UTPS-type models were designed to adequately support planning activities typical of the 1960s and 1970s. However, these packages were not designed to model intelligent transportation systems (ITS) and support incident management planning. To ov...
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...
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.
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...
Isaac, Gayle; Moore, Brian
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…
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...
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...
Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.
Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.
... 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...
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...
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
Anne E. Black
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...
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...
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....
Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.
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
Faulent, J.; Brooks, J.G.
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
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...
To provide information on waste management planning and preparedness before a homeland security incident, including preparing for the large amounts of waste that would need to be managed when an incident occurs, such as a large-scale natural disaster.
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...
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...
Palilingan, V. R.; Batmetan, J. R.
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.
Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.
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...
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)
Faisal R. Ali
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.
Stanger, Michael A.
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 ...
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...
Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark
.... 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...
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 ...
MCKENNEY, JAMES L.
THE PRESENT HARVARD BUSINESS SCHOOL MANAGEMENT SIMULATION GAME WAS DEVELOPED AS A TEACHING DEVICE FOR CLASSES OF 20 OR MORE STUDENTS GROUPED INTO FOUR- AND FIVE-MAN TEAMS CALLED "FIRMS." EACH FIRM COMPETES WITH OTHERS IN AN "INDUSTRY," AN ECONOMIC ABSTRACTION OF A CONSUMER GOODS MARKET PROGRAMED TO BE SIMULATED ON AN ELECTRONIC…
Clark, Brenda G.; Brown, Robert J.; Ploquin, Jodi L.; Kind, Anneke L.; Grimard, Laval
Purpose: To assess efficacy of an incident learning system in the management of error in radiation treatment. Materials and methods: We report an incident learning system implementation customized for radiation therapy where any 'unwanted or unexpected change from normal system behaviour that causes or has the potential to cause an adverse effect to persons or equipment' is reported, investigated and learned from. This system thus captures near-miss (potential) and actual events. Incidents are categorized according to severity, type and origin. Results: Our analysis spans a period of 3 years with an average accrual of 11.6 incidents per week. We found a significant reduction in actual incidents of 28% and 47% in the second and third year when compared to the first year (p < 0.001), which we attribute to the many interventions prompted by the analysis of incidents reported. We also saw a similar significant reduction in incidents generated at the treatment unit correlating with the introduction of direct treatment parameter transfer and electronic imaging (p < 0.001). Conclusions: Implementation of an incident learning system has helped us to establish a just environment where all staff members report deviations from normal system behaviour and thus generate evidence to initiate safety improvements.
Griffin, B.J.; Eresman, R.K.
Industrial operations are commonly managed in terms of such factors as raw material requirements, throughput, equipment reliability, and operator productivity. Simulation can be used to transform standard management performance measures into probabilistic measures which define the associated risks. These results provide valuable insight for effective management of economic risks. Case studies are presented using the Monte Carlo simulation method to demonstrate different applications of simulation techniques, various result formats, and their use for optimizing economic returns. In the first case study, design criteria for a large gas distribution system originally developed from worst-case demand estimates were modelled to provide a risk basis for decisions on alternative upgrading options. In the second, a commercial gas storage facility operation was modelled to develop economic marketing strategies balancing supply and demand requirements from multiple clients. 3 refs
Lagarde, Sjoerd M.; Omloo, Jikke M. T.; de Jong, Koen; Busch, Olivier R. C.; Obertop, Hugo; van Lanschot, J. Jan B.
BACKGROUND: Postoperative chyle leakage is a rare but well-recognized complication after esophageal surgery. The aim of this study was to identify its incidence and potentially predisposing factors and to assess the consequences and management. METHODS: A consecutive series of 536 patients who
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\
Doval, A.; Hesham Abdou
As part of the Probabilistic Safety Analysis of the Multi Purpose Reactor, MPR, the list of Postulated Initiating Events was analyzed and one of these PIEs corresponds to the Loss of Coolant Flow. It is well known that during the operation life of a research reactor a LOFA could eventually occur and, once this event takes place, in time detection and automatic actions, thanks to the engineering safety features of the system, will mitigate the incident evolution. The postulated event corresponds to a loss of flow due to a total loss of power supply. The goal of the present work is to provide a general description and the engineering safety features of the MPR, as well as describe the sequence of scenarios during a LOFA. Temporal evolution of main parameters is presented, also. During Stage A of the Commissioning Program measurements of the core cooling system pump coast-down were performed in order to validate previous simulation results, as well as, flap valves opening time. In this way it was verified that engineering safety features worked properly. On Stage B of the Commissioning Program the upward natural convection flow was verified and results comparison against analytical calculation, showed that the reactor core was cooled within the adopted design goals. (author)
Heuskin, A C; Osseiran, A I; Tang, J; Costes, S V
Estimating cancer risk from space radiation has been an ongoing challenge for decades primarily because most of the reported epidemiological data on radiation-induced risks are derived from studies of atomic bomb survivors who were exposed to an acute dose of gamma rays instead of chronic high-LET cosmic radiation. In this study, we introduce a formalism using cellular automata to model the long-term effects of ionizing radiation in human breast for different radiation qualities. We first validated and tuned parameters for an automata-based two-stage clonal expansion model simulating the age dependence of spontaneous breast cancer incidence in an unexposed U.S. We then tested the impact of radiation perturbation in the model by modifying parameters to reflect both targeted and nontargeted radiation effects. Targeted effects (TE) reflect the immediate impact of radiation on a cell's DNA with classic end points being gene mutations and cell death. They are well known and are directly derived from experimental data. In contrast, nontargeted effects (NTE) are persistent and affect both damaged and undamaged cells, are nonlinear with dose and are not well characterized in the literature. In this study, we introduced TE in our model and compared predictions against epidemiologic data of the atomic bomb survivor cohort. TE alone are not sufficient for inducing enough cancer. NTE independent of dose and lasting ∼100 days postirradiation need to be added to accurately predict dose dependence of breast cancer induced by gamma rays. Finally, by integrating experimental relative biological effectiveness (RBE) for TE and keeping NTE (i.e., radiation-induced genomic instability) constant with dose and LET, the model predicts that RBE for breast cancer induced by cosmic radiation would be maximum at 220 keV/μm. This approach lays the groundwork for further investigation into the impact of chronic low-dose exposure, inter-individual variation and more complex space radiation
House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.
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
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))
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.
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)
Jensen, Jessica; Youngs, George
This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.
Full Text Available ABSTRACT The work presented in this paper is focused on creating of predictive models that help in the process of incident resolution and implementation of IT infrastructure changes to increase the overall support of IT management. Our main objective was to build the predictive models using machine learning algorithms and CRISP-DM methodology. We used the incident and related changes database obtained from the IT environment of the Rabobank Group company, which contained information about the processing of the incidents during the incident management process. We decided to investigate the dependencies between the incident observation on particular infrastructure component and the actual source of the incident as well as the dependency between the incidents and related changes in the infrastructure. We used Random Forests and Gradient Boosting Machine classifiers in the process of identification of incident source as well as in the prediction of possible impact of the observed incident. Both types of models were tested on testing set and evaluated using defined metrics.
Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A
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.
Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger
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)
Hoogendoorn, Mark; Jonker, Catholijn M.; Maanen, Peter-Paul van; Sharpanskykh, Alexei
Within the field of incident management split second decisions have to be made, usually on the basis of incomplete and partially incorrect information. As a result of these conditions, errors occur in such decision processes. In order to avoid repetition of such errors, historic cases, disaster plans, and training logs need to be thoroughly analysed. This paper presents a formal approach for such an analysis that pays special attention to spatial and temporal aspects, to information exchange, and to organisational structure. The formal nature of the approach enables automation of analysis, which is illustrated by case studies of two disasters
Follen, Gregory J.
One of the objectives of the High Performance Computing and Communication Project's (HPCCP) Numerical Propulsion System Simulation (NPSS) is to provide a common and consistent way to manage applications, data, and engine simulations. The NPSS Configuration Management (CM) File Manager integrated with the Common Desktop Environment (CDE) window management system provides a common look and feel for the configuration management of data, applications, and engine simulations for U.S. engine companies. In addition, CM File Manager provides tools to manage a simulation. Features include managing input files, output files, textual notes, and any other material normally associated with simulation. The CM File Manager includes a generic configuration management Application Program Interface (API) that can be adapted for the configuration management repositories of any U.S. engine company.
Lorena Isabel Barona López
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.
Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo
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.
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)
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.
Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R
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.
Each year highway traffic incidents, such as crashes, place responders on and beside roadways with : dangerous high-speed traffic. The unexpected conditions of an incident scene have the potential to surprise : unsuspecting or inattentive drivers, po...
Terblanche, Lourie; van Wyk, André
Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...
Marres, Geertruid; Bemelman, Michael; van der Eijk, John; Leenen, Luke
. Collaboration with the NVIC and infrastructural adjustments enable us to not only care for patients with physical trauma, but also to provide centralized care of patients under quarantine conditions for, say, MRSA, SARS, smallpox, chemical or biological hazards. Triage plays an important role in medical disaster management and is therefore key to organization and infrastructure. Caps facilitate role distribution and recognizibility. The PBR resulted in more accurate registration and real-time availability of patient and group information. Infrastructure and a plan is not enough; training, research and evaluation are necessary to continuously work on disaster preparedness. The MIH in Utrecht (Netherlands) is a globally unique facility that can provide immediate emergency care for multiple casualties under exceptional circumstances. Resulting from the cooperation between a large academic medical institution, a trauma center, a military hospital and the NVIC, the MIH offers not only a good and complete infrastructure but also the expertise required to provide large-scale emergency care during disasters and major incidents.
Guenthner, Daniel H
A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.
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.
Windberg, P.; Hozer, Z.; Nagy, I.; Vimi, A.
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)
...-Hazard Position Task Books for Type 3 Incident Management Teams AGENCY: Federal Emergency Management... Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in... Management Teams were developed to assist personnel achieve qualifications in the All-Hazard ICS positions...
Naradko, Anthony M.
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…
Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke
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
Kamran, Faisal; Andersen, Peter E.
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...
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
Bilek, R. W.
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.
Smith, Graham C; McDonald, Robbie A; Wilkinson, David
Bovine tuberculosis (bTB), caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles) is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2) and were evaluated over the whole of a 300 km(2) area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2) plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.
Graham C Smith
Full Text Available Bovine tuberculosis (bTB, caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2 and were evaluated over the whole of a 300 km(2 area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2 plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.
Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John
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.
MILITARY PERSONNEL DOD Has Processes for Operating and Managing Its Sexual Assault Incident Database Report to...to DSAID’s system speed and ease of use; interfaces with MCIO databases ; utility as a case management tool; and users’ ability to query data and... Managing Its Sexual Assault Incident Database What GAO Found As of October 2013, the Department of Defense’s (DOD) Defense Sexual Assault Incident
Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J
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.
Kennedy, Michael H
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.
Juul, Jonas; Paltved, Charlotte; Krogh, Kristian
for content analysis4 and thematic analysis5. Medical experts and simulation faculty will design scenarios for in situ simulation training based on the analysis. Short-term observations using time logs will be performed along with interviews with key informants at the departments. Video data will be collected...... 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...
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 ...
Michael Hand; Hari Katuwal; David E. Calkin; Matthew P. Thompson
Despite large commitments of personnel and equipment to wildfire suppression, relatively little is known about the factors that affect how many resources are ordered and assigned to wildfire incidents and the variation in resources across incident management teams (IMTs). Using detailed data on suppression resource assignments for IMTs managing the highest complexity...
Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones
This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...
Within the Seattle metropolitan area, traffic incident management (TIM) operations provide a multi-jurisdictional and coordinated strategy to detect, respond to, and clear traffic incidents so that traffic flow can be restored quickly and safely. The...
Background: Aggressive behavior and incidents in psychiatric wards are ... Results: Seventy five people were admitted in the acute psychiatric wards during this ... Although the study sample is small and convenience-based, the dearth of ...
The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair
Buetow, E.; Memmert, G.; Storck, R.; Weymann, J.; Matthies, M.; Vogt, K.J.
Regarding surface facilities two incidents of MAVA (failure of the filter in the exhaust gas system, fire in the bituminization system) and one incident in the Krypton storage and regarding underground systems the water inlet in the pit building have been evaluated. According to the calculations only the two nuclides Tc-99 and J-129 can involve a considerable exposure. The barrier system of overlying rocks and the pit system as a whole is largely redundant and diverse. (DG) [de
Abrahamsen, Håkon B
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
Lin, Shiang-Jiun; Wu, Cheng-Da; Fang, Te-Hua; Chen, Guan-Hung
The bombardment process of a Ni cluster onto a Cu (0 0 1) surface is studied using molecular dynamics (MD) simulations based on the tight-binding second-moment approximation (TB-SMA) many-body potential. The effects of incident cluster size, substrate temperature, and incident energy are evaluated in terms of molecular trajectories, kinetic energy, stress, self-diffusion coefficient, and sputtering yield. The simulation results clearly show that the penetration depth and Cu surface damage increase with increasing incident cluster size for a given incident energy per atom. The self-diffusion coefficient and the penetration depth of a cluster significantly increase with increasing substrate temperature. An incident cluster can be scattered into molecules or atoms that become embedded in the surface after incidence. When the incident energy is increased, the number of volcano-like defects and the penetration depth increase. A high sputtering yield can be obtained by increasing the incident energy at high temperature. The sputtering yield significantly increases with cluster size when the incident energy is above 5 eV/atom.
Fisher, Shelagh; Oulton, Tony
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…
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.
royalty -free government-purpose license to use, duplicate, or disclose the work, in whole or in part and in any manner, and to have or permit others to...Methodology of Incident Handling.” InfoSecurity 2001 Conference Program. Malaysian National Computer Confederation, 2001. 22 CMU/SEI-2004-TR-015
de Castro, S. M. M.; Busch, O. R. C.; van Gulik, T. M.; Obertop, H.; Gouma, D. J.
Background: Optimal management of severe pancreatic leakage after pancreatoduodenectomy can reduce morbidity and mortality. Completion pancreatectomy may be adequate but leads to endocrine insufficiency. This study evaluated an alternative management strategy for pancreatic leakage. Methods: Outcome
van Os, Annemiek; de Gilder, Dick; van Dyck, Cathy; Groenewegen, Peter
The purpose of this paper is to explore sensemaking of incidents by health care professionals through an analysis of the role of professional identity in narratives of incidents. Using insights from social identity theory, the authors argue that incidents may create a threat of professional identity, and that professionals make use of identity management strategies in response to this identity threat. The paper draws on a qualitative analysis of incident narratives in 14 semi-structured interviews with physicians, nurses, and residents at a Dutch specialist hospital. The authors used an existing framework of identity management strategies to categorize the narratives. The analysis yielded two main results. First, nurses and residents employed multiple types of identity management strategies simultaneously, which points to the possible benefit of combining different strategies. Second, physicians used the strategy of patronization of other professional groups, a specific form of downward comparison. The authors discuss the implications of the findings in terms of the impact of identity management strategies on the perpetuation of hierarchical differences in health care. The authors argue that efforts to manage incident handling may profit from considering social identity processes in sensemaking of incidents. This is the first study that systematically explores how health care professionals use identity management strategies to maintain a positive professional identity in the face of incidents. This study contributes to research on interdisciplinary cooperation in health care.
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
Brunton, Margaret Ann; Jeffrey, Lynn Maud
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…
"The intent of this primer is to inform and guide traffic incident management (TIM) professionals and transportation planners to initiate and develop collaborative relationships and advance TIM programs through the metropolitan planning process. The ...
Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.
Mayeda, Elizabeth Rose; Banack, Hailey R; Bibbins-Domingo, Kirsten; Zeki Al Hazzouri, Adina; Marden, Jessica R; Whitmer, Rachel A; Glymour, M Maria
In middle age, stroke incidence is higher among black than white Americans. For unknown reasons, this inequality decreases and reverses with age. We conducted simulations to evaluate whether selective survival could account for observed age patterning of black-white stroke inequalities. We simulated birth cohorts of 20,000 blacks and 20,000 whites with survival distributions based on US life tables for the 1919-1921 birth cohort. We generated stroke incidence rates for ages 45-94 years using Reasons for Geographic and Racial Disparities in Stroke (REGARDS) study rates for whites and setting the effect of black race on stroke to incidence rate difference (IRD) = 20/10,000 person-years at all ages, the inequality observed at younger ages in REGARDS. We compared observed age-specific stroke incidence across scenarios, varying effects of U, representing unobserved factors influencing mortality and stroke risk. Despite a constant adverse effect of black race on stroke risk, the observed black-white inequality in stroke incidence attenuated at older age. When the hazard ratio for U on stroke was 1.5 for both blacks and whites, but U only directly influenced mortality for blacks (hazard ratio for U on mortality =1.5 for blacks; 1.0 for whites), stroke incidence rates in late life were lower among blacks (average observed IRD = -43/10,000 person-years at ages 85-94 years versus causal IRD = 20/10,000 person-years) and mirrored patterns observed in REGARDS. A relatively moderate unmeasured common cause of stroke and survival could fully account for observed age attenuation of racial inequalities in stroke.
Yu Lei; Zhang Gaolong; Le Xiaoyun; Tanihata, I.
The simulation is performed for the monitors of beam direction and beam position for p-p elastic scattering. We set several variables to simulate the monitors of incident beam condition changes: beam positions at the quadrupole magnet and target in beam line polarimeter (BLP2), distance between quadrupole magnet and target, size of plastic scintillators, distance between the target in BLP2 and the centers of plastic scintillators, and beam polarization. Through the rotation of the coordinate system, the distributions of scattered and recoiled protons in the laboratory system were obtained. By analyzing the count yields in plastic scintillators at different beam positions, we found that the beam incident angular change (0.35°) could be detected when the asymmetry of geometries of left and right scintillators in BLP2 was changed by 6%. Therefore, the scattering angle measured in the experiment can be tracked by these monitors. (authors)
Saito, Seiki; Nakamura, Hiroaki; Ito, Atsushi
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)
Canestrari, Niccolo; Chubar, Oleg; Reininger, Ruben
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.
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.)
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 paper uses 3SLS estimation technique as well as carried out policy simulation experiment to investigate ...
In designing an effective traffic management plan for non-recurrent congestion, it is critical for responsible highway agencies to have some vital information, such as estimated incident duration, resulting traffic queues, and the expected delays. Ov...
Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken
The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.
In 2004, the Federal Highway Administration published updated rules governing work zone safety and mobility; all highway construction and maintenance projects using federal-aid highway funds are required to develop transportation management plans (TM...
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.
Lennquist Montán, K; Hreckovski, B; Dobson, B; Örtenwall, P; Montán, C; Khorram-Manesh, A; Lennquist, S
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
Full Text Available Abstract Background A number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents. Methods A face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region. Results 16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination. Conclusion We have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.
Lee, M.D.E. van der; Vugt, M. van der
The field of crisis response and disaster management can be characterized, upon many other factors, by distributed operations, not daily routine work and multidisciplinary aspects. In designing and developing information systems for crisis response these factors need special attention. On behalf of
Riyadh Mohamad Hasan
Full Text Available Background: Perianal fistula is among the most common anorectal diseases encountered in adults, men are more prone to be affected than women. There is a close relationship of abscess and fistula in etiology, anatomy, pathophysiology, therapy, complications and morbidity, it is appropriate to consider them as one entity. Aim of study: To determine the incidence of fistula formation and recurrent abscess in a sample of Iraqi patients in Baghdad and decide whether primary fistulotomy should be performed at the time of incision and drainage of perianal abscesses. Patients and methods: A retrospective study of 68 patients with perianal abscess operations conducted in Baghdad. They underwent incision and drainage under either local or general anesthesia at Al-Kindy Teaching Hospitals and private hospitals over a 15-year period from January 2000 to December 2015. Their ages ranged from 20 to 68 years (40.21 ± 1.34 males (63/68 (92.64% were more than females (5/68 (7.35%. Patients were treated with incision over the abscess under anesthesia and drainage of the abscess was done. The patients were followed up for an average 18 months (range 12–24 months after abscess drainage or until a fistula appeared and abscess recurrence. Results: The study group comprised of 68 (92.64% patients with perianal abscess with a median age 39 years (range 20–68 years. The mean follow-up period was identified to be 18 months (range 12–24 months. Males (63/68 (92.64% were more than females (5/68 (7.35%. The incidence of fistula formation after follow up, the patients with perianal abscess after incision and drainage was 31/68 (45.58% and males (30/31 (44.11% were more than females (1/31 (1.47%. The most common site was posterior then left lateral position. The percentage of patients with recurrent abscess n = 6 (8.82%were lower than fistula formation n = 31 (45.58%. The percentage of males n = 4/6 (5.88% were more than females 2/6 (2.94%. Conclusions: The
Uhles, Neville; Weimer-Elder, Barbette; Lee, James G
Adventist HealthCare developed a workshop with a reality simulation game as an engaging means to teach nonfinancial managers about the relationships between cash flow, income statements, and balance sheets. Thirty AHC staff, about half financial and half nonfinancial, were trained as workshop facilitators, and all managers with budget oversight were asked to complete the workshop. The workshop was very positively received; participants' average scores on workshop questionnaires increased from 77.4 percent correct on a presession questionnaire to 91.3 percent correct on a postsession questionnaire.
Steenbruggen, J.G.M.; Nijkamp, P.; Smits, J.M.; Mohabir, G.
Disaster Management and Traffic Incident Management involves the coordinated interactions of many public and private actors. On many levels, there is clearly a strong relation be-tween the road infrastructure and the effective handling of large scale disasters. To support these tasks in an effective
Dolk, Daniel R.
The design and implementation of a model management system to support combat modeling is discussed. Structured modeling is introduced as a formalism for representing mathematical models. A relational information resource dictionary system is developed which can accommodate structured models. An implementation is described. Structured modeling is then compared to Jackson System Development (JSD) as a methodology for facilitating discrete event simulation. JSD is currently better at representin...
Hansen, Mette Sanne; Rasmussen, Lauge Baungaard; Jacobsen, Peter
of either qualitative or quantitative processes due to the complexity and uncertainty of the more or less interrelated technology tracks. Accordingly, the foresight approach must allow for interaction between the real-world system and the model builders, for example by using an interacting narrative...... is often occurring in companies. The use of CSA makes it possible for management to close the often experienced knowledge and activity gaps between the strategic, tactical and operational levels in a company. The outcome of developing and using CSA is a generic approach that enables the interaction between...... narrative simulation (scenarios) and numerical simulation. These interactive processes can take place on the strategic, tactical and operational levels of an organization and thus contribute to close the gaps that often exist between these levels. The combined foresight simulation approach is, however...
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.
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...
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
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
Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M
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.
Kandic, A.; Jevremovic, T.; Boreli, F.
Monte Carlo simulation (without secondary radiation) of the standard photon interactions (Compton scattering, photoelectric absorption and pair protection) for the complex slab's geometry is used in numerical code ACCA. A typical ACCA run will yield: (a) transmission of primary photon radiation differential in energy, (b) the spectrum of energy deposited in the target as a function of position and (c) the cumulative percent energy deposition as a function of position. A cumulative percent energy deposition of photon monoenergetic beam incident on simplest and complexity tissue slab and Fe slab are presented in this paper. (author). 5 refs.; 2 figs
Cheng, H.S.; Mallen, A.N.; Wulff, W.
This paper presents the results of simulations of the recent power oscillation incident at the LaSalle-2 nuclear power plant using the BNL plant analyzer. The causes of the oscillation were investigated and the sensitivity of the oscillation to key parameters was studied. It is concluded that the observed power oscillation was caused by boiling instability (i.e., density wave oscillation) reinforced by the reactivity feedback in neutron kinetics, and that the density wave oscillation resulted from flow reduction due to recirculation pump trip and feedwater temperature reduction due to partial loss of feedwater heating capability as well as power peaking
Shishkina, S. V.; Pristupa, Yu D.; Pavlova, L. D.; Fryanov, V. N.
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.
Jiang Sen; Zhu Xiaohua; Sun Xiwen; You Zhengqian; Ma Jun; Yu Dong; Peng Gang; Jie Bing; Sun Chunyi
Objective: To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsibly NBSA for hemoptysis. Methods: The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectasis in 41 (1 case with post-lobectomy and 1 case with post-ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results: Seventy-three patients (52.5%) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 case with post-ligation of patent ductus arteriosus, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n=88), internal thoracic arteries (n=27), inferior phrenic arteries (n=21), proper esophageal arteries (n=20), lateral thoracic arteries (n=9), subscapular arteries (n=7), costocervical trunks (n=5) and thyrocervical trunks (n=4). Main responsible NBSA were posterior intercostal arteries (n=75) and branches of subclavian and axillary artery (n=44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n=16) and inferior phrenic arteries (n=17) in bronchiectasis. The clinical
Dearbhaile C. Collins
Full Text Available Urachal carcinoma is an uncommon cancer whose rarity has precluded its study and evidence-based management strategies are lacking. This study assessed all urachal carcinomas in Ireland and clinical parameters in order to improve understanding. Urachal carcinomas diagnosed from 1994 to 2011 were identified from the National Cancer Registry in Ireland. Data obtained included patient age, gender, diagnostic year, pathology, tumor stage, patient treatment strategies and survival. Twenty-six urachal carcinomas were identified, the majority being adenocarcinoma. This comprised 0.3% of all invasive bladder tumors. Patients were predominantly male (62% and over 50 years of age (58%. Twenty-two patients (85% underwent surgery, with only six (23% undergoing chemotherapy. On average, median overall survival was 2.6 years (range 0-15.2 yrs. Survival was longer in women (5 vs. 1.9 yrs, patients under 50 years of age (3.6 vs. 1.9 yrs, those without confirmed metastasis (4.1 vs. 0.7 yrs and those who received chemotherapy (3.6 vs. 2.6 yrs. The overall survival of urachal carcinoma in Ireland is less than expected from published literature. This study highlights the need for centralization of rare tumors with international collaboration to identify the optimal treatment strategy and improve outcome.
White, J. Chris; Sholtes, Robert M.
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.
Stenner, Robert D.
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.
Ueshima, Yutaka; Saitho, Kanji; Koga, James; Isogai, Kentaro
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)
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)
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.
Peter R. Stinson
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.
Vannatta, David S.
This paper proposes the Problem Reporting Management System (PRMS) model as an effective discrete simulation tool that determines the risks involved during the development phase of a Trouble Tracking Reporting Data Base replacement system. The model considers the type of equipment and networks which will be used in the replacement system as well as varying user loads, size of the database, and expected operational availability. The paper discusses the dynamics, stability, and application of the PRMS and addresses suggested concepts to enhance the service performance and enrich them.
Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim
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.
Butera, R; Locatelli, C; Gandini, C; Minuco, G; Mazzoleni, M C; Giordano, A; Zanuti, M; Varango, C; Petrolini, V; Candura, S M; Manzo, L
Health management of major chemical incidents requires a close collaboration between rescuers (on the disaster site and in the emergency department) and the poison center. The study tested telematic technologies allowing telepresence and teleconsulting, a real time and continuous connection among health care personnel and toxicologists involved in the management of the emergency. The link between the poison center (PC) and the emergency department in the local hospital is provided by a ISDN operating video conferencing system, while the data transmission from the site of the accident to the PC is achieved with a personal computer and GSM cellular data transmission. Toxicological databases and risk assessment software are integrated in the system, to support information sharing. To test such instruments in operative nearly realistic conditions, the main phase of the study has implemented simulated chemical disasters in different locations in Italy. Instruments for telepresence and teleconsulting have been effectively utilized to evaluate from a remote location the scenario and the severity of the accident, by inspecting either specific details or the whole scene, to enable PC guiding the triage of the victims before and after hospitalization, to utilize and share data, such as intervention protocols or patient records, and to document all the activities. In summary, this experience shows that the telematic link allows the toxicologists of the poison center to rapidly understand the situation, and to correctly learn about the conditions of patients with the help of images. The results of this study indicate the valuable benefits of telematic instruments for the health care in case of major chemical disasters occurring in a remote geographical location or in an area which lacks local toxicological experts, where specialized expertise can be achieved by the use of telematic technologies.
Ferrete-Morales, C; Vázquez-Pérez, M A; Sánchez-Berna, M; Gilabert-Cerro, I; Corzo-Delgado, J E; Pineda-Vergara, J A; Vergara-López, S; Gómez-Mateos, J
To assess the impact on the incidence of PPIVC by implementing a catheter management protocol and to determine risk factors for PPIVC development in hospitalized patients. A total of 3978 episodes of venous catheterization were prospectively included from September 2002 to December 2007. A catheter management protocol was implemented during this period of time. The incidence and variables associated to the occurrence of PPIVC were determined. The incidence of PPIVC from 2002 to 2007 was 4.8%, 4.3%, 3.6%, 2.5%, 1.3% and 1.8% (phistory of phlebitis was the only factor independently associated to phlebitis due to peripherally inserted central venous catheters (AOR 3.24; CI at 95% CI= 1.05-9.98, p=0.04). A catheter management protocol decreases the incidence of PPIVC in hospitalized patients. The risk of PPIVC increases for peripherally inserted central venous catheters when the patients have a history of phlebitis and for peripheral venous catheters when amiodarone or cefotaxime are infused. Catheterization of peripheral veins performed during morning shifts is associated with a lower incidence of PPIVC when compared with night shift catheterizations.
Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.
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.
DeFraia, Gary S
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.
Shaver, S.R.; Armacost, L.L.; Konynenbelt, H.S.; Wehrman, R.R.
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
Barrett, J; Rayner, A C; Gill, R; Willings, T H; Bright, A
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.
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
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.
Fernandez-Pacheco, Antonio Nieto; Rodriguez, Laura Juguera; Price, Mariana Ferrandini; Perez, Ana Belen Garcia; Alonso, Nuria Perez; Rios, Manuel Pardo
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.
Schulz, Christian M; Schneider, Erich; Kohlbecher, Stefan; Hapfelmeier, Alexander; Heuser, Fabian; Wagner, Klaus J; Kochs, Eberhard F; Schneider, Gerhard
Development of accurate Situation Awareness (SA) depends on experience and may be impaired during excessive workload. In order to gain adequate SA for decision making and performance, anaesthetists need to distribute visual attention effectively. Therefore, we hypothesized that in more experienced anaesthetists performance is better and increase of physiological workload is less during critical incidents. Additionally, we investigated the relation between physiological workload indicators and distribution of visual attention. In fifteen anaesthetists, the increase of pupil size and heart rate was assessed in course of a simulated critical incident. Simulator log files were used for performance assessment. An eye-tracking device (EyeSeeCam) provided data about the anaesthetists' distribution of visual attention. Performance was assessed as time until definitive treatment. T tests and multivariate generalized linear models (MANOVA) were used for retrospective statistical analysis. Mean pupil diameter increase was 8.1% (SD ± 4.3) in the less experienced and 15.8% (±10.4) in the more experienced subjects (p = 0.191). Mean heart rate increase was 10.2% (±6.7) and 10.5% (±8.3, p = 0.956), respectively. Performance did not depend on experience. Pupil diameter and heart rate increases were associated with a shift of visual attention from monitoring towards manual tasks (not significant). For the first time, the following four variables were assessed simultaneously: physiological workload indicators, performance, experience, and distribution of visual attention between "monitoring" and "manual" tasks. However, we were unable to detect significant interactions between these variables. This experimental model could prove valuable in the investigation of gaining and maintaining SA in the operation theatre.
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.
Davari, Fereshteh; Zahed, Arash
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.
Nemesio Rodrigues Capocci
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.
Medina, L.S.; Racadio, J.M.; Schwid, H.A.
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.)
Willersrud, Anders; Imsland, Lars; Blanke, Mogens
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 handling of symptoms of downhole drilling contingencies at an early stage are therefore crucial for the reliability and safety of MPD operations. In this paper we describe a method for early detection and localization of such incidents, based on a fit for purpose model of the downhole pressure hydraulics...... successfully been tested on experimental data from a medium-scale horizontal flow loop in Sta- vanger, Norway. The flow loop represents a 700 m borehole with emulation of the following downhole contingencies: drillstring washout, drill bit nozzle plugging, gas influx and fluid loss. In the tests...
Williams, Henry P.; Tham, Mingpo; Wickens, Christopher D.
NASA's Aviation Safety Reporting System (ASRS) incident reports are reviewed in two related areas: pilots' failures to appropriately manage tasks, and breakdowns in geographic orientation. Examination of 51 relevant reports on task management breakdowns revealed that altitude busts and inappropriate runway usee were the most frequently reported consequences. Task management breakdowns appeared to occur at all levels of expertise, and prominent causal factors were related to breakdowns in crew communications, over-involvement with the flight management system and, for small (general aviation) aircraft, preoccupation with weather. Analysis of the 83 cases of geographic disorientation suggested that these too occurred at all levels of pilot experience. With regard to causal factors, a majority was related to poor cockpit resource management, in which inattention led to a loss of geographic awareness. Other leading causes were related to poor weather and poor decision making. The potential of the ASRS database for contributing to research and design issues is addressed.
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 ...
Wang, Y.P.; Jarvis, P.G.
A simulation model, Maestro, is used to study the influence of beam fraction in the incident radiation and the radiance distribution of the sky diffuse radiation on PAR absorption, photosynthesis and transpiration of a Sitka spruce (Picea sitchensis (Bong.) Carr) tree crown. It is concluded that inaccurate separation of beam and diffuse radiation leads to significant errors in estimating the amounts of PAR absorbed, photosynthesis and transpiration by a tree in the stand. Much more attention should be paid to adequate descriptions of the radiance distribution of the sky diffuse radiation under different sky conditions. A useful approach is proposed for simulating the incident global radiaiton in a physiological, process-based model
Conclusion: The results of this study showed that education of national hospital preparedness program under simulated conditions of incidents and disasters increased knowledge, attitude, and performance (preparation of nurses in response to the incidents and disasters.
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.
Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.
Bormann, Jill E; Oman, Doug; Kemppainen, Jeanne K; Becker, Sheryl; Gershwin, Madeline; Kelly, Ann
This paper reports a study assessing the usefulness of a mantram repetition programme. Complementary/alternative therapies are becoming commonplace, but more research is needed to assess their benefits. A 5-week programme teaching a 'mind-body-spiritual' technique of silently repeating a mantram - a word or phrase with spiritual meaning - to manage stress was developed. A mantram was chosen by individuals, who were taught to repeat it silently throughout the day or night to interrupt unwanted thoughts and elicit the relaxation response. Participants who attended a 5-week course were invited to participate in the study. Of those who consented, a randomly selected subset (n = 66) was contacted approximately 3 months after the course for a telephone interview using the critical incident interviewing technique. Participants were asked whether the intervention was helpful or not, and if helpful, to identify situations where it was applied. Interviews were transcribed and incidents were identified and categorized to create a taxonomy of uses. The data were collected in 2001-2002. Participants included 30 veterans, mostly males (97%), and 36 hospital employees, mostly females (86%). Mean age was 56 years (sd = 12.94). Fifty-five participants (83.3%) practiced the technique and reported 147 incidents where the programme was helpful. Outcomes were organized into a taxonomy of incidents using four major categories that included managing: (a) emotions other than stress (51%); (b) stress (23.8%); (c) insomnia (12.9%); and (d) unwanted thoughts (12.3%). A group of raters reviewed the categories for inter-rater reliability. The majority of participants from two distinct samples reported that the mantram programme was helpful in a variety of situations. The critical incident interviewing method was found to be practical, efficient, and thorough in collecting and analyzing data. Such qualitative methods contribute to understanding the benefits of mind-body complementary therapies.
Lee, Ka L; Graham, Colin A; Yeung, Janice H H; Ahuja, Anil T; Rainer, Timothy H
Occult pneumothorax (OP) is a pneumothorax not visualised on a supine chest X-ray (CXR) but detected on computed tomography (CT) scanning. With increasing CT use for trauma, more OP may be detected. Management of OP remains controversial, especially for patients undergoing mechanical ventilation. This study aimed to identify the incidence of OP using thoracic CT as the gold standard and describe its management amongst Hong Kong Chinese trauma patients. Analysis of prospectively collected trauma registry data. Consecutive significantly injured trauma patients admitted through the emergency department (ED) suffering from blunt chest trauma who underwent thoracic computed tomography (TCT) between in calendar years 2007 and 2008 were included. An OP was defined as the identification (by a specialist radiologist) of a pneumothorax on TCT that had not been previously detected on supine CXR. 119 significantly injured patients were included. 56 patients had a pneumothorax on CXR and a further 36 patients had at least one OP [OP incidence 30% (36/119)]. Bilateral OP was present in 8/36 patients, so total OP numbers were 44. Tube thoracostomy was performed for 8/44 OP, all were mechanically ventilated in the ED. The remaining 36 OP were managed expectantly. No patients in the expectant group had pneumothorax progression, even though 8 patients required subsequent ventilation in the operating room for extrathoracic surgery. The incidence of OP (seen on TCT) in Chinese patients in Hong Kong after blunt chest trauma is higher than that typically reported in Caucasians. Most OP were managed expectantly without significant complications; no pneumothorax progressed even though some patients were mechanically ventilated. (c) 2010 Elsevier Ltd. All rights reserved.
NSTec Environmental Restoration
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
... 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...
Jaeger, M.; Adair, D.
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…
Yulia G. Krasnozhon
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.
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.
Bruynooghe, Christiane; Noel, Marc
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.)
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.
David Bruce Stockton
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.
Dinker R Pai
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.
Pai, Dinker R; Singh, Simerjit
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.
Jeong, K.-S.; Kim, K.-R.; Jung, W.-D.; Ha, J.-J.
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
Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio
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.
Bar-El, Yaron; Tzafrir, Sara; Tzipori, Idan; Utitz, Liora; Halberthal, Michael; Beyar, Rafael; Reisner, Shimon
Mass casualty incidents are probably the greatest challenge to a hospital. When such an event occurs, hospitals are required to instantly switch from their routine activity to conditions of great uncertainty and confront needs that exceed resources. We describe an information system that was uniquely designed for managing mass casualty events. The web-based system is activated when a mass casualty event is declared; it displays relevant operating procedures, checklists, and a log book. The system automatically or semiautomatically initiates phone calls and public address announcements. It collects real-time data from computerized clinical and administrative systems in the hospital, and presents them to the managing team in a clear graphic display. It also generates periodic reports and summaries of available or scarce resources that are sent to predefined recipients. When the system was tested in a nationwide exercise, it proved to be an invaluable tool for informed decision making in demanding and overwhelming situations such as mass casualty events.
Berg, T.W. van den; Jansen, H.G.M.; Jansen, R.E.J.; Prins, L.M.
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
Денис Антонович ХАРИТОНОВ
Full Text Available The article examined the fractal model of organizational diagnosis of pathologies in project management development. The proposed fractal model based on the competency approach to project management and allows evaluating the pathology of the project-oriented organizations.
Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta
On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).
Krogel, Jaron T.
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.
Kulikova, Olga; Heil, Ronald; van den Berg, Jan; Pieters, Wolter
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
Quattrochi, Dale A.; Morin, Cory
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.
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
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.
Shepelev, Aleksandr; Severova, Galina; Potashova, Irina
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.
Pasin, Federico; Giroux, Helene
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…
Yazici, Hulya Julie
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…
Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.
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
Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: email@example.com [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)
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.
Shah, Chirag; Vicini, Frank A.
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.
Chipeta, Effie; Bradley, Susan; Chimwaza-Manda, Wanangwa; McAuliffe, Eilish
Malawi continues to experience critical shortages of key health technical cadres that can adequately respond to Malawi's disease burden. Difficult working conditions contribute to low morale and frustration among health care workers. We aimed to understand how obstetric care staff perceive their working relationships with managers. A qualitative exploratory study was conducted in health facilities in Malawi between October and December 2008. Critical Incident Analysis interviews were done in government district hospitals, faith-based health facilities, and a sample of health centres' providing emergency obstetric care. A total of 84 service providers were interviewed. Data were analyzed using NVivo 8 software. Poor leadership styles affected working relationships between obstetric care staff and their managers. Main concerns were managers' lack of support for staff welfare and staff performance, lack of mentorship for new staff and junior colleagues, as well as inadequate supportive supervision. All this led to frustrations, diminished motivation, lack of interest in their job and withdrawal from work, including staff seriously considering leaving their post. Positive working relationships between obstetric care staff and their managers are essential for promoting staff motivation and positive work performance. However, this study revealed that staff were demotivated and undermined by transactional leadership styles and behavior, evidenced by management by exception and lack of feedback or recognition. A shift to transformational leadership in nurse-manager relationships is essential to establish good working relationships with staff. Improved providers' job satisfaction and staff retentionare crucial to the provision of high quality care and will also ensure efficiency in health care delivery in Malawi.
Eric L. Smith
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...
LIU Tie-zhong; LI Zhi-xiang
Aiming to the deficiency of safety management measure, established simulation model about firm's safety management capability(FSMC) based on organizational learning theory. The system dynamics(SD) method was used, in which level and rate system, variable equation and system structure flow diagram was concluded. Simulation model was verified from two aspects: first, model's sensitivity to variable was tested from the gross of safety investment and the proportion of safety investment; second, variables dependency was checked up from the correlative variable of FSMC and organizational learning. The feasibility of simulation model is verified though these processes.
Robinson, J.E.; Agamy, S.
Using a Monte-Carlo technique, projected range distributions and backscattering coefficients have been calculated for keV protons normally incident on heavy targets. For an incident reduced energy range of 1 less than epsilon 0 less than 20, both the projected range distributions and backscattering coefficients have been found to be in good agreement with a third order Edgeworth range approximation. Backscattered energy and angular distributions have also been calculated and are compared to available theoretical and experimental data. (4 figs.) (U.S.)
Baldassarra, Alessandro; Impastato, Stefano; Ricci, Stefano
A freight terminal is a key node in a transportation network and the transit time of containers through this terminal represents one of the most relevant bottlenecks in logistic chains. The system performance reduction and the corresponding increase of transit time are often due to the increase of the freight flow without a corresponding increase of stacking and handling capacity. For this purpose it was decided to approach the problem by a discrete event simulation model, in order to reprodu...
Thilakarathne, D.J.; Treur, J.
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
Effective planning and management of workforce for new product development (NPD) projects is a great challenge to many organisations, especially in the presence of engineering changes during the product development process. The management objective in effective workforce management is to recruit, develop and deploy the right people at the right place at the right time so as to fulfill organizational objectives. In this paper, we propose a dynamic simulation model to address the workforce mana...
Zantomio, D; Grigg, A P; MacGregor, L; Panek-Hudson, Y; Szer, J; Ayton, R
Female genital tract graft-versus-host disease (GVHD) is an under-recognized complication of allogeneic stem cell transplantation impacting on quality of life. We describe a prospective surveillance programme for female genital GVHD to better characterize incidence, risk factors and clinical features and the impact of a structured intervention policy. A retrospective audit was conducted on the medical records of all female transplant recipients surviving at least 6 months at a single centre over a 5-year period. Patients commenced topical vaginal oestrogen early post transplant with hormone replacement as appropriate for age, prior menopausal status and co-morbidities. A genital tract management programme included regular gynaecological review and self-maintenance of vaginal capacity by dilator or intercourse. The incidence of genital GVHD was 35% (95% confidence interval (CI) (25, 50%)) at 1 year and 49% (95% CI (36, 63%)) at 2 years. Topical therapy was effective in most cases; no patient required surgical intervention to divide vaginal adhesions. The main risk factor was stem cell source with peripheral blood progenitor cells posing a higher risk than marrow (hazard ratio=3.07 (1.22, 7.73), P=0.017). Extensive GVHD in other organs was a common association. We conclude that female genital GVHD is common, and early detection and commencement of topical immunosuppression with dilator use appears to be highly effective at preventing progression.
Reveley, Mary S.; Briggs, Jeffrey L.; Thomas, Megan A.; Evans, Joni K.; Jones, Sharon M.
The Integrated Vehicle Health Management (IVHM) Project is one of the four projects within the National Aeronautics and Space Administration's (NASA) Aviation Safety Program (AvSafe). The IVHM Project conducts research to develop validated tools and technologies for automated detection, diagnosis, and prognosis that enable mitigation of adverse events during flight. Adverse events include those that arise from system, subsystem, or component failure, faults, and malfunctions due to damage, degradation, or environmental hazards that occur during flight. Determining the causal factors and adverse events related to IVHM technologies will help in the formulation of research requirements and establish a list of example adverse conditions against which IVHM technologies can be evaluated. This paper documents the results of an examination of the most recent statistical/prognostic accident and incident data that is available from the Aviation Safety Information Analysis and Sharing (ASIAS) System to determine the causal factors of system/component failures and/or malfunctions in U.S. commercial aviation accidents and incidents.
Ekwere, Paul D; Al Rashid, Mohammed
Recent observations in our hospital of apparent increase in frequency prompted a revisit to the subject of fracture of penis. In a retrospective review, patients' age, marital status, and causal activities; clinical presentations; methods of management; operative findings; and postoperative complications were analyzed for changing trends. Literature was also reviewed briefly. Nineteen episodes of penile fracture in 18 patients exceed the previous incidence by more than 58%. Most were due to noncoital causes (73.7%); more unmarried people (31.6%) were affected. Most presented with the classic symptoms/signs, and tears were repaired by degloving through subcoronal incisions; one was treated conservatively. The higher morbidity observed was attributed to higher rates of hematoma and wound infections, probably enhanced by poor hemostasis and early persistent, postoperative erections. Painful erections, painful coitus, and deformities, however subsided within weeks, with no long-term ill effects. The incidence of penile fracture, postoperative hematoma, and infections has increased; about 32% of the patients were unmarried. The prominence of masturbation as a cause of penile fracture and increased ratio of noncoital to coital causes are highlighted. Degloving through subcoronal incisions remains an acceptable method of approach for repair in line with cultural practices in Saudi Arabia.
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
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.
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)
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.)
Gabriel Vianna Schlatter
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.
Barreiro, S.; Rua, J.; Tomé, M.
Aim of the study. The existing stand level forest simulators available in Portugal were not developed with the aim of including up-to-date model versions and were limited in terms of accounting for forest management. The simulators’ platform, sIMfLOR was recently created to implement different growth models with a common philosophy. The objective was developing one easily-updatable, user-friendly, forest management and climate change sensitive simulator capable of projecting growth for the main tree species in Portugal. Area of the study: Portugal. Material and methods: The new simulator was programmed in a modular form consisting of several modules. The growth module integrates different forest growth and yield models (empirical and process-based) for the main wood production tree species in Portugal (eucalypt, umbrella and maritime pines); whereas the management module drives the growth projections along the planning horizon according to a range of forest management approaches and climate (at present only available for eucalypt). Main results: The main result is the StandsSIM-MD Management Driven simulator that overcomes the limitations of the existing stand level simulators. It is a step forward when compared to the models currently available in the sIMfLOR platform covering more tree species, stand structures and stand compositions. It is focused on end-users and it is based on similar concepts regarding the generation of required inputs and generated outputs. Research highlights: Forest Management Driven simulations approach. Multiple Prescriptions-Per-Stand functionality. StandsSIM-MD can be used to support landowners decisions on stand forest management. StandsSIM-MD simulations at regional level can be combined with optimization routines. (Author)
Guseva, Elena; Varfolomeyeva, Tatyana; Efimova, Irina; Movchan, Irina
This paper describes the simulation modeling methodology aimed to aid in solving the practical problems of the research and analysing the complex systems. The paper gives the review of a simulation platform sand example of simulation model development with Arena 15.0 (Rockwell Automation).The provided example of the simulation model for the patient service management helps to evaluate the workload of the clinic doctors, determine the number of the general practitioners, surgeons, traumatologists and other specialized doctors required for the patient service and develop recommendations to ensure timely delivery of medical care and improve the efficiency of the clinic operation.
Kaplan, Robert E.; And Others
Although simulation is among the least common of the many methods consultants employ to stimulate team development, realistic simulation can help in the diagnosis of management teams. Simulations fill a gap in the repertoire of data collection methods for organizational diagnosis and development by affording an opportunity for direct observation…
Rollins, Brent L; Gunturi, Rahul; Sullivan, Donald
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.
Pages Zamora, Alberto
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
Ahmad, Norazura; Ghani, Noraida Abdul; Kamil, Anton Abdulbasah; Tahar, Razman Mat
Due to the diversity of patient flows and interdependency of the emergency department (ED) with other units in hospital, the use of analytical models seems not practical for ED modeling. One effective approach to study the dynamic complexity of ED problems is by developing a computer simulation model that could be used to understand the structure and behavior of the system. Attempts to build a holistic model using DES only will be too complex while if only using SD will lack the detailed characteristics of the system. This paper discusses the combination of DES and SD in order to get a better representation of the actual system than using either modeling paradigm solely. The model is developed using AnyLogic software that will enable us to study patient flows and the complex interactions among hospital resources for ED operations. Results from the model show that patients' length of stay is influenced by laboratories turnaround time, bed occupancy rate and ward admission rate.
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.)
Shuttleworth-Edwards, Ann B; Noakes, Timothy D; Radloff, Sarah E; Whitefield, Victoria J; Clark, Susan B; Roberts, Craig O; Essack, Fathima B; Zoccola, Diana; Boulind, Melissa J; Case, Stephanie E; Smith, Ian P; Mitchell, Julia L G
The objective of this study was to compare the seasonal concussion incidence for school, university, club and provincial level Rugby Union players in South Africa. The study presents a retrospective statistical analysis of the number of reported concussions documented annually for groups of Rugby Union players as a proportion of those who received preseason neurocognitive assessment. Between 2002 and 2006, concussion management programs using computerized neuropsychological assessment were implemented for clinical and research purposes by psychologists in selected South African institutions involved in Rugby Union from school through to the professional level. The incidence figures were based on 175 concussive episodes reported for 165 athletes who were referred for neurocognitive assessment from a population of 1366 athletes who received preseason baseline testing. Concussion management routines varied according to the protocols adopted by the different psychologists and rugby organizations. It was expected that the incidence of concussion would vary significantly due to level of play and different management protocols. There was wide disparity in the manner in which concussion follow-up was managed by the various organizations. Within broadly comparable cohorts, tighter control was associated with a relatively higher concussion incidence for athletes per rugby playing season, with average institutional figures ranging from 4% to 14% at school level and 3% to 23% at adult level. This analysis suggests that concussion goes unrecognized and therefore incorrectly managed in a number of instances. Recommendations for optimal identification of concussed athletes for follow-up management are presented.
The 2014-2016 epidemic of Ebola virus disease occurred in a region with a recent history of civil war, unstable health systems, and widespread poverty. Despite these contextual challenges, the national Ebola response in Liberia controlled transmission under strong leadership that was able to rapidly coordinate activities, to manage local and international players, and to adapt upon recognizing missteps. Such leadership has persisted to improve public health capacity in post-Ebola Liberia. This article highlights the progress made toward developing a resilient health security system with capacity to prevent, detect, and respond to disease threats before they reach epidemic level. In particular, Liberia's development of a Global Health Security Agenda roadmap, a Joint External Evaluation (JEE) report for International Health Regulation (2005) core capacities, and recent establishment of a National Public Health Institute are described. To better protect the country's population and the greater global community from health threats, emerging institutions and policies in Liberia will depend on leadership and governance that draws from the successes and lessons learned during the Ebola outbreak. The author provides insight based on his role as incident manager of Liberia's Ebola response.
Morales, Peter J
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
Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.
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
Giesen, J. H.
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
Full Text Available Aim of the study: The existing stand level forest simulators available in Portugal were not developed with the aim of including up-to-date model versions and were limited in terms of accounting for forest management. The simulators’ platform, sIMfLOR was recently created to implement different growth models with a common philosophy. The objective was developing one easily-updatable, user-friendly, forest management and climate change sensitive simulator capable of projecting growth for the main tree species in Portugal. Area of the study: Portugal. Material and methods: The new simulator was programmed in a modular form consisting of several modules. The growth module integrates different forest growth and yield models (empirical and process-based for the main wood production tree species in Portugal (eucalypt, umbrella and maritime pines; whereas the management module drives the growth projections along the planning horizon according to a range of forest management approaches and climate (at present only available for eucalypt. Main results: The main result is the StandsSIM-MD Management Driven simulator that overcomes the limitations of the existing stand level simulators. It is a step forward when compared to the models currently available in the sIMfLOR platform covering more tree species, stand structures and stand compositions. It is focused on end-users and it is based on similar concepts regarding the generation of required inputs and generated outputs. Research highlights: - Forest Management Driven simulations approach - Multiple Prescriptions-Per-Stand functionality - StandsSIM-MD can be used to support landowners decisions on stand forest management - StandsSIM-MD simulations at regional level can be combined with optimization routines Keywords: Forest simulator, Forest Management Approaches; StandsSIM-MD; forest management.
Edwards, Donna M.; Ray, Jaideep; Tucker, Mark D.; Whetzel, Jonathan; Cauthen, Katherine Regina
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.
Kulikova, Olga; Heil, Ronald; van den Berg, Jan; Pieters, Wolter
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 fines, and restore confidence and trust of a company's key stakeholders. In this paper, four factors that shape organizational preferences regarding incident information disclosure are introduced....
Jeffrey G. Arnold
Full Text Available Decision tables have been used for many years in data processing and business applications to simulate complex rule sets. Several computer languages have been developed based on rule systems and they are easily programmed in several current languages. Land management and river–reservoir models simulate complex land management operations and reservoir management in highly regulated river systems. Decision tables are a precise yet compact way to model the rule sets and corresponding actions found in these models. In this study, we discuss the suitability of decision tables to simulate management in the river basin scale Soil and Water Assessment Tool (SWAT+ model. Decision tables are developed to simulate automated irrigation and reservoir releases. A simple auto irrigation application of decision tables was developed using plant water stress as a condition for irrigating corn in Texas. Sensitivity of the water stress trigger and irrigation application amounts were shown on soil moisture and corn yields. In addition, the Grapevine Reservoir near Dallas, Texas was used to illustrate the use of decision tables to simulate reservoir releases. The releases were conditioned on reservoir volumes and flood season. The release rules as implemented by the decision table realistically simulated flood releases as evidenced by a daily Nash–Sutcliffe Efficiency (NSE of 0.52 and a percent bias of −1.1%. Using decision tables to simulate management in land, river, and reservoir models was shown to have several advantages over current approaches, including: (1 mature technology with considerable literature and applications; (2 ability to accurately represent complex, real world decision-making; (3 code that is efficient, modular, and easy to maintain; and (4 tables that are easy to maintain, support, and modify.
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.
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
Rusca, M.; Heun, J.; Schwartz, K.
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
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
Christiansen, Sytter; Rethmeier, Anita
authenticity of the simulated learning. The objectives of the course are that students can identify different kinds of chronic wounds and risk factors contributing to decreased wound healing. This demands knowledge related to skin and wound types. We used five medium fidelity mannequins equipped......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...
Jeong, Chang Joon; Suk, Ho Chun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)
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)
Jeong, Chang Joon; Suk, Ho Chun [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)
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)
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.
Bloch, Yuval H; Leiba, Adi; Veaacnin, Nurit; Paizer, Yohanan; Schwartz, Dagan; Kraskas, Ahuva; Weiss, Gali; Goldberg, Avishay; Bar-Dayan, Yaron
Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique profile of injuries allows for the examination of the medical and operational aspects of the management of mild casualties. Data were collected during and after the event, using patient records and formal debriefings. They were processed focusing on the characteristics of patient complaints, medical response, and the dynamics of admission. A total of 64 patients presented to the local emergency department, including two critical casualties. The remaining 62 patients were mildly injured or suffered from stress. Patient presentation to the emergency department was bi-phasic; during the first two hours following the attack (i.e., early phase), the rate of arrival was high (one patient every three minutes), and anxiety was the most frequent chief complaint. During the second phase, the rate of arrival was lower (one patient every 27 minutes), and the typical chief complaint was somatic. Additionally, tinnitus and complaints related to minor trauma also were recorded frequently. Psychiatric consultation was obtained for 58 (91%) of the patients. Social services were involved in the care of 47 of the patients (73%). Otolaryngology and surgery consultations were obtained for 45% and 44%, respectively. The need for some medical specialties (e.g., surgery and orthopedics) mainly was during the first phase, whereas others, mainly psychiatry and otolaryngology, were needed during both phases. Only 13 patients (20%) needed a consultation from internal medicine. Following a terrorist attack, a large number of mildly injured victims and those experiencing stress are to be expected, without a direct relation to the effectiveness of the attack. Mildly injured patients tend to
Freedman, Vicky L.; Lansing, Carina S.; Porter, Ellen A.; Schuchardt, Karen L.; Guillen, Zoe C.; Sivaramakrishnan, Chandrika; Gorton, Ian
In scientific simulation, scientists use measured data to create numerical models, execute simulations and analyze results from advanced simulators executing on high performance computing platforms. This process usually requires a team of scientists collaborating on data collection, model creation and analysis, and on authorship of publications and data. This paper shows that scientific teams can benefit from a user environment called Akuna that permits subsurface scientists in disparate locations to collaborate on numerical modeling and analysis projects. The Akuna user environment is built on the Velo framework that provides both a rich client environment for conducting and analyzing simulations and a Web environment for data sharing and annotation. Akuna is an extensible toolset that integrates with Velo, and is designed to support any type of simulator. This is achieved through data-driven user interface generation, use of a customizable knowledge management platform, and an extensible framework for simulation execution, monitoring and analysis. This paper describes how the customized Velo content management system and the Akuna toolset are used to integrate and enhance an effective collaborative research and application environment. The extensible architecture of Akuna is also described and demonstrates its usage for creation and execution of a 3D subsurface simulation.
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.
Cheng, Po-Liang; Su, Yung-Cheng; Hou, Chung-Hung; Chang, Po-Lun
Near field communications (NFC) is an emerging technology that may potentialy assist with disaster management. A smartphone-based app was designed to help track patient flow in real time. A table-drill was held as a brief evaluation and it showed significant imporvement in both efficacy and accuracy of patient management. It is feasible to use NFC-embedded smartphones to clarify the ambiguous and chaotic patient flow in a mass casualty incident.
Potter, S J; Bamford, N J; Harris, P A; Bailey, S R
The aims of this study were to (1) report the incidence of laminitis among a population of horses and ponies attending Pony Clubs in Victoria, Australia, and (2) describe the dietary and management practices of the sample population. Researchers visited 10 Pony Clubs over a 10-month period. Horse and pony owners completed a questionnaire to provide information on management relating to diet and exercise. Owners were also asked to report their animal's history of laminitis, if any. From a survey population of 233 horses and ponies, 15.0% of animals (35 individuals) were reported to have suffered from at least one episode of laminitis. Of the animals that had suffered from laminitis, more than half had experienced multiple episodes. The majority of previously laminitic horses and ponies (71.4%) had not experienced an episode of laminitis within the past 12 months; however, 14.2% had experienced an incident within the past month. The proportion of ponies affected by laminitis (31/142; 21.8%) was significantly higher (P horses affected by laminitis (4/91; 4.4%). The incidence of laminitis within the pony group sampled was 6.5 cases per 100 pony years, while the incidence in horses was 0.55 cases per 100 horse years. This study provided information on the incidence of laminitis in the general population of pleasure horses and ponies in south-eastern Australia. It also provided an overview of dietary and management practices. Given the high incidence of animals that had been affected by laminitis (and the associated welfare implications), this study highlights the importance of owner education regarding appropriate feeding and management strategies to reduce the risk of laminitis. © 2017 Australian Veterinary Association.
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.
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
Ayodele, Joseph Babatola; Adewumi, Joseph Olukayode
This paper compared the incidence and management of conflicts in secular and non-secular tertiary institutions in Nigeria. The sample of this study was made of sixty staff, and two hundred and forty students randomly selected each from two secular and two non-secular tertiary institutions in south western Nigeria. A validated questionnaire was…
Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L
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
Full Text Available AIM: To evaluate the safety and postoperative complications of femtosecond laser-assisted small incision lenticule extraction(SMILE. METHODS: Retrospective case series. A total of 1127 patients(2 236 eyeswho were treated with SMILE for myopia or myopia astigmatism between June 2016 and May 2017 were enrolled in this study. Eyes that developed postoperative complications were noted and identified. The incidence, risk factors, management and prognosis were analyzed. The follow-up was 6mo.RESULTS: The rate of postoperative complications was 8.05%, included diffuse lamellar keratitis(3.31%, delayed visual acuity(2.59%, minor interface residue(0.63%, and ghost images(1.52%. These complications had an impact on best corrected visual acuity(BCVAat 3mo in only 1 eye with decentered ablation and was re-treated with topography-guided laser-assisted subepithelial keratomileusis(LASEK. Good visual outcomes were achieved in all eyes finally. CONCLUSION: Although few eyes suffered postoperative complications, SMILE is an acceptable safe surgery. Careful surgical skill, appropriate surgical parameter, and rational postoperative medication can decrease the risk of complication.
Ege, G. E-mail: firstname.lastname@example.org; Akman, H.; Kuzucu, K.; Yildiz, S
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.
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
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.
Ragnemalm, Eva L.; Samuelsson, Marcus
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…
Umble, Elisabeth; Umble, Michael
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…
D. Earl Kline; J.K. Wiedenbeck; Philip A. Araman
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...
Gary L. Benson; William F. Laudenslayer
A computer simulation approach (DYNAST) was used to evaluate effects of three timber-management alternatives on wildlife in a 2700-ha (6700-acre) study area located in the Sierra Nevada, California. Wildlife species selected to evaluate the effects of these alternatives were band-tailed pigeon (Columba fusciutu), pileated woodpecker (
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.
Full Text Available Effective planning and management of workforce for new product development (NPD projects is a great challenge to many organisations, especially in the presence of engineering changes during the product development process. The management objective in effective workforce management is to recruit, develop and deploy the right people at the right place at the right time so as to fulfill organizational objectives. In this paper, we propose a dynamic simulation model to address the workforce management problem in a typical NPD project consisting of design, prototyping, and production phases. We assume that workforce demand is a function of project work remaining and the current available skill pool. System dynamics simulation concepts are used to capture the causality relationships and feedback loops in the workforce system from a systems thinking. The evaluation of system dynamics simulation reveals the dynamic behaviour in NPD workforce management systems and shows how adaptive dynamic recruitment and training decisions can effectively balance the workforce system during the NPD process.
Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S
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.
Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C
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.
Forsberg, Helena Hvitfeldt; Aronsson, Håkan; Keller, Christina; Lindblad, Staffan
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.
Murphy, M. R.
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.
Incident Management (IM) is an area of transportation management that can significantly decrease the congestion and increase the : efficiency of transportation networks in non-ideal conditions. In this study, the existing state of the Integrated Inci...
Castilla Rho, J. C.; Mariethoz, G.; Rojas, R. F.; Andersen, M. S.; Kelly, B. F.; Holley, C.
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.
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
Baillot, Richard; Fréchette, Éric; Cloutier, Daniel; Rodès-Cabau, Josep; Doyle, Daniel; Charbonneau, Éric; Mohammadi, Siamak; Dumont, Éric
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.
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
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: email@example.com.
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.
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.
Cowardin, L.M.; Johnson, D.H.; Shaffer, T.L.; Sparling, D.W.
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.
Ekaterinaris, J. A.; Schiff, Lewis B.
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.
Garg, Naveen; Moorthy, Nagaraja
The majority of pacemaker pocket or lead erosions are due to either mechanical erosion by the bulky pulse generator or secondary to pacemaker pocket infection. We describe an unusual case of delayed pacemaker lead erosion causing extrusion of a portion of the pacing lead, with separate entry and exit points, with the gap filled with new skin formation, simulating the "Loch Ness Monster", which was successfully managed conservatively by surgical reinsertion.
The article introduces the use of probabilistic risk assessment for modeling the incident response process of online financial services. The main contribution is the creation of incident response trees, using event tree analysis, which provides us with a visual tool and a systematic way to estimate the probability of a successful incident response process against the currently known risk landscape, making it possible to measure the balance between front-end and back-end security measures. The model is presented using an illustrative example, and is then applied to the incident response process of a Swedish bank. Access to relevant data is verified and the applicability and usability of the proposed model is verified using one year of historical data. Potential advantages and possible shortcomings are discussed, referring to both the design phase and the operational phase, and future work is presented. © 2014 Society for Risk Analysis.
The overall goal of both phases of this project was to reduce responder fatalities and injuries, as well as to prevent : secondary crashes, especially those involving incident responders. The phases of this project worked toward this goal : by creati...
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
Cashmore Aaron W
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
Betts, Bradley J.; DelMundo, Rommel; Elcott, Sharif; McIntosh, Dawn; Niehaus, Brian; Papasin, Richard; Mah, Robert W.; Clancy, Daniel (Technical Monitor)
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.
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.
Dupont, Hélène; Gourmelon, Françoise; Rouan, Mathias; Le Viol, Isabelle; Kerbiriou, Christian
The conservation of biodiversity today must include the participation and support of local stakeholders. Natura 2000 can be considered as a conservation system that, in its application in most EU countries, relies on the participation of local stakeholders. Our study proposes a scientific method for participatory modelling, with the aim of contributing to the conservation management of habitats and species at a Natura 2000 site (Crozon Peninsula, Bretagne, France) that is representative of in landuse changes in coastal areas. We make use of companion modelling and its associated tools (scenario-planning, GIS, multi-agent modelling and simulations) to consider possible futures through the co-construction of management scenarios and the understanding of their consequences on different indicators of biodiversity status (habitats, avifauna, flora). The maintenance of human activities as they have been carried out since the creation of the Natura 2000s zone allows the biodiversity values to remain stable. Extensive agricultural activities have been shown to be essential to this maintenance, whereas management sustained by the multiplication of conservation actions brings about variable results according to the indicators. None of the scenarios has a positive incidence on the set of indicators. However, an understanding of the modelling system and the results of the simulations allow for the refining of the selection of conservation actions in relation to the species to be preserved. Copyright © 2015 Elsevier Ltd. All rights reserved.
The use of paralytic medications in the performance of RSI intubation is a high risk intervention used by many HEMS crews. There is no margin for error in RSI intubation as the results can be fatal. Operating room access for airway management training has become more difficult, and is not representative of the environment in which HEMS crews typically function. LifeEvac of Virginia designed and implemented an SST airway management program to provide a realistic, consistent training platform. The dynamic program incorporates standardized scenarios, and real life challenging cases that this and other programs have encountered. SST is done in a variety of settings including the helicopter, back of ambulances, staged car crashes and simulation centers. The result has been the indoctrination of a well defined, consistent approach to every airway management intervention. The SST program facillitates enhancement of technical skills. as well as team dynamics and communication.
Experience suggests that effective and appropriate responses of an organization's management after a traumatic incident can help mitigate the reactions of primary, secondary, and tertiary victims. This commentary addresses the managerial response of Southwest Airlines to the trauma induced by September 11. It highlights the effectiveness of the unity between the company, the unions, and the Critical Incident Response Team, as well as the types of interventions that were highly regarded by flight attendants and pilots who received such services. This commentary also defines the phenomenon known as fear of flight.
Dieckmann, P; Rall, M; Østergaard, Doris
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...
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.
Meza, Juan; Hubbard, Susan; Freshley, Mark D.; Gorton, Ian; Moulton, David; Denham, Miles E.
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.
Reynolds, Penny S; Michael, Mary J; Spiess, Bruce D
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
Pond, Daniel J.; Greitzer, Frank L.
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
Miller, Ian; Kossik, Rick; Voss, Charlie
Most waste management activities are decided upon and carried out in a public or semi-public arena, typically involving the waste management organization, one or more regulators, and often other stakeholders and members of the public. In these environments, simulation modeling can be a powerful tool in reaching a consensus on the best path forward, but only if the models that are developed are understood and accepted by all of the parties involved. These requirements for understanding and acceptance of the models constrain the appropriate software and model development procedures that are employed. This paper discusses requirements for both simulation software and for the models that are developed using the software. Requirements for the software include transparency, accessibility, flexibility, extensibility, quality assurance, ability to do discrete and/or continuous simulation, and efficiency. Requirements for the models that are developed include traceability, transparency, credibility/validity, and quality control. The paper discusses these requirements with specific reference to the requirements for performance assessment models that are used for predicting the long-term safety of waste disposal facilities, such as the proposed Yucca Mountain repository
Dixon, Paul; Keating, Elizabeth; Moulton, David; Williamson, Mark; Collazo, Yvette; Gerdes, Kurt; Freshley, Mark; Gorton, Ian; Meza, Juan
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
Simunich, K. L.; Sydelko, P.; Dolph, J.; Christiansen, J.
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
Simunich, K. L.; Sydelko, P.; Dolph, J.; Christiansen, J.
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
Kleef, van E.; Ueland, O.; Theodoridis, G.; Rowe, G.; Pfenning, U.; Houghton, J.R.; Dijk, van H.; Chryssochoidis, G.; Frewer, L.J.
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
Zhang, Hui; Duan, Huabo; Zuo, Jian; Song, MingWei; Zhang, Yukui; Yang, Bo; Niu, Yongning
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.
Li, Xiaowei; Ke, Peiling; Lee, Kwang-Ryeol; Wang, Aiying
The influence of incident angles of energetic carbon atoms (0–60°) on the structure and properties of diamond-like carbon (DLC) films was investigated by the molecular dynamics simulation using a Tersoff interatomic potential. The present simulation revealed that as the incident angles increased from 0 to 60°, the surface roughness of DLC films increased and the more porous structure was generated. Along the growth direction of DLC films, the whole system could be divided into four regions including substrate region, transition region, stable region and surface region except the case at the incident angle of 60°. When the incident angle was 45°, the residual stress was significantly reduced by 12% with little deterioration of mechanical behavior. The further structure analysis using both the bond angles and bond length distributions indicated that the compressive stress reduction mainly resulted from the relaxation of highly distorted C–C bond length. - Highlights: • The dependence of films properties on different incident angles was investigated. • The change of incident angles reduced the stress without obvious damage of density. • The stress reduction attributed to the relaxation of highly distorted bond length
Chen, Peiyuan; Bak-Jensen, Birgitte; Chen, Zhe
. It is concluded that the AR(12) model is favored with limited measurement data and that the joint-normal model may provide better results with a large data set. Both models can be applied in general to model load time series and used in time-sequential simulation of distribution system planning.......This paper analyzes a distribution system load time series through autocorrelation coefficient, power spectral density, probabilistic distribution and quantile value. Two probabilistic load models, i.e. the joint-normal model and the autoregressive model of order 12 (AR(12)), are proposed...... to simulate the impact of load management. The joint-normal model is superior in modeling the tail region of the hourly load distribution and implementing the change of hourly standard deviation. Whereas the AR(12) model requires much less parameter and is superior in modeling the autocorrelation...
Walter Roberto Hernandez Vergara
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.
Hirabayashi, Yoshihiro; Kawakami, Takayuki; Suzuki, Hideo; Igarashi, Takashi; Saitoh, Kazuhiko; Seo, Norimasa
Syringe swap is an important problem in anesthetic care, causing harm to patients. We examined the effect of colored syringe and a colored sheet on the incidence of syringe swaps during anesthetic management. We determined the color code. The blue-syringe contains local anesthetics; yellow-syringe, sympathomimetic drugs; and white-syringe with a red label fixed opposite the scale, muscle relaxants. The colored sheet displays the photographs of the syringe with drug name, dose and volume. The colored syringe and colored sheet were supplied for use from February 2004. We compared the incidence of syringe swaps during the period from February 2004 to January 2005 with that from February 2003 to January 2004. Although five syringe swaps were recorded from February 2003 to January 2004, in 5901 procedures, we encountered no syringe swaps from February 2004 to January 2005, in 6078 procedures. The colored syringe and colored sheet significantly decreased the incidence of syringe swaps during anesthetic management (P sheet together with colored syringes can prevent syringe swaps during anesthesia.
Ştefan Gheorghe PENTIUC
Full Text Available This information system was made for its use by the staff responsible for random distribution of cases to the courts. The Information System of Resolution of Procedural Incidents and Management of the Modifications Made to the Electronic Court Registration consists of three new developed modules: the management module is a Web application which chronicles the modifications made in the electronic court registration, regarding the random assignment of cases,the resolution of procedural incidents, which is a Web service whose logic implements a logic Semantic Web application and the module of confirming judges which is a windows service running on the judges’ workstations. The Web service implements a Semantic Web application which processes the knowledgebase achieved through OWL ontology (Ontology Web Language by applying inferences leading to the correct solution. If this does not solve the problem, a set of associated Jena rules are used to infer and generate new knowledge. It also uses the SPARQL(SPARQL Protocol and RDF Query Language language that allows queries on the knowledge,similar to the classic query languages of databases. The novelty of the new conceived, designed and implemented system consists in accessing the domain knowledge as a web service to solve the procedural incidents occurred in electronic court registration.
Leung, Mei-yung; Chan, Isabelle Yee Shan; Yu, Jingyu
Construction workers (CWs) are positioned at the lowest level of an organization and thus have limited control over their work. For this reason, they are often deprived of their due rewards and training or sometimes are even compelled to focus on production at the expense of their own safety. These organizational stressors not only cause the CWs stress but also impair their safety behaviors. The impairment of safety behaviors is the major cause of CW injury incidents. Hence, to prevent injury incidents and enhance safety behaviors of CWs, the current study aimed to identify the impact of various organizational stressors and stress on CW safety behaviors and injury incidents. To achieve this aim, we surveyed 395 CWs. Using factor analysis, we identified five organizational stressors (unfair reward and treatment, inappropriate safety equipment, provision of training, lack of goal setting, and poor physical environment), two types of stress (emotional and physical), and safety behaviors. The results of correlation and regression analyses revealed the following: (1) injury incidents were minimized by safety behaviors but escalated by a lack of goal setting, (2) safety behaviors were maximized by moderate levels of emotional stress (i.e., an inverted U-shape relationship between these two variables) and increased in line with physical stress and inappropriate safety equipment, (3) emotional stress was positively predicted by the provision of training and inappropriate safety equipment, and (4) physical stress was predicted only by inappropriate safety equipment. Based on these results, we suggest various recommendations to construction stakeholders on how to prevent CW injury incidents. Copyright © 2011 Elsevier Ltd. All rights reserved.
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.
Siebers, Peer-Olaf; Aickelin, Uwe; Celia, Helen; Clegg, Chris
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...
Yang Hailiang; Qiu Aici; Zhang Jiasheng; Huang Jianjun; Sun Jianfeng
The incident angles have a heavy effect on the intense pulsed electron beam energy deposition profile, energy deposition fraction and beam current transmission fraction in material. The author presents electron beam energy deposition profile and energy deposition fraction versus electron energy (0.5-2.0 MeV), at various incident angles for three aluminum targets of various thickness via theoretical calculation. The intense pulsed electron beam current transmission fractions versus electron energy (0.4-1.4 MeV) at various incident angles for three thickness of carbon targets were also theoretically calculated. The calculation results indicate that the deposition energy in unit mass of material surface layer increase with the rise of electron beam incident angle, and electron beam with low incident angle (closer to normal incident angle) penetrates deeper into the target material. The electron beams deposit more energy in unit mass of material surface layer at 60 degree-70 degree incident angle
Gagnon, David J; Nielsen, Niklas; Fraser, Gilles L
INTRODUCTION: Prophylactic antibiotics (PRO) reduce the incidence of early-onset pneumonia in comatose patients with structural brain injury, but have not been examined in cardiac arrest survivors undergoing targeted temperature management (TTM). We investigated the effect of PRO on the development...... of pneumonia in that population. METHODS: We conducted a retrospective cohort study comparing patients treated with PRO to those not receiving PRO (no-PRO) using Northern Hypothermia Network registry data. Cardiac arrest survivors ≥ 18 years of age with a GCS...-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...
Suskind, Anne M; Saigal, Christopher S; Hanley, Janet M; Lai, Julie; Setodji, Claude M; Clemens, J Quentin
To determine the incidence and characteristics of women with uncomplicated recurrent urinary tract infections (UTIs) and to explore whether the use of culture-driven treatment affects rates of UTI-related complications and resource utilization. Using MarketScan claims from 2003 to 2011, we identified UTI-naive women ages 18-64 with incident-uncomplicated recurrent UTIs. Recurrent UTIs were defined as 3 UTI visits associated with antibiotics during a 12-month period. Cases were excluded if they had a UTI in the preceding year, or if they had any complicating factors (eg, abnormality of the urinary tract, neurologic condition, pregnancy, diabetes, or currently taking immunosuppression). We next assessed use of urine cultures, imaging, and cystoscopy, and performed propensity score matching with logistic regression to determine whether having a urine culture associated with >50% of UTIs affected rates of complications and downstream resource utilization. We identified 48,283 women with incident-uncomplicated recurrent UTIs, accounting for an overall incidence of 102 per 100,000 women, highest among women ages 18-34 and 55-64. Sixty-one percent of these women had at least 1 urine culture, 6.9% had imaging, and 2.8% had cystoscopy. Having a urine culture >50% of the time was associated with fewer UTI-related hospitalizations and lower rates of intravenous antibiotic use, whereas demonstrating higher rates of UTI-related office visits and pyelonephritis. The incidence of uncomplicated recurrent UTIs increases with age. Urine culture-directed care is beneficial in reducing high-cost services including UTI-related hospitalizations and intravenous antibiotic use, making urine cultures a valuable component to management of these patients. Copyright © 2016 Elsevier Inc. All rights reserved.
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.
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)
Chaawa, Mohamed; Thabet, Inès; Hanachi, Chihab; Ben Said, Lamjed
Crises are complex situations due to the dynamism of the environment, its unpredictability and the complexity of the interactions among several different and autonomous involved organisations. In such a context, establishing an organisational view as well as structuring organisations' communications and their functioning is a crucial requirement. In this article, we propose a multi-agent organisational model (OM) to abstract, simulate and analyse a crisis management system (CMS). The objective is to evaluate the CMS from an organisational view, to assess its strength as well as its weakness and to provide deciders with some recommendations for a more flexible and reactive CMS. The proposed OM is illustrated through a real case study: a snowstorm in a Tunisian region. More precisely, we made the following contribution: firstly, we provide an environmental model that identifies the concepts involved in the crisis. Then, we define a role model that copes with the involved actors. In addition, we specify the organisational structure and the interaction model that rule communications and structure actors' functioning. Those models, built following the GAIA methodology, abstract the CMS from an organisational perspective. Finally, we implemented a customisable multi-agent simulator based on the Janus platform to analyse, through several performed simulations, the organisational model.
The intelligent infrastructure is often the most visible manifestation of intelligent transportation systems (ITS) along with roads, freeways, and incident management is often among the first ITS elements implemented. They can significantly contribut...
Mary A. Taber; Lisa M. Elenz; Paul G. Langowski
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...
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)
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
Zavisca, M.J.; Khatib-Rahbar, M.; Esmaili, H.; Schulz, R.
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)
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.
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
Lemieux, P.; Thorneloe, S.; Hayes, C.; Rodgers, M.; Christman, R.
Unique challenges exist for the handling, transport, and disposal of debris resulting from homeland security incidents, disasters or other national emergencies. Access to guidance for facilitating decision making in the safe and timely disposal of debris is critical to helping restore a community or region and prevent further contamination or spread of disease. For a radiological dispersal device (RDD) or other radiological incident, proper characterization of the quantity, properties, and level of contamination of debris and decontamination residue can have a significant impact on cleanup costs and timelines. A suite of decision support tools (DSTs) is being developed by the U.S. EPA's Office of Research and Development to assist individuals responsible for making decisions associated with handling, transport, treatment, and disposal of such debris. The DSTs are location-specific to help identify specific facilities and contacts for making final disposal decisions. The DSTs provide quick reference to technical information, regulations, and other information to provide decision makers with assistance in guiding disposal decisions that are important for the protection of public health, first responders, and the environment. This tool is being developed in partnership with other U.S. government agencies, EPA program offices, industry, and state and local emergency response programs. (authors)
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.
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
Ungkanont, Kitirat; Boonyabut, Panrasee; Komoltri, Chulaluk; Tanphaichitr, Archwin; Vathanophas, Vannipa
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.
The SRDB architecture is described in detail in . Database VBA VBA Runtime Data Sub run() SQL (“UPDATE Table SET Rank = 5”) Run_query_obj...FilterResources”) Algorithms ( VBA & SQL ) End Sub Arena Process Logic Figure 5: MARS V2 simulation architecture. The MARS managed readiness...database layer below it. Using VBA blocks, the algorithm layer can execute complex data operations on the database layer using SQL and can return
Klil-Drori, Adi J; Coulombe, Janie; Suissa, Samy; Hirsch, Andrew; Tagalakis, Vicky
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.
Yousef, Nadin; Yousef, Farah
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
Sze, San-Nah; Sek, Siaw-Ying Doreen; Chiew, Kang-Leng; Tiong, Wei-King
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.
Banba, Tsunetaka; Kimura, Hideo; Kamizono, Hiroshi; Tashiro, Shingo
Three grades of simulated high-level liquid waste (HLLW)-JW-A, JW-B, and JW-C - were proposed to be used respectively according to stages of various cold tests for safety assessment of HLW management. The composition of HLLW was estimated taking into account the spectrum of fission products and actinides, waste volume, corrosion products, and chemical additives. One of conditions, the spectrum of fission products and actinides of LWR spent fuels, was calculated by DCHAIN-code. Fuel burn-up of 28,000 MWD/tUO 2 and 33,000 MWD/tUO 2 were adopted as normal and maximum values of Japanese LWR power plants. The other conditions were estimated using the data obtained at Marcoule plant in France. (author)
Gonzalez M, J.A.; Santiago C, J.
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)
Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N
Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.
Full Text Available Bile leaks from the intrahepatic biliary tree are an important cause of morbidity following hepatic surgery and trauma. Despite reduction in mortality for hepatic surgery in the last 2 decades, bile leaks rates have not changed significantly. In addition to posted operative bile leaks, leaks may occur following drainage of liver abscess and tumor ablation. Most bile leaks from the intrahepatic biliary tree are transient and managed conservatively by drainage alone or endoscopic biliary decompression. Selected cases may require reoperation and enteric drainage or liver resection for management.
Degnan, Edward; Bozeman, William
Describes development of a computer-based simulation program for training school personnel in crisis management. Addresses the data collection and analysis involved in developing a simulated event, the systems requirements for simulation, and a case study of application and use of the completed simulation. (Contains 21 references.) (Authors/PKP)
Jaspreet Singh Parihar
Conclusions: BNC was identified in 1.6% of patients in our series following RARP. Intraoperative blood loss was a significant risk factor for BNC. In 20% of BNC patients a migrated foreign body was noted at vesicourethral anastomosis. Primary management of patients with BNC following RARP should be bladder neck incision and self CIC regimen.
Paul, Simone; Smith, Peter K.; Blumberg, Herbert H.
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…
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)
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
Loft, Shayne; Bowden, Vanessa; Braithwaite, Janelle; Morrell, Daniel B; Huf, Samuel; Durso, Francis T
The aim of this study was to examine whether the Situation Present Assessment Method (SPAM) and the Situation Awareness Global Assessment Technique (SAGAT) predict incremental variance in performance on a simulated submarine track management task and to measure the potential disruptive effect of these situation awareness (SA) measures. Submarine track managers use various displays to localize and track contacts detected by own-ship sensors. The measurement of SA is crucial for designing effective submarine display interfaces and training programs. Participants monitored a tactical display and sonar bearing-history display to track the cumulative behaviors of contacts in relationship to own-ship position and landmarks. SPAM (or SAGAT) and the Air Traffic Workload Input Technique (ATWIT) were administered during each scenario, and the NASA Task Load Index (NASA-TLX) and Situation Awareness Rating Technique were administered postscenario. SPAM and SAGAT predicted variance in performance after controlling for subjective measures of SA and workload, and SA for past information was a stronger predictor than SA for current/future information. The NASA-TLX predicted performance on some tasks. Only SAGAT predicted variance in performance on all three tasks but marginally increased subjective workload. SPAM, SAGAT, and the NASA-TLX can predict unique variance in submarine track management performance. SAGAT marginally increased subjective workload, but this increase did not lead to any performance decrement. Defense researchers have identified SPAM as an alternative to SAGAT because it would not require field exercises involving submarines to be paused. SPAM was not disruptive, but it is potentially problematic that SPAM did not predict variance in all three performance tasks. © 2014, Human Factors and Ergonomics Society.
Ceruti, Marion G; Wright, Tedd L; Wilcox, Dwight R; McGirr, Scott C
.... The focus of the simulation effort is on a hypothetical scenario designed to simulate how knowledge management technologies, such as ontologies and intelligent agents can be used to improve battle space awareness...
Maria Isabel do Nascimento
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.
Mill, W.B.; Griffith, R.
A retrospective review is reported of 128 patients presenting with multiple myeloma and 16 patients presenting with solitary plasmacytoma. Ninety-one percent of 116 evaluable patients treated for palliation of painful bone disease received some degree of subjective pain relief. The radiation dose most frequently prescribed was between 1500 and 2000 rad. Of the 278 ports treated, only 17 (6.1%) were re-treated to the same area at a later date. There was no increase in incidence of re-treatment with lower radiation doses. Ten of the 13 patients treated for a solitary plasmacytoma with a minimum follow-up period of three years have local tumor control. The median survival in the solitary plasmacytomas is five and one-half years. Data from the literature on 27 additional solitary plasmacytomas combined with our data suggest an improved local control and a decrease in dissemination with doses greater than 5000 rad. It is concluded that low doses of radiation are usually adequate to treat painful bone lesions of multiple myeloma and doses of 5000 to 6500 rad in six to seven weeks are recommended for solitary plasmacytomas.
Gustafsson, Finn; Schou, Morten; Videbaek, Lars
AND RESULTS: A total of 4012 consecutive outpatients referred for HF management in 18 Danish HF clinics were included. Clinical data were collected prospectively. Outcome data were obtained from a validated, national registry. Mean follow-up time was 580 days. The mean age of patients was 69 years, 83% had...... creatinine 1.03 (1.02-1.04), NYHA III and IV 1.32 (1.15-1.52), and hospitalization prior to referral to the HF clinic 1.81 (1.57-2.08). CONCLUSIONS: Event rates in this cohort were lower than most published data from HF clinic populations. Factors such as advanced age, NYHA class, and prior hospitalization...... predict poor outcome in patients managed in multidisciplinary HF clinics....
Wilke, Iris; Witzel, Katrin; Münch, Julia; Pecha, Simon; Blankenberg, Stephan; Reichenspurner, Hermann; Willems, Stephan; Patten, Monica; Aydin, Ali
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.
Olmedilla-Zafra, Aurelio; Rubio, Victor J; Ortega, Enrique; García-Mas, Alexandre
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 youth soccer 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.
Rayane Oliveira Cedraz
Full Text Available Abstract Objective: To evaluate the incidence and risk factors associated with falls and pressure injuries in a clinical unit. Methods: A quantitative, cross-sectional, descriptive-exploratory study was conducted at a university hospital in Rio de Janeiro using secondary data from patient records and information of registers of patients treated in 2015/2016. Data were analyzed using descriptive and inferential statistics. Results: Of the 157 treated patients, women, cardiovascular (43.9% and oncological diseases (35.0% predominated. The risk and incidences of falls and pressure injuries were higher in men. There were significant associations of gender with the risk of falling, the occurrence of falls and pressure injuries, and between the length of hospital stay and risk of falling. Conclusion: Risk management is essential to promote patient safety and improve quality of health care. Nurse staff plays a fundamental role in the process of guiding activities, updating the nursing team and evaluating interventions. The use of tools, such as protocols and indicators, allows the optimization of the work process and the achievement of these goals.
Dana Maria Staňková
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.
Heun, J. C.; Schotanus, T. D.; de Groen, M. M.; Werner, M.
The Simulation Tool for River Management (STORM), based on the River Rhine case, aims to provide insight into river and floodplain management, by (1) raising aware- ness of river functions, (2) exploring alternative strategies, (3) showing the links be- tween natural processes, spatial planning, engineering interventions, river functions and stakeholder interests, (4) facilitating the debate between different policy makers and stakeholders from across the basin and (5) enhancing co-operation and mutual un- derstanding. The simulation game is built around the new concepts of SRoom for the & cedil;RiverT, Flood Retention Areas, Resurrection of former River Channels and SLiving & cedil;with the FloodsT. The Game focuses on the Lower and Middle Rhine from the Dutch Delta to Maxau in Germany. Influences from outside the area are included as scenarios for boundary conditions. The heart of the tool is the hydraulic module, which calcu- lates representative high- and low water-levels for different hydrological scenarios and influenced by river engineering measures and physical planning in the floodplains. The water levels are translated in flood risks, navigation potential, nature development and land use opportunities in the floodplain. Players of the Game represent the institutions: National, Regional, Municipal Government and Interest Organisations, with interests in flood protection, navigation, agriculture, urban expansion, mining and nature. Play- ers take typical river and floodplain engineering, physical planning and administrative measures to pursue their interests in specific river functions. The players are linked by institutional arrangements and budgetary constraints. The game particularly aims at middle and higher level staff of local and regional government, water boards and members of interest groups from across the basin, who deal with particular stretches or functions of the river but who need (1) to be better aware of the integrated whole, (2) to
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.
Hauschild, Veronique D; Watson, Annetta; Bock, Robert
To provide specific guidance and resources for systematic and orderly decontamination of human remains resulting from a chemical terrorist attack or accidental chemical release. A detailed review and health-based decision criteria protocol is summarized. Protocol basis and logic are derived from analyses of compound-specific toxicological data and chemical/physical characteristics. Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present, such as sites of transportation accidents, terrorist operations, or medical examiner processing points. Guidance is developed from data-characterizing controlled experiments with laboratory animals, fabrics, and materiel. Logic and specific procedures for decontamination and management of remains, protection of mortuary affairs personnel, and decision criteria to determine when remains are sufficiently decontaminated are presented. Established procedures as well as existing materiel and available equipment for decontamination and verification provide reasonable means to mitigate chemical hazards from chemically exposed remains. Unique scenarios such as those involving supralethal concentrations of certain liquid chemical warfare agents may prove difficult to decontaminate but can be resolved in a timely manner by application of the characterized systematic approaches. Decision criteria and protocols to "clear" decontaminated remains for transport and processing are also provided. Once appropriate decontamination and verification have been accomplished, normal procedures for management of remains and release can be followed.
Veronesi, Paolo; De Lorenzi, Francesca; Loschi, Pietro; Rietjens, Mario; Veronesi, Umberto
Breast augmentation is the most common cosmetic surgery in the United States, and thousands of augmented patients develop breast cancer each year. The possible effects of implants on cancer incidence, diagnosis, and treatment usually generate a disarming confusion. The present paper represents an update of the more recent oncologic and surgical strategies, aiming to support plastic and general surgeons in such challenging aspects. Several aspects of breast cancer management in augmented women are investigated, including (1) risk estimation and cancer characteristics, stage at diagnosis, and prognosis; (2) cancer diagnosis with clinical examination, mammography, ultrasound, and magnetic resonance imaging; (3) cancer treatment including breast conservation, intraoperative radiotherapy, sentinel node biopsy and mastectomy, and reconstruction. A brief resume of recommendations and conclusions is suggested, elucidating correct trends in the oncologic management of augmented patients and refusing well-established misconceptions: (1) breast augmentation does not increase the risk of breast cancer incidence, and it does not influence the prognosis; (2) possible risks exist in cancer detection due to technical difficulties; (3) sentinel lymph node detection is feasible; (4) intraoperative radiotherapy represents a good chance for conserving treatment; (5) immediate reconstruction with submuscular-subfascial implants is the most common procedure after mastectomy, and biological substitutes could support this procedure. Breast clinicians should be alerted because of high expectations of this subgroup of patients, accustomed to emphasize the aesthetic result. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Jones, M.; Pitts, R.
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
Hartman, Nathan S.; Watts, Charles A.; Treleven, Mark D.
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…
Haq, M.I.; Tahir, M.I.; Mahmood, S.
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)
Carrera, J P; Easter, J R; Roth, E M [Westinghouse Electric Corp., Pittsburgh, PA (United States)
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.
Carrera, J.P.; Easter, J.R.; Roth, E.M.
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
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.
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.
Loon, Mark; Evans, Jason; Kerridge, Clive
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...
Okura, Tsuyoshi; Teramoto, Kei; Koshitani, Rie; Fujioka, Yohei; Endo, Yusuke; Ueki, Masaru; Kato, Masahiko; Taniguchi, Shin-Ichi; Kondo, Hiroshi; Yamamoto, Kazuhiro
Frequent glucose measurements are needed for good blood glucose control in hospitals; however, this requirement means that measurements can be forgotten. We developed a novel glucose management system using an iPod ® and electronic health records. A time schedule system for glucose measurement was developed using point-of-care testing, an iPod ® , and electronic health records. The system contains the glucose measurement schedule and an alarm sounds if a measurement is forgotten. The number of times measurements were forgotten was analyzed. Approximately 7000 glucose measurements were recorded per month. Before implementation of the system, the average number of times measurements were forgotten was 4.8 times per month. This significantly decreased to 2.6 times per month after the system started. We also analyzed the incidence of forgotten glucose measurements as a proportion of the total number of measurements for each period and found a significant difference between the two 9-month periods (43/64,049-24/65,870, P = 0.014, chi-squared test). This computer-based blood glucose monitoring system is useful for the management of glucose monitoring in hospitals. Johnson & Johnson Japan.
Barber, John P.; Johnston, Kyle B.; Daigle, Matthew
Simulations serve as important tools throughout the design and operation of engineering systems. In the context of sys-tems health management, simulations serve many uses. For one, the underlying physical models can be used by model-based health management tools to develop diagnostic and prognostic models. These simulations should incorporate both nominal and faulty behavior with the ability to inject various faults into the system. Such simulations can there-fore be used for operator training, for both nominal and faulty situations, as well as for developing and prototyping health management algorithms. In this paper, we describe a methodology for building such simulations. We discuss the design decisions and tools used to build a simulation of a cryogenic fluid test bed, and how it serves as a core technology for systems health management development and maturation.
Vincent Chi-Chung Cheng
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.
Pankowski, Jennifer; Walker, Joan T.
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…
Behrman, Stephen W; Zarzaur, Ben L
Intra-abdominal sepsis (IAS) following pancreatectomy is associated with the need for therapeutic intervention and may result in mortality. We retrospectively reviewed patients developing IAS following elective pancreatectomy. Risk factors for the development of sepsis were assessed. The microbiology of these infections was ascertained. The number and type of therapeutic interventions required and infectious-related mortality were recorded. One hundred ninety-six patients had a pancreatectomy performed, 32 (16.3%) of who developed IAS. Infected abdominal collections were diagnosed and therapeutically managed at a mean of 11.8 days after the index procedure (range, 4-33). Eleven of 32 (34%) of these infections were diagnosed on or before postoperative day 6, 10 of who had Whipple procedures. Statistically significant risk factors included an overt pancreatic fistula (18.8% vs 5.5%) and a soft pancreatic remnant (74.2% vs 42.3%), but not the lack of intra-abdominal drainage, an antecedent immunocompromised state, postoperative hemorrhage, or the preoperative placement of a biliary stent. Fifty-five per cent had polymicrobial infections and 26 per cent of isolates were resistant organisms. Nineteen per cent and 48 per cent of patients had an isolate positive for fungus and a Gram-positive organism, respectively. Forty-seven therapeutic interventions were used, including 10 reoperations. Length of stay was significantly prolonged in those with IAS (28.5 vs 15.2 days) and mortality was higher (15.6% vs 1.8%). We conclude: 1) septic morbidity after pancreatectomy is associated with a soft pancreatic remnant and an overt pancreatic fistula and in this series resulted in a prolonged length of stay and a significant increase in procedure-related mortality; 2) infected fluid collections may occur very early in the postoperative period before frank abscess formation, and an early threshold for diagnostic imaging and/or therapeutic intervention should be entertained in those
Vocational education should prepare students for the professional demands of the work. In police education, one way to accomplish this is to simulate specific situations so that students may develop professional knowledge. This article aims to increase the understanding of how simulations support learning of knowledge and skills by investigating…
Kachko, Ludmyla; Ben Ami, Shiri; Lieberman, Alon; Shor, Rita; Tzeitlin, Elena; Efrat, Rachel
Chronic pain in children and adolescents is common, but proportion of neuropathic pain (NP), a heterogeneous group of diseases with major impact on health-related quality of life, significant economic burden, and limited treatment options, is unclear. Many studies have focused only on complex regional pain syndrome (CRPS). Our aim was to examine the incidence, clinical features, management, and outcome of non-CRPS NP in patients referred to a chronic pediatric pain clinic (CPPC) at a tertiary-care hospital. Retrospective analyses of the patient's files with non-CRPS NP from 2008 until 2012. Twenty patients (9.9-22.0 years; 10.7% of new referrals) were treated with non-CRPS NP (postoperative 8/20, trauma-related 5/20, disease-related 7/20). The number of consultations performed and the number of medications used before CPPC were significantly higher than in CPPC (Z = 0.75, P = 0.005; Z = 1.68, P = 0.003; respectively, Wilcoxon test). The number of diagnostic procedures was not statistically significant. Invasive treatments were used in 50% of patients. Full/partial recovery was accomplished in 95%. anova with repeated measures yielded a highly significant difference between the initial and final visual analog scale (VAS) scores (8.2 ± 1.3; 1.19 ± 2.01, respectively; P CRPS NP is crucial to timely and correct diagnosis and effective management, but even children with delayed diagnosis still have a good outcome. The management of this condition by an experienced team is recommended. © 2014 John Wiley & Sons Ltd.
Miller, B. W.; Schuurman, G. W.; Symstad, A.; Fisichelli, N. A.; Frid, L.
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
Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter
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.
Pignat, J.; Daillant, J.; Cantin, S.; Perrot, F.; Konovalov, O.
We have analyzed grazing incidence X-ray diffraction (GIXD) data from condensed phases of Langmuir films of long-chain fatty acids at the air-water using a new method consisting in a careful extraction of the structure factors followed by fitting of molecular parameters using simulated annealing. We show that the information contained in GIXD spectra is enough to obtain near-atomic structural information. In particular, we directly determine the orientation of the chain backbone planes and of the carboxylic headgroups, and we evaluate chain conformation defects
Pignat, J. [LIONS/Service de Chimie Moleculaire, CEA-Saclay bat. 125, F-91191 Gif-sur-Yvette Cedex (France); LPPI, universite de Cergy-Pontoise, 5 mail Gay-Lussac Neuville/Oise, 95031 Cergy-Pontoise Cedex (France); Daillant, J. [LIONS/Service de Chimie Moleculaire, CEA-Saclay bat. 125, F-91191 Gif-sur-Yvette Cedex (France)]. E-mail: firstname.lastname@example.org; Cantin, S. [LPPI, universite de Cergy-Pontoise, 5 mail Gay-Lussac Neuville/Oise, 95031 Cergy-Pontoise Cedex (France); Perrot, F. [LPPI, universite de Cergy-Pontoise, 5 mail Gay-Lussac Neuville/Oise, 95031 Cergy-Pontoise Cedex (France); Konovalov, O. [ESRF, 6 rue Jules Horowitz, BP220, 38043 Grenoble Cedex (France)
We have analyzed grazing incidence X-ray diffraction (GIXD) data from condensed phases of Langmuir films of long-chain fatty acids at the air-water using a new method consisting in a careful extraction of the structure factors followed by fitting of molecular parameters using simulated annealing. We show that the information contained in GIXD spectra is enough to obtain near-atomic structural information. In particular, we directly determine the orientation of the chain backbone planes and of the carboxylic headgroups, and we evaluate chain conformation defects.
Mira, José Joaquín; Vicente, Maria Asuncion; Fernandez, Cesar; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora
Background 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. Objective 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. Methods 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. Results 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). Conclusions 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. PMID:27678308
Carrillo, Irene; Mira, José Joaquín; Vicente, Maria Asuncion; Fernandez, Cesar; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora
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.
Graeser, Karin; Konge, Lars; Kristensen, Michael S
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...
the occurrence of ANS impacts (Yes or No) from freshwater algae, large aquatic plants, fish, zebra mussels, Asiatic clams, water fleas, crayfish...2005. Freshwater aquatic nuisance species impacts and management costs and benefits at federal water resources projects. ERDC/TN ANSRP-06-3...ER D C/ EL T R- 10 -1 3 Aquatic Nuisance Species Research Program Incidence and Management Costs of Freshwater Aquatic Nuisance Species
Berger, Ferco H.; Körner, Markus; Bernstein, Mark P.; Sodickson, Aaron D.; Beenen, Ludo F.; McLaughlin, Patrick D.; Kool, Digna R.; Bilow, Ronald M.
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
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.)
Lemieux, P.; Wood, J.; Snyder, E. [U.S. Environmental Protection Agency, Research Triangle Park, NC (United States); Boe, T. [Oak Ridge Inst. for Science and Education, Research Triangle Park, NC (United States); Schulthiesz, D.; Peake, T.; Ierardi, M. [U.S. Environmental Protection Agency, Washington, DC (United States); Hayes, C.; Rodgers, M. [Eastern Research Group, Inc., Morrisville, NC (United States)
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)
Lemieux, P.; Wood, J.; Snyder, E.; Boe, T.; Schulthiesz, D.; Peake, T.; Ierardi, M.; Hayes, C.; Rodgers, M.
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)
Oh, Se Jin; Song, Ho-Young; Nam, Deok Ho; Ko, Heung Kyu; Park, Jung-Hoon; Na, Han Kyu; Lee, Jong Jin; Kang, Min Kyoung
Placement of self-expandable nitinol stents is useful for the treatment of esophageal and upper gastrointestinal (GI) obstruction. However, complications such as stent migration, tumor overgrowth, and bleeding occur. Although stent migration and tumor overgrowth are well documented in previous studies, the occurrence of bleeding has not been fully evaluated. To evaluate the incidence, management strategies, and predictors of bleeding after placement of self-expandable nitinol stents in patients with esophageal and upper GI obstruction. We retrospectively reviewed the medical records and results of computed tomography and endoscopy of 1485 consecutive patients with esophageal and upper GI obstructions who underwent fluoroscopically guided stent placement. Bleeding occurred in 25 of 1485 (1.7%) patients 0 to 348 days after stent placement. Early stent-related bleeding occurred in 10 patients (40%) and angiographic embolization was used for 5/10. Late bleeding occurred in 15 patients (60%) and endoscopic hemostasis was used for 7/15. Twenty-two of 25 (88%) patients with bleeding had received prior radiotherapy and/or chemotherapy. Bleeding is a rare complication after placement of expandable nitinol stents in patients with esophageal and upper GI obstruction, but patients with early bleeding may require embolization for control. Care must be exercised on placing stents in patients who have received prior radiotherapy or chemotherapy. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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
Kim, K. R.; Park, S. H.; Kim, D. H.
Recently KAERI has developed severe accident management guidance to establish Korea standard severe accident management system. On the other hand PC-based severe accident training simulator SATS has been developed, which uses MELCOR computing code as the simulation engine. SATS graphically displays and simulates the severe accident progression with interactive user inputs. The control capability of SATS makes a severe accident training course more interesting and effective. In this paper the development and functions of HyperKAMG module are explained. Furthermore easiness and effectiveness of the HyperKAMG-SATS system in severe accident management are described
Storm, J.; Goemann, A.
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
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.
Van Eeckhout, E.; Roberts, D.; Oakes, R.; Shieh, A.; Hardie, W.; Pope, P.
The two primary modules of Envirosim (the model of Los Alamos TA-55 and the WIPP transport/storage model) have been combined into one application, with the simulated waste generated by TA-55 operations being fed to storage, packaging, and transport simulation entities. Three simulation scenarios were executed which demonstrate the usefulness of Envirosim as a policy analysis tool for use in planning shipments to WIPP. A graphical user interface (GUI) has been implemented using IDL (Interactive Data Language) which allows the analyst to easily view simulation results. While IDL is not necessarily the graphics interface that would be selected for a production version of Envirosim, it does provide some powerful data manipulation capabilities, and it runs on a variety of platforms
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 ...
Bazeli, Javad; Aryankhesal, Aidin; Khorasani-Zavareh, Davoud
Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding. Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims. It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.
Walker, W.E.; Giddings, J.; Armstrong, S.
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
Konstantopoulos, Nikolaos; Bekiaris, Michail G.; Zounta, Stella
The aim of this paper is to examine the factors which determine the problems and the advantages on the design of management accounting information systems (MAIS). A simulation is carried out with a dynamic model of the MAIS design.
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.
Miller, Brian W.; Symstad, Amy J.; Frid, Leonardo; Fisichelli, Nicholas A.; Schuurman, Gregor W.
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
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
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
Gradel, Maximilian; Moder, Stefan; Nicolai, Leo; Pander, Tanja; Hoppe, Boj; Pinilla, Severin; Von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos
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
Liaw, S. Y.; Chen, F. G.; Klainin, P.; Brammer, J.; O'Brien, A.; Samarasekera, D. D.
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…
Webb, G. Scott; Thomas, Stephanie P.; Liao-Troth, Sara
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…
Coggi, J. V.; Clonts, S. E.
This paper discusses the computer simulation of the Integrated Waste Management-Water System Using Radioisotopes for Thermal Energy (RITE) and applications of the simulation. Variations in the system temperature and flows due to particular operating conditions and variations in equipment heating loads imposed on the system were investigated with the computer program. The results were assessed from the standpoint of the computed dynamic characteristics of the system and the potential applications of the simulation to system development and vehicle integration.
M.C. Smith; W.G. Knisel; J.L. Michael; D.G. Neary
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...
Borst, S.C.; Grandhi, S.A.; Kahn, C.L.; Kumaran, K.; Lubachevsky, B.D.; Sand, D.M.
Wireless service providers are continually looking for new features and products to improve quality of service, increase system capacity, and reduce administrative overhead. The simulation tool W provides a flexible platform for the exploration of a broad range of system-level design and performance
management of acute incidents and the prevention of ... High or total (complete) spinal blocks in obstetric .... Pain and opioid analgesics lead to delayed ... Step up postoperative care and use ... recognise suprasternal and supraclavicular.
Sun, Yanxia; Pan, Chuxiong; Li, Tianzuo; Gan, Tong J
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.
This article focuses on the incidence, predictors, classification, impact on prognosis, and management of bleeding associated with the treatment of acute coronary syndrome. The issue of bleeding complications is related to the continual improvement of ischemic heart disease treatment, which involves mainly (a) the widespread use of coronary angiography, (b) developments in percutaneous coronary interventions, and (c) the introduction of new antithrombotics. Bleeding has become an important health and economic problem and has an incidence of 2.0% to 17%. Bleeding significantly influences both the short- and long-term prognoses. If a group of patients at higher risk of bleeding complications can be identified according to known risk factors and a risk scoring system can be developed, we may focus more on preventive measures that should help us to reduce the incidence of bleeding. PMID:24093465
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.
Lavelle, Mary; Attoe, Chris; Tritschler, Christina; Cross, Sean
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
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...
Dennis P. Dykstra; Robert A. Monserud
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...
Wu, Ko-Chiu; Huang, Po-Yuan
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…
Carhart, Elliot D.
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…
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
Pastoors, M.A.; Poos, J.J.; Kraak, S.B.M.; Machiels, M.A.M.
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
Antti Makinen; Jouni Kalliovirta; Jussi Rasinmaki
Late developments in the objectives and the data collection methods of forestry create new challenges and possibilities in forest management planning. Tools in forest management and forest planning systems must be able to make good use of novel data sources, use new models, and solve complex forest planning tasks at different scales. The SIMulation and Optimization (...
Bhandari, Ammar B; Nelson, Nathan O; Sweeney, Daniel W; Baffaut, Claire; Lory, John A; Senaviratne, Anomaa; Pierzynski, Gary M; Janssen, Keith A; Barnes, Philip L
Process-based computer models have been proposed as a tool to generate data for Phosphorus (P) Index assessment and development. Although models are commonly used to simulate P loss from agriculture using managements that are different from the calibration data, this use of models has not been fully tested. The objective of this study is to determine if the Agricultural Policy Environmental eXtender (APEX) model can accurately simulate runoff, sediment, total P, and dissolved P loss from 0.4 to 1.5 ha of agricultural fields with managements that are different from the calibration data. The APEX model was calibrated with field-scale data from eight different managements at two locations (management-specific models). The calibrated models were then validated, either with the same management used for calibration or with different managements. Location models were also developed by calibrating APEX with data from all managements. The management-specific models resulted in satisfactory performance when used to simulate runoff, total P, and dissolved P within their respective systems, with > 0.50, Nash-Sutcliffe efficiency > 0.30, and percent bias within ±35% for runoff and ±70% for total and dissolved P. When applied outside the calibration management, the management-specific models only met the minimum performance criteria in one-third of the tests. The location models had better model performance when applied across all managements compared with management-specific models. Our results suggest that models only be applied within the managements used for calibration and that data be included from multiple management systems for calibration when using models to assess management effects on P loss or evaluate P Indices. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.
It is very important for nurses to have a clear understanding of the patient's pain experience and of management strategies. However, a review of the nursing literature shows that one of the main barriers to proper pain management practice is lack of knowledge. Nursing schools are in a unique position to address the gap in pain management knowledge by facilitating the acquisition and use of knowledge by the next generation of nurses. The purpose of this article is to discuss the role of computer-based simulations as a reliable educational technology strategy that can enhance the learning experience of nursing students acquiring pain management knowledge and practice. Computer-based simulations provide a significant number of learning affordances that can help change nursing students' attitudes and behaviors toward and practice of pain assessment and management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Machado, José A. F.
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.
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
McKenna, Lisa; Missen, Karen; Cooper, Simon; Bogossian, Fiona; Bucknall, Tracey; Cant, Robyn
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.
Yakura, Haruna; Kurimasa, Akihiro
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)
Prothero, W. A.
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
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.
Bereznai, G.; Rizk, K., E-mail: email@example.com, E-mail: firstname.lastname@example.org [Univ. of Ontario Inst. of Technology, Oshawa, ON (Canada)
Technical managers of Canada's nuclear power plants are required to have in-depth knowledge of the normal and abnormal integrated unit operations typical of the plant at which they work. The Advanced Operations Overview for Managers (AOOM) training program was developed by Ontario Power Generation to fulfil this need for many of its managers. The program makes extensive use of 'classroom' simulators that have the same software models as the full-scope training simulators, but use graphical user interface to replicate the control room devices. For the last several years the AOOM program has been delivered by the University of Ontario Institute of Technology. (author)
Bereznai, G.; Rizk, K.
Technical managers of Canada's nuclear power plants are required to have in-depth knowledge of the normal and abnormal integrated unit operations typical of the plant at which they work. The Advanced Operations Overview for Managers (AOOM) training program was developed by Ontario Power Generation to fulfil this need for many of its managers. The program makes extensive use of 'classroom' simulators that have the same software models as the full-scope training simulators, but use graphical user interface to replicate the control room devices. For the last several years the AOOM program has been delivered by the University of Ontario Institute of Technology. (author)
Callantine, Todd J.; Hunt, Sarah M.; Prevot, Thomas
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.
Ciporen, Jeremy; Gillham, Haley; Noles, Michele; Dillman, Dawn; Baskerville, Mark; Haley, Caleb; Spight, Donn; Turner, Ryan C; Lucke-Wold, Brandon P
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.
Hedlund, Frank Huess
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...... of their positive impact on OHS. It is clear though, that such systems cannot substitute authority enforcement activities.......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...
Hubble, Michael W; Richards, Michael E; Wilfong, Denise
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
Malakooti, Marcelo R.; McBride, Mary E.; Mobley, Bonnie; Goldstein, Joshua L.; Adler, Mark D.; McGaghie, William C.
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
Full Text Available This paper relates the experience that students have while accessing Virtual Property Manager (VPM, a Web-based simulation learning tool designed to introduce students to a new discipline being offered at the university – Residential Property Management. The VPM simulation was designed in part to develop student interest in the new program. Results indicate that this simple simulation device did make a notable impact on student interest. Additionally, student acceptance and self-reported impact differed significantly based upon the delivery context. Adding a competitive reward element to the simulation experience improved student's evaluation of the software and self-reported interest in the field. Results indicate that educational simulation evaluation, acceptance, and performance may often be substantially influenced by the delivery context, rather than simply the program itself. Developers may do well to focus "outside the box" of program content to promote audience-specific delivery environments.
Christiansen, Sytter; Rethmeier, Anita
Background: The Danish Society for Wound Healing advocates for the use of telemedicine in chronic wound management. It is crucial that student nurses are prepared for the technological demands of the future so that they will be competent to manage chronic wounds. Aim: The aim of this project...... was to integrate the concept of telemedicine for wound care into a simulation-based class for undergraduate student nurses and to evaluate their experiences with this integrated learning method. Methods: Five medium-fidelity mannequins were used in a simulated learning environment consisting of a simulated......, the simulated learning environment seems to be a constructive didactic method. The simulated learning environment should also be tested with postgraduate nurses with less experience in telemedicine....
This guide presents the essential topics to be developed in a management plan for incidents and accidents involving the transport of radioactive substances for civil use. It does not aim to be exhaustive and could be added to by each party involved in the transport, who can make the necessary adaptations and additions, taking account of the particularities of its shipments and its organisation, as well as those of the company or group to which it belongs. The radioactive substances transport incident and accident management plan is a document comprising a descriptive part and an operational part. It presents the overall response of the party involved in the transport operation to an incident or accident situation concerning one of its shipments and the steps it intends to make in order to support the authorities in charge of this situation, in the best possible conditions. This response is designed to cover the cases of incidents or accidents whether or not they lead to a radiological emergency situation. The guide exclusively concerns: - road transport; - rail transport; - the 'road' and 'rail' parts of multimodal transport operations. The case of an incident or an accident occurring during a particular stop such as a transit site, in a transhipment area (port, airport, railway station, etc.), or in a transport infrastructure, is also covered by the radioactive substances transport incident and accident management plan, which then supports the entities in charge of managing this situation (operator of the transhipment area or the transport infrastructure and - as applicable - their supervisory authorities). The level of risk associated with transport incidents and accidents varies widely, according to the nature and quantities of the materials being carried, the number of shipments made and the package model used. The incident and accident management plan must therefore be tailored to the specific nature of the shipments by the party concerned. The radioactive
Dunscombe, Peter B.; Iftody, Sandra; Ploquin, Nicolas; Ekaette, Edidiong U.; Lee, Robert C.
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
Blancher, Marc; Albasini, François; Elsensohn, Fidel; Zafren, Ken; Hölzl, Natalie; McLaughlin, Kyle; Wheeler, Albert R; Roy, Steven; Brugger, Hermann; Greene, Mike; Paal, Peter
Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas. Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue. We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents. General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings. Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.
Gupta, Pankaj; Guha, Ratan K.
In this paper, we propose an algorithm for reducing the complexity of region matching and efficient multicasting in data distribution management component of High Level Architecture (HLA) Run Time Infrastructure (RTI). The current data distribution management (DDM) techniques rely on computing the intersection between the subscription and update regions. When a subscription region and an update region of different federates overlap, RTI establishes communication between the publisher and the subscriber. It subsequently routes the updates from the publisher to the subscriber. The proposed algorithm computes the update/subscription regions matching for dynamic allocation of multicast group. It provides new multicast routines that exploit the connectivity of federation by communicating updates regarding interactions and routes information only to those federates that require them. The region-matching problem in DDM reduces to clique-covering problem using the connections graph abstraction where the federations represent the vertices and the update/subscribe relations represent the edges. We develop an abstract model based on connection graph for data distribution management. Using this abstract model, we propose a heuristic for solving the region-matching problem of DDM. We also provide complexity analysis of the proposed heuristics.
Piacentino, Massimo; Pilleri, Manuela; Bartolomei, Luigi
Device-related infection is a common occurrence after deep brain stimulation (DBS) surgery, and may result in additional interventions and a loss of efficacy of therapy. This retrospective review aimed to evaluate the incidence, severity and management of device-related infections in 212 DBS procedures performed in our institute. Data on 106 patients, in whom 212 DBS procedures were performed between 2001 and 2011 at our institute by a single neurosurgeon (M.P.), were reviewed to assess the incidence, severity, management and clinical characteristics of infections in the first year after the implantation of a DBS system. Infections occurred in 8.5% of patients and 4.2% of procedures. Of the nine infections, eight involved the neurostimulator and extensions, and one the whole system. The infections occurred 30.7 days after implantation: 7 within 30 days and 2 within 6 months. Infected and uninfected patients were comparable in terms of age, sex, indication for DBS implantation and neurostimulator location. In eight cases, the system components involved were removed and re-implanted after 3 months, while in one case the complete hardware was removed and not re-implanted. The overall incidence of postoperative infections after DBS system implantation was 4.2%; this rate decreased over time. All infections required further surgery. Correct and timely management of partial infections may result in successful salvage of part of the system.
We first carried out a pilot investigation, the aims of which were twofold, the development of suitable methods and the provision of evidence that these methods bring us nearer to the aims of the plan as a whole; the deduction of initial ideas for ergonomic improvements, since this BMFT program is application-oriented and is not a basic program. To the best of our knowledge, our investigation is the only one in which experienced nuclear power plant operators (operations staff) were observed during their handling of an unknown failure situation on a full simulator. During this investigation, the currently most promising methods for the analysis of strategies for the organization and solution of problems were applied, which comprise the interaction (particularly verbal) between the operators of a team with simultaneous video recording. (orig./GL) [de
Mohrmann, Bjoern; Jeck, Peter [Institut fuer Kraftfahrzeuge Aachen (Germany); Simon, Carsten [fortiss GmbH, Muenchen (Germany); Ungermann, Jochen [Audi AG, Ingolstadt (Germany)
The project eperformance, which is funded by the BMBF, is conducted by project partners from RWTH Aachen, Audi, Bosch Engineering and fortiss GmbH, in order to demonstrate the concept of an electric vehicle on the basis of a holistic development approach. To support this, several simulation platforms come into use, i.e. CFD Simulation for cooling concepts, electromagnetic simulations for electric machine design, physical simulation of cooling circuits as well as vehicle mechanics and controller design. To develop an energy efficient vehicle management, some of these simulation domains have to be combined, to simulate interdependencies between for example usage of high-voltage batteries, their thermal response and the impact for controller strategies. Within the project it was decided to use the Tool TISC (TLK Inter Software Connector) to combine as well a physical model, based on Modelica/Dymola to simulate thermal behaviours of components with a longitudinal vehicle model and a controller model, both based in MATLAB/Simulink. Advantages of such a coupled simulation are the re-usability of existing models in both tools with their tool-specific benefits as well as the possibility to cluster the models on different computers. The article will explain how the combined simulation is set up and parameterized, and will show two use cases: the thermal management of the two independent battery systems of the demonstrator vehicle and the torque distribution on the three electric machines in the vehicle, depending on the drive situation and the thermal state of the machines. (orig)
Haas, Timothy C
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...
Foraz, K; CERN. Geneva; CERN. Geneva. TS Department
The main families of LHC superconducting cryomagnets consist of approximately 1240 cryodipoles and 480 Short Straight Sections (SSS). The different contracts, which are constraining the production and installation of these cryomagnets, have been initially rated according to the baseline schedule, based on a "just in time" scheme. However the complexity of the construction and the time required to fully test the cryomagnets require that each contract is decoupled as much as possible from the others' evolutions and impose temporary storage between different assembly and test activities. Therefore, a tool simulating the logistics over the whole duration of the project was created in order to determine the number of cryomagnets to be stored at the various stages of their production. In this paper the organization of cryomagnet flow and the main challenges of logistics are analyzed on the basis of the planning of each main step before installation in the LHC. Finally, the solutions implemented for storage, handlin...
Fisher, Nelli; Bernstein, Peter S; Satin, Andrew; Pardanani, Setul; Heo, Hye; Merkatz, Irwin R; Goffman, Dena
To compare eclampsia and magnesium toxicity management among residents randomly assigned to lecture or simulation-based education. Statified by year, residents (n = 38) were randomly assigned to 3 educational intervention groups: Simulation→Lecture, Simulation, and Lecture. Postintervention simulations were performed for all and scored using standardized lists. Maternal, fetal, eclampsia management, and magnesium toxcity scores were assigned. Mann-Whitney U, Wilcoxon rank sum and χ(2) tests were used for analysis. Postintervention maternal (16 and 15 vs 12; P < .05) and eclampsia (19 vs 16; P < .05) scores were significantly better in simulation based compared with lecture groups. Postintervention magnesium toxcitiy and fetal scores were not different among groups. Lecture added to simulation did not lead to incremental benefit when eclampsia scores were compared between Simulation→Lecture and Simulation (19 vs 19; P = nonsignificant). Simulation training is superior to traditional lecture alone for teaching crucial skills for the optimal management of both eclampsia and magnesium toxicity, 2 life-threatening obstetric emergencies. Published by Mosby, Inc.
Roßmann, J.; Hoppen, M.; Bücken, A.
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.
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.
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.
Urban transport is a comprehensive and dynamic mechanism. Therefore, all the problems for improving and reorganization of the system can be examined only in the light of a systemic approach. Currently, public passenger transport is one of the most important branches of the urban development in cities and metropolis. Public passenger transport activity and all the steps taken to improve that activity are considered to be of great social importance. In the current stage of city development, one of the main tasks is to create a public passenger transportation system that is safe, affordable, economical, reliable and environmentally friendly. The important role of passenger transport in the city's economy and achieving important social services to the population, dictates the need to introduce measures in the system that are harmonious, balanced and effective. This can only be done, in the context of current development, only after the system as a whole is tested extensively through special traffic and management software. (Author)
Sousa, Tiago M; Soares, Tiago; Morais, Hugo
The massive use of distributed generation and electric vehicles will lead to a more complex management of the power system, requiring new approaches to be used in the optimal resource scheduling field. Electric vehicles with vehicle-to-grid capability can be useful for the aggregator players...... in the mitigation of renewable sources intermittency and in the ancillary services procurement. In this paper, an energy and ancillary services joint management model is proposed. A simulated annealing approach is used to solve the joint management for the following day, considering the minimization...... of the aggregator total operation costs. The case study considers a distribution network with 33-bus, 66 distributed generation and 2000 electric vehicles. The proposed simulated annealing is matched with a deterministic approach allowing an effective and efficient comparison. The simulated annealing presents...
Peak, Corey M; Thuan, Phung Duc; Britton, Amadea; Nguyen, Tran Dang; Wolbers, Marcel; Thanh, Ngo Viet; Buckee, Caroline O; Boni, Maciej F
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.
Jarnevich, Catherine S.; Holcombe, Tracy R.; Cullinane Thomas, Catherine; Frid, Leonardo; Olsson, Aaryn D.
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
Catherine S. Jarnevich
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
Barreras, Jorge Varela; Swierczynski, Maciej Jozef; Schaltz, Erik; Andreasen, Søren Juhl; Fleischer, Christian; Sauer, Dirk Uwe; Christensen, Andreas Elkjær
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 pa...
Callantine, Todd J.; Kupfer, Michael; Martin, Lynne Hazel; Prevot, Thomas
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.
Huang, P. S.; Chiu, Y.
In 1970's, the agriculture and aquaculture were rapidly developed at Pingtung coastal area in southern Taiwan. The groundwater aquifers were over-pumped and caused the seawater intrusion. In order to remedy the contaminated groundwater and find the best strategies of groundwater usage, a management model to search the optimal groundwater operational strategies is developed in this study. The objective function is to minimize the total amount of injection water and a set of constraints are applied to ensure the groundwater levels and concentrations are satisfied. A three-dimension density-dependent flow and transport simulation model, called SEAWAT developed by U.S. Geological Survey, is selected to simulate the phenomenon of seawater intrusion. The simulation model is well calibrated by the field measurements and replaced by the surrogate model of trained artificial neural networks (ANNs) to reduce the computational time. The ANNs are embedded in the management model to link the simulation and optimization models, and the global optimizer of differential evolution (DE) is applied for solving the management model. The optimal results show that the fully trained ANNs could substitute the original simulation model and reduce much computational time. Under appropriate setting of objective function and constraints, DE can find the optimal injection rates at predefined barriers. The concentrations at the target locations could decrease more than 50 percent within the planning horizon of 20 years. Keywords : Seawater intrusion, groundwater management, numerical model, artificial neural networks, differential evolution
Full Text Available In light of the course of production operation management status, this article proposes the innovation and reform of the teaching model from three aspects of from the curriculum syllabus reform, the simulation of typical teaching organization model, and the enterprise resource process (ERP sandbox application in the course practice. There are an exhaustive implementation procedure and a further discussion on the promotion outcome. The results indicate that the innovation of teaching model and case studying practice in production operation management based on ERP sandbox simulation is feasible.
Younis, M.H.; Boczar, P.G.
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
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
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.
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.
Ponsich, Aurelia; Goutard, Flavie; Sorn, San; Tarantola, Arnaud
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.
Berkenstadt, Haim; Ben-Menachem, Erez; Simon, Daniel; Ziv, Amitai
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.
Barreras, Jorge Varela; Fleischer, Christian; Christensen, Andreas Elkjær
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...
Márcia de Nazaré Oliveira Ribeiro
Full Text Available Conventional pruning is a very common practice for pruning rose cultivars in Brazil. However, few Brazilian producers known any other efficient plant training method for roses, namely “lateral stem bending” or “arching technique”, which involves bending the branches of the rosebush in order to increase the photosynthetic rate of the plant. As well as plant training, the use of fertilizers must also be done carefully in order to obtain high quality roses. Biofertilizers are recommended because of their multiple effects: fertilizer, protein synthesis stimulant, insect repellent, and disease controller. The aim of this study was to assess the plant training system and management of organic fertilizer on the incidence and severity of disease in the ‘Osiana’ and ‘Carola’ roses. The ‘Osiana’ rosebushes received three concentrations (0%, 5%, and 15% of foliar biofertilizer applied monthly to the leaves together with two plant conduction methods (conventional pruning and lateral stem bending. ‘Carola’ roses were treated with three types of fertilizer (chemical fertilizer on the soil + bokashi on the soil, chemical fertilizer on the soil + foliar FishfertilÒand chemical fertilization on the soil without applying organic fertilizers every two weeks, together with 2 plant conduction systems (conventional pruning and lateral stem bending. The additional treatments in ‘Carola’ roses were composed of two organic fertilizers (Bokashi and foliar Fishfertil® and chemical fertilization with lateral pruning. The incidence and severity of disease in these plants during the experiment were assessed over 5 months. For the ‘Osiana’ rose, the incidence and severity of disease were not influenced by fertilizer management or plant training methods. For the ‘Carola’ roses, the different types of fertilizer caused different responses according to the plant training system used, with the biofertilizer Fishfertil® reducing the incidence
Zhang, Bin; Dong, Yuhao; Liang, Long; Lian, Zhouyang; Liu, Jing; Luo, Xiaoning; Chen, Wenbo; Li, Xinyu; Liang, Changhong; Zhang, Shuixing
Some epidemiologic surveillance studies have recorded adverse drug reactions to radiocontrast agents. We aimed to investigate the incidence and management of acute adverse reactions (AARs) to Ultravist-370 and Isovue-370 in patients who underwent contrast-enhanced computed tomography (CT) scanning.Data from 137,473 patients were analyzed. They had undergone enhanced CT scanning with intravenous injection of Ultravist-370 or Isovue-370 during the period of January 1, 2006 to December 31, 2012 in our hospital. We investigated and classified AARs according to the American College of Radiology and the Chinese Society of Radiology (CSR) guidelines for iodinated contrast media. We analyzed risk factors for AARs and compared the AARs induced by Ultravist-370 and Isovue-370.Four hundred and twenty-eight (0.31%) patients experienced AARs, which included 330 (0.24%) patients with mild AARs, 82 (0.06%) patients with moderate AARs, and 16 (0.01%) patients with severe AARs (including 3 cases of cardiac arrest and one case of death). The incidence of AARs was higher with Ultravist-370 than with Isovue-370 (0.38% vs 0.24%, P management, the symptoms and signs of 96.5% of the AARs resolved within 24 hours without sequelae.Ultravist-370 and Isovue-370 are safe for patients undergoing enhanced CT scanning. The incidence of AARs is higher with Ultravist-370 than with Isovue-370, but this difference is limited only to the mild AARs. The incidence of AARs could be affected by multiple factors.
Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM
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
Full Text Available : situational picture management; data and sensor fusion; user interaction; tactical simulation; incident management; and system interoperability. Applications developed with the framework can be executed and distributed over multiple hosts through a proprietary...
Ding, Zhikun; Yi, Guizhen; Tam, Vivian W Y; Huang, Tengyue
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.
Full Text Available Improving safety and convenience of transfer is one of the most vital tasks in subway system planning, design and operation management. Because of complicated space layout and crowded pedestrian, crowd control is a big challenge for management of transfer stations. Thus, a quantitative evaluation should be done before improvement measures are carried out. Literature review showed that present evaluation indicators about crowd management in subway system were all based on fixed value or experience. Dynamic effect caused by pedestrian congestion and various facility combination cannot be represented based on these indicators. Thus, in this paper, based on the pedestrian simulation tool, dynamic evaluation indicators system of crowd management was established from the point of safety, cost-effectiveness and comfort. In order to aid decision makers to identify the most appropriate scenario to improve the effectiveness of crowd management, Matter-Element Analysis (MEA was used to rate different scenarios. A pedestrian simulation model of a designing intermodal transfer station was built and four different scenarios were tested to demonstrate how to use this indicators system. Simulation results were evaluated based on the dynamic indicators system and MEA. The application results show that the dynamic evaluation indicators system is operational and can reflect level of the crowd management in transfer station comprehensively and precisely.
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.)
Eitzen, David; Zimmermann, Alex
Forensic mortuaries in all Australian jurisdictions are dealing with increasing workloads, with routine cases regularly occupying greater than 50%, and often as much as 85%, of existing cold room body storage capacity, particularly over long weekends and during seasonal increases in respiratory infections. Hence the need to deal with a sudden influx of deceased persons or multiple body parts in a mass fatality incident would overwhelm most Australian forensic mortuaries, thereby requiring other means of body storage and processing. Exercise "Construct" was a joint South Australian Police (SAPol) and Forensic Science South Australia exercise designed to practice the establishment and construction of an emergency mortuary facility (EMF) to deal with a mass fatality incident and the subsequent disaster victim identification process. The aims of the exercise were to test preparedness, activation and construction processes relative to the establishment of an EMF. The exercise provided the opportunity to identify gaps in the capacity to successfully complete the tasks within the allotted time frames. The exercise reinforced the need to have a comprehensive and clearly documented process which must include a current list of suppliers who can deliver goods and services in a timely manner. The aim of this paper is to report on the exercise findings and share the experience with other jurisdictions. It will also provide other jurisdictions with the opportunity to consider whether the South Australian model will be useful to them in improving their own response when confronted with a mass fatality incident that may overwhelm existing local mortuary capacities and capabilities.
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
Khadem, M.; Meier, P.; Rheinheimer, D. E.; Padula, S.; Matrosov, E.; Selby, P. D.; Knox, S.; Harou, J. J.
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.
Morrison, D J
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.
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.
Freedman, V. L.; Agarwal, D.; Bensema, K.; Finsterle, S.; Gable, C. W.; Keating, E. H.; Krishnan, H.; Lansing, C.; Moeglein, W.; Pau, G. S. H.; Porter, E.; Scheibe, T. D.
The U.S. Department of Energy (DOE) is investing in development of a numerical modeling toolset called ASCEM (Advanced Simulation Capability for Environmental Management) to support modeling analyses at legacy waste sites. ASCEM is an open source and modular computing framework that incorporates new advances and tools for predicting contaminant fate and transport in natural and engineered systems. The ASCEM toolset includes both a Platform with Integrated Toolsets (called Akuna) and a High-Performance Computing multi-process simulator (called Amanzi). The focus of this presentation is on Akuna, an open-source user environment that manages subsurface simulation workflows and associated data and metadata. In this presentation, key elements of Akuna are demonstrated, which includes toolsets for model setup, database management, sensitivity analysis, parameter estimation, uncertainty quantification, and visualization of both model setup and simulation results. A key component of the workflow is in the automated job launching and monitoring capabilities, which allow a user to submit and monitor simulation runs on high-performance, parallel computers. Visualization of large outputs can also be performed without moving data back to local resources. These capabilities make high-performance computing accessible to the users who might not be familiar with batch queue systems and usage protocols on different supercomputers and clusters.
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
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...
Chiêm, Jean-Christophe; Van Durme, Thérèse; Vandendorpe, Florence; Schmitz, Olivier; Speybroeck, Niko; Cès, Sophie; Macq, Jean
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.
Saraswat, Satya Prakash; Anderson, Dennis M.; Chircu, Alina M.
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…
Gabrielsson, Jonas; Tell, Joakim; Politis, Diamanto
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…
Moore, D.; Tymons, B.J.
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)
R. M. Rice; R. R. Ziemer; S. C. Hankin
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...
Full Text Available The article outlines the main provisions of the evolutionary-simulative methodology (ESM which is a methodology of mathematical modeling of equilibrium random processes (CPR, widely used in the economy. It discusses the basic directions of use of ESM solutions for social problems and economic management systems.
Martín-Pérez, Víctor; Martín-Cruz, Natalia; Pérez-Santana, Pilar
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…
Chang, Chiung-sui; Huang, Ya-Ping
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…
Lucas, Robert C.; Shechter, Mordechai
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)
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.
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.
Goffman, Dena; Heo, Hye; Pardanani, Setul; Merkatz, Irwin R; Bernstein, Peter S
The objective of the study was to determine whether a simulation-based educational program would improve residents' and attending physicians' performance in a simulated shoulder dystocia. Seventy-one obstetricians participated in an unanticipated simulated shoulder dystocia, an educational debriefing session, and a subsequent shoulder dystocia simulation. Each simulation was scored, based on standardized checklists for 4 technical maneuvers and 6 communication tasks, by 2 physician observers. Paired Student t tests were used for analysis. Forty-three attendings and 28 residents participated. Residents showed significant improvement in mean maneuver (3.3 +/- 0.9 vs 3.9 +/- 0.4, P = .001) and communication (3.5 +/- 1.2 vs 4.9 +/- 1.0, P < .0001) scores after simulation training. Attending physicians' communication (3.6 +/- 1.6 vs 4.9 +/- 1.1, P < .0001) scores were significantly improved after training. Our program improved physician performance in the management of simulated shoulder dystocia deliveries. Obstetric emergency simulation training can improve physicians' communication skills, at all levels of training, and should be incorporated into labor and delivery quality improvement measures.
Bravo, F.; Rodriguez, F.; Ordonez, C.
Growth and yield models at different scales are useful tools for forest stake holders. Adequate simulation of forest stand conditions after different silviculture scenarios allows stake holders to adopt appropriate actions to maintain forest integrity while forest products and services are obtained to benefit society as a whole. SIMANFOR is a platform to simulate sustainable forest management alternatives, integrating different modules to manage forest inventories, simulate and project stand conditions and maintain systems security and integrity. SIMANFOR output is compatible with an Office environment (Microsoft or Open), allowing users to exchange data and files between SIMANFOR and their own software. New developments are being planned under a web 2.0 environment to take advantage of user input to improve SIMANFOR in the future. (Author) 9 refs.
Barreras, Jorge Varela; Swierczynski, Maciej Jozef; Schaltz, Erik
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...
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.
Lee, James S; Franc, Jeffrey M
A high influx of patients during a mass-casualty incident (MCI) may disrupt patient flow in an already overcrowded emergency department (ED) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step ED triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on patient flow during a MCI simulation exercise. Hypothesis/Problem It was hypothesized that there would be no difference in time intervals nor patient volumes at each patient-flow milestone. Physicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. Patient-flow milestones including time intervals and patient volumes from ED arrival to triage, ED arrival to bed assignment, ED arrival to physician assessment, and ED arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes. There were no significant differences in the time interval from ED arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), ED arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), ED arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and ED arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of patients to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar
Gillman, Lawrence M; Brindley, Peter; Paton-Gay, John Damian; Engels, Paul T; Park, Jason; Vergis, Ashley; Widder, Sandy
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.
Odubiyi, Jide; Kocur, David; Pino, Nino; Chu, Don
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.
Zhou, Hangjun; Zhang, Wei; Peng, Yuxing; Li, Sikun
During the course of designing a time management algorithm for DVEs, the researchers always become inefficiency for the distraction from the realization of the trivial and fundamental details of simulation and verification. Therefore, a platform having realized theses details is desirable. However, this has not been achieved in any published work to our knowledge. In this paper, we are the first to design and realize a DVE time management simulation and verification platform providing exactly the same interfaces as those defined by the HLA Interface Specification. Moreover, our platform is based on a new designed causality consistency middleware and might offer the comparison of three kinds of time management services: CO, RO and TSO. The experimental results show that the implementation of the platform only costs small overhead, and that the efficient performance of it is highly effective for the researchers to merely focus on the improvement of designing algorithms.
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.
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,…
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 and e...
W. M. Wang
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.
Liu, Sicong; Poccia, Silvestro; Candan, K Selçuk; Chowell, Gerardo; Sapino, Maria Luisa
Carefully calibrated large-scale computational models of epidemic spread represent a powerful tool to support the decision-making process during epidemic emergencies. Epidemic models are being increasingly used for generating forecasts of the spatial-temporal progression of epidemics at different spatial scales and for assessing the likely impact of different intervention strategies. However, the management and analysis of simulation ensembles stemming from large-scale computational models pose challenges, particularly when dealing with multiple interdependent parameters, spanning multiple layers and geospatial frames, affected by complex dynamic processes operating at different resolutions. We describe and illustrate with examples a novel epidemic simulation data management system, epiDMS, that was developed to address the challenges that arise from the need to generate, search, visualize, and analyze, in a scalable manner, large volumes of epidemic simulation ensembles and observations during the progression of an epidemic. epiDMS is a publicly available system that facilitates management and analysis of large epidemic simulation ensembles. epiDMS aims to fill an important hole in decision-making during healthcare emergencies by enabling critical services with significant economic and health impact. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail email@example.com.
Bilich, Lisa A; Jackson, Sarah C; Bray, Brenda S; Willson, Megan N
Medical emergencies can occur at any time in the dental office, so being prepared to properly manage the situation can be the difference between life and death. The entire dental team must be properly trained regarding all aspects of emergency management in the dental clinic. The aim of this study was to evaluate a new educational approach using a high-fidelity simulator to prepare dental hygiene students for medical emergencies. This study utilized high-fidelity simulation (HFS) to evaluate the abilities of junior dental hygiene students at Eastern Washington University to handle a medical emergency in the dental hygiene clinic. Students were given a medical emergency scenario requiring them to assess the emergency and implement life-saving protocols in a simulated "real-life" situation using a high-fidelity manikin. Retrospective data were collected for four years from the classes of 2010 through 2013 (N=114). The results indicated that learning with simulation was effective in helping the students identify the medical emergency in a timely manner, implement emergency procedures correctly, locate and correctly utilize contents of the emergency kit, administer appropriate intervention/treatment for a specific patient, and provide the patient with appropriate follow-up instructions. For dental hygiene programs seeking to enhance their curricula in the area of medical emergencies, this study suggests that HFS is an effective tool to prepare students to appropriately handle medical emergencies. Faculty calibration is essential to standardize simulation.
Riem, N; Boet, S; Bould, M D; Tavares, W; Naik, V N
Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score. TS and NTS were significantly correlated to each other (r=0.45, P<0.05). During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.
Sañudo-Fontaneda, Luis A; Jato-Espino, Daniel; Lashford, Craig; Coupe, Stephen J
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.
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.
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.
Oeren, T.I.; Elzas, M.S.; Sheng, G.; Wageningen Agricultural Univ., Netherlands; McMaster Univ., Hamilton, Ontario)
As is the case with all scientific simulation studies, computerized simulation of nuclear fuel waste management systems can introduce and hide various types of errors. Frameworks to clarify issues of model reliability and software quality assurance are offered. Potential problems with reference to the main areas of concern for reliability and quality are discussed; e.g., experimental issues, decomposition, scope, fidelity, verification, requirements, testing, correctness, robustness are treated with reference to the experience gained in the past. A list comprising over 80 most common computerization errors is provided. Software tools and techniques used to detect and to correct computerization errors are discussed
Wallett, Thomas M.; Mueller, Carl H.; Griner, James H., Jr.
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.
Fernandes, F.; Silva, M.; Faria, P.
Recent and future changes in power systems, mainly in the smart grid operation context, are related to a high complexity of power networks operation. This leads to more complex communications and to higher network elements monitoring and control levels, both from network’s and consumers’ standpoi......-time simulation from Opal RT. This makes possible the integration of Matlab®/Simulink® real-time simulation models. The main goal of the present paper is to compare the advantages of the resulting improved system, while managing the energy consumption of a domestic consumer....
Mizell, Carolyn; Malone, Linda
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.
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
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.
Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki
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.
Mancini, F.; Jiggins, J.L.S.; O'Malley, M.
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
Mao, Fangjie; Li, Pingheng; Zhou, Guomo; Du, Huaqiang; Xu, Xiaojun; Shi, Yongjun; Mo, Lufeng; Zhou, Yufeng; Tu, Guoqing
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.
Miller, Sally; Overstreet, Maria
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.
Ambrosiadou, V; Compton, T; Panchal, T; Polovina, S
This is a multidisciplinary inter-departmental/faculty project between the departments of computer science, electronic, communications and electrical engineering and nursing and paramedic sciences. The objective is to develop a web based multimedia front end to existing simulations of cardiac emergency scenaria. It will be used firstly in the teaching of nurses. The University of Hertfordshire is the only University in Britain using simulations of cardiac emergency scenaria for nurse and paramedic science education and therefore this project will add the multimedia dimension in distributed courses over the web and will assess the improvement in the educational process. The use of network and multimedia technologies, provide interactive learning, immediate feedback to students' responses, individually tailored instructions, objective testing and entertaining delivery. The end product of this project will serve as interactive material to enhance experiential learning for nursing students using the simulations of cardiac emergency scenaria. The emergency treatment simulations have been developed using VisSim and may be compiled as C code. The objective of the project is to provide a web based user friendly multimedia interface in order to demonstrate the way in which patients may be managed in critical situations by applying advanced technological equipment and drug administration. Then the user will be able to better appreciate the concepts involved by running the VisSim simulations. The evaluation group for the proposed software will be the Department of Nursing and Paramedic Sciences About 200 nurses use simulations every year for training purposes as part of their course requirements.
Full Text Available In this paper we present an optical simulation of light management in Cu(In,GaSe2 thin-film solar cells with reduced absorber layer thickness, with the goal of absorption enhancement in the absorber layer. The light management was achieved by texturing of the substrate layer, and the conformal growth of all the following layers was assumed. Two texturing shapes have been explored: triangular and convex, with different periods and height aspect ratios. The simulations have shown that significant enhancement of absorption within the absorber layer can be achieved using the proposed geometry. The results showed that the triangular textures with small periods (100–200 nm and high aspect ratios have the most prominent effect on the enhancement of absorption within the absorber layer, although they are difficult to achieve experimentally.
Schott, Eric; Brautigam, Robert T; Smola, Jacqueline; Burns, Karyl J
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.
Louis Doru Havriliuc
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.
Malin, Jane T.; Basham, Bryan D.
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.
Aharonson-Daniel, L; Paul, R J; Hedley, A J
Notes that patients attending public outpatient departments in Hong Kong spend a long time waiting for a short consultation, that clinics are congested and that both staff and patients are dissatisfied. Points out that experimentation of management changes in a busy clinical environment can be both expensive and difficult. Demonstrates computerized simulation modelling as a potential tool for clarifying processes occurring within such systems, improving clinic operation by suggesting possible answers to problems identified and evaluating the solutions, without interfering with the clinic routine. Adds that solutions can be implemented after they had proved to be successful on the model. Demonstrates some ways in which managers in health care facilities can benefit from the use of computerized simulation modelling. Specifically, shows the effect of changing the duration of consultation and the effect of the application of an appointment system on patients' waiting time.
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.
Klein-Jöbstl, Daniela; Arnholdt, Tim; Sturmlechner, Franz; Iwersen, Michael; Drillich, Marc
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
Engel,Fernando Luis; Bertol,Ildegardis; Mafra,Álvaro Luiz; Cogo,Neroli Pedro
Soil management influences soil cover by crop residues and plant canopy, affecting water erosion. The objective of this research was to quantify water and soil losses by water erosion under different soil tillage systems applied on a typical aluminic Hapludox soil, in an experiment carried out from April 2003 to May 2004, in the Santa Catarina highland region, Lages, southern Brazil. Simulated rainfall was applied during five soybean cropstages, at the constant intensity of 64.0 mm h-1. Treat...
Louis Doru Havriliuc; Alexandru Capatina; Marius Geru
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 lea...
Chan, P.S.W.; Boczar, P.G.; Ellis, R.J.; Ardeshiri, F.
High neutron economy, on-power refuelling and a simple fuel bundle design result in unsurpassed fuel cycle flexibility for CANDU reactors. These features facilitate the introduction and exploitation of thorium fuel cycles in existing CANDU reactors in an evolutionary fashion. Detailed full-core fuel-management simulations concluded that a once-through thorium fuel cycle can be successfully implemented in an existing CANDU reactor without requiring major modifications. (author)
Full Text Available This paper suggests an event-based scenario manager capable of creating and editing a scenario for shipbuilding process simulation based on multibody dynamics. To configure various situation in shipyards and easily connect with multibody dynamics, the proposed method has two main concepts: an Actor and an Action List. The Actor represents the anatomic unit of action in the multibody dynamics and can be connected to a specific component of the dynamics kernel such as the body and joint. The user can make a scenario up by combining the actors. The Action List contains information for arranging and executing the actors. Since the shipbuilding process is a kind of event-based sequence, all simulation models were configured using Discrete EVent System Specification (DEVS formalism. The proposed method was applied to simulations of various operations in shipyards such as lifting and erection of a block and heavy load lifting operation using multiple cranes.
Jorge Paulo Sequeira
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.
Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael
Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high
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.
Gormley, Gerard J; Fenwick, Tara
Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.
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.
Bril Mykhailo S.
Full Text Available The article is dedicated to the development of models for management of housing and communal services of a city on the basis of the system approach and simulation modeling. A review of the existing models of urban systems is carried out, their advantages and disadvantages are shown. With the use of the methods of simulation and scenario modeling, a simulation model for management of housing and communal services of a city has been developed, which makes it possible to predict the dynamics of the main socio-economic indicators of development of a city. On the basis of the model, the forecast indicators were simulated according to various scenarios for distributing financial resources for the renovation and maintenance of housing facilities of a city. The main criterion for effectiveness of the scenarios is the level of housing provision for the population. The models built can be used for making managerial decisions by local government authorities as well as in elaborating programs for the urban social and economic development.
Stark, Cameron; Garman, Elaine; McMenamin, Jim; McCormick, Duncan; Oates, Ken
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.
Spanoudaki, Katerina; Kampanis, Nikolaos
-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
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
Régo Patricia M
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
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
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
Dawood, Farah Z; Khan, Faraaz; Roediger, Mollie P
the baseline resting 12-lead electrocardiogram of 4,453 HIV-infected patients aged 43.5 ± 9.3 years from the Strategies for Management of Antiretroviral Therapy (SMART) trial. CVD events were identified during a median follow-up of 28.7 months. Quartiles of the spatial QRS-T angle was calculated for men......Widening of the electrocardiographic (ECG) spatial QRS-T angle has been predictive of cardiovascular disease (CVD) events in the general population. However, its prognostic significance in human immunodeficiency virus (HIV)-infected patients remains unknown. The spatial QRS-T angle was derived from...... and women separately, and values in the upper quartile were considered as a widened angle (values >74° for women and >93° for men). A multivariate Cox proportional hazards analysis was used to examine the association between a widened baseline spatial QRS-T angle and incident CVD events. During 11...
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.
Airth, G.L.; Joy, D.S.; Nehls, J.W.
A System Simulation Model has been developed for the Department of Energy to simulate the movement of individual waste packages (spent fuel assemblies and fuel containers) through the Civilian Radioactive Waste Management System (CRWMS). A discrete event simulation language, GPSS/PC, which runs on an IBM/PC and operates under DOS 5.0, mathematically represents the movement and processing of radioactive waste packages through the CRWMS and the interaction of these packages with the equipment in the various facilities. This model can be used to quantify the impacts of different operating schedules, operational rules, system configurations, and equipment reliability and availability considerations on the performance of processes comprising the CRWMS and how these factors combine to determine overall system performance for the purpose of making system design decisions. The major features of the System Simulation Model are: the ability to reference characteristics of the different types of radioactive waste (age, burnup, etc.) in order to make operational and/or system design decisions, the ability to place stochastic variations on operational parameters such as processing time and equipment outages, and the ability to include a rigorous simulation of the transportation system. Output from the model includes the numbers, types, and characteristics of waste packages at selected points in the CRWMS and the extent to which various resources will be utilized in order to transport, process, and emplace the waste
Sapak, Z; Salam, M U; Minchinton, E J; MacManus, G P V; Joyce, D C; Galea, V J
A weather-based simulation model, called Powdery Mildew of Cucurbits Simulation (POMICS), was constructed to predict fungicide application scheduling to manage powdery mildew of cucurbits. The model was developed on the principle that conditions favorable for Podosphaera xanthii, a causal pathogen of this crop disease, generate a number of infection cycles in a single growing season. The model consists of two components that (i) simulate the disease progression of P. xanthii in secondary infection cycles under natural conditions and (ii) predict the disease severity with application of fungicides at any recurrent disease cycles. The underlying environmental factors associated with P. xanthii infection were quantified from laboratory and field studies, and also gathered from literature. The performance of the POMICS model when validated with two datasets of uncontrolled natural infection was good (the mean difference between simulated and observed disease severity on a scale of 0 to 5 was 0.02 and 0.05). In simulations, POMICS was able to predict high- and low-risk disease alerts. Furthermore, the predicted disease severity was responsive to the number of fungicide applications. Such responsiveness indicates that the model has the potential to be used as a tool to guide the scheduling of judicious fungicide applications.
Airth, G.L.; Joy, D.S.; Nehls, J.W.
This paper discusses a System Simulation Model which has been developed for the Department of Energy to simulate the movement of individual waste packages (spent fuel assemblies and fuel containers) through the Civilian Radioactive Waste Management System (CRWMS). A discrete event simulation language, GPSS/PC, which runs on an IBM/PC and operates under DOS 5.0, mathematically represents the movement and processing of radioactive waste packages through the CRWMS and the interaction of these packages with the equipment in the various facilities. The major features of the System Simulation Model are: the ability to reference characteristics of the different types of radioactive waste (age, burnup, etc.) in order to make operational and/or system design decisions, the ability to place stochastic variations on operational parameters such as processing time and equipment outages, and the ability to include a rigorous simulation of the transportation system. Output from the model includes the numbers, types, and characteristics of waste packages at selected points in the CRWMS and the extent to which various resources will be utilized in order to transport, process, and emplace the waste
Anderson, E.; Galagan, C.; Howlett, E.
The On Scene Command and Control (OSC 2 ) system is an oil spill modeling tool which was developed to combine Incident Command System (ICS) forms, an underlying database, an integrated geographical information system (GIS) and an oil spill trajectory and fate model. The first use of the prototype OSC 2 system was at a PREP drill conducted at the U.S. Coast Guard Marine Safety Office, San Diego, in April 1998. The goal of the drill was to simulate a real-time response over a 36-hour period using the Unified Command System. The simulated spill was the result of a collision between two vessels inside San Diego Bay that caused the release of 2,000 barrels of fuel oil. The hardware component of the system which was tested included three notebook computers, two laser printers, and a poster printer. The field test was a success but it was not a rigorous test of the system's capabilities. The map display was useful in quickly setting up the ICS divisions and groups and in deploying resources. 6 refs., 1 tab., 5 figs
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
Rajabi, Mohammad Mahdi; Ketabchi, Hamed
Combined simulation-optimization (S/O) schemes have long been recognized as a valuable tool in coastal groundwater management (CGM). However, previous applications have mostly relied on deterministic seawater intrusion (SWI) simulations. This is a questionable simplification, knowing that SWI models are inevitably prone to epistemic and aleatory uncertainty, and hence a management strategy obtained through S/O without consideration of uncertainty may result in significantly different real-world outcomes than expected. However, two key issues have hindered the use of uncertainty-based S/O schemes in CGM, which are addressed in this paper. The first issue is how to solve the computational challenges resulting from the need to perform massive numbers of simulations. The second issue is how the management problem is formulated in presence of uncertainty. We propose the use of Gaussian process (GP) emulation as a valuable tool in solving the computational challenges of uncertainty-based S/O in CGM. We apply GP emulation to the case study of Kish Island (located in the Persian Gulf) using an uncertainty-based S/O algorithm which relies on continuous ant colony optimization and Monte Carlo simulation. In doing so, we show that GP emulation can provide an acceptable level of accuracy, with no bias and low statistical dispersion, while tremendously reducing the computational time. Moreover, five new formulations for uncertainty-based S/O are presented based on concepts such as energy distances, prediction intervals and probabilities of SWI occurrence. We analyze the proposed formulations with respect to their resulting optimized solutions, the sensitivity of the solutions to the intended reliability levels, and the variations resulting from repeated optimization runs.
Dorier, Matthieu; Antoniu, Gabriel; Cappello, Franck; Snir, Marc; Sisneros, Robert
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.
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
Leon, Barbara D.; Heller, Paul R.
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
Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott
Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.
Johnson, Branden B; Hallman, William K; Cuite, Cara L
Perceptions of institutions that manage hazards are important because they can affect how the public responds to hazard events. Antecedents of trust judgments have received far more attention than antecedents of attributions of responsibility for hazard events. We build upon a model of retrospective attribution of responsibility to individuals to examine these relationships regarding five classes of institutions that bear responsibility for food safety: producers (e.g., farmers), processors (e.g., packaging firms), watchdogs (e.g., government agencies), sellers (e.g., supermarkets), and preparers (e.g., restaurants). A nationally representative sample of 1,200 American adults completed an Internet-based survey in which a hypothetical scenario involving contamination of diverse foods with Salmonella served as the stimulus event. Perceived competence and good intentions of the institution moderately decreased attributions of responsibility. A stronger factor was whether an institution was deemed (potentially) aware of the contamination and free to act to prevent or mitigate it. Responsibility was rated higher the more aware and free the institution. This initial model for attributions of responsibility to impersonal institutions (as opposed to individual responsibility) merits further development. © 2014 Society for Risk Analysis.
Capecci, Louis M; Jeremitsky, Elan; Smith, R Stephen; Philp, Frances
Nonoperative management (NOM) for blunt splenic injury (BSI) is well-established. Angiography (ANGIO) has been shown to improve success rates with NOM. Protocols for NOM are not standardized and vary widely between centers. We hypothesized that trauma centers that performed ANGIO at a greater rate would demonstrate decreased rates of splenectomy compared with trauma centers that used ANGIO less frequently. A large, multicenter, statewide database (Pennsylvania Trauma Systems Foundation) from 2007 to 2011 was used to generate the study cohort of patients with BSI (age ≥ 13). The cohort was divided into 2 populations based on admission to centers with high (≥13%) or low (Splenectomy rates were then compared between the 2 groups, and multivariable logistic regression for predictors of splenectomy (failed NOM) were also performed. The overall rate of splenectomy in the entire cohort was 21.0% (1,120 of 5,333 BSI patients). The high ANGIO group had a lesser rate of splenectoy compared with the low ANGIO group (19% vs 24%; P splenectomy compared with low ANGIO centers (odds ratio, 0.68; 95% CI 0.58-0.80; P splenectomy rates compared with centers with lesser rate of ANGIO. Inclusion of angiographic protocols for NOM of BSI should be considered strongly. Copyright © 2015 Elsevier Inc. All rights reserved.