Incident Management Organization succession planning stakeholder feedback

Science.gov (United States)

Anne E. Black

2013-01-01

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

CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM – AN EMPLOYEE ASSISTANCE PROGRAMME (EAP PERSPECTIVE

Directory of Open Access Journals (Sweden)

Terblanche, Lourie

2014-04-01

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.

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

Directory of Open Access Journals (Sweden)

Faisal R. Ali

2012-01-01

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

The ultimate disposition of depleted uranium

Energy Technology Data Exchange (ETDEWEB)

1990-12-01

Significant amounts of the depleted uranium (DU) created by past uranium enrichment activities have been sold, disposed of commercially, or utilized by defense programs. In recent years, however, the demand for DU has become quite small compared to quantities available, and within the US Department of Energy (DOE) there is concern for any risks and/or cost liabilities that might be associated with the ever-growing inventory of this material. As a result, Martin Marietta Energy Systems, Inc. (Energy Systems), was asked to review options and to develop a comprehensive plan for inventory management and the ultimate disposition of DU accumulated at the gaseous diffusion plants (GDPs). An Energy Systems task team, under the chairmanship of T. R. Lemons, was formed in late 1989 to provide advice and guidance for this task. This report reviews options and recommends actions and objectives in the management of working inventories of partially depleted feed (PDF) materials and for the ultimate disposition of fully depleted uranium (FDU). Actions that should be considered are as follows. (1) Inspect UF{sub 6} cylinders on a semiannual basis. (2) Upgrade cylinder maintenance and storage yards. (3) Convert FDU to U{sub 3}O{sub 8} for long-term storage or disposal. This will include provisions for partial recovery of costs to offset those associated with DU inventory management and the ultimate disposal of FDU. Another recommendation is to drop the term tails'' in favor of depleted uranium'' or DU'' because the tails'' label implies that it is waste.'' 13 refs.

Ultimate disposal of radioactive wastes

International Nuclear Information System (INIS)

Roethemeyer, H.

1991-01-01

The activities developed by the Federal Institution of Physical Engineering PTB and by the Federal Office for Radiation Protection (BfS) concentrated, among others, on work to implement ultimate storage facilities for radioactive wastes. The book illuminates this development from site designation to the preliminary evaluation of the Gorleben salt dome, to the preparation of planning documents proving that the Konrad ore mine is suitable for a repository. The paper shows the legal provisions involved; research and development tasks; collection of radioactive wastes ready for ultimate disposal; safety analysis in the commissioning and post-operational stages, and product control. The historical development of waste management in the Federal Republic of Germany and international cooperation in this area are outlined. (DG) [de

Direct ultimate disposal - state of investigations and prospects

International Nuclear Information System (INIS)

Gasterstaedt, N.

1991-01-01

Based on a decision adopted by the Prime Ministers on 25/10/90, the principles governing preventive waste management of nuclear power plants are reviewed. Increasing importance is attached to the direct ultimate disposal alternative. The legal and political framework, the technology involved, the state of developments, future activities under the R and D programme as well as a cost estimate of direct ultimate disposal are presented. (orig.) [de

Factors affecting fire suppression costs as identified by incident management teams

Science.gov (United States)

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

2006-01-01

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

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

International Nuclear Information System (INIS)

Martin, B.F.

1991-01-01

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

The ultimate challenge of cloacal exstrophy.

Science.gov (United States)

Schober, Justine M; Carmichael, Polly A; Hines, Melissa; Ransley, Philip G

2002-01-01

Our review addresses the various system abnormalities associated with cloacal exstrophy and revisits the question of gender assignment. Gender assignment decisions and psychological aspects of gender issues have become the "ultimate challenge." Exploration of gender identity, gender role behavior and sexual orientation has just begun. A comprehensive literature review was performed with all world literature regarding the current management of cloacal exstrophy. Research focused on management principles, outcomes and documentation of concurrent anomalies. We also describe original research evaluating gender identity in our own series of patients raised as girls to illustrate the challenge of treatment and augment the available literature, which is scant. Abnormalities of the vertebral column ranged from hemivertebra to myelomeningocele. With magnetic resonance imaging, the incidence of spinal dysraphism approached 100% and cord tethering was also more frequently recognized. For children with the short bowel syndrome, advances in antibiotic usage, and parenteral and enteral nutrition have increased the survival rate and reduced morbidity. A neurological component has been recognized for bladder function, bladder neck continence, lower extremity function and erectile capacity. Mitrofanoff-type reconstruction with bladder neck closure and continent catheterizable stoma dramatically increased continence. Diminutive or absent penis has been documented in 30% of males, and no documentation of paternity exists. The majority of females have bicornuate uterus. However, ovaries and tubes were generally normal. No reports of proven fertility exist. The strategy and timing of surgery relating to gender assignment remain controversial. A desperate need exists for research focusing on gender development and quality of life. Until that time, a cautious watchful approach may be most appropriate as our patients with cloacal exstrophy mature into adulthood.

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

Science.gov (United States)

2011-10-04

...-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...

IT Security Vulnerability and Incident Response Management

NARCIS (Netherlands)

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

2006-01-01

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

Military Personnel: DOD Has Processes for Operating and Managing Its Sexual Assault Incident Database

Science.gov (United States)

2017-01-01

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

The ultimate disposition of depleted uranium

Energy Technology Data Exchange (ETDEWEB)

Lemons, T.R. [Uranium Enrichment Organization, Oak Ridge, TN (United States)

1991-12-31

Depleted uranium (DU) is produced as a by-product of the uranium enrichment process. Over 340,000 MTU of DU in the form of UF{sub 6} have been accumulated at the US government gaseous diffusion plants and the stockpile continues to grow. An overview of issues and objectives associated with the inventory management and the ultimate disposition of this material is presented.

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

Science.gov (United States)

Davari, Fereshteh; Zahed, Arash

2015-09-01

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

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

Directory of Open Access Journals (Sweden)

Peter R. Stinson

2008-03-01

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

Incidence and management of chyle leakage after esophagectomy

NARCIS (Netherlands)

Lagarde, Sjoerd M.; Omloo, Jikke M. T.; de Jong, Koen; Busch, Olivier R. C.; Obertop, Hugo; van Lanschot, J. Jan B.

2005-01-01

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

Revisiting perceptions of quality of hospice care: managing for the ultimate referral.

Science.gov (United States)

Churchman, Richard; York, Grady S; Woodard, Beth; Wainright, Charles; Rau-Foster, Mary

2014-08-01

Hospice services provided in the final months of life are delivered through complex interpersonal relationships between caregivers, patients, and families. Often, service value and quality are defined by these interpersonal interactions. This understanding provides hospice leaders with an enormous opportunity to create processes that provide the optimal level of care during the last months of life. The authors argue that the ultimate referral is attained when a family member observes the care of a loved one, and the family member conveys a desire to receive the same quality of services their loved one received at that facility. The point of this article is to provide evidence that supports the methods to ultimately enhance the patient's and family's experience and increase the potential for the ultimate referral. © The Author(s) 2013.

Responses to professional identity threat: Identity management strategies in incident narratives of health care professionals.

Science.gov (United States)

van Os, Annemiek; de Gilder, Dick; van Dyck, Cathy; Groenewegen, Peter

2015-01-01

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 management of radiation treatment error through incident learning

International Nuclear Information System (INIS)

Clark, Brenda G.; Brown, Robert J.; Ploquin, Jodi L.; Kind, Anneke L.; Grimard, Laval

2010-01-01

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.

A management plan for hospitals and medical centers facing radiation incidents

Directory of Open Access Journals (Sweden)

Fereshteh Davari

2015-01-01

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

The influence of incident management teams on the deployment of wildfire suppression resources

Science.gov (United States)

Michael Hand; Hari Katuwal; David E. Calkin; Matthew P. Thompson

2017-01-01

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...

Medical management of three workers following a radiation exposure incident

International Nuclear Information System (INIS)

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

1992-01-01

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

Medical management of three workers following a radiation exposure incident

Energy Technology Data Exchange (ETDEWEB)

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

1992-01-01

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

Coordinated Traffic Incident and Congestion Management (TIM-CM) : Mitigating Regional Impacts of Major Traffic Incidents in the Seattle I-5 Corridor

Science.gov (United States)

2018-02-02

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...

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

Science.gov (United States)

Naradko, Anthony M.

2017-01-01

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

Ultimate load model test for Sizewell 'B' primary containment

International Nuclear Information System (INIS)

Crowder, R.

1988-01-01

This paper considers the factors influencing the adoption of an ultimate load factor for the Sizewell 'B' PWR primary containment structure. As part of the validation process for the ultimate load analysis method, a proposal has been made by Nuclear Design Associates to build and test a 1/10th scale model of the containment structure, which would proceed following the granting of section 2 consent for Sizewell 'B'. The modelling principles, construction method and test proposals are examined in some detail. The proposal is currently being considered by the CEGB's Project Management Team. (author)

Simulating traffic for incident management and ITS investment decisions

Science.gov (United States)

1998-08-01

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...

Safety Incident Management Team Report for NIMLT Case 50796

LENUS (Irish Health Repository)

2017-01-17

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

Preparedness of emergency departments in northwest England for managing chemical incidents: a structured interview survey

Directory of Open Access Journals (Sweden)

Walter Darren

2007-12-01

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.

Traffic incident and crisis management : challenges and obstacles in information sharing

NARCIS (Netherlands)

Steenbruggen, J.G.M.; Nijkamp, P.; Smits, J.M.; Mohabir, G.

2012-01-01

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

Stalking the ultimate particle

CERN Multimedia

2003-01-01

If you missed the ARTE programme entitled "L'Ultime Particule" broadcast in February, you have another chance to catch it in CERN's Main Auditorium on 13 March. "L'Ultime Particule" is a documentary by the French director Michel Andrieu that seeks to explain particle physics through a contemplative quest for the research physicists of matter of today and yesteryear. Invariably kitted out in a red parka and a soft hat, the programme's investigator scours the planet and the archives in search of the research physicists who are stalking the ultimate particle, the Higgs boson, in their quest to understand the structure of matter. Naturally enough, CERN is an important stage of his journey where Michel Andrieu and his team spent several days last year. Both from the physics and metaphysical points of view, "L'Ultime Particule" is worth seeing. The film's director, Michel Andrieu, will introduce his documentary and answer questions from the audience after the documentary has been shown. L'Ultime Particule by Mic...

Defining Incident Management Processes for CSIRTs: A Work in Progress

National Research Council Canada - National Science Library

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

2004-01-01

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

The key incident monitoring and management system - history and role in quality improvement.

Science.gov (United States)

Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken

2018-01-26

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.

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

Science.gov (United States)

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

2017-01-01

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

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

International Nuclear Information System (INIS)

NSTec Environmental Restoration

2007-01-01

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

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

Science.gov (United States)

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

2013-09-01

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

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

Science.gov (United States)

Brunton, Margaret Ann; Jeffrey, Lynn Maud

2010-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Stenner, Robert D.

2007-04-24

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

Program for accident and incident management support, AIMS

International Nuclear Information System (INIS)

Putra, M.A.

1993-12-01

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

Safety related aspects of ultimate disposal of radioactive wastes

International Nuclear Information System (INIS)

Goemmel, R.

1992-01-01

Solutions and questions related to nuclear waste management are presented. In particular, long-term safety of repositories in Germany and Sweden is considered, with special attention being paid to methods of detection, geotechnical barriers and post-operational phase of salt dome repositories, and conditioning of wastes to make them fit for ultimate disposal. (DG) [de

Management and ultimate storage of wastes from nuclear power generation

International Nuclear Information System (INIS)

1989-09-01

The annotation on R and D prorgam 86 parts I-II have been brought together in the present report part I, together with some general viewpoints, and been classified according to subject. Part II of the present report comprises viewpoints of 'Research Program 1987-1992' and part III of 'Alternative methods of ultimate storage'. Swedish and French viewpoints are presented in Swedish, the remaining foreign material in English. The comments are grouped in subject catergories. (O.S.)

Ultimate Electrical Means for Severe Accident and Multi Unit Event Management

International Nuclear Information System (INIS)

Guisez, Xavier

2015-01-01

Following the Multi Unit Severe Accident that occurred at Fukushima as a result of the tsunami on 11 March 2011, the European Council decided to submit its Nuclear Power Plants to a Stress Test. In Belgium, this Stress Test, named BEST (Belgian Stress Test), was successfully concluded at the end of 2011. Nevertheless, Electrabel decided, in agreement with the Authorities, to start a beyond design basis action plan, with the goal to mitigate the consequences of a Beyond Design Basis Accident and a Multi Unit Event. Consequently, this has led to an improvement of the robustness of its Nuclear Power Plants. Considering the importance of electrical power supply to a nuclear power plant, a significant part of this action plan consisted of setting up a mobile, 'plug and play' method for the electrical power supply to some major safety systems. In order to install this ultimate power supply, three factors were retained as essential. First, important reactor monitoring instrumentation is preserved. Second, core cooling is provided at all times. Finally, systems are easily made operational within a very short delay of time. During normal operation and Design Basis Events, core cooling is provided by High Voltage equipment. However, during high stress circumstances, it is too complex to realize connections on this equipment. Therefore, analysis was performed to realize core cooling with, easier to handle, Low Voltage equipment. These systems are powered by several GenSets, especially designed and manufactured for this application. The outcome of this project are easy to use, ultimate means, that supply electric power to important safety systems in order to drastically reduce the risk of core damage, during a beyond design basis event. Additionally, for all ultimate means, procedures and training modules were developed for the operators. (authors)

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

Science.gov (United States)

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

2014-07-05

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

[Incidence of phlebitis due to peripherally inserted venous catheters: impact of a catheter management protocol].

Science.gov (United States)

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

2010-01-01

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.

Flux scaling: Ultimate regime

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Flux scaling: Ultimate regime. With the Nusselt number and the mixing length scales, we get the Nusselt number and Reynolds number (w'd/ν) scalings: and or. and. scaling expected to occur at extremely high Ra Rayleigh-Benard convection. Get the ultimate regime ...

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

Science.gov (United States)

DeFraia, Gary S

2013-01-01

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

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

Directory of Open Access Journals (Sweden)

Yulia G. Krasnozhon

2018-03-01

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

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

Science.gov (United States)

Loop, Carole

2013-01-01

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

Ultimate resources of drinking water in the event of a major pollution crisis: the role of bottled water

International Nuclear Information System (INIS)

Collin, J.J.; Comte, J.P.; Daum, J.R.; Lopoukhine, M.; Mesny, M.

1995-01-01

In the event of a serious and widespread pollution incident - on the level of the ''Chernobyl cloud'' - most of the drinking water resources in France could be contaminated : surface water immediately, ground water in a few days... or a few months. Therefore on the initiative of the Ministry of the Environment's Director for Defence, a study has been initiated as to what might be qualified as ''final emergency resources''. An inventory and map of protected resources have been prepared. In this context it seems reasonable to show bottled water as a resource meeting the necessary protection criteria. However it seems that these criteria are not all, nor always, relevant for defining a ''ultimate emergency resource'' not contaminated by a major incident. This article outlines a typology of situations and defines the main criteria necessary for bottled water to be able to constitute an ultimate resource

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

International Nuclear Information System (INIS)

Lohsiriwat, V.

2009-01-01

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

Management of response to the polonium-210 incident in London

International Nuclear Information System (INIS)

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

2008-01-01

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

Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

DEFF Research Database (Denmark)

Willersrud, Anders; Imsland, Lars; Blanke, Mogens

2015-01-01

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

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

International Nuclear Information System (INIS)

Coleman, C. Norman; Koerner, John F.

2016-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

Making the connection: advancing traffic incident management in transportation planning : a primer.

Science.gov (United States)

2013-07-01

"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 ...

The comparative incidence of reported concussions presenting for follow-up management in South African Rugby Union.

Science.gov (United States)

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

2008-09-01

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.

PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

Directory of Open Access Journals (Sweden)

Vjeran Strahonja

2007-06-01

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

The dream of an ultimate theory

International Nuclear Information System (INIS)

Weinberg, S.

1997-10-01

Steven Weinberg describes how the dream of an ultimate theory began when one tried to unify the fundamental laws governing the stars constellations as elementary particles: electromagnetism, weak-electro theory then standard model which gives only one quantity out of its fields, the gravitation. He tries to explain to what an ultimate theory could look like. but the dream of an ultimate theory is not yet realized, there are some elementary particles to find before and then to build superconducting super colliders. The europe made it. the dream of an ultimate theory became an european dream. (N.C.)

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

Science.gov (United States)

1995-02-01

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

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

Directory of Open Access Journals (Sweden)

Yongfeng Ma

2014-01-01

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

The ultimate quotable Einstein

CERN Document Server

2011-01-01

Here is the definitive new edition of the hugely popular collection of Einstein quotations that has sold tens of thousands of copies worldwide and been translated into twenty-five languages. The Ultimate Quotable Einstein features 400 additional quotes, bringing the total to roughly 1,600 in all. This ultimate edition includes new sections--"On and to Children," "On Race and Prejudice," and "Einstein's Verses: A Small Selection"--as well as a chronology of Einstein's life and accomplishments, Freeman Dyson's authoritative foreword, and new commentary by Alice Calaprice.

Formal analysis of empirical traces in incident management

International Nuclear Information System (INIS)

Hoogendoorn, Mark; Jonker, Catholijn M.; Maanen, Peter-Paul van; Sharpanskykh, Alexei

2008-01-01

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

Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment : Research Summary

Science.gov (United States)

2017-12-01

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...

Towards an Ultimate Battery Thermal Management System

DEFF Research Database (Denmark)

Khan, Mohammad Rezwan; Swierczynski, Maciej Jozef; Kær, Søren Knudsen

2017-01-01

The prevailing standards and scientific literature offer a wide range of options for the construction of a battery thermal management system (BTMS). The design of an innovative yet well-functioning BTMS requires strict supervision, quality audit and continuous improvement of the whole process....... It must address all the current quality and safety (Q&S) standards. In this review article, an effective battery thermal management is sought considering the existing battery Q&S standards and scientific literature. The article contains a broad overview of the current existing standards and literature...... on a generic compliant BTMS. The aim is to assist in the design of a novel compatible BTMS. Additionally, the article delivers a set of recommendations to make an effective BTMS....

Critical infrastructure cyber-security risk management

OpenAIRE

Spyridopoulos, T.; Maraslis, K.; Tryfonas, T.; Oikonomou, G.

2017-01-01

Traditional IT cyber-security risk management methods are based on the evaluation of risks calculated as the likelihood of cyber-security incidents occurring. However, these probabilities are usually estimations or guesses based on past experience and incomplete data. Incorrect estimations can lead to errors in the evaluation of risks that can ultimately affect the protection of the system. This issue is also transferred to methods used in Industrial Control Systems (ICSs), as they are mainly...

Shear wall ultimate drift limits

International Nuclear Information System (INIS)

Duffey, T.A.; Goldman, A.; Farrar, C.R.

1994-04-01

Drift limits for reinforced-concrete shear walls are investigated by reviewing the open literature for appropriate experimental data. Drift values at ultimate are determined for walls with aspect ratios ranging up to a maximum of 3.53 and undergoing different types of lateral loading (cyclic static, monotonic static, and dynamic). Based on the geometry of actual nuclear power plant structures exclusive of containments and concerns regarding their response during seismic (i.e.,cyclic) loading, data are obtained from pertinent references for which the wall aspect ratio is less than or equal to approximately 1, and for which testing is cyclic in nature (typically displacement controlled). In particular, lateral deflections at ultimate load, and at points in the softening region beyond ultimate for which the load has dropped to 90, 80, 70, 60, and 50 percent of its ultimate value, are obtained and converted to drift information. The statistical nature of the data is also investigated. These data are shown to be lognormally distributed, and an analysis of variance is performed. The use of statistics to estimate Probability of Failure for a shear wall structure is illustrated

Comparing badger (Meles meles) management strategies for reducing tuberculosis incidence in cattle.

Science.gov (United States)

Smith, Graham C; McDonald, Robbie A; Wilkinson, David

2012-01-01

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.

Comparing badger (Meles meles management strategies for reducing tuberculosis incidence in cattle.

Directory of Open Access Journals (Sweden)

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.

Towards an Ultimate Battery Thermal Management System

DEFF Research Database (Denmark)

Khan, Mohammad Rezwan; Swierczynski, Maciej Jozef; Kær, Søren Knudsen

2017-01-01

The prevailing standards and scientific literature offer a wide range of options for the construction of a battery thermal management system (BTMS). The design of an innovative yet well-functioning BTMS requires strict supervision, quality audit and continuous improvement of the whole process...

Occult pneumothorax in Chinese patients with significant blunt chest trauma: incidence and management.

Science.gov (United States)

Lee, Ka L; Graham, Colin A; Yeung, Janice H H; Ahuja, Anil T; Rainer, Timothy H

2010-05-01

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.

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

Science.gov (United States)

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

2011-01-01

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

Ultimate and proximate explanations of strong reciprocity.

Science.gov (United States)

Vromen, Jack

2017-08-23

Strong reciprocity (SR) has recently been subject to heated debate. In this debate, the "West camp" (West et al. in Evol Hum Behav 32(4):231-262, 2011), which is critical of the case for SR, and the "Laland camp" (Laland et al. in Science, 334(6062):1512-1516, 2011, Biol Philos 28(5):719-745, 2013), which is sympathetic to the case of SR, seem to take diametrically opposed positions. The West camp criticizes advocates of SR for conflating proximate and ultimate causation. SR is said to be a proximate mechanism that is put forward by its advocates as an ultimate explanation of human cooperation. The West camp thus accuses advocates of SR for not heeding Mayr's original distinction between ultimate and proximate causation. The Laland camp praises advocates of SR for revising Mayr's distinction. Advocates of SR are said to replace Mayr's uni-directional view on the relation between ultimate and proximate causes by the bi-directional one of reciprocal causation. The paper argues that both the West camp and the Laland camp misrepresent what advocates of SR are up to. The West camp is right that SR is a proximate cause of human cooperation. But rather than putting forward SR as an ultimate explanation, as the West camp argues, advocates of SR believe that SR itself is in need of ultimate explanation. Advocates of SR tend to take gene-culture co-evolutionary theory as the correct meta-theoretical framework for advancing ultimate explanations of SR. Appearances notwithstanding, gene-culture coevolutionary theory does not imply Laland et al.'s notion of reciprocal causation. "Reciprocal causation" suggests that proximate and ultimate causes interact simultaneously, while advocates of SR assume that they interact sequentially. I end by arguing that the best way to understand the debate is by disambiguating Mayr's ultimate-proximate distinction. I propose to reserve "ultimate" and "proximate" for different sorts of explanations, and to use other terms for distinguishing

Physical demands in competitive ultimate frisbee

DEFF Research Database (Denmark)

Krustrup, Peter; Mohr, Magni

2015-01-01

The objective was to study game demands in competitive ultimate Frisbee by performing match analysis during a game. Thirteen moderately trained (Yo-Yo intermittent recovery test levels 1 and 2 [Yo-Yo IR1 and IR2] performance: 1790 ± 382 m and 657 ± 225 m, respectively) competitive male ultimate...... = 0.74, p ≤ 0.05). Ultimate Frisbee is an intense intermittent team sport with high cardiovascular loading and clear indications of fatigue toward the end of each half. Yo-Yo IR test performances correlate with physical match performance....

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

Science.gov (United States)

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

2014-07-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-03-24

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

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

Science.gov (United States)

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

2009-06-01

. 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.

Mantram repetition for stress management in veterans and employees: a critical incident study.

Science.gov (United States)

Bormann, Jill E; Oman, Doug; Kemppainen, Jeanne K; Becker, Sheryl; Gershwin, Madeline; Kelly, Ann

2006-03-01

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.

Explaining implementation behaviour of the National Incident Management System (NIMS).

Science.gov (United States)

Jensen, Jessica; Youngs, George

2015-04-01

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.

A Narrative Review on the Pathophysiology and Management for Radiation Cystitis

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C. Browne

2015-01-01

Full Text Available Radiation cystitis is a recognised complication of pelvic radiotherapy. Incidence of radiation cystitis ranges from 23 to 80% and the incidence of severe haematuria ranges from 5 to 8%. High quality data on management strategies for radiation cystitis is sparse. Treatment modalities are subclassified into systemic therapies, intravesical therapies, and hyperbaric oxygen and interventional procedures. Short-term cure rates range from 76 to 95% for hyperbaric oxygen therapy and interventional procedures. Adverse effects of these treatment strategies are acceptable. Ultimately, most patients require multimodal treatment for curative purposes. Large randomised trials exploring emergent management strategies are required in order to strengthen evidence-based treatment strategies. Urologists encounter radiation cystitis commonly and should be familiar with diagnostic modalities and treatment strategies.

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

Science.gov (United States)

2010-01-01

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

Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

International Nuclear Information System (INIS)

Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo

2012-01-01

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.

Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

Energy Technology Data Exchange (ETDEWEB)

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

2012-03-15

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

Critical incidents and critical incident stress management (CISM) - an employee assistance programme (EAP) perspective

OpenAIRE

Terblanche, Lourie; van Wyk, André

2014-01-01

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...

Ultimate justification: Wittgenstein and medical ethics.

Science.gov (United States)

Hughes, J

1995-02-01

Decisions must be justified. In medical ethics various grounds are given to justify decisions, but ultimate justification seems illusory and little considered. The philosopher Wittgenstein discusses the problem of ultimate justification in the context of general philosophy. His comments, nevertheless, are pertinent to ethics. From a discussion of Wittgensteinian notions, such as 'bedrock', the idea that 'ultimate' justification is grounded in human nature as such is derived. This discussion is relevant to medical ethics in at least five ways: it shows generally what type of certainty there is in practical ethics; it seems to imply some objective foundation to our ethical judgements; it squares with our experience of making ethical decisions; it shows something of the nature of moral arguments; and, finally, it has implications for teaching medicine and ethics.

Report: Improvements Needed in CSB’s Identity and Access Management and Incident Response Security Functions

Science.gov (United States)

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.

Boro Silicate Glass: The proven Conditioning of RTR ultimate Waste

International Nuclear Information System (INIS)

Bartagnon, O.; Petitjean, V.

2002-01-01

The possibility to dispose of the RTR spent fuel in a geological repository is neither internationally foreseen nor seems realistic. This due to degradation phenomena and possible criticality incidents. The conditioning by reprocessing is the only solution for back end management of TRT spent fuels

Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south-eastern Australia.

Science.gov (United States)

Potter, S J; Bamford, N J; Harris, P A; Bailey, S R

2017-10-01

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.

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

Science.gov (United States)

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

2015-01-01

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

Ultimate - a new generation of gasoline and diesel fuels; Ultimate - eine neue Generation von Otto- und Dieselkraftstoffen

Energy Technology Data Exchange (ETDEWEB)

Strempel, G. [Aral Forschung/Global Fuels Technology, Bochum (Germany); Beckwith, P. [BP Fuels Management Group, Pangbourne (United Kingdom); Froehling, J. [Aral Forschung, Bochum (Germany). Labor/Analytik; Baron, U. [Aral Forschung, Bochum (Germany). Motor- und Fahrzeuglaboratorium; Sauermann, P.; Balfanz, U. [Aral Forschung, Bochum (Germany). Produktentwicklung; Doermer, W. [Aral Forschung, Bochum (Germany). Produktqualitaet

2005-06-01

With the launch of Ultimate 100 gasoline and Ultimate Diesel, motorists in Germany now have the opportunity to choose new advanced performance fuels designed to get the very best from their engines. This article gives details of the technical development behind these fuels, their wide range of benefits, and how it is possible to manufacture fuels which meet the considerable technical challenge of achieving both more performance and less pollution. (orig.)

Towards Incidence Management in 5G Based on Situational Awareness

Directory of Open Access Journals (Sweden)

Lorena Isabel Barona López

2017-01-01

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

STUDY OF INCIDENCE & MANAGEMENT OF PARA PHARYNGEAL TUMORS

Directory of Open Access Journals (Sweden)

Aruna Kumari

2015-11-01

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

The unified approach of management and critical incident stress management: helping flight attendants and pilots in the aftermath of September 11.

Science.gov (United States)

McIntosh, Tania

2006-01-01

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.

Episodic foresight and anxiety: Proximate and ultimate perspectives.

Science.gov (United States)

Miloyan, Beyon; Bulley, Adam; Suddendorf, Thomas

2016-03-01

In this paper, we examine the relationship between episodic foresight and anxiety from an evolutionary perspective, proposing that together they confer an advantage for modifying present moment decision-making and behaviour in the light of potential future threats to fitness. We review the body of literature on the role of episodic foresight in anxiety, from both proximate and ultimate perspectives. We propose that anxious feelings associated with episodic simulation of possible threat-related future events serve to imbue these simulations with motivational currency. Episodic and semantic details of a future threat may be insufficient for motivating its avoidance, but anxiety associated with a simulation can provoke adaptive threat management. As such, we detail how anxiety triggered by a self-generated, threat-related future simulation prepares the individual to manage that threat (in terms of its likelihood and/or consequences) over greater temporal distances than observed in other animals. We then outline how anxiety subtypes may represent specific mechanisms for predicting and managing particular classes of fitness threats. This approach offers an inroad for understanding the nature of characteristic future thinking patterns in anxiety disorders and serves to illustrate the adaptive function of the mechanism from which clinical anxiety deviates. © 2015 The British Psychological Society.

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

Science.gov (United States)

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

2018-02-01

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

Occupational Risks Associated with Solid Waste Management in the Informal Sector of Gweru, Zimbabwe.

Science.gov (United States)

Jerie, Steven

2016-01-01

This study identifies and analyses the occupational risks associated with solid waste management practices in the informal enterprises of Gweru. Many concerns have been raised about the potential harm from waste to the environment and the general public, but the risks and consequent costs of occupational hazards in waste management have received little attention in the rush to adopt or adapt technologies such as composting. A multimethods research design that triangulates qualitative and quantitative research paradigms is employed in this study. The quantitative design involves physical characterisation of solid waste through material component separation and measurements as well as a questionnaire survey that investigates the risks associated with waste management. The qualitative component includes interviews, open-ended questionnaires, and field observations. Occupational risks occur at every stage in the waste management process, from the point where workers handle waste in the enterprises for collection or recycling to the point of ultimate disposal. Key findings from the study revealed that solid waste management practices are dominated by manual handling tasks hence the higher incidents of muscular-skeletal disorders. Other safety and health hazards associated with waste management in the informal enterprises of Gweru include incidents of diarrhoea, viral hepatitis, and higher incidents of obstructive and restrictive disorders.

Occupational Risks Associated with Solid Waste Management in the Informal Sector of Gweru, Zimbabwe

Science.gov (United States)

Jerie, Steven

2016-01-01

This study identifies and analyses the occupational risks associated with solid waste management practices in the informal enterprises of Gweru. Many concerns have been raised about the potential harm from waste to the environment and the general public, but the risks and consequent costs of occupational hazards in waste management have received little attention in the rush to adopt or adapt technologies such as composting. A multimethods research design that triangulates qualitative and quantitative research paradigms is employed in this study. The quantitative design involves physical characterisation of solid waste through material component separation and measurements as well as a questionnaire survey that investigates the risks associated with waste management. The qualitative component includes interviews, open-ended questionnaires, and field observations. Occupational risks occur at every stage in the waste management process, from the point where workers handle waste in the enterprises for collection or recycling to the point of ultimate disposal. Key findings from the study revealed that solid waste management practices are dominated by manual handling tasks hence the higher incidents of muscular-skeletal disorders. Other safety and health hazards associated with waste management in the informal enterprises of Gweru include incidents of diarrhoea, viral hepatitis, and higher incidents of obstructive and restrictive disorders. PMID:27418935

THE ULTIMATE STATE CONCEPT APPLIED TO TUNNEL SUPPORT

Directory of Open Access Journals (Sweden)

Mladen Hudec

2000-12-01

Full Text Available The most questionable are the values of pressures between rock and support resulting from common deformations on the contact area between rock and support. Therefore the modelling and design of the tunnel support is not reliable, if it is based on active rock pressure resulting from this common deformations. The inversion of the design procedure is proposed. Instead of the active extreme pressure of the rock on support, the influence of ultimate reaction of the support on the rock has to be analysed. This procedure can be performed using the ultimate load principle, as proposed by Eurocodc 7 (Geotechnies. Normally, the rock has the tendency to increase the common conver¬gence until the support reaches its ultimate state. So, loading of profile boundary with the ultimate possible reaction of the support is very plausible. The reactive support pressures have to be probable and itself in equilibrium. The ultimate reactive load has to be reduced by Euro-code safety factor for structural elements and applied on the rock with given properties, or alternatively (as proposed by Eurocode 7 the soil or rock properties have to be diminished and calculated with full ultimate support pressures. If the rock with given (or proposed pro¬perties and loaded with ultimate reactive pressures resulting from supposed support, satisfy its failure criterion, then is the compound system support-rock verificatcd. By this procedure, the number of relevant material properties is reduce to the primary stress ratio and the constants defining the failure criterion. The verification can be performed by any of numerical methods, but we prefer here used boundary elements method (the paper is published in Croatian.

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

International Nuclear Information System (INIS)

Bruynooghe, Christiane; Noel, Marc

2009-01-01

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

Development of the decision make supporting system on incident management

International Nuclear Information System (INIS)

Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

2017-01-01

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

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

Science.gov (United States)

Murphy, M. R.

1980-01-01

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

Ultimate fate of constrained voters

International Nuclear Information System (INIS)

Vazquez, F; Redner, S

2004-01-01

We examine the ultimate fate of individual opinions in a socially interacting population of leftists, centrists and rightists. In an elemental interaction between agents, a centrist and a leftist can both become centrists or both become leftists with equal rates (and similarly for a centrist and a rightist). However leftists and rightists do not interact. This interaction step between pairs of agents is applied repeatedly until the system can no longer evolve. In the mean-field limit, we determine the exact probability that the system reaches consensus (either leftist, rightist or centrist) or a frozen mixture of leftists and rightists as a function of the initial composition of the population. We also determine the mean time until the final state is reached. Some implications of our results for the ultimate fate in a limit of the Axelrod model are discussed

Ultimate fate of constrained voters

Energy Technology Data Exchange (ETDEWEB)

Vazquez, F [Department of Physics, Center for BioDynamics, Boston University, Boston, MA 02215 (United States); Redner, S [Department of Physics, Center for Polymer Studies, Boston University, Boston, MA 02215 (United States)

2004-09-03

We examine the ultimate fate of individual opinions in a socially interacting population of leftists, centrists and rightists. In an elemental interaction between agents, a centrist and a leftist can both become centrists or both become leftists with equal rates (and similarly for a centrist and a rightist). However leftists and rightists do not interact. This interaction step between pairs of agents is applied repeatedly until the system can no longer evolve. In the mean-field limit, we determine the exact probability that the system reaches consensus (either leftist, rightist or centrist) or a frozen mixture of leftists and rightists as a function of the initial composition of the population. We also determine the mean time until the final state is reached. Some implications of our results for the ultimate fate in a limit of the Axelrod model are discussed.

Ultimate Lateral Capacity of Rigid Pile in c- φ Soil

Science.gov (United States)

Zhang, Wei-min

2018-03-01

To date no analytical solution of the pile ultimate lateral capacity for the general c- φ soil has been obtained. In the present study, a new dimensionless embedded ratio was proposed and the analytical solutions of ultimate lateral capacity and rotation center of rigid pile in c- φ soils were obtained. The results showed that both the dimensionless ultimate lateral capacity and dimensionless rotation center were the univariate functions of the embedded ratio. Also, the ultimate lateral capacity in the c- φ soil was the combination of the ultimate lateral capacity ( f c ) in the clay, and the ultimate lateral capacity ( f φ ) in the sand. Therefore, the Broms chart for clay, solution for clay ( φ=0) put forward by Poulos and Davis, solution for sand ( c=0) obtained by Petrasovits and Awad, and Kondner's ultimate bending moment were all proven to be the special cases of the general solution in the present study. A comparison of the field and laboratory tests in 93 cases showed that the average ratios of the theoretical values to the experimental value ranged from 0.85 to 1.15. Also, the theoretical values displayed a good agreement with the test values.

Ultimate Educational Aims, Overridingness, and Personal Well-Being

Science.gov (United States)

Haji, Ishtiyaque; Cuypers, Stefaan E.

2011-01-01

Discussion regarding education's aims, especially its ultimate aims, is a key topic in the philosophy of education. These aims or values play a pivotal role in regulating and structuring moral and other types of normative education. We outline two plausible strategies to identify and justify education's ultimate aims. The first associates these…

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

Science.gov (United States)

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

2009-06-01

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

Contents of management plans for incidents and accidents involving the transport of radioactive substances. Guide no. 17, Version of 22/12/2014

International Nuclear Information System (INIS)

2014-01-01

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

Development of a highway incident management operational and training guide for incident responders in Illinois.

Science.gov (United States)

2011-08-01

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...

[The effect of colored syringes and a colored sheet on the incidence of syringe swaps during anesthetic management].

Science.gov (United States)

Hirabayashi, Yoshihiro; Kawakami, Takayuki; Suzuki, Hideo; Igarashi, Takashi; Saitoh, Kazuhiko; Seo, Norimasa

2005-09-01

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.

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

Science.gov (United States)

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

2017-07-01

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

Experimental investigation of ultimate loads

Energy Technology Data Exchange (ETDEWEB)

Petersen, S M; Larsen, G C; Antoniou, I; Lind, S O; Courtney, M [Risoe National Lab., Wind Energy and Atmospheric Physics, Roskilde (Denmark)

1999-03-01

Verification of the structural integrity of a wind turbine involves analysis of fatigue loading as well as ultimate loading. With the trend of persistently growing turbines, the ultimate loading seems to become relatively more important. For wind turbines designed according to the wind conditions prescribed in the IEC-61400 code, the ultimate load is often identified as the leading load parameter. Exemplified by the use of an extensive measurement campaign a procedure for evaluation of the extreme flap-wise bending moments, occurring during normal operating of a wind turbine, is presented. The structural measurements are made on a NEG Micon 650 kW wind turbine erected at a complex high wind site in Oak Creek, California. The turbine is located on the top of a ridge. The prevailing wind direction is perpendicular to the ridge, and the annual mean wind speed is 9.5 m/s. The associated wind field measurement, are taken from two instrumented masts erected less than one rotor diameter in front of the turbine in direction of the prevailing wind direction. Both masts are instrumented at different heights in order to gain insight of the 3D-wind speed structure over the entire rotor plane. Extreme distributions, associated with a recurrence period of 10 minutes, conditioned on the mean wind speed and the turbulence intensity are derived. Combined with the wind climate model proposed in the IEC standard, these distributions are used to predict extreme distributions with recurrence periods equal to one and fifty years, respectively. The synthesis of the conditioned PDF`s and the wind climate model is performed by means of Monte Carlo simulation. (au)

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

Directory of Open Access Journals (Sweden)

Faouzi Kamoun

2010-12-01

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

Ultimate internal pressure capacity of concrete containment structures

International Nuclear Information System (INIS)

Krishnaswamy, C.N.; Namperumal, R.; Al-Dabbagh, A.

1983-01-01

Lesson learned from the accident at Three-Mile Island nuclear plant has necessitated the computation of the ultimate internal pressure capacity of containment structures as a licensing requirement in the U.S. In general, a containment structure is designed to be essentially elastic under design accident pressure. However, as the containment pressure builds up beyond the design value due to a more severe postulated accident, the containment response turns nonlinear as it sequentially passes through cracking of concrete, yielding of linear plate, yielding of rebar, and yielding of post-tensioning tendon (if the containment concrete is prestressed). This paper reports on the determination of the ultimate internal pressure capacity and nonlinear behavior of typical reinforced and prestressed concrete BWR containments. The probable modes of failure, the criteria for ultimate pressure capacity, and the most critical sections are described. Simple equations to hand-calculate the ultimate pressure capacity and the nonlinear behavior at membrane sections of the containment shell are presented. A nonlinear finite element analysis performed to determine the nonlinear behavior of the entire shell including nonmembrane sections is briefly discribed. The analysis model consisted of laminated axisymmetric shell finite elements with nonlinear stress-strain properties for each material. Results presented for typical BWR concrete containments include nonlinear response plots of internal pressure versus containment deflection and strains in the liner, rebar, and post-tensioning tendons at the most stressed section in the shell. Leak-tightness of the containment liner and the effect of thermal loads on the ultimate capacity are discussed. (orig.)

The non-technical skills used by anaesthetic technicians in critical incidents reported to the Australian Incident Monitoring System between 2002 and 2008.

Science.gov (United States)

Rutherford, J S; Flin, R; Irwin, A

2015-07-01

The outcome of critical incidents in the operating theatre has been shown to be influenced by the behaviour of anaesthetic technicians (ATs) assisting anaesthetists, but the specific non-technical skills involved have not been described. We performed a review of critical incidents (n=1433) reported to the Australian Incident Monitoring System between 2002 and 2008 to identify which non-technical skills were used by ATs. The reports were assessed if they mentioned anaesthetic assistance or had the boxes ticked to identify "inadequate assistance" or "absent supervision or assistance". A total of 90 critical incidents involving ATs were retrieved, 69 of which described their use of non-technical skills. In 20 reports, the ATs ameliorated the critical incident, whilst in 46 they exacerbated the critical incident, and three cases had both positive and negative non-technical skills described. Situation awareness was identified in 39 reports, task management in 23, teamwork in 21 and decision-making in two, but there were no descriptions of issues related to leadership, stress or fatigue management. Situation awareness, task management and teamwork appear to be important non-technical skills for ATs in the development or management of critical incidents in the operating theatre. This analysis has been used to support the development of a non-technical skills taxonomy for anaesthetic assistants.

Management of In-Field Patient Tracking and Triage by Using Near-Field Communication in Mass Casualty Incidents.

Science.gov (United States)

Cheng, Po-Liang; Su, Yung-Cheng; Hou, Chung-Hung; Chang, Po-Lun

2017-01-01

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.

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

Science.gov (United States)

Tucker, J B

1997-08-06

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

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

Science.gov (United States)

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

2017-09-01

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

Ultimate load capacity assessment of reinforced concrete shell structures

International Nuclear Information System (INIS)

Gupta, Amita; Singh, R.K.; Kushwaha, H.S.; Mahajan, S.C.; Kakodkar, A.

1993-01-01

The objective of this study is to develop capability for prediction of ultimate load capacity of reinforced concrete shell structures. The present finite element code ULCA (Ultimate Load Capacity Assessment) adopts a degenerate concept of formulating general isoparametric shell element with a layered approach in the thickness direction. Different failure modes such as crushing, tensile cracking and reinforcement yielding are recognised for various problems. The structure fails by crushing of concrete when the concrete strain/stress reaches the ultimate stress or strain of concrete. Material nonlinearities as a result of tension cracking, tension stiffening between reinforcement and concrete in cracked region and yielding of reinforcement are considered along with geometric nonlinearity. Thus with this code it is possible to predict the pressure at which the first cracking, first through thickness cracking, first yielding of reinforcement occurs. After validating the code with few bench mark problems for different failure modes a reinforced concrete nuclear containment is analysed for its ultimate capacity and the results are matched with the published results. Further the ultimate load capacity of outer containment wall of Narora Atomic Power Station is predicted. It is observed that containment fails in membrane region and has a sufficient margin against design pressure. (author). 9 refs., 56 figs., 3 tabs., 1 appendix with 4 tabs

Workload management and geographic disorientation in aviation incidents: A review of the ASRS data base

Science.gov (United States)

Williams, Henry P.; Tham, Mingpo; Wickens, Christopher D.

1993-01-01

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.

Sensitivity analysis on ultimate strength of aluminium stiffened panels

DEFF Research Database (Denmark)

Rigo, P.; Sarghiuta, R.; Estefen, S.

2003-01-01

This paper presents the results of an extensive sensitivity analysis carried out by the Committee III.1 "Ultimate Strength" of ISSC?2003 in the framework of a benchmark on the ultimate strength of aluminium stiffened panels. Previously, different benchmarks were presented by ISSC committees on ul...

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

Science.gov (United States)

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

2014-10-01

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

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

Science.gov (United States)

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

2017-02-09

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

Emergency response to mass casualty incidents in Lebanon.

Science.gov (United States)

El Sayed, Mazen J

2013-08-01

The emergency response to mass casualty incidents in Lebanon lacks uniformity. Three recent large-scale incidents have challenged the existing emergency response process and have raised the need to improve and develop incident management for better resilience in times of crisis. We describe some simple emergency management principles that are currently applied in the United States. These principles can be easily adopted by Lebanon and other developing countries to standardize and improve their emergency response systems using existing infrastructure.

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

Directory of Open Access Journals (Sweden)

Brian O'Leary

2015-08-01

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

Development of Incident Report Database for Organizational Learning

Science.gov (United States)

Otsuka, Yuichi; Abe, Tomotaka; Noguchi, Hiroshi; Makinouchi, Akifumi

The necessity of an incident reporting system has recently been increasing for hospitals. Japan Council for Quality Health Care (JCQHC) started operating a national incident reporting system to which domestic hospitals would report their incidents. However, the reporting system obtained an additional problem for the hospitals. They managed their own systems which collected reports by papers. The purposes of the reporting systems was to analyze considerable causes involved in incidents to improve the quality of patient safety management. On the contrary, the national reporting system aimed at collecting a statistical tendency of normal incidents. Simultaneously operating the two systems would be too much workload for safety managers. The load may have the managers rest only a short time for summarizing occurrences, not enough for analyzing their causes. However, to the authors' knowledge, there has not been an integrating policy of the two forms to adapt them to practical situations in patient safety management. The scope of this paper is to establish the integrated form in order to use in analyzing the causes of incidents as well as reporting for the national system. We have developed new data base system using XML + XSLT and Java Servlet. The developed system is composed of three computers; DB server , DB client and Data sending server. To investigate usability of the developed system, we conducted a monitoring test by real workers in reporting workplaces. The result of subjective evaluations by examinees was so preferable for the developed system. The results of usability test and the achievement of increasing the number of reports after the introduction can demonstrate the enough effectiveness of the developed system for supporting the activity of patient safety management.

Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

Science.gov (United States)

Blancher, Marc; Albasini, François; Elsensohn, Fidel; Zafren, Ken; Hölzl, Natalie; McLaughlin, Kyle; Wheeler, Albert R; Roy, Steven; Brugger, Hermann; Greene, Mike; Paal, Peter

2018-02-15

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.

Ultimate Strength of Ship Hulls under Torsion

DEFF Research Database (Denmark)

Paik, Jeom Kee; Thayamballi, Anil K.; Pedersen, Preben Terndrup

2001-01-01

For a ship hull with large deck openings such as container vessels and some large bulk carriers, the analysis of warping stresses and hatch opening deformations is an essential part of ship structural analyses. It is thus of importance to better understand the ultimate torsional strength characte......For a ship hull with large deck openings such as container vessels and some large bulk carriers, the analysis of warping stresses and hatch opening deformations is an essential part of ship structural analyses. It is thus of importance to better understand the ultimate torsional strength...... characteristics of ships with large hatch openings. The primary aim of the present study is to investigate the ultimate strength characteristics of ship hulls with large hatch openings under torsion. Axial (warping) as well as shear stresses are normally developed for thin-walled beams with open cross sections...... subjected to torsion. A procedure for calculating these stresses is briefly described. As an illustrative example, the distribution and magnitude of warping and shear stresses for a typical container vessel hull cross section under unit torsion is calculated by the procedure. By theoretical and numerical...

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

Energy Technology Data Exchange (ETDEWEB)

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

2006-02-07

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

Rapid population growth and environmental degradation: ultimate versus proximate factors.

Science.gov (United States)

Shaw, R P

1989-01-01

This philosophical review of 2 arguments about responsibility for and solutions to environmental degradation concludes that both sides are correct: the ultimate and the proximal causes. Ultimate causes of pollution are defined as the technology responsible for a given type of pollution, such as burning fossil fuel; proximate causes are defined as situation-specific factors confounding the problem, such as population density or rate of growth. Commoner and others argue that developed countries with low or negative population growth rates are responsible for 80% of world pollution, primarily in polluting technologies such as automobiles, power generation, plastics, pesticides, toxic wastes, garbage, warfaring, and nuclear weapons wastes. Distortionary policies also contribute; examples are agricultural trade protection, land mismanagement, urban bias in expenditures, and institutional rigidity., Poor nations are responsible for very little pollution because poverty allows little waste or expenditures for polluting, synthetic technologies. The proximal causes of pollution include numbers and rate of growth of populations responsible for the pollution. Since change in the ultimate cause of pollution remains out of reach, altering the numbers of polluters can make a difference. Predictions are made for proportions of the world's total waste production, assuming current 1.6 tons/capita for developed countries and 0.17 tons/capita for developing countries. If developing countries grow at current rates and become more wealthy, they will be emitting half the world's waste by 2025. ON the other hand, unsustainable population growth goes along with inadequate investment in human capital: education, health, employment, infrastructure. The solution is to improve farming technologies in the 117 non-self-sufficient countries, fund development in the most unsustainable enclaves of growing countries, break institutionalized socio-political rigidity in these enclaves, and focus on

Proximate and Ultimate Limiting Nutrients in the Mississippi River Plume: Implications for Hypoxia Reduction Through Nutrient Management

Science.gov (United States)

Fennel, K.; Laurent, A.

2016-02-01

A large hypoxic area (15,000 km2 on average) forms every summer over the Texas-Louisiana shelf in the northern Gulf of Mexico due to decay of organic matter that is primarily derived from nutrient inputs from the Mississippi/Atchafalaya River System. Efforts are underway to reduce the extent of hypoxic conditions through nutrient management in the watershed; for example, an interagency Hypoxia Task Force is developing Action Plans with input from various stakeholders that set out targets for hypoxia reduction. An open question is by how much nutrient loads would have to be decreased in order to produce the desired reductions in hypoxia and when these would be measurable over natural variability. We have performed a large number of multi-year nutrient load reduction scenarios with a regional biogeochemical model for the region. The model is based on the Regional Ocean Modeling System (ROMS), explicitly includes nitrogen (N) and phosphorus (P) species as inorganic nutrients, and has been shown to realistically reproduce the key processes responsible for hypoxia generation. We have quantified the effects of differential reductions in river N and P loads on hypoxic extent. An assessment of the effects of N versus P reductions is important because, thus far, nutrient management efforts have focused on N, yet P is known to limit primary production in spring and early summer. A debate is ongoing as to whether targets for P reductions should be set and whether nutrient reduction efforts should focus solely on P, which results primarily from urban and industrial point sources and is uncoupled from agricultural fertilizer application. Our results strongly indicate that N is the `ultimate' limiting nutrient to primary production determining the areal extent and duration of hypoxic conditions in a cumulative sense, while P is temporarily limiting in spring. Although reductions in river P load would decrease hypoxic extent in early summer, they would have a much smaller effect

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

NARCIS (Netherlands)

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

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

The effect of search channel elimination on purchase incidence, order size and channel choice

NARCIS (Netherlands)

Konus, U.; Neslin, S.A.; Verhoef, P.C.

This study investigates the impact of eliminating a search channel on purchase incidence, order size, channel choice and, ultimately, sales and profits. We analyze customer panel data from a large retailer over a five-year period. The retailer conducted a randomized field test in which the firm

Information System of Resolution of Procedural Incidents and Management of the Modifications Made to the Electronic Court Registration

Directory of Open Access Journals (Sweden)

Ştefan Gheorghe PENTIUC

2011-01-01

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.

Incident Duration Modeling Using Flexible Parametric Hazard-Based Models

Directory of Open Access Journals (Sweden)

Ruimin Li

2014-01-01

Full Text Available Assessing and prioritizing the duration time and effects of traffic incidents on major roads present significant challenges for road network managers. This study examines the effect of numerous factors associated with various types of incidents on their duration and proposes an incident duration prediction model. Several parametric accelerated failure time hazard-based models were examined, including Weibull, log-logistic, log-normal, and generalized gamma, as well as all models with gamma heterogeneity and flexible parametric hazard-based models with freedom ranging from one to ten, by analyzing a traffic incident dataset obtained from the Incident Reporting and Dispatching System in Beijing in 2008. Results show that different factors significantly affect different incident time phases, whose best distributions were diverse. Given the best hazard-based models of each incident time phase, the prediction result can be reasonable for most incidents. The results of this study can aid traffic incident management agencies not only in implementing strategies that would reduce incident duration, and thus reduce congestion, secondary incidents, and the associated human and economic losses, but also in effectively predicting incident duration time.

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2014-10-17

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

Pilot Critical Incident Reports as a Means to Identify Human Factors of Remotely Piloted Aircraft

Science.gov (United States)

Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

2016-01-01

It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. Human factor issues included the impact of reduced sensory cues, traffic separation in the absence of an out-the-window view, control latencies, vigilance during monotonous and ultra-long endurance flights, control station design considerations, transfer of control between control stations, the management of lost link procedures, and decision-making during emergencies. Pilots participated willingly and enthusiastically in the study

An Examination of Commercial Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

Science.gov (United States)

Reveley, Mary S.; Briggs, Jeffrey L.; Thomas, Megan A.; Evans, Joni K.; Jones, Sharon M.

2011-01-01

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.

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

Energy Technology Data Exchange (ETDEWEB)

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

2011-11-15

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

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

International Nuclear Information System (INIS)

Shah, Chirag; Vicini, Frank A.

2011-01-01

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

Assessment and characterization of radioactive waste for ultimate storage

International Nuclear Information System (INIS)

Brennecke, P.; Warnecke, E.

1986-01-01

The waste specifications determined from site safety analyses define the requirements to be met by waste forms for ultimate storage. Product quality control is the process step ensuring compliance with the conditions to be met for ultimate storage. For this purpose, radionuclide inventory, fixation method, container type, waste form and quantity, and type of waste are the most significant items on the checking list. (DG) [de

7 CFR 4280.21 - Eligible REDG Ultimate Recipients and Projects.

Science.gov (United States)

2010-01-01

... care providers; (5) Projects that utilize Advanced Telecommunications or computer networks to... 7 Agriculture 15 2010-01-01 2010-01-01 false Eligible REDG Ultimate Recipients and Projects. 4280... Economic Development Loan and Grant Programs § 4280.21 Eligible REDG Ultimate Recipients and Projects. The...

Reflecting on impact, changes and continuities: restructuring workplace cultures: the ultimate work-family challenge.

OpenAIRE

Lewis, Suzan

2010-01-01

Purpose – The purpose of this paper is to reflect on the paper “Restructuring workplace cultures: the ultimate work-family challenge?” is published in Women in Management Review, Vol. 16 No. 1, 2001, pp. 21-9. \\ud \\ud Design/methodology/approach – The impact of the paper is considered within a framework that takes account of national discursive and political contexts in the UK in 2001 and in the present and uses a gendered organisation lens. \\ud \\ud Findings – The 2001 paper demonstrates that...

The Incidence and Management of Conflicts in Secular and Non-Secular Tertiary Institutions in South West Nigeria

Science.gov (United States)

Ayodele, Joseph Babatola; Adewumi, Joseph Olukayode

2007-01-01

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…

Influence of initial imperfections on ultimate strength of spherical shells

Directory of Open Access Journals (Sweden)

Chang-Li Yu

2017-09-01

Full Text Available Comprehensive consideration regarding influence mechanisms of initial imperfections on ultimate strength of spherical shells is taken to satisfy requirement of deep-sea structural design. The feasibility of innovative numerical procedure that combines welding simulation and non-linear buckling analysis is verified by a good agreement to experimental and theoretical results. Spherical shells with a series of wall thicknesses to radius ratios are studied. Residual stress and deformations from welding process are investigated separately. Variant influence mechanisms are discovered. Residual stress is demonstrated to be influential to stress field and buckling behavior but not to the ultimate strength. Deformations are proved to have a significant impact on ultimate strength. When central angles are less than critical value, concave magnitudes reduce ultimate strengths linearly. However, deformations with central angles above critical value are of much greater harm. Less imperfection susceptibility is found in spherical shells with larger wall thicknesses to radius ratios.

Acute incidents during anaesthesia

African Journals Online (AJOL)

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

Working relationships between obstetric care staff and their managers: a critical incident analysis.

Science.gov (United States)

Chipeta, Effie; Bradley, Susan; Chimwaza-Manda, Wanangwa; McAuliffe, Eilish

2016-08-26

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.

Study on laser welding of austenitic stainless steel by varying incident angle of pulsed laser beam

Science.gov (United States)

Kumar, Nikhil; Mukherjee, Manidipto; Bandyopadhyay, Asish

2017-09-01

In the present work, AISI 304 stainless steel sheets are laser welded in butt joint configuration using a robotic control 600 W pulsed Nd:YAG laser system. The objective of the work is of twofold. Firstly, the study aims to find out the effect of incident angle on the weld pool geometry, microstructure and tensile property of the welded joints. Secondly, a set of experiments are conducted, according to response surface design, to investigate the effects of process parameters, namely, incident angle of laser beam, laser power and welding speed, on ultimate tensile strength by developing a second order polynomial equation. Study with three different incident angle of laser beam 89.7 deg, 85.5 deg and 83 deg has been presented in this work. It is observed that the weld pool geometry has been significantly altered with the deviation in incident angle. The weld pool shape at the top surface has been altered from semispherical or nearly spherical shape to tear drop shape with decrease in incident angle. Simultaneously, planer, fine columnar dendritic and coarse columnar dendritic structures have been observed at 89.7 deg, 85.5 deg and 83 deg incident angle respectively. Weld metals with 85.5 deg incident angle has higher fraction of carbide and δ-ferrite precipitation in the austenitic matrix compared to other weld conditions. Hence, weld metal of 85.5 deg incident angle achieved higher micro-hardness of ∼280 HV and tensile strength of 579.26 MPa followed by 89.7 deg and 83 deg incident angle welds. Furthermore, the predicted maximum value of ultimate tensile strength of 580.50 MPa has been achieved for 85.95 deg incident angle using the developed equation where other two optimum parameter settings have been obtained as laser power of 455.52 W and welding speed of 4.95 mm/s. This observation has been satisfactorily validated by three confirmatory tests.

Exploring the perception of aid organizations' staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study.

Science.gov (United States)

Bazeli, Javad; Aryankhesal, Aidin; Khorasani-Zavareh, Davoud

2017-07-01

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.

Ultimate pressure capacity of CANDU 6 containment structures

International Nuclear Information System (INIS)

Radulescu, J.P.; Pradolin, L.; Mamet, J.C.

1997-01-01

This paper summarizes the analytical work carried out and the results obtained when determining the ultimate pressure capacity (UPC) of the containment structures of CANDU 6 nuclear power plants. The purpose of the analysis work was to demonstrate that such containment structures are capable of meeting design requirements under the most severe accident conditions. For this concrete vessel subjected to internal pressure, the UPC was defined as the pressure causing through cracking in the concrete. The present paper deals with the overall behaviour of the containment. The presence of openings, penetrations and the ultimate pressure of the airlocks were considered separately. (author)

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

International Nuclear Information System (INIS)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing

2016-01-01

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

Energy Technology Data Exchange (ETDEWEB)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing, E-mail: jzeng13@uw.edu [Department of Radiation Oncology, University of Washington Medical Center, 1959 NE Pacific Street, Campus Box 356043, Seattle, Washington 98195 (United States)

2016-05-15

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Incidence and Management Costs of Freshwater Aquatic Nuisance Species at Projects Operated by the U.S. Army Corps of Engineers

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

Abrahamsen, Håkon B

2015-06-10

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Ultimate guide to YouTube for business

CERN Document Server

2018-01-01

Ultimate Guide to YouTube for Business helps small business owners create marketing videos to help promote their products, share their story, build a community around their brand without spending a fortune-all the while making money.

Proximate versus ultimate limiting nutrients in the Mississippi River Plume and Implications for Hypoxia Reductions through Nutrient Management

Science.gov (United States)

Fennel, Katja; Laurent, Arnaud

2016-04-01

A large hypoxic area (15,000 km2 on average) forms every summer over the Texas-Louisiana shelf in the northern Gulf of Mexico due to decay of organic matter that is primarily derived from nutrient inputs from the Mississippi/Atchafalaya River System. Efforts are underway to reduce the extent of hypoxic conditions through nutrient management in the watershed; for example, an interagency Hypoxia Task Force is developing Action Plans with input from various stakeholders that set out targets for hypoxia reduction. An open question is how far nutrient loads would have to be decreased in order to produce the desired reductions in hypoxia and when these would be measurable given significant natural variability. We have simulated a large number of multi-year nutrient load reduction scenarios with a regional biogeochemical model for the region. The model is based on the Regional Ocean Modeling System (ROMS), explicitly includes nitrogen (N) and phosphorus (P) species as inorganic nutrients, and has been shown to realistically reproduce the key processes responsible for hypoxia generation. We have quantified the effects of differential reductions in river N and P loads on hypoxic extent. An assessment of the effects of N versus P reductions is important because, thus far, nutrient management efforts have focused on N, yet P is known to limit primary production in spring and early summer. A debate is ongoing as to whether targets for P reductions should be set and whether nutrient reduction efforts should focus solely on P, which results primarily from urban and industrial point sources and is uncoupled from agricultural fertilizer application. Our results strongly indicate that N is the 'ultimate' limiting nutrient to primary production determining the areal extent and duration of hypoxic conditions in a cumulative sense, while P is temporarily limiting in spring. Although reductions in river P load would decrease hypoxic extent in early summer, they would have a much

Safety culture and learning from incidents: the role of incident reporting and causal analyses

International Nuclear Information System (INIS)

Wilpert, B.

1994-01-01

Nuclear industry more than any other industrial branch has developed and used predictive risk analysis as a method of feedforward control of safety and reliability. Systematic evaluation of operating experience, statistical documentation of component failures, systematic documentation and analysis of incidents are important complementary elements of feedback control: we are dealing here with adjustment and learning from experience, in particular from past incidents. Using preliminary findings from ongoing research at the Research Center Systems Safety at the Berlin University of Technology the contribution discusses preconditions for an effective use of lessons to be learnt from closely matched incident reporting and in depth analyses of causal chains leading to incidents. Such conditions are especially standardized documentation, reporting and analyzing methods of incidents; structured information flows and feedback loops; abstaining from culpability search; mutual trust of employees and management; willingness of all concerned to continually evaluate and optimize the established learning system. Thus, incident related reporting and causal analyses contribute to safety culture, which is seen to emerge from tightly coupled organizational measures and respective change in attitudes and behaviour. (author) 2 figs., 7 refs

Economic injury levels for Asian citrus psyllid control in process oranges from mature trees with high incidence of huanglongbing.

Directory of Open Access Journals (Sweden)

Cesar Monzo

Full Text Available The Asian citrus psyllid (ACP, Diaphorina citri Kuwayama, is the key pest of citrus wherever it occurs due to its role as vector of huanglongbing (HLB also known as citrus greening disease. Insecticidal vector control is considered to be the primary strategy for HLB management and is typically intense owing to the severity of this disease. While this approach slows spread and also decreases severity of HLB once the disease is established, economic viability of increasingly frequent sprays is uncertain. Lacking until now were studies evaluating the optimum frequency of insecticide applications to mature trees during the growing season under conditions of high HLB incidence. We related different degrees of insecticide control with ACP abundance and ultimately, with HLB-associated yield losses in two four-year replicated experiments conducted in commercial groves of mature orange trees under high HLB incidence. Decisions on insecticide applications directed at ACP were made by project managers and confined to designated plots according to experimental design. All operational costs as well as production benefits were taken into account for economic analysis. The relationship between management costs, ACP abundance and HLB-associated economic losses based on current prices for process oranges was used to determine the optimum frequency and timing for insecticide applications during the growing season. Trees under the most intensive insecticidal control harbored fewest ACP resulting in greatest yields. The relationship between vector densities and yield loss was significant but differed between the two test orchards, possibly due to varying initial HLB infection levels, ACP populations or cultivar response. Based on these relationships, treatment thresholds during the growing season were obtained as a function of application costs, juice market prices and ACP densities. A conservative threshold for mature trees with high incidence of HLB would help

Trump er gældsøkonomiens ultimative illusionist

DEFF Research Database (Denmark)

Nielsen, Peter

2018-01-01

Trump giver ikke kun gevaldige skattelettelser og nærer en illusion om, at vækst vil løse alle problemer. Han fortrænger også gældsøkonomiens ultimative bundlinje i form af klimaforandringerne.......Trump giver ikke kun gevaldige skattelettelser og nærer en illusion om, at vækst vil løse alle problemer. Han fortrænger også gældsøkonomiens ultimative bundlinje i form af klimaforandringerne....

Results of an online questionnaire to survey calf management practices on dairy cattle breeding farms in Austria and to estimate differences in disease incidences depending on farm structure and management practices.

Science.gov (United States)

Klein-Jöbstl, Daniela; Arnholdt, Tim; Sturmlechner, Franz; Iwersen, Michael; Drillich, Marc

2015-08-19

Calf disease may result in great economic losses. To implement prevention strategies it is important to gain information on management and to point out risk factors. The objective of this internet based survey was to describe calf management practices on registered dairy breeding farms in Austria and to estimate differences in calf disease incidences depending on farm structure and management practices. A total of 1287 questionnaires were finally analysed (response rate 12.2 %). Herd characteristics and regional distribution of farms indicated that this survey gives a good overview on calf management practices on registered dairy farms in Austria. The median number of cows per farm was 20 (interquartile range 13-30). Significant differences regarding farm characteristics and calf management between small and large farms (≤20 vs >20 cows) were present. Only 2.8 % of farmers tested first colostrum quality by use of a hydrometer. Storing frozen colostrum was more prevalent on large farms (80.8 vs 64.2 %). On 85.1 % of the farms, whole milk, including waste milk, was fed to the calves. Milk replacer and waste milk were more often used on large farms. In accordance with similar studies from other countries, calf diarrhoea was indicated as the most prevalent disease. Multivariable logistic regression analysis revealed that herd size was associated with calf diarrhoea and calf respiratory tract disease, with higher risk of disease on large farms. Furthermore, feeding waste milk to the calves was associated with increasing calf diarrhoea incidence on farm. In the final model with calf respiratory tract disease as outcome, respondents from organic farms reported less often a respiratory tract disease incidence of over 10 % compared with conventional farms [odds ratio (OR) 0.40, 95 % confidence interval (CI) 0.21-0.75] and farmers that housed calves individually or in groups after birth significantly reported more often to have an incidence of respiratory tract

Social, institutional, and psychological factors affecting wildfire incident decision making

Science.gov (United States)

Matthew P. Thompson

2014-01-01

Managing wildland fire incidents can be fraught with complexity and uncertainty. Myriad human factors can exert significant influence on incident decision making, and can contribute additional uncertainty regarding programmatic evaluations of wildfire management and attainment of policy goals. This article develops a framework within which human sources of uncertainty...

Which aspects of safety culture predict incident reporting behavior in neonatal intensive care units? A multilevel analysis

NARCIS (Netherlands)

Snijders, Cathelijne; Kollen, Boudewijn J.; van Lingen, Richard A.; Fetter, Willem P. F.; Molendijk, Harry; Kok, J. H.; te Pas, E.; Pas, H.; van der Starre, C.; Bloemendaal, E.; Lopes Cardozo, R. H.; Molenaar, A. M.; Giezen, A.; van Lingen, R. A.; Maat, H. E.; Molendijk, A.; Snijders, C.; Lavrijssen, S.; Mulder, A. L. M.; de Kleine, M. J. K.; Koolen, A. M. P.; Schellekens, M.; Verlaan, W.; Vrancken, S.; Fetter, W. P. F.; Schotman, L.; van der Zwaan, A.; van der Tuijn, Y.; Tibboel, D.; van der Schaaf, T. W.; Klip, H.; Kollen, B. J.

2009-01-01

OBJECTIVES: Safety culture assessments are increasingly used to evaluate patient-safety programs. However, it is not clear which aspects of safety culture are most relevant in understanding incident reporting behavior, and ultimately improving patient safety. The objective of this study was to

Educational attainment and ultimate fertility among Swedish women born in 1955-59

Directory of Open Access Journals (Sweden)

Gerda Neyer

2006-05-01

Full Text Available This is the second of two companion papers addressing the association between educational attainment and fertility for some sixty educational groups of Swedish women, defined according to field of education as well as level of education. The first paper is about childlessness and education, the present one about the mean number of children ever born. We find that ultimate fertility decreases somewhat with an increasing educational level, but its dependence on the field of education is much more impressive. In general, educational groups with relatively little childlessness also have relatively high ultimate fertility, and educational groups with much childlessness have relatively low ultimate fertility. In particular, women educated for the teaching or health-care professions have less childlessness and a higher ultimate fertility than others. Conversely, women with an education for esthetic or (non-teacher humanist occupations have unusually high fractions childless and low ultimate fertility. Women with religious educations stand out by having very high fractions childless but quite ordinary mean ultimate fertility nevertheless; such women have very little childbearing outside of marriage. Women with research degrees have remarkably ordinary childbearing behavior; they do not forego motherhood to the extent that some theories would predict.

Integrated Incident Management System (IIMS) web client application development, deployment and evaluation: an evaluation of a potential IIMS deployment in Western New York : final report.

Science.gov (United States)

2015-09-30

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...

Bayesian geostatistical modeling of leishmaniasis incidence in Brazil.

Directory of Open Access Journals (Sweden)

Dimitrios-Alexios Karagiannis-Voules

Full Text Available BACKGROUND: Leishmaniasis is endemic in 98 countries with an estimated 350 million people at risk and approximately 2 million cases annually. Brazil is one of the most severely affected countries. METHODOLOGY: We applied Bayesian geostatistical negative binomial models to analyze reported incidence data of cutaneous and visceral leishmaniasis in Brazil covering a 10-year period (2001-2010. Particular emphasis was placed on spatial and temporal patterns. The models were fitted using integrated nested Laplace approximations to perform fast approximate Bayesian inference. Bayesian variable selection was employed to determine the most important climatic, environmental, and socioeconomic predictors of cutaneous and visceral leishmaniasis. PRINCIPAL FINDINGS: For both types of leishmaniasis, precipitation and socioeconomic proxies were identified as important risk factors. The predicted number of cases in 2010 were 30,189 (standard deviation [SD]: 7,676 for cutaneous leishmaniasis and 4,889 (SD: 288 for visceral leishmaniasis. Our risk maps predicted the highest numbers of infected people in the states of Minas Gerais and Pará for visceral and cutaneous leishmaniasis, respectively. CONCLUSIONS/SIGNIFICANCE: Our spatially explicit, high-resolution incidence maps identified priority areas where leishmaniasis control efforts should be targeted with the ultimate goal to reduce disease incidence.

The critical incident technique reappraised: using critical incidents to illuminate organizational practices and build theory

OpenAIRE

Bott, Gregory; Tourish, Dennis

2016-01-01

Purpose: The purpose of this paper is to offer a reconceptualization of the critical incident technique (CIT) and affirm its utility in management and organization studies.\\ud \\ud Design/methodology/approach: Utilizing a case study from a leadership context, the paper applies the CIT to explore various leadership behaviours in the context of nonprofit boards in Canada. Semi-structured critical incident interviews were used to collect behavioural data from 53 participants – board chairs, board...

Error-Based Accidents and Security Incidents in Nuclear Materials Management

International Nuclear Information System (INIS)

Pond, Daniel J.; Greitzer, Frank L.

2005-01-01

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

Ultimate disposition of aluminum clad spent nuclear fuel in the United States

International Nuclear Information System (INIS)

Messick, C.E.; Clark, W.D.; Clapper, M.; Mustin, T.P.

2001-01-01

Treatment and disposition of spent nuclear fuel (SNF) in the United States has changed significantly over the last decade due to change in world climate associated with nuclear material. Chemical processing of aluminum based SNF is ending and alternate disposition paths are being developed that will allow for the ultimate disposition of the enriched uranium in this SNF. Existing inventories of aluminum based SNF are currently being stored primarily in water-filled basins at the Savannah River Site (SRS) while these alternate disposition paths are being developed and implemented. Nuclear nonproliferation continues to be a worldwide concern and it is causing a significant influence on the development of management alternatives for SNF. SRS recently completed an environmental impact statement for the management of aluminum clad SNF that selects alternatives for all of the fuels in inventory. The U.S. Department of Energy and SRS are now implementing a dual strategy of processing small quantities of 'problematic' SNF while developing an alternative technology to dispose of the remaining aluminum clad SNF in the proposed monitored geologic repository. (author)

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

Science.gov (United States)

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

2015-01-01

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

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

OpenAIRE

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

2012-01-01

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

On the decrease of ultimate elongation of gum elastomer by irradiation

International Nuclear Information System (INIS)

Ito, Masayuki

1986-01-01

The reason why the ultimate elongation of gum elastomer decreases by irradiation was studied. The sample used is tetrafluoroethylenepropylene copolymer vulcanized which is a heat resistant elastomer. The sample was irradiated by a electron beam at room temperature. Cross-linking predominate in the operation. (Case 1) Scission predominant condition (Case 2) was given by irradiation of Co-60 γ ray at 100 deg C. Alternative irradiation of γ ray and electron beam under above condition can keep the original cross-linking density by the appropriate choice of each of the doses. (Case 3) The three cases mentioned above involve all of the cases of radiation induced aging of elastomers. Therefor, the following explanation for three cases shows the reason why the ultimate elongation of gum elastomer decreases by irradiation. Case 1. Cross-linking predominant condition. Ultimate elongation is proportional to -0.5 power of the dose. This fact can be explicable by the model of Buche, i.e. the breaking of a short chain causes another to break and that so on throughout the whole sample. Case 2. Chain scission predominant condition. Ultimate elongation increases by irradiation for a certain dose. This fact can understand by the model of Buche. But from a certain dose ultimate elongation does not increase. In the period the structure of the sample turned to be the same structure as the low molecular weight amorphose polymer vulcanized. Case 3. Rate of cross-linking and scission is the same. The average chain length does not chainge in the condition. But the distribution of chain length became wider and wider by irradiation. The increase of short chain result the decrease in ultimate elongation. (author)

Accounting conservatism,ultimate ownership and investment efficiency

Institute of Scientific and Technical Information of China (English)

Xiaodong Xu; Xia Wang; Nina Han

2012-01-01

Purpose-The purpose of this paper is to analyze and examine the role of accounting conservatism on firm investment behavior in China.Design/methodology/approach-By combining a developed theoretical framework and empirical study,this paper examines the impacts of accounting conservatism on firm investment.The sample and data are all collected from Wind and CAMAR databases.Findings-The paper finds that the association between accounting conservatism and capital expenditure is significantly positive when inside capital is not enough to use for investment,suggesting that conservatism can expend the level of investment by decreasing information asymmetry and cost of capital;however,the association between accounting conservatism and capital expenditure is significantly negative when inside capital is enough to use for investment,suggesting that conservatism can curtail the level of investment by mitigating the interest conflicts between management and outside shareholders and decreasing agency costs.Additionally,the paper finds that the severity of information asymmetry and agency problem affects the role of accounting conservatism on firm investment behaviour,and the association between accounting conservatism and capital expenditure is weaker for firms with ultimate ownership controller as local government or individuals.Originality/value-This is the first paper to analyze and examine the impacts of accounting conservatism on firm investment in China directly.The findings are also useful to explain the awkward predicament found by prior literature.

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

Science.gov (United States)

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

2017-12-01

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

Assessment on Ultimate Load of Cold-formed Steel Channel (CFSC Stub Column

Directory of Open Access Journals (Sweden)

Mohd Sani Mohd Syahrul Hisyam

2015-01-01

Full Text Available Cold-formed steel is used as the non-structural and structural material in civil engineering work and building. Cold-formed steel channel is selected and cut into 100 mm, 200 mm, 300 mm, 400 mm and 500 mm. The slenderness ratio is calculated and noted as a stub or short column because below 40. The column is tested by using Universal Testing Machine to determine the ultimate load of the stub column. Besides, the CFSC is determined the material properties of CFSC for checking it’s the originality of steel based material. The experimental data are tested and compared with the Direct Strength Method (DSM. It showed that the CFSC1 with a height of 100 mm is reported to have a higher value of ultimate load when compared with other samples. When the height of the stub column increased, the ultimate load of the sample is decreased. Then, the CFSC1 also showed a higher in initial stiffness when compared with other samples. All samples are shown having a higher data in ultimate load when compared with the Direct Strength Method prediction. The ultimate load of experimental and DSM all gave a ratio below 1.03. Finally, all samples can further recommend determining the relation between the ultimate loads with variations of height of the column.

Excess glycogen does not resolve high ultimate pH of oxidative muscle.

Science.gov (United States)

England, Eric M; Matarneh, Sulaiman K; Oliver, Emily M; Apaoblaza, Ariel; Scheffler, Tracy L; Shi, Hao; Gerrard, David E

2016-04-01

Skeletal muscle glycogen content can impact the extent of postmortem pH decline. Compared to glycolytic muscles, oxidative muscles contain lower glycogen levels antemortem which may contribute to the higher ultimate pH. In an effort to explore further the participation of glycogen in postmortem metabolism, we postulated that increasing the availability of glycogen would drive additional pH decline in oxidative muscles to equivalent pH values similar to the ultimate pH of glycolytic muscles. Glycolysis and pH declines were compared in porcine longissimus lumborum (glycolytic) and masseter (oxidative) muscles using an in vitro system in the presence of excess glycogen. The ultimate pH of the system containing longissimus lumborum reached a value similar to that observed in intact muscle. The pH decline of the system containing masseter samples stopped prematurely resulting in a higher ultimate pH which was similar to that of intact masseter muscle. To investigate further, we titrated powdered longissimus lumborum and masseter samples in the reaction buffer. As the percentage of glycolytic sample increased, the ultimate pH decreased. These data show that oxidative muscle produces meat with a high ultimate pH regardless of glycogen content and suggest that inherent muscle factors associated with glycolytic muscle control the extent of pH decline in pig muscles. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ultimate capabilities of soft x-ray optics

International Nuclear Information System (INIS)

Vinogradov, A.V.; Zorev, N.N.; Kozhevnikov, I.V.

1988-01-01

Nonimaging soft X-ray optics is examined. The ultimate capabilities of a number of X-ray optical components designed for concentration and collimation of radiation from point sources are determined. The applications of X-ray optics are discussed together with the properties of materials in the X-ray range

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

NARCIS (Netherlands)

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

2012-01-01

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

Ultimate Opening Combined with Area Stability Applied to Urban Scenes

OpenAIRE

Marcotegui , Beatriz; Serna , Andrés; Hernández , Jorge

2017-01-01

International audience; This paper explores the use of ultimate opening in urban analysis context. It demonstrates the efficiency of this approach for street level elevation images, derived from 3D point clouds acquired by terrestrial mobile mapping systems. An area-stability term is introduced in the residual definition, reducing the over-segmentation of the vegetation while preserving small significant regions. We compare two possible combinations of the Ultimate Opening and the Area Stabil...

The Ultimate Technology

DEFF Research Database (Denmark)

Riis, Søren

2013-01-01

One of the most influential philosophers of the 20th century, Martin Heidegger (1889-1976), died prior to the remarkable cloning of the sheep Dolly and before Dr. Venter started his experiments on creating synthetic life, and he never explicitly discussed living technologies. However, by reinterp......One of the most influential philosophers of the 20th century, Martin Heidegger (1889-1976), died prior to the remarkable cloning of the sheep Dolly and before Dr. Venter started his experiments on creating synthetic life, and he never explicitly discussed living technologies. However......, by reinterpreting his notion of "modern technology," this article shows how it is possible to philosophically assess living technologies and to recognize ways in which Heidegger anticipated this phenomenon with his notion of cybernetics. The interpretation elucidates the fundamental process of technology becoming...... living and simultaneously presents living technology as the ultimate technology. The thesis of this article is that living technology is not just one more technology; rather, it is the perfection of technology as understood by Aristotle. Aristotle's thinking is in this way a key example of a profound...

A study on nonlinear behavior of reactor containment structures during ultimate accident condition(I)

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Hoon; Kim, Young Jin; Park, Joo Yeon [Youngdong Univ., Yeongdong (Korea, Republic of)] (and others)

2003-03-15

In this study, the following scope and contents are established for first year's study of determining ultimate pressure capacity of CANDU-type reactor containment. State-of-arts on the prediction of the ultimate pressure capacity of prestressed concrete reactor containment. Comparative study on structural characteristics and analysis model of CANDU-type reactor containment. State-of-arts on evaluation method of the ultimate pressure capacity of prestressed concrete reactor containment. Enhancement of evaluation method of the ultimate pressure capacity for PWR containment structure. In order to determine a realistic lower bound of a typical reactor containment structural capacity for internal pressure, modelling techniques and analytical investigation to predict its non-linear behavior up to ultimate capacity are required. Especially, the in-depth evaluation of modeling technique and analysis procedure for determining ultimate pressure capacity of CANDU-type reactor containment is required. Therefore, modelling techniques and analytical investigation to predict its non-linear behavior up to ultimate pressure capacity of CANDU-type reactor containment for internal pressure will be suggested in this study.

A study on nonlinear behavior of reactor containment structures during ultimate accident condition(I)

International Nuclear Information System (INIS)

Kim, Sun Hoon; Kim, Young Jin; Park, Joo Yeon

2003-03-01

In this study, the following scope and contents are established for first year's study of determining ultimate pressure capacity of CANDU-type reactor containment. State-of-arts on the prediction of the ultimate pressure capacity of prestressed concrete reactor containment. Comparative study on structural characteristics and analysis model of CANDU-type reactor containment. State-of-arts on evaluation method of the ultimate pressure capacity of prestressed concrete reactor containment. Enhancement of evaluation method of the ultimate pressure capacity for PWR containment structure. In order to determine a realistic lower bound of a typical reactor containment structural capacity for internal pressure, modelling techniques and analytical investigation to predict its non-linear behavior up to ultimate capacity are required. Especially, the in-depth evaluation of modeling technique and analysis procedure for determining ultimate pressure capacity of CANDU-type reactor containment is required. Therefore, modelling techniques and analytical investigation to predict its non-linear behavior up to ultimate pressure capacity of CANDU-type reactor containment for internal pressure will be suggested in this study

Current approaches to managing aggressive incidents among in ...

African Journals Online (AJOL)

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 ...

75 FR 60133 - Agency Information Collection Activities: Declaration of Ultimate Consignee That Articles Were...

Science.gov (United States)

2010-09-29

... Activities: Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or... the Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or...: Title: Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or...

Ultimate gradient in solid-state accelerators

International Nuclear Information System (INIS)

Whittum, D.H.

1998-08-01

The authors recall the motivation for research in high-gradient acceleration and the problems posed by a compact collider. They summarize the phenomena known to appear in operation of a solid-state structure with large fields, and research relevant to the question of the ultimate gradient. They take note of new concepts, and examine one in detail, a miniature particle accelerator based on an active millimeter-wave circuit and parallel particle beams

Dealing Collectively with Critical Incident Stress Reactions in High Risk Work Environments

DEFF Research Database (Denmark)

Müller-Leonhardt, Alice; Strøbæk, Pernille Solveig; Vogt, joachim

2015-01-01

organisations. Indeed, we found that the CISM programme once integrated within the socio-cultural patterns of this specific working environment enhanced not only individual feelings of being supported but also organisational safety culture. Keywords: coping; safety culture; critical incident stress management......aim of this paper is to shift the representation of coping patterns within high risk occupations to an existential part of cultural pattern and social structure, which characterises high reliability organisations. Drawing upon the specific peer model of critical incident stress management (CISM......), in which qualified operational peers support colleagues who experienced critical incident stress, the paper discusses critical incident stress management in air traffic control. Our study revealed coping patterns that co-vary with the culture that the CISM programme fostered within this specific high...

78 FR 69101 - Agency Information Collection Activities: Declaration of the Ultimate Consignee That Articles...

Science.gov (United States)

2013-11-18

... Activities: Declaration of the Ultimate Consignee That Articles Were Exported for Temporary Scientific or... the Declaration of the Ultimate Consignee that Articles were Exported for Temporary Scientific or...: Title: Declaration of the Ultimate Consignee that Articles were Exported for Temporary Scientific or...

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

International Nuclear Information System (INIS)

Pages Zamora, Alberto

2008-01-01

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

The system for centralized inventory keeping and ultimate disposal of radioactive waste in the former German Democratic Republic

International Nuclear Information System (INIS)

Beise, E.; Mielke, H.G.; Mueller, W.; Oppermann, U.

1991-01-01

The report explains the concept adopted by the former GDR. The system based at Morsleben, for centralized inventory keeping and management of radioactive waste is explained, refewing to the amounts of waste accrued, storage and transport of waste drums, classification and preparation of waste forms, and ultimate disposal of radioactive waste in the Morsleben repository. The report includes information on the management of special waste and spent fuel elements which cannot be stored at the Morsleben site. Most of the radioactive waste produced in the former GDR has been stored since 1979 at the Morsleben site. The waste came from the nuclear power plants (Greifswald, Rheinsberg), and from installations and institutes applying or producing radionuclides - so-called APR waste - (e.g. from the institutes at Rossendorf and Berlin-Buch, and from about 1300 other waste producers). The waste was accepted as or processed to solid waste forms, liquid waste, sealed radiation sources, and special waste; the ultimate storage techniques applied are packing of drums, backfilling, solidification of liquid waste and disposal in boreholes. Up to the end of the year 1989, the Morsleben repository received about 14000 m 3 of radioactive waste (about 40% solid waste, and about 60% liquid waste). (orig.) [de

Integrating environment health and safety management at Petro-Canada

International Nuclear Information System (INIS)

Raymond, G.

1993-01-01

Petro-Canada has developed a tool to integrate, measure, and improve its management systems of environment, health, and safety (EH ampersand S). This tool, called the Total Loss Management System, is described in the areas of general management issues, policies and procedures, evaluations, organization, stewardship, issue management, and performance measures. Petro-Canada's policies on occupational health and safety are consistent with its environmental policy, being structured in the same way. An integrated audit system is used to cover health, safety, industrial hygiene, reliability, environment, and risk management. EH ampersand S matters are integrated at the corporate level in a separate department. Regional divisions review EH ampersand S performance every month, incidents are discussed, and preventive measures are taken as necessary. Regional performances are combined every quarter for ultimate presentation to the Petro-Canada board. New or emerging issues that may affect divisions are assigned an issue sponsor, a member of divisional management who makes sure the issue receives the resources necessary to study and define its impact. Examples of issues include soil contamination, process hazard management, and benzene exposure limits. Performance measures flow from the corporate environment and occupational health and safety policies, and come in two types: those that measure activities to improve performance and those that measure the outcome of the activities

''Project Crystal'' for ultimate storage of highly radioactive waste

International Nuclear Information System (INIS)

Anon.

1983-01-01

NAGRA (The National Association for storage of radioactive waste) in Baden has launched in North Switzerland an extensive geological research program. The current research program, under the title of ''Project Crystal'', aims at providing the scientific knowledge which is required for the assessment of the suitability of the crystalline sub-soil of North Switzerland for the ultimate storage of highly radioactive waste. Safety and feasibility of such ultimate storage are in the forefront of preoccupations. Scientific institutes of France, Germany, USA and Canada are cooperating more particularly on boring research and laboratory analyses. Technical data are given on the USA and German installations used. (P.F.K.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2018-03-01

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

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

Science.gov (United States)

2017-12-01

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

Influence of cracks and pitting corrosion on residual ultimate strength of stiffened plates

Directory of Open Access Journals (Sweden)

ZHANG Jing

2018-02-01

Full Text Available [Objectives] Ships and offshore platforms serve in the harsh sea environment for a long time. Cracks and pitting corrosion will occur in such a structure and the damage will affect its ultimate strength.[Methods] To investigate the influence of cracks and pitting corrosion on ultimate bearing capacity, the ultimate strength of a structure under axial compression is studied by using a nonlinear finite element. The mesh size of a stiffened plate with cracks and pitting corrosion is first discussed. Then the influence of the relative positions of cracks and pitting corrosion, number of corrosion points and crack length impact on the residual ultimate strength of damaged stiffened plates is discussed via a series of calculations.[Results] The results indicate that the increase in crack length and pitting corrosion significantly decreases the ultimate strength of a stiffened plate. [Conclusions] This provides a useful reference for designing and maintaining ships and offshore structures in their life cycles.

Reflections on Leadership and Governance from the Incident Manager of Liberia's Ebola Response.

Science.gov (United States)

Nyenswah, Tolbert

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.

Seismic shear wall ISP NUPEC's seismic ultimate dynamic response test. Comparison report

International Nuclear Information System (INIS)

1996-01-01

In the seismic design of a nuclear power plant, evaluation of the ultimate strength of the nuclear reactor building is an important subject for assessment of seismic reliability of the plant. In order to carry out the evaluation, the response characteristics of reinforced concrete seismic shear walls up to their ultimate state have to be understood. For this purpose, there is a need to develop reliable non-linear response analysis methods which enables the reliable ultimate strength evaluation of nuclear reactor buildings. Along with this need, many computer codes have been developed. These computer codes are compared. (K.A.)

Customer focused incident monitoring in anaesthesia.

Science.gov (United States)

Khan, F A; Khimani, S

2007-06-01

The database of incident forms relating to anaesthesia services in an institutional risk management programme were reviewed for 2003-2005, the aim being to identify any recurring patterns. Incidents were prospectively categorised as relating to attitude/behaviour, communication breakdown, delay in service, or were related to care, cost, environment, equipment, security, administrative process, quality of service or miscellaneous. The total number of anaesthesia-related incidents reported during the period was 287, which related to 0.44% of the total number of anaesthetics administered during the time period. In all, 170 incidents were reported by the department, 96 by internal customers and 21 by external customers. Only 30% of the complaints came from the operating room. Thirty-four per cent of all incidents related to communication, behaviour and delay in service. A requirement to teach communication skills and stress handling formally in anaesthesia training programmes, and at the time of induction of staff into the department, has been identified.

Traffic Incident Clearance Time and Arrival Time Prediction Based on Hazard Models

Directory of Open Access Journals (Sweden)

Yang beibei Ji

2014-01-01

Full Text Available Accurate prediction of incident duration is not only important information of Traffic Incident Management System, but also an effective input for travel time prediction. In this paper, the hazard based prediction models are developed for both incident clearance time and arrival time. The data are obtained from the Queensland Department of Transport and Main Roads’ STREAMS Incident Management System (SIMS for one year ending in November 2010. The best fitting distributions are drawn for both clearance and arrival time for 3 types of incident: crash, stationary vehicle, and hazard. The results show that Gamma, Log-logistic, and Weibull are the best fit for crash, stationary vehicle, and hazard incident, respectively. The obvious impact factors are given for crash clearance time and arrival time. The quantitative influences for crash and hazard incident are presented for both clearance and arrival. The model accuracy is analyzed at the end.

Ductility and Ultimate Capacity of Prestressed Steel Reinforced Concrete Beams

Directory of Open Access Journals (Sweden)

Chengquan Wang

2017-01-01

Full Text Available Nonlinear numerical analysis of the structural behaviour of prestressed steel reinforced concrete (PSRC beams was carried out by using finite element analysis software ABAQUS. By comparing the load-deformation curves, the rationality and reliability of the finite element model have been confirmed; moreover, the changes of the beam stiffness and stress in the forcing process and the ultimate bearing capacity of the beam were analyzed. Based on the model, the effect of prestressed force, and H-steel to the stiffness, the ultimate bearing capacity and ductility of beam were also analyzed.

Ultimate strength and ductility of steel reinforced concrete beam-columns

International Nuclear Information System (INIS)

Shohara, Ryoichi

1991-01-01

The ultimate strength and ductility of SRC beam-columns are investigated using the data gathered in Architectural Institute of Japan. Though the simple superposed strength formula in AIJ standard underestimates the strength of SRC beam-column failed in flexure, the generalized superposed strength formula estimates it satisfactory. The strength formula in AIJ standard does not good agreement with test data. The SRC beam-column failed in shear has almost equalductility with that failed in flexure owing to the encased steel. Author presents the formulas which estimate the ultimate deformation angle for SRC beam-columns. (author)

Hydrogeological problems in the ultimate storage of radioactive wastes

International Nuclear Information System (INIS)

Uerpmann, E.P.

1980-01-01

The following work shows how one can achieve the safe closure of ultimate-stored radioactive wastes by connecting a series of various barriers to the biosphere. The propagation of radionuclides by ground water is considered to be the most important long-term transport mechanism. Salt occurences in the Federal Republic of Germany are considered to be the best form suitable for end storage formations for known reasons. When not observing mining and hydrogeological knowledge, the danger of uncontrollable water flow in the end storage can arise from the water solubility of the salt rocks. Therefore the filling of salt mines and the subsequent procedures are dealt with in detail. The leading of radioactive nuclides is influenced by the properties of the ultimately stored wastes and by the quality of the remaining filling of the caves. These problems are dealt with in detail. A series of barriers to the closure of the underground caves are suggested and discussed. The most important barriers consist of the stability of the corresponding selected end storage structure. Possible arrangements of the storage cave are given which even after storage must maintain a high stability. Proposals are made on how the ultimately stored wastes can protect themselves against contact with free water or salt solutions. (orig.) [de

Prophylactic antibiotics are associated with a lower incidence of pneumonia in cardiac arrest survivors treated with targeted temperature management

DEFF Research Database (Denmark)

Gagnon, David J; Nielsen, Niklas; Fraser, Gilles L

2015-01-01

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...

Sports Related Injuries: Incidence, Management and Prevention

OpenAIRE

Stanger, Michael A.

1982-01-01

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

An incident command system in practice and reality

International Nuclear Information System (INIS)

Spitzer, J.D.

1992-01-01

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

State Methods for a Cyber Incident

Science.gov (United States)

2012-03-01

Glossary S905 - Incident Submission and Response Standard S910 - Data Breach Notification Standard E-5 Our state characterizes information system...Office of Management and Budget. (2011a). Legislative Language Data Breach Notification. Retrieved September 20, 2010, from http://www.whitehouse.gov...sites/default/files/omb/legislative/letters/ data - breach -notification.pdf Executive Office of the President. Office of Management and Budget

Decision-support information system to manage mass casualty incidents at a level 1 trauma center.

Science.gov (United States)

Bar-El, Yaron; Tzafrir, Sara; Tzipori, Idan; Utitz, Liora; Halberthal, Michael; Beyar, Rafael; Reisner, Shimon

2013-12-01

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.

Critical incidents in headteachers’ professional paths

Directory of Open Access Journals (Sweden)

Jurema Silvia de Souza Alves

2015-11-01

Full Text Available School management is considered one of the greatest challenges in achieving quality standards in contemporary education. Understanding the path of its main protagonist, the manager, living in a time and context that is different from those in which he/she acts, is essential to guide continued career management as well as to re-advise the initial career of teachersand future managers. In order to contribute to this knowledge, we present the result of a biographical-narrative research project that seeks to identify the critical incidents present in the professional lives of school managers from a medium-sized municipality in São Paulo state, Brazil. The answers to a questionnaire made it possible to characterize 25 managers, 32 of which being from school units in the city, and to select nine for interview. The interviews, which were transcribed and organized into biograms, showed that these professionals, mostly women, unlike the men surveyed, did not direct their careers to a role in management. Most of the regular critical incidents on their professional paths refer to the influence of supervisors who recommended them or encouraged them to study for admission tests related to management; the birth of their children, which motivated them to progress in their careers and/or promoting a break for future investment; their initial training, for many the Faculty of Education, was considered by participants as being insufficient for a role in management. It is considered that the career in management must be intensified as a continued career and be revised/altered from its initial background, so that managing activities correspond to the objectives of a high quality education.

Analysis of a radiological incident and lessons to be learned: a case of industrial radiographic incident in great Britain

International Nuclear Information System (INIS)

Croft, J.; Lefaure, Ch.

2000-01-01

This note describes a case study to provide feedback analysis and lessons to be learned from a radiological incident. This one occurred in the UK. It has been published in the European ALARA Newsletter no. 2 (January 1997) and has been selected from the IRID database (Ionising Radiation Incident Database) managed by the Health and Safety Executive, National Radiological Protection Board and Environmental Agency. (authors)

Risk assessment of several incidents in nuclear waste management facilities

International Nuclear Information System (INIS)

Buetow, E.; Memmert, G.; Storck, R.; Weymann, J.; Matthies, M.; Vogt, K.J.

1981-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2016-09-27

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

Review article: A systematic review of emergency department incident classification frameworks.

Science.gov (United States)

Murray, Matthew; McCarthy, Sally

2017-10-11

As in any part of the hospital system, safety incidents can occur in the ED. These incidents arguably have a distinct character, as the ED involves unscheduled flows of urgent patients who require disparate services. To aid understanding of safety issues and support risk management of the ED, a comparison of published ED specific incident classification frameworks was performed. A review of emergency medicine, health management and general medical publications, using Ovid SP to interrogate Medline (1976-2016) was undertaken to identify any type of taxonomy or classification-like framework for ED related incidents. These frameworks were then analysed and compared. The review identified 17 publications containing an incident classification framework. Comparison of factors and themes making up the classification constituent elements revealed some commonality, but no overall consistency, nor evolution towards an ideal framework. Inconsistency arises from differences in the evidential basis and design methodology of classifications, with design itself being an inherently subjective process. It was not possible to identify an 'ideal' incident classification framework for ED risk management, and there is significant variation in the selection of categories used by frameworks. The variation in classification could risk an unbalanced emphasis in findings through application of a particular framework. Design of an ED specific, ideal incident classification framework should be informed by a much wider range of theories of how organisations and systems work, in addition to clinical and human factors. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

What have we learned about intelligent transportation systems? Chapter 2, What have we learned about freeway incident and emergency management and electronic toll collection?

Science.gov (United States)

2000-12-01

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...

When Do Companies Need a Board-Level Risk Management Committee?

OpenAIRE

Choi, Ivan

2013-01-01

Risk management is nothing new. But the global financial crisis and corporate failures in recent years have put risk management in the spotlight. Who is ultimately responsible for it? Responsibility for risk management should start in the boardroom, as the board is ultimately responsible for the organization's decision making, business performance, and value creation, all of which are asso...

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

Science.gov (United States)

2012-01-01

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

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

Directory of Open Access Journals (Sweden)

Cashmore Aaron W

2012-08-01

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

Dyslexic entrepreneurs: the incidence; their coping strategies and their business skills.

Science.gov (United States)

Logan, Julie

2009-11-01

This comparative study explores the incidence of dyslexia in entrepreneurs, corporate managers and the general population. It examines the suggestion that dyslexic entrepreneurs develop coping strategies to manage their weaknesses, which are subsequently of benefit in the new venture creation process. Results of this study suggest that there is a significantly higher incidence of dyslexia in entrepreneurs than in the corporate management and general US and UK populations and some of the strategies they adopt to overcome dyslexia (such as delegation of tasks) may be useful in business. The study was undertaken in two parts. First, entrepreneurs and corporate managers completed an online questionnaire, which combined questions about their company, their management or leadership role and their business skills together with questions that were designed to explore the likely incidence of dyslexia. A follow-up study that made use of a semi-structured questionnaire explored business issues and educational experience in more depth with those who had been diagnosed as dyslexic and those who did not have any history of dyslexia or any other learning difficulty.

Ultimate capacity and influenced factors analysis of nuclear RC containment subjected to internal pressure

International Nuclear Information System (INIS)

Song Chenning; Hou Gangling; Zhou Guoliang

2014-01-01

Ultimate compressive bearing capacity, influenced factors and its rules of nuclear RC containment are key problems of safety assessment, accident treatment and structure design, etc. Ultimate compressive bearing capacity of nuclear RC containment is shown by concrete damaged plasticity model and steel double liner model of ABAQUS. The study shows that the concrete of nuclear RC containment cylinder wall becomes plastic when the internal pressure is up to 0.87 MPa, the maximum tensile strain of steel liner exceeds 3000 × 10 6 and nuclear RC containment reaches ultimate status when the internal pressure is up to 1.02 MPa. The result shows that nuclear RC containment is in elastic condition under the design internal pressure and the bearing capacity meets requirement. Prestress and steel liner play key parts in the ultimate internal pressure and failure mode of nuclear RC containment. The study results have value for the analysis of ultimate compressive bearing capacity, structure design and safety assessment. (authors)

Ultimate capacity of piles penetrating in weak soil layers

Directory of Open Access Journals (Sweden)

Al-Obaidi Ahmed

2018-01-01

Full Text Available A pile foundation is one of the most popular forms of deep foundations. They are routinely employed to transfer axial structure loads through the soft soil to stronger bearing strata. Piles generally used to increase the load carrying capacity of the foundation and reduce the settlement of the foundation. On the other hand, many cases in practice where piles pass through different layers of soil that contain weak layers located at different depths and extension, also some time cavities with a different shape, size, and depth are found. In this study, a total of 96 cases is considered and simulated in PLAXIS 2D program aiming to understand the influence of weak soil on the ultimate pile capacity. The piles embedded in the dense sand with a layer of weak soil at different extension and location. The cross section of the geometry used in this study was designed as an axisymmetric model with the 15-node element; the boundary condition recommended at least 5D in the horizontal direction, and (L+5D in the vertical direction where D and L are the diameter and length of pile, respectively. The soil is modeled as Mohr-Coulomb, with five input parameters and the behavior of pile material represented by the linear elastic model. The results of the above cases are compared with the results found in a pile embedded in dense soil without weak layers or cavities. The results indicated that the existence of weak soil layer within the surrounding soil around the pile decreases the ultimate capacity. Furthermore, it has been found that increase in the weak soil width (extension leads to reduction in the ultimate capacity of the pile. This phenomenon is applicable to all depth of weak soil. The influence of weak layer extension on the ultimate capacity is less when it is presentin the upper soil layers.

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

NARCIS (Netherlands)

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

2016-01-01

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

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

African Journals Online (AJOL)

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

Clinical review: Bleeding - a notable complication of treatment in patients with acute coronary syndromes: incidence, predictors, classification, impact on prognosis, and management

Science.gov (United States)

2013-01-01

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

Female genital tract graft-versus-host disease: incidence, risk factors and recommendations for management.

Science.gov (United States)

Zantomio, D; Grigg, A P; MacGregor, L; Panek-Hudson, Y; Szer, J; Ayton, R

2006-10-01

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.

78 FR 55117 - Ultimate Heat Sink for Nuclear Power Plants; Draft Regulatory Guide

Science.gov (United States)

2013-09-09

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0203] Ultimate Heat Sink for Nuclear Power Plants; Draft... (DG), DG-1275, ``Ultimate Heat Sink for Nuclear Power Plants.'' This regulatory guide (RG) describes methods and procedures acceptable to the NRC staff that nuclear power plant facility licensees and...

Human performance evaluation: The procedures of ultimate response guideline for nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Liu, Kang-Hung, E-mail: alvinks@iner.gov.tw [Institute of Nuclear Energy Research, Atomic Engery Council, No. 1000, Whenhua Road, Jiaan Village, Longtan Township, Taoyuan County, Taiwan (China); Hwang, Sheue-Ling, E-mail: slhwang@ie.nthu.edu.tw [Department of Industrial Engineering and Engineering Management, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Road, Hsinchu, Taiwan 30013, Taiwan (China)

2014-07-01

Highlights: • This study adopts SPAR-H to evaluate HEPs in the URG procedures. • The involvement of URG procedures could reduce CDF significantly. • Upgrading the training level of staff will enhance the reliability effectively. • Aiding the plant manager in making URG decision will enhance the reliability. - Abstract: In the nuclear accident which occurred in Japan on March 11, 2011, several units of Fukushima conventional BWR experienced a total loss of power and water supply triggered by a heavy earthquake and subsequent Tsunami which were outside design models. In the past, when an accident occurred, operators in nuclear power plants (NPP) followed emergency operating procedures (EOPs) or severe accident management guidance (SAMG). However, EOP and SAMG are symptom-based procedures to cope with severe transients and accidents, depending on real-time operational parameters. Ultimate response guidelines (URG), a plant specific interim remedy action plan, was developed to manage accidents caused by compound disasters which exceed design models. The URG guides the plant operators’ conduct of reactor depressurization, core cooling water injection, and containment venting. This study adopts NUREG/CR-6883 (Standardized Plant Analysis Risk Human Reliability Analysis, SPAR-H) to evaluate human error probabilities (HEPs) of action and diagnosis in the current URG procedures. We found the human reliability of URG procedures analyzed by SPAR-H is about 85% (depending on different decision makers). Upgrading the training level of staff or enhancing plant managers ability to decide whether to execute URG will enhance the human reliability of URG procedures.

Ultimate strength analysis of ring-stiffened cylinders subjected to hydrostatic pressure

International Nuclear Information System (INIS)

Park, Chi Mo

1990-01-01

In this study, ultimate strength analysis of ring-stiffened cylinders have been performed, considering the elasto-plastic large deflection. In the elasto-plastic analysis, von Mises yield criteria, the plastic flow theory and the layered approach have been adopted. In order to take into account the follower force effect of the hydrostatic pressure, the incremental load components have been updated at every loading step. As collapse modes, axisymmetric yielding, interframe shell buckling and general buckling are considered, while local buckling of ring-stiffener is not considered. Initial shape imperfection is assumed to be the elastic buckling mode to obtain the lower bound of the ultimate strength. Results of numerical analysis are compared with the experimental results to show the validity of the present approach. It has been drawn that the present numerical results are closely correlated with the experimental results. On the other hand, the effects of initial shape imperfection and condition on the ultimate strength have been investigated. (Author)

A comparison of international criteria for the ultimate storage of radioactive wastes

International Nuclear Information System (INIS)

Mielke, H.

1985-01-01

In countries other than the Federal Republic of Germany and internationally there are no comprehensive codes referring to criteria and safety requirements except those of the IAEA and USA. In other countries there exist safety goals for the ultimate storage or for purely geological criteria. The degree of detailing regulations differs widely abroad and internationally. Safety goals abroad and internationally as well as measures for their realisation in the ultimate storage of radioactive wastes in deep geological formations are in line with the German safety goals. The IAEA refers to general aspects of geological, waste technology and ultimate storage technology criteria. In the USA, ultimate storage technology criteria have been quantified in part. The quantitative geological criteria existing in Great Britain and in the Netherlands are only relevant in as much as safety analyses must be performed for a specific site to provide evidence for the safety of this site. The comparison shows that most requirements pronounced abroad are also made for the Federal Republic of Germany. Some requirements are more specified in the Federal Republic of Germany, some are more detailed abroad. (orig./HP) [de

Appraisal of snakebite incidence and mortality in Bolivia.

Science.gov (United States)

Chippaux, Jean-Philippe; Postigo, Jorge R

2014-06-01

No information has been yet published on snakebite in Bolivia. The country includes very different ecological situations leading to various epidemiological risks. A study has been carried out to evaluate the incidence and location of snakebite, particularly in relation with altitude, in order to improve management. Investigations on snakebite epidemiology were based on a) cases treated in health facilities as reported by health authorities and b) household surveys carried out in areas with high variations of altitude, in various regions of Bolivia. An average of 700 bites was treated each year in Bolivia (national annual incidence = 8 bites per 100,000 people) with a great disparity between districts. Household surveys showed annual incidences ranged from 30 to 110 bites per 100,000 inhabitants depending on location. Annual mortality ranged 0.1-3.9 per 100,000 people. A significant and constant inverse correlation was shown between snakebite incidence and altitude, which may be explained by both snake and human distributions and activities. Notification of snakebite is useful for improving patient management and informing antivenom distribution. It should also involve the report of deaths and clinical details of envenomation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mental models of safety: do managers and employees see eye to eye?

Science.gov (United States)

Prussia, Gregory E; Brown, Karen A; Willis, P Geoff

2003-01-01

Disagreements between managers and employees about the causes of accidents and unsafe work behaviors can lead to serious workplace conflicts and distract organizations from the important work of establishing positive safety climate and reducing the incidence of accidents. In this study, the authors examine a model for predicting safe work behaviors and establish the model's consistency across managers and employees in a steel plant setting. Using the model previously described by Brown, Willis, and Prussia (2000), the authors found that when variables influencing safety are considered within a framework of safe work behaviors, managers and employees share a similar mental model. The study then contrasts employees' and managers' specific attributional perceptions. Findings from these more fine-grained analyses suggest the two groups differ in several respects about individual constructs. Most notable were contrasts in attributions based on their perceptions of safety climate. When perceived climate is poor, managers believe employees are responsible and employees believe managers are responsible for workplace safety. However, as perceived safety climate improves, managers and employees converge in their perceptions of who is responsible for safety. It can be concluded from this study that in a highly interdependent work environment, such as a steel mill, where high system reliability is essential and members possess substantial experience working together, managers and employees will share general mental models about the factors that contribute to unsafe behaviors, and, ultimately, to workplace accidents. It is possible that organizations not as tightly coupled as steel mills can use such organizations as benchmarks, seeking ways to create a shared understanding of factors that contribute to a safe work environment. Part of this improvement effort should focus on advancing organizational safety climate. As climate improves, managers and employees are likely to agree

Effects of plant conduction systems and organic fertilizer management on disease incidence and severity in ‘Osiana’ and ‘Carola’ roses

Directory of Open Access Journals (Sweden)

Márcia de Nazaré Oliveira Ribeiro

2015-04-01

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

Ultimate Bound of a 3D Chaotic System and Its Application in Chaos Synchronization

Directory of Open Access Journals (Sweden)

Jiezhi Wang

2014-01-01

Full Text Available Two ellipsoidal ultimate boundary regions of a special three-dimensional (3D chaotic system are proposed. To this chaotic system, the linear coefficient of the ith state variable in the ith state equation has the same sign; it also has two one-order terms and one quadratic cross-product term in each equation. A numerical solution and an analytical expression of the ultimate bounds are received. To get the analytical expression of the ultimate boundary region, a new result of one maximum optimization question is proved. The corresponding ultimate boundary regions are demonstrated through numerical simulations. Utilizing the bounds obtained, a linear controller is proposed to achieve the complete chaos synchronization. Numerical simulation exhibits the feasibility of the designed scheme.

Temporary Operational Protocol for making safe and managing Orphaned or Seized Radioactive Sources

International Nuclear Information System (INIS)

2013-01-01

This protocol outlines the arrangements to manage the safe interim storage of an orphaned radioactive source or of a source identified for seizure, pending its ultimate disposal. Such sources may be sources found outside of regulatory control, detected at a frontier or seized in the public interest. This includes a radioactive source arising from a CBRN, chemical, biological, radiological, nuclear, incident, following neutralisation of any associated dispersal device and confirmation of the suspect object as radioactive. The arrangements in this protocol are meant to be consistent with and used in conjunction with relevant protocols to the Major Emergency Framework Document and may be revisited as necessary as those protocols are further developed

Ultimate concerns in late modernity: Archer, Bourdieu and reflexivity.

Science.gov (United States)

Farrugia, David; Woodman, Dan

2015-12-01

Through a critique of Margaret Archer's theory of reflexivity, this paper explores the theoretical contribution of a Bourdieusian sociology of the subject for understanding social change. Archer's theory of reflexivity holds that conscious 'internal conversations' are the motor of society, central both to human subjectivity and to the 'reflexive imperative' of late modernity. This is established through critiques of Bourdieu, who is held to erase creativity and meaningful personal investments from subjectivity, and late modernity is depicted as a time when a 'situational logic of opportunity' renders embodied dispositions and the reproduction of symbolic advantages obsolete. Maintaining Archer's focus on 'ultimate concerns' in a context of social change, this paper argues that her theory of reflexivity is established through a narrow misreading and rejection of Bourdieu's work, which ultimately creates problems for her own approach. Archer's rejection of any pre-reflexive dimensions to subjectivity and social action leaves her unable to sociologically explain the genesis of 'ultimate concerns', and creates an empirically dubious narrative of the consequences of social change. Through a focus on Archer's concept of 'fractured reflexivity', the paper explores the theoretical necessity of habitus and illusio for understanding the social changes that Archer is grappling with. In late modernity, reflexivity is valorized just as the conditions for its successful operation are increasingly foreclosed, creating 'fractured reflexivity' emblematic of the complex contemporary interaction between habitus, illusio, and accelerating social change. © London School of Economics and Political Science 2015.

Hardware-related infections after deep brain stimulation surgery: review of incidence, severity and management in 212 single-center procedures in the first year after implantation.

Science.gov (United States)

Piacentino, Massimo; Pilleri, Manuela; Bartolomei, Luigi

2011-12-01

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.

Trends in the incidence, clinical presentation, and management of traumatic rupture of the corpus cavernosum.

Science.gov (United States)

Ekwere, Paul D; Al Rashid, Mohammed

2004-02-01

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.

Ultimate internal pressure capacity assessment of SC structure

International Nuclear Information System (INIS)

Park, Hyungkui; Choi, Inkil

2013-01-01

An SC structure applied to a containment building can be quite effective. However, an SC structure cannot be applied to a containment building, because its internal pressure resistance performance has not been verified. The containment building, which undergoes ultimate internal pressure, resists the internal pressure through a pre-stress tendon. It is hard to apply a tendon to an SC structure because of its structural characteristics. Therefore, the internal pressure resistance performance of the SC structure itself should be ensured to apply it to a structure with internal pressure resistance. In this study, the suitability of an SC structure as a substitution for the tendon of a pressure resistant structure was evaluated. A containment structure model was used in this study, because it was representative structures that resistance of ultimate internal pressure be required. In this study, a nonlinear analysis was performed to evaluate and compare the behaviors of tendon model and SC structure model. By comparing the internal pressure-displacement according to the structure type, the stability of SC structure model was assessed

Ultimate dynamics of the Kirschner-Panetta model: Tumor eradication and related problems

Science.gov (United States)

Starkov, Konstantin E.; Krishchenko, Alexander P.

2017-10-01

In this paper we consider the ultimate dynamics of the Kirschner-Panetta model which was created for studying the immune response to tumors under special types of immunotherapy. New ultimate upper bounds for compact invariant sets of this model are given, as well as sufficient conditions for the existence of a positively invariant polytope. We establish three types of conditions for the nonexistence of compact invariant sets in the domain of the tumor-cell population. Our main results are two types of conditions for global tumor elimination depending on the ratio between the proliferation rate of the immune cells and their mortality rate. These conditions are described in terms of simple algebraic inequalities imposed on model parameters and treatment parameters. Our theoretical studies of ultimate dynamics are complemented by numerical simulation results.

The importance of mines for ultimate storage at Deilmann-Haniel Shaft Sinking

International Nuclear Information System (INIS)

Greinacher, Jochen; Oellers, Thomas; Ahlbrecht, Thomas

2011-01-01

Deilmann-Haniel Shaft Sinking GmbH and its predecessor and associate companies have been involved in projects for underground ultimate storage in Germany, Europe and America for over 45 years. The field of activities previously comprised surveying, planning and sinking of shafts, repair and conversion work, design of underground sealing structures, planning of conveyors and support of the BfS in planning approval procedures. Following discontinuation of activities in the German coal mining industry the use of mines for ultimate storage is an important support for German specialist mining companies. The use of mines for ultimate storage ensures that the existing mining know how in Germany is maintained, because training of the younger generation on the commercial and engineering side of the companies is made possible by the imminent major projects.

Incidence and Management of Uncomplicated Recurrent Urinary Tract Infections in a National Sample of Women in the United States.

Science.gov (United States)

Suskind, Anne M; Saigal, Christopher S; Hanley, Janet M; Lai, Julie; Setodji, Claude M; Clemens, J Quentin

2016-04-01

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.

Maintained ship hull girder ultimate strength reliability considering corrosion and fatigue

DEFF Research Database (Denmark)

Hu, Yong; Cui, W.; Pedersen, Preben Terndrup

2004-01-01

The prupose of this paper is to propose a methodology to assess the time-variant ultimate strength of ship hull girder under the degradations of corrosion and fatigue. The effects of fatigue cracks on the tensile and compressive residual ultimate strength of stiffened panels and unstiffened plates......, webs and flanges, respectively. The effects of inspections and repair are taken into account. A minimum net thickness rule is used to determine repair policies. A procedure is proposed to determine the maximum allowable corrosion thickness of different parts of the hull cross section. The procedure...

Manual handling incident claims in the healthcare sector: Factors and outcomes.

Science.gov (United States)

Dockrell, Sara; Johnson, Muriel; Ganly, Joe; Bennett, Kathleen

2011-01-01

Manual handling (MH) incidents may result in injury, absenteeism and/or compensation claim. This study investigated the factors associated with MH incidents among healthcare workers who had made a claim, and the management and outcome of those workers. A national sample of healthcare sector MH incident claim files (n=247) were accessed and 35~files met the inclusion criteria. Data were collected and presented graphically or descriptively using percentages (and 95% Confidence intervals, CI). Chi-square (χ2) tests were used for comparing proportions between groups. SPSS (v14.0) was used for analysis. Significance at p 52 weeks. Only 58% (49%, 65%) returned to work. Claimants who had been in communication with employers were significantly more likely to return to work than those who did not (χ2 test, p=0.017). Improved management of MH incidents and injured workers are recommended.

Spatial Distribution of Black Bear Incident Reports in Michigan.

Directory of Open Access Journals (Sweden)

Jamie E McFadden-Hiller

Full Text Available Interactions between humans and carnivores have existed for centuries due to competition for food and space. American black bears are increasing in abundance and populations are expanding geographically in many portions of its range, including areas that are also increasing in human density, often resulting in associated increases in human-bear conflict (hereafter, bear incidents. We used public reports of bear incidents in Michigan, USA, from 2003-2011 to assess the relative contributions of ecological and anthropogenic variables in explaining the spatial distribution of bear incidents and estimated the potential risk of bear incidents. We used weighted Normalized Difference Vegetation Index mean as an index of primary productivity, region (i.e., Upper Peninsula or Lower Peninsula, primary and secondary road densities, and percentage land cover type within 6.5-km2 circular buffers around bear incidents and random points. We developed 22 a priori models and used generalized linear models and Akaike's Information Criterion (AIC to rank models. The global model was the best compromise between model complexity and model fit (w = 0.99, with a ΔAIC 8.99 units from the second best performing model. We found that as deciduous forest cover increased, the probability of bear incident occurrence increased. Among the measured anthropogenic variables, cultivated crops and primary roads were the most important in our AIC-best model and were both positively related to the probability of bear incident occurrence. The spatial distribution of relative bear incident risk varied markedly throughout Michigan. Forest cover fragmented with agriculture and other anthropogenic activities presents an environment that likely facilitates bear incidents. Our map can help wildlife managers identify areas of bear incident occurrence, which in turn can be used to help develop strategies aimed at reducing incidents. Researchers and wildlife managers can use similar mapping

Spatial Distribution of Black Bear Incident Reports in Michigan.

Science.gov (United States)

McFadden-Hiller, Jamie E; Beyer, Dean E; Belant, Jerrold L

2016-01-01

Interactions between humans and carnivores have existed for centuries due to competition for food and space. American black bears are increasing in abundance and populations are expanding geographically in many portions of its range, including areas that are also increasing in human density, often resulting in associated increases in human-bear conflict (hereafter, bear incidents). We used public reports of bear incidents in Michigan, USA, from 2003-2011 to assess the relative contributions of ecological and anthropogenic variables in explaining the spatial distribution of bear incidents and estimated the potential risk of bear incidents. We used weighted Normalized Difference Vegetation Index mean as an index of primary productivity, region (i.e., Upper Peninsula or Lower Peninsula), primary and secondary road densities, and percentage land cover type within 6.5-km2 circular buffers around bear incidents and random points. We developed 22 a priori models and used generalized linear models and Akaike's Information Criterion (AIC) to rank models. The global model was the best compromise between model complexity and model fit (w = 0.99), with a ΔAIC 8.99 units from the second best performing model. We found that as deciduous forest cover increased, the probability of bear incident occurrence increased. Among the measured anthropogenic variables, cultivated crops and primary roads were the most important in our AIC-best model and were both positively related to the probability of bear incident occurrence. The spatial distribution of relative bear incident risk varied markedly throughout Michigan. Forest cover fragmented with agriculture and other anthropogenic activities presents an environment that likely facilitates bear incidents. Our map can help wildlife managers identify areas of bear incident occurrence, which in turn can be used to help develop strategies aimed at reducing incidents. Researchers and wildlife managers can use similar mapping techniques to

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

LENUS (Irish Health Repository)

Hargrove, M

2012-02-03

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

Lessons learned from process incident databases and the process safety incident database (PSID) approach sponsored by the Center for Chemical Process Safety

International Nuclear Information System (INIS)

Sepeda, Adrian L.

2006-01-01

Learning from the experiences of others has long been recognized as a valued and relatively painless process. In the world of process safety, this learning method is an essential tool since industry has neither the time and resources nor the willingness to experience an incident before taking corrective or preventative steps. This paper examines the need for and value of process safety incident databases that collect incidents of high learning value and structure them so that needed information can be easily and quickly extracted. It also explores how they might be used to prevent incidents by increasing awareness and by being a tool for conducting PHAs and incident investigations. The paper then discusses how the CCPS PSID meets those requirements, how PSID is structured and managed, and its attributes and features

Ultimate load design and testing of a cylindrical prestressed concrete vessel

International Nuclear Information System (INIS)

Stefanou, G.D.

1982-01-01

The object of this research was to design, construct and test to failure a prestressed concrete pressure vessel model that could be used to investigate the behavior of a full scale structure underworking and ultimate load. The properties and the design of the model was based generally on full scale vessels already constructed to house the nuclear reactors used in atomic power stations. To design the model the ultimate load approach was adopted throughout. All load factors associated with the prestressing have been defined and kept to a minimum in order that the vessel's behavior may be predicted. The tests on the vessel were carried out first on the elastic range to observe its behavior at working load and then at the ultimate range to observe the modes of failure and compare the actual results in both cases with the predicted values. Although full agreement between observed results and predicted values was not obtained, the conclusions drawn from the study were useful for the design of full scale vessels. (author)

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

Science.gov (United States)

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

2010-01-01

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

Reduced design load basis for ultimate blade loads estimation in multidisciplinary design optimization frameworks

DEFF Research Database (Denmark)

Pavese, Christian; Tibaldi, Carlo; Larsen, Torben J.

2016-01-01

The aim is to provide a fast and reliable approach to estimate ultimate blade loads for a multidisciplinary design optimization (MDO) framework. For blade design purposes, the standards require a large amount of computationally expensive simulations, which cannot be efficiently run each cost...... function evaluation of an MDO process. This work describes a method that allows integrating the calculation of the blade load envelopes inside an MDO loop. Ultimate blade load envelopes are calculated for a baseline design and a design obtained after an iteration of an MDO. These envelopes are computed...... for a full standard design load basis (DLB) and a deterministic reduced DLB. Ultimate loads extracted from the two DLBs with the two blade designs each are compared and analyzed. Although the reduced DLB supplies ultimate loads of different magnitude, the shape of the estimated envelopes are similar...

Ultimate loading of wind turbines

DEFF Research Database (Denmark)

Larsen, Gunner Chr.; Ronold, K.; Ejsing Jørgensen, Hans

1999-01-01

An extreme loading study has been conducted comprising a general wind climate analysis as well as a wind turbine reliability study. In the wind climate analysis, the distribution of the (horizontal) turbulence standard deviation, conditioned on the meanwind speed, has been approximated by fitting......, a design turbulence intensity for off-shore application is proposed which, in the IEC code framework, is applicable for extreme as well as for fatigue loaddetermination. In order to establish a rational method to analyse wind turbine components with respect to failure in ultimate loading, and in addition...... a three parameter Weibull distribution to the measured on-shore and off-shore data for wind speed variations. Specific recommendations on off-shore design turbulence intensities are lacking in the presentIEC-code. Based on the present analysis of the off-shore wind climate on two shallow water sites...

Ultimate Explanations of the Universe

CERN Document Server

Heller, Michael

2009-01-01

We humans are collectively driven by a powerful - yet not fully explained - instinct to understand. We would like to see everything established, proven, laid bare. The more important an issue, the more we desire to see it clarified, stripped of all secrets, all shades of gray. What could be more important than to understand the Universe and ourselves as a part of it? To find a window onto our origin and our destiny? This book examines how far our modern cosmological theories - with their sometimes audacious models, such as inflation, cyclic histories, quantum creation, parallel universes - can take us towards answering these questions. Can such theories lead us to ultimate truths, leaving nothing unexplained? Last, but not least, Heller addresses the thorny problem of why and whether we should expect to find theories with all-encompassing explicative power.

IMPLEMENTATION OF INCIDENT DETECTION ALGORITHM BASED ON FUZZY LOGIC IN PTV VISSIM

Directory of Open Access Journals (Sweden)

Andrey Borisovich Nikolaev

2017-05-01

Full Text Available Traffic incident management is a major challenge in the management of movement, requiring constant attention and significant investment, as well as fast and accurate solutions in order to re-establish normal traffic conditions. Automatic control methods are becoming an important factor for the reduction of traffic congestion caused by an arising incident. In this paper, the algorithm of automatic detection incident based on fuzzy logic is implemented in the software PTV VISSIM. 9 different types of tests were conducted on the two lane road section segment with changing traffic conditions: the location of the road accident, loading of traffic. The main conclusion of the research is that the proposed algorithm for the incidents detection demonstrates good performance in the time of detection and false alarms

75 FR 76746 - Agency Information Collection Activities: Declaration of Ultimate Consignee That Articles Were...

Science.gov (United States)

2010-12-09

... Activities: Declaration of Ultimate Consignee That Articles Were Exported for Temporary Scientific or... That Articles Were Exported for Temporary Scientific or Educational Purposes. This is a proposed... forms of information. Title: Declaration of Ultimate Consignee That Articles Were Exported for Temporary...

The relationship between the implementation of voluntary Five-Star occupational health and safety management system and the incidence of fatal and permanently disabling injury

DEFF Research Database (Denmark)

Hedlund, Frank Huess

2014-01-01

This paper examines two properties of the South African NOSA 5-Star System, a voluntary occupational health and safety (OHS) management system. The first property is the association between system implementation and final OHS outcomes measured as incidence rates of fatal and permanently disabling...... 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...

Conception of electron beam-driven subcritical molten salt ultimate safety reactor

Energy Technology Data Exchange (ETDEWEB)

Abalin, S.S.; Alekseev, P.N.; Ignat`ev, V.V. [Kurchatov Institute, Moscow (Russian Federation)] [and others

1995-10-01

This paper is a preliminary sketch of a conception to develop the {open_quotes}ultimate safety reactor{close_quotes} using modern reactor and accelerator technologies. This approach would not require a long-range R&D program. The ultimate safety reactor could produce heat and electric energy, expand the production of fuel, or be used for the transmutation of long-lived wastes. The use of the combined double molten salt reactor system allows adequate neutron multiplication to permit using an electron accelerator for the initial neutron flux. The general parameters of such a system are discussed in this paper.

Addressing the common pathway underlying hypertension and diabetes in people who are obese by maximizing health: the ultimate knowledge translation gap.

Science.gov (United States)

Dean, Elizabeth; Lomi, Constantina; Bruno, Selma; Awad, Hamzeh; O'Donoghue, Grainne

2011-03-06

In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM), and obesity and the low profile of noninvasive (nondrug) compared with invasive (drug) interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

Addressing the Common Pathway Underlying Hypertension and Diabetes in People Who Are Obese by Maximizing Health: The Ultimate Knowledge Translation Gap

Directory of Open Access Journals (Sweden)

Elizabeth Dean

2011-01-01

Full Text Available In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM, and obesity and the low profile of noninvasive (nondrug compared with invasive (drug interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

Incident Command System - Environmental Unit responsibilities

International Nuclear Information System (INIS)

Hillman, S. O.

1997-01-01

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

Qualitative analysis of factors leading to clinical incidents.

Science.gov (United States)

Smith, Matthew D; Birch, Julian D; Renshaw, Mark; Ottewill, Melanie

2013-01-01

The purpose of this paper is to evaluate the common themes leading or contributing to clinical incidents in a UK teaching hospital. A root-cause analysis was conducted on patient safety incidents. Commonly occurring root causes and contributing factors were collected and correlated with incident timing and severity. In total, 65 root-cause analyses were reviewed, highlighting 202 factors implicated in the clinical incidents and 69 categories were identified. The 14 most commonly occurring causes (encountered in four incidents or more) were examined as a key-root or contributory cause. Incident timing was also analysed; common factors were encountered more frequently during out-hours--occurring as contributory rather than a key-root cause. In total, 14 commonly occurring factors were identified to direct interventions that could prevent many clinical incidents. From these, an "Organisational Safety Checklist" was developed to involve departmental level clinicians to monitor practice. This study demonstrates that comprehensively investigating incidents highlights common factors that can be addressed at a local level. Resilience against clinical incidents is low during out-of-hours periods, where factors such as lower staffing levels and poor service provision allows problems to escalate and become clinical incidents, which adds to the literature regarding out-of-hours care provision and should prove useful to those organising hospital services at departmental and management levels.

Ultimate deformation capacity of reinforced concrete slabs underblast load

NARCIS (Netherlands)

Doormaal, J.C.A.M. van; Weerheijm, J.

1996-01-01

In this paper a test method to determine the deformation capacity and the resistance-deformation curve of blast-loaded slabs is described. This method was developed at TNO-PML. The method has been used to determine the ultimate deformation capacity of some simply supported reinforced concrete slabs

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-07-15

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

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

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

Jones, M.; Pitts, R.

2017-12-01

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

Managing the risks of risk management on large fires

Science.gov (United States)

Donald G. MacGregor; Armando González-Cabán

2013-01-01

Large fires pose risks to a number of important values, including the ecology, property and the lives of incident responders. A relatively unstudied aspect of fire management is the risks to which incident managers are exposed due to organizational and sociopolitical factors that put them in a position of, for example, potential liability or degradation of their image...

The Incidence, Classification, and Management of Acute Adverse Reactions to the Low-Osmolar Iodinated Contrast Media Isovue and Ultravist in Contrast-Enhanced Computed Tomography Scanning.

Science.gov (United States)

Zhang, Bin; Dong, Yuhao; Liang, Long; Lian, Zhouyang; Liu, Jing; Luo, Xiaoning; Chen, Wenbo; Li, Xinyu; Liang, Changhong; Zhang, Shuixing

2016-03-01

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.

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

Directory of Open Access Journals (Sweden)

Maria Isabel do Nascimento

2014-03-01

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

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

Science.gov (United States)

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

2018-04-01

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

reputation Risks through Information Security Incidents

Directory of Open Access Journals (Sweden)

Vitaly Eduardovich Dorokhov

2014-05-01

Full Text Available The article deals with accounting reputational risks arising through information security breaches in the management of a business entity. Security breach incidents which results to the loss of reputation are identified. Based on this analysis the definition of reputational risk in information security is given.

Ultimate-gradient accelerators physics and prospects

CERN Document Server

Skrinsky, Aleksander Nikolayevich

1995-01-01

As introduction, the needs and ways for ultimate acceleration gradients are discussed briefly. The Plasma Wake Field Acceleration is analized in the most important details. The structure of specific plasma oscillations and "high energy driver beam SP-plasma" interaction is presented, including computer simulation of the process. Some pratical ways to introduce the necessary mm-scale bunching in driver beam and to arrange sequential energy multiplication are dicussed. The influence of accelerating beam particle - plasma binary collisions is considered, also. As applications of PWFA, the use of proton super-colliders beams (LHC and Future SC) to drive the "multi particle types" accelerator, and the arrangements for the electron-positron TeV range collider are discussed.

Numerical Study on Ultimate Behaviour of Bolted End-Plate Steel Connections

Directory of Open Access Journals (Sweden)

R.E.S. Ismail

Full Text Available Abstract Bolted end-plate steel connections have become more popular due to ease of fabrication. This paper presents a three dimension Finite Element Model (FEM, using the multi-purpose software ABAQUS, to study the effect of different geometrical parameters on the ultimate behavior of the connection. The proposed model takes into account material and geometrical non-linearities, initial imperfection, contact between adjacent surfaces and the pretension force in the bolts. The Finite Element results are calibrated with published experimental results ''briefly reviewed in this paper'' and verified that the numerical model can simulate and analyze the overall and detailed behavior of different types of bolted end-plate steel connections. Using verified FEM, parametric study is then carried out to study the ultimate behavior with variations in: bolt diameter, end-plate thickness, length of column stiffener, angle of rib stiffener. The results are examined with respect to the failure modes, the evolution of the resistance, the initial stiffness, and the rotation capacity. Finally, the ultimate behavior of the bolted end-plate steel connection is discussed in detail, and recommendations for the design purpose are made.

Cable tray ultimate strength test employing a large shaker table

Energy Technology Data Exchange (ETDEWEB)

Komatsu, K.; Myojin, K.; Imai, K. [The Kansai Electric Power Co., Osaka (Japan); Fuyama, H. [Mitsubishi Heavy Industries Ltd, Takasago (Japan); Kokubo, E. [Mitsubishi Heavy Industdries Ltd, Kobe (Japan)

2004-07-01

Ultimate behaviors of cable trays, used in nuclear plants, have not been well studied since cable trays are designed based on conservative design criteria. In this study, by employing a large shaker table, an ultimate strength test was conducted for cable trays used in nuclear power plants. This report describes the results of shaker table test. The following results were obtained. First, in an S{sub 2} earthquake, the damping ratio was so large - more than 30% due to the rubbing of cables - that a large response was not present and the strains in the support were within the elastic limits. Secondly, the support was strong enough to sustain the cable trays even when the strain in the support was 20 times larger than the elastic limit. (authors)

Out-of-plane ultimate shear strength of RC mat-slab foundations

International Nuclear Information System (INIS)

Kumagai, Hitoshi; Nukui, Yasushi; Imamura, Akira; Terayama, Takeshi; Hagiwara, Tetsuya; Kojima, Isao

2011-01-01

There have been few studies on the out-of-plane shear in RC mat-slab foundations, and the reasonable method has been demanded to estimate ultimate shear strength of RC mat-slab foundations in the nuclear facilities. In the previous study, the out-of-plane loading tests on the 20 square slab specimens had been performed to collect the fundamental data. In this study, the test results were successfully predicted by 3D non-linear Finite Element Analysis. It has been confirmed that the ultimate shear stress in the slab specimen can be estimated by the Arakawa's formula, which is commonly used to estimate the shear strength of RC beams. (author)

Analysis of ultimate-heat-sink spray ponds. Technical report

International Nuclear Information System (INIS)

Codell, R.

1981-08-01

This report develops models which can be utilized in the design of certain types of spray ponds used in ultimate heat sinks at nuclear power plants, and ways in which the models may be employed to determine the design basis required by U.S. Nuclear Regulatory Commission Regulatory Guide 1.27

Managing mild casualties in mass-casualty incidents: lessons learned from an aborted terrorist attack.

Science.gov (United States)

Bloch, Yuval H; Leiba, Adi; Veaacnin, Nurit; Paizer, Yohanan; Schwartz, Dagan; Kraskas, Ahuva; Weiss, Gali; Goldberg, Avishay; Bar-Dayan, Yaron

2007-01-01

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

Ultimate Owner and Firm Performance - Evidence from Romanian Mining and Quarrying Listed Firms

Directory of Open Access Journals (Sweden)

Cosmin MIHAI

2012-08-01

Full Text Available The main objectives of this paper are to describe the necessary steps to identify the ultimate owner and to investigate the relation between the ultimate ownership and the financial performance of Romanian mining and quarrying listed firms. The study was conducted for the companies listed on Bucharest Stock Exchange, in both regulated and non-regulated segments. The final sample included 17 companies of mining and quarrying. Return on Equity was used for measuring the financial performance of the firms. The ultimate ownership was measured by the percentage of voting rights held by a shareholder. Econometric tools like multiple linear regression analysis were used for analysis. The results of the study suggest that there is a significant negative link between financial performance and divergence between voting rights and cash-flow rights.

Constitution of an incident database suited to statistical analysis and examples

International Nuclear Information System (INIS)

Verpeaux, J.L.

1990-01-01

The Nuclear Protection and Safety Institute (IPSN) has set up and is developing an incidents database, which is used for the management and analysis of incidents encountered in French PWR plants. IPSN has already carried out several incidents or safety important events statistical analysis, and is improving its database on the basis of the experience it gained from this various studies. A description of the analysis method and of the developed database is presented

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

Directory of Open Access Journals (Sweden)

Lei Ding

2015-10-01

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

49 Stories That Make an Ultimate STEM Lesson Plan

Science.gov (United States)

Mehta, Swati; Mehta, Rohit; Berzina-Pitcher, Inese; Seals, Christopher; Mishra, Punya

2016-01-01

In this paper we reviewed what 49 large urban public school district STEM teachers enrolled in a year-long graduate certificate and fellowship program at a large Midwestern university considered as their amazing teaching moments. They were asked to share their amazing teaching moments that would make an Ultimate Lesson Plan in STEM. In smaller…

Ultimate Gradient Limitation in Niobium Superconducting Accelerating Cavities

Energy Technology Data Exchange (ETDEWEB)

Checchin, Mattia [Illinois Inst. of Technology, Chicago, IL (United States); Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Grassellino, Anna [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Martinello, Martina [Illinois Inst. of Technology, Chicago, IL (United States); Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Posen, Sam [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Romanenko, Alexander [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Zasadzinski, John [Illinois Inst. of Technology, Chicago, IL (United States)

2016-06-01

The present study is addressed to the theoretical description of the ultimate gradient limitation in SRF cavities. Our intent is to exploit experimental data to confirm models which provide feed-backs on how to improve the current state-of-art. New theoretical insight on the cavities limiting factor can be suitable to improve the quench field of N-doped cavities, and therefore to take advantage of high Q₀ at high gradients.

Ultimate survival in anomalous ψ(2S) decays

International Nuclear Information System (INIS)

Gérard, Jean-Marc; Martini, Antony

2014-01-01

The hierarchy among the radiative γ(π 0 ,η,η ′ ) decay channels for the ψ ′ looks quite different from the J/ψ one. The fate of charm, namely an ultimate survival of on-shell cc ¯ intermediate states, might give us the clue for this new puzzle in exclusive charmonium decays. A similar self-preservation has already been invoked in the past to solve the so-called ρπ puzzle.

Reliability analysis of production ships with emphasis on load combination and ultimate strength

Energy Technology Data Exchange (ETDEWEB)

Wang, Xiaozhi

1995-05-01

This thesis deals with ultimate strength and reliability analysis of offshore production ships, accounting for stochastic load combinations, using a typical North Sea production ship for reference. A review of methods for structural reliability analysis is presented. Probabilistic methods are established for the still water and vertical wave bending moments. Linear stress analysis of a midships transverse frame is carried out, four different finite element models are assessed. Upon verification of the general finite element code ABAQUS with a typical ship transverse girder example, for which test results are available, ultimate strength analysis of the reference transverse frame is made to obtain the ultimate load factors associated with the specified pressure loads in Det norske Veritas Classification rules for ships and rules for production vessels. Reliability analysis is performed to develop appropriate design criteria for the transverse structure. It is found that the transverse frame failure mode does not seem to contribute to the system collapse. Ultimate strength analysis of the longitudinally stiffened panels is performed, accounting for the combined biaxial and lateral loading. Reliability based design of the longitudinally stiffened bottom and deck panels is accomplished regarding the collapse mode under combined biaxial and lateral loads. 107 refs., 76 refs., 37 tabs.

Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

NARCIS (Netherlands)

Burgmans, J.P.J.

2015-01-01

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

Critical incident monitoring in anaesthesia.

Science.gov (United States)

Choy, Y C

2006-12-01

Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors. Thus, it is well suited to be used in probing the complex factors behind human error and system failure. Human error has significant contributions to morbidities and mortalities in anaesthesia. Understanding the relationships between, errors, incidents and accidents is important for prevention and risk management to reduce harm to patients. Cardiac arrests in the operating theatre (OT) and prolonged stay in recovery, constituted the bulk of reported incidents. Cardiac arrests in OT resulted in significant mortality and involved mostly de-compensated patients and those with unstable cardiovascular functions, presenting for emergency operations. Prolonged-stay in the recovery extended period of observation for ill patients. Prolonged stay in recovery was justifiable in some cases, as these patients needed a longer period of post-operative observation until they were stable enough to return to the ward. The advantages of the relatively low cost, and the ability to provide a comprehensive body of detailed qualitative information, which can be used to develop strategies to prevent and manage existing problems and to plan further initiatives for patient safety makes critical incident monitoring a valuable tool in ensuring patient safety. The contribution of critical incident reporting to the issue of patient safety is

Quality Management in Project Management Consulting. A Case Study in an International Consulting Company

OpenAIRE

Ceptureanu, Eduard-Gabriel; Ceptureanu, Sebastian-Ion; Luchian, Cristian-Eugen; Luchian, Iuliana

2017-01-01

The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the ...

Determination of Ultimate Torque for Multiply Connected Cross Section Rod

Directory of Open Access Journals (Sweden)

V. L. Danilov

2015-01-01

Full Text Available The aim of this work is to determine load-carrying capability of the multiply cross-section rod. This calculation is based on the model of the ideal plasticity of the material, so that the desired ultimate torque is a torque at which the entire cross section goes into a plastic state.The article discusses the cylindrical multiply cross-section rod. To satisfy the equilibrium equation and the condition of plasticity simultaneously, two stress function Ф and φ are introduced. By mathematical transformations it has been proved that Ф is constant along the path, and a formula to find its values on the contours has been obtained. The paper also presents the rationale of the line of stress discontinuity and obtained relationships, which allow us to derive the equations break lines for simple interaction of neighboring circuits, such as two lines, straight lines and circles, circles and a different sign of the curvature.After substitution into the boundary condition at the end of the stress function Ф and mathematical transformations a formula is obtained to determine the ultimate torque for the multiply cross-section rod.Using the doubly connected cross-section and three-connected cross-section rods as an example the application of the formula of ultimate torque is studied.For doubly connected cross-section rod, the paper offers a formula of the torque versus the radius of the rod, the aperture radius and the distance between their centers. It also clearly demonstrates the torque dependence both on the ratio of the radii and on the displacement of hole. It is shown that the value of the torque is more influenced by the displacement of hole, rather than by the ratio of the radii.For the three-connected cross-section rod the paper shows the integration feature that consists in selection of a coordinate system. As an example, the ultimate torque is found by two methods: analytical one and 3D modeling. The method of 3D modeling is based on the Nadai�

The ultimate challenge of pregnancy-associated breast carcinoma

International Nuclear Information System (INIS)

Raja, R.; Tahira, A.

2005-01-01

Pregnancy associated breast carcinoma requires making judicious use of all diagnostic modalities and the therapeutic options of surgery, irradiation, chemotherapy and hormonal therapy to enhance survival rates. Individualization of treatment for each patient is the key to success. The effects on future fertility, the time interval before next conception, and whether to breast feed or not are all well-documented. A multidisciplinary coordinated team approach to this ultimate challenge of patient care will prove fruitful. (author)

Ultimate survival in anomalous ψ(2S) decays

Energy Technology Data Exchange (ETDEWEB)

Gérard, Jean-Marc; Martini, Antony

2014-03-07

The hierarchy among the radiative γ(π{sup 0},η,η{sup ′}) decay channels for the ψ{sup ′} looks quite different from the J/ψ one. The fate of charm, namely an ultimate survival of on-shell cc{sup ¯} intermediate states, might give us the clue for this new puzzle in exclusive charmonium decays. A similar self-preservation has already been invoked in the past to solve the so-called ρπ puzzle.

Getting “Just Deserts” or Seeing the “Silver Lining”: The Relation between Judgments of Immanent and Ultimate Justice

Science.gov (United States)

Harvey, Annelie J.; Callan, Mitchell J.

2014-01-01

People can perceive misfortunes as caused by previous bad deeds (immanent justice reasoning) or resulting in ultimate compensation (ultimate justice reasoning). Across two studies, we investigated the relation between these types of justice reasoning and identified the processes (perceptions of deservingness) that underlie them for both others (Study 1) and the self (Study 2). Study 1 demonstrated that observers engaged in more ultimate (vs. immanent) justice reasoning for a “good” victim and greater immanent (vs. ultimate) justice reasoning for a “bad” victim. In Study 2, participants' construals of their bad breaks varied as a function of their self-worth, with greater ultimate (immanent) justice reasoning for participants with higher (lower) self-esteem. Across both studies, perceived deservingness of bad breaks or perceived deservingness of ultimate compensation mediated immanent and ultimate justice reasoning respectively. PMID:25036011

A Retrospective Study of the Incidence of Missed Opportunities in Identifying, Managing and Referring At-Risk of Overweight and Overweight Children and Adolescents in an Outpatient Primary Care Setting

National Research Council Canada - National Science Library

Quirke, Amy

2004-01-01

A descriptive study of the incidence of missed opportunities in identifying, managing and referring children and adolescents at-risk of overweight and overweight were conducted using a retrospective...

Preparedness for and response to a radiological or nuclear incident

International Nuclear Information System (INIS)

Norman Coleman, C.

2014-01-01

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

Transcending matter: physics and ultimate meaning.

Science.gov (United States)

Paulson, Steve; Frank, Adam; Kaiser, David; Maudlin, Tim; Natarajan, Priyamvada

2015-12-01

From the discovery of new galaxies and nearly undetectable dark energy to the quantum entanglement of particles across the universe, new findings in physics naturally elicit a sense of awe and wonder. For the founders of modern physics-from Einstein and Bohr to Heisenberg, Pauli, and Bohm-a fascination with deeper questions of meaning and ultimate reality led some of them to explore esoteric traditions and metaphysics. More recently, however, physicists have largely shunned such philosophical and spiritual associations. What can contemporary physics offer us in the quest to understand our place in the universe? Has physics in some ways become a religion unto itself that rejects the search for existential meaning? Discussion of these and related questions is presented in this paper. © 2015 New York Academy of Sciences.

The discourses of incidents: Cougars on Mt. Elden and in Sabino Canyon, Arizona

Science.gov (United States)

Mattson, David J.; Clark, Susan G.

2012-01-01

Incidents are relatively short periods of intensified discourse that arise from public responses to symbolically important actions by public officials, and an important part of the conflict that increasingly surrounds state wildlife management in the West. In an effort to better understand incidents as a facet of this conflict, we analyzed the discourses of two incidents in Arizona that were precipitated by the intended removal of cougars by managers in response to public safety concerns. We used newspaper content, 1999–2007, to elucidate seminal patterns of public discourses and discourse coalitions as well as differences in discursive focus between incident periods and background periods. Cougars were mentioned in newspaper articles 13–33 times more often during incidents compared with background periods. State wildlife agency commissioners and hunters were part of a discourse coalition that advocated killing cougars to solve problems, blamed cougars and those who promoted the animals’ intrinsic value and sought to retain power to define and solve cougar-related problems. Personnel from affected state and federal agencies expressed a similar discourse. Environmentalists, animal protection activists, and some elected officials were of a coalition that defined “the problem” primarily in terms of people’s behaviors, including behaviors associated with current institutional arrangements. This discourse advocated decentralizing power over cougar management. The discourses reflected different preferences for the allocations of power and use of lethal versus non-lethal methods, which aligned with apparent core beliefs and participants’ enfranchisement or disenfranchisement by current state-level management power arrangements.

Medication incidents reported to an online incident reporting system.

LENUS (Irish Health Repository)

Alrwisan, Adel

2011-01-15

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

Fuzzy Algorithm for the Detection of Incidents in the Transport System

Science.gov (United States)

Nikolaev, Andrey B.; Sapego, Yuliya S.; Jakubovich, Anatolij N.; Berner, Leonid I.; Stroganov, Victor Yu.

2016-01-01

In the paper it's proposed an algorithm for the management of traffic incidents, aimed at minimizing the impact of incidents on the road traffic in general. The proposed algorithm is based on the theory of fuzzy sets and provides identification of accidents, as well as the adoption of appropriate measures to address them as soon as possible. A…

The Equivalent Uniform Dose as a severity metric for radiation treatment incidents

International Nuclear Information System (INIS)

Dunscombe, Peter B.; Iftody, Sandra; Ploquin, Nicolas; Ekaette, Edidiong U.; Lee, Robert C.

2007-01-01

In allocating resources within a risk management program, ideally we would like to know both the probabilities and consequences of potential incidents. We simulate, on a treatment planning computer, several commonly reported incidents in radiation treatment and explore their consequences for the EUDs of targets and organs at risk

Impact of Incidents on Traffic Congestion in Dar es Salaam City

Directory of Open Access Journals (Sweden)

David Mfinanga

2013-06-01

Full Text Available Poorly managed traffic incidents have largely contributed to congestion and delay in the city of Dar es Salaam. A thorough understanding of travel delays caused by incidents is therefore essential for effective countermeasures against the increasing congestion. The method used to determine delays in this research is based on the deterministic queuing theory. Information on incidents was obtained from traffic surveys, traffic police and road users. Counting of the number of vehicles passing the incident location was done on incident and incident-free days. The cumulative traffic counts on incident and incident-free days were then calculated and used to plot the queuing diagram used to determine incident induced delay. This method turned out to be a useful tool for estimating incident induced delay in areas with less sophisticated equipment i.e. where there are no sensors, CCTV cameras, etc. The method provided good estimates of incident induced delay which may help planners and transportation officials in better understanding incident related congestion and in selecting more effective countermeasures against incident related traffic congestion in the city. It was found out that the effects of incidents were different for the different zones, types of incidents and the periods the incident occurred. In addition to the incident duration and the number of vehicles affected, the impact of incidents also depended on availability of alternative routes, number of lanes on the road, discipline of the driver in manoeuvring at incident location and traffic control at the scene.

From novice to proficient general practitioner: a critical incident study.

Science.gov (United States)

Sim, M G; Kamien, M; Diamond, M R

1996-09-01

To obtain information about any change in the performance or perceptions of doctors undertaking the Royal Australian College of General Practitioners (RACGP) Training Program, with advancing general practice experience. The critical incident technique' was used, which is a comparative qualitative analysis. It involved interviews at 12 to 18 months after the basic term interview. Eighteen Western Australian doctors, who had been interviewed in 1992, at the end of their first 6 months of general practice training and were now completing their advanced or mentor terms in the RACGP Training Program took part in the study. Doctors reported an average of 4.4 critical incidents in their first interview and 5.0 in their second interview. The major areas of positive change included relationships with patients and other health care professionals, including supervisors; paediatrics and orthopaedics skills; the skills of developing a therapeutic relationship to enhance patient compliance and the ability to manage complex cardiovascular and psychiatric problems without reliance on specialist referral; attitudes of responsibility for and enjoyment of long term care of patients and families; and reduced levels of anxiety over difficult problems. New or continuing areas of difficulty were found in gynaecology; pharmacotherapy and dermatology; the diagnosis of common complaints with uncommon presentations; the skill of managing difficult or angry patients; the organisation for the follow-up of patients with potentially severe disorders; and in managing feelings of guilt over missed diagnoses or poor management. An analysis of commonly occurring positive and negative critical incidents shows that RACGP Training Program doctors develop competence, confidence and reduced levels of performance anxiety with advancing experience. All but one doctor found the Training Program helpful in achieving these proficiencies. However, many ongoing areas of difficulty remain. The Critical Incident

Direct ultimate disposal of spent fuel DEAB. Systems analysis. Ultimate disposal concepts. Final report. Main volume

International Nuclear Information System (INIS)

Wahl, A.

1995-10-01

The results elaborated under the project, systems analysis of mixed radwaste disposal concepts and systems analysis of ultimate disposal concepts, provide a comprehensive description and assessment of a radwaste repository, for heat generating wastes and for wastes with negligible heat generation, and thus represent the knowledge basis for forthcoming planning work for a repository in an abandoned salt mine. A fact to be considered is that temperature field calculations have shown that there is room for further optimization with regard to the mine layout. The following aspects have been analysed: (1) safety of operation; (2) technical feasibility and realisation and licensability of the concepts; (3) operational aspects; (4) varieties of utilization of the salt dome for the intended purpose (boreholes for waste emplacement, emplacement in galleries, multi-horizon systems); (5) long-term structural stability of the mine; (6) economic efficiency; (7) nuclear materials safeguards. (orig./HP) [de

Ultimate explanations and suboptimal choice.

Science.gov (United States)

Vasconcelos, Marco; Machado, Armando; Pandeirada, Josefa N S

2018-07-01

Researchers have unraveled multiple cases in which behavior deviates from rationality principles. We propose that such deviations are valuable tools to understand the adaptive significance of the underpinning mechanisms. To illustrate, we discuss in detail an experimental protocol in which animals systematically incur substantial foraging losses by preferring a lean but informative option over a rich but non-informative one. To understand how adaptive mechanisms may fail to maximize food intake, we review a model inspired by optimal foraging principles that reconciles sub-optimal choice with the view that current behavioral mechanisms were pruned by the optimizing action of natural selection. To move beyond retrospective speculation, we then review critical tests of the model, regarding both its assumptions and its (sometimes counterintuitive) predictions, all of which have been upheld. The overall contention is that (a) known mechanisms can be used to develop better ultimate accounts and that (b) to understand why mechanisms that generate suboptimal behavior evolved, we need to consider their adaptive value in the animal's characteristic ecology. Copyright © 2018 Elsevier B.V. All rights reserved.

Landau damping: the mechanics model and its ultimate entropy gain

International Nuclear Information System (INIS)

Hannay, J H; Kluge, Michel

2011-01-01

Classical mechanics has only been invoked to account for Landau damping in a rather half-hearted way, alongside plasma perturbation theory. In particular this invocation is essential for the study of the saturation, or post-linear (or 'nonlinear') regime of the damping initiated by Dawson and O'Neill. By embracing mechanics wholeheartedly here, with its attendant phase space, one can access results, old and new, cleanly and directly, and with one fewer numerical integration for the post-linear regime. By using a summation technique familiar in semiclassical quantum mechanics (Poisson summation), the one remaining numerical integration can be much improved in accuracy. Also accessible from mechanics is the ultimate entropy gain. Though zero for any finite time (in the absence of coarse graining), the entropy gain is ultimately non-zero (at infinite time the required coarse graining is zero). It is calculated analytically by using the appropriate asymptotics, hitherto not fully exploited.

[Deniss Hanovs, Valdis Tēraudkalns: Ultimate Freedom - no choice] / Olaf Mertelsmann

Index Scriptorium Estoniae

Mertelsmann, Olaf, 1969-

2014-01-01

Arvustus: Deniss Hanovs, Valdis Tēraudkalns: Ultimate Freedom - no choice. The culture of authoritarianism in Latvia, 1934-1940. (Central and Eastern Europe. Reginal perspectives in global context, Bd. 2.) Brill. Leiden-Boston 2013

The ultimate security bounds of quantum key distribution protocols

International Nuclear Information System (INIS)

Nikolopoulos, G.M.; Alber, G.

2005-01-01

Full text: Quantum key distribution (QKD) protocols exploit quantum correlations in order to establish a secure key between two legitimate users. Recent work on QKD has revealed a remarkable link between quantum and secret correlations. In this talk we report on recent results concerning the ultimate upper security bounds of various QKD schemes (i.e., the maximal disturbance up to which the two legitimate users share quantum correlations) under the assumption of general coherent attacks. In particular, we derive an analytic expression for the ultimate upper security bound of QKD schemes that use two mutually unbiased bases. As long as the two legitimate users focus on the sifted key and treat each pair of data independently during the post processing, our results are valid for arbitrary dimensions of the information carriers. The bound we have derived is well below the predictions of optimal cloning machines. The possibility of extraction of a secret key beyond entanglement distillation is also discussed. In the case of qutrits we argue that any eavesdropping strategy is equivalent to a symmetric one. For higher dimensions, however, such equivalence is generally no longer valid. (author)

Safe management of spent radiation source

International Nuclear Information System (INIS)

Kosako, Toshiso; Sugiura, Nobuyuki; Valdezco, E.M.; Choi, Kwang-Sub

2003-01-01

Presented are 8 investigation reports concerning the safe management of spent radiation source (SRS) during the current 2 years. Four reports from Japan are: Scheme for SRS management (approach and present status of the SRS management and consideration toward solving problems); Current International Atomic Energy Agency (IAEA) activities related to safety of radiation sources (Chronology of action plan development, Outline of revised action plan, and Asian regional activities); Current status of SRS management in Japan (Regulation system, Obligations of licensed users, Regulatory system on sealed sources, Status in the incidents on sources occurred, Incident of source loss, and Incidents of orphan sources); and SRS management system in Japan (Current status of using of sealed sources, collection system of SRS-Japan Radioisotope Association (JRIA) services, and Disposal of SRS). Four reports from the Asian countries also concern the current statuses of SRS management in the Philippine (Radioactive waste sources, Waste management strategies, Conditioning of Ra sources, Ra project action plan, as low as reasonably achievable (ALARA) program, Dose assessment, Regulations on radioactive waste, Action plan on the safety and security of sources, IAEA Regional Demonstration Centers, and sitting studies for a near surface disposal facility); Thailand (Current status of using sealed sources, Inventory of SRS, and Current topics of SRS management); Indonesia (Principles of management of radiation sources, Legislative framework of SRS management practices, Regulatory on SRS, management of sealed SRS, management hurdles, and reported incidents); and Korea (Regulatory frame work, Collection systems of SRS, Radioisotope waste generation, Radiation exposure incident, and Scrap monitoring system). (N.I.)

Successful emergency operations and the Incident Command System

International Nuclear Information System (INIS)

Montgomery, M.

1994-01-01

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

The Critical Incident Technique in Library and Information Management Research.

Science.gov (United States)

Fisher, Shelagh; Oulton, Tony

1999-01-01

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

Defining Incident Management Processes for CSIRTs: A Work in Progress

Science.gov (United States)

2004-10-01

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

Incidence and physical properties of PSE chicken meat in a commercial processing plant

Directory of Open Access Journals (Sweden)

RG Garcia

2010-12-01

Full Text Available It is known that PSE meat present important functional defects, such as low water holding capacity and ultimate pH, which may compromise the quality of further-processed meat products. In this study, L* (lightness, a* (redness, and b* (yellowness values of 500 chicken breast fillets were determined using a portable colorimeter (Minolta, model CR-400 in a commercial processing plant. Fillets were considered pale when their L* was >49. Out of those samples, 30 fillets with normal color and 30 pale fillets were evaluated as to pH, drip loss, cooking loss, water holding capacity, shear force, and submitted to sensorial analysis. An incidence of 10.20% PSE meat was determined. Pale and normal fillets presented significantly different (p0.05 between pale and normal fillets. Despite the significant differences in meat physical properties, these were not perceived by consumers in terms of tenderness, aspect, and flavor. The observed incidence of PSE may cause losses due to its low water retention capacity.

Incidence and management of pancreatic leakage after pancreatoduodenectomy

NARCIS (Netherlands)

de Castro, S. M. M.; Busch, O. R. C.; van Gulik, T. M.; Obertop, H.; Gouma, D. J.

2005-01-01

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

Concept for an ultimate storage facility for heat-generating radioactive waste in clay stone in Germany

International Nuclear Information System (INIS)

Bollingerfehr, Wilhelm; Poehler, Matthias

2010-01-01

According to the German reference ultimate storage concept heat-generating radioactive waste from the operation of nuclear power stations should be stored permanently maintenance-free and in a non-recoverable manner in a salt formation. Within the framework of investigations into the utilisation of alternative host rocks a concept for an ultimate storage facility in clay stone was developed in an R and D project. For this purpose all important aspects of the design, development, operation and shutdown were taken into account for a model region in northern Germany. It was established that storage in 50 m deep vertical boreholes in a mine at a depth of about 350 m appears to be the most practical solution for an ultimate storage facility in clay stone. Compared to the reference concept in salt an ultimate storage facility in clay stone requires solid support of all mine openings with steel arches or shotcrete. Because of the lower maximum permissible temperature in the backfilling material (bentonite) the area required for the ultimate storage facility is about five times larger. A period of more than 100 years is estimated from survey to shutdown. (orig.)

Emergency surgical airway management in Denmark

DEFF Research Database (Denmark)

Rosenstock, C V; Nørskov, A K; Wetterslev, J

2016-01-01

for difficult airway management. RESULTS: In the DAD cohort 27 out of 452 461 patients had an ESA representing an incidence of 0.06 events per thousand (95% CI; 0.04 to 0.08). A total of 12 149/452 461 patients underwent Ear-Nose and Throat (ENT) surgery, giving an ESA incidence among ENT patients of 1.6 events...... of which three failed. Reviewers evaluated airway management as satisfactory in 10/27 patients. CONCLUSIONS: The incidence of ESA in the DAD cohort was 0.06 events per thousand. Among ENT patients, the ESA Incidence was 1.6 events per thousand. Airway management was evaluated as satisfactory for 10......BACKGROUND: The emergency surgical airway (ESA) is the final option in difficult airway management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed airway management. METHODS: We extracted a cohort of 452 461 adult patients undergoing...

Investigation of excess thyroid cancer incidence in Los Alamos County

Energy Technology Data Exchange (ETDEWEB)

Athas, W.F.

1996-04-01

Los Alamos County (LAC) is home to the Los Alamos National Laboratory, a U.S. Department of Energy (DOE) nuclear research and design facility. In 1991, the DOE funded the New Mexico Department of Health to conduct a review of cancer incidence rates in LAC in response to citizen concerns over what was perceived as a large excess of brain tumors and a possible relationship to radiological contaminants from the Laboratory. The study found no unusual or alarming pattern in the incidence of brain cancer, however, a fourfold excess of thyroid cancer was observed during the late-1980`s. A rapid review of the medical records for cases diagnosed between 1986 and 1990 failed to demonstrate that the thyroid cancer excess had resulted from enhanced detection. Surveillance activities subsequently undertaken to monitor the trend revealed that the excess persisted into 1993. A feasibility assessment of further studies was made, and ultimately, an investigation was conducted to document the epidemiologic characteristics of the excess in detail and to explore possible causes through a case-series records review. Findings from the investigation are the subject of this report.

Investigation of excess thyroid cancer incidence in Los Alamos County

International Nuclear Information System (INIS)

Athas, W.F.

1996-04-01

Los Alamos County (LAC) is home to the Los Alamos National Laboratory, a U.S. Department of Energy (DOE) nuclear research and design facility. In 1991, the DOE funded the New Mexico Department of Health to conduct a review of cancer incidence rates in LAC in response to citizen concerns over what was perceived as a large excess of brain tumors and a possible relationship to radiological contaminants from the Laboratory. The study found no unusual or alarming pattern in the incidence of brain cancer, however, a fourfold excess of thyroid cancer was observed during the late-1980's. A rapid review of the medical records for cases diagnosed between 1986 and 1990 failed to demonstrate that the thyroid cancer excess had resulted from enhanced detection. Surveillance activities subsequently undertaken to monitor the trend revealed that the excess persisted into 1993. A feasibility assessment of further studies was made, and ultimately, an investigation was conducted to document the epidemiologic characteristics of the excess in detail and to explore possible causes through a case-series records review. Findings from the investigation are the subject of this report

Using incident response trees as a tool for risk management of online financial services.

Science.gov (United States)

Gorton, Dan

2014-09-01

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.

Evaluation of the effectiveness of ATM messages used during incidents : final report.

Science.gov (United States)

2016-01-01

This project investigated the use of Intelligent Lane Control Signs based Active Traffic Management for : Incident Management on a heavily traveled urban freeway. The subject of the research was the ILCS : system on I-94 westbound in downtown Minneap...

Decision basis for a Danish ultimate storage for low and intermediate radioactive wastes

International Nuclear Information System (INIS)

2008-11-01

In 2003 the Danish Parliament consented to let the government start the preparation of a basis for decision on a Danish ultimate storage for low and intermediate radioactive wastes. The present report was prepared by a working group and it presents the final proposal for such a decision basis. The report describes the fundamental safety and environmental principles for establishing an ultimate storage, including determining the principles for site selection, storage construction, and safety analysis. In an appendix, the amount, types, and activity level of the Danish radioactive wastes are presented. (ln)

Incidence of fistula after management of perianal abscess

Directory of Open Access Journals (Sweden)

Riyadh Mohamad Hasan

2016-10-01

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

UHS, Ultimate Heat Sink Cooling Pond Analysis

International Nuclear Information System (INIS)

Codell, R.; Nuttle, W.K.

1998-01-01

1 - Description of program or function: Three programs model performance of an ultimate heat sink cooling pond. National Weather Service data is read and analyzed to predict periods of lowest cooling performance and highest evaporative loss. The data is compared to local site data for significant differences. Then the maximum pond temperature is predicted. Five programs model performance of an ultimate heat sink spray pond. The cooling performance, evaporative water loss, and drift water loss as a function of wind speed are estimated for a spray field. These estimates are used in conjunction with National Weather Service data to predict periods of lowest cooling performance and highest evaporative loss. This data is compared to local site data for significant differences. Then the maximum pond temperature is predicted. 2 - Method of solution: The transfer of heat and water vapor is modeled using an equilibrium temperature procedure for an UHS cooling pond. The UHS spray pond model considers heat, mass, and momentum transfer from a single water drop with the surrounding air, and modification of the surrounding air resulting from the heat, mass, and momentum transfer from many drops in different parts of a spray field. 3 - Restrictions on the complexity of the problem: The program SPRCO uses RANF, a uniform random number generator which is an intrinsic function on the CDC. All programs except COMET use the NAMELIST statement, which is non standard. Otherwise these programs conform to the ANSI Fortran 77 standard. The meteorological data scanning procedure requires tens of years of recorded data to be effective. The models and methods, provided as useful tool for UHS analyses of cooling ponds and spray ponds, are intended as guidelines only. Use of these methods does not automatically assure NRC approval, nor are they required procedures for nuclear-power-plant licensing

Major incidents in Kenya: the case for emergency services development and training.

Science.gov (United States)

Wachira, Benjamin W; Smith, Wayne

2013-04-01

Kenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality. This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.

Experience with enterocutaneous fistula management in a district ...

African Journals Online (AJOL)

Experience with enterocutaneous fistula management in a district hospital in Nigeria. ... Malnutrition and sepsis are the leading causes of death. There are no clear guidelines for optimal nutritional management. Aggressive measures to maintain positive nitrogen balance is the ultimate goal of nutritional management.

Evaluation of the Safety Issue Concerning the Potential for Loss of Decay Heat Removal Function due to Crude Oil Spill in the Ultimate Heat Sink of Nuclear Reactors

International Nuclear Information System (INIS)

Jo, Jong Chull; Roh, Kyung Wan; Yune, Young Gill; Kang, Dong Gu; Kim, Hho Jhung

2008-01-01

A barge crashed into a moored oil tanker at about 7:15 a.m., Dec. 12, 2007, dumping around 10,500 tons of crude oil into the sea in Korea. The incident took place about 15 kilometers northwest of Manripo beach in South Chungcheong where is Korea's west coast in the Yellow Sea. In a few days, the oil slicks spread to the northern and southern tips of the Taean Peninsula by strong winds and tides. As time went the spilled oil floating on the surface of sea water was volatilized to become tar-balls and lumps and drifted far away in the southern direction. 13 days after the incident, some of oil slicks and tar lumps were observed to flow in the service water intake at the Younggwang nuclear power plants (NPPs) operating 6 reactors, which are over 150 km away from the incident spot in the southeastern direction. According to the report by the Younggwang NPPs, a total weight 83 kg of tar lumps was removed for about 3 days. Oil spills in the sea can happen in any country or anytime due to human errors or mistakes, wars, terrors, intentional dumping of waste oils, and natural disasters like typhoon and tsunami. In fact, there have been 7 major oil spills over 10,000 tons that have occurred around the world since 1983. As such serious oil spill incidents may happen near the operating power plants using the sea water as ultimate heat sink. To ensure the safe operation of nuclear reactors it is required to evaluate the potential for loss of decay heat removal function of nuclear reactors due to the spilled oils flowing in the service water intake, from which the service water is pumped. Thus, Korea Institute of Nuclear Safety identified this problem as one of the important safety. When an incident of crude oil spill from an oil carrier occurs in the sea near the nuclear power plants, the spilled oil can be transported to the intake pit, where all service water pumps locate, by sea current and wind drift (induced) current. The essential service water pumps take the service

Evaluation of the Safety Issue Concerning the Potential for Loss of Decay Heat Removal Function due to Crude Oil Spill in the Ultimate Heat Sink of Nuclear Reactors

Energy Technology Data Exchange (ETDEWEB)

Jo, Jong Chull; Roh, Kyung Wan; Yune, Young Gill; Kang, Dong Gu; Kim, Hho Jhung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2008-05-15

A barge crashed into a moored oil tanker at about 7:15 a.m., Dec. 12, 2007, dumping around 10,500 tons of crude oil into the sea in Korea. The incident took place about 15 kilometers northwest of Manripo beach in South Chungcheong where is Korea's west coast in the Yellow Sea. In a few days, the oil slicks spread to the northern and southern tips of the Taean Peninsula by strong winds and tides. As time went the spilled oil floating on the surface of sea water was volatilized to become tar-balls and lumps and drifted far away in the southern direction. 13 days after the incident, some of oil slicks and tar lumps were observed to flow in the service water intake at the Younggwang nuclear power plants (NPPs) operating 6 reactors, which are over 150 km away from the incident spot in the southeastern direction. According to the report by the Younggwang NPPs, a total weight 83 kg of tar lumps was removed for about 3 days. Oil spills in the sea can happen in any country or anytime due to human errors or mistakes, wars, terrors, intentional dumping of waste oils, and natural disasters like typhoon and tsunami. In fact, there have been 7 major oil spills over 10,000 tons that have occurred around the world since 1983. As such serious oil spill incidents may happen near the operating power plants using the sea water as ultimate heat sink. To ensure the safe operation of nuclear reactors it is required to evaluate the potential for loss of decay heat removal function of nuclear reactors due to the spilled oils flowing in the service water intake, from which the service water is pumped. Thus, Korea Institute of Nuclear Safety identified this problem as one of the important safety. When an incident of crude oil spill from an oil carrier occurs in the sea near the nuclear power plants, the spilled oil can be transported to the intake pit, where all service water pumps locate, by sea current and wind drift (induced) current. The essential service water pumps take the

[Dental caries incidence in adolescents in a city Northeast Brazil, 2006].

Science.gov (United States)

Noro, Luiz Roberto Augusto; Roncalli, Angelo Giuseppe; Mendes Júnior, Francisco Ivan Rodrigues; Lima, Kenio Costa

2009-04-01

The main objective of this study was to evaluate the incidence of tooth decay in adolescents, associated with socioeconomic status, access to services, and self-perceived oral health. This was a longitudinal study using an epidemiological survey of dental caries and a structured questionnaire with a sample of 688 adolescents residing in Sobral, Ceará State, Brazil. Incidence increased progressively with age, from 1.60 at 12 years of age to 2.28 at 15, with a mean incidence of 1.86 decayed teeth per adolescent. Among the study variables, tooth pain in the previous six months [RR = 1.46 (1.22-1.76)], school lunch [RR = 1.45 (1.21-1.74)], frequency of dental appointments [RR = 1.48 (1.33-1.79)], and access to the Health Service [RR = 1.21 (1.01-1.45)], adjusted by perceived need for treatment, were associated with high caries incidence. It is essential for health professionals and health system managers to formulate public policies that are not limited merely to clinical and preventive aspects, encouraging the population to struggle for better living conditions and allowing equitable access to services and developing collective management of health actions.

Ultimate analysis of PWR prestressed concrete containment subjected to internal pressure

International Nuclear Information System (INIS)

Hu, H.-T.; Lin, Y.-H.

2006-01-01

Numerical analyses are carried out by using the ABAQUS finite element program to predict the ultimate pressure capacity and the failure mode of the PWR prestressed concrete containment at Maanshan nuclear power plant. Material nonlinearity such as concrete cracking, tension stiffening, shear retention, concrete plasticity, yielding of prestressing tendon, yielding of steel reinforcing bar and degradation of material properties due to high temperature are all simulated with proper constitutive models. Geometric nonlinearity due to finite deformation has also been considered. The results of the analysis show that when the prestressed concrete containment fails, extensive cracks take place at the apex of the dome, the junction of the dome and cylinder, and the bottom of the cylinder connecting to the base slab. In addition, the ultimate pressure capacity of the containment is higher than the design pressure by 86%

Ultimate Limit State Model Basis for Assessment of Offshore Wind Energy Converters

DEFF Research Database (Denmark)

Thöns, Sebastian; Faber, M. H.; Rücker, W.

2012-01-01

then in combina-tion with the ultimate limit state requirements leads to the specific constitutive relations. As a result finite element models based on shell elements incorporating a structural and a loading model are introduced and described in detail. Applying these models the ultimate capacity of the support...... on the basis of literature review and measurement data from a prototype Multibrid M5000 support structure. In combination with the developed structural and loading models, sensitivity analyses in regard to the responses are peiformed to enhance the understanding and to refine the developed models. To this end...... variables on the responses including nonlinearity the refinement of the model is performed on a quantitative basis....

Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

Directory of Open Access Journals (Sweden)

Cheryl Dye

2018-04-01

Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

Literature review on medical incident command.

Science.gov (United States)

Rimstad, Rune; Braut, Geir Sverre

2015-04-01

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

Transition to the Ultimate Regime in Two-Dimensional Rayleigh-Bénard Convection

Science.gov (United States)

Zhu, Xiaojue; Mathai, Varghese; Stevens, Richard J. A. M.; Verzicco, Roberto; Lohse, Detlef

2018-04-01

The possible transition to the so-called ultimate regime, wherein both the bulk and the boundary layers are turbulent, has been an outstanding issue in thermal convection, since the seminal work by Kraichnan [Phys. Fluids 5, 1374 (1962), 10.1063/1.1706533]. Yet, when this transition takes place and how the local flow induces it is not fully understood. Here, by performing two-dimensional simulations of Rayleigh-Bénard turbulence covering six decades in Rayleigh number Ra up to 1 014 for Prandtl number Pr =1 , for the first time in numerical simulations we find the transition to the ultimate regime, namely, at Ra*=1013 . We reveal how the emission of thermal plumes enhances the global heat transport, leading to a steeper increase of the Nusselt number than the classical Malkus scaling Nu ˜Ra1 /3 [Proc. R. Soc. A 225, 196 (1954), 10.1098/rspa.1954.0197]. Beyond the transition, the mean velocity profiles are logarithmic throughout, indicating turbulent boundary layers. In contrast, the temperature profiles are only locally logarithmic, namely, within the regions where plumes are emitted, and where the local Nusselt number has an effective scaling Nu ˜Ra0.38 , corresponding to the effective scaling in the ultimate regime.

Cyber Incidents Involving Control Systems

Energy Technology Data Exchange (ETDEWEB)

Robert J. Turk

2005-10-01

The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this

ULtiMATE system for rapid assembly of customized TAL effectors.

Directory of Open Access Journals (Sweden)

Junjiao Yang

Full Text Available Engineered TAL-effector nucleases (TALENs and TALE-based constructs have become powerful tools for eukaryotic genome editing. Although many methods have been reported, it remains a challenge for the assembly of designer-based TALE repeats in a fast, precise and cost-effective manner. We present an ULtiMATE (USER-based Ligation Mediated Assembly of TAL Effector system for speedy and accurate assembly of customized TALE constructs. This method takes advantage of uracil-specific excision reagent (USER to create multiple distinct sticky ends between any neighboring DNA fragments for specific ligation. With pre-assembled templates, multiple TALE DNA-binding domains could be efficiently assembled in order within hours with minimal manual operation. This system has been demonstrated to produce both functional TALENs for effective gene knockout and TALE-mediated gene-specific transcription activation (TALE-TA. The feature of both ease-of-operation and high efficiency of ULtiMATE system makes it not only an ideal method for biologic labs, but also an approach well suited for large-scale assembly of TALENs and any other TALE-based constructions.

A critical incident study of general practice trainees in their basic general practice term.

Science.gov (United States)

Diamond, M R; Kamien, M; Sim, M G; Davis, J

1995-03-20

To obtain information on the experiences of general practice (GP) trainees during their first general practice (GP) attachment. Critical incident technique--a qualitative analysis of open-ended interviews about incidents which describe competent or poor professional practice. Thirty-nine Western Australian doctors from the Royal Australian College of General Practitioners' (RACGP) Family Medicine Program who were completing their first six months of general practice in 1992. Doctors reported 180 critical incidents, of which just over 50% involved problems (and sometimes successes) with: difficult patients; paediatrics; the doctor-patient relationship; counselling skills; obstetrics and gynaecology; relationships with other health professionals and practice staff; and cardiovascular disorders. The major skills associated with both positive and negative critical incidents were: the interpersonal skills of rapport and listening; the diagnostic skills of thorough clinical assessment and the appropriate use of investigations; and the management skills of knowing when and how to obtain help from supervisors, hospitals and specialists. Doctors reported high levels of anxiety over difficult management decisions and feelings of guilt over missed diagnoses and inadequate management. The initial GP term is a crucial transition period in the development of the future general practitioner. An analysis of commonly recurring positive and negative critical incidents can be used by the RACGP Training Program to accelerate the learning process of doctors in vocational training and has implications for the planning of undergraduate curricula.

Human factors in waste management

International Nuclear Information System (INIS)

Moray, N.

1994-01-01

This article examines the role of human factors in radioactive waste management. Although few problems and ergonomics are special to radioactive waste management, some problems are unique especially with long term storage. The entire sociotechnical system must be looked at in order to see where improvement can take place because operator errors, as seen in Chernobyl and Bhopal, are ultimately the result of management errors

Nonlinearity management and diffraction management for the ...

Indian Academy of Sciences (India)

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

Assessment of System of Rice Intensification (SRI and Conventional Practices under Organic and Inorganic Management in Japan

Directory of Open Access Journals (Sweden)

Tejendra CHAPAGAIN

2011-12-01

Full Text Available The system of rice intensification (SRI is a production system that involves the adoption of certain changes in management practices for rice cultivation that create a better growing environment for the crop. This system was compared with conventional practices and assessed under organic and inorganic management. SRI practices showed significant response in root number, number of effective tillers per hill, days to flowering and harvest index. In addition, SRI was found effective in minimizing pest and disease incidence, shortening the crop cycle, and improving plant stand. Grain yield was not different from conventional method. Except for harvest index and plant lodging percentage, there were no significant effects from management treatments. Synergistic responses were noted when SRI practices were combined with organic management for plant height, number of effective tillers per hill, days to flowering and to maturity. The improved panicle characteristics, lower plant lodging percentage and higher harvest index that ultimately led to comparable grain yields. Net returns increased approximately 1.5 times for SRI-organic management regardless of the added labor requirements for weed control. However, comparatively higher grain yield from conventional-inorganic methods underscore the need for further investigations in defining what constitutes an optimum set of practices for an SRI-organic system specifically addressing grain yield and weed management.

Dyslexic Entrepreneurs: The Incidence; Their Coping Strategies and Their Business Skills

Science.gov (United States)

Logan, Julie

2009-01-01

This comparative study explores the incidence of dyslexia in entrepreneurs, corporate managers and the general population. It examines the suggestion that dyslexic entrepreneurs develop coping strategies to manage their weaknesses, which are subsequently of benefit in the new venture creation process. Results of this study suggest that there is a…

The ultimate nuclear accident

International Nuclear Information System (INIS)

Abdus Salam, A.

1988-01-01

The estimated energy equivalent of Chernobyl explosion was the 1/150 th of the explosive energy equivalent of atomic bomb dropped on Hiroshima; while the devastation that could be caused by the world's stock pile of nuclear weapons, could be equivalent to 160 millions of Chernobyl-like incidents. As known, the number of nuclear weapons is over 50,000 and 2000 nuclear weapons are sufficient to destroy the world. The Three Mile Island and Chernobyl accidents have been blamed on human factors but also the human element, particularly in the form of psychological stresses on those operating the nuclear weapons, could accidentally bring the world to a nuclear catastrophe. This opinion is encouraged by the London's Sunday Times magazine which gave a graphic description of life inside a nuclear submarine. So, to speak of nuclear reactor accidents and not of nuclear weapons is false security. (author)

Longitudinal variation in pressure injury incidence among long-term aged care facilities.

Science.gov (United States)

Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Westbrook, Johanna I

2018-05-04

To examine variation in pressure injury (PI) incidence among long-term aged care facilities and identify resident- and facility-level factors that explain this variation. Longitudinal incidence study using routinely-collected electronic care management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. About 6556 people aged 65 years and older who were permanent residents in 60 long-term care facilities between December 2014 and November 2016. Risk-adjusted PI incidence rates over eight study quarters. Incidence density over the study period was 1.33 pressure injuries per 1000 resident days (95% confidence interval (CI) = 1.29-1.37). Funnel plots were used to identify variation among facilities. On average, 14% of facilities had risk-adjusted PI rates that were higher than expected in each quarter (above 95% funnel plot control limits). Ten percent of facilities had persistently high rates in any three or more consecutive quarters (n = 6). The variation between facilities was only partly explained by resident characteristics in multilevel regression models. Residents were more likely to have higher-pressure injury rates in facilities in regional areas compared with major city areas (adjusted incidence rate ratio = 1.25, 95% CI = 1.04-1.51), and facilities with persistently high rates were more likely to be located in areas with low socioeconomic status (P = 0.038). There is considerable variation among facilities in PI incidence. This study demonstrates the potential of routinely-collected care management data to monitor PI incidence and to identify facilities that may benefit from targeted intervention.

Radiological incident preparedness for community hospitals: a demonstration project.

Science.gov (United States)

Jafari, Mary Ellen

2010-08-01

In November 2007, the Wisconsin Division of Public Health Hospital Disaster Preparedness Program State Expert Panel on Radiation Emergencies issued a report titled The Management of Patients in a Radiological Incident. Gundersen Lutheran Health System was selected to conduct a demonstration project to implement the recommendations in that report. A comprehensive radiological incident response plan was developed and implemented in the hospital's Trauma and Emergency Center, including the purchase and installation of radiation detection and identification equipment, staff education and training, a tabletop exercise, and three mock incident test exercises. The project demonstrated that the State Expert Panel report provides a flexible template that can be implemented at community hospitals using existing staff for an approximate cost of $25,000.

Risks management in the hospital environment: incidence and risk factors associated with falls and pressure injuries in a clinical unit

Directory of Open Access Journals (Sweden)

Rayane Oliveira Cedraz

2018-03-01

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.

Molar mass of poly(ethylene terephthalate) (PET) during ultimate uniaxial drawing

NARCIS (Netherlands)

Göschel, U.; Cools, P.J.C.H.

2000-01-01

The changes of the average molar mass Mw, Mn, Mz, and molar mass distributions during multistep uniaxial drawing of poly(ethylene terephthalate) (PET) to achieve ultimate mechanical properties have been studied in detail by means of size exclusion chromatography (SEC) with triple detection:

Molar-Mass of Poly(Ethylene-Terephthalate) (PET) During Ultimate Uniaxial Drawing

NARCIS (Netherlands)

Göschel, A.G.P.U.; Cools, P.J.C.H.

2000-01-01

The changes of the average molar mass Mw, Mn, Mz, and molar mass distributions during multistep uniaxial drawing of poly(ethylene terephthalate) (PET) to achieve ultimate mechanical properties have been studied in detail by means of size exclusion chromatography (SEC) with triple detection:

Management options to increase soil organic matter and nitrogen availability in cultivated drylands

International Nuclear Information System (INIS)

Grace, P.R.

1998-01-01

Cropping of dryland soils in marginal regions with an emphasis on economic rather than ecological sustainability has generally led to decline in soil organic matter reserves and hence nutrient availability. Outputs commonly exceed inputs, with degradation of soil structure, reduction in infiltration and increase in runoff. Biological productivity is severely affected, leading to a vicious cycle of events usually culminating in decreased N release, excessive soil loss and ultimately desertification. Reducing the incidence of bare fallow, increasing crop-residue retention, strategic N-fertilizer application and shifting to cereal-legume rotations (as opposed to monocultures) and intercropping can slow the spiral. Simulation models such as DSSAT and SOCRATES provide suitable and easy-to-use platforms to evaluate these management strategies in terms of soil organic matter accumulation and yield performance. Through the linkage of these models to global information systems and the use of spatial-characterization software to identify zones of similarity, it is now possible to examine the transportability and risk of a particular management strategy under a wide range of climatic and soil conditions. (author)

A Computer-Based Glucose Management System Reduces the Incidence of Forgotten Glucose Measurements: A Retrospective Observational Study.

Science.gov (United States)

Okura, Tsuyoshi; Teramoto, Kei; Koshitani, Rie; Fujioka, Yohei; Endo, Yusuke; Ueki, Masaru; Kato, Masahiko; Taniguchi, Shin-Ichi; Kondo, Hiroshi; Yamamoto, Kazuhiro

2018-04-17

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.

Current Trends in the Oncologic and Surgical Managements of Breast Cancer in Women with Implants: Incidence, Diagnosis, and Treatment.

Science.gov (United States)

Veronesi, Paolo; De Lorenzi, Francesca; Loschi, Pietro; Rietjens, Mario; Veronesi, Umberto

2016-04-01

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.

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

Science.gov (United States)

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

2016-07-01

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

Wall roughness induces asymptotic ultimate turbulence

Science.gov (United States)

Zhu, Xiaojue; Verschoof, Ruben A.; Bakhuis, Dennis; Huisman, Sander G.; Verzicco, Roberto; Sun, Chao; Lohse, Detlef

2018-04-01

Turbulence governs the transport of heat, mass and momentum on multiple scales. In real-world applications, wall-bounded turbulence typically involves surfaces that are rough; however, characterizing and understanding the effects of wall roughness on turbulence remains a challenge. Here, by combining extensive experiments and numerical simulations, we examine the paradigmatic Taylor-Couette system, which describes the closed flow between two independently rotating coaxial cylinders. We show how wall roughness greatly enhances the overall transport properties and the corresponding scaling exponents associated with wall-bounded turbulence. We reveal that if only one of the walls is rough, the bulk velocity is slaved to the rough side, due to the much stronger coupling to that wall by the detaching flow structures. If both walls are rough, the viscosity dependence is eliminated, giving rise to asymptotic ultimate turbulence—the upper limit of transport—the existence of which was predicted more than 50 years ago. In this limit, the scaling laws can be extrapolated to arbitrarily large Reynolds numbers.

IDAS-RR: an incident data base system for research reactors

International Nuclear Information System (INIS)

Matsumoto, Kiyoshi; Kohsaka, Atsuo; Kaminaga, Masanori; Murayama, Youji; Ohnishi, Nobuaki; Maniwa, Masaki.

1990-03-01

An Incident Data Base System for Research Reactors, IDAS-RR, has been developed. IDAS-RR has information about abnormal incidents (failures, transients, accidents, etc.) of research reactors in the world. Data reference, input, editing and other functions of IDAS-RR are menu driven. The routine processing and data base management functions are performed by the system software and hardware. PC-9801 equipment was selected as the hardware because of its portability and popularity. IDAS-RR provides effective reference information for the following activities. 1) Analysis of abnormal incident of research reactors, 2) Detail analysis of research reactor behavior in the abnormal incident for building the knowledge base of the reactor emergency diagnostic system for research reactor, 3) Planning counter-measure for emergency situation in the research reactor. This report is a user's manual of IDAS-RR. (author)

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

Science.gov (United States)

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

2012-04-01

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

The ultimate solution. Disposal of disused sealed radioactive sources (DSRS)

International Nuclear Information System (INIS)

Heard, R.G.

2011-01-01

The borehole disposal concept (BDC) was first presented to ICEM by Potier, J-M in 2005. This paper repeats the basics introduced by Potier and relates further developments. It also documents the history of the development of the BDC. For countries with no access to existing or planned geological disposal facilities for radioactive wastes, the only options for managing high activity or long-lived disused radioactive sources are to store them indefinitely, return them to the supplier or find an alternative method of disposal. Disused sealed radioactive sources (DSRS) pose an unacceptable radiological and security risk if not properly managed. Out of control sources have already led to many high-profile incidents or accidents. One needs only to remember the recent accident in India that occurred earlier this year. Countries without solutions in place need to consider the future management of DSRSs urgently. An on-going problem in developing countries is what to do with sources that cannot be returned to the suppliers, sources for which there is no further use, sources that have not been maintained in a working condition and sources that are no longer suitable for their intended purpose. Disposal in boreholes is intended to be simple and effective, meeting the same high standards of long-term radiological safety as any other type of radioactive waste disposal. It is believed that the BDC can be readily deployed with simple, cost-effective technologies. These are appropriate both to the relatively small amounts and activities of the wastes and the resources that can realistically be found in developing countries. The South African Nuclear Energy Corporation Ltd (Necsa) has carried out project development and demonstration activities since 1996. The project looked into the technical feasibility, safety and economic viability of BDC under the social, economic, environmental and infrastructural conditions currently prevalent in Africa. Implementation is near at hand with

Prisoner Fasting as Symbolic Speech: The Ultimate Speech-Action Test.

Science.gov (United States)

Sneed, Don; Stonecipher, Harry W.

The ultimate test of the speech-action dichotomy, as it relates to symbolic speech to be considered by the courts, may be the fasting of prison inmates who use hunger strikes to protest the conditions of their confinement or to make political statements. While hunger strikes have been utilized by prisoners for years as a means of protest, it was…

Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

Energy Technology Data Exchange (ETDEWEB)

Greenwalt, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hibbard, W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2016-08-09

Emergency response agencies in most US communities are organized, sized, and equipped to manage those emergencies normally expected. Hospitals in particular do not typically have significant excess capacity to handle massive numbers of casualties, as hospital space is an expensive luxury if not needed. Unfortunately this means that in the event of a mass casualty chemical incident the emergency response system will be overwhelmed. This document provides a self-assessment means for emergency managers to examine their response system and identify shortfalls. It also includes lessons from a detailed analysis of five communities: Baltimore, Boise, Houston, Nassau County, and New Orleans. These lessons provide a list of potential critical decisions to allow for pre-planning and a library of best practices that may be helpful in reducing casualties in the event of an incident.

Contaminated Mexican steel incident

International Nuclear Information System (INIS)

1985-01-01

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

Method for ultimate disposition of borate containing radioactive wastes by vitrification

International Nuclear Information System (INIS)

Bege, D.; Faust, H.J.; Puthawala, A.; Stunkel, H.

1984-01-01

Method for the ultimate disposition of radioactive wastes by vitrification, in which weak to medium radioactive waste concentrates from borate-containing radioactive liquids are mixed with added glass-forming materials, maximally in a ratio of 1:3, and the mixture heated to obtain a glass-forming melt

Radioactive waste management and their ultimate disposal technologies in India: recent practices and developments

International Nuclear Information System (INIS)

Bajpai, R.K.

2015-01-01

The radioactive wastes that arise from the use of uranium, thorium and other radioactive isotopes during their various applications in the field of power generation, industry, agriculture and medicine are among the most talked about and at time even highly dreaded substances created by man in recent past. Most of the fears owe their genesis to extraordinary periods of time over which such waste remain radioactive and continue to emit radiations which are invisible to human eyes. These time periods run into tens of thousands of years and as a result any solution for management and permanent isolation of such waste needs to demonstrate safety of mankind and environment over such lengthy time frames. For example a radioactive isotope of strontium, known as 90 Sr takes about 300 years to loose its entire radioactivity. Similarly a popular isotope of plutonium 239 Pu needs almost 2.5 lakhs years to shed its entire radioactivity by converting itself to a non radioactive element. In this talk some salient aspects of radioactive waste management and solutions for their permanent isolation under consideration in India are discussed

Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

Science.gov (United States)

Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and

[Rules and regulations applying to incidents in radiotherapy].

Science.gov (United States)

Lohr, F; Baus, W; Vorwerk, H; Schlömp, B; André, L; Georg, D; Hodapp, N

2012-07-01

Radiotherapy is an essential and reliable element of the treatment armamentarium in oncology. Numerous rules, regulations, and protocols minimize the associated risks. It can, however, never be excluded that errors in the treatment delivery chain result in inadequate tumor doses or unnecessary damage to organs at risk. A legal framework governs the management of such incidents. The most important European and North American regulations are reported. Various directives issued by the European Union are differently implemented nationally. This applies particularly to the characterization of incidents that must be reported to authorities. Reporting thresholds, audit systems, and the extent of the integration of voluntary reporting systems vary. Radiotherapy incidents are dealt with differently on an international level. Changes are to be expected based on the European Basic Safety Standards Directive that is currently being prepared and will have to be implemented nationally in due course.

Rules and regulations applying to incidents in radiotheraphy

International Nuclear Information System (INIS)

Lohr, F.; Andre, L.; Georg, D.; Hodapp, N.

2012-01-01

Aims and purpose: Radiotherapy is an essential and reliable element of the treatment armamentarium in oncology. Numerous rules, regulations, and protocols minimize the associated risks. It can, however, never be excluded that errors in the treatment delivery chain result in inadequate tumor doses or unnecessary damage to organs at risk. A legal framework governs the management of such incidents. The most important European and North American regulations are reported. Results: Various directives issued by the European Union are differently implemented nationally. This applies particularly to the characterization of incidents that must be reported to authorities. Reporting thresholds, audit systems, and the extent of the integration of voluntary reporting systems vary. Conclusion: Radiotherapy incidents are dealt with differently on an international level. Changes are to be expected based on the European Basic Safety Standards Directive that is currently being prepared and will have to be implemented nationally in due course. (orig.)

Duties of the Physikalisch-Technische Bundesanstalt (PTB) in connection with radioactive waste safeguarding and ultimate storage

International Nuclear Information System (INIS)

Roethemeyer, H.

1977-01-01

An outline of the history and duties of the Physikalisch-Technische Bundesanstalt (PTB) is to illustrate that the new duties of the PTB in connection with radioactive substance safeguarding and ultimate storage fit in very well with the range of duties of the PTB. The organisatory and technical accomplishment of these duties in cooperation with a building and operating company and with industry is explained. The department of the PTB for the 'safeguarding and ultimate storage of radioactive wastes' has an examining, appraising and licensing function in connection with construction, operation and shutdown of safety facilities. Methods for the safeguarding and ultimate storage of all the radioactive wastes in the Federal Republic of Germany are described. (HS) [de

Student Well-Being Interventions: The Effects of Stress Management Techniques and Gratitude Journaling in the Management Education Classroom

Science.gov (United States)

Flinchbaugh, Carol L.; Moore, E. Whitney G.; Chang, Young K.; May, Douglas R.

2012-01-01

Student well-being in the management classroom is of concern to both educators and managers. Well-being is conceptualized here as students' reduction in stress, enhanced experienced meaning and engagement in the classroom, and, ultimately, heightened satisfaction with life. The authors investigated whether purposeful semester-long classroom…

Spent Nuclear Fuel Project Document Management Plan

International Nuclear Information System (INIS)

Connor, M.D.; Harizison, G.L.; Rice, W.C.

1995-12-01

The SNF Project Document Management Plan identifies and describes the currently available systems and processes for implementing and maintaining an effective document control and records management program. This program governs the methods by which documents are generated, released, distributed, maintained current, retired, and ultimately disposed

LRFD software for design and actual ultimate capacity of confined rectangular columns.

Science.gov (United States)

2013-04-01

The analysis of concrete columns using unconfined concrete models is a well established practice. On the : other hand, prediction of the actual ultimate capacity of confined concrete columns requires specialized nonlinear : analysis. Modern codes and...

INCIDENCE OF MAXILLOFACIAL TRAUMA IN SONEPAT (HARYANA, INDIA

Directory of Open Access Journals (Sweden)

Malik SUNITA

2013-03-01

Full Text Available Background: Maxillofacial injuries represent a therapeutic challenge to oral and maxillofacial surgeons working in emerging countries. This study was carried out to determine the incidence of maxillofacial trauma, clinical management and associated complications. This study highlights the need of oral and maxillofacial surgery along with other disciplines to deliver the emergency services and management to the maxillofacial trauma patients. Patients and Methods: A prospective Medical institute study of maxillofacial injured patients was carried out between September 20122 and December 2012, at the recently founded B.P.S Government Medical College for women, Khanpur kalan, Sonepat, Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed. Results: A total of 462 patients were studied. Males outnumbered females by a ratio of 2.9:1. age range was 9 months to 75 years with the peak incidence occurring in the age group 17-34 years .Most injuries were caused by road traffic accidents (75.8%, followed by assault and falls in 10.6% and 8% respectively. Soft tissue injuries and mandibular fractures were the most common type of injuries. Head/neck (53.1% and limb injuries (28.1% were the most prevalent associated injuries. Surgical debridement and soft tissue suturing (95.1% were the most common surgical procedures. Closed reduction of maxillofacial fractures was employed in 56% of patients, Open reduction and internal fixation was performed in 35% of cases and 9% were managed conservatively. Complications occurred in 3.4% of patients, mainly due to infection and malocclusion. The mean duration of hospital stay was 10.12 ± 6.24 days. Conclusion: This study highlights the importance of Dental surgery department alongwith other disciplinaes in the management of maxillofacial injuries. Moreover there is a need to reinforce legislation aimed to

The role of poison control centers in CBRN incidents

International Nuclear Information System (INIS)

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

2009-01-01

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

Long-term experience in salt mining and experience in salt mine decommissioning - a chance for ultimate storage?

International Nuclear Information System (INIS)

Sitz, P.; Rauche, H.

2003-01-01

The author discusses similarities between salt mining and ultimate storage and the possibility of using abandoned salt mines as ultimate storage site. He states that with all the numeric prediction tools now available, expert knowledge of mining engineers is still indispensable [de

Incidence of falls and preventive actions in a University Hospital.

Science.gov (United States)

Luzia, Melissa de Freitas; Cassola, Talita Portela; Suzuki, Lyliam Midori; Dias, Vera Lucia Mendes; Pinho, Leandro Barbosa de; Lucena, Amália de Fátima

2018-01-01

Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

Ultimate load capacities of expansion anchor bolts

International Nuclear Information System (INIS)

Czarnecki, R.M.; Manrique, M.A.; Samaddar, S.K.

1993-01-01

A summary of available experimental expansion anchor bolt test data is presented. These data were collected as part of programs by the nuclear industry to address generic issues related to verification of seismic adequacy of equipment in nuclear power plants. Some of the data presented are suitable for use in seismic probabilistic risk assessments. For example, mean values of ultimate strength, along with their standard deviation and coefficients of variation, for a range of most typical expansion anchor bolt sizes are presented. Effects of interaction between shear and tension, edge distance, spacing, and cracking of the concrete are presented in a manner that is more suitable for use in deterministic evaluations. Related industry programs to derive anchor bolt capacities are briefly discussed. Recommendations for areas of further investigation are also presented

Global incidence and outcome of testicular cancer

Science.gov (United States)

Shanmugalingam, Thurkaa; Soultati, Aspasia; Chowdhury, Simon; Rudman, Sarah; Van Hemelrijck, Mieke

2013-01-01

Background Testicular cancer is a rare tumor type accounting for 1% of malignancies in men. It is, however, the most common cancer in young men in Western populations. The incidence of testicular cancer is increasing globally, although a decline in mortality rates has been reported in Western countries. It is important to identify whether the variations in trends observed between populations are linked to genetic or environmental factors. Methods Age-standardized incidence rates and age-standardized mortality rates for testicular cancer were obtained for men of all ages in ten countries from the Americas, Asia, Europe, and Oceania using the Cancer Incidence in Five Continents (CI5plus) and World Health Organization (WHO) mortality databases. The annual percent change was calculated using Joinpoint regression to assess temporal changes between geographical regions. Results Testicular cancer age-standardized incidence rates are highest in New Zealand (7.8), UK (6.3), Australia (6.1), Sweden (5.6), USA (5.2), Poland (4.9), and Spain (3.8) per 100,000 men. India, China, and Colombia had the lowest incidence (0.5, 1.3, and 2.2, respectively) per 100,000 men. The annual percent changes for overall testicular cancer incidence significantly increased in the European countries Sweden 2.4%, (2.2; 2.6); UK 2.9%, (2.2; 3.6); and Spain 5.0%, (1.7; 8.4), Australia 3.0%, (2.2; 3.7), and China 3.5%, (1.9; 5.1). India had the lowest overall testicular cancer incidence −1.7%, (−2.5; −0.8). Annual percent changes for overall testicular cancer mortality rates were decreasing in all study populations, with the greatest decline observed in Sweden −4.2%, (−4.8; −3.6) and China −4.9%, (−6.5; −3.3). Conclusion Testicular cancer is increasing in incidence in many countries; however, mortality rates remain low and most men are cured. An understanding of the risks and long-term side effects of treatment are important in managing men with this disease. PMID:24204171

proximate and ultimate analysis of fuel pellets from oil palm residues

African Journals Online (AJOL)

HOD

Keywords: Oil Palm Residues, Fuel Pellets, Proximate Analysis, Ultimate Analysis. 1. INTRODUCTION ... Pelletizing of this biomass resources into pellets is a way of ensuring a ... demand for pellets [3], and alternative feed-stocks such as palm kernel ... agro-residues, selection of the best pellets has to be made based on ...

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

Directory of Open Access Journals (Sweden)

Huber-Wagner S

2009-12-01

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

Explaining mastitis incidence in Dutch dairy farming: the influence of farmers' attitudes and behaviour.

Science.gov (United States)

Jansen, J; van den Borne, B H P; Renes, R J; van Schaik, G; Lam, T J G M; Leeuwis, C

2009-11-15

When mastitis incidence increases, either infection pressure has increased or cows' resistance has decreased. This usually indicates that farm management is not optimal. Numerous quantitative studies have demonstrated the effect of management practices on mastitis. In most of these studies, the identified risk factors could explain only part of the variance in mastitis incidence on farms. Several studies suggest that the unexplained variance is caused by farmers' attitudes towards different aspects of mastitis treatment and preventive behaviour. This study aims to determine, to quantify and to specify the extent to which farmers' attitudes, over and above farmers' behaviour, are factors that explain the variation in mastitis incidence, measured in terms of the quantifiable effect of management factors. An extensive survey on self-reported attitudes, behaviour and mastitis incidence was conducted on 336 Dutch dairy farms. Results of multiple linear regression analyses show that farmers' self-reported behaviour and attitudes together explain 48%, 31% and 23% of the variation within, respectively, the average farm bulk milk somatic cell count (BMSCC), the clinical mastitis incidence and the combined clinical and subclinical mastitis incidence. Both behaviour and attitudes explain part of the variance. However, most of the variance in all three dependant measures is explained solely by the attitude variables. The variation in BMSCC value is best explained by (1) farmers' normative frame of reference about mastitis, (2) farmers' perceptions about the control of mastitis and (3) the perceived effect of a BMSCC penalty level. The variation in clinical mastitis is best explained by farmers' perceptions about mastitis control. The variation in the combined clinical and subclinical mastitis incidence rate is best explained by the perceived effect of a BMSCC penalty level and the frequency of contact with others. The results of this study show that farmers' attitudes are a

Evaluation of time-accelerated irradiation method of elastomer by modulus-ultimate elongation profile

International Nuclear Information System (INIS)

Ito, Masayuki; Oka, Toshitaka; Hama, Yosimasa

2009-01-01

'Generalized modulus-ultimate elongation profile' was induced from the relationship between the modulus and the ultimate elongation of an elastomer that was quantitatively added crosslinking and scission. This profile can be used to evaluate the time-accelerated irradiation methods of ethylene-propylene-diene elastomer. The irradiation under low dose rate (0.33 kGy/h) at room temperature was the reference condition. The short-time irradiation condition was 4.2 kGy/h in 0.5 MPa oxygen at room temperature and 5.0 kGy/h in air at 70 o C. The former tended to bring about the higher ratio of scission than the reference condition; the latter tended to bring about the higher ratio of crosslinking.

The safety performance management system: A tool for diagnosis, intervention and measurement

International Nuclear Information System (INIS)

Haber, S.B.; Shurberg, D.A.

2002-01-01

Many organizations depend on human performance to avoid incidents involving significant adverse consequences. Such organizations are typically termed high reliability organizations (HROs). While heavy emphasis has been placed on designing system hardware and software to intercept and mitigate events that could cause adverse consequences, dealing with the design of the human component has proven to be more complicated. Examination of various safety-related incidents makes it clear that human performance, and in particular organizational processes, plays a dominant role. The human errors are of various origins and are typically part of larger organizational processes that encourage unsafe acts that ultimately produce system failures. It is generally postulated that without an effective organizational safety culture, a safe working environment is impossible. While many different perspectives exist from which safety issues might be addressed, a method that allows the quantitative measurement of organizational processes deemed to impact overall safety performance is considered useful to understand the potential for future inadequate safety performance. This paper describes the Safety Performance Management System, a method useful for diagnosis, subsequent intervention and follow-on measurement. Implications for use of this method are presented and the concluding discussion includes insights regarding the general application of the method to improved facility safety performance. (author)

Thrombocytopenia in neonates with polycythemia: incidence, risk factors and clinical outcome.

Science.gov (United States)

Vlug, Roos D; Lopriore, Enrico; Janssen, Marleen; Middeldorp, Johanna M; Rath, Mirjam E A; Smits-Wintjens, Vivianne E H J

2015-02-01

Polycythemia occurs in 1 to 5% of neonates and is associated with complications, including an increased risk of thrombocytopenia. To evaluate incidence, risk factors, management and outcome of thrombocytopenia in neonates with polycythemia. All neonates with polycythemia admitted to our neonatal intensive care unit between 2006 and 2013 were included in this retrospective study. We evaluated the incidence of thrombocytopenia (platelet count polycythemia and is independently associated with growth restriction. Increased hematocrit is associated with decreased platelet count.

Preventing construction worker injury incidents through the management of personal stress and organizational stressors.

Science.gov (United States)

Leung, Mei-yung; Chan, Isabelle Yee Shan; Yu, Jingyu

2012-09-01

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.

Hospital planning for weapons of mass destruction incidents

Directory of Open Access Journals (Sweden)

Perry Ronald

2006-01-01

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

Analysis on incidence and management of complications after femtosecond laser-assisted small incision lenticule extraction

Directory of Open Access Journals (Sweden)

Cai-Hong Li

2018-04-01

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.

Comparison between field data and ultimate heat-sink cooling-pond and spray-pond models

International Nuclear Information System (INIS)

Codell, R.

1982-09-01

Two previously published reports, NUREG-0693 and NUREG-0733, presented models and methods by which ultimate heat sink cooling ponds and spray ponds used for safety-related water supplies in nuclear power plants could be analyzed for design-basis conditions of heat load and meteorology. These models were only partially verified with field data. The present report compares the NRC models to data collected for NRC by Battelle Pacific Northwest Laboratories on the performance of small geothermally heated ponds and spray ponds. These comparisons generally support the conclusion that the NRC models are useful tools in predicting ultimate heat sink performance

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

Science.gov (United States)

Bearman, Christopher; Bremner, Peter A

2013-05-01

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

Neuropathic pain other than CRPS in children and adolescents: incidence, referral, clinical characteristics, management, and clinical outcomes.

Science.gov (United States)

Kachko, Ludmyla; Ben Ami, Shiri; Lieberman, Alon; Shor, Rita; Tzeitlin, Elena; Efrat, Rachel

2014-06-01

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.

Challenges of information security incident learning: An industrial case study in a Chinese healthcare organization.

Science.gov (United States)

He, Ying; Johnson, Chris

2017-12-01

Security incidents can have negative impacts on healthcare organizations, and the security of medical records has become a primary concern of the public. However, previous studies showed that organizations had not effectively learned lessons from security incidents. Incident learning as an essential activity in the "follow-up" phase of security incident response lifecycle has long been addressed but not given enough attention. This paper conducted a case study in a healthcare organization in China to explore their current obstacles in the practice of incident learning. We interviewed both IT professionals and healthcare professionals. The results showed that the organization did not have a structured way to gather and redistribute incident knowledge. Incident response was ineffective in cycling incident knowledge back to inform security management. Incident reporting to multiple stakeholders faced a great challenge. In response to this case study, we suggest the security assurance modeling framework to address those obstacles.

Recommendation for basis for decision on a Danish ultimate storage for low and intermediate radioactive wastes

International Nuclear Information System (INIS)

2006-12-01

In 2003 the Danish Parliament consented to let the government start the preparation of a basis for decision on a Danish ultimate storage for low and intermediate radioactive wastes. The present report is the result of the preparation process, and it describes the fundamental safety and environmental principles for establishing an ultimate storage, including determining the principles for the site selection, storage construction, and safety analyses. (LN)

A Technique for Temperature and Ultimate Load Calculations of Thin Targets in a Pulsed Electron Beam

DEFF Research Database (Denmark)

Hansen, Jørgen-Walther; Lundsager, Per

1979-01-01

A technique is presented for the calculation of transient temperature distributions and ultimate load of rotationally symmetric thin membranes with uniform lateral load and exposed to a pulsed electron beam from a linear accelerator. Heat transfer by conduction is considered the only transfer...... mechanism. The ultimate load is calculated on the basis of large plastic strain analysis. Analysis of one aluminum and one titanium membrane is shown....

Explaining mastitis incidence in Dutch dairy farming: The influence of farmers’ attitudes and behaviour

NARCIS (Netherlands)

Jansen, J.; Borne, van den B.H.P.; Renes, R.J.; Schaik, van G.; Lam, T.J.G.M.; Leeuwis, C.

2009-01-01

When mastitis incidence increases, either infection pressure has increased or cows’ resistance has decreased. This usually indicates that farm management is not optimal. Numerous quantitative studies have demonstrated the effect of management practices on mastitis. In most of these studies, the

Treatment of the loss of ultimate heat sink initiating events in the IRSN level 1 PSA

International Nuclear Information System (INIS)

Dupuy, Patricia; Georgescu, Gabriel; Corenwinder, Francois

2014-01-01

The total loss of the ultimate heat sink is an initiating event which, even it is mainly of external origin, has been considered in the frame of internal events Level 1 PSA by IRSN. The on-going actions on the development of external hazards PSA and the recent incident of loss of the heat sink induced by the ingress of vegetable matter that occurred in France in 2009 have pointed out the need to improve the modeling of the loss of the heat sink initiating event and sequences to better take into account the fact that this loss may be induced by external hazards and thus affect all the site units. The paper presents the historical steps of the modeling of the total loss of the heat sink, the safety stakes of this modeling, the main assumptions used by IRSN in the associated PSA for the 900 MWe reactors and the results obtained. The total loss of the heat sink was not initially addressed in the safety demonstration of French NPPs. On the basis of the insights of the first probabilistic assessments performed in the 80's, the risks associated to this 'multiple failure situation' turned out to be very significant and design and organisational improvements were implemented on the plants. Reviews of the characterization of external hazards and of their consequences on the installations and French operating feedback have revealed that extreme hazards may induce a total loss of the heat sink. Moreover, the accident that occurred at Fukushima in 2011 has pointed out the risk of such a loss of long duration at all site units in case of extreme hazards. In this context, it seems relevant to further improve the modelling of the total loss of the heat sink by considering the external hazards that may cause this loss. In a first step, IRSN has improved the assumptions and data used in the loss of the heat sink PSA model, in particular by considering that such a loss may affect all the site units. The next challenge will be the deeper analysis of the impact of external hazards on

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

African Journals Online (AJOL)

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

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

National Research Council Canada - National Science Library

Briggs, Darryl J

2007-01-01

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

Methodology for predicting ultimate pressure capacity of the ACR-1000 containment structure

International Nuclear Information System (INIS)

Saudy, A.M.; Awad, A.; Elgohary, M.

2006-01-01

The Advanced CANDU Reactor or the ACR-1000 is developed by Atomic Energy of Canada Limited (AECL) to be the next step in the evolution of the CANDU product line. It is based on the proven CANDU technology and incorporates advanced design technologies. The ACR containment structure is an essential element of the overall defense in depth approach to reactor safety, and is a physical barrier against the release of radioactive material to the environment. Therefore, it is important to provide a robust design with an adequate margin of safety. One of the key design requirements of the ACR containment structure is to have an ultimate pressure capacity that is at least twice the design pressure Using standard design codes, the containment structure is expected to behave elastically at least up to 1.5 times the design pressure. Beyond this pressure level, the concrete containment structure with reinforcements and post-tension tendons behaves in a highly non-linear manner and exhibits a complex response when cracks initiate and propagate. To predict the structural non-linear responses, at least two critical features are involved. These are: the structural idealization by the geometry and material property models, and the adopted solution algorithm. Therefore, detailed idealization of the concrete structure is needed in order to accurately predict its ultimate pressure capacity. This paper summarizes the analysis methodology to be carried out to establish the ultimate pressure capacity of the ACR containment structure and to confirm that the structure meets the specified design requirements. (author)

Experimental research on the ultimate strength of hard aluminium alloy 2017 subjected to short-time radioactive heating

International Nuclear Information System (INIS)

Dafang, Wu; Yuewu, Wang; Bing, Pan; Meng, Mu; Lin, Zhu

2012-01-01

Highlights: ► Ultimate strength at transient heating is critical to security design of missiles. ► We measure the ultimate strength of alloy 2017 subjected to transient heating. ► Experimental results at transient heating are lacking in strength design handbook. ► Ultimate strength of alloy 2017 experimented is much higher than handbook value. ► The results provide a new method for optimal design of high-speed flight vehicles. -- Abstract: Alloy 2017 (Al–Cu–Mg) is a hard aluminium alloy strengthened by heat treatment. Because of its higher strength, finer weldability and ductility, hard aluminium alloy 2017 has been widely used in the field of aeronautics and astronautics. However, the ultimate strength and other characteristic mechanical parameters of aluminium alloy 2017 in a transient heating environment are still unclear, as these key mechanical parameters are lacking in the existing strength design handbook. The experimental characterisation of these critical parameters of aluminium alloy 2017 is undoubtedly meaningful for reliably estimating life span of and improving safety in designing high-speed flight vehicles. In this paper, the high-temperature ultimate strength, loading time and other mechanical properties of hard aluminium alloy 2017 under different transient heating temperatures and loading conditions are investigated by combining a transient aerodynamic heating simulation system and a material testing machine. The experimental results reveal that the ultimate strength and loading capability of aluminium alloy 2017 subjected to transient thermal heating are much higher than those tested in a long-time stable high-temperature environment. The research of this work not only provides a substantial basis for the loading capability improvement and optimal design of aerospace materials and structures subject to transient heating but also presents a new research direction with a practical application value.

Spatial Interaction Modeling to Identify Potentially Exposed Populations during RDD or IND Terrorism Incidents

International Nuclear Information System (INIS)

Regens, J.L.; Gunter, J.T.; Gupta, S.

2009-01-01

Homeland Security Presidential Directive no.5 (HSPD-5) Management of Domestic Incidents and Department of Homeland Security (DHS) Planning Guidance for Protection and Recovery Following Radiological Dispersal Device (RDD) and Improvised Nuclear Device (IND) Incidents underscore the need to delineate radiological emergency guidance applicable to remedial action and recovery following an RDD or IND incident. Rapid delineation of the population potentially exposed to ionizing radiation from fallout during terrorist incidents involving RDDs or low-yield nuclear devices (≤ 20 KT) is necessary for effective medical response and incident management as part of the recovery process. This paper illustrates the application of spatial interaction models to allocate population data for a representative U.S. urban area (≅1.3M people; 1,612.27 km 2 area) at a geographical scale relevant for accurately estimating risk given dose concentrations. Estimated total dose equivalents (TEDE) are calculated for isopleths moving away from the detonation point for typical release scenarios. Population is estimated within the TEDE zones using Euclidean distances between zip code polygon centroids generated in ArcGIS version 9.1 with distance decay determined by regression analysis to apportion origin-destination pairs to a population count and density matrix on a spatial basis for daytime and night-time release scenarios. (authors)

Development of a highway incident management operational and training guide : phase II.

Science.gov (United States)

2014-08-01

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...

7 CFR 4280.29 - Supplemental financing required for the Ultimate Recipient Project.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Supplemental financing required for the Ultimate Recipient Project. 4280.29 Section 4280.29 Agriculture Regulations of the Department of Agriculture... AND GRANTS Rural Economic Development Loan and Grant Programs § 4280.29 Supplemental financing...

Incidence, causes and pattern of cancellation of Elective surgical ...

African Journals Online (AJOL)

This study was carried out to assess the incidence, causes and pattern of cancellation of elective surgical operations in our setting and to find the appropriate solutions for better patient management. Methods: This was a prospective hospital-based study which was conducted in a teaching hospital at Bugando medical ...

Focused ion beam technology and ultimate applications

International Nuclear Information System (INIS)

Gierak, Jacques

2009-01-01

In this topical review, the potential of the focused ion beam (FIB) technology and ultimate applications are reviewed. After an introduction to the technology and to the operating principles of liquid metal ion sources (LMIS), of ion optics and instrument architectures, several applications are described and discussed. First, the application of FIB for microcircuit inspection, metrology and failure analysis is presented. Then, we introduce and illustrate some advanced patterning schemes we propose as next generation FIB processing examples. These patterning schemes are (i) local defect injection or smoothing in magnetic thin film direct patterning, (ii) functionalization of graphite substrates to guide organization of clusters, (iii) local and selective epitaxy of III–V semiconductor quantum dots and (iv) FIB patterned solid-state nanopores for biological molecules manipulation and analysis. We conclude this work by giving our vision of the future developments for FIB technology. (topical review)

Critical incidents among women entrepreneurs: Personal and professional issues

Directory of Open Access Journals (Sweden)

Vânia Maria Jorge Nassif

2016-06-01

Full Text Available ABSTRACT The objective of this paper is to analyze critical situations experienced by women entrepreneurs and understand how they have overcome such situations. The study contributes to the understanding of the issues related to the activities of women entrepreneurs and shows that the use of the critical incident technique is relevant to the development of research in the field of entrepreneurship. The data were collected using a specific form with 115 women participating in the study. The analysis of critical incidents showed that in addition to the practical issues regarding the management of their business, emotions are interconnected with their business development. Unlike international studies in the field, the critical incidents experienced by Brazilian women entrepreneurs overlap with personal aspects. The women involved in this study face emotional difficulties, but are also motivated by strong feelings of determination to overcome their problems.

Acanthamoeba keratitis: study of the 5-year incidence in Israel.

Science.gov (United States)

Graffi, Shmuel; Peretz, Avi; Jabaly, Haneen; Koiefman, Anna; Naftali, Modi

2013-11-01

Acanthamoeba keratitis (AK) is not a notifiable disease in Israel, so there are no accurate incidence rates for this condition in Israel. The aim of this study was to estimate the incidence of AK in Israel for the years 2008-2012. We distributed a survey questionnaire to laboratory managers in Israel. The laboratories were affiliated to medical institutes that either provided ophthalmology services or served community ophthalmology clinics. Our questionnaire requested survey respondents to provide information regarding the methods used to diagnose AK, and the number of positive and negative cultures for Acanthamoebae species performed for each of the years from 2008 to 2012. Six laboratories used non-nutrient agar with Escherichia coli as the culture medium, one used calcofluor-white staining with fluorescent microscopy, and two used PCR for diagnosing AK. Twenty-three AK cases were identified, to give an estimated incidence of 1/1 668 552. AK is mostly attributable to the use of contact lenses. As contact lenses are popular in Israel, we expected a higher incidence rate. A lower than expected incidence rate may indicate insufficient awareness of AK in Israel.

Automatic road traffic safety management system in urban areas

Directory of Open Access Journals (Sweden)

Oskarbski Jacek

2017-01-01

Full Text Available Traffic incidents and accidents contribute to decreasing levels of transport system reliability and safety. Traffic management and emergency systems on the road, using, among others, automatic detection, video surveillance, communication technologies and institutional solutions improve the organization of the work of various departments involved in traffic and safety management. Automation of incident management helps to reduce the time of a rescue operation as well as of the normalization of the flow of traffic after completion of a rescue operation, which also affects the reduction of the risk of secondary accidents and contributes to reducing their severity. The paper presents the possibility of including city traffic departments in the process of incident management. The results of research on the automatic incident detection in cities are also presented.

Report on R and D work on radioactive waste management and dumping of chemical-toxic wastes sponsored by the BMFT in the second half of 1991

International Nuclear Information System (INIS)

1992-05-01

On behalf of the Federal Minister of Research and Technology, the Kernforschungszentrum Karlsruhe has undertaken the projekt management of the R and D programme sector of waste management, subdivided into the programmes decommissioning and nuclear fuel cycle, and ultimate disposal of dangerous wastes. Ultimate disposal of dangerous wastes is understood to be the ultimate disposal of radioactive wastes and the dumping of chemical-toxic wastes. The progress report documents its programme sector of waste management. Its main part contains the formalized interim reports (as of 31.12.1991) on all projects attended by the manager of the waste management project, arranged according to promotion marks (letter C in the promotion mark stands for chemical-toxic, E for ultimate disposal, S for decommisioning, W for reprocessing, and U - for historical reasons - for university project). (orig./BBR) [de

Ultimate uniaxial compressive strength of stiffened panel with opening under lateral pressure

Directory of Open Access Journals (Sweden)

Chang-Li Yu

2015-03-01

Full Text Available This paper concentrated on the ultimate uniaxial compressive strength of stiffened panel with opening under lateral load and also studied the design-oriented formulae. For this purpose, three series of well executed experiments on longitudinal stiffened panel with rectangular opening subjected to the combined load have been selected as test models. The finite element analysis package, ABAQUS, is used for simulation with considering the large elasticplastic deflection behavior of stiffened panels. The feasibility of the numerical procedure is verified by a good agreement of experimental results and numerical results. More cases studies are executed employing nonlinear finite element method to analyze the influence of design variables on the ultimate strength of stiffened panel with opening under combined pressure. Based on data, two design formulae corresponding to different opening types are fitted, and accuracy of them is illustrated to demonstrate that they could be applied to basic design of practical engineering structure.

Analysis of mass incident diffusion in Weibo based on self-organization theory

Science.gov (United States)

Pan, Jun; Shen, Huizhang

2018-02-01

This study introduces some theories and methods of self-organization system to the research of the diffusion mechanism of mass incidents in Weibo (Chinese Twitter). Based on the analysis on massive Weibo data from Songjiang battery factory incident happened in 2013 and Jiiangsu Qidong OJI PAPER incident happened in 2012, we find out that diffusion system of mass incident in Weibo satisfies Power Law, Zipf's Law, 1/f noise and Self-similarity. It means this system is the self-organization criticality system and dissemination bursts can be understood as one kind of Self-organization behavior. As the consequence, self-organized criticality (SOC) theory can be used to explain the evolution of mass incident diffusion and people may come up with the right strategy to control such kind of diffusion if they can handle the key ingredients of Self-organization well. Such a study is of practical importance which can offer opportunities for policy makers to have good management on these events.

Adobe Photoshop CS5 for Photographers The Ultimate Workshop

CERN Document Server

Evening, Martin

2010-01-01

If you already have a good knowledge of Adobe Photoshop and are looking to advance your skills, Adobe Photoshop CS5 for Photographers: The Ultimate Workshop is the book you've been waiting for.  Renowned photographers Martin Evening and Jeff Schewe impart their Photoshop tips and workflow, showing you how to use a vast array of rarely seen advanced Photoshop techniques.  Whether the subject is serious retouching work, weird and wonderful compositions, or planning a shoot before you've even picked up a camera, you can be sure that the advice is based on years of practical experience.

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

Directory of Open Access Journals (Sweden)

Adam D.

2015-03-01

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

A preliminary analysis of incident investigation reports of an integrated steel plant: some reflection.

Science.gov (United States)

Verma, A; Maiti, J; Gaikwad, V N

2018-06-01

Large integrated steel plants employ an effective safety management system and gather a significant amount of safety-related data. This research intends to explore and visualize the rich database to find out the key factors responsible for the occurrences of incidents. The study was carried out on the data in the form of investigation reports collected from a steel plant in India. The data were processed and analysed using some of the quality management tools like Pareto chart, control chart, Ishikawa diagram, etc. Analyses showed that causes of incidents differ depending on the activities performed in a department. For example, fire/explosion and process-related incidents are more common in the departments associated with coke-making and blast furnace. Similar kind of factors were obtained, and recommendations were provided for their mitigation. Finally, the limitations of the study were discussed, and the scope of the research works was identified.

Classification of radioactive waste and determination of waste specifications as well as conditions of acceptance for ultimate storage

International Nuclear Information System (INIS)

Merz, E.

1983-04-01

The determination of waste specification and conditions of acceptance must follow a certain scheme, the basics of which will be presented. First the types of waste and the ultimate storage facilities will be characterized. The various categories of waste will be listed in a universally valid system, and the preliminary conditioning options will be determined. Based on the results of safety analysis taking into account the whole system - geological circumstances, ultimate store mines, types and forms of waste - specifications for the various ultimate store products are to be derived following iterative methods. Suggestions though not of a binding nature and probably subject to eventual revisions in part will be presented. To ensure the safety goals, i.e. the exclusion of radioactivity from the human biosphere, appropriate quality control is required concerning the production and the acceptance at the ultimate store. The guiding principles to be heeded will be discussed in brief. (orig./HP) [de

Neuropathic pain: A personal case reflection on a critical incident

Directory of Open Access Journals (Sweden)

Balaji P Duraisamy

2011-01-01

Full Text Available Neuropathic pain is a distressing symptom for the patient and a difficult symptom for the physician to treat. There is lack of evidence-based clinical guidelines for the management of malignant neuropathic pain. The case reflection is a personal account of what has been learnt from a critical incident in a particular patient in the management of neuropathic pain. Psychological issues are known to increase pain percetion and affect the quality of life. The case reflection explores problem areas, defines lacunae in knowledge, and demonstrates active learning of the management of neuropathic pain through reflective practice.

Step 7: Choose the "Best" Risk Management Alternative

Science.gov (United States)

The ultimate purpose of the SRM tactical phase is to choose how to manage risk. Prior to this stage, we determined the sources of risk, identified the relevant management actions and estimated the likelihood of all known outcomes. Next, we combine this information with your personal risk preference...

Influence of ambient ozone on the incidence of bone fractures especially among the elderly

Energy Technology Data Exchange (ETDEWEB)

Calabrese, E.J.

1979-02-01

Elevated levels of breatheable ozone will reduce the amount of uv radiation in the range of 280 to 305 nm reaching the surface of earth. This range of uv converts the provitamin 7-dehydrocholesterol to vitamin D, within the human. Since most typical diets contain low levels of vitamin D, the role of uv-related vitamin D synthesis in the skin is considered to provide very important contributions to the total vitamin D content of the blood. Thus, elevated levels of ambient ozone should result in a decreased level of vitamin D synthesis which may be expressed as an increase in the incidence of histological osteomalacia and ultimately bone fractures, especially among the elderly.

Too many journals? Towards a theory of repeated rejections and ultimate acceptance

NARCIS (Netherlands)

Oosterhaven, Jan

Under a set of reasonable assumptions, it is shown that all manuscripts submitted to any journal will ultimately be published, either by the first journal or by one of the following journals to which a manuscript is resubmitted. This suggests that low quality manuscripts may also be published, which

Magnetic surfaces, particle orbits and neutral injection in conventional and ultimate torsatrons

International Nuclear Information System (INIS)

Anderson, D.T.; Derr, J.A.; Kruckewitt, T.; Shohet, J.L.; Rehker, S.; Tataronis, J.A.

1979-01-01

Capabilities in fully non-axisymmetric numerical methods have resulted in a parametric study of various conventional and ultimate torsatron configurations. No superbananas are found in torsatrons without local magnetic wells. Neutral injection calculations show that, if the vacuum magnetic surfaces are well defined, tangential injection is very efficient

Global Managers

DEFF Research Database (Denmark)

Barakat, Livia L.; Lorenz, Melanie P.; Ramsey, Jase R.

2016-01-01

Purpose: – The purpose of this paper is to examine the effect of cultural intelligence (CQ) on the job performance of global managers. Design/methodology/approach: – In total, 332 global managers were surveyed from multinational companies operating in Brazil. The mediating effect of job...... satisfaction was tested on the CQ-job performance relationship. Findings: – The findings suggest that job satisfaction transmits the effect of CQ to job performance, such that global managers high in CQ exhibit more job satisfaction in an international setting, and therefore perform better at their jobs....... Practical implications: – Results imply that global managers should increase their CQ in order to improve their job satisfaction and ultimately perform better in an international context. Originality/value: – The authors make three primary contributions to the international business literature. First...

Laboratory biorisk management biosafety and biosecurity

CERN Document Server

Salerno, Reynolds M

2015-01-01

Over the past two decades bioscience facilities worldwide have experienced multiple safety and security incidents, including many notable incidents at so-called ""sophisticated facilities"" in North America and Western Europe. This demonstrates that a system based solely on biosafety levels and security regulations may not be sufficient.Setting the stage for a substantively different approach for managing the risks of working with biological agents in laboratories, Laboratory Biorisk Management: Biosafety and Biosecurity introduces the concept of biorisk management-a new paradigm that encompas

75 FR 69791 - Risk Management Controls for Brokers or Dealers With Market Access

Science.gov (United States)

2010-11-15

... relationship with the ultimate customer, can more effectively implement them. In addition, a broker or dealer... specific risk management controls and supervisory procedures to a customer that is a registered broker... such customer, based on its position in the transaction and relationship with the ultimate customer...

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

Science.gov (United States)

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

2017-03-01

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

ZIO: The Ultimate Linux I/O Framework

CERN Document Server

Gonzalez Cobas, J D; Rubini, A; Nellaga, S; Vaga, F

2014-01-01

ZIO (with Z standing for “The Ultimate I/O” Framework) was developed for CERN with the specific needs of physics labs in mind, which are poorly addressed in the mainstream Linux kernel. ZIO provides a framework for industrial, high-bandwith, high-channel count I/O device drivers (digitizers, function generators, timing devices like TDCs) with performance, generality and scalability as design goals. Among its features, it offers abstractions for • both input and output channels, and channel sets • run-time selection of trigger types • run-time selection of buffer types • sysfs-based configuration • char devices for data and metadata • a socket interface (PF ZIO) as alternative to char devices In this paper, we discuss the design and implementation of ZIO, and describe representative cases of driver development for typical and exotic applications: drivers for the FMC (FPGAMezzanine Card, see [1]) boards developed at CERN like the FMC ADC 100Msps digitizer, FMC TDC timestamp counter, and FMC DEL ...

Ultimately short ballistic vertical graphene Josephson junctions

Science.gov (United States)

Lee, Gil-Ho; Kim, Sol; Jhi, Seung-Hoon; Lee, Hu-Jong

2015-01-01

Much efforts have been made for the realization of hybrid Josephson junctions incorporating various materials for the fundamental studies of exotic physical phenomena as well as the applications to superconducting quantum devices. Nonetheless, the efforts have been hindered by the diffusive nature of the conducting channels and interfaces. To overcome the obstacles, we vertically sandwiched a cleaved graphene monoatomic layer as the normal-conducting spacer between superconducting electrodes. The atomically thin single-crystalline graphene layer serves as an ultimately short conducting channel, with highly transparent interfaces with superconductors. In particular, we show the strong Josephson coupling reaching the theoretical limit, the convex-shaped temperature dependence of the Josephson critical current and the exceptionally skewed phase dependence of the Josephson current; all demonstrate the bona fide short and ballistic Josephson nature. This vertical stacking scheme for extremely thin transparent spacers would open a new pathway for exploring the exotic coherence phenomena occurring on an atomic scale. PMID:25635386

The Assessment of the Ultimate Hull Girder Strength of RO-RO Ship after Damages

Science.gov (United States)

Zubair Muis Alie, Muhammad; Sitepu, Ganding; Izaak Latumahin, Samuel

2018-03-01

Many accidents of Ro-Ro ships happen in Indonesia such as collision and grounding. When the collision or grounding takes place on the Ro-Ro ship, the ultimate strength of hull structure after damage becomes decrease. Car and passenger decks are critical location since collision and/or grounding occur. In the present study, the assessment of the ultimate hull girder strength is conducted. The cross section of Ro-Ro ship is taken to be analyzed. The collision and grounding damages are assumed to be palced on the side and bottom area, respectively. The damages are created by removing the element from the side shell and bottom part. Finally, the result obtained is compared with one another.

Strategies for Improved Hospital Response to Mass Casualty Incidents.

Science.gov (United States)

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

2018-03-19

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

Evaluation of Ultimate Pressure Capacity of a Prestressed Concrete Containment Building with Steel or Polyamide Fiber Reinforcement

Energy Technology Data Exchange (ETDEWEB)

Choun, Youngsun; Hahm, Daegi [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2014-05-15

Fiber reinforced concrete (FRC) includes thousands of small fibers that are distributed randomly in the concrete. Fibers resist the growth of cracks in concrete through their bridging at the cracks. Therefore, FRC fails in tension only when the fibers break or are pulled out of the cement matrix. For this reason, the addition of fibers in concrete mixing increases the tensile toughness of concrete and enhances the post-cracking behavior. A prevention of through-wall cracks and an increase of the post-cracking ductility will improve the ultimate internal pressure capacity of a prestressed concrete containment building (PCCB). In this study, the effects of steel or polyamide fiber reinforcement on the ultimate pressure capacity of a PCCB are evaluated. When R-SFRC contains hooked steel fibers in a volume fraction of 1.0%, the ultimate pressure capacity of a PCCB can be improved by 17%. When R-PFRC contains polyamide fibers in a volume fraction of 1.5%, the ultimate pressure capacity of a PCCB can be enhanced by 10%. Further studies are needed to determine the strain limits acceptable for PCCBs reinforced with fibers.

Evaluation of Ultimate Pressure Capacity of a Prestressed Concrete Containment Building with Steel or Polyamide Fiber Reinforcement

International Nuclear Information System (INIS)

Choun, Youngsun; Hahm, Daegi

2014-01-01

Fiber reinforced concrete (FRC) includes thousands of small fibers that are distributed randomly in the concrete. Fibers resist the growth of cracks in concrete through their bridging at the cracks. Therefore, FRC fails in tension only when the fibers break or are pulled out of the cement matrix. For this reason, the addition of fibers in concrete mixing increases the tensile toughness of concrete and enhances the post-cracking behavior. A prevention of through-wall cracks and an increase of the post-cracking ductility will improve the ultimate internal pressure capacity of a prestressed concrete containment building (PCCB). In this study, the effects of steel or polyamide fiber reinforcement on the ultimate pressure capacity of a PCCB are evaluated. When R-SFRC contains hooked steel fibers in a volume fraction of 1.0%, the ultimate pressure capacity of a PCCB can be improved by 17%. When R-PFRC contains polyamide fibers in a volume fraction of 1.5%, the ultimate pressure capacity of a PCCB can be enhanced by 10%. Further studies are needed to determine the strain limits acceptable for PCCBs reinforced with fibers

Prediction of Local Ultimate Strain and Toughness of Trabecular Bone Tissue by Raman Material Composition Analysis

Directory of Open Access Journals (Sweden)

Roberto Carretta

2015-01-01

Full Text Available Clinical studies indicate that bone mineral density correlates with fracture risk at the population level but does not correlate with individual fracture risk well. Current research aims to better understand the failure mechanism of bone and to identify key determinants of bone quality, thus improving fracture risk prediction. To get a better understanding of bone strength, it is important to analyze tissue-level properties not influenced by macro- or microarchitectural factors. The aim of this pilot study was to identify whether and to what extent material properties are correlated with mechanical properties at the tissue level. The influence of macro- or microarchitectural factors was excluded by testing individual trabeculae. Previously reported data of mechanical parameters measured in single trabeculae under tension and bending and its compositional properties measured by Raman spectroscopy was evaluated. Linear and multivariate regressions show that bone matrix quality but not quantity was significantly and independently correlated with the tissue-level ultimate strain and postyield work (r=0.65–0.94. Principal component analysis extracted three independent components explaining 86% of the total variance, representing elastic, yield, and ultimate components according to the included mechanical parameters. Some matrix parameters were both included in the ultimate component, indicating that the variation in ultimate strain and postyield work could be largely explained by Raman-derived compositional parameters.

Decreased incidence of gout in diabetic patients using pioglitazone.

Science.gov (United States)

Niu, Sheng-Wen; Chang, Kai-Ting; Lin, Hugo You-Hsien; Kuo, I-Ching; Chang, Yu-Han; Chen, Yu-Han; Hung, Chi-Chih; Chiu, Yi-Wen; Hwang, Shang-Jyh

2018-01-01

The incidence and prevalence of gout are increasing, but the management is poor. Considering the increased prevalence of gout in the diabetic population, this study evaluated the effects of pioglitazone, an insulin resistance inhibitor, on the incidence of gout in the diabetic population. We used data from the National Health Insurance program in Taiwan. The pioglitazone cohort contained 30 100 patients and each patient was age and sex matched with three non-pioglitazone users who were randomly selected from the diabetic population. Cox proportional hazards regression analysis was conducted to estimate the effects of pioglitazone on the incidence of gout in the diabetic population. The incidence of gout was significantly lower in pioglitazone users than in non-pioglitazone users [adjusted hazard ratio (aHR) 0.81 (95% CI 0.78, 0.85)]. The HR for the incidence of gout was lower in both male [aHR 0.80 (95% CI 0.75, 0.85)] and female [aHR 0.83 (95% CI 0.78, 0.88)] pioglitazone users than in non-pioglitazone users. An analysis of three age groups (gout in the diabetic population using pioglitazone was less. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Incidence, epidemiology and clinical features of Kawasaki disease in Catalonia, Spain.

Science.gov (United States)

Sánchez-Manubens, Judith; Antón, Jordi; Bou, Rosa; Iglesias, Estíbaliz; Calzada-Hernandez, Joan

2016-01-01

To assess the incidence, epidemiology and clinical features of Kawasaki disease (KD) in Catalonia (northeast region of Spain). This was an observational population-based study including all Paediatric Units in Catalonia, under both public and private management. Retrospective data retrieval was performed for 10 years (2004-2013). A 12-month (March 2013 to March 2014) prospective collection of new cases of KD was carried out to determine the incidence of KD. Data from 399 patients over the 10-year study period was analysed, revealing that 233 (58.4%) had complete KD, 159 (39.8) incomplete KD and 7 (1.7%) were considered atypical KD. Mean annual incidence was 3.5/105 children 10(th) day of illness, ages 8 yo and the presence of sterile piuria, aseptic meningitis, abdominal pain and uveitis at diagnosis were found to have higher risk of coronary aneurisms (CAA) (pIncidence, clinical features and treatment plans in our cohort are similar to those described in other European studies.

Sci-Fri AM: Quality, Safety, and Professional Issues 06: An Evaluation of Incident Reporting and Learning using the Canadian National System for Incident Reporting – Radiation Treatment

Energy Technology Data Exchange (ETDEWEB)

Montgomery, Logan; Kildea, John [McGill University Health Centre (Canada)

2016-08-15

We report on the development and clinical deployment of an in-house incident reporting and learning system that implements the taxonomy of the Canadian National System for Incident Reporting – Radiation Treatment (NSIR-RT). In producing our new system, we aimed to: Analyze actual incidents, as well as potentially dangerous latent conditions. Produce recommendations on the NSIR-RT taxonomy. Incorporate features to divide reporting responsibility among clinical staff and expedite incident categorization within the NSIR-RT framework. Share anonymized incident data with the national database. Our multistep incident reporting workflow is focused around an initial report and a detailed follow-up investigation. An investigator, chosen at the time of reporting, is tasked with performing the investigation. The investigation feature is connected to our electronic medical records database to allow automatic field population and quick reference of patient and treatment information. Additional features include a robust visualization suite, as well as the ability to flag incidents for discussion at monthly Risk Management meetings and task ameliorating actions to staff. Our system was deployed into clinical use in January 2016. Over the first three months of use, 45 valid incidents were reported; 31 of which were reported as actual incidents as opposed to near-misses or reportable circumstances. However, we suspect there is ambiguity within our centre in determining the appropriate event type, which may be arising from the taxonomy itself. Preliminary trending analysis aided in revealing workflow issues pertaining to storage of treatment accessories and treatment planning delays. Extensive analysis will be undertaken as more data are accrued.

Sci-Fri AM: Quality, Safety, and Professional Issues 06: An Evaluation of Incident Reporting and Learning using the Canadian National System for Incident Reporting – Radiation Treatment

International Nuclear Information System (INIS)

Montgomery, Logan; Kildea, John

2016-01-01

We report on the development and clinical deployment of an in-house incident reporting and learning system that implements the taxonomy of the Canadian National System for Incident Reporting – Radiation Treatment (NSIR-RT). In producing our new system, we aimed to: Analyze actual incidents, as well as potentially dangerous latent conditions. Produce recommendations on the NSIR-RT taxonomy. Incorporate features to divide reporting responsibility among clinical staff and expedite incident categorization within the NSIR-RT framework. Share anonymized incident data with the national database. Our multistep incident reporting workflow is focused around an initial report and a detailed follow-up investigation. An investigator, chosen at the time of reporting, is tasked with performing the investigation. The investigation feature is connected to our electronic medical records database to allow automatic field population and quick reference of patient and treatment information. Additional features include a robust visualization suite, as well as the ability to flag incidents for discussion at monthly Risk Management meetings and task ameliorating actions to staff. Our system was deployed into clinical use in January 2016. Over the first three months of use, 45 valid incidents were reported; 31 of which were reported as actual incidents as opposed to near-misses or reportable circumstances. However, we suspect there is ambiguity within our centre in determining the appropriate event type, which may be arising from the taxonomy itself. Preliminary trending analysis aided in revealing workflow issues pertaining to storage of treatment accessories and treatment planning delays. Extensive analysis will be undertaken as more data are accrued.

Perioperative anaesthetic adverse events in Thailand (PAAd THAI) study: Incident report of perioperative convulsion.

Science.gov (United States)

Eiamcharoenwit, Jatuporn; Akavipat, Phuping; Ariyanuchitkul, Thidarat; Wirachpisit, Nichawan; Pulnitiporn, Aksorn; Pongraweewan, Orawan

2018-01-01

The aim of this study was to identify the characteristics of perioperative convulsion and to suggest possible correcting strategies. The multi-centre study was conducted prospectively in 22 hospitals across Thailand in 2015. The occurrences of perioperative adverse events were collected. The data was collated by site manager and forwarded to the data management unit. All perioperative convulsion incidences were enrolled and analysed. The consensus was documented for the relevant factors and the corrective strategies. Descriptive statistics were used. From 2,000 incident reports, perioperative convulsions were found in 16 patients. Six episodes (37.5%) were related to anaesthesia, 31.3% to patients, 18.8% to surgery, and 12.5% to systemic processes. The contributing factor was an inexperienced anaesthesia performer (25%), while the corrective strategy was improvements to supervision (43.8%). Incidents of perioperative convulsion were found to be higher than during the last decade. The initiation and maintenance of safe anaesthesia should be continued.

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

International Nuclear Information System (INIS)

Ren Yinxiang; Yu Ren; Zhou Gang; Chen Dengke

2008-01-01

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

Difficult incidents and tutor interventions in problem-based learning tutorials.

Science.gov (United States)

Kindler, Pawel; Grant, Christopher; Kulla, Steven; Poole, Gary; Godolphin, William

2009-09-01

Tutors report difficult incidents and distressing conflicts that adversely affect learning in their problem-based learning (PBL) groups. Faculty development (training) and peer support should help them to manage this. Yet our understanding of these problems and how to deal with them often seems inadequate to help tutors. The aim of this study was to categorise difficult incidents and the interventions that skilled tutors used in response, and to determine the effectiveness of those responses. Thirty experienced and highly rated tutors in our Year 1 and 2 medical curriculum took part in semi-structured interviews to: identify and describe difficult incidents; describe how they responded, and assess the success of each response. Recorded and transcribed data were analysed thematically to develop typologies of difficult incidents and interventions and compare reported success or failure. The 94 reported difficult incidents belonged to the broad categories 'individual student' or 'group dynamics'. Tutors described 142 interventions in response to these difficult incidents, categorised as: (i) tutor intervenes during tutorial; (ii) tutor gives feedback outside tutorial, or (iii) student or group intervenes. Incidents in the 'individual student' category were addressed relatively unsuccessfully (effective 75% of the time) by response (iii). None of the interventions worked well when used in response to problems related to 'group dynamics'. Overall, 59% of the difficult incidents were dealt with successfully. Dysfunctional PBL groups can be highly challenging, even for experienced and skilled tutors. Within-tutorial feedback, the treatment that tutors are most frequently advised to apply, was often not effective. Our study suggests that the collective responsibility of the group, rather than of the tutor, to deal with these difficulties should be emphasised.

The role of the collaboratory in enabling large-scale identity management for HEP

International Nuclear Information System (INIS)

Cowles, Robert; Jackson, Craig; Welch, Von

2014-01-01

The authors are defining a model that describes and guides existing and future scientific collaboratory identity management implementations. Our ultimate goal is to provide guidance to virtual organizations and resource providers in designing an identity management implementation. Our model is captured in previously published work. Here, we substantially extend our analysis in terms of six motivation factors (user isolation, persistence of user data, complexity of virtual organization roles, cultural and historical inertia, scaling, and incentive for collaboration), observed in interviews with community members involved in identity management, that impact implementation decisions. This analysis is a significant step towards our ultimate goal of providing guidance to virtual organizations.

Scrutinizing incident reporting in anaesthesia: why is an incident perceived as critical?

DEFF Research Database (Denmark)

Maaløe, R; la Cour, M; Hansen, A

2006-01-01

The purpose of the present study was to measure the incidence and type of incidents that occurred in relation to anaesthesia and surgery during a 1-year period in six Danish hospitals. Furthermore, we wanted to identify risk factors for incidents, as well as risk factors for incidents being deeme...... critical....

Trends in Diabetes Incidence Among 7 Million Insured Adults, 2006–2011

Science.gov (United States)

Nichols, Gregory A.; Schroeder, Emily B.; Karter, Andrew J.; Gregg, Edward W.; Desai, Jay; Lawrence, Jean M.; O'Connor, Patrick J.; Xu, Stanley; Newton, Katherine M.; Raebel, Marsha A.; Pathak, Ram D.; Waitzfelder, Beth; Segal, Jodi; Lafata, Jennifer Elston; Butler, Melissa G.; Kirchner, H. Lester; Thomas, Abraham; Steiner, John F.

2015-01-01

An observational cohort analysis was conducted within the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) DataLink, a consortium of 11 integrated health-care delivery systems with electronic health records in 10 US states. Among nearly 7 million adults aged 20 years or older, we estimated annual diabetes incidence per 1,000 persons overall and by age, sex, race/ethnicity, and body mass index. We identified 289,050 incident cases of diabetes. Age- and sex-adjusted population incidence was stable between 2006 and 2010, ranging from 10.3 per 1,000 adults (95% confidence interval (CI): 9.8, 10.7) to 11.3 per 1,000 adults (95% CI: 11.0, 11.7). Adjusted incidence was significantly higher in 2011 (11.5, 95% CI: 10.9, 12.0) than in the 2 years with the lowest incidence. A similar pattern was observed in most prespecified subgroups, but only the differences for persons who were not white were significant. In 2006, 56% of incident cases had a glycated hemoglobin (hemoglobin A1c) test as one of the pair of events identifying diabetes. By 2011, that number was 74%. In conclusion, overall diabetes incidence in this population did not significantly increase between 2006 and 2010, but increases in hemoglobin A1c testing may have contributed to rising diabetes incidence among nonwhites in 2011. PMID:25515167

Neonatal brachial plexus injury: comparison of incidence and antecedents between 2 decades.

LENUS (Irish Health Repository)

Walsh, Jennifer M

2011-04-01

We sought to compare the incidence and antecedents of neonatal brachial plexus injury (BPI) in 2 different 5-year epochs a decade apart following the introduction of specific staff training in the management of shoulder dystocia.

The prospects of transition metal dichalcogenides for ultimately scaled CMOS

Science.gov (United States)

Thiele, S.; Kinberger, W.; Granzner, R.; Fiori, G.; Schwierz, F.

2018-05-01

MOSFET gate length scaling has been a main source of progress in digital electronics for decades. Today, researchers still spend considerable efforts on reducing the gate length and on developing ultimately scaled MOSFETs, thereby exploring both new device architectures and alternative channel materials beyond Silicon such as two-dimensional TMDs (transition metal dichalcogenide). On the other hand, the envisaged scaling scenario for the next 15 years has undergone a significant change recently. While the 2013 ITRS edition required a continuation of aggressive gate length scaling for at least another 15 years, the 2015 edition of the ITRS suggests a deceleration and eventually a levelling off of gate length scaling and puts more emphasis on alternative options such as pitch scaling to keep Moore's Law alive. In the present paper, future CMOS scaling is discussed in the light of emerging two-dimensional MOSFET channel, in particular two-dimensional TMDs. To this end, the scaling scenarios of the 2013 and 2015 ITRS editions are considered and the scaling potential of TMD MOSFETs is investigated by means of quantum-mechanical device simulations. It is shown that for ultimately scaled MOSFETs as required in the 2013 ITRS, the heavy carrier effective masses of the Mo- and W-based TMDs are beneficial for the suppression of direct source-drain tunneling, while to meet the significantly relaxed scaling targets of the 2016 ITRS heavy-effective-mass channels are not needed.

Future Synchrotron Light Sources Based on Ultimate Storage Rings

International Nuclear Information System (INIS)

Cai, Yunhai

2012-01-01

The main purpose of this talk is to describe how far one might push the state of the art in storage ring design. The talk will start with an overview of the latest developments and advances in the design of synchrotron light sources based on the concept of an 'ultimate' storage ring. The review will establish how bright a ring based light source might be, where the frontier of technological challenges are, and what the limits of accelerator physics are. Emphasis will be given to possible improvements in accelerator design and developments in technology toward the goal of achieving an ultimate storage ring. An ultimate storage ring (USR), defined as an electron ring-based light source having an emittance in both transverse planes at the diffraction limit for the range of X-ray wavelengths of interest for a scientific community, would provide very high brightness photons having high transverse coherence that would extend the capabilities of X-ray imaging and probe techniques beyond today's performance. It would be a cost-effective, high-coherence 4th generation light source, competitive with one based on energy recovery linac (ERL) technology, serving a large number of users studying material, chemical, and biological sciences. Furthermore, because of the experience accumulated over many decades of ring operation, it would have the great advantage of stability and reliability. In this paper we consider the design of an USR having 10-pm-rad emittance. It is a tremendous challenge to design a storage ring having such an extremely low emittance, a factor of 100 smaller than those in existing light sources, especially such that it has adequate dynamic aperture and beam lifetime. In many ultra-low emittance designs, the injection acceptances are not large enough for accumulation of the electron beam, necessitating on-axis injection where stored electron bunches are completely replaced with newly injected ones. Recently, starting with the MAX-IV 7-bend achromatic cell, we

Future Synchrotron Light Sources Based on Ultimate Storage Rings

Energy Technology Data Exchange (ETDEWEB)

Cai, Yunhai; /SLAC

2012-04-09

The main purpose of this talk is to describe how far one might push the state of the art in storage ring design. The talk will start with an overview of the latest developments and advances in the design of synchrotron light sources based on the concept of an 'ultimate' storage ring. The review will establish how bright a ring based light source might be, where the frontier of technological challenges are, and what the limits of accelerator physics are. Emphasis will be given to possible improvements in accelerator design and developments in technology toward the goal of achieving an ultimate storage ring. An ultimate storage ring (USR), defined as an electron ring-based light source having an emittance in both transverse planes at the diffraction limit for the range of X-ray wavelengths of interest for a scientific community, would provide very high brightness photons having high transverse coherence that would extend the capabilities of X-ray imaging and probe techniques beyond today's performance. It would be a cost-effective, high-coherence 4th generation light source, competitive with one based on energy recovery linac (ERL) technology, serving a large number of users studying material, chemical, and biological sciences. Furthermore, because of the experience accumulated over many decades of ring operation, it would have the great advantage of stability and reliability. In this paper we consider the design of an USR having 10-pm-rad emittance. It is a tremendous challenge to design a storage ring having such an extremely low emittance, a factor of 100 smaller than those in existing light sources, especially such that it has adequate dynamic aperture and beam lifetime. In many ultra-low emittance designs, the injection acceptances are not large enough for accumulation of the electron beam, necessitating on-axis injection where stored electron bunches are completely replaced with newly injected ones. Recently, starting with the MAX-IV 7-bend

Incidence and Outcome of CPAP Failure in Preterm Infants.

Science.gov (United States)

Dargaville, Peter A; Gerber, Angela; Johansson, Stefan; De Paoli, Antonio G; Kamlin, C Omar F; Orsini, Francesca; Davis, Peter G

2016-07-01

Data from clinical trials support the use of continuous positive airway pressure (CPAP) for initial respiratory management in preterm infants, but there is concern regarding the potential failure of CPAP support. We aimed to examine the incidence and explore the outcomes of CPAP failure in Australian and New Zealand Neonatal Network data from 2007 to 2013. Data from inborn preterm infants managed on CPAP from the outset were analyzed in 2 gestational age ranges (25-28 and 29-32 completed weeks). Outcomes after CPAP failure (need for intubation CPAP using adjusted odds ratios (AORs). Within the cohort of 19 103 infants, 11 684 were initially managed on CPAP. Failure of CPAP occurred in 863 (43%) of 1989 infants commencing on CPAP at 25-28 weeks' gestation and 2061 (21%) of 9695 at 29-32 weeks. CPAP failure was associated with a substantially higher rate of pneumothorax, and a heightened risk of death, bronchopulmonary dysplasia (BPD) and other morbidities compared with those managed successfully on CPAP. The incidence of death or BPD was also increased: (25-28 weeks: 39% vs 20%, AOR 2.30, 99% confidence interval 1.71-3.10; 29-32 weeks: 12% vs 3.1%, AOR 3.62 [2.76-4.74]). The CPAP failure group had longer durations of respiratory support and hospitalization. CPAP failure in preterm infants is associated with increased risk of mortality and major morbidities, including BPD. Strategies to promote successful CPAP application should be pursued vigorously. Copyright © 2016 by the American Academy of Pediatrics.

Ultimate strength performance of tankers associated with industry corrosion addition practices

Directory of Open Access Journals (Sweden)

Kim Do Kyun

2014-09-01

Full Text Available In the ship and offshore structure design, age-related problems such as corrosion damage, local denting, and fatigue damage are important factors to be considered in building a reliable structure as they have a significant influence on the residual structural capacity. In shipping, corrosion addition methods are widely adopted in structural design to prevent structural capacity degradation. The present study focuses on the historical trend of corrosion addition rules for ship structural design and investigates their effects on the ultimate strength performance such as hull girder and stiffened panel of double hull oil tankers. Three types of rules based on corrosion addition models, namely historic corrosion rules (pre-CSR, Common Structural Rules (CSR, and harmonised Common Structural Rules (CSRH are considered and compared with two other corrosion models namely UGS model, suggested by the Union of Greek Shipowners (UGS, and Time-Dependent Corrosion Wastage Model (TDCWM. To identify the general trend in the effects of corrosion damage on the ultimate longitudinal strength performance, the corrosion addition rules are applied to four representative sizes of double hull oil tankers namely Panamax, Aframax, Suezmax, and VLCC. The results are helpful in understanding the trend of corrosion additions for tanker structures

Ultimate strength performance of tankers associated with industry corrosion addition practices

Directory of Open Access Journals (Sweden)

Do Kyun Kim

2014-09-01

Full Text Available In the ship and offshore structure design, age-related problems such as corrosion damage, local denting, and fatigue damage are important factors to be considered in building a reliable structure as they have a significant influence on the residual structural capacity. In shipping, corrosion addition methods are widely adopted in structural design to prevent structural capacity degradation. The present study focuses on the historical trend of corrosion addition rules for ship structural design and investigates their effects on the ultimate strength performance such as hull girder and stiffened panel of double hull oil tankers. Three types of rules based on corrosion addition models, namely historic corrosion rules (pre-CSR, Common Structural Rules (CSR, and harmonised Common Structural Rules (CSRH are considered and compared with two other corrosion models namely UGS model, suggested by the Union of Greek Shipowners (UGS, and Time-Dependent Corrosion Wastage Model (TDCWM. To identify the general trend in the effects of corrosion damage on the ultimate longitudinal strength performance, the corrosion addition rules are applied to four representative sizes of double hull oil tankers namely Panamax, Aframax, Suezmax, and VLCC. The results are helpful in understanding the trend of corrosion additions for tanker structures.

Incident command linkup: the vital key for CBRN response

International Nuclear Information System (INIS)

Smith, D.

2009-01-01

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

Building Maintenance, Management, and Budgeting.

Science.gov (United States)

Pawsey, M. R.

1982-01-01

Australian methods and formulas for funding building maintenance and management are outlined and found to be haphazard. Discussed are: ultimate costs of deferred maintenance, major plant replacements, life cycle costing, types of maintenance programs (including full preventive maintenance), use of computer programs for planning, and organization…

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

Directory of Open Access Journals (Sweden)

Vincent Chi-Chung Cheng

2013-11-01

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

Introduction of a prehospital critical incident monitoring system--pilot project results.

Science.gov (United States)

Stella, Julian; Davis, Anna; Jennings, Paul; Bartley, Bruce

2008-01-01

Hospital medical incident monitoring improves preventable morbidity and mortality rates. Error management systems have been adopted widely in this setting. Data relating to incident monitoring in the prehospital setting is limited. Implementation of an incident monitoring process in a prehospital setting. This is a prospective, descriptive study of the pilot phase of the implementation of an incident monitoring process in a regional prehospital setting, with a focus on trauma care. Paramedics and emergency department staff submitted anonymous incident reports, and a chart review was performed on patients who met major trauma criteria. Selected trauma cases were analyzed by a structured interview/debriefing process to elucidate undocumented incidents. A project committee coded and logged all incidents and developed recommendations. Of 4,429 ambulance responses, 41 cases were analyzed. Twenty-four (58.5%; 95% CI = 49.7-67.4%) were reported anonymously, and the rest were major trauma patients. A total of 77 incidents were identified (mean per case = 1.8; CI = 1.03-2.57). Anonymous cases revealed 26 incidents (mean = 1.1; CI = 0.98-1.22); eight trauma debriefings revealed 38 incidents (mean = 4.8; CI = 0.91-8.69) and nine trauma chart reviews revealed 13 incidents (mean = 1.6; CI = 1.04-2.16). A total of 56 of 77 (72.7%; CI = 65.5-80.0%) incidents related to system inadequacies, and 15 (57.7%; CI = 46.7-68.6%) anonymously reported incidents related to resource problems. A total of 35 of 77 (45.5%; CI = 40.4-50.5%) incidents had minimal or no impact on the patients' outcomes. Thirty-four of 77 (44.2%; CI = 39.3-49.1%) incidents were considered mitigated by circumstance. Incident monitoring led to generalized feedback in most cases (65 of 77; 84.4%; CI = 77.6-91.3%); in three cases (3.9%; CI = 3.7-4.1%), specific education occurred; two cases were reported to an external body (2.6%; CI = 2.5-2.7%); three cases resulted in remedial action (3.9%; CI = 3.7-4.1%); four for

Behaviour of concrete nuclear containment structures upto ultimate failure with special reference to MAPP-1 containment

International Nuclear Information System (INIS)

Appa Rao, T.V.S.R.

1975-01-01

Theoretical and experimental methods for investigating the behaviour of concrete secondary containment structures subjected to loads upto their ultimate failure have been discussed in the paper. Need for inelastic nonlinear analysis of containments has been emphasized. Different contitutive models of concrete that can be employed in the nonlinear analysis of concrete structures were briefly reviewed. Based on the experimental results obtained in a 1:12 scale model test conducted at the Structural Engineering Research (Regional) Centre, Madras, behaviour of the MAPP-1 containment to internal pressure loading upto its ultimate failure has been discussed. (author)

Analysis of human factors in incidents reported by Swiss nuclear power plants to the inspectorate

International Nuclear Information System (INIS)

Alder, H.P.; Hausmann, W.

1997-01-01

197 reported incidents in Swiss Nuclear Power Plants were analyzed by a team of the Swiss Federal Nuclear Safety Inspectorate (HSK) using the OECD/NEA Incident Reporting System. The following conclusions could be drawn from this exercise. While the observed cause reported by the plant was ''technical failure'' in about 90% of the incidents, the HSK-Team identified for more than 60% of the incidents ''human factors'' as the root cause. When analyzing this root cause further it was shown that only a smaller contribution came from the side of the operators and the more important shares were caused by plant maintenance, vendors/constructors and plant management with procedural and organizational deficiencies. These findings demonstrate that root cause analysis of incidents by the IRS-Code is a most useful tool to analyze incidents and to find weak points in plant performance. (author). 5 tabs

Handbook of hazardous waste management

International Nuclear Information System (INIS)

Metry, A.A.

1980-01-01

The contents of this work are arranged so as to give the reader a detailed understanding of the elements of hazardous waste management. Generalized management concepts are covered in Chapters 1 through 5 which are entitled: Introduction, Regulations Affecting Hazardous Waste Management, Comprehensive Hazardous Waste Management, Control of Hazardous Waste Transportation, and Emergency Hazardous Waste Management. Chapters 6 through 11 deal with treatment concepts and are entitled: General Considerations for Hazardous Waste Management Facilities, Physical Treatment of Hazardous Wastes, Chemical Treatment of Hazardous Wastes, Biological Treatment of Hazardous Wastes, Incineration of Hazardous Wastes, and Hazardous Waste Management of Selected Industries. Chapters 12 through 15 are devoted to ultimate disposal concepts and are entitled: Land Disposal Facilities, Ocean Dumping of Hazardous Wastes, Disposal of Extremely Hazardous Wastes, and Generalized Criteria for Hazardous Waste Management Facilities

Incidents with hazardous radiation sources

International Nuclear Information System (INIS)

Schoenhacker, Stefan

2016-01-01

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

The perception & attitudes of SMEs managers towards e-commerce ...

African Journals Online (AJOL)

An empirical study has been conducted by authors in the Wilaya (County) of Ghardaia (Southern Algeria) with the ultimate aim of surveying the local SMEs managers' perception and attitudes towards e-commerce. It seems that, these managers' perception and attitudes are on the whole positive. However, due mainly to ...

Incidents analysis

International Nuclear Information System (INIS)

Francois, P.

1996-01-01

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

Incidents analysis

Energy Technology Data Exchange (ETDEWEB)

Francois, P

1997-12-31

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

Unmanned Aircraft Systems Traffic Management (UTM)

Science.gov (United States)

Johnson, Ronald D.

2018-01-01

UTM is an 'air traffic management' ecosystem for uncontrolled operations. UTM utilizes industry's ability to supply services under FAA's regulatory authority where these services do not exist. UTM development will ultimately enable the management of large scale, low-altitude UAS operations. Operational concept will address beyond visual line of sight UAS operations under 400 ft. AGL. Information architecture, data exchange protocols, software functions. Roles/responsibilities of FAA and operators. Performance requirements.

Waste management in Canadian nuclear programs

International Nuclear Information System (INIS)

Dyne, P.J.

1975-08-01

The report describes the wide-ranging program of engineering developments and applications to provide the Canadian nuclear industry with the knowledge and expertise it needs to conduct its waste management program. The need for interim dry storage of spent fuel, and the storage and ultimate disposal of waste from fuel reprocessing are examined. The role of geologic storage in AECL's current waste management program is also considered. (R.A.)

Effect of farming practices and farm history on incidence of coconut ...

African Journals Online (AJOL)

Management of coconut (Cocos nucifera) lethal yellowing disease (CLYD), which has killed about eight million coconut trees in Mozambique, has proved challenging. The objective of this study was to investigate the impact of farming practices and related history, on the CLYD incidence in Mozambique. The methodology ...

Incidence of severe critical events in paediatric anaesthesia (APRICOT)

DEFF Research Database (Denmark)