children is used to exemplify the application of theory to practice. Impact and outcome evaluation studies have indicated the effectiveness of these steps in providing increased rigor and accountability, suggesting their utility for educators and developers seeking to apply simulations to enhance self-management behaviors in patients.

  20. Groundwater resources management through the applications of simulation modeling: a review.

    Science.gov (United States)

    Singh, Ajay

    2014-11-15

    The global population is increasing rapidly and expected to touch the 9.5 billion mark by 2050 from the current 7.2 billion. The management of the groundwater resources is a challenging task worldwide against the backdrop of the growing water demand for industrial, agricultural, and domestic uses and shrinking resources. Moreover, this task has been hampered significantly due to declining/rising groundwater levels and associated contamination. A broad range of solutions could be considered to address the aforementioned problems of groundwater management, but the effectiveness of all the solutions and their combinations cannot be verified with field experiments. Given their predictive capability, simulation models are often the only viable means of providing input to management decisions, as they can forecast the likely impacts of a particular water management strategy. This paper presents a comprehensive review on the simulation modeling applications for the management of groundwater resources. The past papers on the overview of groundwater simulation models, use of remote sensing and GIS in groundwater modeling, and application of simulation models in arid and semiarid regions are described in detail. Conclusions are drawn where gaps exist and more research needs to be focused. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Simulation-Based Learning Environments to Teach Complexity: The Missing Link in Teaching Sustainable Public Management

    Directory of Open Access Journals (Sweden)

    Michael Deegan

    2014-05-01

    Full Text Available While public-sector management problems are steeped in positivistic and socially constructed complexity, public management education in the management of complexity lags behind that of business schools, particularly in the application of simulation-based learning. This paper describes a Simulation-Based Learning Environment for public management education that includes a coupled case study and System Dynamics simulation surrounding flood protection, a domain where stewardship decisions regarding public infrastructure and investment have direct and indirect effects on businesses and the public. The Pointe Claire case and CoastalProtectSIM simulation provide a platform for policy experimentation under conditions of exogenous uncertainty (weather and climate change as well as endogenous effects generated by structure. We discuss the model in some detail, and present teaching materials developed to date to support the use of our work in public administration curricula. Our experience with this case demonstrates the potential of this approach to motivate sustainable learning about complexity in public management settings and enhance learners’ competency to deal with complex dynamic problems.

  2. The Equivalent Uniform Dose as a severity metric for radiation treatment incidents

    International Nuclear Information System (INIS)

    Dunscombe, Peter B.; Iftody, Sandra; Ploquin, Nicolas; Ekaette, Edidiong U.; Lee, Robert C.

    2007-01-01

    In allocating resources within a risk management program, ideally we would like to know both the probabilities and consequences of potential incidents. We simulate, on a treatment planning computer, several commonly reported incidents in radiation treatment and explore their consequences for the EUDs of targets and organs at risk

  3. Preparing Student Nurses for the Future of Wound Management: Telemedicine in a Simulated Learning Enviroment

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    2015-01-01

    laboratory and a simulated wound clinic. A primitive electronic platform was used to allow the students to experience the benefits and challenges of telemedicine in wound care. At the end of the course, the students were asked to evaluate the course based on their experiences with telemedicine and simulation....... Findings: Students found the concept of telemedicine relevant and enjoyable, and the challenges and benefits of telemedicine clearly emerged in the simulated learning environment. Conclusions: Based on student evaluations and the need to prepare students for “real-life” telemedicine for wound management...

  4. Training in trauma management: the role of simulation-based medical education.

    Science.gov (United States)

    Berkenstadt, Haim; Ben-Menachem, Erez; Simon, Daniel; Ziv, Amitai

    2013-03-01

    Simulation-based medical education (SBME) offers a safe and "mistake-forgiving" environment to teach and train medical professionals. The diverse range of medical-simulation modalities enables trainees to acquire and practice an array of tasks and skills. SBME offers the field of trauma training multiple opportunities to enhance the effectiveness of the education provided in this challenging domain. Further research is needed to better learn the role of simulation-based learning in trauma management and education. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. An Advanced HIL Simulation Battery Model for Battery Management System Testing

    DEFF Research Database (Denmark)

    Barreras, Jorge Varela; Fleischer, Christian; Christensen, Andreas Elkjær

    2016-01-01

    Developers and manufacturers of battery management systems (BMSs) require extensive testing of controller Hardware (HW) and Software (SW), such as analog front-end and performance of generated control code. In comparison with the tests conducted on real batteries, tests conducted on a state......-of-the-art hardware-in-the-loop (HIL) simulator can be more cost and time effective, easier to reproduce, and safer beyond the normal range of operation, especially at early stages in the development process or during fault insertion. In this paper, an HIL simulation battery model is developed for purposes of BMS...... testing on a commercial HIL simulator. A multicell electrothermal Li-ion battery (LIB) model is integrated in a system-level simulation. Then, the LIB system model is converted to C code and run in real time with the HIL simulator. Finally, in order to demonstrate the capabilities of the setup...

  6. Simulation applied to innovative waste management options; Simulation appliquee aux options innovantes de gestion des dechets

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-10-01

    The aim of this workshop is to share experience and methods in the domains of neutronics, spallation, thermo-hydraulics, corrosion, materials, mechanics; to define the needs for the other domains in order to improve the evaluation of concepts: ADS, MSR, Gas cooled reactors; and to determine the necessity or not to couple codes and tools for the concepts studied in the frame of GEDEON activities. This document groups together the transparencies of 6 presentations given at this workshop: design and performances of CEA spallation targets; simulation of spallation; the neutronic benchmark on the Megapie spallation target; the core physics of fast spectrum gas cooled reactors; the study and modeling of the thermal-mechanical behaviour of composite fuel in reactor. (J.S.)

  7. A system dynamics-based environmental performance simulation of construction waste reduction management in China.

    Science.gov (United States)

    Ding, Zhikun; Yi, Guizhen; Tam, Vivian W Y; Huang, Tengyue

    2016-05-01

    A huge amount of construction waste has been generated from increasingly higher number of construction activities than in the past, which has significant negative impacts on the environment if they are not properly managed. Therefore, effective construction waste management is of primary importance for future sustainable development. Based on the theory of planned behaviors, this paper develops a system dynamic model of construction waste reduction management at the construction phase to simulate the environmental benefits of construction waste reduction management. The application of the proposed model is shown using a case study in Shenzhen, China. Vensim is applied to simulate and analyze the model. The simulation results indicate that source reduction is an effective waste reduction measure which can reduce 27.05% of the total waste generation. Sorting behaviors are a premise for improving the construction waste recycling and reuse rates which account for 15.49% of the total waste generated. The environmental benefits of source reduction outweigh those of sorting behaviors. Therefore, to achieve better environmental performance of the construction waste reduction management, attention should be paid to source reduction such as low waste technologies and on-site management performance. In the meantime, sorting behaviors encouragement such as improving stakeholders' waste awareness, refining regulations, strengthening government supervision and controlling illegal dumping should be emphasized. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Simulations

    CERN Document Server

    Ngada, Narcisse

    2015-06-15

    The complexity and cost of building and running high-power electrical systems make the use of simulations unavoidable. The simulations available today provide great understanding about how systems really operate. This paper helps the reader to gain an insight into simulation in the field of power converters for particle accelerators. Starting with the definition and basic principles of simulation, two simulation types, as well as their leading tools, are presented: analog and numerical simulations. Some practical applications of each simulation type are also considered. The final conclusion then summarizes the main important items to keep in mind before opting for a simulation tool or before performing a simulation.

  9. Application of simulation techniques for accident management training in nuclear power plants

    International Nuclear Information System (INIS)

    2003-05-01

    core. These capabilities include the optimized use of design margins as well as complementary measures for the prevention of accident progression, its monitoring, and the mitigation of severe accidents. Finally, level 5 includes off-site emergency response measures, the objective of which is to mitigate the radiological consequences of significant releases of radioactive material. Accident management is defined in the IAEA Safety Report on Development and Implementation of Accident Management Programmes in Nuclear Power Plants. The IAEA definitions are in line with the definitions of severe accident management in OECD/NEA documents as given, for example. This report describes simulation techniques used in the training of personnel involved in accident management of NPPs. This concerns both the plant personnel and the persons involved in the management of off-site releases. The report pertains to light water reactors (LWRs) and pressurized heavy water reactors (PHWRs), but it can equally be applied to power reactors of other types. The report is intended for use by experts responsible for planning, developing, executing or supervising the training of personnel involved in the implementation of AMPs in NPPs. It concentrates on existing techniques, but future prospects are also discussed. Various simulation techniques are considered, from incorporating graphical interfaces into existing severe accident codes to full-scope replica simulators. Both preventive and mitigative accident management measures, different training levels and different target personnel groups are taken into account. Based on the available information compiled worldwide, present views on the applicability of simulation techniques for the training of personnel involved in accident management are provided in this report. Apart from the introduction, this report consists of four sections and three appendices. In Section 2, specific aspects of accident management are summarized. Basic approaches in the

  10. How should we build a generic open-source water management simulator?

    Science.gov (United States)

    Khadem, M.; Meier, P.; Rheinheimer, D. E.; Padula, S.; Matrosov, E.; Selby, P. D.; Knox, S.; Harou, J. J.

    2014-12-01

    Increasing water needs for agriculture, industry and cities mean effective and flexible water resource system management tools will remain in high demand. Currently many regions or countries use simulators that have been adapted over time to their unique system properties and water management rules and realities. Most regions operate with a preferred short-list of water management and planning decision support systems. Is there scope for a simulator, shared within the water management community, that could be adapted to different contexts, integrate community contributions, and connect to generic data and model management software? What role could open-source play in such a project? How could a genericuser-interface and data/model management software sustainably be attached to this model or suite of models? Finally, how could such a system effectively leverage existing model formulations, modeling technologies and software? These questions are addressed by the initial work presented here. We introduce a generic water resource simulation formulation that enables and integrates both rule-based and optimization driven technologies. We suggest how it could be linked to other sub-models allowing for detailed agent-based simulation of water management behaviours. An early formulation is applied as an example to the Thames water resource system in the UK. The model uses centralised optimisation to calculate allocations but allows for rule-based operations as well in an effort to represent observed behaviours and rules with fidelity. The model is linked through import/export commands to a generic network model platform named Hydra. Benefits and limitations of the approach are discussed and planned work and potential use cases are outlined.

  11. Strategic management simulations is a novel way to measure resident competencies.

    Science.gov (United States)

    Satish, U; Streufert, S; Marshall, R; Smith, J S; Powers, S; Gorman, P; Krummel, T

    2001-06-01

    The Strategic Management Simulation (SMS) has been used extensively to test and train higher cognitive functions in persons who occupy professional and leadership positions (i.e., skills like those needed by a surgeon). The SMS was used to predict surgical residents' competency in decision making. Skills required for integrative surgical decision making including critical thinking, crisis management, flexibility, factual knowledge, and team building were assessed. Surgical residents with at least 2 years of experience participated. In additional, attending faculty familiar with the residents' work evaluated each resident with a standard comprehensive rating scale. Simulation performance on multiple measures was compared with faculty ratings. A number of measures obtained on simulation performance (eg, activity level, response speed, initiative, adequate usage of and appropriate search for relevant information) generated high correlations with comprehensive faculty assessment (eg, measures of crisis management, team interactions, flexibility of approach). The simulation technique is able to accurately assess performance of surgical residents (on a number of parameters) in a relatively brief time period. Simulation data were highly similar to faculty ratings that were based on at least 2 years of experience with the resident.

  12. Development of nuclear power plant simulator for an accident management design

    International Nuclear Information System (INIS)

    Yoshida, Shota; Narabayashi, Tadashi; Tsuji, Masashi

    2011-01-01

    An accident management is very important for nuclear reactor safety to prevent core damage and a large amount of radioactive release in severe accidents taking place in Fukushima Daiichi nuclear power site. We are aiming at developing nuclear power plant simulator for an accident management design. For this purpose, THYDE-NEU developed by JAEA was selected as a candidate simulation code because it is open source code and has a high simulation capability dealing with severe accidents. For confirming the availability of simulation code, mitigation analysis about the Three Mile Island (TMI) accident has been carried out. TMI accident was caused by the following three events; stuck-open of pressurizer relief valve (loss of coolant), closing outlet valve of auxiliary feed water and stop of ECCS operation based on misjudgment. We analyzed three mitigation scenarios about the three events and compared simulation results of the scenarios. This analysis shows that a short time recovery from loss of coolant event is very important to prevent core damage and THYDE-NEU code has a high performance to design accident management programs. (author)

  13. Developing clinical competency in crisis event management: an integrated simulation problem-based learning activity.

    Science.gov (United States)

    Liaw, S Y; Chen, F G; Klainin, P; Brammer, J; O'Brien, A; Samarasekera, D D

    2010-08-01

    This study aimed to evaluate the integration of a simulation based learning activity on nursing students' clinical crisis management performance in a problem-based learning (PBL) curriculum. It was hypothesized that the clinical performance of first year nursing students who participated in a simulated learning activity during the PBL session would be superior to those who completed the conventional problem-based session. The students were allocated into either simulation with problem-based discussion (SPBD) or problem-based discussion (PBD) for scenarios on respiratory and cardiac distress. Following completion of each scenario, students from both groups were invited to sit an optional individual test involving a systematic assessment and immediate management of a simulated patient facing a crisis event. A total of thirty students participated in the first post test related to a respiratory scenario and thirty-three participated in the second post test related to a cardiac scenario. Their clinical performances were scored using a checklist. Mean test scores for students completing the SPBD were significantly higher than those who completing the PBD for both the first post test (SPBD 20.08, PBD 18.19) and second post test (SPBD 27.56, PBD 23.07). Incorporation of simulation learning activities into problem-based discussion appeared to be an effective educational strategy for teaching nursing students to assess and manage crisis events.

  14. Collaborative Management of Complex Major Construction Projects: AnyLogic-Based Simulation Modelling

    Directory of Open Access Journals (Sweden)

    Na Zhao

    2016-01-01

    Full Text Available Complex supply chain system collaborative management of major construction projects effectively integrates the different participants in the construction project. This paper establishes a simulation model based on AnyLogic to reveal the collaborative elements in the complex supply chain management system and the modes of action as well as the transmission problems of the intent information. Thus it is promoting the participants to become an organism with coordinated development and coevolution. This study can help improve the efficiency and management of the complex system of major construction projects.

  15. Computer simulation as a teaching aid in pharmacy management--Part 1: Principles of accounting.

    Science.gov (United States)

    Morrison, D J

    1987-06-01

    The need for pharmacists to develop management expertise through participation in formal courses is now widely acknowledged. Many schools of pharmacy lay the foundations for future management training by providing introductory courses as an integral or elective part of the undergraduate syllabus. The benefit of such courses may, however, be limited by the lack of opportunity for the student to apply the concepts and procedures in a practical working environment. Computer simulations provide a means to overcome this problem, particularly in the field of resource management. In this, the first of two articles, the use of a computer model to demonstrate basic accounting principles is described.

  16. Numerical strategies for corrosion management : Spatial statistics and finite element simulation

    NARCIS (Netherlands)

    Lopez De La Cruz, J.M.

    2008-01-01

    The techniques presented in this thesis are focused to improve corrosion management by providing a better insight into the nature of corrosion. Spatial statistics and finite element simulations are applied to different corrosion patterns to study possible interaction among pits. In order to achieve

  17. Decision support simulation model for water management at a regional and national scale (SIWARE)

    NARCIS (Netherlands)

    Boels, D.

    1996-01-01

    The model includes modules for physical dimensions of the irrigation canal system, water allocation, simulation of distribution and salinity of irrigation including reuse of drainage water, on-farm water management including :evapotranspiration of crops and the dynamics of soil salinity, and

  18. Business Simulation Exercises in Small Business Management Education: Using Principles and Ideas from Action Learning

    Science.gov (United States)

    Gabrielsson, Jonas; Tell, Joakim; Politis, Diamanto

    2010-01-01

    Recent calls to close the rigour-relevance gap in business school education have suggested incorporating principles and ideas from action learning in small business management education. In this paper we discuss how business simulation exercises can be used as a platform to trigger students' learning by providing them with a platform where they…

  19. Usability Assessment of E-Café Operational Management Simulation Game

    Science.gov (United States)

    Chang, Chiung-sui; Huang, Ya-Ping

    2013-01-01

    To ensure the quality of digital simulation game, we utilized the usability evaluation heuristic in the design and development processes of e-café operational management game-based learning material for students. The application of usability evaluations during this study is described. Additionally, participant selection, data collection and…

  20. Expert knowledge elicitation using computer simulation: the organization of frail elderly case management as an illustration.

    Science.gov (United States)

    Chiêm, Jean-Christophe; Van Durme, Thérèse; Vandendorpe, Florence; Schmitz, Olivier; Speybroeck, Niko; Cès, Sophie; Macq, Jean

    2014-08-01

    Various elderly case management projects have been implemented in Belgium. This type of long-term health care intervention involves contextual factors and human interactions. These underlying complex mechanisms can be usefully informed with field experts' knowledge, which are hard to make explicit. However, computer simulation has been suggested as one possible method of overcoming the difficulty of articulating such elicited qualitative views. A simulation model of case management was designed using an agent-based methodology, based on the initial qualitative research material. Variables and rules of interaction were formulated into a simple conceptual framework. This model has been implemented and was used as a support for a structured discussion with experts in case management. The rigorous formulation provided by the agent-based methodology clarified the descriptions of the interventions and the problems encountered regarding: the diverse network topologies of health care actors in the project; the adaptation time required by the intervention; the communication between the health care actors; the institutional context; the organization of the care; and the role of the case manager and his or hers personal ability to interpret the informal demands of the frail older person. The simulation model should be seen primarily as a tool for thinking and learning. A number of insights were gained as part of a valuable cognitive process. Computer simulation supporting field experts' elicitation can lead to better-informed decisions in the organization of complex health care interventions. © 2013 John Wiley & Sons, Ltd.

  1. A Recreational Visitor Travel Simulation Model as an Aid to Management Planning

    Science.gov (United States)

    Lucas, Robert C.; Shechter, Mordechai

    1977-01-01

    The article describes the use of a simulation for outdoor recreation management which is applicable for any type of dispersed recreation area where visitor flows are of concern, where there are capacity constraints, where visitor encounters are significant, and where it is desired to allow visitors substantial freedom to move about flexibly. (MJB)

  2. KMsim: A Meta-modelling Approach and Environment for Creating Process-Oriented Knowledge Management Simulations.

    NARCIS (Netherlands)

    Anjewierden, Anjo Allert; Shostak, I.; Tsjernikova, Irina; de Hoog, Robert; Gómez Perez, A.; Benjamins, V.R.

    2002-01-01

    This paper presents a new approach to modelling process-oriented knowledge management (KM) and describes a simulation environment (called KMSIM) that embodies the approach. Since the beginning of modelling researchers have been looking for better and novel ways to model systems and to use

  3. Slope stability effects of fuel management strategies – inferences from Monte Carlo simulations

    Science.gov (United States)

    R. M. Rice; R. R. Ziemer; S. C. Hankin

    1982-01-01

    A simple Monte Carlo simulation evaluated the effect of several fire management strategies on soil slip erosion and wildfires. The current condition was compared to (1) a very intensive fuelbreak system without prescribed fires, and (2) prescribed fire at four time intervals with (a) current fuelbreaks and (b) intensive fuel-breaks. The intensive fuelbreak system...

  4. Teaching Business Process Management with Simulation in Graduate Business Programs: An Integrative Approach

    Science.gov (United States)

    Saraswat, Satya Prakash; Anderson, Dennis M.; Chircu, Alina M.

    2014-01-01

    This paper describes the development and evaluation of a graduate level Business Process Management (BPM) course with process modeling and simulation as its integral component, being offered at an accredited business university in the Northeastern U.S. Our approach is similar to that found in other Information Systems (IS) education papers, and…

  5. Learning-by-Doing Teamwork KSA: The Role of Strategic Management Simulation

    Science.gov (United States)

    Martín-Pérez, Víctor; Martín-Cruz, Natalia; Pérez-Santana, Pilar

    2012-01-01

    The objective of this paper is to evaluate the effectiveness of strategic management simulations as a learning-by-doing tool so that university students can learn to work in a team, that is, they can enhance their knowledge, skills, and abilities (KSA) for effective teamwork. The authors have carried out an analysis of the effect of strategic…

  6. Simulation of Hiërarchical Resource Management for Meta-computing Systems

    NARCIS (Netherlands)

    Santoso, J.; van Albada, G.D.; Sloot, P.M.A.; Nazief, B.A.A.

    2000-01-01

    Optimal scheduling in meta-computing environments still is an open research question. Various research management (RM) architectures have been proposed in the literature. In the present paper we explore, through simulation, various muli-level scheduling strategies for compound computing environments

  7. A users guide for the radioactive waste management code 'SIMULATION 2'

    International Nuclear Information System (INIS)

    Moore, D.; Tymons, B.J.

    1984-09-01

    This report is a users' guide to the radioactive waste management program SIMULATION. It gives a complete description of the calculational method used (with worked examples) a specification of the input data requirements, and samples of printout from the program. (author)

  8. Developing and investigating validity of a knowledge management game simulation model

    NARCIS (Netherlands)

    Tsjernikova, Irina

    2009-01-01

    The goals of this research project were to develop a game simulation model which supports learning knowledge management in a game environment and to investigate the validity of that model. The validity of the model is approached from two perspectives: educational validity and representational

  9. Scenario Based Education as a Framework for Understanding Students Engagement and Learning in a Project Management Simulation Game

    DEFF Research Database (Denmark)

    Misfeldt, Morten

    2015-01-01

    In this paper I describe s how students use a project management simulation game based on an attack‑defense mechanism where two teams of players compete by challenging each other⠒s projects. The project management simulation game is intended to be playe d by pre‑service construction workers...... opponent⠒s building project for weak spots. The intention of the project management simulation game, is to provide students with an increased sensitivity towards the relation between planning and reality in complex construction projects. The project management simulation game can be interpreted both...... as a competitive game and as a simulation. Both of these views are meaningful and can be seen as supporting learnin g. Emphasizing the simulation aspect let us explain how students learn by being immersed into a simulated world, where the players identify with specific roles, live out specific situations...

  10. Measured and Monte Carlo simulated surface dose reduction for superficial X-rays incident on tissue with underlying air or bone.

    Science.gov (United States)

    Baines, John; Zawlodzka, Sylwia; Markwell, Tim; Chan, Millicent

    2018-02-01

    Measurement of surface dose reduction effects for superficial x-rays incident on tissue with underlying air or bone and comparison with Monte Carlo simulations of such effects. Further to investigate the correlation between surface dose reduction and changes in Compton backscatter spectra with tissue-bone separation. An Advanced Markus chamber with entrance window facing downstream on the surface of a solid water phantom was used to investigate changes in surface dose with an underlying air or bone interface located at various depths below the surface. Chamber readings were obtained for interface depths ranging from 1 to 100 mm using the 50 kV, 100 kV and 150 kV beams of an Xstrahl 150 x-ray unit, with field diameters (ϕ) = 2.5 cm and 5 cm. For each beam quality and field size the dose correction factor, DCF(t), namely the ratio of measured dose (t) to dose (t = 100 mm) was determined. Monte Carlo simulations of DCF(t) for air and bone interfaces in tissue are used to validate corresponding measured data. For a given beam and field size, the difference between simulated spectra with an air or bone interface at t = 3 mm was used to determine the Compton backscatter from bone at the surface. For air, DCF(t tube potentials corresponding factors, ϕ = 2.5 cm, for air(bone) are 0.94(0.96) and 0.92(0.99). Calculated DCF(t) based on Monte Carlo simulations are consistent with experimental observations to within 2%. Monte Carlo simulations of x-ray spectra demonstrate the presence of Compton backscatter from underlying bone in tissue. With bone at 3 mm depth calculated backscatter spectra at the tissue surface suggest that surface dose is influenced by the proximity of bone and that this effect depends on beam quality. This work demonstrates the feasibility of using an Advanced Markus chamber with entrance window facing downstream to investigate surface dose reduction with underlying air or bone in tissue. As the field size decreases and beam quality increases surface

  11. Simulation training program for midwives to manage postpartum hemorrhage: A randomized controlled trial.

    Science.gov (United States)

    Kato, Chiho; Kataoka, Yaeko

    2017-04-01

    To explore the effectiveness of a simulation training program for midwives in performance and knowledge for the management of postpartum hemorrhage (PPH). The study design was a randomized controlled trial. Midwives working at one obstetrics ward in an urban area were randomly assigned to simulation training program or no training. This "simulation program" included pre study e-learning and simulation. Inclusion criteria were midwives who: 1) had two or three years of clinical experience, 2) worked in an obstetrics ward, and 3) had experience with birth assistance. There was one exclusion criterion namely prior experience of simulation training for PPH. Change in performance was evaluated using a PPH scenario performance test at one month after the simulation training. Change in knowledge was evaluated by a 25-item multiple-choice questionnaire completed shortly before the training and one month after the training. The ethical review committee of St Luke's International University granted approval (No. 14-096). Eighty-one midwives were randomly assigned to either the intervention group (n=40) or the control group (n=41). Performance in the simulation training group was significantly better in comparison to the no training group; mean performance score was 23.85(SD 2.71) in the training group versus 18.00(SD 3.01) in the no training group (MD 5.85 95% CI 4.85-7.12, t=9.17, pmanagement of PPH were significantly improved after simulation training. However, assessments of long-term effects on performance, and knowledge and the clinical outcomes in managing of obstetric complications are necessary to adequately evaluate the effectiveness of simulation training. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Functional Analysis of Battery Management Systems using Multi-Cell HIL Simulator

    DEFF Research Database (Denmark)

    Barreras, Jorge Varela; Swierczynski, Maciej Jozef; Schaltz, Erik

    2015-01-01

    Developers and manufacturers of Battery Management Systems (BMSs) require extensive testing of controller HW and SW, such as analog front-end (AFE) and performance of generated control code. In comparison with tests conducted on real batteries, tests conducted on hardware-in-the-loop (HIL......) simulator may be more costant time effective, easier to reproduce and safer beyond the normal range of operation, especially at early stages in the development process or during fault simulation. In this paper a li-ion battery (LIB) electro-thermal multicell model coupled with an aging model is designed......, characterized and validated based on experimental data, converted to C code and emulated in real-time with a dSpace HIL simulator. The BMS to be tested interacts with the emulated battery pack as if it was managing a real battery pack. BMS functions such as protection, measuring of current, voltage...

  13. SIMULATION OF QUALITY GOALS: A MISSING LINK BETWEEN CORPORATE STRATEGY AND BUSINESS PROCESS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Zora Arsovski

    2009-12-01

    Full Text Available This paper describes design methodology for quality goals simulation model as a supporting tool for quality goal-directed decision-making at strategic management level. The paper presents such an integrated, system (MIS/DES and draw attention to the essential role of simulation based strategic quality goal-directed decision-making within it. With proposed approach it is possible to converge, or focus, comprehensive but static MIS knowledge in dynamic simulation models and to fully utilize prediction power of simulation for effective and integrated quality goal-directed strategic decision making. Importance of modeling in field of control, equality of knowledge and models, dynamic nature and complexity of models and real systems from viewpoint of modern cybernetic science are also presented in the paper. The final goal is a purposeful decision-making simulation system that guides in the right direction strategically focused management action promising implementation of strategic plans and achievement of related quality goals. In its experimental section the paper describes a quality goals model designed for concrete environment. Overall model structure, components structure, components relations, mathematical models, and other elements of modeling approach are also given in this section. Finally, an example of successfully designed simulation solution is given. The approach presented in the paper gives verbal and mathematical problem description, builds ontology of quality goals problem domain, uses Extended Petri Nets as modeling tools in order to obtain faithful model which easily can be replicated in object oriented class and object hierarchy.

  14. Simulated Trauma and Resuscitation Team Training course-evolution of a multidisciplinary trauma crisis resource management simulation course.

    Science.gov (United States)

    Gillman, Lawrence M; Brindley, Peter; Paton-Gay, John Damian; Engels, Paul T; Park, Jason; Vergis, Ashley; Widder, Sandy

    2016-07-01

    We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating scale and an Advanced Trauma Life Support primary survey checklist. Eleven "trauma teams," consisting of physicians, nurses, and respiratory therapists, each completed 4 crisis simulations over 3 courses. Satisfaction remained high among participants with overall mean satisfaction being 4.39 on a 5-point Likert scale. As participants progressed through scenarios, improvements in global rating scale scores were seen between the 1st and 4th (29.8 vs 36.1 of 42, P = .022), 2nd and 3rd (28.2 vs 34.6, P = .017), and 2nd and 4th (28.2 vs 36.1, P = .003) scenarios. There were no differences in Advanced Trauma Life Support checklist with mean scores for each scenario ranging 11.3 to 13.2 of 17. The evolved Simulated Trauma and Resuscitative Team Training curriculum has maintained high participant satisfaction and is associated with improvement in team crisis resource management skills over the duration of the course. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Prophylactic antibiotics are associated with a lower incidence of pneumonia in cardiac arrest survivors treated with targeted temperature management

    DEFF Research Database (Denmark)

    Gagnon, David J; Nielsen, Niklas; Fraser, Gilles L

    2015-01-01

    -34 °C were enrolled in the registry. Differences were analyzed in univariate analyses and with logistic regression models to evaluate independent associations of clinical factors with incidence of pneumonia and good functional outcome. RESULTS: 416 of 1240 patients (33.5%) received PRO. Groups were...... of a good functional outcome (41.1 vs. 36.6%, p = 0.19) were similar between groups. Backwards stepwise logistic regression demonstrated PRO were independently associated with a lower incidence of pneumonia (OR 0.09, 95% 0.06-0.14, p

  16. Earth-Mars Telecommunications and Information Management System (TIMS): Antenna Visibility Determination, Network Simulation, and Management Models

    Science.gov (United States)

    Odubiyi, Jide; Kocur, David; Pino, Nino; Chu, Don

    1996-01-01

    This report presents the results of our research on Earth-Mars Telecommunications and Information Management System (TIMS) network modeling and unattended network operations. The primary focus of our research is to investigate the feasibility of the TIMS architecture, which links the Earth-based Mars Operations Control Center, Science Data Processing Facility, Mars Network Management Center, and the Deep Space Network of antennae to the relay satellites and other communication network elements based in the Mars region. The investigation was enhanced by developing Build 3 of the TIMS network modeling and simulation model. The results of several 'what-if' scenarios are reported along with reports on upgraded antenna visibility determination software and unattended network management prototype.

  17. Critical incident stress management (CISM) in support of special agents and other first responders responding to the Fort Hood shooting: summary and recommendations.

    Science.gov (United States)

    Strand, Russell; Felices, Karina; Williams, Kenneth

    2010-01-01

    On November 5, 2009, an individual entered the Fort Hood Soldier Readiness Processing (SRP) site and opened fire with a handgun. The result of the shooting was a total of 13 people killed and 31 wounded. A two-person critical incident peer support (CIPS) team from the United States Army Military Police School (USAMPS) provided critical incident stress management (CISM) in the forms of critical incident stress debriefings (CISD) and one-on-one crisis intervention for investigators and their spouses. This article provides a summary and discussion of the results of the interventions that were conducted. Key results for successful CISM were accessibility of CIPS team, the credibility of trained peers and the development of supportive relationships, the reduction of stigma by requiring attendance at interventions, and the commitment of the CIPS team to the principles of CISM (e.g., homogenous groups, utilizing a multicomponent approach, and facilitating the normalization of emotional reactions to the crisis). Recommendations include mandating critical incident peer support cells for Criminal Investigation Division (CID) units, Director of Emergency Services (DES) on military installations, and Military Police units; providing a pool of trained peers in the above-mentioned organizations; providing permanent funding for USAMPS' CIPS Course; and recognition of CIPS/CISMas an essential element of Comprehensive Soldier Fitness and Army Human Capital in promoting Soldier Family, and Civilian well-being and resiliency. This article would benefit leaders, chaplains, mental health professionals, and emergency services personnel in investigative, operational, and U.S. Army Garrison units.

  18. Development and evaluation of simulation-based fever management module for children with febrile convulsion.

    Science.gov (United States)

    Kim, Shin-Jeong; Oh, Jina; Kang, Kyung-Ah; Kim, SungHee

    2014-06-01

    A reliable and valid checklist for the evaluation of simulation learning outcomes has great value in nursing education. This study focuses on simulation-based fever management module including checklist for febrile convulsion in pediatric nursing. This study has two aims; (a) to develop a simulation-based fever management module for treating children with febrile convulsion, and (b) to evaluate students' performance and satisfaction. A convenient sample of 147 senior nursing students from two nursing schools in South Korea participated in this study from April 29 to June 14, 2013. This study was a three-stage process: developing the simulation-based module including algorithm with scenarios, items in checklist, and contents of debriefing (Stage I), performing simulation and debriefing for nursing students (Stage II), and evaluating the evaluation checklist of simulation performance and satisfaction of nursing students (Stage III). Student satisfaction was measured using the Satisfaction of Simulations Experience [SSE] scale. Debriefing data were analyzed using the Matrix Method. A scenario script was created to treat the patient's health issues. The algorithm proceeded as follows: identification of patient's condition (Step I), nursing interventions (Step II), and outcome evaluation and feedback (Step III). The total mean score of the evaluation checklist was 2.67 (±.32). The debriefing categories were as follows: non-technical skills, self-efficacy, critical thinking, and technical skills. The total mean score of the SSE was 4.48 (±.42). This study provides a blueprint for simulation-based practice for both nursing educators and nursing students. Further studies of checklists used in different contexts would be valuable for expanding upon this research. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Measuring the association between artemisinin-based case management and malaria incidence in southern Vietnam, 1991-2010.

    Science.gov (United States)

    Peak, Corey M; Thuan, Phung Duc; Britton, Amadea; Nguyen, Tran Dang; Wolbers, Marcel; Thanh, Ngo Viet; Buckee, Caroline O; Boni, Maciej F

    2015-04-01

    In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8-41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not. © The American Society of Tropical Medicine and Hygiene.

  20. Scenario Based Education as a Framework for Understanding Students Engagement and Learning in a Project Management Simulation Game

    Science.gov (United States)

    Misfeldt, Morten

    2015-01-01

    In this paper I describe how students use a project management simulation game based on an attack-defense mechanism where two teams of players compete by challenging each other's projects. The project management simulation game is intended to be played by pre-service construction workers and engineers. The gameplay has two parts: a planning part,…

  1. Development of a Computational Simulation Model for Conflict Management in Team Building

    Directory of Open Access Journals (Sweden)

    W. M. Wang

    2011-05-01

    Full Text Available Conflict management is one of the most important issues in leveraging organizational competitiveness. However, traditional social scientists built theories or models in this area which were mostly expressed in words and diagrams are insufficient. Social science research based on computational modeling and simulation is beginning to augment traditional theory building. Simulation provides a method for people to try their actions out in a way that is cost effective, faster, appropriate, flexible, and ethical. In this paper, a computational simulation model for conflict management in team building is presented. The model is designed and used to explore the individual performances related to the combination of individuals who have a range of conflict handling styles, under various types of resources and policies. The model is developed based on agent-based modeling method. Each of the agents has one of the five conflict handling styles: accommodation, compromise, competition, contingency, and learning. There are three types of scenarios: normal, convex, and concave. There are two types of policies: no policy, and a reward and punishment policy. Results from running the model are also presented. The simulation has led us to derive two implications concerning conflict management. First, a concave type of resource promotes competition, while convex type of resource promotes compromise and collaboration. Second, the performance ranking of different styles can be influenced by introducing different policies. On the other hand, it is possible for us to promote certain style by introducing different policies.

  2. The Application of Modeling and Simulation in Capacity Management within the ITIL Framework

    Science.gov (United States)

    Rahmani, Sonya; vonderHoff, Otto

    2010-01-01

    Tightly integrating modeling and simulation techniques into Information Technology Infrastructure Library (ITIL) practices can be one of the driving factors behind a successful and cost-effective capacity management effort for any Information Technology (IT) system. ITIL is a best practices framework for managing IT infrastructure, development and operations. Translating ITIL theory into operational reality can be a challenge. This paper aims to highlight how to best integrate modeling and simulation into an ITIL implementation. For cases where the project team initially has difficulty gaining consensus on investing in modeling and simulation resources, a clear definition for M&S implementation into the ITIL framework, specifically its role in supporting Capacity Management, is critical to gaining the support required to garner these resources. This implementation should also help to clearly define M&S support to the overall system mission. This paper will describe the development of an integrated modeling approach and how best to tie M&S to definitive goals for evaluating system capacity and performance requirements. Specifically the paper will discuss best practices for implementing modeling and simulation into ITIL. These practices hinge on implementing integrated M&S methods that 1) encompass at least two or more predictive modeling techniques, 2) complement each one's respective strengths and weaknesses to support the validation of predicted results, and 3) are tied to the system's performance and workload monitoring efforts. How to structure two forms of modeling: statistical and simUlation in the development of "As Is" and "To Be" efforts will be used to exemplify the integrated M&S methods. The paper will show how these methods can better support the project's overall capacity management efforts.

  3. Simulating Free-Roaming Cat Population Management Options in Open Demographic Environments

    Science.gov (United States)

    Miller, Philip S.; Boone, John D.; Briggs, Joyce R.; Lawler, Dennis F.; Levy, Julie K.; Nutter, Felicia B.; Slater, Margaret; Zawistowski, Stephen

    2014-01-01

    Large populations of free-roaming cats (FRCs) generate ongoing concerns for welfare of both individual animals and populations, for human public health, for viability of native wildlife populations, and for local ecological damage. Managing FRC populations is a complex task, without universal agreement on best practices. Previous analyses that use simulation modeling tools to evaluate alternative management methods have focused on relative efficacy of removal (or trap-return, TR), typically involving euthanasia, and sterilization (or trap-neuter-return, TNR) in demographically isolated populations. We used a stochastic demographic simulation approach to evaluate removal, permanent sterilization, and two postulated methods of temporary contraception for FRC population management. Our models include demographic connectivity to neighboring untreated cat populations through natural dispersal in a metapopulation context across urban and rural landscapes, and also feature abandonment of owned animals. Within population type, a given implementation rate of the TR strategy results in the most rapid rate of population decline and (when populations are isolated) the highest probability of population elimination, followed in order of decreasing efficacy by equivalent rates of implementation of TNR and temporary contraception. Even low levels of demographic connectivity significantly reduce the effectiveness of any management intervention, and continued abandonment is similarly problematic. This is the first demographic simulation analysis to consider the use of temporary contraception and account for the realities of FRC dispersal and owned cat abandonment. PMID:25426960

  4. Simulation of the hydraulic performance of highway filter drains through laboratory models and stormwater management tools.

    Science.gov (United States)

    Sañudo-Fontaneda, Luis A; Jato-Espino, Daniel; Lashford, Craig; Coupe, Stephen J

    2017-05-23

    Road drainage is one of the most relevant assets in transport infrastructure due to its inherent influence on traffic management and road safety. Highway filter drains (HFDs), also known as "French Drains", are the main drainage system currently in use in the UK, throughout 7000 km of its strategic road network. Despite being a widespread technique across the whole country, little research has been completed on their design considerations and their subsequent impact on their hydraulic performance, representing a gap in the field. Laboratory experiments have been proven to be a reliable indicator for the simulation of the hydraulic performance of stormwater best management practices (BMPs). In addition to this, stormwater management tools (SMT) have been preferentially chosen as a design tool for BMPs by practitioners from all over the world. In this context, this research aims to investigate the hydraulic performance of HFDs by comparing the results from laboratory simulation and two widely used SMT such as the US EPA's stormwater management model (SWMM) and MicroDrainage®. Statistical analyses were applied to a series of rainfall scenarios simulated, showing a high level of accuracy between the results obtained in laboratory and using SMT as indicated by the high and low values of the Nash-Sutcliffe and R 2 coefficients and root-mean-square error (RMSE) reached, which validated the usefulness of SMT to determine the hydraulic performance of HFDs.

  5. A prospective study on the incidence of dog bites and management in a rural Cambodian, rabies-endemic setting.

    Science.gov (United States)

    Ponsich, Aurelia; Goutard, Flavie; Sorn, San; Tarantola, Arnaud

    2016-08-01

    Rabies circulates intensely in Cambodia, mainly affecting rural populations. We conducted a prospective study to estimate the baseline incidence of potentially infective dog bites in rural villages of Siem Reap province, Cambodia. The study was conducted in a convenience sample of 844 families totaling 1779 persons in four villages. The study collected data in a total of 802.3 person-years. Trained village health workers (VHW) exhaustively documented consecutive dog bites at the end of each month. Between May 15th and November 15th, 2011, a total of 40 attacks (43 bites; 1.07 bites per attack) were notified by 39 persons (50% female; one suffered two distinct incidents) to VHW. The all-age attack rate for bites over this 6-month period was 2.3% (CI95%: 1.7-3.1%), with a global incidence rate estimated at 4.84 bites/100 person-years (CI95%: 3.5-6.6). The mean age in bite victims was 20.8±18.9years (median 12.5; interquartile range 6-36; range 1-63). The dog was identified in 39 (97.5%) of cases, being the household dog in 9 (22.5%) of cases. Bites were classified as severe (WHO Category III-broken skin with bleeding) in 33 (82.5%) of cases with a severe dog bites incidence estimated at 4/100 person-years (CI95%: 2.8-5.6). The bites involved the hand or face in 1 (2.5%) case each (both Category III). In 20 incidents (50%), only rice was applied to the wounds. There were no suspected or confirmed human rabies deaths during the study period but one dog died after biting (2 others were lost to follow-up and 14 were put down by their owner). Our study documented an extremely high incidence of dog bites in of rural Cambodian adults and children. Adapted control policies for canine vaccination are urgently needed. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Integrated Vehicle Health Management Project-Modeling and Simulation for Wireless Sensor Applications

    Science.gov (United States)

    Wallett, Thomas M.; Mueller, Carl H.; Griner, James H., Jr.

    2009-01-01

    This paper describes the efforts in modeling and simulating electromagnetic transmission and reception as in a wireless sensor network through a realistic wing model for the Integrated Vehicle Health Management project at the Glenn Research Center. A computer model in a standard format for an S-3 Viking aircraft was obtained, converted to a Microwave Studio software format, and scaled to proper dimensions in Microwave Studio. The left wing portion of the model was used with two antenna models, one transmitting and one receiving, to simulate radio frequency transmission through the wing. Transmission and reception results were inconclusive.

  7. A Project Management Approach to Using Simulation for Cost Estimation on Large, Complex Software Development Projects

    Science.gov (United States)

    Mizell, Carolyn; Malone, Linda

    2007-01-01

    It is very difficult for project managers to develop accurate cost and schedule estimates for large, complex software development projects. None of the approaches or tools available today can estimate the true cost of software with any high degree of accuracy early in a project. This paper provides an approach that utilizes a software development process simulation model that considers and conveys the level of uncertainty that exists when developing an initial estimate. A NASA project will be analyzed using simulation and data from the Software Engineering Laboratory to show the benefits of such an approach.

  8. A simulation model of hospital management based on cost accounting analysis according to disease.

    Science.gov (United States)

    Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki

    2004-12-01

    Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.

  9. Development of the BIOME-BGC model for the simulation of managed Moso bamboo forest ecosystems.

    Science.gov (United States)

    Mao, Fangjie; Li, Pingheng; Zhou, Guomo; Du, Huaqiang; Xu, Xiaojun; Shi, Yongjun; Mo, Lufeng; Zhou, Yufeng; Tu, Guoqing

    2016-05-01

    Numerical models are the most appropriate instrument for the analysis of the carbon balance of terrestrial ecosystems and their interactions with changing environmental conditions. The process-based model BIOME-BGC is widely used in simulation of carbon balance within vegetation, litter and soil of unmanaged ecosystems. For Moso bamboo forests, however, simulations with BIOME-BGC are inaccurate in terms of the growing season and the carbon allocation, due to the oversimplified representation of phenology. Our aim was to improve the applicability of BIOME-BGC for managed Moso bamboo forest ecosystem by implementing several new modules, including phenology, carbon allocation, and management. Instead of the simple phenology and carbon allocation representations in the original version, a periodic Moso bamboo phenology and carbon allocation module was implemented, which can handle the processes of Moso bamboo shooting and high growth during "on-year" and "off-year". Four management modules (digging bamboo shoots, selective cutting, obtruncation, fertilization) were integrated in order to quantify the functioning of managed ecosystems. The improved model was calibrated and validated using eddy covariance measurement data collected at a managed Moso bamboo forest site (Anji) during 2011-2013 years. As a result of these developments and calibrations, the performance of the model was substantially improved. Regarding the measured and modeled fluxes (gross primary production, total ecosystem respiration, net ecosystem exchange), relative errors were decreased by 42.23%, 103.02% and 18.67%, respectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Geriatric simulation: practicing management and leadership in care of the older adult.

    Science.gov (United States)

    Miller, Sally; Overstreet, Maria

    2015-06-01

    According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. A Retrospective Study of the Incidence of Missed Opportunities in Identifying, Managing and Referring At-Risk of Overweight and Overweight Children and Adolescents in an Outpatient Primary Care Setting

    National Research Council Canada - National Science Library

    Quirke, Amy

    2004-01-01

    A descriptive study of the incidence of missed opportunities in identifying, managing and referring children and adolescents at-risk of overweight and overweight were conducted using a retrospective...

  12. Evaluation of leadership skills during the simulation education course for the initial management of blunt trauma.

    Science.gov (United States)

    Schott, Eric; Brautigam, Robert T; Smola, Jacqueline; Burns, Karyl J

    2012-04-01

    Leadership skills of senior residents, trauma fellows, and a nurse practitioner were assessed during simulation training for the initial management of blunt trauma. This was a pilot, observational study, that in addition to skill development and assessment also sought to determine the need for a dedicated leadership training course for surgical residents. The study evaluated the leadership skills and adherence to Advance Trauma Life Support (ATLS) guidelines of the team leaders during simulation training. The team leaders' performances on criteria regarding prearrival planning, critical actions based on ATLS, injury identification, patient management, and communication were evaluated for each of five blunt-trauma scenarios. Although there was a statistically significant increase in leadership skills for performing ATLS critical actions, P skills for team leadership willbe a worthwhile endeavor at our institution.

  13. CONFIG - Adapting qualitative modeling and discrete event simulation for design of fault management systems

    Science.gov (United States)

    Malin, Jane T.; Basham, Bryan D.

    1989-01-01

    CONFIG is a modeling and simulation tool prototype for analyzing the normal and faulty qualitative behaviors of engineered systems. Qualitative modeling and discrete-event simulation have been adapted and integrated, to support early development, during system design, of software and procedures for management of failures, especially in diagnostic expert systems. Qualitative component models are defined in terms of normal and faulty modes and processes, which are defined by invocation statements and effect statements with time delays. System models are constructed graphically by using instances of components and relations from object-oriented hierarchical model libraries. Extension and reuse of CONFIG models and analysis capabilities in hybrid rule- and model-based expert fault-management support systems are discussed.

  14. Sustainable management of a coupled groundwater-agriculture hydrosystem using multi-criteria simulation based optimisation.

    Science.gov (United States)

    Grundmann, Jens; Schütze, Niels; Lennartz, Franz

    2013-01-01

    In this paper we present a new simulation-based integrated water management tool for sustainable water resources management in arid coastal environments. This tool delivers optimised groundwater withdrawal scenarios considering saltwater intrusion as a result of agricultural and municipal water abstraction. It also yields a substantially improved water use efficiency of irrigated agriculture. To allow for a robust and fast operation we unified process modelling with artificial intelligence tools and evolutionary optimisation techniques. The aquifer behaviour is represented using an artificial neural network (ANN) which emulates a numerical density-dependent groundwater flow model. The impact of agriculture is represented by stochastic crop water production functions (SCWPF). Simulation-based optimisation techniques together with the SCWPF and ANN deliver optimal groundwater abstraction and cropping patterns. To address contradicting objectives, e.g. profit-oriented agriculture vs. sustainable abstraction scenarios, we performed multi-objective optimisations using a multi-criteria optimisation algorithm.

  15. HOW TO MITIGATE THE RISKS OF MANAGING ONLINE ADVERTISING CAMPAIGNS BY TRAINING WITH SIMBOUND SIMULATION GAME

    Directory of Open Access Journals (Sweden)

    Louis Doru Havriliuc

    2013-12-01

    Full Text Available This paper aims to describe how a digital marketing simulation system improve the knowledge and skills of students, as well as their status as members of a virtual community, which gradually evolve from novice to expert in managing online advertising campaigns. The body of the article encompasses three contributions: the know-how of the Simbound Game author, the practical experiences of an instructor, who coordinated students’ activities during three courses and of a Master student – the leader of a team which got the first position after the completion of a game. The advantages of managing no-risk online advertising campaigns are revealed and the students are able to understand how various online marketing tools become useful while a firm expands its operations in e-commerce and must fulfill new tasks and responsibilities. The paper concludes with the practical implications of the Simbound simulation-based learning and the ideas included in the future research agenda.

  16. Effects of Comprehensive Risk Management Program on the Preparedness of Rofeide Rehabilitation Hospital in Disasters and Incidents

    Directory of Open Access Journals (Sweden)

    Samira Rajabi

    2017-07-01

    Conclusion: Considering the positive impact of the implementation of the risk management program on the preparedness of Rofeide Rehabilitation Hospital and promotion of its preparedness level from poor to moderate, as well as relatively high vulnerability of hospitals against internal and external risks, national hospitals are recommended to use the comprehensive hospital risk management model to be more prepared for disasters.

  17. The relationship between the implementation of voluntary Five-Star occupational health and safety management system and the incidence of fatal and permanently disabling injury

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2014-01-01

    This paper examines two properties of the South African NOSA 5-Star System, a voluntary occupational health and safety (OHS) management system. The first property is the association between system implementation and final OHS outcomes measured as incidence rates of fatal and permanently disabling...... injury. The second is the association between the Star audit rating and rates of serious occupational injury. Although there are many uncertainties involved the paper argues that companies committed to the NOSA system experienced fewer fatal and permanently disabling injuries than the general...

  18. Simulation Aided Life Cycle Sustainability Assessment Framework for Manufacturing Design and Management

    OpenAIRE

    Mijoh A. Gbededo; Kapila Liyanage; Ilias Oraifige

    2016-01-01

    Decision making for sustainable manufacturing design and management requires critical considerations due to the complexity and partly conflicting issues of economic, social and environmental factors. Although there are tools capable of assessing the combination of one or two of the sustainability factors, the frameworks have not adequately integrated all the three factors. Case study and review of existing simulation applications also shows the approach lacks integration of the sustainability...

  19. 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

  20. SIMULATIONS AND GAMES IN MANAGEMENT EDUCATION: TOWARDS A MULTI-DIMENSIONAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Jorge Paulo Sequeira

    2013-06-01

    Full Text Available Games and simulations have been used in the field of education for many years, particularly in the areas of business, training staff in financial and economic skills, combat training and war gaming. Internet-based games are also commonly used in the areas of education, business and policy to provide a safe but realistic experience of the real world. This paper explores some of the rationale that a team of lecturers at the Lisbon School of Accounting and Administration (ISCAL think should underpin simulation and game usage in an educational context, specifically in management education. Our aim with this work is about promoting learning and knowledge building through one of the latest evolved socio-cultural artifact: online simulations and games.

  1. Development of Software and Strategies for Battery Management System Testing on HIL Simulator

    DEFF Research Database (Denmark)

    Fleischer, Christian; Sauer, Dirk Uwe; Barreras, Jorge Varela

    2016-01-01

    . This is particularly the case of tests at early stages in the development process or during fault simulation. However, the use of a HIL battery simulator requires the development of software (SW) and strategies for testing. While the possibilities are immense, it should be noted that the greater the level......In comparison with tests conducted on real Li-ion batteries, Battery Management System (BMS) tests conducted on a Hardware-In-the-Loop (HIL) battery simulator may be more cost and time effective, more flexible and traceable, easier to reproduce and safer beyond the normal range of operation...... of complexity of the tests, the higher the demands for ad hoc development of SW and strategies. With regard to the latter, there is not a universal definition and there are different points of view. Therefore different strategies may be followed, which can be classified into many different ways according...

  2. Implementation of a Real-Time Microgrid Simulation Platform Based on Centralized and Distributed Management

    Directory of Open Access Journals (Sweden)

    Omid Abrishambaf

    2017-06-01

    Full Text Available Demand response and distributed generation are key components of power systems. Several challenges are raised at both technical and business model levels for integration of those resources in smart grids and microgrids. The implementation of a distribution network as a test bed can be difficult and not cost-effective; using computational modeling is not sufficient for producing realistic results. Real-time simulation allows us to validate the business model’s impact at the technical level. This paper comprises a platform supporting the real-time simulation of a microgrid connected to a larger distribution network. The implemented platform allows us to use both centralized and distributed energy resource management. Using an optimization model for the energy resource operation, a virtual power player manages all the available resources. Then, the simulation platform allows us to technically validate the actual implementation of the requested demand reduction in the scope of demand response programs. The case study has 33 buses, 220 consumers, and 68 distributed generators. It demonstrates the impact of demand response events, also performing resource management in the presence of an energy shortage.

  3. Emergency medicine resident crisis resource management ability: a simulation-based longitudinal study

    Directory of Open Access Journals (Sweden)

    Samuel Clarke

    2014-12-01

    Full Text Available Background: Simulation has been identified as a means of assessing resident physicians’ mastery of technical skills, but there is a lack of evidence for its utility in longitudinal assessments of residents’ non-technical clinical abilities. We evaluated the growth of crisis resource management (CRM skills in the simulation setting using a validated tool, the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS. We hypothesized that the Ottawa GRS would reflect progressive growth of CRM ability throughout residency. Methods: Forty-five emergency medicine residents were tracked with annual simulation assessments between 2006 and 2011. We used mixed-methods repeated-measures regression analyses to evaluate elements of the Ottawa GRS by level of training to predict performance growth throughout a 3-year residency. Results: Ottawa GRS scores increased over time, and the domains of leadership, problem solving, and resource utilization, in particular, were predictive of overall performance. There was a significant gain in all Ottawa GRS components between postgraduate years 1 and 2, but no significant difference in GRS performance between years 2 and 3. Conclusions: In summary, CRM skills are progressive abilities, and simulation is a useful modality for tracking their development. Modification of this tool may be needed to assess advanced learners’ gains in performance.

  4. Inventory-based landscape-scale simulation of management effectiveness and economic feasibility with BioSum

    Science.gov (United States)

    Jeremy S. Fried; Larry D. Potts; Sara M. Loreno; Glenn A. Christensen; R. Jamie Barbour

    2017-01-01

    The Forest Inventory and Analysis (FIA)-based BioSum (Bioregional Inventory Originated Simulation Under Management) is a free policy analysis framework and workflow management software solution. It addresses complex management questions concerning forest health and vulnerability for large, multimillion acre, multiowner landscapes using FIA plot data as the initial...

  5. A simulation-optimization model for effective water resources management in the coastal zone

    Science.gov (United States)

    Spanoudaki, Katerina; Kampanis, Nikolaos

    2015-04-01

    -diffusion equation describing the fate and transport of contaminants introduced in a 3D turbulent flow field to the partial differential equation describing the fate and transport of contaminants in 3D transient groundwater flow systems. The model has been further developed to include the effects of density variations on surface water and groundwater flow, while the already built-in solute transport capabilities are used to simulate salinity interactions. The refined model is based on the finite volume method using a cell-centred structured grid, providing thus flexibility and accuracy in simulating irregular boundary geometries. For addressing water resources management problems, simulation models are usually externally coupled with optimisation-based management models. However this usually requires a very large number of iterations between the optimisation and simulation models in order to obtain the optimal management solution. As an alternative approach, for improved computational efficiency, an Artificial Neural Network (ANN) is trained as an approximate simulator of IRENE. The trained ANN is then linked to a Genetic Algorithm (GA) based optimisation model for managing salinisation problems in the coastal zone. The linked simulation-optimisation model is applied to a hypothetical study area for performance evaluation. Acknowledgement The work presented in this paper has been funded by the Greek State Scholarships Foundation (IKY), Fellowships of Excellence for Postdoctoral Studies (Siemens Program), 'A simulation-optimization model for assessing the best practices for the protection of surface water and groundwater in the coastal zone', (2013 - 2015). References Spanoudaki, K., Stamou, A.I. and Nanou-Giannarou, A. (2009). Development and verification of a 3-D integrated surface water-groundwater model. Journal of Hydrology, 375 (3-4), 410-427. Spanoudaki, K. (2010). Integrated numerical modelling of surface water groundwater systems (in Greek). Ph.D. Thesis, National Technical

  6. Simulation of the hydrodynamic behaviour of a Mediterranean reservoir under different climate change and management scenarios

    Directory of Open Access Journals (Sweden)

    Jordi Prats

    2017-11-01

    Full Text Available One of the most important current issues in the management of lakes and reservoirs is the prediction of global climate change effects to determine appropriate mitigation and adaptation actions. In this paper we analyse whether management actions can limit the effects of climate change on water temperatures in a reservoir. For this, we used the model EOLE to simulate the hydrodynamic and thermal behaviour of the reservoir of Bimont (Provence region, France in the medium term (2036-2065 and in the long term (2066-2095 using regionalised projections by the model CNRM-CERFACS-CNRM-CM5 under the emission scenarios RCP 4.5 and RCP 8.5. Water temperature projections were compared to simulations for the reference period 1993-2013, the longest period for which we had year-long data for both hydrology and meteorology. We calibrated the model using profile measurements for the period 2010-2011 and we carried an extensive validation and assessment of model performance. In fact, we validated the model using profile measurements for 2012-2014, obtaining a root mean square error of 1.08°C and mean bias of -0.11°C, and we assured the consistency of model simulations in the long term by comparing simulated surface temperature to satellite measurements for 1999-2013. We assessed the effect using synthetic input data instead of measured input data by comparing simulations made using both kinds of data for the reference period. Using synthetic data resulted in slightly lower (-0.3°C average and maximum epilimnion temperatures, a somewhat deeper thermocline, and slightly higher evaporation (+7%. To investigate the effect of different management strategies, we considered three management scenarios: i bottom outlet and present water level; ii bottom outlet and elevated water level; and iii surface outlet and elevated water level. According to the simulations, the reservoir of Bimont will have a low rate of warming of the epilimnion of 0.009-0.024 °C·yr-1, but a

  7. Is simulation training effective in increasing podiatrists' confidence in foot ulcer management?

    Directory of Open Access Journals (Sweden)

    Régo Patricia M

    2011-06-01

    Full Text Available Abstract Background Foot ulcers are a frequent reason for diabetes-related hospitalisation. Clinical training is known to have a beneficial impact on foot ulcer outcomes. Clinical training using simulation techniques has rarely been used in the management of diabetes-related foot complications or chronic wounds. Simulation can be defined as a device or environment that attempts to replicate the real world. The few non-web-based foot-related simulation courses have focused solely on training for a single skill or "part task" (for example, practicing ingrown toenail procedures on models. This pilot study aimed to primarily investigate the effect of a training program using multiple methods of simulation on participants' clinical confidence in the management of foot ulcers. Methods Sixteen podiatrists participated in a two-day Foot Ulcer Simulation Training (FUST course. The course included pre-requisite web-based learning modules, practicing individual foot ulcer management part tasks (for example, debriding a model foot ulcer, and participating in replicated clinical consultation scenarios (for example, treating a standardised patient (actor with a model foot ulcer. The primary outcome measure of the course was participants' pre- and post completion of confidence surveys, using a five-point Likert scale (1 = Unacceptable-5 = Proficient. Participants' knowledge, satisfaction and their perception of the relevance and fidelity (realism of a range of course elements were also investigated. Parametric statistics were used to analyse the data. Pearson's r was used for correlation, ANOVA for testing the differences between groups, and a paired-sample t-test to determine the significance between pre- and post-workshop scores. A minimum significance level of p Results An overall 42% improvement in clinical confidence was observed following completion of FUST (mean scores 3.10 compared to 4.40, p Conclusions This pilot study suggests simulation training

  8. Simulating post-wildfire forest trajectories under alternative climate and management scenarios.

    Science.gov (United States)

    Tarancón, Alicia Azpeleta; Fulé, Peter Z; Shive, Kristen L; Sieg, Carolyn H; Meador, Andrew Sánchez; Strom, Barbara

    Post-fire predictions of forest recovery under future climate change and management actions are necessary for forest managers to make decisions about treatments. We applied the Climate-Forest Vegetation Simulator (Climate-FVS), a new version of a widely used forest management model, to compare alternative climate and management scenarios in a severely burned multispecies forest of Arizona, USA. The incorporation of seven combinations of General Circulation Models (GCM) and emissions scenarios altered long-term (100 years) predictions of future forest condition compared to a No Climate Change (NCC) scenario, which forecast a gradual increase to high levels of forest density and carbon stock. In contrast, emissions scenarios that included continued high greenhouse gas releases led to near-complete deforestation by 2111. GCM-emissions scenario combinations that were less severe reduced forest structure and carbon stock relative to NCC. Fuel reduction treatments that had been applied prior to the severe wildfire did have persistent effects, especially under NCC, but were overwhelmed by increasingly severe climate change. We tested six management strategies aimed at sustaining future forests: prescribed burning at 5, 10, or 20-year intervals, thinning 40% or 60% of stand basal area, and no treatment. Severe climate change led to deforestation under all management regimes, but important differences emerged under the moderate scenarios: treatments that included regular prescribed burning fostered low density, wildfire-resistant forests composed of the naturally dominant species, ponderosa pine. Non-fire treatments under moderate climate change were forecast to become dense and susceptible to severe wildfire, with a shift to dominance by sprouting species. Current U.S. forest management requires modeling of future scenarios but does not mandate consideration of climate change effects. However, this study showed substantial differences in model outputs depending on climate

  9. Incidence and management of infusion reactions to infliximab in 186 italian patient’s with rheumatoid arthritis: the Padua experience

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Objective: We report the incidence and treatment of infusion reactions to infliximab, a chimeric monoclonal IgG1 antibody against tumor necrosis factor a, in a large cohort of patients with rheumatoid arthritis. Patients and methods: One hundred eighty six patients with rheumatoid arthritis treated with infliximab for a total of 216.6 patient years were retrospectively evaluated. Patients received 2160 infliximab infusions at the Division of Rheumatology at the University Hospital of Padua from May, 2000 to April, 2004. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. Results: The overall incidence of infusion reactions to infliximab was 0.8% (19 out of 2160 of infusions, affecting 10.2% of patients (19 out of 186. Mild, moderate, or severe acute reactions occurred in 0.1% (3 of 2160, 0.6% (13 of 2160, and 0.04% (1 of 2160 of infliximab infusions, respectively. Delayed infusion reactions occurred in 0.09% (2 of 2160 of infusions. Use of specific treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With a prophylaxis protocol, all patients who experienced an initial mild acute reaction were able to receive additional infusions. Conclusions: Using appropriate treatment protocols, infliximab infusion reactions were effectively treated and prevented in patients with mild acute reactions upon retreatment. In the case of moderate to severe infusion reactions, the risks and the benefits of the continuation of infliximab therapy need to be carefully considered.

  10. Operational simulation, design and management of decentralized energy systems; Betriebliche Modellierung, Auslegung und Management von dezentralen Energiesystemen

    Energy Technology Data Exchange (ETDEWEB)

    Matics, J.

    2007-06-28

    Chapter 2 describes the worldwide increase of primary energy consumption, which is expected in coming decades and results in possible solutions of a decentralised energy supply that is mainly based upon renewable energy carriers and the use of cogeneration systems. Chapter 3 shows the characteristics of decentralised system components that have been investigated in the frame of this research work as well as the resulting model library to depict the operational performance of the individual components and their mutual influence. A detailed dynamic simulation of a complete fuel cell system based on a steam reformer including the concept of local and superordinate control circuits is presented in chapter 4. Chapter 5 includes the integrated concepts for the intelligent and adaptable management of complex decentralised energy systems as well as a description of their implementation. Apart from the applied metaheuristic optimization methods the adaptable fuzzy-system, used in this case, is presented. The components of the model library of decentralised system components (chapter 3), the dynamic simulation of a complete fuel cell system based on a reformer (chapter 4), as well as the intelligent and adaptable plant management (chapter 5) are used in chapter 6 to investigate the various decentralised energy systems. The investigation focuses in particular on a) the electricity supply of a one-family home based on photovoltaics including different storage technologies and an increasing degree of energetic independence; b) the operational performance of a wind park with 72 individual plants as well as the combination of flywheel mass storage and wind energy plant; c) the control concepts, which have been developed for a fuel cell test stand based on a steam reformer, and their effects on the operation of the individual components as well as their interaction; d) the use of the developed management modules for the flexible and adaptable operation of a cogeneration system for

  11. Fostering Sustainable Transportation Operations through Corridor Management: A Simulation Gaming Approach

    Directory of Open Access Journals (Sweden)

    Shalini Kurapati

    2018-02-01

    Full Text Available Synchromodality is described as a network of well-synchronised and interconnected transportation modes. One of the most important advantages of synchromodality is the development of a sustainable transportation system. Given the numerous stakeholders and network interdependencies within freight transport corridors, achieving efficient coordination and management is complex. In this paper, we regard information exchange as one of the main enablers of collaboration between the infrastructure managers. We developed a digital single-player simulation game called “Modal Manager” comprising logistic service providers and infrastructure managers. Each player takes over the role of an infrastructure manager who must use information provision as a tool to control flows in a network where various planned and unplanned disruptions occur. We include the game in a session where participants are able to interact with the game and with each other. The first gameplay session with Dutch experts revealed that infrastructure managers perceive synchromodality as a way to cope with disruptions more efficiently. On the other hand, the concept of synchromodal corridor management is ambiguous and various legal and governance barriers exist that hinder its implementation.

  12. Dynamical system modeling to simulate donor T cell response to whole exome sequencing-derived recipient peptides: Understanding randomness in alloreactivity incidence following stem cell transplantation.

    Directory of Open Access Journals (Sweden)

    Vishal Koparde

    Full Text Available Quantitative relationship between the magnitude of variation in minor histocompatibility antigens (mHA and graft versus host disease (GVHD pathophysiology in stem cell transplant (SCT donor-recipient pairs (DRP is not established. In order to elucidate this relationship, whole exome sequencing (WES was performed on 27 HLA matched related (MRD, & 50 unrelated donors (URD, to identify nonsynonymous single nucleotide polymorphisms (SNPs. An average 2,463 SNPs were identified in MRD, and 4,287 in URD DRP (p<0.01; resulting peptide antigens that may be presented on HLA class I molecules in each DRP were derived in silico (NetMHCpan ver2.0 and the tissue expression of proteins these were derived from determined (GTex. MRD DRP had an average 3,670 HLA-binding-alloreactive peptides, putative mHA (pmHA with an IC50 of <500 nM, and URD, had 5,386 (p<0.01. To simulate an alloreactive donor cytotoxic T cell response, the array of pmHA in each patient was considered as an operator matrix modifying a hypothetical cytotoxic T cell clonal vector matrix; each responding T cell clone's proliferation was determined by the logistic equation of growth, accounting for HLA binding affinity and tissue expression of each alloreactive peptide. The resulting simulated organ-specific alloreactive T cell clonal growth revealed marked variability, with the T cell count differences spanning orders of magnitude between different DRP. Despite an estimated, uniform set of constants used in the model for all DRP, and a heterogeneously treated group of patients, higher total and organ-specific T cell counts were associated with cumulative incidence of moderate to severe GVHD in recipients. In conclusion, exome wide sequence differences and the variable alloreactive peptide binding to HLA in each DRP yields a large range of possible alloreactive donor T cell responses. Our findings also help understand the apparent randomness observed in the development of alloimmune responses.

  13. [Incidence, management and costs of adverse effects in chronic hepatitis C patients on triple therapy with telaprevir or boceprevir: first 12 weeks of treatment].

    Science.gov (United States)

    Guglieri-López, Beatriz; Ventura-Cerdá, José Manuel; Gómez-Álvarez, Sandra; Climente-Martí, Mónica

    2015-05-01

    The aim of the study was to analyze the incidence, management and cost associated to hematological and dermatological adverse effects (AE) in chronic hepatitis C patients on triple therapy (TT) with telaprevir (TVR) or boceprevir (BOC). An analysis was made on the data recorded on patients who started treatment with TVR or BOC associated with peginterferon alfa and ribavirin in a 12-week follow-up period. Fifty-three patients were included (TVR n=36; BOC n=17). Thrombocytopenia (83% TVR vs. 88% BOC) followed by neutropenia (89% TVR vs. 82% BOC) were the most common AE. Dermatological AE were observed in 32% of patients. Eleven patients required treatment discontinuation (all of them received TVR), and toxicity was the main reason for discontinuation (64%). The percentage of patients who required supportive treatment for management of AE was 66%. The most used supportive treatment was erythropoietin. Eight patients required emergency health care, and 2 were hospitalized due to AE. Total cost of additional supportive resources was 32,522€ (625 [SD=876]€/patient) (TVR 759 [SD=1,022]€/patient vs. BOC 349 [SD=327]€/patient; P>.05). Patients with gradeiii-iv toxicity required greater supportive care with higher costs, compared to patients with gradei-ii toxicity (849 [SD=1,143]€/patient vs. 387 [SD=397]€/patient; P=.053). The addition of new protease inhibitors to conventional treatment leads to a higher incidence of hematological AE in our study, compared to data described in clinical trials. The elevated incidence of AE involves the use of supportive care, increasing total costs of therapy. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. Damaris: Addressing performance variability in data management for post-petascale simulations

    International Nuclear Information System (INIS)

    Dorier, Matthieu; Antoniu, Gabriel; Cappello, Franck; Snir, Marc; Sisneros, Robert

    2016-01-01

    With exascale computing on the horizon, reducing performance variability in data management tasks (storage, visualization, analysis, etc.) is becoming a key challenge in sustaining high performance. Here, this variability significantly impacts the overall application performance at scale and its predictability over time. In this article, we present Damaris, a system that leverages dedicated cores in multicore nodes to offload data management tasks, including I/O, data compression, scheduling of data movements, in situ analysis, and visualization. We evaluate Damaris with the CM1 atmospheric simulation and the Nek5000 computational fluid dynamic simulation on four platforms, including NICS’s Kraken and NCSA’s Blue Waters. Our results show that (1) Damaris fully hides the I/O variability as well as all I/O-related costs, thus making simulation performance predictable; (2) it increases the sustained write throughput by a factor of up to 15 compared with standard I/O approaches; (3) it allows almost perfect scalability of the simulation up to over 9,000 cores, as opposed to state-of-the-art approaches that fail to scale; and (4) it enables a seamless connection to the VisIt visualization software to perform in situ analysis and visualization in a way that impacts neither the performance of the simulation nor its variability. In addition, we extended our implementation of Damaris to also support the use of dedicated nodes and conducted a thorough comparison of the two approaches—dedicated cores and dedicated nodes—for I/O tasks with the aforementioned applications.

  15. Descriptive study of current therapeutic practices, clinical reproductive findings and incidence of pregnancy loss in intensively managed thoroughbred mares.

    Science.gov (United States)

    Rose, B V; Firth, M; Morris, B; Roach, J M; Wathes, D C; Verheyen, K L P; de Mestre, A M

    2018-01-01

    Therapeutic practices in equine reproductive medicine have dramatically evolved over the last 20 years but current usage is not described. The aims of this study were to provide a description of medication use and clinical findings of reproductive examinations alongside measures of reproductive efficiency in thoroughbreds. A prospective cohort study was conducted in the 2013 and 2014 breeding seasons. Mare and stallion details, information on veterinary interventions and findings of reproductive ultrasound scans were collected using questionnaires and entered into a custom-designed Microsoft Access database. Descriptive summary statistics were derived directly from the database and using Microsoft Excel. Information was collected from 2246 pregnancies in 1754 mares from 29 stud farms. Ovulatory induction agents were used in 91.8% of cases, oestrus induction agents in 38.4% and covering therapies in 62.7%. Intrauterine antimicrobials were used in 49.6% of mares. Single pregnancies accounted for 83.9% of pregnancies, twins for 15.3% and triplets for 0.7%. The overall incidence of pregnancy loss between days 15-42 was 6.4% (95% CI 5.4%, 7.4%) and 1.6% (95% CI 1.1%, 2.1%) between days 43-65. A further 1.3% of pregnancies were lost by October and 4.5% by birth (including stillbirths). Eighty-three percent of all pregnancies resulted in a live foal. In conclusion, there has been a considerable increase in the use of reproductive therapeutics over the last 12 years. Nonetheless, incidence of pregnancy loss and live foal percentages remain essentially unchanged. Risk factor studies are required to determine if the substantial increase in therapeutic usage is conferring positive benefits. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review.

    Science.gov (United States)

    Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott

    2015-01-01

    Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

  17. Simulation of the Effect of Intensive Forest Management on Forest Production in Sweden

    Directory of Open Access Journals (Sweden)

    Ola Rosvall

    2011-03-01

    Full Text Available The effects of intensifying the management of 15% of the Swedish forest land on potential future forest production over a 100-year period were investigated in a simulation study. The intensive management treatments, which were introduced over a period of 50 years, were: intensive fertilization of Norway spruce (IntFert; bulking-up Norway spruce elite populations using somatic embryogenesis (SE-seedlings; planting of lodgepole pine, hybrid larch, and Sitka spruce (Contorta, Larch, and Sitka; fertilization with wood ash on peatlands (Wood ash; and conventional fertilization in mature forests (ConFert. Potential sites for applying intensive forest management (IFM to sites with low nature conservation values were determined with a nature conservation score (NCS. Four different scenarios were simulated: “Base scenario”, which aimed at reducing the negative impact on nature conservation values, “Fast implementation”, “No IntFert” (IntFert was not used, and “Large Forest Companies”, where the majority of plots were selected on company land. Total yields during the 100-year simulation period were about 85–92% higher for the intensive forest management scenarios than for the reference scenario (business as usual. In the “No IntFert” scenario total production was 1.8% lower and in the “Large Forest Companies” scenario total production was 4.8% lower than in the “Base scenario”. “Fast implementation” of IFM increased yield by 15% compared to the “Base scenario”. Norway spruce SE-seedlings and IntFert gave the highest yields, measured as total production during the 100-year simulation period, but relative to the yields in the reference scenario, the highest increases in yield were for Contorta. The “Base scenario” and “No IntFert” gave the highest yields for plots with the lowest NCS, but plots with higher NCS had to be used in the “Fast implementation” and “Large Forest Companies” scenarios. More than

  18. An Expert System And Simulation Approach For Sensor Management & Control In A Distributed Surveillance Network

    Science.gov (United States)

    Leon, Barbara D.; Heller, Paul R.

    1987-05-01

    A surveillance network is a group of multiplatform sensors cooperating to improve network performance. Network control is distributed as a measure to decrease vulnerability to enemy threat. The network may contain diverse sensor types such as radar, ESM (Electronic Support Measures), IRST (Infrared search and track) and E-0 (Electro-Optical). Each platform may contain a single sensor or suite of sensors. In a surveillance network it is desirable to control sensors to make the overall system more effective. This problem has come to be known as sensor management and control (SM&C). Two major facets of network performance are surveillance and survivability. In a netted environment, surveillance can be enhanced if information from all sensors is combined and sensor operating conditions are controlled to provide a synergistic effect. In contrast, when survivability is the main concern for the network, the best operating status for all sensors would be passive or off. Of course, improving survivability tends to degrade surveillance. Hence, the objective of SM&C is to optimize surveillance and survivability of the network. Too voluminous data of various formats and the quick response time are two characteristics of this problem which make it an ideal application for Artificial Intelligence. A solution to the SM&C problem, presented as a computer simulation, will be presented in this paper. The simulation is a hybrid production written in LISP and FORTRAN. It combines the latest conventional computer programming methods with Artificial Intelligence techniques to produce a flexible state-of-the-art tool to evaluate network performance. The event-driven simulation contains environment models coupled with an expert system. These environment models include sensor (track-while-scan and agile beam) and target models, local tracking, and system tracking. These models are used to generate the environment for the sensor management and control expert system. The expert system

  19. Value of debriefing during simulated crisis management: oral versus video-assisted oral feedback.

    Science.gov (United States)

    Savoldelli, Georges L; Naik, Viren N; Park, Jason; Joo, Hwan S; Chow, Roger; Hamstra, Stanley J

    2006-08-01

    The debriefing process during simulation-based education has been poorly studied despite its educational importance. Videotape feedback is an adjunct that may enhance the impact of the debriefing and in turn maximize learning. The purpose of this study was to investigate the value of the debriefing process during simulation and to compare the educational efficacy of two types of feedback, oral feedback and videotape-assisted oral feedback, against control (no debriefing). Forty-two anesthesia residents were enrolled in the study. After completing a pretest scenario, participants were randomly assigned to receive no debriefing, oral feedback, or videotape-assisted oral feedback. The debriefing focused on nontechnical skills performance guided by crisis resource management principles. Participants were then required to manage a posttest scenario. The videotapes of all performances were later reviewed by two blinded independent assessors who rated participants' nontechnical skills using a validated scoring system. Participants' nontechnical skills did not improve in the control group, whereas the provision of oral feedback, either assisted or not assisted with videotape review, resulted in significant improvement (P crisis without constructive debriefing by instructors offers little benefit to trainees. The addition of video review did not offer any advantage over oral feedback alone. Valuable simulation training can therefore be achieved even when video technology is not available.

  20. Reducing the Incidence of Acute Pesticide Poisoning by Educating Farmers on Integrated Pest Management in South India

    NARCIS (Netherlands)

    Mancini, F.; Jiggins, J.L.S.; O'Malley, M.

    2009-01-01

    Sixty-five farmers reported on pesticide use and the signs and symptoms of acute pesticide poisoning when using two different plant protection strategies: in 2003 using chemical controls and in 2004 using an approach to Integrated Pest Management (IPM) based on an ecological analysis of the field

  1. Utilizing Social Networks in Times of Crisis: Understanding, Exploring and Analyzing Critical Incident Management at Institutions of Higher Education

    Science.gov (United States)

    Asselin, Martha Jo

    2012-01-01

    With the rising number of major crises on college campuses today (Security on Campus Inc., 2009), institutions of higher education can benefit from understanding of how social networks may be used in times of emergency. What is currently known about the usage of social networks is not integral to the current practices of crisis management that are…

  2. Modeling and Simulation of Project Management through the PMBOK® Standard Using Complex Networks

    Directory of Open Access Journals (Sweden)

    Luz Stella Cardona-Meza

    2017-01-01

    Full Text Available Discussion about project management, in both the academic literature and industry, is predominantly based on theories of control, many of which have been developed since the 1950s. However, issues arise when these ideas are applied unilaterally to all types of projects and in all contexts. In complex environments, management problems arise from assuming that results, predicted at the start of a project, can be sufficiently described and delivered as planned. Thus, once a project reaches a critical size, a calendar, and a certain level of ambiguity and interconnection, the analysis centered on control does not function adequately. Projects that involve complex situations can be described as adaptive complex systems, consistent in multiple interdependent dynamic components, multiple feedback processes, nonlinear relations, and management of hard data (process dynamics and soft data (executive team dynamics. In this study, through a complex network, the dynamic structure of a project and its trajectories are simulated using inference processes. Finally, some numerical simulations are described, leading to a decision making tool that identifies critical processes, thereby obtaining better performance outcomes of projects.

  3. Hardware-in-the-Loop Simulation of Distributed Intelligent Energy Management System for Microgrids

    Directory of Open Access Journals (Sweden)

    Dong-Jun Won

    2013-07-01

    Full Text Available Microgrids are autonomous low-voltage power distribution systems that contain multiple distributed energy resources (DERs and smart loads that can provide power system operation flexibility. To effectively control and coordinate multiple DERs and loads of microgrids, this paper proposes a distributed intelligent management system that employs a multi-agent-based control system so that delicate decision-making functions can be distributed to local intelligent agents. This paper presents the development of a hardware-in-the-loop simulation (HILS system for distributed intelligent management system for microgrids and its promising application to an emergency demand response program. In the developed HILS system, intelligent agents are developed using microcontrollers and ZigBee wireless communication technology. Power system dynamic models are implemented in real-time simulation environments using the Opal-RT system. This paper presents key features of the data communication and management schemes based on multi-agent concepts. The performance of the developed system is tested for emergency demand response program applications.

  4. Incidences of Unfavorable Events in the Management of Low-Risk Papillary Microcarcinoma of the Thyroid by Active Surveillance Versus Immediate Surgery.

    Science.gov (United States)

    Oda, Hitomi; Miyauchi, Akira; Ito, Yasuhiro; Yoshioka, Kana; Nakayama, Ayako; Sasai, Hisanori; Masuoka, Hiroo; Yabuta, Tomonori; Fukushima, Mitsuhiro; Higashiyama, Takuya; Kihara, Minoru; Kobayashi, Kaoru; Miya, Akihiro

    2016-01-01

    The incidence of papillary microcarcinoma (PMC) of the thyroid is rapidly increasing globally, making the management of PMC an important clinical issue. Excellent oncological outcomes of active surveillance for low-risk PMC have been reported previously. Here, unfavorable events following active surveillance and surgical treatment for PMC were studied. From February 2005 to August 2013, 2153 patients were diagnosed with low-risk PMC. Of these, 1179 patients chose active surveillance and 974 patients chose immediate surgery. The oncological outcomes and the incidences of unfavorable events of these groups were analyzed. In the active surveillance group, 94 patients underwent surgery for various reasons; tumor enlargement and the appearance of novel lymph node metastases were the reasons in 27 (2.3%) and six patients (0.5%), respectively. One of the patients with conversion to surgery had nodal recurrence, and five patients in the immediate surgery group had a recurrence in a cervical node or unresected thyroid lobe. All of these recurrences were successfully treated. None of the patients had distant metastases, and none died of the disease. The immediate surgery group had significantly higher incidences of transient vocal cord paralysis (VCP), transient hypoparathyroidism, and permanent hypoparathyroidism than the active-surveillance group did (4.1% vs. 0.6%, p < 0.0001; 16.7% vs. 2.8%, p < 0.0001; and 1.6% vs. 0.08%, p < 0.0001, respectively). Permanent VCP occurred only in two patients (0.2%) in the immediate surgery group. The proportion of patients on L-thyroxine for supplemental or thyrotropin (TSH)-suppressive purposes was significantly larger in the immediate surgery group than in the active surveillance group (66.1% vs. 20.7%, p < 0.0001). The immediate surgery group had significantly higher incidences of postsurgical hematoma and surgical scar in the neck compared with the active surveillance group (0.5% vs. 0%, p < 0.05; and 8.0% vs

  5. Results of an online questionnaire to survey calf management practices on dairy cattle breeding farms in Austria and to estimate differences in disease incidences depending on farm structure and management practices.

    Science.gov (United States)

    Klein-Jöbstl, Daniela; Arnholdt, Tim; Sturmlechner, Franz; Iwersen, Michael; Drillich, Marc

    2015-08-19

    Calf disease may result in great economic losses. To implement prevention strategies it is important to gain information on management and to point out risk factors. The objective of this internet based survey was to describe calf management practices on registered dairy breeding farms in Austria and to estimate differences in calf disease incidences depending on farm structure and management practices. A total of 1287 questionnaires were finally analysed (response rate 12.2 %). Herd characteristics and regional distribution of farms indicated that this survey gives a good overview on calf management practices on registered dairy farms in Austria. The median number of cows per farm was 20 (interquartile range 13-30). Significant differences regarding farm characteristics and calf management between small and large farms (≤20 vs >20 cows) were present. Only 2.8 % of farmers tested first colostrum quality by use of a hydrometer. Storing frozen colostrum was more prevalent on large farms (80.8 vs 64.2 %). On 85.1 % of the farms, whole milk, including waste milk, was fed to the calves. Milk replacer and waste milk were more often used on large farms. In accordance with similar studies from other countries, calf diarrhoea was indicated as the most prevalent disease. Multivariable logistic regression analysis revealed that herd size was associated with calf diarrhoea and calf respiratory tract disease, with higher risk of disease on large farms. Furthermore, feeding waste milk to the calves was associated with increasing calf diarrhoea incidence on farm. In the final model with calf respiratory tract disease as outcome, respondents from organic farms reported less often a respiratory tract disease incidence of over 10 % compared with conventional farms [odds ratio (OR) 0.40, 95 % confidence interval (CI) 0.21-0.75] and farmers that housed calves individually or in groups after birth significantly reported more often to have an incidence of respiratory tract

  6. Initial Study of An Effective Fast-Time Simulation Platform for Unmanned Aircraft System Traffic Management

    Science.gov (United States)

    Xue, Min; Rios, Joseph

    2017-01-01

    Small Unmanned Aerial Vehicles (sUAVs), typically 55 lbs and below, are envisioned to play a major role in surveilling critical assets, collecting important information, and delivering goods. Large scale small UAV operations are expected to happen in low altitude airspace in the near future. Many static and dynamic constraints exist in low altitude airspace because of manned aircraft or helicopter activities, various wind conditions, restricted airspace, terrain and man-made buildings, and conflict-avoidance among sUAVs. High sensitivity and high maneuverability are unique characteristics of sUAVs that bring challenges to effective system evaluations and mandate such a simulation platform different from existing simulations that were built for manned air traffic system and large unmanned fixed aircraft. NASA's Unmanned aircraft system Traffic Management (UTM) research initiative focuses on enabling safe and efficient sUAV operations in the future. In order to help define requirements and policies for a safe and efficient UTM system to accommodate a large amount of sUAV operations, it is necessary to develop a fast-time simulation platform that can effectively evaluate requirements, policies, and concepts in a close-to-reality environment. This work analyzed the impacts of some key factors including aforementioned sUAV's characteristics and demonstrated the importance of these factors in a successful UTM fast-time simulation platform.

  7. Simulating post-wildfire forest trajectories under alternative climate and management scenarios

    Science.gov (United States)

    Azpeleta, Alicia; Fule, Peter; Shive, Kristen; Sieg, Carolyn; Sanchez-Meador, Andrew; Strom, Barbara

    2013-04-01

    To assess post-fire vegetation recovery under the influence of climate change, we applied the Climate-Forest Vegetation Simulator (Climate-FVS), a new version of a widely used forest management model, to compare alternative climate and management scenarios in a severely burned multi-species forest of Arizona, U.S.A. The incorporation of seven combinations of General Circulation Models (GCM) and emissions scenarios altered long-term (100 years) projections of future forest condition compared to a No Climate Change (NCC) scenario, which forecast a gradual increase to high levels of forest density and carbon storage. In contrast, emissions scenarios that included continued high greenhouse gas releases led to near-complete deforestation by 2111. GCM-emissions scenario combinations that were less severe reduced forest structure and carbon storage relative to NCC. Fuel reduction treatments that had been applied prior to the severe wildfire did have persistent effects, especially under NCC, but were overwhelmed by increasingly severe climate change. We tested six management strategies aimed at sustaining future forests: prescribed burning at 5, 10, or 20-year intervals, thinning 40% or 60% of stand basal area, and no-treatment. Severe climate change led to deforestation under all management regimes, but important differences emerged under the moderate scenarios: treatments that included regular prescribed burning fostered low density, wildfire-resistant forests composed of the naturally dominant species, ponderosa pine. Non-fire treatments under moderate climate change were forecast to become dense and susceptible to severe wildfire, with a shift to dominance by sprouting species. Current U.S.A. management requires modeling of future scenarios but does not mandate consideration of climate change effects. However, this study showed substantial differences in model outputs depending on climate and management actions. Managers should incorporate climate change into the

  8. FLASH Interface; a GUI for managing runtime parameters in FLASH simulations

    Science.gov (United States)

    Walker, Christopher; Tzeferacos, Petros; Weide, Klaus; Lamb, Donald; Flocke, Norbert; Feister, Scott

    2017-10-01

    We present FLASH Interface, a novel graphical user interface (GUI) for managing runtime parameters in simulations performed with the FLASH code. FLASH Interface supports full text search of available parameters; provides descriptions of each parameter's role and function; allows for the filtering of parameters based on categories; performs input validation; and maintains all comments and non-parameter information already present in existing parameter files. The GUI can be used to edit existing parameter files or generate new ones. FLASH Interface is open source and was implemented with the Electron framework, making it available on Mac OSX, Windows, and Linux operating systems. The new interface lowers the entry barrier for new FLASH users and provides an easy-to-use tool for experienced FLASH simulators. U.S. Department of Energy (DOE), NNSA ASC/Alliances Center for Astrophysical Thermonuclear Flashes, U.S. DOE NNSA ASC through the Argonne Institute for Computing in Science, U.S. National Science Foundation.

  9. Simulation of passive thermal management system for lithium-ion battery packs

    Science.gov (United States)

    Mills, Andrew; Al-Hallaj, Said

    A passive thermal management system that uses a phase change material (PCM) is designed and simulated for a lithium-ion (Li-ion) laptop battery pack. The problem of low thermal conductivity of the PCM was significantly improved by impregnating an expanded graphite (EG) matrix with the PCM. The heat generation rate for a commercial 186502.2 Ah Li-ion battery was experimentally measured for various constant power discharges. Simulation of the battery pack, composed of six Li-ion batteries, shows that safe operation of the battery pack during the most extreme case requires the volume of the battery pack be almost doubled to fit sufficient PCM in the pack. Improving the properties of the PCM composite have the potential to significantly reduce the volume increase in comparison to the original battery pack volume.

  10. Flight management research utilizing an oculometer. [pilot scanning behavior during simulated approach and landing

    Science.gov (United States)

    Spady, A. A., Jr.; Kurbjun, M. C.

    1978-01-01

    This paper presents an overview of the flight management work being conducted using NASA Langley's oculometer system. Tests have been conducted in a Boeing 737 simulator to investigate pilot scan behavior during approach and landing for simulated IFR, VFR, motion versus no motion, standard versus advanced displays, and as a function of various runway patterns and symbology. Results of each of these studies are discussed. For example, results indicate that for the IFR approaches a difference in pilot scan strategy was noted for the manual versus coupled (autopilot) conditions. Also, during the final part of the approach when the pilot looks out-of-the-window he fixates on his aim or impact point on the runway and holds this point until flare initiation.

  11. 'Virtual Learning-by-Doing' Teamwork KSA: Strategic Management Simulation as an Effective Tool

    Science.gov (United States)

    Martín-Pérez, Víctor; Martín-Cruz, Natalia; Pérez-Santana, Pilar; Hernangómez-Barahona, Juan; Martín-Sierra, Celia

    The objective of this paper is to evaluate the effectiveness of strategic management simulations as a learning-by-doing tool, that is they can enhance their knowledge, skills and abilities for effective teamwork. We have carried out an analysis of the effect of business simulation on the teamwork KSA with a group of undergraduates of the Business School. The results show that the teamwork KSA can improve and that the initial knowledge of those teamwork KSA, at the individual level, is the only factor which conditions their learning. Initial knowledge of the teamwork KSA and the spread of this knowledge within the team, are not a determinant influence on the individual learning-by-doing. Neither are features such as intelligence, personality, attitude to teamwork and teamwork self-efficacy.

  12. Modeling and Simulation Resource Repository (MSRR)(System Engineering/Integrated M&S Management Approach

    Science.gov (United States)

    Milroy, Audrey; Hale, Joe

    2006-01-01

    NASA s Exploration Systems Mission Directorate (ESMD) is implementing a management approach for modeling and simulation (M&S) that will provide decision-makers information on the model s fidelity, credibility, and quality, including the verification, validation and accreditation information. The NASA MSRR will be implemented leveraging M&S industry best practices. This presentation will discuss the requirements that will enable NASA to capture and make available the "meta data" or "simulation biography" data associated with a model. The presentation will also describe the requirements that drive how NASA will collect and document relevant information for models or suites of models in order to facilitate use and reuse of relevant models and provide visibility across NASA organizations and the larger M&S community.

  13. Functional Assessment of Battery Management System Tested on Hardware-in-the-Loop Simulator

    DEFF Research Database (Denmark)

    Kalogiannis, Theodoros; Stroe, Daniel-Ioan; Swierczynski, Maciej Jozef

    2017-01-01

    A Hardware-in-the-Loop (HIL) simulator renders possible to conduct on-line tests on Battery Management Systems (BMSs) with an emulated battery pack instead of a real one. In this case, the BMS can be repeatedly evaluated under the exact same experimental scenarios, with safety and accuracy......, or under a flexible and beyond the normal operation area range, with less cost and time efforts. For this purpose, a multi-cell Li-ion battery pack consisting of 32 cells in series has been implemented and validated based on experimental results, converted into C code and emulated through the HIL simulator....... The BMS under test is interacting in real-time with the emulated battery pack and several of its functions such as current, voltage and State of Charge (SOC) estimation are evaluated. Also, passive balancing experiments are conducted during charging in order to assess different balancing settings...

  14. Example of severe accident management guidelines validation and verification using full scope simulator

    International Nuclear Information System (INIS)

    Krajnc, B.; Basic, I.; Spiler, J.

    2001-01-01

    The purpose of Severe Accident Management Guidelines (SAMG) is to provide guidelines to mitigate and control beyond design bases accidents. These guidelines are to be used by the technical support center that is established at the plant within one hour after the beginning of the accident as a technical support for the main control room operators. Since some of the accidents can progress very fast there are also two guidelines provided for the main control room operators. The first one is to be used if the core damage occurs and the TSC is not established yet and the second one after technical support center become operational. After SG replacement and power uprate in year 2000, NPP Krsko developed Rev.1 of these procedures, which have been validated and verified during one-week effort. Plant specific simulator capable of simulating severe accidents was extensively used.(author)

  15. Dynamic simulation of energy management control functions for HVAC systems in buildings

    International Nuclear Information System (INIS)

    Wen Zhenhuang; Zaheeruddin, M.; Cho, S.H.

    2006-01-01

    Five energy management control (EMC) functions such as outside air (OA) economizer cycle, programmed start and stop lead time, load reset and occupied time adaptive control strategy are developed and evaluated using a variable air volume heating, ventilating and air conditioning, VAV-HVAC, system level dynamic model as a simulation platform. A real time system embedded with the above EMC functions is presented. The simulation results manifest that energy savings of 17% can be achieved when the system is operated with the EMC functions and optimal set points compared with the system without such functions. These results do point out that the optimal set point strategy is very useful in achieving energy efficient operation of HVAC systems

  16. Dynamic Voltage Frequency Scaling Simulator for Real Workflows Energy-Aware Management in Green Cloud Computing.

    Science.gov (United States)

    Cotes-Ruiz, Iván Tomás; Prado, Rocío P; García-Galán, Sebastián; Muñoz-Expósito, José Enrique; Ruiz-Reyes, Nicolás

    2017-01-01

    Nowadays, the growing computational capabilities of Cloud systems rely on the reduction of the consumed power of their data centers to make them sustainable and economically profitable. The efficient management of computing resources is at the heart of any energy-aware data center and of special relevance is the adaptation of its performance to workload. Intensive computing applications in diverse areas of science generate complex workload called workflows, whose successful management in terms of energy saving is still at its beginning. WorkflowSim is currently one of the most advanced simulators for research on workflows processing, offering advanced features such as task clustering and failure policies. In this work, an expected power-aware extension of WorkflowSim is presented. This new tool integrates a power model based on a computing-plus-communication design to allow the optimization of new management strategies in energy saving considering computing, reconfiguration and networks costs as well as quality of service, and it incorporates the preeminent strategy for on host energy saving: Dynamic Voltage Frequency Scaling (DVFS). The simulator is designed to be consistent in different real scenarios and to include a wide repertory of DVFS governors. Results showing the validity of the simulator in terms of resources utilization, frequency and voltage scaling, power, energy and time saving are presented. Also, results achieved by the intra-host DVFS strategy with different governors are compared to those of the data center using a recent and successful DVFS-based inter-host scheduling strategy as overlapped mechanism to the DVFS intra-host technique.

  17. Management of simulated maternal cardiac arrest by residents: didactic teaching versus electronic learning.

    Science.gov (United States)

    Hards, Andrea; Davies, Sharon; Salman, Aliya; Erik-Soussi, Magda; Balki, Mrinalini

    2012-09-01

    Successful resuscitation of a pregnant woman undergoing cardiac arrest and survival of the fetus require prompt, high-quality cardiopulmonary resuscitation. The objective of this observational study was to assess management of maternal cardiac arrest by anesthesia residents using high-fidelity simulation and compare subsequent performance following either didactic teaching or electronic learning (e-learning). Twenty anesthesia residents were randomized to receive either didactic teaching (Didactic group, n = 10) or e-learning (Electronic group, n = 10) on maternal cardiac arrest. Baseline management skills were tested using high-fidelity simulation, with repeat simulation testing one month after their teaching intervention. The time from cardiac arrest to start of perimortem Cesarean delivery (PMCD) was measured, and the technical and nontechnical skills scores between the two teaching groups were compared. The median [interquartile range] time to PMCD decreased after teaching, from 4.5 min [3.4 to 5.1 min] to 3.5 min [2.5 to 4.0 min] (P = 0.03), although the change within each group was not statistically significant (Didactic group 4.9 to 3.8 min, P = 0.2; Electronic group 3.9 to 2.5 min, P = 0.07; Didactic group vs Electronic group, P = 1.0). Even after teaching, only 65% of participants started PMCD within four minutes. Technical and nontechnical skills scores improved after teaching in both groups, and there were no differences between the groups. There are gaps in the knowledge and implementation of resuscitation protocols and the recommended modifications for pregnancy among residents. Teaching can improve performance during management of maternal cardiac arrest. Electronic learning and didactic teaching offer similar benefits.

  18. Dynamic Voltage Frequency Scaling Simulator for Real Workflows Energy-Aware Management in Green Cloud Computing

    Science.gov (United States)

    Cotes-Ruiz, Iván Tomás; Prado, Rocío P.; García-Galán, Sebastián; Muñoz-Expósito, José Enrique; Ruiz-Reyes, Nicolás

    2017-01-01

    Nowadays, the growing computational capabilities of Cloud systems rely on the reduction of the consumed power of their data centers to make them sustainable and economically profitable. The efficient management of computing resources is at the heart of any energy-aware data center and of special relevance is the adaptation of its performance to workload. Intensive computing applications in diverse areas of science generate complex workload called workflows, whose successful management in terms of energy saving is still at its beginning. WorkflowSim is currently one of the most advanced simulators for research on workflows processing, offering advanced features such as task clustering and failure policies. In this work, an expected power-aware extension of WorkflowSim is presented. This new tool integrates a power model based on a computing-plus-communication design to allow the optimization of new management strategies in energy saving considering computing, reconfiguration and networks costs as well as quality of service, and it incorporates the preeminent strategy for on host energy saving: Dynamic Voltage Frequency Scaling (DVFS). The simulator is designed to be consistent in different real scenarios and to include a wide repertory of DVFS governors. Results showing the validity of the simulator in terms of resources utilization, frequency and voltage scaling, power, energy and time saving are presented. Also, results achieved by the intra-host DVFS strategy with different governors are compared to those of the data center using a recent and successful DVFS-based inter-host scheduling strategy as overlapped mechanism to the DVFS intra-host technique. PMID:28085932

  19. Dynamic Voltage Frequency Scaling Simulator for Real Workflows Energy-Aware Management in Green Cloud Computing.

    Directory of Open Access Journals (Sweden)

    Iván Tomás Cotes-Ruiz

    Full Text Available Nowadays, the growing computational capabilities of Cloud systems rely on the reduction of the consumed power of their data centers to make them sustainable and economically profitable. The efficient management of computing resources is at the heart of any energy-aware data center and of special relevance is the adaptation of its performance to workload. Intensive computing applications in diverse areas of science generate complex workload called workflows, whose successful management in terms of energy saving is still at its beginning. WorkflowSim is currently one of the most advanced simulators for research on workflows processing, offering advanced features such as task clustering and failure policies. In this work, an expected power-aware extension of WorkflowSim is presented. This new tool integrates a power model based on a computing-plus-communication design to allow the optimization of new management strategies in energy saving considering computing, reconfiguration and networks costs as well as quality of service, and it incorporates the preeminent strategy for on host energy saving: Dynamic Voltage Frequency Scaling (DVFS. The simulator is designed to be consistent in different real scenarios and to include a wide repertory of DVFS governors. Results showing the validity of the simulator in terms of resources utilization, frequency and voltage scaling, power, energy and time saving are presented. Also, results achieved by the intra-host DVFS strategy with different governors are compared to those of the data center using a recent and successful DVFS-based inter-host scheduling strategy as overlapped mechanism to the DVFS intra-host technique.

  20. 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

  1. A one-day "Helping Babies Breathe" course improves simulated performance but not clinical management of neonates

    DEFF Research Database (Denmark)

    Ersdal, H L; Vossius, C; Bayo, E

    2013-01-01

    "Helping Babies Breathe" (HBB) is a simulation-based one-day course developed to help reduce neonatal mortality globally. The study objectives were to (1) determine the effect on practical skills and management strategies among providers using simulations seven months after HBB training, and (2...

  2. Abstract Radio Resource Management Framework for System Level Simulations in LTE-A Systems

    DEFF Research Database (Denmark)

    Fotiadis, Panagiotis; Viering, Ingo; Zanier, Paolo

    2014-01-01

    This paper provides a simple mathematical model of different packet scheduling policies in Long Term Evolution- Advanced (LTE-A) systems, by investigating the performance of Proportional Fair (PF) and the generalized cross-Component Carrier scheduler from a theoretical perspective. For that purpose......, an abstract Radio Resource Management (RRM) framework has been developed and tested for different ratios of users with Carrier Aggregation (CA) capabilities. The conducted system level simulations confirm that the proposed model can satisfactorily capture the main properties of the aforementioned scheduling...

  3. A new model to simulate climate-change impacts on forest succession for local land management.

    Science.gov (United States)

    Yospin, Gabriel I; Bridgham, Scott D; Neilson, Ronald P; Bolte, John P; Bachelet, Dominique M; Gould, Peter J; Harrington, Constance A; Kertis, Jane A; Evers, Cody; Johnson, Bart R

    2015-01-01

    the dynamic global vegetation model simulations. Our results indicate that dynamic global vegetation models may overestimate future rates of vegetation change, especially in the absence of stand-replacing disturbances. Modeling tools such as CV-STSM that simulate rates and direction of vegetation change affected by interactions and feedbacks between climate and land-use change can help policy makers, land managers, and society as a whole develop effective plans to adapt to rapidly changing climate.

  4. Computer simulation for risk management: Hydrogen refueling stations and water supply of a large region

    DEFF Research Database (Denmark)

    Markert, Frank; Kozine, Igor

    2012-01-01

    Risk management of complex environments needs the supportive tools provided by computer models and simulation. During time, various tools have been developed and been applied with different degree of success. The still lasting increase in computer power and the associated development potentials...... stimulate and promote their application within risk management. Today, computer supported models as fault trees, event trees and Bayesian networks are commonly regarded and applied as standard tools for reliability and risk practitioners. There are though some important features that hardly can be captured...... in applying DES models to the analysis of large infrastructures for refueling stations and water supply. Two case studies are described which are concerned with the inherently safer supply and storage of hydrogen at refueling stations and an established drinking water supply system of a large metropolitan...

  5. Simulation and modeling efforts to support decision making in healthcare supply chain management.

    Science.gov (United States)

    AbuKhousa, Eman; Al-Jaroodi, Jameela; Lazarova-Molnar, Sanja; Mohamed, Nader

    2014-01-01

    Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM) by improving the decision making pertaining processes' efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM) has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.

  6. Simulation and Modeling Efforts to Support Decision Making in Healthcare Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Eman AbuKhousa

    2014-01-01

    Full Text Available Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM by improving the decision making pertaining processes’ efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.

  7. Software simulator for property investigation of document management system with RFID tags

    Directory of Open Access Journals (Sweden)

    Kiedrowicz Maciej

    2016-01-01

    Full Text Available The study outlines the method for examining the properties of the RFID-tagged document management system. The system is composed of computers, where the software for supporting processes of the RFID-tagged doc-uments was installed. Furthermore, the system cooperates with many other elements of the secret office (cabinets, sluices, photocopiers, desks. The examination of the properties of the RFID-tagged document management system is, in this case, complex due to the number of a possible examination scenarios. The simulation method for examining the system properties was proposed. It allows to conduct the examination of the properties in a short period of time for numerous testing scenarios.

  8. Simulation

    DEFF Research Database (Denmark)

    Gould, Derek A; Chalmers, Nicholas; Johnson, Sheena J

    2012-01-01

    Recognition of the many limitations of traditional apprenticeship training is driving new approaches to learning medical procedural skills. Among simulation technologies and methods available today, computer-based systems are topical and bring the benefits of automated, repeatable, and reliable...... performance assessments. Human factors research is central to simulator model development that is relevant to real-world imaging-guided interventional tasks and to the credentialing programs in which it would be used....

  9. Major incidents in rural areas: managing a pandemic A/H1N1/2009 cluster.

    Science.gov (United States)

    Stark, Cameron; Garman, Elaine; McMenamin, Jim; McCormick, Duncan; Oates, Ken

    2010-01-01

    Pandemic Influenza (A/H1N1/2009) caused worldwide concern because of its potential to spread rapidly in human populations. In Scotland, Government policy had been to seek to contain the spread of the virus for as long as possible in order to allow time for service preparations, and for vaccine development and supply. The first major Scottish outbreak of pandemic A/H1N1/2009 was in the rural area of Cowal and Bute. After two initial cases were identified, contact tracing found a cluster of cases associated with a football supporters' bus. Within 3 weeks, 130 cases had been identified in the area. Rapid provision of treatment doses of anti-viral medication to cases and prophylactic treatment of asymptomatic close contacts, advice on self-isolation and, where required, interruption of transmission by temporary school closure, were successful in containing the outbreak. Pre-existing Major Incident and Pandemic Flu plans were used and adapted to the particular circumstances of the outbreak and the area. Supporting operational decision-making as close to the cases as possible allowed for speed and flexibility of response. Contact tracing and tracking of cases and results was performed by specialist public health staff who were geographically removed from the cases. This was possible because of effective use of existing telephone conferencing facilities, clarity of roles, and frequent communication among staff working on all areas of the response. Basing the work on established plans, staff experience of rural areas and rural service provision was successful.

  10. Evaluation of wholesale electric power market rules and financial risk management by agent-based simulations

    Science.gov (United States)

    Yu, Nanpeng

    As U.S. regional electricity markets continue to refine their market structures, designs and rules of operation in various ways, two critical issues are emerging. First, although much experience has been gained and costly and valuable lessons have been learned, there is still a lack of a systematic platform for evaluation of the impact of a new market design from both engineering and economic points of view. Second, the transition from a monopoly paradigm characterized by a guaranteed rate of return to a competitive market created various unfamiliar financial risks for various market participants, especially for the Investor Owned Utilities (IOUs) and Independent Power Producers (IPPs). This dissertation uses agent-based simulation methods to tackle the market rules evaluation and financial risk management problems. The California energy crisis in 2000-01 showed what could happen to an electricity market if it did not go through a comprehensive and rigorous testing before its implementation. Due to the complexity of the market structure, strategic interaction between the participants, and the underlying physics, it is difficult to fully evaluate the implications of potential changes to market rules. This dissertation presents a flexible and integrative method to assess market designs through agent-based simulations. Realistic simulation scenarios on a 225-bus system are constructed for evaluation of the proposed PJM-like market power mitigation rules of the California electricity market. Simulation results show that in the absence of market power mitigation, generation company (GenCo) agents facilitated by Q-learning are able to exploit the market flaws and make significantly higher profits relative to the competitive benchmark. The incorporation of PJM-like local market power mitigation rules is shown to be effective in suppressing the exercise of market power. The importance of financial risk management is exemplified by the recent financial crisis. In this

  11. Spatial analysis and simulation tools for groundwater management: the FREEWAT platform

    Directory of Open Access Journals (Sweden)

    Rudy Rossetto

    2017-09-01

    Full Text Available FREEWAT is an HORIZON 2020 project financed by the EU Commission under the call WATER INNOVATION: BOOSTING ITS VALUE FOR EUROPE. FREEWAT main result is an open source and public domain GIS-integrated modeling environment for the simulation of groundwater quantity and quality, with an integrated water management and planning module. FREEWAT aims at promoting water resource management by simplifying the application of the Water Framework Directive and other EU water-related Directives. To this scope, the FREEWAT platform results from the integration in the QGIS Desktop of spatially distributed and physically-based codes (mostly belonging to the USGS MODFLOW family, which allow to get a deep insight in groundwater dynamics, taking into account the space and time variability of stresses which control the hydrological cycle. This is attempted in a unique GIS environment, where large spatial datasets can be managed and visualized. In this paper, a review of the tools/modules integrated in FREEWAT for data pre-processing and model implementation is provided. FREEWAT applicability was demonstrated through running 14 case studies, in the general framework of an innovative participatory approach, which consists in involving technical staff and relevant stakeholders (in primis policy and decision makers during modeling activities, thus creating a common environment to enhance science and evidence-based decision making in water resource management.

  12. Prospective randomized study of contrast reaction management curricula: Computer-based interactive simulation versus high-fidelity hands-on simulation

    International Nuclear Information System (INIS)

    Wang, Carolyn L.; Schopp, Jennifer G.; Kani, Kimia; Petscavage-Thomas, Jonelle M.; Zaidi, Sadaf; Hippe, Dan S.; Paladin, Angelisa M.; Bush, William H.

    2013-01-01

    Purpose: We developed a computer-based interactive simulation program for teaching contrast reaction management to radiology trainees and compared its effectiveness to high-fidelity hands-on simulation training. Materials and methods: IRB approved HIPAA compliant prospective study of 44 radiology residents, fellows and faculty who were randomized into either the high-fidelity hands-on simulation group or computer-based simulation group. All participants took separate written tests prior to and immediately after their intervention. Four months later participants took a delayed written test and a hands-on high-fidelity severe contrast reaction scenario performance test graded on predefined critical actions. Results: There was no statistically significant difference between the computer and hands-on groups’ written pretest, immediate post-test, or delayed post-test scores (p > 0.6 for all). Both groups’ scores improved immediately following the intervention (p < 0.001). The delayed test scores 4 months later were still significantly higher than the pre-test scores (p ≤ 0.02). The computer group's performance was similar to the hands-on group on the severe contrast reaction simulation scenario test (p = 0.7). There were also no significant differences between the computer and hands-on groups in performance on the individual core competencies of contrast reaction management during the contrast reaction scenario. Conclusion: It is feasible to develop a computer-based interactive simulation program to teach contrast reaction management. Trainees that underwent computer-based simulation training scored similarly on written tests and on a hands-on high-fidelity severe contrast reaction scenario performance test as those trained with hands-on high-fidelity simulation

  13. 3-PG simulations of young ponderosa pine plantations under varied management intensity: why do they grow so differently?

    Science.gov (United States)

    Liang Wei; Marshall John; Jianwei Zhang; Hang Zhou; Robert Powers

    2014-01-01

    Models can be powerful tools for estimating forest productivity and guiding forest management, but their credibility and complexity are often an issue for forest managers. We parameterized a process-based forest growth model, 3-PG (Physiological Principles Predicting Growth), to simulate growth of ponderosa pine (Pinus ponderosa) plantations in...

  14. Virtual Simulation in Leadership Development Training: The Impact of Learning Styles and Conflict Management Tactics on Adult Learner Performance

    Science.gov (United States)

    Putman, Paul G.

    2012-01-01

    Adult learners can develop leadership skills and competencies such as conflict management and negotiation skills. Virtual simulations are among the emerging new technologies available to adult educators and trainers to help adults develop various leadership competencies. This study explored the impact of conflict management tactics as well as…

  15. Simulation of operator's actions during severe accident management

    International Nuclear Information System (INIS)

    Viktorov, A.

    2015-01-01

    Implementing accident management counter measures or actions to mitigate consequences of a severe accident is essential to reduce radiological risks to the public and environment. Station-specific severe accident management guidelines (SAMGs) have been developed and implemented at all Canadian nuclear power plants. Following the Fukushima Daiichi nuclear accident certain enhancements were introduced to the SAMG, namely consideration of multi-units accidents, events involving spent fuel pools, incorporation of capability offered by the portable emergency mitigating equipment, and so on. To evaluate the adequacy and usability of the SAMGs, CNSC staff initiated a number of activities including a desktop review of SAMG documentation, evaluation of SAMG implementation through exercises and interviews with station staff, and independent verification of SAMG action effectiveness. This paper focuses on the verification of SAMG actions through analytical simulations. The objectives of the work are two-folds: (a) to understand the effectiveness of SAMG-specified mitigation actions in addressing the safety challenges and (b) to check for potential negative effects of the action. Some sensitivity calculations were performed to help understanding of the impact from actions that rely on the partially effective equipment or limited material resources. The severe accident computer code MAAP4-CANDU is used as a tool in this verification. This paper will describe the methodology used in the verification of SAMG actions and some results obtained from simulations. (author)

  16. Anastomotic Strictures after Esophageal Atresia Repair: Incidence, Investigations, and Management, Including Treatment of Refractory and Recurrent Strictures

    Directory of Open Access Journals (Sweden)

    Renato Tambucci

    2017-05-01

    Full Text Available Improved surgical techniques, as well as preoperative and postoperative care, have dramatically changed survival of children with esophageal atresia (EA over the last decades. Nowadays, we are increasingly seeing EA patients experiencing significant short- and long-term gastrointestinal morbidities. Anastomotic stricture (AS is the most common complication following operative repair. An esophageal stricture is defined as an intrinsic luminal narrowing in a clinically symptomatic patient, but no symptoms are sensitive or specific enough to diagnose an AS. This review aims to provide a comprehensive view of AS in EA children. Given the lack of evidence-based data, we critically analyzed significant studies on children and adults, including comments on benign strictures with other etiologies. Despite there is no consensus about the goal of the luminal diameter based on the patient’s age, esophageal contrast study, and/or endoscopy are recommended to assess the degree of the narrowing. A high variability in incidence of ASs is reported in literature, depending on different definitions of AS and on a great number of pre-, intra-, and postoperative risk factor influencing the anastomosis outcome. The presence of a long gap between the two esophageal ends, with consequent anastomotic tension, is determinant for stricture formation and its response to treatment. The cornerstone of treatment is endoscopic dilation, whose primary aims are to achieve symptom relief, allow age-appropriate capacity for oral feeding, and reduce the risk of pulmonary aspiration. No clear advantage of either balloon or bougie dilator has been demonstrated; therefore, the choice is based on operator experience and comfort with the equipment. Retrospective evidences suggest that selective dilatations (performed only in symptomatic patients results in significantly less number of dilatation sessions than routine dilations (performed to prevent symptoms with equal long

  17. OpenDanubia - An integrated, modular simulation system to support regional water resource management

    Science.gov (United States)

    Muerth, M.; Waldmann, D.; Heinzeller, C.; Hennicker, R.; Mauser, W.

    2012-04-01

    The already completed, multi-disciplinary research project GLOWA-Danube has developed a regional scale, integrated modeling system, which was successfully applied on the 77,000 km2 Upper Danube basin to investigate the impact of Global Change on both the natural and anthropogenic water cycle. At the end of the last project phase, the integrated modeling system was transferred into the open source project OpenDanubia, which now provides both the core system as well as all major model components to the general public. First, this will enable decision makers from government, business and management to use OpenDanubia as a tool for proactive management of water resources in the context of global change. Secondly, the model framework to support integrated simulations and all simulation models developed for OpenDanubia in the scope of GLOWA-Danube are further available for future developments and research questions. OpenDanubia allows for the investigation of water-related scenarios considering different ecological and economic aspects to support both scientists and policy makers to design policies for sustainable environmental management. OpenDanubia is designed as a framework-based, distributed system. The model system couples spatially distributed physical and socio-economic process during run-time, taking into account their mutual influence. To simulate the potential future impacts of Global Change on agriculture, industrial production, water supply, households and tourism businesses, so-called deep actor models are implemented in OpenDanubia. All important water-related fluxes and storages in the natural environment are implemented in OpenDanubia as spatially explicit, process-based modules. This includes the land surface water and energy balance, dynamic plant water uptake, ground water recharge and flow as well as river routing and reservoirs. Although the complete system is relatively demanding on data requirements and hardware requirements, the modular structure

  18. A Simulation Curriculum for Management of Trauma and Surgical Critical Care Patients.

    Science.gov (United States)

    Miyasaka, Kiyoyuki W; Martin, Niels D; Pascual, Jose L; Buchholz, Joseph; Aggarwal, Rajesh

    2015-01-01

    Expectations continue to rise for residency programs to provide integrated simulation training to address clinical competence. How to implement such training sustainably remains a challenge. We developed a compact module for first-year surgery residents integrating theory with practice in high-fidelity simulations, to reinforce the preparedness and confidence of junior residents in their ability to manage common emergent patient care scenarios in trauma and critical care surgery. The 3-day module features a combination of simulated patient encounters using standardized patients and electronic manikins, didactic sessions, and hands-on training. Manikin-based scenarios developed in-house were used to teach trauma and critical care management concepts and skills. Separate scenarios in collaboration with the regional organ donation program addressed communication in difficult situations such as brain death. Didactic material based on contemporary evidence, as well as skills stations, was developed to complement the scenarios. Residents were surveyed before and after training on their confidence in meeting the 14 learning objectives of the curriculum on a 5-point Likert scale. Data from 15 residents who underwent this training show an overall improvement in confidence across all learning objectives defined for the module, with confidence scores before to after training improving significantly from 2.8 (σ = 0.85, median = 3) to 3.9 (σ = 0.87, median = 4) of 5, p < 0.001. Although female residents reported higher posttraining confidence scores compared with male residents (average 4.2 female vs 3.8 male, p = 0.002), there were no other significant differences in confidence scores or changes to scores owing to resident sex or program status (categorical or preliminary). We successfully implemented a multimodal simulation-based curriculum that provides skills training integrated with the clinical context of managing trauma and critical care patients, simultaneously

  19. A Linked Simulation-Optimization (LSO) Model for Conjunctive Irrigation Management using Clonal Selection Algorithm

    Science.gov (United States)

    Islam, Sirajul; Talukdar, Bipul

    2016-09-01

    A Linked Simulation-Optimization (LSO) model based on a Clonal Selection Algorithm (CSA) was formulated for application in conjunctive irrigation management. A series of measures were considered for reducing the computational burden associated with the LSO approach. Certain modifications were incurred to the formulated CSA, so as to decrease the number of function evaluations. In addition, a simple problem specific code for a two dimensional groundwater flow simulation model was developed. The flow model was further simplified by a novel approach of area reduction, in order to save computational time in simulation. The LSO model was applied in the irrigation command of the Pagladiya Dam Project in Assam, India. With a view to evaluate the performance of the CSA, a Genetic Algorithm (GA) was used as a comparison base. The results from the CSA compared well with those from the GA. In fact, the CSA was found to consume less computational time than the GA while converging to the optimal solution, due to the modifications incurred in it.

  20. Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

    Science.gov (United States)

    Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

    2017-12-19

    To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p Technical performance scores correlated with NOTSS scores (p technical performance (p technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.