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Sample records for incident response system

  1. Incidence Handling and Response System

    OpenAIRE

    Kalbande, Prof. Dhananjay R.; Thampi, Dr. G. T.; Singh, Mr. Manish

    2009-01-01

    A computer network can be attacked in a number of ways. The security-related threats have become not only numerous but also diverse and they may also come in the form of blended attacks. It becomes difficult for any security system to block all types of attacks. This gives rise to the need of an incidence handling capability which is necessary for rapidly detecting incidents, minimizing loss and destruction, mitigating the weaknesses that were exploited and restoring the computing services. I...

  2. 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

  3. Incidence of systemic inflammatory response syndrome after endovascular aortic repair

    DEFF Research Database (Denmark)

    De La Motte, L; Vogt, K; Jensen, Leif Panduro

    2011-01-01

    AIM: The aim of this study was to estimate the incidence of the post-implantation syndrome/systemic inflammatory response syndrome (SIRS) after endovascular aortic repair. METHODS: All patients, undergoing elective primary endovascular repair of an asymptomatic infrarenal abdominal aortic aneurysm...

  4. Incidence of systemic inflammatory response syndrome after endovascular aortic repair

    DEFF Research Database (Denmark)

    De La Motte, L; Vogt, K; Jensen, Leif Panduro

    2011-01-01

    AIM: The aim of this study was to estimate the incidence of the post-implantation syndrome/systemic inflammatory response syndrome (SIRS) after endovascular aortic repair. METHODS: All patients, undergoing elective primary endovascular repair of an asymptomatic infrarenal abdominal aortic aneurysm...... during 2007, were retrospectively evaluated for SIRS within the first 5 postoperative days. The only exclusion-criteria were missing data. SIRS was assessed using the criteria defined by the American College of Chest Physicians and Society of Critical Care Medicine Consensus Conference Committee. RESULTS......: Sixty-six patients were included, 40 (60%) met the SIRS criteria within the first 5 postoperative days (95% of the 40 patients met the criteria within 3 days). We found no significant differences between the SIRS and the non-SIRS group in baseline characteristics or other data including volume...

  5. Linux malware incident response an excerpt from malware forensic field guide for Linux systems

    CERN Document Server

    Malin, Cameron H; Aquilina, James M

    2013-01-01

    Linux Malware Incident Response is a ""first look"" at the Malware Forensics Field Guide for Linux Systems, exhibiting the first steps in investigating Linux-based incidents. The Syngress Digital Forensics Field Guides series includes companions for any digital and computer forensic investigator and analyst. Each book is a ""toolkit"" with checklists for specific tasks, case studies of difficult situations, and expert analyst tips. This compendium of tools for computer forensics analysts and investigators is presented in a succinct outline format with cross-references to suppleme

  6. The effect of a workflow-based response system on hospital-wide voluntary incident reporting rates.

    Science.gov (United States)

    Wang, Szu-Chang; Li, Ying-Chun; Huang, Hung-Chi

    2013-02-01

    Hospital incident reporting systems are usually evaluated on their theoretical benefit to the hospital or increase in reporting rates alone. To evaluate a workflow-based response system on staff incident reporting rates. A prospective cohort study of incident reports made by staff members before (2006-2007) and after (2008-2009) the system was implemented on 1 January 2008 at a medical center in southern Taiwan. Pre-system and post-system data were based on 713 129 and 730 176 inpatient days and 160 692 and 168 850 emergency department visits. The addition of a workflow-based response system to a reporting system processing incident reports and intra-hospital responses. Voluntary incident reporting rates and distribution of incident severities. Inpatient reports [9.9 vs. 28.8 per 10 000 patient days; rate ratio (RR): 2.9, 95% confidence interval (CI): 2.7-3.2, P reports (5.9 vs. 19.2 per 10 000 visits, RR: 3.3, 95% CI: 2.6-4.1, P system reported incidents were more evenly distributed over five severity levels than pre-sytem incidents, moving more toward the very severe level (RR: 17.6, 95% CI: 8.4-37.0, P system to the hospital incident reporting system significantly increased hospital-wide voluntary incident report rates at all incident injury levels.

  7. 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.

  8. Endotoxemia, immune response to periodontal pathogens, and systemic inflammation associate with incident cardiovascular disease events.

    Science.gov (United States)

    Pussinen, Pirkko J; Tuomisto, Karolina; Jousilahti, Pekka; Havulinna, Aki S; Sundvall, Jouko; Salomaa, Veikko

    2007-06-01

    In periodontitis, overgrowth of gram-negative bacteria may cause endotoxemia and systemic inflammation leading to cardiovascular diseases (CVD). We investigated in a prospective study the associations of serum endotoxin, antibodies to periodontal pathogens, and inflammation markers with the risk of incident CVD. The FINRISK 1992 cohort of 6051 individuals was followed up for 10 years. We examined 185 incident CVD events and a control cohort of 320 individuals using a prospective case-cohort design. High antibody response to periodontal pathogens independently predicted incident CVD events with hazard ratios (HR, quartile 4 versus quartiles 1 to 3, 95% CI) of 1.87 (1.13 to 3.08). The subjects with a high antibody response and high CRP or interleukin (IL)-6 had multivariate-adjusted HRs of 3.01 (1.27 to 7.09) and 3.11 (1.42 to 6.83) compared with low-responders, respectively. The corresponding HRs for high endotoxin concentration were 1.82 (1.22 to 2.73, alone), 3.92 (1.99 to 7.74, with CRP), 3.54 (1.78 to 7.03, with IL-6), and 2.26 (1.13 to 4.52, with tumor necrosis factor (TNF)-alpha) after adjusting for age and gender. These associations were abolished after adjusting for serum lipids. High endotoxin/HDL ratio, however, had a multivariate-adjusted HR of 1.92 (1.19 to 3.08) for CVD events. Our results suggest that the exposure to periodontal pathogens or endotoxin induces systemic inflammation leading to increased risk for CVD.

  9. Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents

    Science.gov (United States)

    Hunter, Jennifer C.; Yang, Jane E.; Crawley, Adam W.; Biesiadecki, Laura; Aragón, Tomás J.

    2013-01-01

    As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems. PMID:24236137

  10. A prototype forensic toolkit for industrial-control-systems incident response

    Science.gov (United States)

    Carr, Nickolas B.; Rowe, Neil C.

    2015-05-01

    Industrial control systems (ICSs) are an important part of critical infrastructure in cyberspace. They are especially vulnerable to cyber-attacks because of their legacy hardware and software and the difficulty of changing it. We first survey the history of intrusions into ICSs, the more serious of which involved a continuing adversary presence on an ICS network. We discuss some common vulnerabilities and the categories of possible attacks, noting the frequent use of software written a long time ago. We propose a framework for designing ICS incident response under the constraints that no new software must be required and that interventions cannot impede the continuous processing that is the norm for such systems. We then discuss a prototype toolkit we built using the Windows Management Instrumentation Command-Line tool for host-based analysis and the Bro intrusion-detection software for network-based analysis. Particularly useful techniques we used were learning the historical range of parameters of numeric quantities so as to recognize anomalies, learning the usual addresses of connections to a node, observing Internet addresses (usually rare), observing anomalous network protocols such as unencrypted data transfers, observing unusual scheduled tasks, and comparing key files through registry entries and hash values to find malicious modifications. We tested our methods on actual data from ICSs including publicly-available data, voluntarily-submitted data, and researcher-provided "advanced persistent threat" data. We found instances of interesting behavior in our experiments. Intrusions were generally easy to see because of the repetitive nature of most processing on ICSs, but operators need to be motivated to look.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Yarmohammadian

    2011-01-01

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

  13. Systemic inflammatory response syndrome (SIRS) after extracorporeal membrane oxygenation (ECMO): Incidence, risks and survivals.

    Science.gov (United States)

    Thangappan, Karthik; Cavarocchi, Nicholas C; Baram, Michael; Thoma, Brandi; Hirose, Hitoshi

    2016-01-01

    Systemic inflammatory response syndrome (SIRS) is frequently observed after extracorporeal membrane oxygenation (ECMO) decannulation; however, these issues have not been investigated well in the past. Retrospective chart review was performed to identify post-ECMO SIRS phenomenon, defined by exhibiting 2/3 of the following criteria: fever, leukocytosis, and escalation of vasopressors. The patients were divided into 2 groups: patients with documented infections (Group I) and patients with true SIRS (Group TS) without any evidence of infection. Survival and pre-, intra- and post-ECMO risk factors were analyzed. Among 62 ECMO survivors, 37 (60%) patients developed the post-ECMO SIRS phenomenon, including Group I (n = 22) and Group TS (n = 15). The 30-day survival rate of Group I and TS was 77% and 100%, respectively (p = 0.047), although risk factors were identical. SIRS phenomenon after ECMO decannulation commonly occurs. Differentiating between the similar clinical presentations of SIRS and infection is important and will impact clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Development of a Tailored Methodology and Forensic Toolkit for Industrial Control Systems Incident Response

    Science.gov (United States)

    2014-06-01

    amount of ICS network segmentation is exchanged for the ability to easily manage patches, antivirus definitions, and firmware updates. Patch...the operation cyber-physical systems. Because antivirus signatures exist for much broad-audience malware, the detection rate is high and there is...Backdoor keys are placed in the default software classes under \\InProcServer32\\@=expand:”C:\\WINDOWS\\temp\\install.ocx” within HKEY_USERS in the registry

  15. Linux Incident Response Volatile Data Analysis Framework

    Science.gov (United States)

    McFadden, Matthew

    2013-01-01

    Cyber incident response is an emphasized subject area in cybersecurity in information technology with increased need for the protection of data. Due to ongoing threats, cybersecurity imposes many challenges and requires new investigative response techniques. In this study a Linux Incident Response Framework is designed for collecting volatile data…

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

    CERN Document Server

    Johnson, Leighton

    2013-01-01

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

  17. Computer Security Incident Response Planning at Nuclear Facilities

    International Nuclear Information System (INIS)

    2016-06-01

    The purpose of this publication is to assist Member States in developing comprehensive contingency plans for computer security incidents with the potential to impact nuclear security and/or nuclear safety. It provides an outline and recommendations for establishing a computer security incident response capability as part of a computer security programme, and considers the roles and responsibilities of the system owner, operator, competent authority, and national technical authority in responding to a computer security incident with possible nuclear security repercussions

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

    Science.gov (United States)

    2007-03-23

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

  19. 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

  20. 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.

  1. 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

  2. Incident response monitoring technologies for aircraft cabin

    NARCIS (Netherlands)

    Havermans, J.B.G.A.; Houtzager, M.M.G.; Jacobs, P.

    2015-01-01

    The Netherlands Organization for Applied Scientific Research (TNO) was granted by ASHRAE (1306-RP) to conduct scientfic review and feasibility analysis of technologies and methods for measuring aircraft power system contaminants in the cabin air during unanticipated adverse incidents. In particular,

  3. Incident Management Systems are essential for Effective Coordination of Large Disease Outbreaks: Perspectives from the Coordination of the Ebola Outbreak Response in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Olushayo Oluseun Olu

    2016-11-01

    Full Text Available Background: Response to the 2014–2015 Ebola Virus Disease (EVD outbreak in Sierra Leone overwhelmed the national capacity to contain it and necessitated a massive international response and strong coordination platform. Consequently, the Sierra Leone Government, with support of the international humanitarian community, established and implemented various models for national coordination of the outbreak. In this article we review the strengths and limitations of the EVD outbreak response coordination systems in Sierra Leone and propose recommendations for improving coordination of similar outbreaks in the future. Conclusions: There were two main frameworks used for the coordination of the outbreak; the Emergency Operation Center (EOC and the National Ebola Response Center (NERC. We observed an improvement in outbreak coordination as the management mechanism evolved from the EOC to the NERC. Both coordination systems had their advantages and disadvantages; however the NERC coordination mechanism appeared to be more robust. We identified challenges, such as competition and duplication of efforts between the numerous coordination groups, slow resource mobilization, inadequate capacity of NERC/EOC staff for health coordination and an overtly centralized coordination and decision making system as the main coordination challenges during the outbreak. Recommendations: We recommend the establishment of emergency operation centers with simple incident management system-based coordination prior to outbreaks, strong government leadership, decentralization of coordination systems and functions to the epicenter of outbreaks, with clear demarcation of roles and responsibilities between different levels, regular training of key coordination leaders and better community participation as methods to improve coordination of future disease outbreaks.

  4. 9 CFR 121.14 - Incident response. 11

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Incident response. 11 121.14 Section 121.14 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF... (including information systems); severe weather and other natural disasters; workplace violence; bomb threats...

  5. 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)

  6. Designed Incident Reporting System in P2TKN BATAN

    International Nuclear Information System (INIS)

    Supriatna, Piping; Sudarsyamsu S; Bambang S; Karyana, Edy

    2000-01-01

    Incident Reporting System is a routine activating for record all incident of Nuclear Plant Characteristic of the incident Reporting System (IRS) recording can be made locally, regionally or national scope. IRS recording of nuclear activity responsible to Nuclear Safety Technology Development Center (NSTDC). In this report has been designed IRS for nuclear incident in Batan, which the socialization in the field will be done step by step. The first step will be applied in NSTCD scope, the second step will be applied in PPTA Serpong area, and the third step will be applied in Batan area

  7. Urgent medical response in CBR incidents

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  8. National Fire Incident Reporting System (NFIRS)

    Data.gov (United States)

    Department of Homeland Security — The National Fire Incident Reporting System (NFIRS) is a reporting standard that fire departments use to uniformly report on the full range of their activities, from...

  9. 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

  10. Critical Incident Reporting Systems: Perceived Competing Social ...

    African Journals Online (AJOL)

    The safe operation of complex socio-technical systems is dependent upon the reporting of safety critical incidents by operators within a system. Through the action of reporting, systems develop the capability as a learning organisation to improve human and organisational performance. The aim of the study is therefore to ...

  11. NEA incident reporting system: Three years' experience

    International Nuclear Information System (INIS)

    Otsuka, Y.; Haeussermann, W.

    1984-01-01

    The paper presents an overview of the NEA Incident Reporting System (IRS) which was set up to collect, assess and disseminate on safety-related incidents in nuclear power plants. The IRS information exchange is significant in two senses. First, it enables regulatory authorities and utilities in participating countries to take appropriate action to prevent the reported mishaps occurring again elsewhere. Secondly, the continuous collection and systematic analysis of such information allows identification of areas of concern where safety research should be strengthened. There are two stages in the IRS information exchange. First, the national IRS Co-ordinator selects information on significant incidents, in accordance with a common reporting threshold, from the abnormal occurrences reported to the regulatory body, to be distributed through the NEA Secretariat. This screening is intended to exclude minor events, so that only significant information is sent to participating countries. Secondly, a group of experts periodically reviews the incidents reported during the preceding twelve months to identify major areas of concern. To assist this process, a computer-based data retrieval system is being developed for IRS incident reports. The paper gives some details of the IRS mechanism and discusses reporting criteria and the information included in a report. Areas of concern derived from reported incidents, an outline of the data retrieval system, and examples of feedback of lessons learned and possibilities for international co-operation are also discussed. (author)

  12. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

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

  13. Acute incident rapid response at a mass-gathering event through comprehensive planning systems: a case report from the 2013 Shamrock Shuffle.

    Science.gov (United States)

    Başdere, Mehmet; Ross, Colleen; Chan, Jennifer L; Mehrotra, Sanjay; Smilowitz, Karen; Chiampas, George

    2014-06-01

    Planning and execution of mass-gathering events involves various challenges. In this case report, the Chicago Model (CM), which was designed to organize and operate such events and to maintain the health and wellbeing of both runners and the public in a more effective way, is described. The Chicago Model also was designed to prepare for unexpected incidents, including disasters, during the marathon event. The model has been used successfully in the planning and execution stages of the Bank of America Shamrock Shuffle and the Bank of America Chicago Marathon since 2008. The key components of the CM are organizational structure, information systems, and communication. This case report describes how the organizers at the 2013 Shamrock Shuffle used the key components of the CM approach in order to respond to an acute incident caused by a man who was threatening to jump off the State Street Bridge. The course route was changed to accommodate this unexpected event, while maintaining access to key health care facilities. The lessons learned from the incident are presented and further improvements to the existing model are proposed.

  14. Computer security incident response team effectiveness : A needs assessment

    NARCIS (Netherlands)

    Kleij, R. van der; Kleinhuis, G.; Young, H.J.

    2017-01-01

    Computer security incident response teams (CSIRTs) respond to a computer security incident when the need arises. Failure of these teams can have far-reaching effects for the economy and national security. CSIRTs often have to work on an ad-hoc basis, in close cooperation with other teams, and in

  15. Exploring the Development of Critical Incident Response Teams

    Science.gov (United States)

    Lockhart, Charlotte Fiona; Woods, Kevin

    2017-01-01

    Critical incidents, such as human or natural disasters, can have profound effects upon children and young people, and upon the adults who work with and care for them. Educational psychologists have contributed to and led the development of critical incident response teams to support those affected. This study sought to develop understanding of the…

  16. Prerequisites for building a computer security incident response capability

    CSIR Research Space (South Africa)

    Mooi, M

    2015-08-01

    Full Text Available There are a number of considerations before one can commence with establishing a Computer Security Incident Response Team (CSIRT). This paper presents the results of a structured literature review investigating the business requirements...

  17. Safety Outreach and Incident Response Stakeholder Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Rosewater, David Martin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Conover, David [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-06-01

    The objective of this document is to set out a strategy to reach all stakeholders that can impact the timely deployment of safe stationary energy storage systems in the built environment with information on ESS technology and safety that is relevant to their role in deployment of the technology.

  18. Meeting national response time targets for priority 1 incidents in an ...

    African Journals Online (AJOL)

    Background. Response time is viewed as a key performance indicator in most emergency medical services (EMS) systems. Objective. To determine the effect of increased emergency vehicle numbers on response time performance for priority 1 incidents in an urban EMS system in Cape Town, South Africa, using ...

  19. A nationwide medication incidents reporting system in the netherlands

    NARCIS (Netherlands)

    K.C. Cheung (Ka Chun); P.M.L.A. van den Bemt (Patricia); M.L. Bouvy (Marcel); M.E. Wensing (Michel); P.A. de Smet (Peter)

    2011-01-01

    textabstractObjective Many Dutch hospitals have established internal systems for reporting incidents. However, such internal systems do not allow learning from incidents that occur in other hospitals. Therefore a multicenter, information technology (IT) supported reporting system named central

  20. A nationwide medication incidents reporting system in The Netherlands

    NARCIS (Netherlands)

    Cheung, K.C.; Bemt, P.M. van den; Bouvy, M.L.; Wensing, M.J.P.; Smet, P.A.G.M. de

    2011-01-01

    Objective Many Dutch hospitals have established internal systems for reporting incidents. However, such internal systems do not allow learning from incidents that occur in other hospitals. Therefore a multicenter, information technology (IT) supported reporting system named central medication

  1. Dynamical system modeling to simulate donor T cell response to whole exome sequencing-derived recipient peptides: Understanding randomness in alloreactivity incidence following stem cell transplantation.

    Directory of Open Access Journals (Sweden)

    Vishal Koparde

    Full Text Available Quantitative relationship between the magnitude of variation in minor histocompatibility antigens (mHA and graft versus host disease (GVHD pathophysiology in stem cell transplant (SCT donor-recipient pairs (DRP is not established. In order to elucidate this relationship, whole exome sequencing (WES was performed on 27 HLA matched related (MRD, & 50 unrelated donors (URD, to identify nonsynonymous single nucleotide polymorphisms (SNPs. An average 2,463 SNPs were identified in MRD, and 4,287 in URD DRP (p<0.01; resulting peptide antigens that may be presented on HLA class I molecules in each DRP were derived in silico (NetMHCpan ver2.0 and the tissue expression of proteins these were derived from determined (GTex. MRD DRP had an average 3,670 HLA-binding-alloreactive peptides, putative mHA (pmHA with an IC50 of <500 nM, and URD, had 5,386 (p<0.01. To simulate an alloreactive donor cytotoxic T cell response, the array of pmHA in each patient was considered as an operator matrix modifying a hypothetical cytotoxic T cell clonal vector matrix; each responding T cell clone's proliferation was determined by the logistic equation of growth, accounting for HLA binding affinity and tissue expression of each alloreactive peptide. The resulting simulated organ-specific alloreactive T cell clonal growth revealed marked variability, with the T cell count differences spanning orders of magnitude between different DRP. Despite an estimated, uniform set of constants used in the model for all DRP, and a heterogeneously treated group of patients, higher total and organ-specific T cell counts were associated with cumulative incidence of moderate to severe GVHD in recipients. In conclusion, exome wide sequence differences and the variable alloreactive peptide binding to HLA in each DRP yields a large range of possible alloreactive donor T cell responses. Our findings also help understand the apparent randomness observed in the development of alloimmune responses.

  2. Federal Response Assets for a Radioactive Dispersal Device Incident

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan,T.

    2009-06-30

    If a large scale RDD event where to occur in New York City, the magnitude of the problem would likely exceed the capabilities of City and State to effectively respond to the event. New York State could request Federal Assistance if the United States President has not already made the decision to provide it. The United States Federal Government has a well developed protocol to respond to emergencies. The National Response Framework (NRF) describes the process for responding to all types of emergencies including RDD incidents. Depending on the location and type of event, the NRF involves appropriate Federal Agencies, e.g., Department of Homeland Security (DHS), the Department of Energy (DOE), Environmental Protection Agency (EPA), United States Coast Guard (USCG), Department of Defense (DOD), Department of Justice (DOJ), Department of Agriculture (USDA), and Nuclear Regulatory Commission (NRC). The Federal response to emergencies has been refined and improved over the last thirty years and has been tested on natural disasters (e.g. hurricanes and floods), man-made disasters (oil spills), and terrorist events (9/11). However, the system has never been tested under an actual RDD event. Drills have been conducted with Federal, State, and local agencies to examine the initial (early) phases of such an event (TopOff 2 and TopOff 4). The Planning Guidance for Protection and Recovery Following Radiological Dispersal Device (RDD) and Improvised Nuclear Device (IND) incidents issued by the Department of Homeland Security (DHS) in August 2008 has never been fully tested in an interagency exercise. Recently, another exercise called Empire 09 that was situated in Albany, New York was conducted. Empire 09 consists of 3 different exercises be held in May and June, 2009. The first exercise, May 2009, involved a table top exercise for phase 1 (0-48 hours) of the response to an RDD incident. In early June, a full-scale 3- day exercise was conducted for the mid-phase response (48

  3. Agency procedures for the NRC incident response plan. Final report

    International Nuclear Information System (INIS)

    1983-02-01

    The NRC Incident Response Plan, NUREG-0728/MC 0502 describes the functions of the NRC during an incident and the kinds of actions that comprise an NRC response. The NRC response plan will be activated in accordance with threshold criteria described in the plan for incidents occurring at nuclear reactors and fuel facilities involving materials licensees; during transportation of licensed material, and for threats against facilities or licensed material. In contrast to the general overview provided by the Plan, the purpose of these agency procedures is to delineate the manner in which each planned response function is performed; the criteria for making those response decisions which can be preplanned; and the information and other resources needed during a response. An inexperienced but qualified person should be able to perform functions assigned by the Plan and make necessary decisions, given the specified information, by becoming familiar with these procedures. This rule of thumb has been used to determine the amount of detail in which the agency procedures are described. These procedures form a foundation for the training of response personnel both in their normal working environment and during planned emergency exercises. These procedures also form a ready reference or reminder checklist for technical team members and managers during a response

  4. Computer Security Incident Response Team Effectiveness: A Needs Assessment

    Directory of Open Access Journals (Sweden)

    Rick Van der Kleij

    2017-12-01

    Full Text Available Computer security incident response teams (CSIRTs respond to a computer security incident when the need arises. Failure of these teams can have far-reaching effects for the economy and national security. CSIRTs often have to work on an ad hoc basis, in close cooperation with other teams, and in time constrained environments. It could be argued that under these working conditions CSIRTs would be likely to encounter problems. A needs assessment was done to see to which extent this argument holds true. We constructed an incident response needs model to assist in identifying areas that require improvement. We envisioned a model consisting of four assessment categories: Organization, Team, Individual and Instrumental. Central to this is the idea that both problems and needs can have an organizational, team, individual, or technical origin or a combination of these levels. To gather data we conducted a literature review. This resulted in a comprehensive list of challenges and needs that could hinder or improve, respectively, the performance of CSIRTs. Then, semi-structured in depth interviews were held with team coordinators and team members of five public and private sector Dutch CSIRTs to ground these findings in practice and to identify gaps between current and desired incident handling practices. This paper presents the findings of our needs assessment and ends with a discussion of potential solutions to problems with performance in incident response.

  5. Piloting an online incident reporting system in Australasian emergency medicine.

    Science.gov (United States)

    Schultz, Timothy J; Crock, Carmel; Hansen, Kim; Deakin, Anita; Gosbell, Andrew

    2014-10-01

    Medical-specific incident reporting systems are critical to understanding error in healthcare but underreporting by doctors reduces their value. We conducted a pilot study of the implementation of an online ED-specific incident reporting system in Australasian hospitals and evaluated its use. The reporting system was based on the literature and input of experts. Thirty-one hospital EDs were approached to pilot the Emergency Medicine Events Register (EMER). The pilot evaluated: website usage and analytics, reporting behaviours and rates, the quality of information collected in EMER. Semi-structured interviews of three site champions responsible for implementing EMER were conducted. Seventeen EDs expressed interest; however, due to delays and other barriers reporting only occurred at three sites. Over 354 days, the website received 362 unique visitors and 77 incidents. The median time to report was 4.6 min. The reporting rate was 0.07 reports per doctor month, suggesting a reporting rate of 0.08% of ED presentations. Data quality, as measured by the number of completed non-mandatory fields and ability to classify incidents, was very high. The interviews identified enablers (the EMER system, site champions) and barriers (chiefly the context of EM) to EMER uptake. Collecting patient safety information by frontline doctors is essential to actively engage the profession in patent safety. Although the EMER system allowed easy online reporting of high quality incident data by doctors, site recruitment and system uptake proved difficult. System use by ED doctors requires dedicated and conscious effort from the profession. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  6. 7 CFR 331.14 - Incident response. 6

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Incident response. 6 331.14 Section 331.14 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE... other natural disasters; workplace violence; bomb threats and suspicious packages; and emergencies such...

  7. What stops hospital clinical staff from following protocols? An analysis of the incidence and factors behind the failure of bedside clinical staff to activate the rapid response system in a multi-campus Australian metropolitan healthcare service.

    Science.gov (United States)

    Shearer, Bill; Marshall, Stuart; Buist, Michael David; Finnigan, Monica; Kitto, Simon; Hore, Tonina; Sturgess, Tamica; Wilson, Stuart; Ramsay, Wayne

    2012-07-01

    To explore the causes of failure to activate the rapid response system (RRS). The organisation has a recognised incidence of staff failing to act when confronted with a deteriorating patient and leading to adverse outcomes. A multi-method study using the following: a point prevalence survey to determine the incidence of abnormal simple bedside observations and activation of the rapid response team by clinical staff; a prospective audit of all patients experiencing a cardiac arrest, unplanned intensive care unit admission or death over an 8-week period; structured interviews of staff to explore cognitive and sociocultural barriers to activating the RRS. Southern Health is a comprehensive healthcare network with 570 adult in-patient beds across four metropolitan teaching hospitals in the south-eastern sector of Melbourne. Frequency of physiological instability and outcomes within the in-patient hospital population. Qualitative data from staff interviews were thematically coded. The incidence of physiological instability in the acute adult population was 4.04%. Nearly half of these patients (42%) did not receive an appropriate clinical response from the staff, despite most (69.2%) recognising their patient met physiological criteria for activating the RRS, and being 'quite', or 'very' concerned about their patient (75.8%). Structured interviews with 91 staff members identified predominantly sociocultural reasons for failure to activate the RRS. Despite an organisational commitment to the RRS, clinical staff act on local cultural rules within the clinical environment that are usually not explicit. Better understanding of these informal rules may lead to more appropriate activation of the RRS.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  9. Improving Cybersecurity Incident Response Team (CSIRT) Skills, Dynamics and Effectiveness

    Science.gov (United States)

    2017-03-01

    form its architecture, but institutions of higher education have responded by producing human talent that is adept at using the latest technologies...managed, skilled and efficient Cybersecurity Incident Response Team (CSIRT). For CSIRT managers, finding the right mixture of talent and creating the...members join. Managers should have regular team social activities (e.g., team lunches, sports activities), especially if the team is not new. Engaging

  10. Incident Management in Academic Information System using ITIL Framework

    Science.gov (United States)

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

    2018-02-01

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

  11. Automated Safety Incident Surveillance and Tracking System (ASISTS)

    Data.gov (United States)

    Department of Veterans Affairs — The Automated Safety Incident Surveillance and Tracking System (ASISTS) is a repository of Veterans Health Administration (VHA) employee accident data. Many types of...

  12. 49 CFR 191.9 - Distribution system: Incident report.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Distribution system: Incident report. 191.9... CONDITION REPORTS § 191.9 Distribution system: Incident report. (a) Except as provided in paragraph (c) of... report required by this section need not be submitted with respect to master meter systems or LNG...

  13. Studies on normal incidence backscattering in nodule areas using the multibeam-hydrosweep system

    Digital Repository Service at National Institute of Oceanography (India)

    Pathak, D.; Chakraborty, B.

    The acoustic response from areas of varying nodule abundance and number densities in the Central Indian Ocean has been studied by using the echo peak amplitudes of the normal incidence beam in the Multibeam Hydrosweep system. It is observed...

  14. Incident-response monitoring technologies for aircraft cabin air quality

    Science.gov (United States)

    Magoha, Paul W.

    Poor air quality in commercial aircraft cabins can be caused by volatile organophosphorus (OP) compounds emitted from the jet engine bleed air system during smoke/fume incidents. Tri-cresyl phosphate (TCP), a common anti-wear additive in turbine engine oils, is an important component in today's global aircraft operations. However, exposure to TCP increases risks of certain adverse health effects. This research analyzed used aircraft cabin air filters for jet engine oil contaminants and designed a jet engine bleed air simulator (BAS) to replicate smoke/fume incidents caused by pyrolysis of jet engine oil. Field emission scanning electron microscopy (FESEM) with X-ray energy dispersive spectroscopy (EDS) and neutron activation analysis (NAA) were used for elemental analysis of filters, and gas chromatography interfaced with mass spectrometry (GC/MS) was used to analyze used filters to determine TCP isomers. The filter analysis study involved 110 used and 90 incident filters. Clean air filter samples exposed to different bleed air conditions simulating cabin air contamination incidents were also analyzed by FESEM/EDS, NAA, and GC/MS. Experiments were conducted on a BAS at various bleed air conditions typical of an operating jet engine so that the effects of temperature and pressure variations on jet engine oil aerosol formation could be determined. The GC/MS analysis of both used and incident filters characterized tri- m-cresyl phosphate (TmCP) and tri-p-cresyl phosphate (TpCP) by a base peak of an m/z = 368, with corresponding retention times of 21.9 and 23.4 minutes. The hydrocarbons in jet oil were characterized in the filters by a base peak pattern of an m/z = 85, 113. Using retention times and hydrocarbon thermal conductivity peak (TCP) pattern obtained from jet engine oil standards, five out of 110 used filters tested had oil markers. Meanwhile 22 out of 77 incident filters tested positive for oil fingerprints. Probit analysis of jet engine oil aerosols obtained

  15. 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

  16. System Issues Leading to "Found-on-Floor" Incidents: A Multi-Incident Analysis.

    Science.gov (United States)

    Shaw, James; Bastawrous, Marina; Burns, Susan; McKay, Sandra

    2016-11-02

    Although attention to patient safety issues in the home care setting is growing, few studies have highlighted health system-level concerns that contribute to patient safety incidents in the home. Found-on-floor (FOF) incidents are a key patient safety issue that is unique to the home care setting and highlights a number of opportunities for system-level improvements to drive enhanced patient safety. We completed a multi-incident analysis of FOF incidents documented in the electronic record system of a home health care agency in Toronto, Canada, for the course of 1 year between January 2012 and February 2013. Length of stay (LOS) was identified as the cross-cutting theme, illustrating the following 3 key issues: (1) in the short LOS group, a lack of information continuity led to missed fall risk information by home care professionals; (2) in the medium LOS group, a lack of personal support worker/carer training in fall prevention led to inadequate fall prevention activity; and (3) in the long LOS group, a lack of accountability policy at a system level led to a lack of fall risk assessment follow-up. Our study suggests that considering LOS in the home care sector helps expose key system-level issues enabling safety incidents such as FOF to occur. Our multi-incident analysis identified a number of opportunities for system-level changes that might improve fall prevention practice and reduce the likelihood of FOF incidents in the home. Specifically, investment in electronic health records that are functional across the continuum of care, further research and understanding of the training and skills of personal support workers, and enhanced incentives or more punitive approaches (depending on the circumstances) to ensure accountability in home safety will strengthen the home care sector and help prevent FOF incidents among older people.

  17. A Tactical Emergency Response Management System (Terms ...

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... Emergencies are incidents that threaten public safety, health ... very critical role in responding to an incident. Information systems designed for emergency response operations can provide valuable help for better planning and coordination during .... Object Modeling Technique (OMT) and. Object-Oriented ...

  18. A nationwide medication incidents reporting system in The Netherlands.

    Science.gov (United States)

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

    2011-01-01

    Many Dutch hospitals have established internal systems for reporting incidents. However, such internal systems do not allow learning from incidents that occur in other hospitals. Therefore a multicenter, information technology (IT) supported reporting system named central medication incidents registration (CMR) was developed. This article describes the architecture, implementation and current status of the CMR in The Netherlands and compare it with similar systems in other countries. Adequate IT is required to sufficiently support a multicenter reporting system. The CMR system consists of a website, a database, a web-based reporting form, an application to import reports generated in other reporting systems, an application to generate an overview of reported medication incidents, and a national warning system for healthcare providers. From the start of CMR 90 of all 93 (96.8%) hospitals and 872 of 1948 (44.8%) community pharmacies participated. Between March 2006 and March 2010 the CMR comprised 15,694 reports of incidents. In the period from March 2010 to March 2011, 1642 reports were submitted by community pharmacies in CMR and the hospitals submitted 2517 reports. CMR is similar to various systems in other countries, but it seems to use more IT applications. The CMR is developing into a nationwide reporting system of medication incidents in The Netherlands, in which hospitals, community pharmacies, mental healthcare organizations and general practitioners participate. The architecture of the system met the requirements of a nationwide reporting system across different healthcare providers.

  19. Pediatric safety incidents from an intensive care reporting system.

    Science.gov (United States)

    Skapik, Julia Lynn; Pronovost, Peter J; Miller, Marlene R; Thompson, David A; Wu, Albert W

    2009-06-01

    Adverse events impose a great burden on patients and the health care system, but not enough is known about how to address incidents involving pediatric patients. This study examined the demographic factors, types of events, contributing system factors, and harm associated with incidents that occur in pediatric intensive care units. Cross-sectional analysis of 2 years of data on all pediatric safety incidents and near misses reported to the voluntary provider-recorded Intensive Care Unit Safety Reporting System in regards to harm and contributing factors. In 464 incidents reported from 23 intensive care units to the Intensive Care Unit Safety Reporting System, patients were physically injured in one third of incidents and harmed in some way in two thirds of incidents. Medication errors were the most common incident type, but were associated with less harm than other event types. Line, tube, and airway events comprised one third of incidents and were associated with more harm than other types. Patient contributing factors were a strong predictor of harm; training and education factors were also commonly cited. In multivariate analysis, patient factors were the strongest predictor of harm adjusting for age, sex, and race. Pediatric patients are commonly harmed in intensive care units. There are several potential ways to improve safety including protocols for high-risk procedures involving lines and tubes, improved monitoring, and staffing, training and communication initiatives. Providers may be able to identify patients at increased risk for harm and intervene to protect patient safety.

  20. Workplace Disruption following Psychological Trauma: Influence of Incident Severity Level on Organizations' Post-Incident Response Planning and Execution

    Directory of Open Access Journals (Sweden)

    GS DeFraia

    2016-04-01

    Full Text Available Background: Psychologically traumatic workplace events (known as critical incidents, which occur globally, are increasing in prevalence within the USA. Assisting employers in their response is a growing practice area for occupational medicine, occupational social work, industrial psychology and other occupational health professions. Traumatic workplace events vary greatly in their level of organizational disruption. Objective: To explore whether extent of workplace disruption influences organizations' decisions for post-incident response planning and plan execution. Methods: Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring extent of workplace disruption associated with organizational decisions regarding post-incident response. Results: The more severe and disruptive the incident, the more likely organizations planned for and followed through to deliver on-site interventions. Following more severe incidents, organizations were also more likely to deliver group sessions and to complete follow-up consultations to ensure ongoing worker recovery. Conclusion: Increasing occupational health practitioners' knowledge of varying levels of organizational disruption and familiarity with a range of organizational response strategies improves incident assessment, consultation and planning, and ensures interventions delivered are consistent with the level of assistance needed on both worker and organizational levels.

  1. Workplace Disruption following Psychological Trauma: Influence of Incident Severity Level on Organizations' Post-Incident Response Planning and Execution.

    Science.gov (United States)

    DeFraia, G S

    2016-04-01

    Psychologically traumatic workplace events (known as critical incidents), which occur globally, are increasing in prevalence within the USA. Assisting employers in their response is a growing practice area for occupational medicine, occupational social work, industrial psychology and other occupational health professions. Traumatic workplace events vary greatly in their level of organizational disruption. To explore whether extent of workplace disruption influences organizations' decisions for post-incident response planning and plan execution. Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring extent of workplace disruption associated with organizational decisions regarding post-incident response. The more severe and disruptive the incident, the more likely organizations planned for and followed through to deliver on-site interventions. Following more severe incidents, organizations were also more likely to deliver group sessions and to complete follow-up consultations to ensure ongoing worker recovery. Increasing occupational health practitioners' knowledge of varying levels of organizational disruption and familiarity with a range of organizational response strategies improves incident assessment, consultation and planning, and ensures interventions delivered are consistent with the level of assistance needed on both worker and organizational levels.

  2. Performance indicators for initial regional medical response to major incidents: a possible quality control tool

    Directory of Open Access Journals (Sweden)

    Nilsson Heléne

    2012-12-01

    Full Text Available Abstract Background Timely decisions concerning mobilization and allocation of resources and distribution of casualties are crucial in medical management of major incidents. The aim of this study was to evaluate documented initial regional medical responses to major incidents by applying a set of 11 measurable performance indicators for regional medical command and control and test the feasibility of the indicators. Methods Retrospective data were collected from documentation from regional medical command and control at major incidents that occurred in two Swedish County Councils. Each incident was assigned to one of nine different categories and 11 measurable performance indicators for initial regional medical command and control were systematically applied. Two-way analysis of variance with one observation per cell was used for statistical analysis and the post hoc Tukey test was used for pairwise comparisons. Results The set of indicators for regional medical command and control could be applied in 102 of the130 major incidents (78%, but 36 incidents had to be excluded due to incomplete documentation. The indicators were not applicable as a set for 28 incidents (21.5% due to different characteristics and time frames. Based on the indicators studied in 66 major incidents, the results demonstrate that the regional medical management performed according to the standard in the early phases (1–10 min after alert, but there were weaknesses in the secondary phase (10–30 min after alert. The significantly lowest scores were found for Indicator 8 (formulate general guidelines for response and Indicator 10 (decide whether or not resources in own organization are adequate. Conclusions Measurable performance indicators for regional medical command and control can be applied to incidents that directly or indirectly involve casualties provided there is sufficient documentation available. Measurable performance indicators can enhance follow- up and be

  3. 78 FR 38949 - Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response

    Science.gov (United States)

    2013-06-28

    ... indicators of incidents. The organizations work together to achieve common goals (i.e., fast, effective... and Analysis Center (ISAC)? What are the benefits? Are there any pain points? 4. How is information...

  4. Incident Command Systems: Because Life Happens

    Science.gov (United States)

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Preparing for every possible contingency seems daunting, but with teamwork and some help from the government, it's almost do-able. There is a great system out there that will help business professionals and educators develop a strong, effective emergency preparedness plan. If they haven't done a good job of implementing a solid emergency response…

  5. An error taxonomy system for analysis of haemodialysis incidents.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji; Suzuki, Satoshi

    2014-12-01

    This paper describes the development of a haemodialysis error taxonomy system for analysing incidents and predicting the safety status of a dialysis organisation. The error taxonomy system was developed by adapting an error taxonomy system which assumed no specific specialty to haemodialysis situations. Its application was conducted with 1,909 incident reports collected from two dialysis facilities in Japan. Over 70% of haemodialysis incidents were reported as problems or complications related to dialyser, circuit, medication and setting of dialysis condition. Approximately 70% of errors took place immediately before and after the four hours of haemodialysis therapy. Error types most frequently made in the dialysis unit were omission and qualitative errors. Failures or complications classified to staff human factors, communication, task and organisational factors were found in most dialysis incidents. Device/equipment/materials, medicine and clinical documents were most likely to be involved in errors. Haemodialysis nurses were involved in more incidents related to medicine and documents, whereas dialysis technologists made more errors with device/equipment/materials. This error taxonomy system is able to investigate incidents and adverse events occurring in the dialysis setting but is also able to estimate safety-related status of an organisation, such as reporting culture. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  6. Analysis of Passenger Incident Data from Five Rail Transit Systems

    Directory of Open Access Journals (Sweden)

    Katharine Hunter-Zaworski

    2017-09-01

    Full Text Available The study results reported here are part of a larger research project that developed a manual for practitioners to improve safety at rail transit platform/train and platform/guideway interfaces. As part of that effort, passenger injury incident data was collected from five rail transit systems, and interviews were conducted with safety officers at other rail transit systems in the US and Canada. The data collected showed that stairs and escalators and general platform tripping produced more injury incidents than the platform/train and platform/guideway interfaces. Heavy rail transit with platforms that are higher than 24 inches from top of rail had more injury incidents than light rail transit that typically operates on low level platforms. Other causes of injury incidents included intoxication, attempted suicide, and distraction.

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

    International Nuclear Information System (INIS)

    2011-01-01

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

  8. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2007-04-01

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

  10. NRC source term assessment for incident response dose projections

    International Nuclear Information System (INIS)

    Easley, P.; Pasedag, W.

    1984-01-01

    The NRC provides advice and assistance to licensees and State and local authorities in responding to accidents. The TACT code supports this function by providing source term projections for two situations during early (15 to 60 minutes) accident response: (1) Core/containment damage is indicated, but there are no measured releases. Quantification of a predicted release permits emergency response before people are exposed. With TACT, response personnel can estimate releases based on fuel and cladding conditions, coolant boundary and containment integrity, and mitigative systems operability. For this type of estimate, TACT is intermediate between default assumptions and time-consuming mechanistic codes. (2) A combination of plant status and limited release data are available. For this situation, iterations between predictions based on known conditions which are compared to measured releases gives reasonable confidence in supplemental source term information otherwise unavailable: nuclide mix, releases not monitored, and trending or abrupt changes. The assumptions and models used in TACT, and examples of its use, are given in this paper

  11. Incidence of systemic lupus erythematosus and lupus nephritis in Denmark

    DEFF Research Database (Denmark)

    Hermansen, Marie-Louise From; Lindhardsen, Jesper; Torp-Pedersen, Christian

    2016-01-01

    Objective. To determine the incidence of systemic lupus erythematosus (SLE) and SLE with concomitant or subsequent lupus nephritis (LN) in Denmark during 1995.2011, using data from the Danish National Patient Registry (NPR).  Methods. To assess the incidence of SLE, we identified all persons aged...... with or after first SLE registration.  Results. The overall annual incidence rate per 100,000 for SLE was 2.35 (95% CI 2.24.2.49); 0.69 (95% CI 0.60.0.78) for men and 3.96 (95% CI 3.75.4.17) for women. For LN, the mean annual incidence rate per 100,000 was estimated to be 0.45 (95% CI 0.38.0.53); 0.20 (95% CI 0...... (December 31, 2011) per 100,000 was 45.2 (95% CI 43.3.47.4) and 6.4 (95% CI 5.7.7.2) for SLE and LN, respectively.  Conclusion. Our Danish population-based data showed a stable incidence of SLE and LN. As expected, we found higher incidence rates among women than among men, particularly in younger persons....

  12. 10 CFR 1.46 - Office of Nuclear Security and Incident Response.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Office of Nuclear Security and Incident Response. 1.46... Headquarters Program Offices § 1.46 Office of Nuclear Security and Incident Response. The Office of Nuclear... evaluation and assessment of technical issues involving security at nuclear facilities, and is the agency...

  13. The evaluation of a web-based incident reporting system.

    Science.gov (United States)

    Kuo, Ya-Hui; Lee, Ting-Ting; Mills, Mary Etta; Lin, Kuan-Chia

    2012-07-01

    A Web-based reporting system is essential to report incident events anonymously and confidentially. The purpose of this study was to evaluate a Web-based reporting system in Taiwan. User satisfaction and impact of system use were evaluated through a survey answered by 249 nurses. Incident events reported in paper and electronic systems were collected for comparison purposes. Study variables included system user satisfaction, willingness to report, number of reports, severity of the events, and efficiency of the reporting process. Results revealed that senior nurses were less willing to report events, nurses on internal medicine units had higher satisfaction than others, and lowest satisfaction was related to the time it took to file a report. In addition, the Web-based reporting system was used more often than the paper system. The percentages of events reported were significantly higher in the Web-based system in laboratory, environment/device, and incidents occurring in other units, whereas the proportions of reports involving bedsores and dislocation of endotracheal tubes were decreased. Finally, moderate injury event reporting decreased, whereas minor or minimal injury event reporting increased. The study recommends that the data entry process be simplified and the network system be improved to increase user satisfaction and reporting rates.

  14. Automated Generation of Traffic Incident Response Plan Based on Case-Based Reasoning and Bayesian Theory

    Directory of Open Access Journals (Sweden)

    Yongfeng Ma

    2014-01-01

    Full Text Available Traffic incident response plan, specifying response agencies and their responsibilities, can guide responders to take actions effectively and timely after traffic incidents. With a reasonable and feasible traffic incident response plan, related agencies will save many losses, such as humans and wealth. In this paper, how to generate traffic incident response plan automatically and specially was solved. Firstly, a well-known and approved method, Case-Based Reasoning (CBR, was introduced. Based on CBR, a detailed case representation and R5-cycle of CBR were developed. To enhance the efficiency of case retrieval, which was an important procedure, Bayesian Theory was introduced. To measure the performance of the proposed method, 23 traffic incidents caused by traffic crashes were selected and three indicators, Precision P, Recall R, and Indicator F, were used. Results showed that 20 of 23 cases could be retrieved effectively and accurately. The method is practicable and accurate to generate traffic incident response plans. The method will promote the intelligent generation and management of traffic incident response plans and also make Traffic Incident Management more scientific and effective.

  15. History of aerial surveys in response to radiological incidents and accidents

    International Nuclear Information System (INIS)

    Jobst, J.E.

    1986-01-01

    EG and G Energy Measurements Inc., operates the Remote Sensing Laboratory for the US Department of Energy (DOE). The Laboratory plays a key role in the federal response to a radiological incident or accident. It assists the DOE in the establishment of a Federal Radiological Monitoring and Assessment Center (FRMAC). The Remote Sensing Laboratory has played a major role in more than 13 incidents, including lost sources, accidental dispersions, and nuclear reactor incidents

  16. Learning From Incident Reporting? Analysis of Incidents Resulting in Patient Injuries in a Web-Based System in Swedish Health Care.

    Science.gov (United States)

    Ahlberg, Eva-Lena; Elfström, Johan; Borgstedt, Madeleine Risberg; Öhrn, Annica; Andersson, Christer; Sjödahl, Rune; Nilsen, Per

    2017-11-04

    Incident reporting (IR) systems have the potential to improve patient safety if they enable learning from the reported risks and incidents. The aim of this study was to investigate incidents registered in an IR system in a Swedish county council. The study was conducted in the County Council of Östergötland, Sweden. Data were retrieved from the IR system, which included 4755 incidents occurring in somatic care that resulted in patient injuries from 2004 to 2012. One hundred correctly classified patient injuries were randomly sampled from 3 injury severity levels: injuries leading to deaths, permanent harm, and temporary harm. Three aspects were analyzed: handling of the incident, causes of the incident, and actions taken to prevent its recurrence. Of the 300 injuries, 79% were handled in the departments where they occurred. The department head decided what actions should be taken to prevent recurrence in response to 95% of the injuries. A total of 448 causes were identified for the injuries; problems associated with procedures, routines, and guidelines were most common. Decisions taken for 80% of the injuries could be classified using the IR system documentation and root cause analysis. The most commonly pursued type of action was change of work routine or guideline. The handling, causes, and actions taken to prevent recurrence were similar for injuries of different severity levels. Various forms of feedback (information, education, and dialogue) were an integral aspect of the IR system. However, this feedback was primarily intradepartmental and did not yield much organizational learning.

  17. Major incident response: collecting ante-mortem data.

    Science.gov (United States)

    De Valck, Eddy

    2006-05-15

    The Asian tsunami of 26 December 2004, which devastated coastal parts of more than 10 countries in and around the Indian Ocean caused over 200,000 casualties. People from more than 58 nationalities were amongst the victims and subsequently an international effort for disaster victim identification (DVI) was set up, coordinated by Interpol. DVI teams from more than 20 countries took part in the identification process which, because of the complexity of the situation, had to be conducted in an internationally agreed upon procedure. Standard operating protocols of post-mortem (PM) procedures were established for fingerprinting, forensic pathology, forensic odontology and DNA profiling and were crucial in the quality of the entire DVI process of the quickly decomposing bodies. A very important and underestimated part of the DVI process is the gathering of the ante-mortem (AM) data of the persons reported missing in their home countries. In the wake of this tsunami event it appeared to be even more problematic as entire families had died and information was difficult to obtain. As dentistry proved to be the most valuable identification mean--up to 85% of the cases--the AM dental records proved to be crucial elements for DVI. Standard operating protocols (SOP) were again established as to who, where, when and what information had to be collected by the dentists by the AM teams abroad. Transcribing the AM dental information by experienced forensic odontologists was another crucial element in the whole identification procedure as the information had to be loaded into the DVI System International (Plass Data, Holbaek, Denmark) for comparison with incoming PM data. The Interpol DVI Standing Committee thus recommends that forward planning, adequate funding, international cooperation and standardisation are essential to guarantee an effective response to any major mass disaster of this kind in the future.

  18. 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.

  19. Plutonium Reclamation Facility incident response project progress report

    Energy Technology Data Exchange (ETDEWEB)

    Austin, B.A.

    1997-11-25

    This report provides status of Hanford activities in response to process deficiencies highlighted during and in response to the May 14, 1997, explosion at the Plutonium Reclamation Facility. This report provides specific response to the August 4, 1997, memorandum from the Secretary which requested a progress report, in 120 days, on activities associated with reassessing the known and evaluating new vulnerabilities (chemical and radiological) at facilities that have been shut down, are in standby, are being deactivated or have otherwise changed their conventional mode of operation in the last several years. In addition, this report is intended to provide status on emergency response corrective activities as requested in the memorandum from the Secretary on August 28, 1997. Status is also included for actions requested in the second August 28, 1997, memorandum from the Secretary, regarding timely notification of emergencies.

  20. 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...

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

    International Nuclear Information System (INIS)

    2011-01-01

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

  2. INFORMATION SECURITY: Challenges to Improving DOD's Incident Response Capabilities

    National Research Council Canada - National Science Library

    2001-01-01

    .... Many of these systems and networks are interconnected through the public telecommunications infrastructure, including the Internet, and they may be targeted by an increasing variety of cyber attacks...

  3. Incidence and risk of heart failure in systemic lupus erythematosus.

    Science.gov (United States)

    Kim, Chang H; Al-Kindi, Sadeer G; Jandali, Bochra; Askari, Ali D; Zacharias, Michael; Oliveira, Guilherme H

    2017-02-01

    Although case series suggest a higher burden of cardiovascular risk factors in patients with systemic lupus erythematosus (SLE) compared with the general population, the association between SLE and heart failure (HF) remains undefined. We sought to investigate the incidence and risk of HF in patients with SLE. In April 2016, we performed a retrospective cohort analysis using the Explorys platform, which provides aggregated electronic medical record data from 26 major integrated healthcare systems across the USA from 1999 to present. Demographic and regression analyses were performed to assess the impact of SLE on HF incidence. Among 45 284 540 individuals in the database, we identified 95 400 (0.21%) with SLE and 98 900 (0.22%) with a new diagnosis of HF between May 2015 and April 2016. HF incidence was markedly higher in the SLE group compared with controls (0.97% vs 0.22%, relative risk (RR): 4.6 (95% CI 4.3 to 4.9)), as were other cardiovascular risk factors. In regression analysis, SLE was an independent predictor of HF (adjusted OR: 3.17 (2.63 to 3.83), prisk but decreasing RR with advancing age in both sexes. Renal involvement in SLE correlated with earlier and higher incidence of HF. The findings of this study suggest that patients with SLE have significantly higher risk of developing HF and a worse cardiovascular risk profile compared with the general population. These results need to be confirmed by prospective studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. RESPONSE PROTOCOL TOOLBOX: PLANNING FOR AND RESPONDING TO DRINKING WATER CONTAMINATION THREATS AND INCIDENTS. MODULE 1: WATER UTILITIES PLANNING GUIDE - INTERIM FINAL - DECEMBER 2003

    Science.gov (United States)

    The interim final Response Protocol Toolbox: Planning for and Responding to Contamination Threats to Drinking Water Systems is designed to help the water sector effectively and appropriately respond to intentional contamination threats and incidents. It was produced by EPA, buil...

  5. Evaluation of pressure response in the Los Alamos controlled air incinerator during three incident scenarios

    International Nuclear Information System (INIS)

    Vavruska, J.S.; Elsberry, K.; Thompson, T.K.; Pendergrass, J.A.

    1996-01-01

    The Los Alamos Controlled Air Incinerator (CAI) is a system designed to accept radioactive mixed waste containing alpha-emitting radionuclides. A mathematical model was developed to predict the pressure response throughout the offgas treatment system of the CAI during three hypothetical incident scenarios. The scenarios examined included: (1) loss of burner flame and failure of the flame safeguard system with subsequent reignition of fuel gas in the primary chamber, (2) pyrolytic gas buildup from a waste package due to loss of induced draft and subsequent restoration of induced draft, and (3) accidental charging of propellant spray cans in a solid waste package to the primary chamber during a normal feed cycle. For each of the three scenarios, the finite element computer model was able to determine the transient pressure surge and decay response throughout the system. Of particular interest were the maximum absolute pressures attainable at critical points in the system as well as maximum differential pressures across the high efficiency particulate air (HEPA) filters. Modeling results indicated that all three of the scenarios resulted in maximum HEPA filter differential pressures well below the maximum allowable levels

  6. Dysphonia in preterm children: assessing incidence and response to treatment.

    Science.gov (United States)

    Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel P

    2014-03-01

    Mild dysphonia in childhood is surprisingly common, yet moderate to severe dysphonia is rare. The latter has been associated with complex medical conditions and congenital abnormalities. Intubation injury has also been documented as a cause of childhood dysphonia. Children born very preterm may be intubated as part of the intensive care administered in the perinatal and neonatal periods, yet there are few studies investigating dysphonia in this population. This study will be the first to: use an objective acoustic voice assessment in a paediatric study, document the incidence of dysphonia in very preterm children at school age, and conduct a controlled trial of behavioural voice therapy in this population. This study will consist of three phases: assessment of voice quality and its impact on quality of life in up to 200 children born at less than 32 weeks' gestation: assessment of the nature and extent of laryngeal pathology in children with moderate to severe dysphonia; and a non-blinded, randomised controlled trial of behavioural voice therapy in children with moderate to severe dysphonia. This study will be the first to use clinical assessment to examine the voice quality of very preterm children, and to use fibre optic endoscopic evaluation of laryngeal function to determine the nature and extent of any laryngeal pathology in such children. Those participants with significant voice difficulties will be randomised to receive treatment immediately or after the eight week assessment. This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12613001015730/ACTRN12613001012763). Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  7. Establishing national medical imaging incident reporting systems: issues and challenges.

    Science.gov (United States)

    Jones, D Neil; Benveniste, Klee A; Schultz, Timothy J; Mandel, Catherine J; Runciman, William B

    2010-08-01

    Radiology incident reporting systems provide one source of invaluable patient safety data that, when combined with appropriate analysis and action, can result in significantly safer health care, which is now an urgent priority for governments worldwide. Such systems require integration into a wider safety, quality, and risk management framework because many issues have global implications, and they also require an international classification scheme, which is now being developed. These systems can be used to inform global research activities as identified by the World Health Organization, many of which intersect with the activities of and issues seen in medical imaging departments. How to ensure that radiologists (and doctors in general) report incidents, and are engaged in the process, is a challenge. However, as demonstrated with the example of the Australian Radiology Events Register, this can be achieved when the reporting system is integrated with their professional organization and its other related activities (such as training and education) and administered by a patient safety organization. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. Teachers' Responses to Bullying Incidents: Effects of Teacher Characteristics and Contexts

    Science.gov (United States)

    Yoon, Jina; Sulkowski, Michael L.; Bauman, Sheri A.

    2016-01-01

    School is a critical context of bullying. This study investigated teacher responses to bullying incidents and the effects of individual and contextual variables on these responses. Participating teachers (N = 236) viewed streaming video vignettes depicting physical, verbal, and relational bullying and reported how they would respond to bullies and…

  9. Identifying and Embedding Common Indicators of Compromise in Virtual Machines for Lab-Based Incident Response Education

    Science.gov (United States)

    2015-09-01

    artifacts for indicators of compromise and prominent incident investigative tools. These scenarios will help facilitate the educational experience...distribution is unlimited IDENTIFYING AND EMBEDDING COMMON INDICATORS OF COMPROMISE IN VIRTUAL MACHINES FOR LAB-BASED INCIDENT RESPONSE EDUCATION ...AND SUBTITLE IDENTIFYING AND EMBEDDING COMMON INDICATORS OF COMPROMISE IN VIRTUAL MACHINES FOR LAB-BASED INCIDENT RESPONSE EDUCATION 5. FUNDING

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

    Science.gov (United States)

    1992-02-01

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

  11. 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

  12. 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

  13. Emergency preparedness and response in the Commonwealth of Pennsylvania - the Three Mile Island incident

    International Nuclear Information System (INIS)

    Henderson, O.K.

    1981-01-01

    This paper addresses the emergency response mechanism and legal basis in effect in the Commonwealth of Pennsylvania at the time of the Three Mile Island incident. It reviews the sequence of events as they directly affected the Pennsylvania Emergency Management Agency and examines the method used by the Agency to discharge its responsibilities. Finally, the paper lists some of the lessons learned from the Three Mile Island experience. (author)

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

    Science.gov (United States)

    1999-01-01

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

  15. Dynamic Response of Underground Circular Lining Tunnels Subjected to Incident P Waves

    Directory of Open Access Journals (Sweden)

    Hua Xu

    2014-01-01

    Full Text Available Dynamic stress concentration in tunnels and underground structures during earthquakes often leads to serious structural damage. A series solution of wave equation for dynamic response of underground circular lining tunnels subjected to incident plane P waves is presented by Fourier-Bessel series expansion method in this paper. The deformation and stress fields of the whole medium of surrounding rock and tunnel were obtained by solving the equations of seismic wave propagation in an elastic half space. Based on the assumption of a large circular arc, a series of solutions for dynamic stress were deduced by using a wave function expansion approach for a circular lining tunnel in an elastic half space rock medium subjected to incident plane P waves. Then, the dynamic response of the circular lining tunnel was obtained by solving a series of algebraic equations after imposing its boundary conditions for displacement and stress of the circular lining tunnel. The effects of different factors on circular lining rock tunnels, including incident frequency, incident angle, buried depth, rock conditions, and lining stiffness, were derived and several application examples are presented. The results may provide a good reference for studies on the dynamic response and aseismic design of tunnels and underground structures.

  16. 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.

  17. Summary of canister overheating incident at the Carbon Tetrachloride Expedited Response Action site

    Energy Technology Data Exchange (ETDEWEB)

    Driggers, S.A.

    1994-03-10

    The granular activated carbon (GAC)-filled canister that overheated was being used to adsorb carbon tetrachloride vapors drawn from a well near the 216-Z-9 Trench, a subsurface disposal site in the 200 West Area of the Hanford Site. The overheating incident resulted in a band of discolored paint on the exterior surface of the canister. Although there was no other known damage to equipment, no injuries to operating personnel, and no releases of hazardous materials, the incident is of concern because it was not anticipated. It also poses the possibility of release of carbon tetrachloride and other hazardous vapors if the incident were to recur. All soil vapor extraction system (VES) operations were halted until a better understanding of the cause of the incident could be determined and controls implemented to reduce the possibility of a recurrence. The focus of this report and the intent of all the activities associated with understanding the overheating incident has been to provide information that will allow safe restart of the VES operations, develop operational limits and controls to prevent recurrence of an overheating incident, and safely optimize recovery of carbon tetrachloride from the ground.

  18. Pilot Study for the Creation of a European Union Radiation Accident and Incident Data Exchange System (EURAIDE)

    International Nuclear Information System (INIS)

    Stewart, J.E.; Lefaure, C; Czarwinski, R.

    2004-01-01

    contacted is given in appendix. Responses were not obtained from 6 of the 31 countries contacted; Denmark, Bulgaria, Estonia, Hungary, Latvia and Malta. The questionnaire, which is reproduced in appendix, was split into three parts. Part A was by way of an introduction elaborating on the structure of the subsequent questions and how to complete them. Part B requested summary information on national systems for collecting information on radiation incidents, while Part C requested detailed, structured, information on (each) system. The results of the survey are discussed in detail. The detailed responses to Part B of the questionnaire are presented in a Table 1. In summary of the five countries, which responded (an 80% response rate): - five have no formal incident data system: (Austria, Belgium, Irish Republic, Portugal, and Cyprus); - twelve have established data systems: (Finland, France, Germany, Luxembourg, Netherlands, Spain, Sweden, United Kingdom, Czech Republic, Lithuania, Romania, Slovenia); - three are currently developing incident data Systems: (Turkey, Iceland, and Switzerland); - five reported that they had no specific national data systems, but that they supported the INES*1 system: (Greece, Italy, Poland, and Slovakia) or RADEV; - two countries (France and Germany) operate specific nuclear incidents data systems, in addition to systems recording non-nuclear incidents; - one country (UK) operates two national non-nuclear incident data systems, one for general non-nuclear applications and one specifically addressing incidents relating to the transport of radioactive materials. As for the countries that did not respond (Denmark, Bulgaria, Estonia, Hungary, Latvia and Malta), personal contacts suggest that, in general, they do not have formal incident data systems

  19. The systemic inflammatory response syndrome.

    Science.gov (United States)

    Robertson, Charles M; Coopersmith, Craig M

    2006-04-01

    The systemic inflammatory response syndrome (SIRS) is the body's response to an infectious or noninfectious insult. Although the definition of SIRS refers to it as an "inflammatory" response, it actually has pro- and anti-inflammatory components. This review outlines the pathophysiology of SIRS and highlights potential targets for future therapeutic intervention in patients with this complex entity.

  20. Health information systems' usability-related use errors in patient safety incidents

    OpenAIRE

    Hautamäki E; Kinnunen U-M; Palojoki S

    2017-01-01

    Health information systems contain usability issues that cause use errors, which may pose a risk to patient safety. The aim of this study was to identify what kind of usability issues in information systems cause use errors that lead to patient safety incidents. Patient safety incidents reported into an incident reporting system in a Finnish hospital district during the year 2014 (n=2500) were analyzed from the perspectives of usability and use errors. An inductive content analysis was carrie...

  1. Critical incidence reporting systems - an option in equine anaesthesia? Results from a panel meeting.

    Science.gov (United States)

    Hartnack, Sonja; Bettschart-Wolfensberger, Regula; Driessen, Bernd; Pang, Daniel; Wohlfender, Franziska

    2013-11-01

    To provide a brief introduction into Critical Incident Reporting Systems (CIRS) as used in human medicine, and to report the discussion from a recent panel meeting discussion with 23 equine anaesthetists in preparation for a new CEPEF-4 (Confidential Enquiry into Perioperative Equine Fatalities) study. Moderated group discussions, and review of literature. The first group discussion focused on the definition of 'preventable critical incidents' and/or 'near misses' in the context of equine anaesthesia. The second group discussion focused on categorizing critical incidents according to an established framework for analysing risk and safety in clinical medicine. While critical incidents do occur in equine anaesthesia, no critical incident reporting system including systematic collection and analysis of critical incidents is in place. Critical incident reporting systems could be used to improve safety in equine anaesthesia - in addition to other study types such as mortality studies. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  2. The development of an incident event reporting system for nursing students.

    Science.gov (United States)

    Chiou, Shwu-Fen; Huang, Ean-Wen; Chuang, Jen-Hsiang

    2009-01-01

    Incident events may occur when nursing students are present in the clinical setting. Their inexperience and unfamiliarity with clinical practice put them at risk for making mistakes that could potentially harm patients and themselves. However, there are deficiencies with incident event reporting systems, including incomplete data and delayed reports. The purpose of this study was to develop an incident event reporting system for nursing students in clinical settings and evaluate its effectiveness. This study was undertaken in three phases. In the first phase, a literature review and focus groups were used to develop the architecture of the reporting system. In the second phase, the reporting system was implemented. Data from incident events that involved nursing students were collected for a 12-month period. In the third phase, a pre-post trial was undertaken to evaluate the performance of the reporting system. The ASP.NET software and Microsoft Access 2003 were used to create an interactive web-based interface and design a database for the reporting system. Email notifications alerted the nursing student's teacher when an incident event was reported. One year after installing the reporting system, the number of reported incident events increased tenfold. However, the time to report the incident event and the time required to complete the reporting procedures were shorter than before implementation of the reporting system. The incident event reporting system appeared to be effective in more comprehensively reporting the number of incident events and shorten the time required for reporting them compared to traditional written reports.

  3. Enhancing Police Responses to Domestic Violence Incidents: Reports From Client Advocates in New South Wales.

    Science.gov (United States)

    Goodman-Delahunty, Jane; Crehan, Anna Corbo

    2016-07-01

    In an online survey about experiences with the police complaint system, 239 client advocates described a recent incident in which a client with grounds to lodge a complaint declined to do so. Almost one third of those incidents involved domestic violence. Thematic analysis of case descriptions revealed that many police did not take domestic violence reports seriously. A typology of problematic police conduct was developed. Many officers failed to observe current procedures and appeared to lack knowledge of relevant laws. Citizens feared retaliatory victimization by police and/or perceived that complaining was futile. Implications of these findings are reviewed in light of procedural justice theory. © The Author(s) 2015.

  4. Multi-Tiered Observation and Response Charts: Prevalence and Incidence of Triggers, Modifications and Calls, to Acutely Deteriorating Adult Patients.

    Directory of Open Access Journals (Sweden)

    Arthas Flabouris

    Full Text Available Observation charts are the primary tool for recording patient vital signs. They have a critical role in documenting triggers for a multi-tiered escalation response to the deteriorating patient. The objectives of this study were to ascertain the prevalence and incidence of triggers, trigger modifications and escalation response (Call amongst general medical and surgical inpatients following the introduction of an observation and response chart (ORC.Prospective (prevalence, over two 24-hour periods, and retrospective (incidence, over entire hospital stay, observational study of documented patient observations intended to trigger one of three escalation responses, being a MER-Medical Emergency Response [highest tier], MDT-Multidisciplinary Team [admitting team], or Nurse-senior ward nurse [lowest tier] response amongst adult general medical and surgical patients.416 patients, 321 (77.2% being medical admissions, median age 76 years (IQR 62, 85 and 95 (22.8% Not for Resuscitation (NFR. Overall, 193 (46.4% patients had a Trigger, being 17 (4.1% MER, 45 (10.8% MDT and 178 (42.8% Nurse triggers. 60 (14.4% patients had a Call, and 72 (17.3% a modified Trigger.206 patients, of similar age, of whom 166 (80.5% had a Trigger, 122 (59.2% a Call, and 91 (44.2% a modified Trigger. PREVALENCE and incidence of failure to Call was 33.2% and 68% of patients, respectively, particular for Nurse Triggers (26.7% and 62.1%, respectively. The number of Modifications, Calls, and failure to Call, correlated with the number of Triggers (0.912 [p<0.01], 0.631 [p<0.01], 0.988 [p<0.01].Within a multi-tiered response system for the detection and response to the deteriorating patient Triggers, their Modifications and failure to Call are common, particularly within the lower tiers of escalation. The number of Triggers and their Modifications may erode the structure, compliance, and potential efficacy of structured observation and response charts within a multi-tiered response

  5. I-131 Dose Response for Incident Thyroid Cancers in Ukraine Related to the Chornobyl Accident

    OpenAIRE

    Brenner, Alina V.; Tronko, Mykola D.; Hatch, Maureen; Bogdanova, Tetyana I.; Oliynik, Valery A.; Lubin, Jay H.; Zablotska, Lydia B.; Tereschenko, Valery P.; McConnell, Robert J.; Zamotaeva, Galina A.; O?Kane, Patrick; Bouville, Andre C.; Chaykovskaya, Ludmila V.; Greenebaum, Ellen; Paster, Ihor P.

    2011-01-01

    Background: Current knowledge about Chornobyl-related thyroid cancer risks comes from ecological studies based on grouped doses, case?control studies, and studies of prevalent cancers. Objective: To address this limitation, we evaluated the dose?response relationship for incident thyroid cancers using measurement-based individual iodine-131 (I-131) thyroid dose estimates in a prospective analytic cohort study. Methods: The cohort consists of individuals < 18 years of age on 26 April 1986 who ...

  6. Pilot program: NRC severe reactor accident incident response training manual: US Nuclear Regulatory Commission response

    International Nuclear Information System (INIS)

    Sakenas, C.A.; McKenna, T.J.; Perkins, K.; Miller, C.W.; Hively, L.M.; Sharpe, R.W.; Giitter, J.G.; Watkins, R.M.

    1987-02-01

    This pilot training manual has been written to fill the need for a general text on NRC response to reactor accidents. The manual is intended to be the foundation for a course for all NRC response personnel. US Nuclear Regulatory Commission Response is the fifth in a series of volumes that collectively summarize the US Nuclear Regulatory Commission (NRC) emergency response during severe power reactor accidents and provide necessary background information. This volume describes NRC response modes, organizations, and official positions; roles of other federal agencies are also described briefly. Each volume serves, respectively, as the text for a course of instruction in a series of courses for NRC response personnel. These materials do not provide guidance or license requirements for NRC licensees. Each volume is accompanied by an appendix of slides that can be used to present this material. The slides are called out in the text

  7. STRATEG - an incident training system for thermohydraulic effects and principles

    International Nuclear Information System (INIS)

    Rehn, H.; Majohr, N.

    1993-01-01

    STRATEG is a 1:10 scale glass model of a PWR (Biblis B reactor coolant circuit) built by RWE in 1986 on the site of the Biblis plant as a training model. The model can be used for training of normal operation and incident situations since all important operating and incident sequences of a PWR can be simulated. Thermodynamic phenomena can also be demonstrated occurring under various operating situations and in particular associated with malfunctions. (Z.S.) 1 tab., 3 figs., 1 ref

  8. SICOEM: emergency response data system

    International Nuclear Information System (INIS)

    Martin, A.; Villota, C.; Francia, L.

    1993-01-01

    The main characteristics of the SICOEM emergency response system are: -direct electronic redundant transmission of certain operational parameters and plant status informations from the plant process computer to a computer at the Regulatory Body site, - the system will be used in emergency situations, -SICOEM is not considered as a safety class system. 1 fig

  9. SICOEM: emergency response data system

    Energy Technology Data Exchange (ETDEWEB)

    Martin, A.; Villota, C.; Francia, L. (UNESA, Madrid (Spain))

    1993-01-01

    The main characteristics of the SICOEM emergency response system are: -direct electronic redundant transmission of certain operational parameters and plant status informations from the plant process computer to a computer at the Regulatory Body site, - the system will be used in emergency situations, -SICOEM is not considered as a safety class system. 1 fig.

  10. System Safety Assessment Based on Past Incidents in Oil and Gas Industries: A Focused Approach in Forecasting of Minor, Severe, Critical, and Catastrophic Incidents, 2010–2015

    Directory of Open Access Journals (Sweden)

    Praveen Patel

    2016-01-01

    Full Text Available Accident in an occupation which occurred due to series of repetitive minor incidents within the working environment. This work demonstrates the critical system safety assessment based on various incidents that took place to the different system and subsystem of two Indian oil refineries in five years of span 2010 to 2015. The categorization of incidents and hazard rate function of each incident category were classified and calculated. The result of Weibull analysis estimators in the form of scale and shape parameters provides useful information of incidents forecasting and their patterns in a particular time.

  11. Modelling psychological responses to the Great East Japan earthquake and nuclear incident.

    Science.gov (United States)

    Goodwin, Robin; Takahashi, Masahito; Sun, Shaojing; Gaines, Stanley O

    2012-01-01

    The Great East Japan (Tōhoku/Kanto) earthquake of March 2011 was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11-13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants), Tokyo/Chiba (approximately 220 km from the nuclear plants), and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants). Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan). The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.

  12. Modelling psychological responses to the Great East Japan earthquake and nuclear incident.

    Directory of Open Access Journals (Sweden)

    Robin Goodwin

    Full Text Available The Great East Japan (Tōhoku/Kanto earthquake of March 2011 was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11-13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants, Tokyo/Chiba (approximately 220 km from the nuclear plants, and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants. Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan. The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.

  13. 49 CFR 191.15 - Transmission and gathering systems: Incident report.

    Science.gov (United States)

    2010-10-01

    ...-RELATED CONDITION REPORTS § 191.15 Transmission and gathering systems: Incident report. (a) Except as... 49 Transportation 3 2010-10-01 2010-10-01 false Transmission and gathering systems: Incident report. 191.15 Section 191.15 Transportation Other Regulations Relating to Transportation (Continued...

  14. Survey of state and tribal emergency response capabilities for radiological transportation incidents

    Energy Technology Data Exchange (ETDEWEB)

    Vilardo, F J; Mitter, E L; Palmer, J A; Briggs, H C; Fesenmaier, J [Indiana Univ., Bloomington, IN (USA). School of Public and Environmental Affairs

    1990-05-01

    This publication is the final report of a project to survey the fifty states, the District of Columbia, Puerto Rico, and selected Indian Tribal jurisdictions to ascertain their emergency-preparedness planning and capabilities for responding to transportation incidents involving radioactive materials. The survey was conducted to provide the Nuclear Regulatory Commission and other federal agencies with information concerning the current level of emergency-response preparedness of the states and selected tribes and an assessment of the changes that have occurred since 1980. There have been no major changes in the states' emergency-response planning strategies and field tactics. The changes noted included an increased availability of dedicated emergency-response vehicles, wider availability of specialized radiation-detection instruments, and higher proportions of police and fire personnel with training in the handling of suspected radiation threats. Most Indian tribes have no capability to evaluate suspected radiation threats and have no formal relations with emergency-response personnel in adjacent states. For the nation as a whole, the incidence of suspected radiation threats declined substantially from 1980 to 1988. 58 tabs.

  15. 2011 Japanese Nuclear Incident

    Science.gov (United States)

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

  16. International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process.

    Science.gov (United States)

    Howell, Ann-Marie; Burns, Elaine M; Hull, Louise; Mayer, Erik; Sevdalis, Nick; Darzi, Ara

    2017-02-01

    Patient safety incident reporting systems (PSRS) have been established for over a decade, but uncertainty remains regarding the role that they can and ought to play in quantifying healthcare-related harm and improving care. To establish international, expert consensus on the purpose of PSRS regarding monitoring and learning from incidents and developing recommendations for their future role. After a scoping review of the literature, semi-structured interviews with experts in PSRS were conducted. Based on these findings, a survey-based questionnaire was developed and subsequently completed by a larger expert panel. Using a Delphi approach, consensus was reached regarding the ideal role of PSRSs. Recommendations for best practice were devised. Forty recommendations emerged from the Delphi procedure on the role and use of PSRS. Experts agreed reporting system should not be used as an epidemiological tool to monitor the rate of harm over time or to appraise the relative safety of hospitals. They agreed reporting is a valuable mechanism for identifying organisational safety needs. The benefit of a national system was clear with respect to medication error, device failures, hospital-acquired infections and never events as these problems often require solutions at a national level. Experts recommended training for senior healthcare professionals in incident investigation. Consensus recommendation was for hospitals to take responsibility for creating safety solutions locally that could be shared nationally. We obtained reasonable consensus among experts on aims and specifications of PSRS. This information can be used to reflect on existing and future PSRS, and their role within the wider patient safety landscape. The role of PSRS as instruments for learning needs to be elaborated and developed further internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Risk factors for radiotherapy incidents and impact of an online electronic reporting system

    International Nuclear Information System (INIS)

    Chang, David W.; Cheetham, Lynn; Marvelde, Luc te; Bressel, Mathias; Kron, Tomas; Gill, Suki; Tai, Keen Hun; Ball, David; Rose, William; Silva, Linas; Foroudi, Farshad

    2014-01-01

    Background and purpose: To ascertain the rate, type, significance, trends and the potential risk factors associated with radiotherapy incidents in a large academic department. Materials and methods: Data for all radiotherapy activities from July 2001 to January 2011 were reviewed from radiotherapy incident reporting forms. Patient and treatment data were obtained from the radiotherapy record and verification database (MOSAIQ) and the patient database (HOSPRO). Logistic regression analyses were performed to determine variables associated with radiotherapy incidents. Results: In that time, 65,376 courses of radiotherapy were delivered with a reported incident rate of 2.64 per 100 courses. The rate of incidents per course increased (1.96 per 100 courses to 3.52 per 100 courses, p < 0.001) whereas the proportion of reported incidents resulting in >5% deviation in dose (10.50 to 2.75%, p < 0.001) had decreased after the introduction of an online electronic reporting system. The following variables were associated with an increased rate of incidents: afternoon treatment time, paediatric patients, males, inpatients, palliative plans, head-and-neck, skin, sarcoma and haematological malignancies. In general, complex plans were associated with higher incidence rates. Conclusion: Radiotherapy incidents were infrequent and most did not result in significant dose deviation. A number of risk factors were identified and these could be used to highlight high-risk cases in the future. Introduction of an online electronic reporting system resulted in a significant increase in the number of incidents being reported

  18. Field assessment of a model tuberculosis outbreak response plan for low-incidence areas

    Directory of Open Access Journals (Sweden)

    Pascopella Lisa

    2007-10-01

    Full Text Available Abstract Background For a regional project in four low-incidence states, we designed a customizable tuberculosis outbreak response plan. Prior to dissemination of the plan, a tuberculosis outbreak occurred, presenting an opportunity to perform a field assessment of the plan. The purpose of the assessment was to ensure that the plan included essential elements to help public health professionals recognize and respond to outbreaks. Methods We designed a semi-structured questionnaire and interviewed all key stakeholders involved in the response. We used common themes to assess validity of and identify gaps in the plan. A subset of participants provided structured feedback on the plan. Results We interviewed 11 public health and six community stakeholders. The assessment demonstrated that (1 almost all of the main response activities were reflected in the plan; (2 the plan added value by providing a definition of a tuberculosis outbreak and guidelines for communication and evaluation. These were areas that lacked written protocols during the actual outbreak response; and (3 basic education about tuberculosis and the interpretation and use of genotyping data were important needs. Stakeholders also suggested adding to the plan questions for evaluation and a section for specific steps to take when an outbreak is suspected. Conclusion An interactive field assessment of a programmatic tool revealed the value of a systematic outbreak response plan with a standard definition of a tuberculosis outbreak, guidelines for communication and evaluation, and response steps. The assessment highlighted the importance of education and training for tuberculosis in low-incidence areas.

  19. Active Response Gravity Offload System

    Science.gov (United States)

    Valle, Paul; Dungan, Larry; Cunningham, Thomas; Lieberman, Asher; Poncia, Dina

    2011-01-01

    The Active Response Gravity Offload System (ARGOS) provides the ability to simulate with one system the gravity effect of planets, moons, comets, asteroids, and microgravity, where the gravity is less than Earth fs gravity. The system works by providing a constant force offload through an overhead hoist system and horizontal motion through a rail and trolley system. The facility covers a 20 by 40-ft (approximately equals 6.1 by 12.2m) horizontal area with 15 ft (approximately equals4.6 m) of lifting vertical range.

  20. SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

    International Nuclear Information System (INIS)

    Pappas, D; Reis, S; Ali, A; Kapur, A

    2015-01-01

    Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to see how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results

  1. SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

    Energy Technology Data Exchange (ETDEWEB)

    Pappas, D; Reis, S; Ali, A [Hofstra University, Hempstead, NY (United States); Kapur, A [Long Island Jewish Medical Center, New Hyde Park, NY (United States)

    2015-06-15

    Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to see how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results.

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

    Science.gov (United States)

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

    2014-08-01

    470 participants. Based on continuous evaluations and accumulated experience, the setup of the simulation was step-wise adjusted to the present model, including also collaborating agencies such as fire and rescue services as well as the police, both on-scene and on superior command levels. The accuracy of the simulation cards for this purpose was evaluated as "very good" by 63 % of the trainees and as "good" by 33 %, the highest two of the six given alternatives. The participants' ranking of the extent that the course increased their competencies related to the given objectives on a 1-5 scale for prehospital staff had an average value of 4.25 ± 0.77 and that for hospital staff had an average value of 4.25 ± 0.72. The accuracy of the course for the training of major incident response on a 1-5 scale by prehospital staff was evaluated as 4.35 ± 0.73 and that by hospital staff as 4.30 ± 0.74. The simulation system tested in this study could, with adjustments based on accumulated experience and evaluations, be developed into a tool for the training of major incident response meeting the specific demands on such training based on recent experiences from major incidents and disasters. Experienced trainees in several courses evaluated the methodology to be accurate for this training, markedly increasing their perceived knowledge and skills in fields of importance for a successful outcome of the response to a major incident.

  3. International Cyber Incident Repository System: Information Sharing on a Global Scale

    Energy Technology Data Exchange (ETDEWEB)

    Joyce, Amanda L.; Evans, PhD, Nathaniel; Tanzman, Edward A.; Israeli, Daniel

    2017-02-02

    According to the 2016 Internet Security Threat Report, the largest number of cyber attacks were recorded last year (2015), reaching a total of 430 million incidents throughout the world. As the number of cyber incidents increases, the need for information and intelligence sharing increases, as well. This fairly large increase in cyber incidents is driving the need for an international cyber incident data reporting system. The goal of the cyber incident reporting system is to make available shared and collected information about cyber events among participating international parties. In its 2014 report, Insurance Industry Working Session Readout Report-Insurance for CyberRelated Critical Infrastructure Loss: Key Issues, on the outcomes of a working session on cyber insurance, the U.S. Department of Homeland Security observed that “many participants cited the need for a secure method through which organizations could pool and share cyber incident information” and noted that one underwriter emphasized the importance of internationally harmonized data taxonomies. This cyber incident data reporting system could benefit all nations that take part in reporting incidents to provide a more common operating picture. In addition, this reporting system could allow for trending and anticipated attacks and could potentially benefit participating members by enabling them to get in front of potential attacks. The purpose of this paper is to identify options for consideration for such a system in fostering cooperative cyber defense.

  4. Using Pareto Analysis with Trend Analysis: Statistical Techniques to Investigate Incident Reports within a Housing System

    Science.gov (United States)

    Luna, Andrew L.

    1998-01-01

    The purpose of this study was to determine trends and difficulties concerning student incident reports within the residence halls as they relate to the incident reporting system from the Department of Housing and Residential Life at a Southeastern Doctoral I Granting Institution. This study used the frequency distributions of each classified…

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

    Science.gov (United States)

    Morrow, H E

    2001-01-01

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

  6. I-131 dose response for incident thyroid cancers in Ukraine related to the Chornobyl accident.

    Science.gov (United States)

    Brenner, Alina V; Tronko, Mykola D; Hatch, Maureen; Bogdanova, Tetyana I; Oliynik, Valery A; Lubin, Jay H; Zablotska, Lydia B; Tereschenko, Valery P; McConnell, Robert J; Zamotaeva, Galina A; O'Kane, Patrick; Bouville, Andre C; Chaykovskaya, Ludmila V; Greenebaum, Ellen; Paster, Ihor P; Shpak, Victor M; Ron, Elaine

    2011-07-01

    Current knowledge about Chornobyl-related thyroid cancer risks comes from ecological studies based on grouped doses, case-control studies, and studies of prevalent cancers. To address this limitation, we evaluated the dose-response relationship for incident thyroid cancers using measurement-based individual iodine-131 (I-131) thyroid dose estimates in a prospective analytic cohort study. The cohort consists of individuals radioactivity measurements taken within 2 months after the accident, environmental transport models, and interview data. Excess radiation risks were estimated using Poisson regression models. Sixty-five incident thyroid cancers were diagnosed during the second through fourth screenings and 73,004 person-years (PY) of observation. The dose-response relationship was consistent with linearity on relative and absolute scales, although the excess relative risk (ERR) model described data better than did the excess absolute risk (EAR) model. The ERR per gray was 1.91 [95% confidence interval (CI), 0.43-6.34], and the EAR per 10⁴ PY/Gy was 2.21 (95% CI, 0.04-5.78). The ERR per gray varied significantly by oblast of residence but not by time since exposure, use of iodine prophylaxis, iodine status, sex, age, or tumor size. I-131-related thyroid cancer risks persisted for two decades after exposure, with no evidence of decrease during the observation period. The radiation risks, although smaller, are compatible with those of retrospective and ecological post-Chornobyl studies.

  7. Dynamics of a Delayed HIV-1 Infection Model with Saturation Incidence Rate and CTL Immune Response

    Science.gov (United States)

    Guo, Ting; Liu, Haihong; Xu, Chenglin; Yan, Fang

    2016-12-01

    In this paper, we investigate the dynamics of a five-dimensional virus model incorporating saturation incidence rate, CTL immune response and three time delays which represent the latent period, virus production period and immune response delay, respectively. We begin this model by proving the positivity and boundedness of the solutions. Our model admits three possible equilibrium solutions, namely the infection-free equilibrium E0, the infectious equilibrium without immune response E1 and the infectious equilibrium with immune response E2. Moreover, by analyzing corresponding characteristic equations, the local stability of each of the feasible equilibria and the existence of Hopf bifurcation at the equilibrium point E2 are established, respectively. Further, by using fluctuation lemma and suitable Lyapunov functionals, it is shown that E0 is globally asymptotically stable when the basic reproductive numbers for viral infection R0 is less than unity. When the basic reproductive numbers for immune response R1 is less than unity and R0 is greater than unity, the equilibrium point E1 is globally asymptotically stable. Finally, some numerical simulations are carried out for illustrating the theoretical results.

  8. The Federal Emergency Management Agency's National Incident Management System

    Science.gov (United States)

    The NIMS provides an integrated framework defining the roles and responsibilities of federal, state and local first responders, developed with responders from different jurisdictions and disciplines, to better work together during emergency events.

  9. A web-based incident reporting system and multidisciplinary collaborative projects for patient safety in a Japanese hospital.

    Science.gov (United States)

    Nakajima, K; Kurata, Y; Takeda, H

    2005-04-01

    When patient safety programs were mandated for Japanese health care institutions, a safety culture, a tool for collecting incident reports, an organizational arrangement for multidisciplinary collaboration, and interventional methods for improvement had to be established. Observational study of effects of new patient safety programs. Osaka University Hospital, a large government-run teaching hospital. A voluntary and anonymous web-based incident reporting system was introduced. For the new organizational structure a clinical risk management committee, a department of clinical quality management, and area clinical risk managers were established with their respective roles clearly defined to advance the plan-do-study-act cycle and to integrate efforts. For preventive action, alert procedures, staff education, ward rounds by peers, a system oriented approach for reducing errors, and various feedback channels were introduced. Continuous incident reporting by all hospital staff has been observed since the introduction of the new system. Several error inducing situations have been improved: wrong choice of drug in computer prescribing, maladministration of drugs due to a look-alike appearance or confusion about the manipulation of a medical device, and poor after hours service of the blood transfusion unit. Staff participation in educational seminars has been dramatically improved. Ward rounds have detected problematic procedures which needed to be dealt with. Patient safety programs based on a web-based incident reporting system, responsible persons, staff education, and a variety of feedback procedures can help promote a safety culture, multidisciplinary collaboration, and strong managerial leadership resulting in system oriented improvement.

  10. Results of the implementation of a learning system with incidents in an radiotherapy department

    International Nuclear Information System (INIS)

    Radicchi, Lucas Augusto; Vilela, Ellen Pedroso Severino; Faustino, Fabio de Lima C.; Rodrigues, Fernanda Arantes C.; Gomes, Franciele N.; Souza, Guilherme Vicente de; Silva, Rose Marta S.; Toledo, Jose Carlos de

    2016-01-01

    An incident learning system (ILS) is an important tool for improving aspects of patient and staff safety. In radiation oncology, ILS has been implemented both at the institutional level as at the national level, allowing to share lessons learned from incidents that have already occurred. The objective of this study is to present the preliminary results of the ILS implemented in a radiation oncology department. In total, 128 incidents were reviewed by a multidisciplinary committee, and the professional groups that registered more were medical physicists, radiation oncologists and radiation therapists. In addition, incidents have occurred and have been detected mainly in the treatment step. The incident learning system proved to be an important process improvement tool, according to the results shown,the improvement actions proposed and the perception of the people involved. (author)

  11. Human Factors of Remotely Piloted Aircraft Systems: Lessons from Incident Reports

    Science.gov (United States)

    Hobbs, Alan; Null, Cynthia

    2016-01-01

    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. 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.

  12. 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)

  13. IAEA response assistance network. Incident and Emergency Centre. Emergency preparedness and response. Date effective: 1 May 2006

    International Nuclear Information System (INIS)

    2006-03-01

    This publication is intended to serve as a tool for supporting the provision of international assistance in the case of nuclear or radiological incident or emergency, cooperation between States, their Competent Authorities and the IAEA, and harmonization of response capabilities of States offering assistance. The publication is issued under the authority of the Director General of the IAEA: (1) under the auspices of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (the Assistance Convention) [1], to promote, facilitate and support cooperation between States Parties to coordinate and/or provide assistance to a State Party and/or Member State; and (2) in the case of an incident or emergency, as statutory functions, to provide for the application of its safety standards, upon request by a Member State, and to act as an intermediary for the purposes of securing the performance of services or the supplying of materials, equipment or facilities by one Member State for another. The publication sets out the following: a) the RANET concept and the organizational structure for providing assistance; b) functions, responsibilities and activities within the RANET; c) the RANET response operations and arrangements needed for preparedness; and d) the prerequisites for RANET membership and conditions of registration. The RANET is divided into four sections. After the introduction in Section 1, the RANET concept, objectives and scope are described in Section 2. Section 3 presents the concept of operations of the RANET and Section 4 describes expected tasks, capabilities and resources. In addition, EPR-RANET (2006) has three supporting documents, which are issued separately, as follows: 1. Assistance Action Plans with samples of Assistance Action Plans for providing international assistance. 2. Registry with the details of the registry and instructions on how to register national assistance capabilities for the RANET. 3. Technical Guidelines

  14. The national response system: Where do we go from here?

    International Nuclear Information System (INIS)

    Johnson, R.C.

    1993-01-01

    The response to the Exxon Valdez incident showed that the nation needs to be better prepared to respond to a spill of that magnitude. In research conducted on the Valdez response, several inadequacies were noted in the National Response System (NRS). A key deficiency identified was the critical need for a standardized management system to direct the response effort more effectively and efficiently. The most pressing question for preparedness planners in improving the NRS is open-quotes where do we go from here?close quotes. In answering this question, planners must address another question, open-quotes how long is it going to take?close quotes. There has been wide spread failure to put existing knowledge into practice. To fill the management void identified in the NRS, it is imperative that a response management system be adopted as soon as possible. Once adopted, it can be modified and refined to provide a more effective response. The system proposed in this paper uses the sound management practices of an incident command system and modifies and/or expands these practices to fit onto the foundation built by the NRS. This response management system could be used for all spills from minor ones to large, catastrophic spills of national significance (SONS)

  15. Improving Security Incidents Detection for Networked Multilevel Intelligent Control Systems in Railway Transport

    Directory of Open Access Journals (Sweden)

    A. V. Chernov

    2016-06-01

    Full Text Available Security monitoring and incident management systems have become the main research focus in the area of intelligent railway control systems. In this work, we discuss a system architecture of multilevel intelligent control system in Russian Railway transport and security incident classification and the handling of theprocess. We make a detailed explanation of problems and tasks of security information and event management system as an important part of a multilevel intelligent control system. We use a rough sets theory to detect an abnormal activity in the considered system. Our main result consists in the development of simple and fast detection techniques that are based on rough sets theory and allow investigating a new type of incidents.

  16. Incidence of Type II CRISPR1-Cas Systems in Enterococcus Is Species-Dependent.

    Directory of Open Access Journals (Sweden)

    Casandra Lyons

    Full Text Available CRISPR-Cas systems, which obstruct both viral infection and incorporation of mobile genetic elements by horizontal transfer, are a specific immune response common to prokaryotes. Antiviral protection by CRISPR-Cas comes at a cost, as horizontally-acquired genes may increase fitness and provide rapid adaptation to habitat change. To date, investigations into the prevalence of CRISPR have primarily focused on pathogenic and clinical bacteria, while less is known about CRISPR dynamics in commensal and environmental species. We designed PCR primers and coupled these with DNA sequencing of products to detect and characterize the presence of cas1, a universal CRISPR-associated gene and proxy for the Type II CRISPR1-Cas system, in environmental and non-clinical Enterococcus isolates. CRISPR1-cas1 was detected in approximately 33% of the 275 strains examined, and differences in CRISPR1 carriage between species was significant. Incidence of cas1 in E. hirae was 73%, nearly three times that of E. faecalis (23.6% and 10 times more frequent than in E. durans (7.1%. Also, this is the first report of CRISPR1 presence in E. durans, as well as in the plant-associated species E. casseliflavus and E. sulfureus. Significant differences in CRISPR1-cas1 incidence among Enterococcus species support the hypothesis that there is a tradeoff between protection and adaptability. The differences in the habitats of enterococcal species may exert varying selective pressure that results in a species-dependent distribution of CRISPR-Cas systems.

  17. Incidence of Type II CRISPR1-Cas Systems in Enterococcus Is Species-Dependent

    Science.gov (United States)

    Lyons, Casandra; Raustad, Nicole; Bustos, Mario A.; Shiaris, Michael

    2015-01-01

    CRISPR-Cas systems, which obstruct both viral infection and incorporation of mobile genetic elements by horizontal transfer, are a specific immune response common to prokaryotes. Antiviral protection by CRISPR-Cas comes at a cost, as horizontally-acquired genes may increase fitness and provide rapid adaptation to habitat change. To date, investigations into the prevalence of CRISPR have primarily focused on pathogenic and clinical bacteria, while less is known about CRISPR dynamics in commensal and environmental species. We designed PCR primers and coupled these with DNA sequencing of products to detect and characterize the presence of cas1, a universal CRISPR-associated gene and proxy for the Type II CRISPR1-Cas system, in environmental and non-clinical Enterococcus isolates. CRISPR1-cas1 was detected in approximately 33% of the 275 strains examined, and differences in CRISPR1 carriage between species was significant. Incidence of cas1 in E. hirae was 73%, nearly three times that of E. faecalis (23.6%) and 10 times more frequent than in E. durans (7.1%). Also, this is the first report of CRISPR1 presence in E. durans, as well as in the plant-associated species E. casseliflavus and E. sulfureus. Significant differences in CRISPR1-cas1 incidence among Enterococcus species support the hypothesis that there is a tradeoff between protection and adaptability. The differences in the habitats of enterococcal species may exert varying selective pressure that results in a species-dependent distribution of CRISPR-Cas systems. PMID:26600384

  18. Estimating Concussion Incidence Using Sports Injury Surveillance Systems: Complexities and Potential Pitfalls.

    Science.gov (United States)

    Kerr, Zachary Y; Zuckerman, Scott L; Register-Mihalik, Johna K; Wasserman, Erin B; Valovich McLeod, Tamara C; Dompier, Thomas P; Comstock, R Dawn; Marshall, Stephen W

    2017-08-01

    Numerous sports injury surveillance systems exist with the capability of tracking concussion incidence data. It is important for the consumers of sport-related concussion data, be they researchers or the public, to have a comprehensive understanding of the strengths and limitations of sports injury surveillance systems. This article discusses issues of system design and analysis that affect the interpretation and understanding of sport-related concussion incidence data from sports injury surveillance systems. Such understanding will help inform the design of sports injury surveillance systems and research studies that aim to identify risk factors, develop prevention strategies, and evaluate prevention mechanisms. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Effectiveness Analysis of a Part-Time Rapid Response System During Operation Versus Nonoperation.

    Science.gov (United States)

    Kim, Youlim; Lee, Dong Seon; Min, Hyunju; Choi, Yun Young; Lee, Eun Young; Song, Inae; Park, Jong Sun; Cho, Young-Jae; Jo, You Hwan; Yoon, Ho Il; Lee, Jae Ho; Lee, Choon-Taek; Do, Sang Hwan; Lee, Yeon Joo

    2017-06-01

    To evaluate the effect of a part-time rapid response system on the occurrence rate of cardiopulmonary arrest by comparing the times of rapid response system operation versus nonoperation. Retrospective cohort study. A 1,360-bed tertiary care hospital. Adult patients admitted to the general ward were screened. Data were collected over 36 months from rapid response system implementation (October 2012 to September 2015) and more than 45 months before rapid response system implementation (January 2009 to September 2012). None. The rapid response system operates from 7 AM to 10 PM on weekdays and from 7 AM to 12 PM on Saturdays. Primary outcomes were the difference of cardiopulmonary arrest incidence between pre-rapid response system and post-rapid response system periods and whether the rapid response system operating time affects the cardiopulmonary arrest incidence. The overall cardiopulmonary arrest incidence (per 1,000 admissions) was 1.43. Although the number of admissions per month and case-mix index were increased (3,555.18 vs 4,564.72, p rapid response system (1.60 vs 1.23; p = 0.021), and mortality (%) was unchanged (1.38 vs 1.33; p = 0.322). After rapid response system implementation, the cardiopulmonary arrest incidence significantly decreased by 40% during rapid response system operating times (0.82 vs 0.49/1,000 admissions; p = 0.001) but remained similar during rapid response system nonoperating times (0.77 vs 0.73/1,000 admissions; p = 0.729). The implementation of a part-time rapid response system reduced the cardiopulmonary arrest incidence based on the reduction of cardiopulmonary arrest during rapid response system operating times. Further analysis of the cost effectiveness of part-time rapid response system is needed.

  20. The Use of Virtual Reality in the Study of People's Responses to Violent Incidents

    Science.gov (United States)

    Rovira, Aitor; Swapp, David; Spanlang, Bernhard; Slater, Mel

    2009-01-01

    This paper reviews experimental methods for the study of the responses of people to violence in digital media, and in particular considers the issues of internal validity and ecological validity or generalisability of results to events in the real world. Experimental methods typically involve a significant level of abstraction from reality, with participants required to carry out tasks that are far removed from violence in real life, and hence their ecological validity is questionable. On the other hand studies based on field data, while having ecological validity, cannot control multiple confounding variables that may have an impact on observed results, so that their internal validity is questionable. It is argued that immersive virtual reality may provide a unification of these two approaches. Since people tend to respond realistically to situations and events that occur in virtual reality, and since virtual reality simulations can be completely controlled for experimental purposes, studies of responses to violence within virtual reality are likely to have both ecological and internal validity. This depends on a property that we call ‘plausibility’ – including the fidelity of the depicted situation with prior knowledge and expectations. We illustrate this with data from a previously published experiment, a virtual reprise of Stanley Milgram's 1960s obedience experiment, and also with pilot data from a new study being developed that looks at bystander responses to violent incidents. PMID:20076762

  1. The Use of Virtual Reality in the Study of People's Responses to Violent Incidents.

    Science.gov (United States)

    Rovira, Aitor; Swapp, David; Spanlang, Bernhard; Slater, Mel

    2009-01-01

    This paper reviews experimental methods for the study of the responses of people to violence in digital media, and in particular considers the issues of internal validity and ecological validity or generalisability of results to events in the real world. Experimental methods typically involve a significant level of abstraction from reality, with participants required to carry out tasks that are far removed from violence in real life, and hence their ecological validity is questionable. On the other hand studies based on field data, while having ecological validity, cannot control multiple confounding variables that may have an impact on observed results, so that their internal validity is questionable. It is argued that immersive virtual reality may provide a unification of these two approaches. Since people tend to respond realistically to situations and events that occur in virtual reality, and since virtual reality simulations can be completely controlled for experimental purposes, studies of responses to violence within virtual reality are likely to have both ecological and internal validity. This depends on a property that we call 'plausibility' - including the fidelity of the depicted situation with prior knowledge and expectations. We illustrate this with data from a previously published experiment, a virtual reprise of Stanley Milgram's 1960s obedience experiment, and also with pilot data from a new study being developed that looks at bystander responses to violent incidents.

  2. The use of virtual reality in the study of people's responses to violent incidents

    Directory of Open Access Journals (Sweden)

    Aitor Rovira

    2009-12-01

    Full Text Available This paper reviews experimental methods for the study of the responses of people to violence in digital media, and in particular considers the issues of internal validity on the one hand and ecological validity or generalisability of results to events in the real world. Experimental methods typically involve a significant level of abstraction from reality, with participants required to carry out tasks that are far removed from violence in real life, and hence their ecological validity is questionable. On the other hand studies based on field data, while having ecological validity, cannot control multiple confounding variables that may have an impact on observed results, so that their internal validity is questionable. It is argued that immersive virtual reality may provide a unification of these two approaches. Since people tend to respond realistically to situations and events that occur in virtual reality, and since virtual reality simulations can be completely controlled for experimental purposes, studies of responses to violence within virtual reality are likely to have both ecological and internal validity. This depends on a property that we call ‘plausibility’ – including the fidelity of the depicted situation with prior knowledge and expectations. We illustrate this with data from a previously published experiment, a virtual reprise of Stanley Milgram’s 1960s obedience experiment, and also with pilot data from a new study being developed that looks at bystander responses to violent incidents.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

  5. Incidence of systemic lupus erythematosus (SLE) in HIV seropositive ...

    African Journals Online (AJOL)

    Background: Viral agents especially retroviruses play either an aetiologic or contributory role in autoimmune diseases. Aim: To determine the rate of occurrence of systemic lupus erythematosus (SLE) in already confirmed HIV positive individuals. Methods: Subjects comprised of already diagnosed patients with HIV and ...

  6. Incidence of systemic lupus erythematosus (SLE) in HIV seropositive ...

    African Journals Online (AJOL)

    Abstract. Background: Viral agents especially retroviruses play either an aetiologic or contributory role in autoimmune diseases. Aim: To determine the rate of occurrence of systemic lupus erythematosus (SLE) in already confirmed HIV positive individuals. Methods: Subjects comprised of already diagnosed patients with HIV ...

  7. Patient safety incidents involving neuromuscular blockade: analysis of the UK National Reporting and Learning System data from 2006 to 2008.

    Science.gov (United States)

    Arnot-Smith, J; Smith, A F

    2010-11-01

    Neuromuscular blockade is a powerful anaesthetic tool that has the potential for significant adverse outcomes. We sought to explore the national picture by analysing incidents relating to neuromuscular blockade in anaesthesia from the National Reporting and Learning System from England and Wales between 2006 and 2008. We searched the database of incidents using SNOMED CT search terms and reading the free text of relevant incidents. There were 231 incidents arising from the use or reversal of neuromuscular blocking agents. The main themes identified were: non-availability of drugs (45 incidents, 19%), possible unintentional awareness under general anaesthesia (42 incidents, 18%), potential allergic reaction (31 incidents, 13%), problems with reversal of blockade (13 incidents, 6%), storage (13 incidents, 6%) and prolonged apnoea (11 incidents, 5%). We make recommendations to reduce human error in the use of neuromuscular blocking agents and on future incident reporting in anaesthesia. © 2010 The Authors. Anaesthesia © 2010 The Association of Anaesthetists of Great Britain and Ireland.

  8. Civil Support: DOD Needs to Clarify Its Roles and Responsibilities for Defense Support of Civil Authorities during Cyber Incidents

    Science.gov (United States)

    2016-04-01

    CIVIL SUPPORT DOD Needs to Clarify Its Roles and Responsibilities for Defense Support of Civil Authorities during...Clarify Its Roles and Responsibilities for Defense Support of Civil Authorities during Cyber Incidents Why GAO Did This Study Cyber threats to U.S...recognizes that the department plays a crucial role in supporting a national effort to confront cyber threats to critical infrastructure. House

  9. NRPB emergency response information system

    International Nuclear Information System (INIS)

    Higgins, N.A.; Casey, K.

    1993-01-01

    To enhance emergency response management NRPB has introduced an advanced information handling and map display facility. The NRPB Emergency Response Information System (NERIS) provides a central resource which holds, displays and analyses the available information on an accidental release of radioactivity. The bringing together of the commercial tools of computerised map display and database technology, capable of storing geographically referenced information, provided the initial building blocks for the development of NERIS. The rapid manipulation of the large amounts of data used by NERIS is achieved by the use of complex software on powerful computers and a substantial investment of both staff time and resources. The synthesis of these products with the analysis tools under development by NRPB staff will provide a system which will greatly enhance the organisation's emergency response capability. The need to assess the consequences of an accident and give advice on countermeasure strategies and actions will inevitably place high demands on NRPB staff. NERIS will enable a more complete understanding of the situation to be gained and give staff the time and tools to cope effectively with all exigencies. (Author)

  10. Benefits, barriers, and limitations on the use of Hospital Incident Command System

    Directory of Open Access Journals (Sweden)

    Shahin Shooshtari

    2017-01-01

    Full Text Available Hospital Incident Command System (HICS has been established with the mission of prevention, response, and recovery in hazards. Regarding the key role of hospitals in medical management of events, the present study is aimed at investigating benefits, barriers, and limitations of applying HICS in hospital. Employing a review study, articles related to the aforementioned subject published from 1995 to 2016 were extracted from accredited websites and databases such as PubMed, Google Scholar, Elsevier, and SID by searching keywords such as HICS, benefits, barriers, and limitations. Then, those articles were summarized and reported. Using of HICS can cause creating preparedness in facing disasters, constructive management in strategies of controlling events, and disasters. Therefore, experiences indicate that there are some limitations in the system such as failure to assess the strength and severity of vulnerabilities of hospital, no observation of standards for disaster management in the design, constructing and equipping hospitals, and the absence of a model for evaluating the system. Accordingly, the conducted studies were investigated for probing the performance HICS. With regard to the role of health in disaster management, it requires advanced international methods in facing disasters. Using accurate models for assessing, the investigation of preparedness of hospitals in precrisis conditions based on components such as command, communications, security, safety, development of action plans, changes in staff's attitudes through effective operational training and exercises and creation of required maneuvers seems necessary.

  11. Meteorological Integration for the Biological Warning and Incident Characterization (BWIC) System: General Guidance for BWIC Cities

    Energy Technology Data Exchange (ETDEWEB)

    Shaw, William J.; Wang, Weiguo; Rutz, Frederick C.; Chapman, Elaine G.; Rishel, Jeremy P.; Xie, YuLong; Seiple, Timothy E.; Allwine, K Jerry

    2007-02-16

    The U.S. Department of Homeland Security (DHS) is responsible for developing systems to detect the release of aerosolized bioagents in urban environments. The system that accomplishes this, known as BioWatch, is a robust first-generation monitoring system. In conjunction with the BioWatch detection network, DHS has also developed a software tool for cities to use to assist in their response when a bioagent is detected. This tool, the Biological Warning and Incident Characterization (BWIC) System, will eventually be deployed to all BioWatch cities to aid in the interpretation of the public health significance of indicators from the BioWatch networks. BWIC consists of a set of integrated modules, including meteorological models, that estimate the effect of a biological agent on a city’s population once it has been detected. For the meteorological models in BWIC to successfully calculate the distribution of biological material, they must have as input accurate meteorological data, and wind fields in particular. The purpose of this document is to provide guidance for cities to use in identifying sources of good-quality local meteorological data that BWIC needs to function properly. This process of finding sources of local meteorological data, evaluating the data quality and gaps in coverage, and getting the data into BWIC, referred to as meteorological integration, is described. The good news for many cities is that meteorological measurement networks are becoming increasingly common. Most of these networks allow their data to be distributed in real time via the internet. Thus, cities will often only need to evaluate the quality of available measurements and perhaps add a modest number of stations where coverage is poor.

  12. Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

    Directory of Open Access Journals (Sweden)

    Hansen Elisabeth

    2009-07-01

    Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

  13. TU-D-201-04: Veracity of Data Elements in Radiation Oncology Incident Learning Systems

    Energy Technology Data Exchange (ETDEWEB)

    Kapur, A [Northwell Health System, New Hyde Park, NY (United States); Evans, S [Yale University New Haven, CT (United States); Brown, D [University of California, San Diego, La Jolla, CA (United States); Ezzell, G [Mayo Clinic Arizona, Phoenix, AZ (United States); Hoopes, D [The University of California San Diego, San Diego, CA (United States); Dieterich, S [UC Davis Medical Center, Sacramento, CA (United States); Kapetanovic, K; Tomlinson, C [American Society for Radiation Oncology, Fairfax, VA (United States)

    2016-06-15

    Purpose: Incident learning systems encompass volumes, varieties, values, and velocities of underlying data elements consistent with the V’s of big data. Veracity, the 5th V however exists only if there is high inter-rater reliability (IRR) within the data elements. The purpose of this work was to assess IRR in the nationally deployed RO-ILS: Radiation Oncology-Incident Learning System (R) sponsored by the American Society for Radiation Oncology (ASTRO) and the American Association of Physicists in Medicine (AAPM). Methods: Ten incident reports covering a wide range of scenarios were created in standardized narrative and video formats and disseminated to 67 volunteers of multiple disciplines from 26 institutions along with two published narratives from the International Commission of Radiological Protection to assess IRR on a nationally representative level. The volunteers were instructed to independently enter the associated data elements in a test version of RO-ILS over a 3-week period. All responses were aggregated into a spreadsheet to assess IRR using free-marginal kappa metrics. Results: 48 volunteers from 21 institutions completed all reports in the study period. The average kappa score for all raters across all critical data elements was 0.659 [range 0.326–1.000]. Statistically significant differences (p <0.05) were noted between reporters of different disciplines and raters with varying levels of experience. Kappa scores were high for event classification (0.781) and contributory factors (0.777) and low for likelihood-of-harm (0.326). IRR was highest among AAPM-ASTRO members (0.672) and lowest among trainees (0.463). Conclusion: A moderate-to-substantial level of IRR in RO-ILS was noted in this study. Although the number of events reviewed in this study was small, opportunities for improving the taxonomy for the lower scoring data elements as well as specific educational targets for training were identified by assessing data veracity quantitatively

  14. TU-D-201-04: Veracity of Data Elements in Radiation Oncology Incident Learning Systems

    International Nuclear Information System (INIS)

    Kapur, A; Evans, S; Brown, D; Ezzell, G; Hoopes, D; Dieterich, S; Kapetanovic, K; Tomlinson, C

    2016-01-01

    Purpose: Incident learning systems encompass volumes, varieties, values, and velocities of underlying data elements consistent with the V’s of big data. Veracity, the 5th V however exists only if there is high inter-rater reliability (IRR) within the data elements. The purpose of this work was to assess IRR in the nationally deployed RO-ILS: Radiation Oncology-Incident Learning System (R) sponsored by the American Society for Radiation Oncology (ASTRO) and the American Association of Physicists in Medicine (AAPM). Methods: Ten incident reports covering a wide range of scenarios were created in standardized narrative and video formats and disseminated to 67 volunteers of multiple disciplines from 26 institutions along with two published narratives from the International Commission of Radiological Protection to assess IRR on a nationally representative level. The volunteers were instructed to independently enter the associated data elements in a test version of RO-ILS over a 3-week period. All responses were aggregated into a spreadsheet to assess IRR using free-marginal kappa metrics. Results: 48 volunteers from 21 institutions completed all reports in the study period. The average kappa score for all raters across all critical data elements was 0.659 [range 0.326–1.000]. Statistically significant differences (p <0.05) were noted between reporters of different disciplines and raters with varying levels of experience. Kappa scores were high for event classification (0.781) and contributory factors (0.777) and low for likelihood-of-harm (0.326). IRR was highest among AAPM-ASTRO members (0.672) and lowest among trainees (0.463). Conclusion: A moderate-to-substantial level of IRR in RO-ILS was noted in this study. Although the number of events reviewed in this study was small, opportunities for improving the taxonomy for the lower scoring data elements as well as specific educational targets for training were identified by assessing data veracity quantitatively

  15. Global Stability of Delayed Viral Infection Models with Nonlinear Antibody and CTL Immune Responses and General Incidence Rate

    OpenAIRE

    Miao, Hui; Teng, Zhidong; Li, Zhiming

    2016-01-01

    The dynamical behaviors for a five-dimensional viral infection model with three delays which describes the interactions of antibody, cytotoxic T-lymphocyte (CTL) immune responses, and nonlinear incidence rate are investigated. The threshold values for viral infection, antibody response, CTL immune response, CTL immune competition, and antibody competition, respectively, are established. Under certain assumptions, the threshold value conditions on the global stability of the infection-free, im...

  16. An Evaluation of Departmental Radiation Oncology Incident Reports: Anticipating a National Reporting System

    International Nuclear Information System (INIS)

    Terezakis, Stephanie A.; Harris, Kendra M.; Ford, Eric; Michalski, Jeff; DeWeese, Theodore; Santanam, Lakshmi; Mutic, Sasa; Gay, Hiram

    2013-01-01

    Purpose: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface, (6) error at the software-hardware interface, and (7) error at the human-hardware interface. Results: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement

  17. An Evaluation of Departmental Radiation Oncology Incident Reports: Anticipating a National Reporting System

    Energy Technology Data Exchange (ETDEWEB)

    Terezakis, Stephanie A., E-mail: stereza1@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Harris, Kendra M. [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Ford, Eric [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Department of Radiation Oncology, University of Washington, Seattle, Washington (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); DeWeese, Theodore [Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Santanam, Lakshmi; Mutic, Sasa; Gay, Hiram [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-03-15

    Purpose: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface, (6) error at the software-hardware interface, and (7) error at the human-hardware interface. Results: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement.

  18. Incidence of Systemic Lupus Erythematosus and Lupus Nephritis in Denmark: A Nationwide Cohort Study.

    Science.gov (United States)

    Hermansen, Marie-Louise F; Lindhardsen, Jesper; Torp-Pedersen, Christian; Faurschou, Mikkel; Jacobsen, Søren

    2016-07-01

    To determine the incidence of systemic lupus erythematosus (SLE) and SLE with concomitant or subsequent lupus nephritis (LN) in Denmark during 1995-2011, using data from the Danish National Patient Registry (NPR). To assess the incidence of SLE, we identified all persons aged ≥ 18 years in the NPR with at least 1 International Classification of Diseases, 10th ed (ICD-10) code of SLE and at least 365 days of followup under this diagnosis. Identification of LN cases was based on fulfillment of these criteria and ≥ 1 registration under an ICD-10 code of nephritis concomitantly with or after first SLE registration. The overall annual incidence rate per 100,000 for SLE was 2.35 (95% CI 2.24-2.49); 0.69 (95% CI 0.60-0.78) for men and 3.96 (95% CI 3.75-4.17) for women. For LN, the mean annual incidence rate per 100,000 was estimated to be 0.45 (95% CI 0.38-0.53); 0.20 (95% CI 0.13-0.28) for men and 0.69 (95% CI 0.57-0.83) for women. The differences in SLE incidence rates between sexes decreased by age, and the incidence did not differ between men and women after the age of 60 years for LN. The estimated incidences showed no trends by calendar time. Estimated overall point prevalence (December 31, 2011) per 100,000 was 45.2 (95% CI 43.3-47.4) and 6.4 (95% CI 5.7-7.2) for SLE and LN, respectively. Our Danish population-based data showed a stable incidence of SLE and LN. As expected, we found higher incidence rates among women than among men, particularly in younger persons.

  19. 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.

  20. Pharmaceutical sales of pseudoephedrine: the impact of electronic tracking systems on methamphetamine crime incidents.

    Science.gov (United States)

    Mazerolle, Lorraine; McGuffog, Ingrid; Ferris, Jason; Chamlin, Mitchell B

    2017-03-01

    Electronic tracking systems (ETS) are used extensively in pharmacies across the United States and Australia to control suspicious sales of pseudoephedrine. This study measures the impact of one ETS-Project STOP-on the capacity of police to reduce production, supply and possession of methamphetamine. Using official police data of incidents of production, supply and possession from January 1996 to December 2011 (n = 192 data points/months over 16 years), we used a quasi-experimental, time-series approach. The State of Queensland, Australia. No individual participants are included in the study. The unit of analysis is reported police incidents. The study examines the impact of the ETS on production (n = 5938 incidents), drug supply and trafficking (n = 20 094 incidents) and drug possession or use (n = 118 926) of methamphetamine. Introduction of the ETS in November 2005 was associated with an insignificant decrease (P = 0.15) in the production of methamphetamine. The intervention was associated with a statistically significant increase in supply incidents (P = 0.0001). There was no statistically significant effect on the incidence of possession (P = 0.59). Electronic tracking systems can reduce the capacity of people to produce methamphetamine domestically, but seem unlikely to affect other aspects of the methamphetamine problem such as possession, distribution and importation. © 2016 Society for the Study of Addiction.

  1. Quality review of an adverse incident reporting system and root cause analysis of serious adverse surgical incidents in a teaching hospital of Scotland

    Directory of Open Access Journals (Sweden)

    Khorsandi Maziar

    2012-08-01

    Full Text Available Abstract Background A significant proportion of surgical patients are unintentionally harmed during their hospital stay. Root Cause Analysis (RCA aims to determine the aetiology of adverse incidents that lead to patient harm and produce a series of recommendations, which would minimise the risk of recurrence of similar events, if appropriately applied to clinical practice. A review of the quality of the adverse incident reporting system and the RCA of serious adverse incidents at the Department of Surgery of Ninewells hospital, in Dundee, United Kingdom was performed. Methods The Adverse Incident Management (AIM database of the Department of Surgery of Ninewells Hospital was retrospectively reviewed. Details of all serious (red, sentinel incidents recorded between May 2004 and December 2009, including the RCA reports and outcomes, where applicable, were reviewed. Additional related information was gathered by interviewing the involved members of staff. Results The total number of reported surgical incidents was 3142, of which 81 (2.58% cases had been reported as red or sentinel. 19 of the 81 incidents (23.4% had been inappropriately reported as red. In 31 reports (38.2% vital information with regards to the details of the adverse incidents had not been recorded. In 12 cases (14.8% the description of incidents was of poor quality. RCA was performed for 47 cases (58% and only 12 cases (15% received recommendations aiming to improve clinical practice. Conclusion The results of our study demonstrate the need for improvement in the quality of incident reporting. There are enormous benefits to be gained by this time and resource consuming process, however appropriate staff training on the use of this system is a pre-requisite. Furthermore, sufficient support and resources are required for the implementation of RCA recommendations in clinical practice.

  2. Medication incidents related to automated dose dispensing in community pharmacies and hospitals--a reporting system study.

    Directory of Open Access Journals (Sweden)

    Ka-Chun Cheung

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

  3. Development of a staff recall system for mass casualty incidents using cell phone text messaging.

    Science.gov (United States)

    Epstein, Richard H; Ekbatani, Ali; Kaplan, Javier; Shechter, Ronen; Grunwald, Zvi

    2010-03-01

    After a mass casualty incident (MCI), rapid mobilization of hospital personnel is required because of an expected surge of victims. Risk assessment of our department's manual phone tree recall system revealed multiple weaknesses that would limit an effective response. Because cell phone use is widespread within the department, we developed and tested a staff recall system, based in our anesthesia information management system (AIMS), using Short Message Service (SMS) text messaging. We sent test text messages to anesthesia staff members' cell phone numbers, determined the distance from their home to the hospital, and stored this information in our AIMS. Latency testing for the time from transmission of SMS test messages from the server to return of an e-mail reply was determined at 2 different times on 2 different dates, 1 of which was a busy holiday weekend, using volunteers within the department. Two unannounced simulated disaster recall drills were conducted, with text messages sent asking for the anticipated time to return to the hospital. A timeline of available staff on site was determined. Reasons for failure to respond to the disaster notification message were tabulated. Latency data were fit by a log-normal distribution with an average of 82 seconds from message transmission to e-mail reply. Replies to the simulated disaster alert were received from approximately 50% of staff, with 16 projecting that they would have been able to be back at the hospital within 30 minutes on both dates. There would have been 21 and 23 staff in-house at 30 minutes, and 32 and 37 staff in-house at 60 minutes on the first and second test date, respectively, including in-house staff. Of the nonresponders to the alert, 48% indicated that their cell phone was not with them or was turned off, whereas 22% missed the message. Our SMS staff recall system is likely to be able to rapidly mobilize sufficient numbers of anesthesia personnel in response to an MCI, but actual performance

  4. Molecular typing of Staphylococcus aureus isolate responsible for staphylococcal poisoning incident in homemade food

    Directory of Open Access Journals (Sweden)

    Guerrino Macori

    2016-06-01

    Full Text Available In October 2012, two persons fell ill with symptoms consistent with staphylococcal food poisoning after eating home-canned tuna fish and tomatoes. Laboratory investigation detected the enterotoxins in the home-canned tuna and molecular analysis of the isolated Staphylococcus aureus confirmed it carried toxin genes. Qualitative enzyme-linked immunosorbent assay and enzime linked fluorescent assay methods and quantitative assay identified the enterotoxins in the food leftovers, specifically staphylococcal enterotoxins type A (SEA and D (SED, respectively 0.49 and 2.04 ng/g. The laboratory results are discussed considering the relation to the fish in oil, survival and heat resistance of S. aureus, and presumptive microbial contamination due to improper handling during home-canning procedures. This is the first reported cluster of foodborne illnesses due to staphylococcal enterotoxins in tuna in Italy. In this study, we reported cases described and analysed for their spa-type. Showing a high heterogeneity of isolates, spa-type t13252 is correlated in a node of the minimum spanning tree and it has never been reported as responsible for foodborne outbreak. This case underlines the importance of risk communication and dissemination of home-canning guidelines to reduce the incidence of foodborne outbreaks caused by homemade conserves.

  5. HASCAL -- A system for estimating contamination and doses from incidents at worldwide nuclear facilities

    International Nuclear Information System (INIS)

    Sjoreen, A.L.

    1995-01-01

    The Hazard Assessment System for Consequence Analysis (HASCAL) is being developed to support the analysis of radiological incidents anywhere in the world for the Defense Nuclear Agency (DNA). HASCAL is a component of the Hazard Prediction and Assessment Capability (HPAC), which is a comprehensive nuclear, biological, and chemical hazard effects planning and forecasting modeling system that is being developed by DNA. HASCAL computes best-guess estimates of the consequences of radiological incidents. HASCAL estimates the amount of radioactivity released, its atmospheric transport and deposition, and the resulting radiological doses

  6. Intelligent Ramp Control for Incident Response Using Dyna-Q Architecture

    Directory of Open Access Journals (Sweden)

    Chao Lu

    2015-01-01

    Full Text Available Reinforcement learning (RL has shown great potential for motorway ramp control, especially under the congestion caused by incidents. However, existing applications limited to single-agent tasks and based on Q-learning have inherent drawbacks for dealing with coordinated ramp control problems. For solving these problems, a Dyna-Q based multiagent reinforcement learning (MARL system named Dyna-MARL has been developed in this paper. Dyna-Q is an extension of Q-learning, which combines model-free and model-based methods to obtain benefits from both sides. The performance of Dyna-MARL is tested in a simulated motorway segment in the UK with the real traffic data collected from AM peak hours. The test results compared with Isolated RL and noncontrolled situations show that Dyna-MARL can achieve a superior performance on improving the traffic operation with respect to increasing total throughput, reducing total travel time and CO2 emission. Moreover, with a suitable coordination strategy, Dyna-MARL can maintain a highly equitable motorway system by balancing the travel time of road users from different on-ramps.

  7. Sensitivity of routine system for reporting patient safety incidents in an NHS hospital: retrospective patient case note review.

    Science.gov (United States)

    Sari, Ali Baba-Akbari; Sheldon, Trevor A; Cracknell, Alison; Turnbull, Alastair

    2007-01-13

    To evaluate the performance of a routine incident reporting system in identifying patient safety incidents. Two stage retrospective review of patients' case notes and analysis of data submitted to the routine incident reporting system on the same patients. A large NHS hospital in England. 1006 hospital admissions between January and May 2004: surgery (n=311), general medicine (n=251), elderly care (n=184), orthopaedics (n=131), urology (n=61), and three other specialties (n=68). Proportion of admissions with at least one patient safety incident; proportion and type of patient safety incidents missed by routine incident reporting and case note review methods. 324 patient safety incidents were identified in 230/1006 admissions (22.9%; 95% confidence interval 20.3% to 25.5%). 270 (83%) patient safety incidents were identified by case note review only, 21 (7%) by the routine reporting system only, and 33 (10%) by both methods. 110 admissions (10.9%; 9.0% to 12.8%) had at least one patient safety incident resulting in patient harm, all of which were detected by the case note review and six (5%) by the reporting system. The routine incident reporting system may be poor at identifying patient safety incidents, particularly those resulting in harm. Structured case note review may have a useful role in surveillance of routine incident reporting and associated quality improvement programmes.

  8. On experimental determination of the random-incidence response of microphones

    DEFF Research Database (Denmark)

    Barrera Figueroa, Salvador; Rasmussen, Knud; Jacobsen, Finn

    2007-01-01

    The random-incidence sensitivity of a microphone is defined as the ratio of the output voltage to the sound pressure that would exist at the position of the acoustic center of the microphone in the absence of the microphone in a sound field with incident plane waves coming from all directions. Th...

  9. Nuclear power plant operating experiences from the IAEA / Nea incident reporting system 2002-2005

    International Nuclear Information System (INIS)

    2006-01-01

    The Incident Reporting System (IRS) is an essential element of the international operating experience feedback system for nuclear power plants. The IRS is jointly operated and managed by the Nuclear Energy Agency (NEA), a semi-autonomous body within the Organisation for Economic Co-operation and Development (OECD), and the International Atomic Energy Agency (IAEA), a specialized agency within the United Nations System. (author)

  10. Incident and Trafficking Database: New Systems for Reporting and Accessing State Information

    International Nuclear Information System (INIS)

    Dimitrovski, D.; Kittley, S.

    2015-01-01

    The IAEA's Incident and Trafficking Database (ITDB) is the Agency's authoritative source for information on incidents in which nuclear and other radioactive material is out of national regulatory control. It was established in 1995 and, as of June 2014, 126 States participate in the ITDB programme. Currently, the database contains over 2500 confirmed incidents, out of which 21% involve nuclear material, 62% radioactive source and 17% radioactively contaminated material. In recent years, the system for States to report incidents to the ITDB has been evolving — moving from fax-based to secure email and most recently to secure on-line reporting. A Beta version of the on-line system was rolled out this June, offering a simple, yet secure, communication channel for member states to provide information. In addition the system serves as a central hub for information related to official communication of the IAEA with Member States so some communication that is traditionally shared by e-mail does not get lost when ITDB counterparts change. In addition the new reporting system incorporates optional features that allow multiple Member State users to collaboratively contribute toward an INF. States are also being given secure on-line access to a streamlined version of the ITDB. This improves States' capabilities to retrieve and analyze information for their own purposes. In addition, on-line access to ITDB statistical information on incidents is available to States through an ITDB Dashboard. The dashboard contains aggregate information on number and types of incidents, material involved, as well some other statistics related to the ITDB that is typically provided in the ITDB Quarterly reports. (author)

  11. Incidence and outcomes of primary central nervous system lymphoma in solid organ transplant recipients.

    Science.gov (United States)

    Mahale, Parag; Shiels, Meredith S; Lynch, Charles F; Engels, Eric A

    2018-02-01

    Primary central nervous system lymphoma (PCNSL) risk is greatly increased in immunosuppressed human immunodeficiency virus-infected people. Using data from the US transplant registry linked with 17 cancer registries (1987-2014), we studied PCNSL and systemic non-Hodgkin lymphoma (NHL) in 288 029 solid organ transplant recipients. Transplant recipients had elevated incidence for PCNSL compared with the general population (standardized incidence ratio = 65.1; N = 168), and this elevation was stronger than for systemic NHL (standardized incidence ratio=11.5; N = 2043). Compared to kidney recipients, PCNSL incidence was lower in liver recipients (adjusted incidence rate ratio [aIRR] = 0.52), similar in heart and/or lung recipients, and higher in other/multiple organ recipients (aIRR = 2.45). PCNSL incidence was higher in Asians/Pacific Islanders than non-Hispanic whites (aIRR = 2.09); after induction immunosuppression with alemtuzumab (aIRR = 3.12), monoclonal antibodies (aIRR = 1.83), or polyclonal antibodies (aIRR = 2.03); in recipients who were Epstein-Barr virus-seronegative at the time of transplant and at risk of primary infection (aIRR = 1.95); and within the first 1.5 years after transplant. Compared to other recipients, those with PCNSL had increased risk of death (adjusted hazard ratio [aHR] = 11.79) or graft failure/retransplantation (aHR = 3.24). Recipients with PCNSL also had higher mortality than those with systemic NHL (aHR = 1.48). In conclusion, PCNSL risk is highly elevated among transplant recipients, and it carries a poor prognosis. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  12. 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

  13. 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.

  14. Adult Perpetrator Gender Asymmetries in Child Sexual Assault Victim Selection: Results from the 2000 National Incident-Based Reporting System

    Science.gov (United States)

    McCloskey, Kathy A.; Raphael, Desreen N.

    2005-01-01

    Data from the 2000 National Incident-Based Reporting System (NIBRS) show that while males make up about nine out of every 10 adult sexual assault perpetrators, totaling about 26,878 incidents within the reporting period, females account for about one out of 10 perpetrators, totaling about 1,162 incidents. Male sexual assault perpetrators offend…

  15. RO-ILS: Radiation Oncology Incident Learning System: A report from the first year of experience.

    Science.gov (United States)

    Hoopes, David J; Dicker, Adam P; Eads, Nadine L; Ezzell, Gary A; Fraass, Benedick A; Kwiatkowski, Theresa M; Lash, Kathy; Patton, Gregory A; Piotrowski, Tom; Tomlinson, Cindy; Ford, Eric C

    2015-01-01

    Incident learning is a critical tool to improve patient safety. The Patient Safety and Quality Improvement Act of 2005 established essential legal protections to allow for the collection and analysis of medical incidents nationwide. Working with a federally listed patient safety organization (PSO), the American Society for Radiation Oncology and the American Association of Physicists in Medicine established RO-ILS: Radiation Oncology Incident Learning System (RO-ILS). This paper provides an overview of the RO-ILS background, development, structure, and workflow, as well as examples of preliminary data and lessons learned. RO-ILS is actively collecting, analyzing, and reporting patient safety events. As of February 24, 2015, 46 institutions have signed contracts with Clarity PSO, with 33 contracts pending. Of these, 27 sites have entered 739 patient safety events into local database space, with 358 events (48%) pushed to the national database. To establish an optimal safety culture, radiation oncology departments should establish formal systems for incident learning that include participation in a nationwide incident learning program such as RO-ILS. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  16. Analysis of Aviation Safety Reporting System Incident Data Associated With the Technical Challenges of the Vehicle Systems Safety Technology Project

    Science.gov (United States)

    Withrow, Colleen A.; Reveley, Mary S.

    2014-01-01

    This analysis was conducted to support the Vehicle Systems Safety Technology (VSST) Project of the Aviation Safety Program (AVsP) milestone VSST4.2.1.01, "Identification of VSST-Related Trends." In particular, this is a review of incident data from the NASA Aviation Safety Reporting System (ASRS). The following three VSST-related technical challenges (TCs) were the focus of the incidents searched in the ASRS database: (1) Vechicle health assurance, (2) Effective crew-system interactions and decisions in all conditions; and (3) Aircraft loss of control prevention, mitigation, and recovery.

  17. Editorial: Incident command systems: A dynamic tension among goals, rules and practice

    NARCIS (Netherlands)

    Boersma, F.K.; Comfort, L.K.; Groenendaal, J.; Wolbers, J.J.

    2014-01-01

    This special issue examines the process of implementation, change and adaptation of Incident Command Systems (ICS) as a strategy for mobilizing and managing disaster operations in comparative perspective, focusing on ICS in practice in the United States, France, the Netherlands and Norway. Shorter

  18. Bystander responses to a violent incident in an immersive virtual environment.

    Science.gov (United States)

    Slater, Mel; Rovira, Aitor; Southern, Richard; Swapp, David; Zhang, Jian J; Campbell, Claire; Levine, Mark

    2013-01-01

    Under what conditions will a bystander intervene to try to stop a violent attack by one person on another? It is generally believed that the greater the size of the crowd of bystanders, the less the chance that any of them will intervene. A complementary model is that social identity is critical as an explanatory variable. For example, when the bystander shares common social identity with the victim the probability of intervention is enhanced, other things being equal. However, it is generally not possible to study such hypotheses experimentally for practical and ethical reasons. Here we show that an experiment that depicts a violent incident at life-size in immersive virtual reality lends support to the social identity explanation. 40 male supporters of Arsenal Football Club in England were recruited for a two-factor between-groups experiment: the victim was either an Arsenal supporter or not (in-group/out-group), and looked towards the participant for help or not during the confrontation. The response variables were the numbers of verbal and physical interventions by the participant during the violent argument. The number of physical interventions had a significantly greater mean in the in-group condition compared to the out-group. The more that participants perceived that the Victim was looking to them for help the greater the number of interventions in the in-group but not in the out-group. These results are supported by standard statistical analysis of variance, with more detailed findings obtained by a symbolic regression procedure based on genetic programming. Verbal interventions made during their experience, and analysis of post-experiment interview data suggest that in-group members were more prone to confrontational intervention compared to the out-group who were more prone to make statements to try to diffuse the situation.

  19. Bystander responses to a violent incident in an immersive virtual environment.

    Directory of Open Access Journals (Sweden)

    Mel Slater

    Full Text Available Under what conditions will a bystander intervene to try to stop a violent attack by one person on another? It is generally believed that the greater the size of the crowd of bystanders, the less the chance that any of them will intervene. A complementary model is that social identity is critical as an explanatory variable. For example, when the bystander shares common social identity with the victim the probability of intervention is enhanced, other things being equal. However, it is generally not possible to study such hypotheses experimentally for practical and ethical reasons. Here we show that an experiment that depicts a violent incident at life-size in immersive virtual reality lends support to the social identity explanation. 40 male supporters of Arsenal Football Club in England were recruited for a two-factor between-groups experiment: the victim was either an Arsenal supporter or not (in-group/out-group, and looked towards the participant for help or not during the confrontation. The response variables were the numbers of verbal and physical interventions by the participant during the violent argument. The number of physical interventions had a significantly greater mean in the in-group condition compared to the out-group. The more that participants perceived that the Victim was looking to them for help the greater the number of interventions in the in-group but not in the out-group. These results are supported by standard statistical analysis of variance, with more detailed findings obtained by a symbolic regression procedure based on genetic programming. Verbal interventions made during their experience, and analysis of post-experiment interview data suggest that in-group members were more prone to confrontational intervention compared to the out-group who were more prone to make statements to try to diffuse the situation.

  20. A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

    Science.gov (United States)

    Manser, Tanja; Imhof, Michael; Lessing, Constanze; Briner, Matthias

    2017-06-01

    This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. The survey was originally sent to 2136 hospitals in Germany and Switzerland. Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%). None. Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V. Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination. This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. Emergency response and radiation monitoring systems in Russian regions

    International Nuclear Information System (INIS)

    Arutyunyan, R.; Osipiyants, I.; Kiselev, V.; Ogar, K; Gavrilov, S.

    2008-01-01

    Full text: Preparedness of the emergency response system to elimination of radiation incidents and accidents is one of the most important elements of ensuring safe operation of nuclear power facilities. Routine activities on prevention of emergency situations along with adequate, efficient and opportune response actions are the key factors reducing the risks of adverse effects on population and environment. Both high engineering level and multiformity of the nuclear branch facilities make special demands on establishment of response system activities to eventual emergency situations. First and foremost, while resolving sophisticated engineering and scientific problems emerging during the emergency response process, one needs a powerful scientific and technical support system.The emergency response system established in the past decade in Russian nuclear branch provides a high efficiency of response activities due to the use of scientific and engineering potential and experience of the involved institutions. In Russia the responsibility for population protection is imposed on regional authority. So regional emergence response system should include up-to-date tools of radiation monitoring and infrastructure. That's why new activities on development of radiation monitoring and emergency response system were started in the regions of Russia. The main directions of these activities are: 1) Modernization of the existing and setting-up new facility and territorial automatic radiation monitoring systems, including mobile radiation surveillance kits; 2) Establishment of the Regional Crisis Centres and Crisis Centres of nuclear and radiation hazardous facilities; 3) Setting up communication systems for transfer, acquisition, processing, storage and presentation of data for participants of emergency response at the facility, regional and federal levels; 4) Development of software and hardware systems for expert support of decision-making on protection of personnel, population

  2. Safety incidents involving confused and forgetful older patients in a specialised care setting--analysis of the safety incidents reported to the HaiPro reporting system.

    Science.gov (United States)

    Kinnunen-Luovi, Kaisa; Saarnio, Reetta; Isola, Arja

    2014-09-01

    To describe the safety incidents involving confused and forgetful older patients in a specialised care setting entered in the HaiPro reporting system. About 10% of patients experience a safety incident during hospitalisation, which causes or could cause them harm. The possibility of a safety incident during hospitalisation increases significantly with age. A mild or moderate memory disorder and acute confusion are often present in the safety incidents originating with an older patient. The design of the study was action research with this study using findings from one of the first-phase studies, which included qualitative and quantitative analysed data. Data were collected from the reporting system for safety incidents (HaiPro) in a university hospital in Finland. There were 672 reported safety incidents from four acute medical wards during the years 2009-2011, which were scrutinised. Seventy-five of them were linked to a confused patient and were analysed. The majority of the safety incidents analysed involved patient-related accidents. In addition to challenging behaviour, contributing factors included ward routines, shortage of nursing staff, environmental factors and staff knowledge and skills. Nurses tried to secure the patient safety in many different ways, but the modes of actions were insufficient. Nursing staff need evidence-based information on how to assess the cognitive status of a confused patient and how to encounter such patients. The number of nursing staff and ward routines should be examined critically and put in proportion to the care intensity demands caused by the patient's confused state. The findings can be used as a starting point in the prevention of safety incidents and in improving the care of older patients. © 2013 John Wiley & Sons Ltd.

  3. National Emergency Preparedness and Response: Improving for Incidents of National Significance

    National Research Council Canada - National Science Library

    Clayton, Christopher M

    2006-01-01

    .... More appropriately, the Department of Defense (DoD), the Department of Homeland Security (DHS), and the states need to become better partners in planning for, exercising for, and responding to Incidents of National Significance...

  4. NOAA's Office of Response and Restoration: Historical Oil and Chemical Spill Incidents Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Historical Incidents database contains reports and images from oil and chemical spills that occurred between 1968 and 2002. The database includes reports on...

  5. Prevention of a wrong-location misadministration through the use of an intradepartmental incident learning system

    Energy Technology Data Exchange (ETDEWEB)

    Ford, Eric C.; Smith, Koren; Harris, Kendra; Terezakis, Stephanie [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231 (United States)

    2012-11-15

    Purpose: A series of examples are presented in which potential errors in the delivery of radiation therapy were prevented through use of incident learning. These examples underscore the value of reporting near miss incidents. Methods: Using a departmental incident learning system, eight incidents were noted over a two-year period in which fields were treated 'out-of-sequence,' that is, fields from a boost phase were treated, while the patient was still in the initial phase of treatment. As a result, an error-prevention policy was instituted in which radiation treatment fields are 'hidden' within the oncology information system (OIS) when they are not in current use. In this way, fields are only available to be treated in the intended sequence and, importantly, old fields cannot be activated at the linear accelerator control console. Results: No out-of-sequence treatments have been reported in more than two years since the policy change. Furthermore, at least three near-miss incidents were detected and corrected as a result of the policy change. In the first two, the policy operated as intended to directly prevent an error in field scheduling. In the third near-miss, the policy operated 'off target' to prevent a type of error scenario that it was not directly intended to prevent. In this incident, an incorrect digitally reconstructed radiograph (DRR) was scheduled in the OIS for a patient receiving lung cancer treatment. The incorrect DRR had an isocenter which was misplaced by approximately two centimeters. The error was a result of a field from an old plan being scheduled instead of the intended new plan. As a result of the policy described above, the DRR field could not be activated for treatment however and the error was discovered and corrected. Other quality control barriers in place would have been unlikely to have detected this error. Conclusions: In these examples, a policy was adopted based on incident learning, which

  6. Prevention of a wrong-location misadministration through the use of an intradepartmental incident learning system

    International Nuclear Information System (INIS)

    Ford, Eric C.; Smith, Koren; Harris, Kendra; Terezakis, Stephanie

    2012-01-01

    Purpose: A series of examples are presented in which potential errors in the delivery of radiation therapy were prevented through use of incident learning. These examples underscore the value of reporting near miss incidents. Methods: Using a departmental incident learning system, eight incidents were noted over a two-year period in which fields were treated “out-of-sequence,” that is, fields from a boost phase were treated, while the patient was still in the initial phase of treatment. As a result, an error-prevention policy was instituted in which radiation treatment fields are “hidden” within the oncology information system (OIS) when they are not in current use. In this way, fields are only available to be treated in the intended sequence and, importantly, old fields cannot be activated at the linear accelerator control console. Results: No out-of-sequence treatments have been reported in more than two years since the policy change. Furthermore, at least three near-miss incidents were detected and corrected as a result of the policy change. In the first two, the policy operated as intended to directly prevent an error in field scheduling. In the third near-miss, the policy operated “off target” to prevent a type of error scenario that it was not directly intended to prevent. In this incident, an incorrect digitally reconstructed radiograph (DRR) was scheduled in the OIS for a patient receiving lung cancer treatment. The incorrect DRR had an isocenter which was misplaced by approximately two centimeters. The error was a result of a field from an old plan being scheduled instead of the intended new plan. As a result of the policy described above, the DRR field could not be activated for treatment however and the error was discovered and corrected. Other quality control barriers in place would have been unlikely to have detected this error. Conclusions: In these examples, a policy was adopted based on incident learning, which prevented several errors

  7. Systems analysis of voluntary reported anaesthetic safety incidents occurring in a university teaching hospital.

    Science.gov (United States)

    McMillan, Matthew W; Lehnus, Kristina S

    2018-01-01

    To identify factors contributing to the development of anaesthetic safety incidents. Prospective, descriptive, voluntary reporting audit of safety incidents with subsequent systems analysis. All animals anaesthetized in a multispecies veterinary teaching hospital from November 2014 to October 2016. Peri-anaesthetic incidents that risked or caused unnecessary harm to an animal were reported by anaesthetists alongside animal morbidity and mortality data. A modified systems analysis framework was used to identify contributing factors from the following categories: Animal and Owner, Task and Technology, Individual, Team, Work Environmental, and Organizational and Management. The outcome was graded using a simple descriptive scale. Data were analysed using Pearson's Chi-Square test for association and univariable and multivariable logistic regression analysis. Totally, 3379 anaesthetics were performed during the audit period. Of these, 174 incident reports were analysed, 163 of which impacted safe veterinary care and 26 incidents were considered to have had major or catastrophic outcomes. Incident outcome was believed to have been limited by anaesthetist intervention in 104 (63.8%) cases. Various factors were identified as: Individual in 123 (70.7%), Team in 108 (62.1%), Organizational and Management in 94 (54.0%), Task and Technology in 80 (46.0%), Work Environmental in 53 (30.5%) and Animal and Owner in 36 (20.7%) incidents. Individual factors were rarely seen in isolation. Significant associations were identified between Experience and Supervision, X 2 (1, n=174)=54177, p=0.001, Failure to follow a standard operating procedure and Task Management, X 2 (2, n=174)=11318, p=0.001, and Staffing and Poor Scheduling, X 2 (1, n=174)=36742, p=0.001. Animal Condition [odds ratio (OR)=16210, 95% confidence interval (CI)=5573-47147)] and anaesthetist Decision Making (OR=3437, 95% CI=1184-9974) were risk factors for catastrophic and major outcomes. Individual factors contribute

  8. Sunlight Responsive Thermochromic Window System

    Energy Technology Data Exchange (ETDEWEB)

    Millett, F,A; Byker,H, J

    2006-10-27

    Pleotint has embarked on a novel approach with our Sunlight Responsive Thermochromic, SRT™, windows. We are integrating dynamic sunlight control, high insulation values and low solar heat gain together in a high performance window. The Pleotint SRT window is dynamic because it reversibly changes light transmission based on thermochromics activated directly by the heating effect of sunlight. We can achieve a window package with low solar heat gain coefficient (SHGC), a low U value and high insulation. At the same time our windows provide good daylighting. Our innovative window design offers architects and building designers the opportunity to choose their desired energy performance, excellent sound reduction, external pane can be self-cleaning, or a resistance to wind load, blasts, bullets or hurricanes. SRT windows would provide energy savings that are estimated at up to 30% over traditional window systems. Glass fabricators will be able to use existing equipment to make the SRT window while adding value and flexibility to the basic design. Glazing installers will have the ability to fit the windows with traditional methods without wires, power supplies and controllers. SRT windows can be retrofit into existing buildings,

  9. National critical incident reporting systems relevant to anaesthesia: a European survey.

    Science.gov (United States)

    Reed, S; Arnal, D; Frank, O; Gomez-Arnau, J I; Hansen, J; Lester, O; Mikkelsen, K L; Rhaiem, T; Rosenberg, P H; St Pierre, M; Schleppers, A; Staender, S; Smith, A F

    2014-03-01

    Critical incident reporting is a key tool in the promotion of patient safety in anaesthesia. We surveyed representatives of national incident reporting systems in six European countries, inviting information on scope and organization, and intelligence on factors determining success and failure. Some systems are government-run and nationally conceived; others started out as small, specialty-focused initiatives, which have since acquired a national reach. However, both national co-ordination and specialty enthusiasts seem to be necessary for an optimally functioning system. The role of reporting culture, definitional issues, and dissemination is discussed. We make recommendations for others intending to start new systems and speculate on the prospects for sharing patient safety lessons relevant to anaesthesia at European level.

  10. Environmental factors responsible for the incidence of antibiotic resistance genes in pristine Crassostrea virginica reefs

    International Nuclear Information System (INIS)

    Barkovskii, Andrei L.; Thomas, Michael; Hurley, Dorset; Teems, Clifford

    2012-01-01

    Highlights: ► Estuary was the major source of antibiotic resistance genes (ARG) for tidal creeks. ► Watersheds were the secondary source of ARG for tidal creeks. ► Watershed contribution corresponded to the degree of its anthropogenic disturbance. ► ARG in tidal creeks were carried by native hosts preferring low termohaline niches. ► ARG incidence was the highest in oysters implying ARG bioaccumulation/proliferation. - Abstract: The occurrence of tetracycline resistance (TRG) and integrase (INT) genes were monitored in Crassostrea virginica oyster reefs of three pristine creeks (SINERR, Georgia, USA). Their profiles revealed 85% similarity with the TRG/INT profiles observed in the adjacent to the SINERR and contaminated Altamaha River estuary (Barkovskii et al., 2010). The TRG/INT spectra and incidence frequencies corresponded to the source of oceanic input and to run-offs from creeks’ watersheds. The highest incidence frequencies and concentrations were observed in oysters. TRG/INT incidences correlated positively (Spearman Rank = 0.88), and negatively correlated (−0.63 to −0.79) with creek salinity, conductivity, dissolved solids, and temperature. Coliform incidence positively correlated with temperature, and not with the TRG/INT incidence. The Altamaha River estuary was the primary TRG/INT source for the reefs with contributions from creek’s watersheds. TRG/INT were carried by non-coliforms with a preference for low-to-temperate thermohaline environments coupled with bioaccumulation by oysters.

  11. Attachment insecurity, responses to critical incident distress, and current emotional symptoms in ambulance workers.

    Science.gov (United States)

    Halpern, Janice; Maunder, Robert G; Schwartz, Brian; Gurevich, Maria

    2012-02-01

    Ambulance workers are exposed to critical incidents that may evoke intense distress and can result in long-term impairment. Individuals who can regulate distress may experience briefer post-incident distress and fewer long-term emotional difficulties. Attachment research has contributed to our understanding of individual differences in stress regulation, suggesting that secure attachment is associated with effective support-seeking and coping strategies, and fewer long-term difficulties. We tested the effect of attachment insecurity on emotional distress in ambulance workers, hypothesizing that (1) insecure attachment is associated with symptoms of current distress and (2) prolonged recovery from acute post-critical incident distress, coping strategies and supportive contact mediate this relationship. We measured (1) attachment insecurity, (2) acute distress, coping and social contact following an index critical incident and (3) current symptoms of post-traumatic stress, depression, somatization and burnout and tested the hypothesized associations. Fearful-avoidant insecure attachment was associated with all current symptoms, most strongly with depression (R=0.38, pinsecurity was also associated with maladaptive coping, reduced social support and slower recovery from social withdrawal and physical arousal following the critical incident, but these processes did not mediate the relationship between attachment insecurity and current symptoms. These findings are relevant for optimizing post-incident support for ambulance workers. Copyright © 2011 John Wiley & Sons, Ltd.

  12. A Modular Telerobot Control System for Accident Response

    International Nuclear Information System (INIS)

    Anderson, Robert J.; Shirey, David L.

    1999-01-01

    The Accident Response Mobile Manipulator System (ARMMS) is a teleoperated emergency response vehicle that deploys two hydraulic manipulators, five cameras, and an array of sensors to the scene of an incident. It is operated from a remote base station that can be situated up to four kilometers away from the site. Recently, a modular telerobot control architecture called SMART (Sandia's Modular Architecture for Robotic and Teleoperation) was applied to ARMMS to improve the precision, safety, and operability of the manipulators on board. Using SMART, a prototype manipulator control system was developed in a couple of days, and an integrated working system was demonstrated within a couple of months. New capabilities such as camera teleoperation, autonomous tool changeout and dual manipulator control have been incorporated. The final system incorporates twenty-two separate modules and implements eight different behavior modes. This paper describes the integration of SMART into the ARMMS system

  13. A Modular Telerobot Control System for Accident Response

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Robert J.; Shirey, David L.

    1999-07-20

    The Accident Response Mobile Manipulator System (ARMMS) is a teleoperated emergency response vehicle that deploys two hydraulic manipulators, five cameras, and an array of sensors to the scene of an incident. It is operated from a remote base station that can be situated up to four kilometers away from the site. Recently, a modular telerobot control architecture called SMART (Sandia's Modular Architecture for Robotic and Teleoperation) was applied to ARMMS to improve the precision, safety, and operability of the manipulators on board. Using SMART, a prototype manipulator control system was developed in a couple of days, and an integrated working system was demonstrated within a couple of months. New capabilities such as camera teleoperation, autonomous tool changeout and dual manipulator control have been incorporated. The final system incorporates twenty-two separate modules and implements eight different behavior modes. This paper describes the integration of SMART into the ARMMS system.

  14. Incidence and prevalence of systemic sclerosis in Campo Grande, State of Mato Grosso do Sul, Brazil.

    Science.gov (United States)

    Horimoto, Alex Magno Coelho; Matos, Erica Naomi Naka; Costa, Márcio Reis da; Takahashi, Fernanda; Rezende, Marcelo Cruz; Kanomata, Letícia Barrios; Locatelli, Elisangela Possebon Pradebon; Finotti, Leandro Tavares; Maegawa, Flávia Kamy Maciel; Rondon, Rosa Maria Ribeiro; Machado, Natália Pereira; Couto, Flávia Midori Arakaki Ayres Tavares do; Figueiredo, Túlia Peixoto Alves de; Ovidio, Raphael Antonio; Costa, Izaias Pereira da

    Systemic sclerosis is an autoimmune disease which shows extreme heterogeneity in its clinical presentation and that follows a variable and unpredictable course. Although some discrepancies in the incidence and prevalence rates between geographical regions may reflect methodological differences in the definition and verification of cases, they may also reflect true local differences. To determine the prevalence and incidence of systemic sclerosis in the city of Campo Grande, state capital of Mato Grosso do Sul (MS), Brazil, during the period from January to December 2014. All health care services of the city of Campo Grande - MS with attending in the specialty of Rheumatology were invited to participate in the study through a standardized form of clinical and socio-demographic assessment. Physicians of any specialty could report a suspected case of systemic sclerosis, but necessarily the definitive diagnosis should be established by a rheumatologist, in order to warrant the standardization of diagnostic criteria and exclusion of other diseases resembling systemic sclerosis. At the end of the study, 15 rheumatologists reported that they attended patients with systemic sclerosis and sent the completed forms containing epidemiological data of patients. The incidence rate of systemic sclerosis in Campo Grande for the year 2014 was 11.9 per million inhabitants and the prevalence rate was 105.6 per million inhabitants. Systemic sclerosis patients were mostly women, white, with a mean age of 50.58 years, showing the limited form of the disease with a mean duration of the disease of 8.19 years. Regarding laboratory tests, 94.4% were positive for antinuclear antibody, 41.6% for anti-centromere antibody and 19.1% for anti-Scl70; anti-RNA Polymerase III was performed in 37 patients, with 16.2% positive. The city of Campo Grande, the state capital of MS, presented a lower incidence/prevalence of systemic sclerosis in comparison with those numbers found in US studies and close

  15. Trust Evaluation for Embedded Systems Security research challenges identified from an incident network scenario

    OpenAIRE

    Gehrmann, Christian; Löfvenberg , Jacob

    2011-01-01

    This paper is about trust establishment and trust evaluations techniques. A short background about trust, trusted computing and security in embedded systems is given. An analysis has been done of an incident network scenario with roaming users and a set of basic security needs has been identified. These needs have been used to derive security requirements for devices and systems, supporting the considered scenario. Using the requirements, a list of major security challenges for...

  16. Hospital Incident Command System (HICS) performance in Iran; decision making during disasters.

    Science.gov (United States)

    Djalali, Ahmadreza; Castren, Maaret; Hosseinijenab, Vahid; Khatib, Mahmoud; Ohlen, Gunnar; Kurland, Lisa

    2012-02-06

    Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.

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

    Directory of Open Access Journals (Sweden)

    Djalali Ahmadreza

    2012-02-01

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

  18. Integrating incident data from five reporting systems to assess patient safety: making sense of the elephant.

    Science.gov (United States)

    Levtzion-Korach, Osnat; Frankel, Allan; Alcalai, Hanna; Keohane, Carol; Orav, John; Graydon-Baker, Erin; Barnes, Janet; Gordon, Kathleen; Puopulo, Anne Louise; Tomov, Elena Ivanova; Sato, Luke; Bates, David W

    2010-09-01

    A study was conducted to examine and compare information gleaned from five different reporting systems within one institution: incident reporting, patient complaints, risk management, medical malpractice claims, and executive walk rounds. These data sources vary in the timing of the reporting (retrospective or prospective), severity of the events, and profession of the reporters. A common methodology was developed for classifying incidents. Data specific to each incident were abstracted from each system and then categorized using the same framework into one of 23 categories. Overall, there was little overlap, although each reporting system identified important safety issues. Communication problems were common among patient complaints and malpractice claims; malpractice claims' leading category was clinical judgement. Walk rounds identified issues with equipment and supplies. Adverse event reporting systems highlighted identification issues, especially mislabelled specimens. The frequency of contributions of reports by provider group varied substantially by system. Physicians accounted for 50% of risk management reports, but in adverse event reporting, where nurses were the main reporters, physicians accounted for only 2.5% of reports. Complaints and malpractice claims come primarily from patients. The five reporting systems each identified different yet complementary patient safety issues. To obtain a comprehensive picture of their patient safety problems and to develop priorities for improving safety, hospitals should use a broad portfolio of approaches and then synthesize the messages from all individual approaches into a collated and cohesive whole.

  19. SU-E-T-524: Web-Based Radiation Oncology Incident Reporting and Learning System (ROIRLS)

    Energy Technology Data Exchange (ETDEWEB)

    Kapoor, R; Palta, J; Hagan, M [Virginia Commonwealth University, Richmond, VA (United States); National Radiation Oncology Program (10P4H), Richmond, VA (United States); Grover, S; Malik, G [TSG Innovations Inc., Richmond, VA (United States)

    2014-06-01

    Purpose: Describe a Web-based Radiation Oncology Incident Reporting and Learning system that has the potential to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: The VA National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and near miss data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. Software used for this program is deployed on the VAs intranet as a Website. All data entry forms (adverse event or near miss reports, work product reports) utilize standard causal, RT process step taxonomies and data dictionaries defined in AAPM and ASTRO reports on error reporting (AAPM Work Group Report on Prevention of Errors and ASTROs safety is no accident report). All reported incidents are investigated by the radiation oncology domain experts. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The operational workflow is similar to that of the Aviation Safety Reporting System. This system is also synergistic with ROSIS and SAFRON. Results: The ROIRLS facilitates the collection of data that help in tracking adverse events and near misses and develop new interventions to prevent such incidents. The ROIRLS electronic infrastructure is fully integrated with each registered facility profile data thus minimizing key strokes and multiple entries by the event reporters. Conclusions: OIRLS is expected to improve the quality and safety of a broad spectrum of radiation therapy patients treated in the VA and fulfills our goal of Effecting Quality While Treating Safely The Radiation Oncology Incident Reporting and Learning System software used for this program has been developed, conceptualized and maintained by TSG Innovations

  20. SU-E-T-524: Web-Based Radiation Oncology Incident Reporting and Learning System (ROIRLS)

    International Nuclear Information System (INIS)

    Kapoor, R; Palta, J; Hagan, M; Grover, S; Malik, G

    2014-01-01

    Purpose: Describe a Web-based Radiation Oncology Incident Reporting and Learning system that has the potential to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: The VA National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and near miss data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. Software used for this program is deployed on the VAs intranet as a Website. All data entry forms (adverse event or near miss reports, work product reports) utilize standard causal, RT process step taxonomies and data dictionaries defined in AAPM and ASTRO reports on error reporting (AAPM Work Group Report on Prevention of Errors and ASTROs safety is no accident report). All reported incidents are investigated by the radiation oncology domain experts. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The operational workflow is similar to that of the Aviation Safety Reporting System. This system is also synergistic with ROSIS and SAFRON. Results: The ROIRLS facilitates the collection of data that help in tracking adverse events and near misses and develop new interventions to prevent such incidents. The ROIRLS electronic infrastructure is fully integrated with each registered facility profile data thus minimizing key strokes and multiple entries by the event reporters. Conclusions: OIRLS is expected to improve the quality and safety of a broad spectrum of radiation therapy patients treated in the VA and fulfills our goal of Effecting Quality While Treating Safely The Radiation Oncology Incident Reporting and Learning System software used for this program has been developed, conceptualized and maintained by TSG Innovations

  1. Systemic inflammatory responses in asthma

    NARCIS (Netherlands)

    Hove, W. ten

    2007-01-01

    In asthma, inflammatory cells undergo a process referred to as priming. During priming responses, cells are not directly activated by inflammatory stimuli, but acquire increased responsiveness towards heterologous stimuli. The focus of the studies presented in the thesis of Willem ten Hove was

  2. Incidence and prevalence of systemic lupus erythematosus among the native Arab population in UAE.

    Science.gov (United States)

    Al Dhanhani, A M; Agarwal, M; Othman, Y S; Bakoush, O

    2017-05-01

    Background and objectives There is a paucity of information about the epidemiology of systemic lupus erythematosus (SLE) amongst Arabs. The objective of this study was to determine the incidence and prevalence of SLE among the native Arab population of United Arab Emirates (UAE). Methods Patients with SLE were identified from three sources: medical records of two local tertiary hospitals (four years; 2009 to 2012), laboratory requests for serum double stranded deoxyribonucleic acid and serum anti-nuclear antibody and confirmed histopathologic diagnosis of SLE (skin and kidney biopsy specimens). All the patients identified with SLE met the criteria of the American College of Rheumatology. Incidence and prevalence were calculated using the state records of the UAE native population as the denominator. The age-adjusted incidence was calculated by direct standardization using the World Health Organization world standard population 2000-2025. Results Sixteen new cases (13 females and three males) fulfilled the American College of Rheumatology SLE criteria. The mean (±SD) age at time of diagnosis was 28.6 ± 12.4 years. The crude incidence ratio (per 100,000 population) was 3.5, 1.1, 2.1 and 2.1 in years 2009, 2010, 2011, 2012, respectively. The age-standardized incidence per 100,000 population for the four years was 8.6 (95% confidence interval 4.2-15.9). The age-standardized prevalence of SLE among the native population according to the 2012 population consensus was 103/100,000 population (95% confidence interval 84.5-124.4). Conclusion The age-adjusted incidence and prevalence among UAE Arabs is higher than has been reported among most other Caucasian populations. Furthermore, the prevalence of SLE in UAE seems much higher than other similar Arab countries in the Gulf region.

  3. Notification system of incidents without damage in the health system of Castilla y León (Spain

    Directory of Open Access Journals (Sweden)

    María José PEREZ-BOILLOS

    2017-03-01

    Full Text Available Introduction and objective: Patient safety is an important part of the quality work in the Regional Health Management of Castilla y León. Numerous projects are part of this line, including the no-harm incident reporting system. Objective: Reporting incidents without harm can significantly improve patient safety and improve an organization's safety culture. Material and method: After an exhaustive analysis of the available systems, it was decided to develop an own system, SISNOT (system of notification of incidents without damage, which followed the characteristics recommended by the international organisms in relation to these systems in the health field. Results: 3249 notifications were made through SISNOT, between primary and specialized care, of which 48% could have had high damage in case of reoccurrence of the incident. Conclusions: The implementation of SISNOT has been carried out in all hospitals and in primary care. The results obtained are unequal in each unit. This is due to numerous local barriers: leadership, characteristics of professionals, etc. Although there is a common, lack of safety culture. This is a challenge to keep working.

  4. Rosatom's Crisis Response Centre within the national nuclear safety system

    International Nuclear Information System (INIS)

    Smirnov, S.N.; Komarovskij, A.V.; Moskalev, V.A.

    2011-01-01

    The Rosatom Corporation includes a number of subsidiaries associated with nuclear energy use as well as with the military, scientific, technological, nuclear and radiation safety management aspects. The Rosatom Corporation has a well-established and efficient industry-wide system of emergency prevention and response, whose purpose is to ensure safe functioning of the nuclear industry, protection of personnel, the public and nature from potential dangers; it is also a functional subsystem of the unified national system of emergency prevention and response. Overall management of the system is performed by Director General of the Rosatom Corporation, overall methodological management - by the Department of Licensing, Nuclear and Radiation Safety; everyday management of the emergency prevention and response system, round-the-clock monitoring and informational support - by the Rosatom Crisis and Response Centre (CRC). CRC acts as the national focal point for warning and communication in Russia, which provides continuous round-the-clock preparedness to cooperate with the IAEA's Incident and Emergency Centre using the formats of the ENATOM international emergency response system, similar national crisis response centres abroad [ru

  5. The efficacy of teachers' responses to incidents of bullying and victimization: The mediational role of moral disengagement for bullying.

    Science.gov (United States)

    Campaert, Kristel; Nocentini, Annalaura; Menesini, Ersilia

    2017-09-01

    Teachers respond differently to bullying and victimization. Socio-cognitive and moral domain theory suggest that students process teachers' behavior cognitively and that teachers' responses to incidents of bullying and victimization could affect students' level of moral disengagement. We examined the mediating effect of students' moral disengagement between types of teachers' responses to situations of bullying and victimization and individual bullying using multilevel mediation modelling. Participants were 609 students (50% boys, age M = 11.47, SD = 1.14) of central Italy, nested in 34 classes. Students rated the frequency of self-reported bullying and of teachers' responses to incidents of bullying and victimization on a 5-point Likert scale. Teachers' responses to bullying included non-intervention, mediation, group discussion, and sanctions. Teachers' responses to victimization included non-intervention, mediation, group discussion, and victim support. Results indicated that in the teachers' responses to incidents of bullying model, a significant indirect effect of non-intervention (β = .03; 95%CI [.01, .05]) and of sanctions (β = -.02; 95%CI [-.04, -.01]) on bullying through moral disengagement was found at the individual level. Similarly, in the model on teachers' responses toward victims there was a significant indirect effect through moral disengagement of non-intervention (β = .03; 95%CI [.02, .04]) and victim support (β = -.01; 95%CI [-.02, -.001]). At the class level there were no significant indirect effects. In sum, results indicated that moral disengagement is an important mediator at the individual level and suggest including teachers in anti-bullying interventions with a specific focus on their role for moral development. © 2017 Wiley Periodicals, Inc.

  6. Lighting Systems Control for Demand Response

    NARCIS (Netherlands)

    Husen, S.A.; Pandharipande, A.; Tolhuizen, L.M.G.; Wang, Y.; Zhao, M.

    2012-01-01

    Lighting is a major part of energy consumption in buildings. Lighting systems will thus be one of the important component systems of a smart grid for dynamic load management services like demand response.In the scenario considered in this paper, under a demand response request, lighting systems in a

  7. 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

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

    Science.gov (United States)

    Gordon, Morris; Parakh, Dillan

    2017-10-01

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

  9. Survey to identify depth of penetration of critical incident reporting systems in Austrian healthcare facilities.

    Science.gov (United States)

    Sendlhofer, Gerald; Eder, Harald; Leitgeb, Karina; Gorges, Roland; Jakse, Heidelinde; Raiger, Marianne; Türk, Silvia; Petschnig, Walter; Pregartner, Gudrun; Kamolz, Lars-Peter; Brunner, Gernot

    2018-01-01

    Incident reporting systems or so-called critical incident reporting systems (CIRS) were first recommended for use in health care more than 15 years ago. The uses of these CIRS are highly variable among countries, ranging from being used to report critical incidents, falls, or sentinel events resulting in death. In Austria, CIRS have only been introduced to the health care sector relatively recently. The goal of this work, therefore, was to determine whether and specifically how CIRS are used in Austria. A working group from the Austrian Society for Quality and Safety in Healthcare (ASQS) developed a survey on the topic of CIRS to collect information on penetration of CIRS in general and on how CIRS reports are used to increase patient safety. Three hundred seventy-one health care professionals from 274 health care facilities were contacted via e-mail. Seventy-eight respondents (21.0%) completed the online survey, thereof 66 from hospitals and 12 from other facilities (outpatient clinics, nursing homes). In all, 64.1% of the respondents indicated that CIRS were used in the entire health care facility; 20.6% had not yet introduced CIRS and 15.4% used CIRS only in particular areas. Most often, critical incidents without any harm to patients were reported (76.9%); however, some health care facilities also use their CIRS to report patient falls (16.7%), needle stick injuries (17.9%), technical problems (51.3%), or critical incidents involving health care professionals. CIRS are not yet extensively or homogeneously used in Austria. Inconsistencies exist with respect to which events are reported as well as how they are followed up and reported to health care professionals. Further recommendations for general use are needed to support the dissemination in Austrian health care environments.

  10. Optimal Alignment of Search and Rescue Response Posture with Historical Incident Occurrence

    Science.gov (United States)

    2014-04-01

    potential distress incidents. Significance for defence and security The primary goal of Canada’s National SAR Program is to save lives at risk throughout...vies humaines en danger dans l’ensemble de la zone de responsabilité de SAR du Canada. Les FAC sont l’une des nombreuses organisations participantes...and security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i Résumé

  11. Study for the development of a standardized system of incidents in radiotherapy

    International Nuclear Information System (INIS)

    Ribeiro, A.LC.; Silva, A.L. da; Moreira, J.G.R.; Silva, K.R.R. da

    2017-01-01

    Radiotherapy is a modality that, along with surgery, has become essential for the success of cancer treatment. Over the years, radiotherapy has been improved to increase the effectiveness of the chances of cure. The objective of this study was to capture data from on-site visits in two clinics that offer the radiotherapy service in the state of Rio de Janeiro. After observing that each clinic had similar procedures, however, with some different methods and in view of these data obtained, a model was developed for an institutional system of incident record with the purpose of sharing results to assist in the improvement of safety protocols to mitigate possible accidents in one or more units. We conclude that this system has everything to fulfill the proposal of assisting in learning incidents. However, it is primary and updates will be of utmost importance for your improvement

  12. Social Responsibility as a Management Control System

    National Research Council Canada - National Science Library

    Barger, Anthony

    2004-01-01

    .... Finally, they overlay the model from corporate America onto the Naval Postgraduate School to examine where socially responsible management control systems operate to control and adjust the overall...

  13. Theory and analysis of a large field polarization imaging system with obliquely incident light.

    Science.gov (United States)

    Lu, Xiaotian; Jin, Weiqi; Li, Li; Wang, Xia; Qiu, Su; Liu, Jing

    2018-02-05

    Polarization imaging technology provides information about not only the irradiance of a target but also the polarization degree and angle of polarization, which indicates extensive application potential. However, polarization imaging theory is based on paraxial optics. When a beam of obliquely incident light passes an analyser, the direction of light propagation is not perpendicular to the surface of the analyser and the applicability of the traditional paraxial optical polarization imaging theory is challenged. This paper investigates a theoretical model of a polarization imaging system with obliquely incident light and establishes a polarization imaging transmission model with a large field of obliquely incident light. In an imaging experiment with an integrating sphere light source and rotatable polarizer, the polarization imaging transmission model is verified and analysed for two cases of natural light and linearly polarized light incidence. Although the results indicate that the theoretical model is consistent with the experimental results, the theoretical model distinctly differs from the traditional paraxial approximation model. The results prove the accuracy and necessity of the theoretical model and the theoretical guiding significance for theoretical and systematic research of large field polarization imaging.

  14. Patient safety is improved with an incident learning system-Clinical evidence in brachytherapy.

    Science.gov (United States)

    Deufel, Christopher L; McLemore, Luke B; de Los Santos, Luis E Fong; Classic, Kelly L; Park, Sean S; Furutani, Keith M

    2017-10-01

    Health leaders have advocated for incident learning systems (ILSs) to prevent errors, but there is limited evidence demonstrating that ILSs improve cancer patient safety. Herein, we report a long-term retrospective review of ILS reports for the brachytherapy practice at a large academic institution. Over a nine-year period, the brachytherapy practice was encouraged to report all standard operating procedure deviations, including low risk deviations. A multidisciplinary committee assigned root causes and risk scores to all incidents. Evidence based practice changes were made using ILS data, and relevant incidents were communicated to all staff in order to reduce recurrence rates. 5258 brachytherapy procedures were performed and 2238 incidents were reported from 2007 to 2015. A ramp-up period was observed in ILS participation between 2007 (0.12 submissions/procedures) and 2011 (1.55 submissions/procedures). Participation remained stable between 2011 and 2015, and we achieved a 60% (psafety policy and a 70% (ppatient care. Safety improvements have been sustained over several years. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Incidence, clinical features, treatment and outcome of primary central nervous system lymphoma in Norway.

    Science.gov (United States)

    Salvesen Haldorsen, Ingfrid; Aarseth, Jan Harald; Hollender, Aase; Larsen, John Ludvig; Espeland, Ansgar; Mella, Olav

    2004-01-01

    The incidence of primary central nervous system lymphoma (PCNSL) has been reported to increase in some parts of the world, while being stable in other regions. In an attempt to characterize the incidence rate, clinical features, treatment, outcome, and prognostic factors of PCNSL in Norway, we report our experience in a large unselected series of patients. Clinical features, histological diagnosis, radiological findings, treatment, and outcome of all patients diagnosed with PCNSL in Norway in the years 1989-1998 were registered. During the 10-year period 58 new cases of histologically verified PCNSL were registered in Norway. The annual incidence rate of PCNSL was on average 1.34 cases per million people with a non-significant increasing trend (p=0.069). For patients diagnosed before death (n=45) the estimated survival following histological diagnosis was 55%, 47%, and 23% at 1, 2, and 5 years, respectively. In Cox-regression analysis age, WHO performance status and treatment had independent prognostic impact on survival. In the studied decade, there was a non-significant trend towards increased incidence of PCNSL, perhaps due to increased availability of diagnostic imaging, especially magnetic resonance imaging.

  16. Recovering about 5 km of LHC Beam Vacuum System after Sector 3-4 Incident

    CERN Document Server

    Baglin, Vincent; Jenninger, Berthold; Jimenez, Jose; Mahner, Edgar; Schneider, Gerhard; Sinturel, Alexandre; Vidal, Alexis

    2010-01-01

    During the sec­tor 3-4 incident, the two apertures of the 3 km long cryogenic vacuum sectors of the CERN Large Hadron Collider (LHC) were brutally vented to helium. A systematic visual inspection of the beam pipe revealed the presence of soot, metallic debris and super insulation debris. After four month of cleaning, the beam vacuum system was recovered. This paper describes the tools and methodologies developed during this period, the achieved performances and discusses possible upgrades

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

    Science.gov (United States)

    2012-09-01

    federal agencies that were the early adopters. This chapter also discusses the development of the ICS in Australia . The development of the Australian ...ICS is a key parallel to the United States system and the lessons learned from Australia can be applied here. This chapter concludes with incidents...morning. After the full area was surveyed for damage assessment, the number of people left homeless was estimated at close to 10,000, and damage estimates

  18. Exploring human error in military aviation flight safety events using post-incident classification systems.

    Science.gov (United States)

    Hooper, Brionny J; O'Hare, David P A

    2013-08-01

    Human error classification systems theoretically allow researchers to analyze postaccident data in an objective and consistent manner. The Human Factors Analysis and Classification System (HFACS) framework is one such practical analysis tool that has been widely used to classify human error in aviation. The Cognitive Error Taxonomy (CET) is another. It has been postulated that the focus on interrelationships within HFACS can facilitate the identification of the underlying causes of pilot error. The CET provides increased granularity at the level of unsafe acts. The aim was to analyze the influence of factors at higher organizational levels on the unsafe acts of front-line operators and to compare the errors of fixed-wing and rotary-wing operations. This study analyzed 288 aircraft incidents involving human error from an Australasian military organization occurring between 2001 and 2008. Action errors accounted for almost twice (44%) the proportion of rotary wing compared to fixed wing (23%) incidents. Both classificatory systems showed significant relationships between precursor factors such as the physical environment, mental and physiological states, crew resource management, training and personal readiness, and skill-based, but not decision-based, acts. The CET analysis showed different predisposing factors for different aspects of skill-based behaviors. Skill-based errors in military operations are more prevalent in rotary wing incidents and are related to higher level supervisory processes in the organization. The Cognitive Error Taxonomy provides increased granularity to HFACS analyses of unsafe acts.

  19. Properties of incident reporting systems in relation to statistical trend and pattern analysis

    International Nuclear Information System (INIS)

    Kalfsbeek, H.W.; Arsenis, S.P.

    1990-01-01

    This paper describes the properties deemed desirable for an incident reporting system in order to render it useful for extracting valid statistical trend and pattern information. The perspective under which a data collection system is seen in this paper is the following: data are essentially gathered on a set of variables describing an event or incident (the items featuring on a reporting format) in order to learn about (multiple) dependencies (called interactions) between these variables. Hence, the necessary features of the data source are highlighted and potential problem sources limiting the validity of the results to be obtained are identified. In this frame, important issues are the reporting completeness, related to the reporting criteria and reporting frequency, and of course the reporting contents and quality. The choice of the report items (the variables) and their categorization (code dictionary) may influence (bias) the insights gained from trend and pattern analyses, as may the presence or absence of a structure for correlating the reported issues within an incident. The issues addressed in this paper are brought in relation to some real world reporting systems on safety related events in Nuclear Power Plants, so that their possibilities and limitations with regard to statistical trend and pattern analysis become manifest

  20. Radiation response of the central nervous system

    International Nuclear Information System (INIS)

    Schultheiss, T.E.; Kun, L.E.; Ang, K.K.; Stephens, L.C.

    1995-01-01

    This report reviews the anatomical, pathophysiological, and clinical aspects of radiation injury to the central nervous system (CNS). Despite the lack of pathognomonic characteristics for CNS radiation lesions, demyelination and malacia are consistently the dominant morphological features of radiation myelopathy. In addition, cerebral atrophy is commonly observed in patients with neurological deficits related to chemotherapy and radiation, and neurocognitive deficits are associated with diffuse white matter changes. Clinical and experimental dose-response information have been evaluated and summarized into specific recommendations for the spinal cord and brain. The common spinal cord dose limit of 45 Gy in 22 to 25 fractions is conservative and can be relaxed if respecting this limit materially reduces the probability of tumor control. It is suggested that the 5% incidence of radiation myelopathy probably lies between 57 and 61 Gy to the spinal cord in the absence of dose modifying chemotherapy. A clinically detectable length effect for the spinal cord has not been observed. The effects of chemotherapy and altered fractionation are also discussed. Brain necrosis in adults is rarely noted below 60 Gy in conventional fractionation, with imaging and clinical changes being observed generally only above 50 Gy. However, neurocognitive effects are observed at lower doses, especially in children. A more pronounced volume effect is believed to exist in the brain than in the spinal cord. Tumor progression may be hard to distinguish from radiation and chemotherapy effects. Diffuse white matter injury can be attributed to radiation and associated with neurological deficits, but leukoencephalopathy is rarely observed in the absence of chemotherapy. Subjective, objective, management, and analytic (SOMA) parameters related to radiation spinal cord and brain injury have been developed and presented on ordinal scales

  1. Radiation response of the central nervous system

    International Nuclear Information System (INIS)

    Schultheiss, T.E.; Kun, L.E.; Stephens, L.C.

    1995-01-01

    This report reviews the anatomical, pathophysiological, and clinical aspects of radiation injury to the central nervous system (CNS). Despite the lack of pathoGyomonic characteristics for CNS radiation lesions, demyelination and malacia are consistently the dominant morphological features of radiation myelopathy. In addition, cerebral atrophy is commonly observed in patients with neurological deficits related to chemotherapy and radiation, and neurocognitive deficits are associated with diffuse white matter changes. Clinical and experimental dose-response information have been evaluated and summarized into specific recommendations for the spinal cord and brain. The common spinal cord dose limit of 45 Gn in 22 to 25 fractions is conservative and can be relaxed if respecting this limit materially reduces the probability of tumor control. It is suggested that the 5% incidence of radiation myelopathy probably lies between 57 and 61 Gy to the spinal cord in the absence of dose modifying chemotherapy. A clinically detectable length effect for the spinal cord has not been observed. The effects of chemotherapy and altered fractionation are also discussed. Brain necrosis in adults is rarely noted below 60 Gy in conventional fractionation, with imaging and clinical changes being observed generally only above 50 Gy. However, neurocognitive effects are observed at lower doses, especially in children. A more pronounced volume effect is believed to exist in the brain than in the spinal cord. Tumor progression may be hard to distinguish from radiation and chemotherapy effects. Diffuse white matter injury can be attributed to radiation and associated with neurological deficits, but leukoencephalopathy is rarely observed in the absence of chemotherapy. Subjective, objective, management, and analytic (SOMA) parameters related to radiation spinal cord and brain injury have been developed and presented on ordinal scales. 140 refs., 3 figs., 6 tabs

  2. Expert system for USNRC emergency response

    International Nuclear Information System (INIS)

    Sebo, D.E.; Bray, M.A.; King, M.A.

    1986-01-01

    The Reactor Safety Assessment System (RSAS) is an expert system under development for the United States Nuclear Regulatory Commission (USNRC). RSAS is intended for use at the NRC's Operations Center in the event of a serious incident at a licensed nuclear power plant. RSAS is a situation assessment expert system which uses plant parametric data to generate conclusions for use by the NRC Reactor Safety Team. RSAS uses multiple rule bases and plant specific setpoint files in order to be applicable to all licensed power plants. RSAS currently covers several generic reactor types and power plants within those classes

  3. Emergency response information within the National LLW Information Management System

    International Nuclear Information System (INIS)

    Paukert, J.G.; Fuchs, R.L.

    1986-01-01

    The U.S. Department of Energy, with operational assistance from EG and G Idaho, Inc., maintains the National Low-Level Waste Information Management System, a relational data base management system with extensive information collection and reporting capabilities. The system operates on an IBM 4341 main-frame computer in Idaho Falls, Idaho and is accessible through terminals in 46 states. One of the many programs available on the system is an emergency response data network, which was developed jointly by EG and G Idaho, Inc. and the Federal Emergency Management Agency. As a prototype, the program comprises emergency response team contacts, policies, activities and decisions; federal, state and local government contacts; facility and support center locations; and news releases for nine reactor sites in the southeast. The emergency response program provides a method for consolidating currently fragmented information into a central and user-friendly system. When the program is implemented, immediate answers to response questions will be available through a remote terminal or telephone on a 24-hour basis. In view of current hazardous and low-level waste shipment rates and future movements of high-level waste, the program can offer needed and timely information for transportation as well as site incident response

  4. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data.

    Science.gov (United States)

    Howell, Ann-Marie; Burns, Elaine M; Bouras, George; Donaldson, Liam J; Athanasiou, Thanos; Darzi, Ara

    2015-01-01

    The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems. This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure. 5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), preport death than other staff [OR 3.04(95%CI: 2.43 to 3.80) preported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation claims per bed were significantly negatively associated with incident reports. Patient satisfaction and mortality outcomes were not significantly associated with reporting rates. Staff survey responses revealed that keeping reports confidential, keeping staff informed about

  5. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data.

    Directory of Open Access Journals (Sweden)

    Ann-Marie Howell

    significantly negatively associated with incident reports. Patient satisfaction and mortality outcomes were not significantly associated with reporting rates. Staff survey responses revealed that keeping reports confidential, keeping staff informed about incidents and giving feedback on safety initiatives increased reporting rates [r = 0.26 (p<0.01, r = 0.17 (p = 0.04, r = 0.23 (p = 0.01, r = 0.20 (p = 0.02].The NRLS is the largest patient safety reporting system in the world. This study did not demonstrate many hospital characteristics to significantly influence overall reporting rate. There were no association between size of hospital, number of staff, mortality outcomes or patient satisfaction outcomes and incident reporting rate. The study did show that hospitals where staff reported more incidents had reduced litigation claims and when clinician staffing is increased fewer incidents reporting patient harm are reported, whilst near misses remain the same. Certain specialties report more near misses than others, and doctors report more harm incidents than near misses. Staff survey results showed that open environments and reduced fear of punitive response increases incident reporting. We suggest that reporting rates should not be used to assess hospital safety. Different healthcare professionals focus on different types of safety incidents and focusing on these areas whilst creating a responsive, confidential learning environment will increase staff engagement with error disclosure.

  6. Operational Resilience Improving Criteria in case of Information Security Incidents

    Directory of Open Access Journals (Sweden)

    P. A. Demin

    2012-12-01

    Full Text Available Resilience management system states and behavior are described with the use of fuzzy Petri net. Operational resilience improving criteria in case of information security incidents is defined. Information security incident response management model is introduced.

  7. Linear systems formulation of scattering theory for rough surfaces with arbitrary incident and scattering angles.

    Science.gov (United States)

    Krywonos, Andrey; Harvey, James E; Choi, Narak

    2011-06-01

    Scattering effects from microtopographic surface roughness are merely nonparaxial diffraction phenomena resulting from random phase variations in the reflected or transmitted wavefront. Rayleigh-Rice, Beckmann-Kirchhoff. or Harvey-Shack surface scatter theories are commonly used to predict surface scatter effects. Smooth-surface and/or paraxial approximations have severely limited the range of applicability of each of the above theoretical treatments. A recent linear systems formulation of nonparaxial scalar diffraction theory applied to surface scatter phenomena resulted first in an empirically modified Beckmann-Kirchhoff surface scatter model, then a generalized Harvey-Shack theory that produces accurate results for rougher surfaces than the Rayleigh-Rice theory and for larger incident and scattered angles than the classical Beckmann-Kirchhoff and the original Harvey-Shack theories. These new developments simplify the analysis and understanding of nonintuitive scattering behavior from rough surfaces illuminated at arbitrary incident angles.

  8. The Barrow-in-Furness legionnaires' outbreak: qualitative study of the hospital response and the role of the major incident plan.

    Science.gov (United States)

    Smith, A F; Wild, C; Law, J

    2005-04-01

    To document the organisational response of Furness General Hospital to the large outbreak of legionnaire's disease in April 2002 and assess the contribution made by the hospital's major incident plan. Qualitative analysis of interview transcripts and written comments from some staff involved in the management of the incident. Documentary analysis of major incident plan and other written materials. The incident posed considerable managerial and clinical problems and this paper describes how they were overcome. In particular, strategies for dealing with supply (of staff, beds, and resources) and managing demand (by liaising with primary care and the public) seem to have been successful. Many functions necessary for managing the incident were poorly dealt with in the plan, especially procedures for handling the news media and liaison with agencies outside the hospital. Lack of explicit guidance appeared not to hinder the organisational response. There may have been an unspoken high level decision to allow staff to draw on their skills and experience in improvising a response to the initial challenge and learning adaptively as the incident unfolded. There was also evidence that staff disregarded existing job and role boundaries and focused instead on tasks, working flexibly to ensure that these tasks were completed. Protracted major incidents pose particular management challenges and may benefit from an approach different from that set out in typical major incident plans. Staff must be able to act flexibly and responsively. Some form of checklist or toolkit may be preferable to a detailed plan for some types of incident.

  9. Ovarian cysts in lactating dairy cows: incidence, response to GnRH, and reproductive performance

    OpenAIRE

    Santos, R.M.; Démetrio, D.G.B.; Vasconcelos, J.L.M.

    2009-01-01

    A incidência de cistos ovarianos, a resposta ao tratamento com GnRH e os efeitos da ocorrência de cisto no desempenho reprodutivo e na taxa de descarte foram determinados em vacas lactantes da raça Holandesa. Vacas lactantes (n=333) foram avaliadas semanalmente por ultrassonografia a partir da quarta semana pós-parto, visando à detecção de corpos lúteos (CL) e de folículos ovarianos maiores que 10mm. Na sétima semana pós-parto, as vacas foram classificadas: em ciclando (n=248; presença de CL ...

  10. Incidence Rate of Concomitant Systemic Diseases in the Aging Population with Postmenopausal Osteoporosis

    Directory of Open Access Journals (Sweden)

    Selçuk Sayılır

    2016-08-01

    Full Text Available Objective: To evaluate the concomitant systemic diseases with postmenopausal osteoporosis and to investigate the points to be considered in treatment approach of patients with osteoporosis. Materials and Methods: The study included 110 female patients admitted to our clinic and followed up after postmenopausal osteoporosis diagnosis. Besides the demographic data; the concomitant diseases of the patients such as hypertension, hypo-hyperthyroidism, diabetes mellitus, Alzheimer’s disease, malignancy, osteoarthritis, gastrointestinal system diseases, chronic obstructive pulmonary disease (COPD- asthma and depression were also recorded. Results: The mean age of the patients included in our study was 65.9±9.8 years. When the concomitant systemic diseases were examined; 40 patients had hypertension, 32 patients had osteoarthritis, 24 patients had gastrointestinal tract problems, 22 patients had thyroid disease, 21 patients had depression, 15 patients had hyperlipidemia, 12 patients had diabetes mellitus, 10 patients had COPD - asthma, 7 patients had cardiac diseases, 5 patients had malignancy and 2 patients had Alzheimer disease. Conclusion: Osteoporosis is a common disease in the geriatric population. As a chronic disease with an increasing incidence with aging; it can cause many health problems, prevalently pathological bone fractures, in our country and all over the world. Constitutively, prophylaxis of osteoporosis should be the first step. Because systemic diseases with increasing incidence with aging may affect the severity of osteoporosis and impair the treatment; it is important for both clinicians and the society to have sufficient information about osteoporosis.

  11. IAEA/NEA Fuel Incident Notification and Analysis System (FINAS) guidelines

    International Nuclear Information System (INIS)

    2006-01-01

    The Fuel Incident Notification and Analysis System (FINAS) is an international system jointly operated by the International Atomic Energy Agency (IAEA) and the Nuclear Energy Agency of the Organisation for Economic Cooperation and Development (OECD/NEA). The fundamental objective of FINAS is to contribute to improving the safety of fuel cycle facilities, which are operated worldwide. This objective can be achieved by providing timely and detailed information on both technical and human factors related to events of safety significance, which occur at these facilities. The purpose of these guidelines, which supersede the previous NEA FINAS guidelines is to describe the system and to give users the necessary background and guidance to enable them to produce FINAS reports meeting a high standard of quality while retaining the high efficiency of the system expected by all Member States operating FCFs. These guidelines have been jointly developed and approved by the NEA/IAEA

  12. Application examples of the reports of the NEA Incident Reporting System of the OECD and evolution of the system

    International Nuclear Information System (INIS)

    Libmann, J.

    1989-06-01

    Some reports of the work group no. 1 of the Nuclear Installations Security Committee of NEA, are summarized. An example of the report coding system concerning human factors, is given. The aim of the study is to improve the report contents as well as the coding system. In this case, a fast data selection is possible, and allows an efficient analysis of a particular situation. Moreover, the corrective procedures of the nuclear installation conception or operation can be easily modified, by the national organisations. Due to the improvements in quality, the opinion of the member countries on the incident reporting systems efficiency was enhanced [fr

  13. SU-F-T-223: Radiotherapy Incident Reporting and Analysis System (RIRAS):Early Experience

    Energy Technology Data Exchange (ETDEWEB)

    Kapoor, R; Palta, J; Hagan, M [National Radiation Oncology Program (10P4H), Dept. of Veterans Affairs, Richmond, VA (United States); Burkett, D; Leidholdt, E [National Health Physics Program (10P4X), Dept. of Veterans Affairs, Little Rock, AR (United States)

    2016-06-15

    Background & Purpose: RIRAS is a web-based information system deployed on the Veterans Health Administration intranet in early 2014 to collect adverse events and good catch data; analyze the causes and contributing factors; and find ways to prevent future occurrences. Material and Methods: Incident learning consists of a feedback loop which starts with reporting an event, followed by analysis of contributing factors, and culminates in the development of a patient safety work product (PSWP) to prevent recurrence. RIRAS permits both anonymous and non-anonymous reporting. Each report is analyzed by a team of medical physicists who are independent of the reporting facility. The analysts usually contact the reporting facilities for additional information. We analyzed all reports and held telephonic interviews (when necessary) with the reporters. We then generated PSWPs with corrective/preventive and learning actions. Anonymous reporting is handled in the same manner, except without the ability to further interview the reporter. Results: In a significant number of reports, the causes and recommended preventive actions were considerably altered by the independent analysis and additional information from the facility. 130 reports have been entered in RIRAS; 9 misadministrations, 83 good catches, 3 anonymous good catches, and 35 earlier reported incidents from FY2005-14. 45% of the reported incidents occurred in the treatment delivery stages, 19% in on-treatment management, and 16% in pre-treatment verification. 80% of the good catches were found in the treatment delivery workflow. Majority of these incidents were due to inconsistent patient setup instructions or documentation, nonadherence to policies and procedures, lax time-out policy, distracted RTTs, and inadequate RTT staffing. Conclusion: RIRAS has identified many areas for improvement and elevated the quality and safety of radiation treatments in the VHA. We found that the ability to learn is significantly

  14. Incidence and predictors of urotoxic adverse events in cyclophosphamide-treated patients with systemic necrotizing vasculitides.

    Science.gov (United States)

    Le Guenno, Guillaume; Mahr, Alfred; Pagnoux, Christian; Dhote, Robin; Guillevin, Loïc

    2011-05-01

    To assess hemorrhagic cystitis and urinary tract cancer incidence and predictors in cyclophosphamide (CYC)-treated patients with systemic necrotizing vasculitis (SNV). The French Vasculitis Study Group database, which contains longitudinal data on SNV patients, was searched for urinary tract cancer and/or hemorrhagic cystitis occurrences in patients diagnosed as having Wegener's granulomatosis (WG), microscopic polyangiitis, Churg-Strauss syndrome, or polyarteritis nodosa. The observed incidence of urinary tract cancer was compared to the expected incidence in the general population by calculating standardized incidence ratios (SIRs). Relationships between urinary tract cancer and/or hemorrhagic cystitis and 10 variables, including CYC dosage and administration route, were investigated by survival analyses for a nested subgroup of patients for whom detailed information on CYC exposure was available. Among the 805 patients observed over 4,230 patient-years (mean followup 5.3 years), 22 cases of hemorrhagic cystitis and 7 of urinary tract cancer were identified in 27 patients. The SIRs for urinary tract cancer were 5.00 for all patients with SNV (P = 0.001) and 5.96 for patients with WG (P = 0.03). Based on 467 patients with detailed CYC information, cumulative CYC dose (hazard ratio [HR] for 10-gm increments 1.09; P = 0.03), ever-oral CYC administration (HR 5.50; P = 0.001), and WG (HR 2.96; P = 0.01) independently predicted urinary tract cancer and/or hemorrhagic cystitis. According to univariate analyses, smoking (ever) (HR 8.20; P = 0.02) and a prior hemorrhagic cystitis episode (HR 5.20; P = 0.046) significantly predicted urinary tract cancer. Our findings indicate that CYC treatment of SNV is associated with a 5-fold higher risk of developing urinary tract cancer. Urotoxicity risk in SNV is associated with the cumulative CYC dose and its oral administration, and might be higher in WG. Copyright © 2011 by the American College of Rheumatology.

  15. Incidence of Congenital Spinal Abnormalities Among Pediatric Patients and Their Association With Scoliosis and Systemic Anomalies.

    Science.gov (United States)

    Passias, Peter G; Poorman, Gregory W; Jalai, Cyrus M; Diebo, Bassel G; Vira, Shaleen; Horn, Samantha R; Baker, Joseph F; Shenoy, Kartik; Hasan, Saqib; Buza, John; Bronson, Wesley; Paul, Justin C; Kaye, Ian; Foster, Norah A; Cassilly, Ryan T; Oren, Jonathan H; Moskovich, Ronald; Line, Breton; Oh, Cheongeun; Bess, Shay; LaFage, Virginie; Errico, Thomas J

    2017-10-09

    Congenital abnormalities when present, according to VACTERL theory, occur nonrandomly with other congenital anomalies. This study estimates the prevalence of congenital spinal anomalies, and their concurrence with other systemic anomalies. A retrospective cohort analysis on Health care Cost and Utilization Project's Kids Inpatient Database (KID), years 2000, 2003, 2006, 2009 was performed. ICD-9 coding identified congenital anomalies of the spine and other body systems. Overall incidence of congenital spinal abnormalities in pediatric patients, and the concurrence of spinal anomaly diagnoses with other organ system anomalies. Frequencies of congenital spine anomalies were estimated using KID hospital-and-year-adjusted weights. Poisson distribution in contingency tables tabulated concurrence of other congenital anomalies, grouped by body system. Of 12,039,432 patients, rates per 100,000 cases were: 9.1 hemivertebra, 4.3 Klippel-Fiel, 56.3 Chiari malformation, 52.6 tethered cord, 83.4 spina bifida, 1.2 absence of vertebra, and 6.2 diastematomyelia. Diastematomyelia had the highest concurrence of other anomalies: 70.1% of diastematomyelia patients had at least one other congenital anomaly. Next, 63.2% of hemivertebra, and 35.2% of Klippel-Fiel patients had concurrent anomalies. Of the other systems deformities cooccuring, cardiac system had the highest concurrent incidence (6.5% overall). In light of VACTERL's definition of a patient being diagnosed with at least 3 VACTERL anomalies, hemivertebra patients had the highest cooccurrence of ≥3 anomalies (31.3%). With detailed analysis of hemivertebra patients, secundum ASD (14.49%), atresia of large intestine (10.2%), renal agenesis (7.43%) frequently cooccured. Congenital abnormalities of the spine are associated with serious systemic anomalies that may have delayed presentations. These patients continue to be at a very high, and maybe higher than previously thought, risk for comorbidities that can cause devastating

  16. The hospital incident command system: modified model for hospitals in iran.

    Science.gov (United States)

    Djalali, Ahmadreza; Hosseinijenab, Vahid; Peyravi, Mahmoudreza; Nekoei-Moghadam, Mahmood; Hosseini, Bashir; Schoenthal, Lisa; Koenig, Kristi L

    2015-03-27

    Effectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran. In 2013, a group of 11 subject matter experts participated in an expert consensus modified Delphi to develop modifications to the 2006 version of HICS. The following changes were recommended by the expert panel and subsequently implemented: 1) A Quality Control Officer was added to the Command group; 2) Security was defined as a new section; 3) Infrastructure and Business Continuity Branches were moved from the Operations Section to the Logistics and the Administration Sections, respectively; and 4) the Planning Section was merged within the Finance/Administration Section. An expert consensus group developed a modified HICS that is more feasible to implement given the managerial organization of hospitals in Iran. This new model may enhance hospital performance in managing disasters. Additional studies are needed to test the feasibility and efficacy of the modified HICS in Iran, both during simulations and actual disasters. This process may be a useful model for other countries desiring to improve disaster incident management systems for their hospitals.

  17. Incidence of cervical human papillomavirus infection in systemic lupus erythematosus women.

    Science.gov (United States)

    Mendoza-Pinto, C; García-Carrasco, M; Vallejo-Ruiz, V; Méndez-Martínez, S; Taboada-Cole, A; Etchegaray-Morales, I; Muñóz-Guarneros, M; Reyes-Leyva, J; López-Colombo, A

    2017-08-01

    Objectives Our objective was to study the incidence, persistence and clearance of human papillomavirus infection in systemic lupus erythematosus women and assess risk factors for persistence of human papillomavirus infection. Methods We carried out a prospective, observational cohort study of 127 systemic lupus erythematosus women. Patients were evaluated at baseline and at three years. Traditional and systemic lupus erythematosus women-related disease risk factors were collected. Gynaecological evaluations and cervical cytology screening were made. Human papillomavirus detection and genotyping were made by polymerase chain reaction and linear array. Results The cumulative prevalence of human papillomavirus infection increased from 22.8% at baseline to 33.8% at three years; p = lupus erythematosus women, the cumulative prevalence of human papillomavirus infection, including high risk-human papillomavirus and multiple human papillomavirus infections, may increase over time. Most persistent infections were low risk-human papillomavirus. The number of lifetime sexual partners and the cumulative cyclophosphamide dose were independently associated with incident human papillomavirus infection.

  18. EUROCONTROL-Systemic Occurrence Analysis Methodology (SOAM)-A 'Reason'-based organisational methodology for analysing incidents and accidents

    International Nuclear Information System (INIS)

    Licu, Tony; Cioran, Florin; Hayward, Brent; Lowe, Andrew

    2007-01-01

    The Safety Occurrence Analysis Methodology (SOAM) developed for EUROCONTROL is an accident investigation methodology based on the Reason Model of organisational accidents. The purpose of a SOAM is to broaden the focus of an investigation from human involvement issues, also known as 'active failures of operational personnel' under Reason's original model, to include analysis of the latent conditions deeper within the organisation that set the context for the event. Such an approach is consistent with the tenets of Just Culture in which people are encouraged to provide full and open information about how incidents occurred, and are not penalised for errors. A truly systemic approach is not simply a means of transferring responsibility for a safety occurrence from front-line employees to senior managers. A consistent philosophy must be applied, where the investigation process seeks to correct deficiencies wherever they may be found, without attempting to apportion blame or liability

  19. Chemical and biological agent incident response and decision process for civilian and public sector facilities.

    Science.gov (United States)

    Raber, Ellen; Hirabayashi, Joy M; Mancieri, Saverio P; Jin, Alfred L; Folks, Karen J; Carlsen, Tina M; Estacio, Pete

    2002-04-01

    In the event of a terrorist attack or catastrophic release involving potential chemical and/or biological warfare agents, decisionmakers will need to make timely and informed choices about whether, or how, to respond. The objective of this article is to provide a decision framework to specify initial and follow-up actions, including possible decontamination, and to address long-term health and environmental issues. This decision framework consists of four phases, beginning with the identification of an incident and ending with verification that cleanup and remediation criteria have been met. The flowchart takes into account both differences and similarities among potential agents or toxins at key points in the decision-making process. Risk evaluation and communication of information to the public must be done throughout the process to ensure a successful effort.

  20. Healthcare system responsiveness in Jiangsu Province, China.

    Science.gov (United States)

    Chao, Jianqian; Lu, Boyang; Zhang, Hua; Zhu, Liguo; Jin, Hui; Liu, Pei

    2017-01-13

    The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Recently, there has been increasing attention paid to responsiveness in evaluating the performance of a healthcare system in a variety of service settings. However, the factors that affect the responsiveness have been inconclusive so far and measures of improved responsiveness have not always thoroughly considered the factors. The aim of this study was to evaluate both the responsiveness of the healthcare system in Jiangsu Province, China, the factors that influence responsiveness and the measures of improved responsiveness considering it, as determined by a responsiveness survey. A multistage, stratified random sampling method was used to select 1938 adult residents of Jiangsu Province in 2011. Face-to-face interviews were conducted using a self-designed questionnaire modeled on the World Health Organization proposal. The final analysis was based on 1783 (92%) valid questionnaires. Canonical correlation analysis was used to assess the factors that affect responsiveness. The average score of all responsiveness-related domains in the surveyed healthcare system was satisfactory (7.50 out of a maximum 10.0). The two highest scoring domains were dignity and confidentiality, and the two lowest scoring domains choice and prompt attention. The factors affecting responsiveness were age, regional economic development level, and geographic area (urban vs. rural). The responsiveness regarding basic amenities was rated worse by the elderly than by younger respondents. Responsiveness ranked better by those with a poorer economic status. Choice in cities was better than in rural regions. The responsiveness of the Jiangsu healthcare system was considered to be satisfactory but could be improved by offering greater choice and providing more prompt attention. Perceptions of healthcare system responsiveness differ with age

  1. Social Responsibility as a Management Control System

    National Research Council Canada - National Science Library

    Barger, Anthony

    2004-01-01

    In this report, the authors examine how businesses with social responsibility as part of their core strategy use related management control systems within the business strategy control model set forth...

  2. 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

  3. Association among house infestation index, dengue incidence, and sociodemographic indicators: surveillance using geographic information system.

    Science.gov (United States)

    Vargas, Waldemir Paixão; Kawa, Hélia; Sabroza, Paulo Chagastelles; Soares, Valdenir Bandeira; Honório, Nildimar Alves; de Almeida, Andréa Sobral

    2015-08-05

    We identified dengue transmission areas by using the Geographic Information Systems located at local surveillance units of the Itaboraí municipality in state of Rio de Janeiro. We considered the association among the house infestation index, the disease incidence, and sociodemographic indicators during a prominent dengue outbreak in 2007 and 2008. In this ecological study, the Local Surveillance Units (UVLs) of the municipality were used as spatial pattern units. For the house analysis, we used the period of higher vector density that occurred previous to the larger magnitude epidemic range of dengue cases. The average dengue incidence rates calculated in this epidemic range were smoothed using the Bayesian method. The associations among the House Infestation Index (HI), the Bayesian rate of the average dengue incidence, and the sociodemographic indicators were evaluated using a Pearson's correlation coefficient. The areas that were at a higher risk of dengue occurrence were detected using a kernel density estimation with the kernel quartic function. The dengue transmission pattern in Itaboraí showed that the increase in the vector density preceded the increase in incidence. The HI was positively correlated to the Bayesian dengue incidence rate (r = 0.641; p = 0.01). The higher risk areas were those that were close to the main highways. In the Kernel density estimation analysis, we observed that the regions that were at a higher risk of dengue were those that were located in the UVLs and had the highest population densities; these locations were typically located along major highways. Four nuclei were identified as epicenters of high risk. The spatial analysis units used in this research, i.e., UVLs, served as a methodological resource for examining the compatibility of different information sources concerning the disease, the vector indices, and the municipal sociodemographic aspects and were arranged in distinct cartographic bases. Dengue is a multi

  4. Incidence of skin cancer in Nagasaki atomic bomb survivors based on DS86 dosimetry system, 1958-1985

    Energy Technology Data Exchange (ETDEWEB)

    Sadamori, Naoki (Nagasaki Univ. (Japan). School of Medicine); Otake, Masanori; Honda, Takeo

    1992-03-01

    The incidence of skin cancer during the period 1958-1985 was examined in the population registered in the life span study extension (LSSE) and the adult health study (AHS). Among 25,942 A-bomb survivors in whom DS86 was available, skin cancer was confirmed in 47 A-bomb survivors. These A-bomb survivors consisted of 24 males and 23 females. According to DS86 dosimetry system, ten A-bomb survivors had been exposed to 0.50 Gy or more. The most common histology was basal cell epithelioma (n=25), followed by malignant melanoma (n=4) and basosquamous cell carcinoma and sweat gland carcinoma (one each). In the group of 0.50 Gy or more, the incidence of occurrence of skin cancer was 20.8/100,000 population per year (PY) for the LSSE population and 22.8/100,000 PY for the AHS population. In the group of 0.01-0.49 Gy, it was 6.8/100,000 PY for the LSSE population and 12.8/100,000 PY for the AHS population. It was significantly associated with higher exposure doses. The dose-response relationship was linear. (N.K.).

  5. Analysis of Aviation Safety Reporting System Incident Data Associated with the Technical Challenges of the Atmospheric Environment Safety Technology Project

    Science.gov (United States)

    Withrow, Colleen A.; Reveley, Mary S.

    2014-01-01

    This study analyzed aircraft incidents in the NASA Aviation Safety Reporting System (ASRS) that apply to two of the three technical challenges (TCs) in NASA's Aviation Safety Program's Atmospheric Environment Safety Technology Project. The aircraft incidents are related to airframe icing and atmospheric hazards TCs. The study reviewed incidents that listed their primary problem as weather or environment-nonweather between 1994 and 2011 for aircraft defined by Federal Aviation Regulations (FAR) Parts 121, 135, and 91. The study investigated the phases of flight, a variety of anomalies, flight conditions, and incidents by FAR part, along with other categories. The first part of the analysis focused on airframe-icing-related incidents and found 275 incidents out of 3526 weather-related incidents over the 18-yr period. The second portion of the study focused on atmospheric hazards and found 4647 incidents over the same time period. Atmospheric hazards-related incidents included a range of conditions from clear air turbulence and wake vortex, to controlled flight toward terrain, ground encounters, and incursions.

  6. Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS: relevance and structure

    Directory of Open Access Journals (Sweden)

    Wangler Martin

    2011-04-01

    Full Text Available Abstract Background In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU and the European Academy of Chiropractic (EAC involved in the European Committee for Standardization (CEN process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of potentially harmful interventions and to facilitate the treatment of patients within the context of achieving maximum benefit with a minimum risk of harm; second, to inform the training objectives for the Graduate Education and Continuing Professional Development programmes of all 19 ECU member nations, regarding knowledge and skills to be acquired for maximising patient safety; and third, to develop a guideline on patient safety incident reporting as it is likely to be part of future CEN standards for ECU member nations. Objective To introduce patient safety incident reporting within the context of chiropractic practice in Europe and to help individual countries and their national professional associations to develop or improve reporting and learning systems. Discussion Providing health care of any kind, including the provision of chiropractic treatment, can be a complex and, at times, a risky activity. Safety in healthcare cannot be guaranteed, it can only be improved. One of the most important aspects of any learning and reporting system lies in the appropriate use of the data and information it gathers. Reporting should not just be seen as a vehicle for obtaining information on patient safety issues, but also be utilised as a tool to facilitate learning, advance quality improvement and to ultimately minimise the rate of the occurrence of errors linked to patient care. Conclusions Before a reporting and learning system can be established it has to be clear

  7. Incidence of Severe Malaria Syndromes and Status of Immune Responses among Khat Chewer Malaria Patients in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Tsige Ketema

    Full Text Available Although more emphasis has been given to the genetic and environmental factors that determine host vulnerability to malaria, other factors that might have a crucial role in burdening the disease have not been evaluated yet. Therefore, this study was designed to assess the effect of khat chewing on the incidence of severe malaria syndromes and immune responses during malaria infection in an area where the two problems co-exist. Clinical, physical, demographic, hematological, biochemical and immunological data were collected from Plasmodium falciparum mono-infected malaria patients (age ≥ 10 years seeking medication in Halaba Kulito and Jimma Health Centers. In addition, incidences of severe malaria symptoms were assessed. The data were analyzed using SPSS (version 20 software. Prevalence of current khat chewer malaria patients was 57.38% (95%CI =53-61.56%. Malaria symptoms such as hyperpyrexia, prostration and hyperparasitemia were significantly lower (P0.05, IgG3 antibody was significantly higher (P<0.001 among khat chewer malaria patients. Moreover, IgM, IgG, IgG1and IgG3 antibodies had significant negative association (P<0.001 with parasite burden and clinical manifestations of severe malaria symptoms, but not with severe anemia and hypoglycemia. Additionally, a significant increment (P<0.05 in CD4+ T-lymphocyte population was observed among khat users. Khat might be an important risk factor for incidence of some severe malaria complications. Nevertheless, it can enhance induction of humoral immune response and CD4+ T-lymphocyte population during malaria infection. This calls for further investigation on the effect of khat on parasite or antigen-specifc protective malaria immunity and analysis of cytokines released upon malaria infection among khat chewers.

  8. Abdominal wall injuries occurring after blunt trauma: incidence and grading system.

    Science.gov (United States)

    Dennis, Ryan W; Marshall, Andre; Deshmukh, Harshal; Bender, Jeffrey S; Kulvatunyou, Narong; Lees, Jason S; Albrecht, Roxie M

    2009-03-01

    Traumatic abdominal wall injuries (AWIs) are being increasingly recognized after blunt force injury. All available abdominal/pelvic computed axial tomography (CAT) scans of blunt trauma patients evaluated at our level I trauma center from January 2005 to August 2006 were reviewed for the presence of AWI. AWI was graded using a severity-based numeric system. AWI grade was then compared with variables from a prospectively maintained trauma registry. Of 1,549 reviewed CAT scans, 9% showed AWI (grade I = 53%, grade II = 28%, grade III = 9%, grade IV = 8%, and grade V = 2%). There was no association between AWI and seatbelt use, Injury Severity Score, weight, or need for abdominal surgery. AWI occurs in 9% of blunt trauma patients undergoing abdominal/pelvic CAT scans. The incidence of herniation on CAT at presentation after blunt trauma is .2%, and the incidence of patients at risk of future hernia formation is 1.5%. AWI can be effectively cataloged using a straightforward numeric grading system.

  9. 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.

  10. The Incidence of Lesions of Different Systems and Organs in Children with Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    O.Z. Gnateyko

    2016-09-01

    Full Text Available Introduction. Gastroesophageal reflux disease (GERD — a chronic recurrent disease caused by the disturbances of the motor-evacuating function of the gastroesophageal zone and is characterized by spontaneous and/or regular reflux of the gastric or duodenal fluid that leads to the damage of the distal part of the esophagus. GERD is one of the most frequent diseases that affect the esophagus. Taking into the account the huge amount of the causes, which may lead to GERD, its etiology is still not well defined, and the contribution of each factor requires further analysis. The aim of the study was to analyze the peculiarities and the incidence of GERD association with other organ and system pathologies.Materials and methods. Clinical analysis of 73 cases of GERD in school-aged children has been performed. The incidence of GERD combination with other system and organ pathologies has been evaluated using thorough anamnesis and patient’s medical history analysis. Results. In 66 % of children with GERD, the association of this pathology with other digestive tract diseases has been revealed, in 50.7 % — with lesions of musculoskeletal system, in 12.3 % — with urinary tract pathology. Almost one third of children with GERD suffered from congenital defects of different organs and systems, such as dolichosigmoid, mitral valve prolapse, nephroptosis/rotation of the kidneys/pyelectasis/bladder-pelvic reflux, gallbladder deformities. The article presents the analysis of a clinical case of the combination of cardiovascular, digestive and urinary lesions that enables us to assume the presence of possible common etiology factor of the diagnosed diseases. The analyzed data regarding the association of GERD with other organ and system pathologies, as well as the results of other research groups indicate a probable common component in their etiology. The common factor in the described cases of the combination of pathologies may be a violation of the

  11. The Vacuous Rhetoric of Diversity: Exploring How Institutional Responses to National Racial Incidences Effect Faculty of Color Perceptions of University Commitment to Diversity

    Science.gov (United States)

    Squire, Dian

    2017-01-01

    Recent news cycles have illuminated the disparate, racialized experiences of Black people in the United States but university leadership responses have been reactionary, or worse non-responsive. This study examines how university responses to national racial incidences such as the police brutality affect how faculty of color in one discipline…

  12. Dose-Response Association Between Physical Activity and Incident Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Liu, Xuejiao; Zhang, Dongdong; Liu, Yu; Sun, Xizhuo; Han, Chengyi; Wang, Bingyuan; Ren, Yongcheng; Zhou, Junmei; Zhao, Yang; Shi, Yuanyuan; Hu, Dongsheng; Zhang, Ming

    2017-05-01

    Despite the inverse association between physical activity (PA) and incident hypertension, a comprehensive assessment of the quantitative dose-response association between PA and hypertension has not been reported. We performed a meta-analysis, including dose-response analysis, to quantitatively evaluate this association. We searched PubMed and Embase databases for articles published up to November 1, 2016. Random effects generalized least squares regression models were used to assess the quantitative association between PA and hypertension risk across studies. Restricted cubic splines were used to model the dose-response association. We identified 22 articles (29 studies) investigating the risk of hypertension with leisure-time PA or total PA, including 330 222 individuals and 67 698 incident cases of hypertension. The risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.96) with each 10 metabolic equivalent of task h/wk increment of leisure-time PA. We found no evidence of a nonlinear dose-response association of PA and hypertension ( P nonlinearity =0.094 for leisure-time PA and 0.771 for total PA). With the linear cubic spline model, when compared with inactive individuals, for those who met the guidelines recommended minimum level of moderate PA (10 metabolic equivalent of task h/wk), the risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.97). This meta-analysis suggests that additional benefits for hypertension prevention occur as the amount of PA increases. © 2017 American Heart Association, Inc.

  13. Towards automated incident handling: how to select an appropriate response against a network-based attack?

    NARCIS (Netherlands)

    Ossenbühl, Sven; Steinberger, Jessica; Baier, Harald

    2015-01-01

    The increasing amount of network-based attacks evolved to one of the top concerns responsible for network infrastructure and service outages. In order to counteract these threats, computer networks are monitored to detect malicious traffic and initiate suitable reactions. However, initiating a

  14. Social responsibility as a management system

    Directory of Open Access Journals (Sweden)

    Nuria Arimany-Serrat

    2018-02-01

    Originality/value: The study identifies a business management system that continuously organises and improves the performances of a company in the area of Corporate Social Responsibility, through audited certification that enhances the competitivity of companies that hold the international standard. The study also demonstrates the need for a management system to integrate into business models.

  15. Linear response theory for quantum open systems

    OpenAIRE

    Wei, J. H.; Yan, YiJing

    2011-01-01

    Basing on the theory of Feynman's influence functional and its hierarchical equations of motion, we develop a linear response theory for quantum open systems. Our theory provides an effective way to calculate dynamical observables of a quantum open system at its steady-state, which can be applied to various fields of non-equilibrium condensed matter physics.

  16. Identity Crisis: Defining the Problem and Framing a Solution for Terrorism Incident Response

    Science.gov (United States)

    2007-09-01

    securely verifies identification, levels of training/certification, and currency , for the multitude of responders that converge on the scene of a high...groups to develop standards for training, experience, and currency for specific positions within each response discipline. When developed, these...10-11. 64 The Associated technical publications include ISO/IEC 7816, ISO/IEC 10373 (1&3), ISO/IEC 14443 (1- 4), ISO/IEC 10373 (6), Crypto -Modules

  17. Emergency responses for accounting and security systems

    International Nuclear Information System (INIS)

    Powers, J.A.

    1980-01-01

    The Institute of Nuclear Materials Management recognizes the need to be in a position to provide assistance to the Nuclear Industry, both private and government, in the event of a safeguards incident. In recognition of that need, the Executive Committee established an ad hoc Public Information/Response Committee. The committee was given the charter of developing ''an inventory/directory of INMM expertise and capabilities for (1) providing public information, education, consultation and expert assistance when and as requested and (2) for responding appropriately to new developments (whether abrupt, emergency or gradually evolving) within our area of expertise.'' In this paper, the development of the inventory is described and its use illustrated by postulated diversion scenarios

  18. Resveratrol Reduces the Incidence of Portal Vein System Thrombosis after Splenectomy in a Rat Fibrosis Model

    Directory of Open Access Journals (Sweden)

    Meng Xu

    2016-01-01

    Full Text Available Purpose. To investigate the preventive effect of resveratrol (RES on the formation of portal vein system thrombosis (PVST in a rat fibrosis model. Methods. A total of 64 male SD rats, weighing 200–300 g, were divided into five groups: Sham operation, Splenectomy I, Splenectomy II, RES, and low molecular weight heparin (LMWH, with the former two groups as nonfibrosis controls. Blood samples were subjected to biochemical assays. Platelet apoptosis was measured by flow cytometry. All rats were euthanized for PVST detection one week after operation. Results. No PVST occurred in nonfibrosis controls. Compared to Splenectomy II, the incidences of PVST in RES and LMWH groups were significantly decreased (both p<0.05. Two rats in LMWH group died before euthanasia due to intra-abdominal hemorrhage. In RES group, significant decreases in platelet aggregation, platelet radical oxygen species (ROS production, and increase in platelet nitric oxide (NO synthesis and platelet apoptosis were observed when compared with Splenectomy II (all p<0.001, while in LMWH group only significant decrease in platelet aggregation was observed. Conclusion. Prophylactic application of RES could safely reduce the incidence of PVST after splenectomy in cirrhotic rat. Regulation of platelet function and induction of platelet apoptosis might be the underlying mechanisms.

  19. Fruit and vegetables consumption and incident hypertension: dose-response meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Wu, L; Sun, D; He, Y

    2016-10-01

    The role of dietary factors on chronic diseases seems essential in the potentially adverse or preventive effects. However, no evidence of dose-response meta-analysis of prospective cohort studies has verified the association between the intake of fruit and/or vegetables and the risk of developing hypertension. The PubMed and Embase were searched for prospective cohort studies. A generic inverse-variance method with random effects model was used to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs). Generalized least squares trend estimation model was used to calculate the study-specific slopes for the dose-response analyses. Seven articles comprised nine cohorts involving 185 676 participants were assessed. The highest intake of fruit or vegetables separately, and total fruit and vegetables were inversely associated with the incident risk of hypertension compared with the lowest level, and the pooled RRs and 95% CIs were 0.87 (0.79, 0.95), 0.88 (0.79, 0.99) and 0.90 (0.84, 0.98), respectively. We also found an inverse dose-response relation between the risk of developing hypertension and fruit intake, and total fruit and vegetables consumption. The incident risk of hypertension was decreased by 1.9% for each serving per day of fruit consumption, and decreased by 1.2% for each serving per day of total fruit and vegetables consumption. Our results support the recommendation to increase the consumption of fruit and vegetables with respect to preventing the risk of developing hypertension. However, further large prospective studies and long-term high-quality randomized controlled trials are still needed to confirm the observed association.

  20. Effect of colistin and tylosin used as feed additives on the performance, diarrhea incidence, and immune response of nursery pigs

    Directory of Open Access Journals (Sweden)

    Kelly Mazutti

    2016-08-01

    Full Text Available For the last several decades, antimicrobial compounds have been used as feed additives to promote piglet growth at weaning, through the prevention of subclinical and clinical disease. However, few studies have assessed the influence of these antibiotics on the immune response of nursery pigs, as well as the relation between performance, health, and immunity of animals that receive feed additives. Therefore, the present study aimed to evaluate the effects of colistin and tylosin when used as feed additives on the performance, incidence of diarrhea, and immune response of nursery pigs. In this study, 72 weaned pigs (average age, 28 days were allotted into one of three treatment groups: a control group (feed with no antibiotics, tylosin group (feed containing 22 ppm tylosin, and colistin group (feed containing 20 ppm colistin. Weekly, during a five week period, the average daily feed intake, average daily gain, and feed conversion ratio of the pigs were evaluated. Stools were scored daily, in accordance with a fecal texture scale. Blood samples were collected on the day of housing (d0 and on d7, d21, d28, and d35 for immune cell phenotyping. The results of this study showed that piglets in both the colistin and tylosin groups exhibited a significantly higher average daily feed intake, resulting in a higher body weight at the end of the experimental period (d35 when compared with piglets from the control group. Colistin and tylosin also significantly reduced the incidence of diarrhea. Colistin and tylosin modulated the piglets’ immune responses, particularly on d28, by changing the percentage of circulating B lymphocytes, CD4+CD8+ T cells, and the CD4:CD8 ratio.

  1. Systemic inflammarory response in canine pyometra

    OpenAIRE

    Fransson, Boel

    2003-01-01

    Research efforts have focused mainly on the hormonal aspects of canine pyometra for more than 6 decades. However, this disease is often manifested as systemic illness in response to the bacterial uterine infection. Studies I-II were undertaken to clarify bacteriological aspects of canine pyometra; i.e. the origin of the infecting bacteria, the infecting bacteria’s impact on severity of the systemic illness and the presence of bacterial endotoxin in the systemic circulation. Study I, a bacteri...

  2. Preliminary report on operational guidelines developed for use in emergency preparedness and response to a radiological dispersal device incident.

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C.; Cheng, J.-J.; Kamboj, S.; Domotor, S.; Wallo, A.; Environmental Science Division; DOE

    2006-12-15

    This report presents preliminary operational guidelines and supporting work products developed through the interagency Operational Guidelines Task Group (OGT). The report consolidates preliminary operational guidelines, all ancillary work products, and a companion software tool that facilitates their implementation into one reference source document. The report is intended for interim use and comment and provides the foundation for fostering future reviews of the operational guidelines and their implementation within emergency preparedness and response initiatives in the event of a radiological dispersal device (RDD) incident. The report principally focuses on the technical derivation and presentation of the operational guidelines. End-user guidance providing more details on how to apply these operational guidelines within planning and response settings is being considered and developed elsewhere. The preliminary operational guidelines are categorized into seven groups on the basis of their intended application within early, intermediate, and long-term recovery phases of emergency response. We anticipate that these operational guidelines will be updated and refined by interested government agencies in response to comments and lessons learned from their review, consideration, and trial application. This review, comment, and trial application process will facilitate the selection of a final set of operational guidelines that may be more or less inclusive of the preliminary operational guidelines presented in this report. These and updated versions of the operational guidelines will be made available through the OGT public Web site (http://ogcms.energy.gov) as they become finalized for public distribution and comment.

  3. LOFT system structural response during subcooled blowdown

    International Nuclear Information System (INIS)

    Martinell, J.S.

    1978-01-01

    The Loss-of-Fluid Test (LOFT) facility is a highly instrumented, pressurized water reactor test system designed to be representative of large pressurized water reactors (LPWRs) for the simulation of loss-of-coolant accidents (LOCAs). Detailed structural analysis and appropriate instrumentation (accelerometers and strain gages) on the LOFT system provided information for evaluation of the structural response of the LOFT facility for loss-of-coolant experiment (LOCE) induced loads. In general, the response of the system during subcooled blowdown was small with typical structural accelerations below 2.0 G's and dynamic strains less than 150 x 10 - 6 m/m. The accelerations measured at the steam generator and simulated steam generator flange exceeded LOCE design values; however, integration of the accelerometer data at these locations yielded displacements which were less than one half of the design values associated with a safe shutdown earthquake (SSE), which assures structural integrity for LOCE loads. The existing measurement system was adequate for evaluation of the LOFT system response during the LOCEs. The conditions affecting blowdown loads during nuclear LOCEs will be nearly the same as those experienced during the nonnuclear LOCEs, and the characteristics of the structural response data in both types of experiments are expected to be the same. The LOFT system is concluded to be adequately designed and further analysis of the LOFT system with structural codes is not required for future LOCE experiments

  4. Nuclear power plant operating experiences from the IAEA/NEA Incident Reporting System 1999-2002

    International Nuclear Information System (INIS)

    2003-01-01

    Incident reporting has become an increasingly important aspect of the operation and regulation of all public health and safety-related industries. Diverse industries such as aeronautics, chemicals, pharmaceuticals and explosives all depend on operating experience feedback to provide lessons learned about safety. The Incident Reporting System (IRS) is an essential element of the system for feeding back international operating experience for nuclear power plants. IRS reports contain information on events of Safety significance with important lessons learned. These experiences assist in reducing or eliminating recurrence of events at other plants. The IRS is jointly operated and managed by the Nuclear Energy Agency (NEA), a semi-autonomous body within the Organisation for Economic Co-operation and Development (OECD), and the International Atomic Energy Agency (IAEA). It is important that sufficient national resources be allocated to enable timely and high quality reporting of events important to safety, and to share these events in the IRS database. The first report, which covered the period July 1996 - June 1999, was widely acclaimed and encouraged both agencies to prepare this second report in order to highlight important lessons learned from around 300 events reported to the IRS for the period July 1999 - December 2002. Several areas were selected in this report to show the range of important topics available in the IRS. These include different types of failure in a variety of plant systems, as well as human performance considerations. This report is primarily aimed at senior officials in industry and government who have decision-making roles in the nuclear power industry

  5. Improving reconciliation following medical injury: a qualitative study of responses to patient safety incidents in New Zealand.

    Science.gov (United States)

    Moore, Jennifer; Mello, Michelle M

    2017-10-01

    Despite the investment in exploring patient-centred alternatives to medical malpractice in New Zealand (NZ), the UK and the USA, patients' experiences with these processes are not well understood. We sought to explore factors that facilitate and impede reconciliation following patient safety incidents and identify recommendations for strengthening institution-led alternatives to malpractice litigation. We conducted semistructured interviews with 62 patients injured by healthcare in NZ, administrators of 12 public hospitals, 5 lawyers specialising in Accident Compensation Corporation (ACC) claims and 3 ACC staff. NZ was chosen as the research site because it has replaced medical malpractice litigation with a no-fault scheme. Thematic analysis was used to identify key themes from interview transcripts. Interview responses converged on five elements of the reconciliation process that were important: (1) ask, rather than assume, what patients and families need from the process and recognise that, for many patients, being heard is important and should occur early in the reconciliation process; (2) support timely, sincere, culturally appropriate and meaningful apologies, avoiding forced or tokenistic quasi-apologies; (3) choose words that promote reconciliation; (4) include the people who patients want involved in the reconciliation discussion, including practitioners involved in the harm event; and (5) engage the support of lawyers and patient relations staff as appropriate. Policymakers and healthcare institutions are keenly interested in non-litigation approaches to resolving malpractice incidents. Interviewing participants involved in patient safety incident reconciliation processes suggests that healthcare institutions should not view apology as a substitute for other remedial actions; use flexible guidelines that distil best-practice principles, ensuring that steps are not missed, while not prescribing a 'one size fits all' communication approach. Published by the

  6. New insights into microbial responses to oil spills from the Deepwater Horizon incident

    Energy Technology Data Exchange (ETDEWEB)

    Mason, O.U.; Hazen, T.C.

    2011-06-15

    On April 20, 2010, a catastrophic eruption of methane caused the Deepwater Horizon exploratory drill rig drilling the Macondo Well in Mississippi Canyon Block 252 (MC252) to explode. The Deepwater Horizon oil spill was unprecendeted for several reasons: the volume of oil released; the spill duration; the well depth; the distance from the shore-line (77 km or about 50 miles); the type of oil (light crude); and the injection of dispersant directly at the wellhead. This study clearly demonstrated that there was a profound and significant response by certain members of the in situ microbial community in the deep-sea in the Gulf of Mexico. In particular putative hydrocarbon degrading Bacteria appeared to bloom in response to the Deepwater Horizon oil spill, even though the temperature at these depths is never >5 C. As the plume aged the shifts in the microbial community on a temporal scale suggested that different, yet metabolically important members of the community were able to respond to a myriad of plume constituents, e.g. shifting from propane/ethane to alkanes and finally to methane. Thus, the biodegradation of hydrocarbons in the plume by Bacteria was a highly significant process in the natural attenuation of many compounds released during the Deepwater Horizon oil spill.

  7. Design of a system for detecting and reporting security incidents and adverse events in thyroid and parathyroid surgery

    Directory of Open Access Journals (Sweden)

    José Luis PARDAL-REFOYO

    2016-03-01

    Full Text Available Introduction: Patient safety is defined as the reduction of risk of unnecessary harm associated with healthcare. Up to 9.3% of patients admitted into a hospital present some adverse event related to the assistance. This can cause damage to the patient, more instrumentation, increased morbidity, increased hospital stay and increased cost. To identify, record and analyze adverse events is necessary to have an incident reporting system. Objective: Developing a local system for reporting security incidents and adverse events in surgery of the thyroid gland. Method: A working group was formed with representatives from all units related to the process of thyroidectomy, checkpoints were established, checklists for each control point were designed, a strategic analysis of the group's activity was performed, a literature review was done in order to identify the major incident reporting systems, the items that the incident report form must have were identified and the form was designed. Results: The incident report form collects data on the patient, the communicator and the incident (type, cause, consequence, severity, frequency, risk matrix. It has a first paragraph with narrative sections and a second with drop-down lists. The form is accessible only to the working group for voluntary use. Conclusions: The purpose of the reporting system is learning and prevention.

  8. MCFRS Incidents by Station

    Data.gov (United States)

    Montgomery County of Maryland — This dataset contains the monthly summary data indicating incident occurred in each fire station response area. The summary data is the incident count broken down by...

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

    NARCIS (Netherlands)

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

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

  10. Oil Spill Incident Tracking [ds394

    Data.gov (United States)

    California Department of Resources — The Office of Spill Prevention and Response (OSPR) Incident Tracking Database is a statewide oil spill tracking information system. The data are collected by OSPR...

  11. Oil Spill Incident Tracking [ds394

    Data.gov (United States)

    California Natural Resource Agency — The Office of Spill Prevention and Response (OSPR) Incident Tracking Database is a statewide oil spill tracking information system. The data are collected by OSPR...

  12. RETRAN code analysis of Tsuruga-2 plant chemical volume control system (CVCS) reactor coolant leakage incident

    International Nuclear Information System (INIS)

    Kawai, H.

    2001-01-01

    JAPC purchased RETRAN, a program for transient thermal hydraulic analysis of complex fluid flow system, from the U.S. Electric Power Research Institute in 1992. Since then, JAPC has been utilizing RETRAN to evaluate safety margins of actual plant operation, in coping with troubles (investigating trouble causes and establishing countermeasures), and supporting reactor operation (reviewing operational procedures etc.). In this paper, a result of plant analysis performed on a CVCS reactor primary coolant leakage incident which occurred at JAPC's Tsuruga-2 plant (4-loop PWR, 3423 MWt, 1160 MW) on July 12 of 1999 and, based on the result, we made a plan to modify our operational procedure for reactor primary coolant leakage events in order to make earlier plant shutdown and this reduced primary coolant leakage. (author)

  13. Resveratrol Reduces the Incidence of Portal Vein System Thrombosis after Splenectomy in a Rat Fibrosis Model

    Science.gov (United States)

    Xu, Meng; Xue, Wanli; Ma, Zhenhua; Bai, Jigang

    2016-01-01

    Purpose. To investigate the preventive effect of resveratrol (RES) on the formation of portal vein system thrombosis (PVST) in a rat fibrosis model. Methods. A total of 64 male SD rats, weighing 200–300 g, were divided into five groups: Sham operation, Splenectomy I, Splenectomy II, RES, and low molecular weight heparin (LMWH), with the former two groups as nonfibrosis controls. Blood samples were subjected to biochemical assays. Platelet apoptosis was measured by flow cytometry. All rats were euthanized for PVST detection one week after operation. Results. No PVST occurred in nonfibrosis controls. Compared to Splenectomy II, the incidences of PVST in RES and LMWH groups were significantly decreased (both p Splenectomy II (all p splenectomy in cirrhotic rat. Regulation of platelet function and induction of platelet apoptosis might be the underlying mechanisms. PMID:27433290

  14. Intersubband Quantum Disc-in-Nanowire Photodetectors with Normal-Incidence Response in the Long-Wavelength Infrared.

    Science.gov (United States)

    Karimi, Mohammad; Heurlin, Magnus; Limpert, Steven; Jain, Vishal; Zeng, Xulu; Geijselaers, Irene; Nowzari, Ali; Fu, Ying; Samuelson, Lars; Linke, Heiner; Borgström, Magnus T; Pettersson, Håkan

    2018-01-10

    Semiconductor nanowires have great potential for realizing broadband photodetectors monolithically integrated with silicon. However, the spectral range of such detectors has so far been limited to selected regions in the ultraviolet, visible, and near-infrared regions. Here, we report on the first intersubband nanowire heterostructure array photodetectors exhibiting a spectrally resolved photoresponse from the visible to long-wavelength infrared. In particular, the infrared response from 3 to 20 μm is enabled by intersubband transitions in low-bandgap InAsP quantum discs synthesized axially within InP nanowires. The intriguing optical characteristics, including unexpected sensitivity to normal incident radiation, are explained by excitation of the longitudinal component of optical modes in the photonic crystal formed by the nanostructured portion of the detectors. Our results provide a generalizable insight into how broadband nanowire photodetectors may be designed and how engineered nanowire heterostructures open up new, fascinating opportunities for optoelectronics.

  15. Response of the 'patient dose calibrator' chamber for incident positions and sizes of X-ray fields

    International Nuclear Information System (INIS)

    Oliveira, Cassio M.; Abrantes, Marcos Eugenio S.; Ferreira, Flavia C. Bastos; Lacerda, Marco A. de Souza; Alonso, Thessa C.; Silva, Teogenes A. da; Oliveira, Paulo Marcio C.

    2009-01-01

    The evaluation of patient doses is an important tool for optimizing radiodiagnostic medical procedures with conventional X-ray equipment and for improving the quality of the radiographic image. The Patient Dose Calibrator (PDC) chamber is a dosimetric instrument that is used in the evaluation of the air kerma-area product (P KA ) quantity aiming the reduction of patient doses. The objective this work was to study the P KA variation caused by different field incident positions and sizes of the X-ray beam on the PDC chamber. Results showed that the PDC chamber has repeatability lower than 0.6%, beam position dependence of 3% and linearity response within ± 6%; these characteristics are to be taken into account during evaluation of the radiological protection conditions of conventional x-ray equipment. (author)

  16. The systemic inflammatory response syndrome predicts short-term outcome after transapical transcatheter aortic valve implantation

    NARCIS (Netherlands)

    Rettig, Thijs C D; Rigter, Sander; Nijenhuis, Vincent J.; Van Kuijk, Jan Peter; Ten Berg, Jurriën M.; Heijmen, Robin H.; Van De Garde, Ewoudt M W; Noordzij, Peter G.

    2015-01-01

    Objective Despite the minimally invasive nature of transcatheter aortic valve implantation (TAVI), the incidence of acute kidney injury (AKI) and mortality is of major concern. Several studies showed that outcome was influenced by the systemic inflammatory response syndrome (SIRS) in patients

  17. Nuclear incident response in industrial areas: assessing the economic impact of the decision to evacuate

    International Nuclear Information System (INIS)

    Pauwels, N.; Walle, B. van de; Hardeman, F.; Sohier, A.; Soudan, K.

    1996-01-01

    The economic impact of imposing countermeasures in case of a nuclear emergency is a very important aspect in both the Probabilistic Risk Assessment code COSYMA and the Real-time On-line DecisiOn Support system RODOS. Therefore, these codes make use of the economic model ECONOM. In this paper, we will show that this economic model is not very well suited, nor designed, to predict the economic impact of evacuating a highly industrialised area in case of a nuclear emergency. Furthermore, we will indicate how recent economic investment theories can be used to deal with this decision problem in a more elaborate way. (author)

  18. Intrapixel response test system for multispectral characterization

    Science.gov (United States)

    Lind, Thomas A.; Reich, Robert K.; McGonagle, William H.; Kosicki, Bernard B.

    1999-04-01

    We report on the design of a system used to measure the multispectral intrapixel response of imaging sensor arrays. An Airy disk spot size of approximately 4 micrometers has been achieved for wavelength bands that extend from the visible blue to near IR. The automated system does rapid intrapixel row and/or column spatial mapping of individual pixels as well as rastered 2D spatial scans over multi-pixel girds. Commercially available equipment including a photometric eyepiece, a reflective objects, programmable pushers, and light-emitting diodes are utilized in the system. Scanned results using the system are presented for both front- and back-illuminating charge-coupled device imagers. The intrapixel response of a front-illuminated device shows good correlation with the physical cross section of the devices tested.

  19. Operating Experience from Events Reported to the IAEA Incident Reporting System for Research Reactors

    International Nuclear Information System (INIS)

    2015-03-01

    Operating experience feedback is an effective mechanism in providing lessons learned from events and the associated corrective actions to prevent them, helping to improve safety at nuclear installations. The Incident Reporting System for Research Reactors (IRSRR), which is operated by the IAEA, is an important tool for international exchange of operating experience feedback for research reactors. The IRSRR reports contain information on events of safety significance with their root causes and lessons learned which help in reducing the occurrence of similar events at research reactors. To improve the effectiveness of the system, it is essential that national organizations demonstrate an appropriate interest for the timely reporting of events important to safety and share the information in the IRSRR database. At their biennial technical meetings, the IRSRR national coordinators recommended collecting the operating experience from the events reported to the IRSRR and disseminating it in an IAEA publication. This publication highlights the root causes, safety significance, lessons learned, corrective actions and the causal factors for the events reported to the IRSRR up to September 2014. The publication also contains relevant summary information on research reactor events from sources other than the IRSRR, operating experience feedback from the International Reporting System for Operating Experience considered relevant to research reactors, and a description of the elements of an operating experience programme as established by the IAEA safety standards. This publication will be of use to research reactor operating organizations, regulators and designers, and any other organizations or individuals involved in the safety of research reactors

  20. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care

    NARCIS (Netherlands)

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M.; Hoffmann, Barbara; Esmail, Aneez

    2015-01-01

    Background: Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety.Objective: To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary

  1. Can a pediatric trauma center improve the response to a mass casualty incident?

    Science.gov (United States)

    Barthel, Erik R; Pierce, James R; Goodhue, Catherine J; Burke, Rita V; Ford, Henri R; Upperman, Jeffrey S

    2012-10-01

    Recent events including the 2001 terrorist attacks on New York; Hurricane Katrina; the 2010 Haitian and Chilean earthquakes; and the 2011 earthquake, tsunami, and nuclear disaster in Japan have reminded disaster planners and responders of the tremendous scale of mass casualty disasters and their resulting human devastation. Although adult disaster medicine is a well-developed field with roots in wartime medicine, we are increasingly recognizing that children may comprise up to 50% of disaster victims, and response mechanisms are often designed without adequate preparation for the number of pediatric victims that can result. In this short educational review, we explore the differences between the pediatric and adult disaster and trauma populations, the requirements for designation of a site as a pediatric trauma center (PTC), and the magnitude of the problem of pediatric disaster patients as described in the literature, specifically as it pertains to the availability and use of designated PTCs as opposed to trauma centers in general. We also review our own experience in planning and simulating pediatric mass casualty events and suggest strategies for preparedness when there is no PTC available. We aim to demonstrate from this brief survey that the availability of a designated PTC in the setting of a mass casualty disaster event is likely to significantly improve the outcome for the pediatric demographic of the affected population. We conclude that the relative scarcity of disaster data specific to children limits epidemiologic study of the pediatric disaster population and offer suggestions for strategies for future study of our hypothesis. Systematic review, level III.

  2. Thermoelectric-Driven Sustainable Sensing and Actuation Systems for Fault-Tolerant Nuclear Incidents

    Energy Technology Data Exchange (ETDEWEB)

    Longtin, Jon [Stony Brook Univ., NY (United States)

    2016-02-08

    The Fukushima Daiichi nuclear incident in March 2011 represented an unprecedented stress test on the safety and backup systems of a nuclear power plant. The lack of reliable information from key components due to station blackout was a serious setback, leaving sensing, actuation, and reporting systems unable to communicate, and safety was compromised. Although there were several independent backup power sources for required safety function on site, ultimately the batteries were drained and the systems stopped working. If, however, key system components were instrumented with self-powered sensing and actuation packages that could report indefinitely on the status of the system, then critical system information could be obtained while providing core actuation and control during off-normal status for as long as needed. This research project focused on the development of such a self-powered sensing and actuation system. The electrical power is derived from intrinsic heat in the reactor components, which is both reliable and plentiful. The key concept was based around using thermoelectric generators that can be integrated directly onto key nuclear components, including pipes, pump housings, heat exchangers, reactor vessels, and shielding structures, as well as secondary-side components. Thermoelectric generators are solid-state devices capable of converting heat directly into electricity. They are commercially available technology. They are compact, have no moving parts, are silent, and have excellent reliability. The key components to the sensor package include a thermoelectric generator (TEG), microcontroller, signal processing, and a wireless radio package, environmental hardening to survive radiation, flooding, vibration, mechanical shock (explosions), corrosion, and excessive temperature. The energy harvested from the intrinsic heat of reactor components can be then made available to power sensors, provide bi-directional communication, recharge batteries for other

  3. Thermoelectric-Driven Sustainable Sensing and Actuation Systems for Fault-Tolerant Nuclear Incidents

    International Nuclear Information System (INIS)

    Longtin, Jon

    2015-09-01

    The Fukushima Daiichi nuclear incident in March 2011 represented an unprecedented stress test on the safety and backup systems of a nuclear power plant. The lack of reliable information from key components due to station blackout was a serious setback, leaving sensing, actuation, and reporting systems unable to communicate, and safety was compromised. Although there were several independent backup power sources for required safety function on site, ultimately the batteries were drained and the systems stopped working. If, however, key system components were instrumented with self-powered sensing and actuation packages that could report indefinitely on the status of the system, then critical system information could be obtained while providing core actuation and control during off-normal status for as long as needed. This research project focused on the development of such a self-powered sensing and actuation system. The electrical power is derived from intrinsic heat in the reactor components, which is both reliable and plentiful. The key concept was based around using thermoelectric generators that can be integrated directly onto key nuclear components, including pipes, pump housings, heat exchangers, reactor vessels, and shielding structures, as well as secondary-side components. Thermoelectric generators are solid-state devices capable of converting heat directly into electricity. They are commercially available technology. They are compact, have no moving parts, are silent, and have excellent reliability. The key components to the sensor package include a thermoelectric generator (TEG), microcontroller, signal processing, and a wireless radio package, environmental hardening to survive radiation, flooding, vibration, mechanical shock (explosions), corrosion, and excessive temperature. The energy harvested from the intrinsic heat of reactor components can be then made available to power sensors, provide bi-directional communication, recharge batteries for other

  4. CLASSIFICATION OF THE MGR EMERGENCY RESPONSE SYSTEM

    International Nuclear Information System (INIS)

    Zeigler, J.A.

    1999-01-01

    The purpose of this analysis is to document the Quality Assurance (QA) classification of the Monitored Geologic Repository (MGR) emergency response system structures, systems and components (SSCs) performed by the MGR Safety Assurance Department. This analysis also provides the basis for revision of YMP/90-55Q, Q-List (YMP 1998). The Q-List identifies those MGR SSCs subject to the requirements of DOE/RW-0333P7 ''Quality Assurance Requirements and Description'' (QARD) (DOE 1998)

  5. Systemic Inflammatory Response and Adhesion Molecules

    Directory of Open Access Journals (Sweden)

    L. V. Molchanova

    2005-01-01

    Full Text Available The lecture presents the materials of foreign studies on the mechanisms responsible for the formation of a systemic inflammatory response syndrome (SIRS. The hypotheses accounting for the occurrence of SIRS in emergencies are described. Adhesion molecules (AM and endothelial dysfunction are apparent to be involved in the inflammatory process, no matter what the causes of SIRS are. The current classification of AM and adhesion cascades with altered blood flow is presented. There are two lines in the studies of AM. One line is to measure the concentration of AM in the plasma of patients with emergencies of various etiology. The other is to study the impact of antiadhesion therapy on the alleviation of the severity of terminal state and its outcome. The studies provide evidence for that an adhesive process is a peculiar prelude to a systemic inflammatory response.

  6. From Management Systems to Corporate Social Responsibility

    NARCIS (Netherlands)

    Zwetsloot, G.I.J.M.

    2003-01-01

    At the start of the 21st century, Corporate Social Responsibility (CSR) seems to have great potential for innovating business practices with a positive impact on People, Planet and Profit. In this article the differences between the management systems approach of the nineties, and Corporate Social

  7. Magnetic Field Response Measurement Acquisition System

    Science.gov (United States)

    Woodward, Stanley E. (Inventor); Taylor, Bryant D. (Inventor)

    2007-01-01

    Magnetic field response sensors designed as passive inductor- capacit or circuits produce magnetic field responses whose harmonic frequenci es correspond to states of physical properties for which the sensors measure. Power to the sensing element is acquired using Faraday induc tion. A radio frequency antenna produces the time varying magnetic fi eld used for powering the sensor, as well as receiving the magnetic field response of the sensor. An interrogation architecture for disce rning changes in sensor's response frequency, resistance and amplitud e is integral to the method thus enabling a variety of measurements. Multiple sensors can be interrogated using this method, thus eliminat ing the need to have a data acquisition channel dedicated to each se nsor. The method does not require the sensors to be in proximity to a ny form of acquisition hardware. A vast array of sensors can be used as interchangeable parts in an overall sensing system.

  8. Dog bite histories and response to incidents in canine rabies-enzootic KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Melinda Hergert

    Full Text Available The objective of this paper is to report evaluated observations from survey records captured through a cross-sectional observational study regarding canine populations and dog owners in rabies enzootic KwaZulu-Natal province, South Africa. Our aim was to evaluate respondent knowledge of canine rabies and response to dog bite incidents towards improved rabies control. Six communities consisting of three land use types were randomly sampled from September 2009 to January 2011, using a cluster design. A total of 1992 household records were analyzed using descriptive statistics and regression modeling to evaluate source of rabies knowledge, experiences with dog bites, and factors affecting treatment received within respective households that occurred within the 365 day period prior to the surveys. 86% of the population surveyed had heard of rabies. Non-dog owners were 1.6 times more likely to have heard of rabies than dog owners; however, fear of rabies was not a reason for not owning a dog. Government veterinary services were reported most frequently as respondent source of rabies knowledge. Nearly 13% of households had a member bitten by a dog within the year prior to the surveys with 82% of the victims visiting a clinic as a response to the bite. 35% of these clinic visitors received at least one rabies vaccination. Regression modeling determined that the only response variable that significantly reflected the likelihood of a patient receiving rabies vaccination or not was the term for the area surveyed. Overall the survey showed that most respondents have heard of dog associated rabies and seek medical assistance at a clinic in response to a dog bite regardless of offending dog identification. An in-depth study involving factors associated within area clinics may highlight the area dependency for patients receiving rabies post exposure prophylaxis shown by this model.

  9. Marshall Grazing Incidence X-ray Spectrometer (MaGIXS) Slit-Jaw Imaging System

    Science.gov (United States)

    Wilkerson, P.; Champey, P. R.; Winebarger, A. R.; Kobayashi, K.; Savage, S. L.

    2017-12-01

    The Marshall Grazing Incidence X-ray Spectrometer is a NASA sounding rocket payload providing a 0.6 - 2.5 nm spectrum with unprecedented spatial and spectral resolution. The instrument is comprised of a novel optical design, featuring a Wolter1 grazing incidence telescope, which produces a focused solar image on a slit plate, an identical pair of stigmatic optics, a planar diffraction grating and a low-noise detector. When MaGIXS flies on a suborbital launch in 2019, a slit-jaw camera system will reimage the focal plane of the telescope providing a reference for pointing the telescope on the solar disk and aligning the data to supporting observations from satellites and other rockets. The telescope focuses the X-ray and EUV image of the sun onto a plate covered with a phosphor coating that absorbs EUV photons, which then fluoresces in visible light. This 10-week REU project was aimed at optimizing an off-axis mounted camera with 600-line resolution NTSC video for extremely low light imaging of the slit plate. Radiometric calculations indicate an intensity of less than 1 lux at the slit jaw plane, which set the requirement for camera sensitivity. We selected a Watec 910DB EIA charge-coupled device (CCD) monochrome camera, which has a manufacturer quoted sensitivity of 0.0001 lux at F1.2. A high magnification and low distortion lens was then identified to image the slit jaw plane from a distance of approximately 10 cm. With the selected CCD camera, tests show that at extreme low-light levels, we achieve a higher resolution than expected, with only a moderate drop in frame rate. Based on sounding rocket flight heritage, the launch vehicle attitude control system is known to stabilize the instrument pointing such that jitter does not degrade video quality for context imaging. Future steps towards implementation of the imaging system will include ruggedizing the flight camera housing and mounting the selected camera and lens combination to the instrument structure.

  10. Warning systems and public warning response

    Energy Technology Data Exchange (ETDEWEB)

    Sorensen, J.H.

    1993-09-01

    This background paper reviews current knowledge on warning systems and human response to warnings. It expands on an earlier paper prepared for a workshop on the Second Assessment on Natural Hazards, held in Estes Park, Colorado in July 1992. Although it has a North American perspective, many of the lessons learned are universally applicable. The paper addresses warning systems in terms of dissemination and does not cover physical science issues associated with prediction and forecast. Finally, it covers hazards with relatively short lead times -- 48 hours or less. It does not address topics such as long-term forecasts of earthquakes or volcanic eruptions or early famine warning systems.

  11. Post-event reviews: Using a quantitative approach for analysing incident response to demonstrate the value of business continuity programmes and increase planning efficiency.

    Science.gov (United States)

    Vaidyanathan, Karthik

    2017-01-01

    Business continuity management is often thought of as a proactive planning process for minimising impact from large-scale incidents and disasters. While this is true, and it is critical to plan for the worst, consistently validating plan effectiveness against smaller disruptions can enable an organisation to gain key insights about its business continuity readiness, drive programme improvements, reduce costs and provide an opportunity to quantitatively demonstrate the value of the programme to management. This paper describes a post mortem framework which is used as a continuous improvement mechanism for tracking, reviewing and learning from real-world events at Microsoft Customer Service & Support. This approach was developed and adopted because conducting regular business continuity exercises proved difficult and expensive in a complex and distributed operations environment with high availability requirements. Using a quantitative approach to measure response to incidents, and categorising outcomes based on such responses, enables business continuity teams to provide data-driven insights to leadership, change perceptions of incident root cause, and instil a higher level of confidence towards disaster response readiness and incident management. The scope of the framework discussed here is specific to reviewing and driving improvements from operational incidents. However, the concept can be extended to learning and evolving readiness plans for other types of incidents.

  12. Response to the Rio Orinoco incident: A small-scale indicent that lasted a whole year

    International Nuclear Information System (INIS)

    Audet, A.

    1993-01-01

    When the tanker Rio Orinoco ran aground on October 16, 1990, in the Gulf of St Lawrence near Anticosti Island, approximately 200 metric tons, or 200,000 liters, of fuel oil were spilled. Most of the pollution drifted onto the shores of Anticosti Island, which is considered a hunting and fishing paradise. The island is a controlled provincial reserve that is home to more than 100,000 deer and many species of sea birds. It provides ideal grazing for deer and feeding grounds for sea birds. Within hours of the grounding, the Canadian Coast Guard set its emergency system in motion and dispatched a team of experts to the site. Since Anticosti Island is located in the middle of the Gulf of St Lawrence, the only way to reach the area quickly was to charter a plane. The first to arrive established a command post in the municipal offices of the small community of Port Meunier. During the first few days, experts hired by the insurance company devised a salvage plan. Unfortunately, it could not be carried out owing to bad weather, and all five attempts made in the weeks that followed were also futile. All this time, cleanup operations on the shoreline continued, with about a hundred men deployed over more than 60 kilometers. Getting to the shore proved to be a challenge since roads are nonexistent on most of the island. The Canadian Coast Guard turned to an air cushion vehicle to solve a tricky problem in an isolated area. Here in Canada, the elements are a constant challenge when trying to recover oil and clean up a shoreline. On December 21, 1990, Mother Nature got the upper hand, and there was no choice but to abandon, for the winter, the idea of removing the wreck of the Rio Orinoco. All winter long, it continued to pose a serious pollution threat. In June 1991, restoration and cleanup work on the shoreline resumed and this was completed in late July. The wreck of the Rio Orinoco was removed on August 6, 1991

  13. Stress Response, Brain Noradrenergic System and Cognition.

    Science.gov (United States)

    Winklewski, Pawel J; Radkowski, Marek; Wszedybyl-Winklewska, Magdalena; Demkow, Urszula

    2017-01-01

    Locus coeruleus is a critical component of the brain noradrenergic system. The brain noradrenergic system provides the neural substrate for the architecture supporting the interaction with, and navigation through, an external world complexity. Changes in locus coeruleus tonic and phasic activity and the interplay between norepinephrine and α 1 - and α 2 -adrenoceptors in the prefrontal cortex are the key elements of this sophisticated architecture. In this narrative review we discuss how the brain noradrenergic system is affected by increased exposure to corticotropin-releasing hormone triggered by stress response. In particular, we present the mechanisms responsible for thinking inflexibility often observed under highly stressful conditions. Finally, the main directions for future research are highlighted.

  14. Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections

    Directory of Open Access Journals (Sweden)

    Gajović Olgica

    2011-01-01

    Full Text Available Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30% patients developed nosocomial pneumonia. The time to develop pneumonia was 10±6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS score <9, mechanical ventilation, duration of mechanical ventilation, tracheostomy, presence of nasogastric tube and enteral feeding. The most commonly isolated pathogens were Klebsiella-Enterobacter spp. (33.3%, Pseudomonas aeruginosa (24.1%, Acinetobacter spp. (16.6% and Staphylococcus aureus (25.9%. Conclusion. Nosocomial pneumonia is the major cause of morbidity and mortality of patients with central nervous system infections. Patients on mechanical ventilation are particularly at a high risk. The mortality rate of patients with nosocomial pneumonia was 54.4% and it was five times higher than in patients without pneumonia.

  15. Compensation of errors due to incident beam drift in a 3 DOF measurement system for linear guide motion.

    Science.gov (United States)

    Hu, Pengcheng; Mao, Shuai; Tan, Jiu-Bin

    2015-11-02

    A measurement system with three degrees of freedom (3 DOF) that compensates for errors caused by incident beam drift is proposed. The system's measurement model (i.e. its mathematical foundation) is analyzed, and a measurement module (i.e. the designed orientation measurement unit) is developed and adopted to measure simultaneously straightness errors and the incident beam direction; thus, the errors due to incident beam drift can be compensated. The experimental results show that the proposed system has a deviation of 1 μm in the range of 200 mm for distance measurements, and a deviation of 1.3 μm in the range of 2 mm for straightness error measurements.

  16. The incidence and prevalence of systemic lupus erythematosus in Thrace, 2003-2014: A 12-year epidemiological study.

    Science.gov (United States)

    Pamuk, O N; Balci, M A; Donmez, S; Tsokos, G C

    2016-01-01

    We estimated the prevalence and incidence, clinical features, treatment, and prognosis of systemic lupus erythematosus (SLE) patients in the Thrace region of Turkey. We retrospectively evaluated 331 patients (307 female, 24 male, mean age 38.5 years) diagnosed with SLE between 2003 and 2014. Clinical features, treatments, and response to various treatment modalities were recorded. Our hospital has been the only tertiary referral center for rheumatological diseases for a mixed rural and urban population of 620,477 people (306,036 females, 314,411 males) for more than 16 years. The mean annual incidence of SLE was 4.44/100,000 (females, 8.4/100,000; males, 0.6/100,000). The overall prevalence of SLE was 51.7/100,000 (females, 97.7/100,000; males, 7/100,000). Major organ involvement was present in the following percentages: neurologic involvement: 20.1%; renal involvement: 28.2%; autoimmune hemolytic anemia: 9.6%; thrombocytopenia: 14.7%. Seventeen SLE patients (13 females, four males) died at a median follow-up of 48 months. The five-year survival was 94.5%, and the ten-year survival was 89.9%. According to Kaplan-Meier survival analysis, poor prognostic factors were: male gender (p = 0.015); smoking (p = 0.02); pleural involvement (p = 0.011); thrombocytopenia (p = 0.021); myocarditis (p = 0.028); renal involvement (p = 0.037); treatment with cyclophosphamide (p = 0.011); and an initial high SLEDAI score (>4) (p = 0.02). Lymphopenia at the time of diagnosis appeared as a favorable prognostic factor (p = 0.008). Cox regression analysis revealed myocarditis (OR: 20.4, p = 0.018) and age at diagnosis (OR: 1.11, p = 0.035) to be poor, and lymphopenia at the time of diagnosis to be good prognostic factors (OR:0.13, p = 0.031). The annual incidence and prevalence of SLE in the Thrace region of Turkey is lower than those reported in North America, however they are similar to those reported for European countries. Clinical manifestations appear to be milder, whereas

  17. Thermometry of the system “heat-resistant sample - incident plasma stream”

    Science.gov (United States)

    Sargsyan, M. A.; Chinnov, V. F.; Kavyrshin, D. I.; Gadzhiev, M. Kh; Khromov, M. A.; Chistolinov, A. V.; Senchenko, V. N.

    2017-11-01

    To study the interacting system “heat-resistant sample – an incident plasma stream” a setup of synchronized measurement equipment was developed and tested that recorded the main parameters of such interaction. Heat resistance tests were carried out on the samples of MPG-6 grade isotropic graphite, and samples of pyrolytic graphite that were subjected to a long (60 … 100 s) exposure to nitrogen, argon and air plasma streams at atmospheric pressure. As plasma generators a series of plasma torches with a vortex stabilization of the stream and an expanding anode channels was used. The temperature and composition of the plasma in the jet and near the sample were determined using two AvaSpec2048 and AvaSpec3648 scanning optical spectrometers and the MS5402i spectrograph with the Andor matrix at its outlet. The surface temperature of the sample was determined in real time using three independent ways: two pyrometric systems - a high-speed micro-pyrometer FMP1001 and a two-position visualization of the heated sample by high-speed Motion Pro X3 and VS-FAST cameras, and the spectral analysis of the wide-range thermal radiation of the samples. The main method for determining the rate of material loss during the action of a plasma jet on it was to analyze a two-position synchronous visualization of the “jet-sample” system. When a crater was formed on the surface of the sample under the “dagger” effect of a plasma jet, a video recording system of the crater zone was used, backlit using the “laser knife” method.

  18. Ventilator-Related Adverse Events: A Taxonomy and Findings From 3 Incident Reporting Systems

    Science.gov (United States)

    Pham, Julius Cuong; Williams, Tamara L; Sparnon, Erin M; Cillie, Tam K; Scharen, Hilda F; Marella, William M

    2016-01-01

    BACKGROUND: In 2009, researchers from Johns Hopkins University's Armstrong Institute for Patient Safety and Quality; public agencies, including the FDA; and private partners, including the Emergency Care Research Institute and the University HealthSystem Consortium (UHC) Safety Intelligence Patient Safety Organization, sought to form a public-private partnership for the promotion of patient safety (P5S) to advance patient safety through voluntary partnerships. The study objective was to test the concept of the P5S to advance our understanding of safety issues related to ventilator events, to develop a common classification system for categorizing adverse events related to mechanical ventilators, and to perform a comparison of adverse events across different adverse event reporting systems. METHODS: We performed a cross-sectional analysis of ventilator-related adverse events reported in 2012 from the following incident reporting systems: the Pennsylvania Patient Safety Authority's Patient Safety Reporting System, UHC's Safety Intelligence Patient Safety Organization database, and the FDA's Manufacturer and User Facility Device Experience database. Once each organization had its dataset of ventilator-related adverse events, reviewers read the narrative descriptions of each event and classified it according to the developed common taxonomy. RESULTS: A Pennsylvania Patient Safety Authority, FDA, and UHC search provided 252, 274, and 700 relevant reports, respectively. The 3 event types most commonly reported to the UHC and the Pennsylvania Patient Safety Authority's Patient Safety Reporting System databases were airway/breathing circuit issue, human factor issues, and ventilator malfunction events. The top 3 event types reported to the FDA were ventilator malfunction, power source issue, and alarm failure. CONCLUSIONS: Overall, we found that (1) through the development of a common taxonomy, adverse events from 3 reporting systems can be evaluated, (2) the types of

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

    Science.gov (United States)

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

    2018-01-01

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

  20. 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…

  1. Demand Response as a System Reliability Resource

    Energy Technology Data Exchange (ETDEWEB)

    Eto, Joseph H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Lewis, Nancy Jo [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Watson, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Kiliccote, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Auslander, David [Univ. of California, Berkeley, CA (United States); Paprotny, Igor [Univ. of California, Berkeley, CA (United States); Makarov, Yuri [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2012-12-31

    The Demand Response as a System Reliability Resource project consists of six technical tasks: • Task 2.1. Test Plan and Conduct Tests: Contingency Reserves Demand Response (DR) Demonstration—a pioneering demonstration of how existing utility load-management assets can provide an important electricity system reliability resource known as contingency reserve. • Task 2.2. Participation in Electric Power Research Institute (EPRI) IntelliGrid—technical assistance to the EPRI IntelliGrid team in developing use cases and other high-level requirements for the architecture. • Task 2.3. Research, Development, and Demonstration (RD&D) Planning for Demand Response Technology Development—technical support to the Public Interest Energy Research (PIER) Program on five topics: Sub-task 1. PIER Smart Grid RD&D Planning Document; Sub-task 2. System Dynamics of Programmable Controllable Thermostats; Sub-task 3. California Independent System Operator (California ISO) DR Use Cases; Sub-task 4. California ISO Telemetry Requirements; and Sub-task 5. Design of a Building Load Data Storage Platform. • Task 2.4. Time Value of Demand Response—research that will enable California ISO to take better account of the speed of the resources that it deploys to ensure compliance with reliability rules for frequency control. • Task 2.5. System Integration and Market Research: Southern California Edison (SCE)—research and technical support for efforts led by SCE to conduct demand response pilot demonstrations to provide a contingency reserve service (known as non-spinning reserve) through a targeted sub-population of aggregated residential and small commercial customers enrolled in SCE’s traditional air conditioning (AC) load cycling program, the Summer Discount Plan. • Task 2.6. Demonstrate Demand Response Technologies: Pacific Gas and Electric (PG&E)—research and technical support for efforts led by PG&E to conduct a demand response pilot demonstration to provide non

  2. [Preliminary results of an anonymous internet-based reporting system for critical incidents in ambulatory primary care].

    Science.gov (United States)

    Brun, A

    2005-03-01

    To learn from errors is not always easy, especially if they happened to others! This paper describes the organization and management of a critical incident reporting system for primary care physicians in Switzerland and reports about the difficulties and experiences during the first 18 months since the start of the program. It seems to be particularly difficult to enhance the attentiveness of physicians for apparently harmless daily critical incidents and to motivate them to report it even in an anonymous reporting system. As incentives for more intensive participation there are the hope for comments on reported cases by other participants and the expectation that reported errors will be avoided by the readers.

  3. Relationship of the imaging properties of the I.I./TV based DR system for incident exposures

    International Nuclear Information System (INIS)

    Ogura, Toshihiro

    1993-01-01

    We investigated imaging properties of a 2048 x 2048 matrix I.I./TV based digital radiography (DR) system (DR-2000 H) for various incident exposures. It should be noted that the resolution property of the I.I./TV based DR system depends on the incident exposures, the level of signal current from the TV image pickup tube and also regarding the size of the iris in the TV lens. Digital Wiener spectra and the detectabilities of low-contrast objects were measured for different incident exposures. It can be clearly seen that the noise properties and detectabilities decreased with a decrease in the incident exposures. The digital Wiener spectra also seemed to depend on the specific combination of the MTF's of the optical lenses, the level of signal current from the TV image pickup tube and quantum mottle. We must pay attention to these parameters when acquiring clinical images and evaluating the imaging properties. Furthermore, because the sensitivity of this system is higher than that of screen-film system, an X-ray tube of 0.2-mm focal spot is available routinely, the effect of geometric unsharpness can be reduced in practical clinical implementation; the resolving power of the DR system with 7''-I.I. mode at a certain magnification factor are equivalent or even superior to the resolving power of screen-film system employed. (author)

  4. Dynamic Response of Wall Backfill Retaining System

    Directory of Open Access Journals (Sweden)

    Sreenivas Alampalli

    1997-01-01

    Full Text Available An in situ full-scale test is conducted to measure the dynamic response of a long cantilever wall that retains backfill soil. The recorded modal parameters of this retaining wall exhibited significant similarity to those of a clamped cantilever plate (rather than those of a cantilever beam or plane-strain analysis. Such a three-dimensional (3-D response pattern is not accounted for by current analysis procedures. A simple 3-D finite element model is employed to further analyze the observed resonant configurations. The results indicate that such configurations play an important role in the seismic response of wall backfill soil systems of variable height, such as wing walls supporting highway approach ramps.

  5. Central nervous system complications during pediatric extracorporeal life support: incidence and risk factors.

    Science.gov (United States)

    Cengiz, Pelin; Seidel, Kristy; Rycus, Peter T; Brogan, Thomas V; Roberts, Joan S

    2005-12-01

    Identify the incidence and risk factors for development of acute, severe central nervous system (CNS) complications of pediatric extracorporeal life support (ECLS). Retrospective review of Extracorporeal Life Support Organization (ELSO) registry database. Pediatric intensive care units of 115 tertiary centers internationally. Pediatric patients, 1 month to 18 yrs of age, who had ECLS between the years 1981-2002. Data concerning 4,942 patients who underwent one run of ECLS were analyzed. Six hundred thirty-six patients (12.9%) developed acute, severe CNS complications. Patients who required ECLS during extracorporeal cardiopulmonary resuscitation (n = 161; 3.3%) were more likely to develop CNS complications (n = 42; 26.1%) than patients who did not have extracorporeal cardiopulmonary resuscitation (p 3.0 mg/dL, use of inotropes, presence of myocardial stun, and requirement of cardiopulmonary resuscitation during ECLS independently predicted development of CNS complications. Patients who have metabolic acidosis, a bicarbonate or inotrope/vasopressor requirement, cardiopulmonary resuscitation, or a left ventricular assist device before initiation of ECLS are at greater risk for development of CNS complications. After initiation of ECLS, patients who develop renal failure or metabolic acidosis or undergo venoarterial ECLS should be closely monitored for development of CNS complications.

  6. The United States Department of Energy (DOE) Computerized Accident/Incident Reporting System (CAIRS)

    International Nuclear Information System (INIS)

    Briscoe, G.J.

    1993-01-01

    The Department of Energy's (DOE) Computerized Accident/Incident Reporting System (CAIRS) is a comprehensive data base containing more than 50,000 investigation reports of injury/illness, property damage and vehicle accident cases representing safety data from 1975 to the present for more than 150 DOE contractor organizations. A special feature is that the text of each accident report is translated using a controlled dictionary and rigid sentence structure called Factor Relationship and Sequence of Events (FRASE) that enhances the ability to retrieve specific types of information and to perform detailed analyses. DOE summary and individual contractor reports are prepared quarterly and annually. In addition, ''Safety Performance Profile'' reports for individual organizations are prepared to provide advance information to appraisal teams, and special topical reports are prepared for areas of concern such as an increase in the number of security injuries or environmental releases. The data base is open to all DOE and Contractor registered users with no access restrictions other than that required by the Privacy Act

  7. Selective tuberculosis incidence estimation by digital computer information technologies in the MS Excel system

    Directory of Open Access Journals (Sweden)

    G. I. Ilnitsky

    2014-01-01

    Full Text Available The incidence of tuberculosis was estimated in different age groups of people, applying the digital computer information technologies of tracking. For this, the author used the annual forms of the reporting materials stipulated by the Ministry of Health of Ukraine, the results of his observations, and the data of bank information accumulation in the MS Excel system. The initial positions were formed in terms of the epidemiological indicators of Ukraine and the Lvov Region during a 10-year period (2000-2009 that was, in relation with different initial characteristics, divided into Step 1 (2000-2004 in which the tuberculosis epidemic situation progressively deteriorated and Step 2 (2005-2009 in which relative morbidity was relatively stabilized. The results were processed using the MS Excel statistical and mathematical functions that were parametric and nonparametric in establishing a correlation when estimating the changes in epidemic parameters. The findings of studies among the general population could lead to the conclusion that the mean tuberculosis morbidity in Ukraine was much greater than that in the Lvov Region irrespective of the age of a population. At the same time, the morbidity rate in the foci of tuberculosis infection suggested that it rose among both the children, adolescents, and adults, which provided a rationale for that therapeutic and preventive measures should be better implemented.

  8. Recent events in NPPs and incident reporting system (IRS) activity. Working material

    International Nuclear Information System (INIS)

    1996-01-01

    The IAEA convened the 1996 Joint Meeting to Exchange Information on Recent Events in Nuclear Power Plants and the Technical Committee-Annual Meeting of the Incident Reporting System (IRS) national co-ordinators, organized jointly with the Nuclear Energy Agency (NEA) of the OECD in Paris, France from 22-26 April 1996. These consecutive meetings took place at the OECD Headquarters, 2 rue Andre Pascal. The main objective of the first meeting (22-24 April 1996) was to exchange and discuss information on recent events which occurred in NPPs. The second meeting (25-26 April 1996) was devoted to the IAEA and NEA activity in the framework of the IRS. The main issues of the programme at the meetings were as follows: in-depth discussion on NPP recent events, presented by the participants; panel discussion on operational safety experience issues identified by the participants; IAEA and NEA activities on IRS subjects in 1995-1996 and plans for the future; issues from the inter-agency's IRS Advisory Committee. Annexes I and II provide more information on the programme at the meetings. A list of participants is given in Annex III (50 participants from 22 countries and 3 international organization). Annexes IV and V provide information on national presentations on recent events. Figs, tabs

  9. Audience response systems: technology to engage learners.

    Science.gov (United States)

    Collins, Jannette

    2008-09-01

    An audience response system (ARS) provides a means of infusing interaction into a traditional didactic lecture format, enhancing student attention and learning. It can be used in a variety of ways, with both large and small audiences, to evaluate participants' knowledge, attitudes, and opinions or to verify student attendance at a lecture. The technology of ARS has markedly improved over the years, resulting in systems that are less costly and easier to use. Commercial systems that can be rented or purchased as well as local systems that can be downloaded free via the Internet are available. In this essay, the author reviews the components of an ARS, the history of ARS, educational outcomes related to ARS use, the benefits and limitations of ARS, tips for using an ARS, and current developments in ARS.

  10. Response of Kondo lattice systems to pressure

    International Nuclear Information System (INIS)

    Thompson, J.D.; Borges, H.A.; Fisk, Z.; Horn, S.; Parks, R.D.; Wells, G.L.

    1987-01-01

    Yb-based Kondo lattice systems (YbAgCu 4 , YbCu 2 Si 2 , YbRh 2 Si 2 ) represent an interesting class of materials in which it is possible to study systematically the development of heavy electron behavior through the application of pressure. Certainly, additional experiments are required to determine to what extent Yb compounds are mirror images of their Ce counterparts. Finally, pressure reveals the presence of competing interactions for which a simple model exists that qualitatively accounts for the pressure response observed in a large number of Ce, U and Yb-based Kondo lattice systems

  11. Ion-Responsive Drug Delivery Systems.

    Science.gov (United States)

    Yoshida, Takayuki; Shakushiro, Kohsuke; Sako, Kazuhiro

    2018-02-08

    Some kinds of cations and anions are contained in body fluids such as blood, interstitial fluid, gastrointestinal juice, and tears at relatively high concentration. Ionresponsive drug delivery is available to design the unique dosage formulations which provide optimized drug therapy with effective, safe and convenient dosing of drugs. The objective of the present review was to collect, summarize, and categorize recent research findings on ion-responsive drug delivery systems. Ions in body fluid/formulations caused structural changes of polymers/molecules contained in the formulations, allow formulations exhibit functions. The polymers/molecules responding to ions were ion-exchange resins/fibers, anionic or cationic polymers, polymers exhibiting transition at lower critical solution temperature, self-assemble supramolecular systems, peptides, and metalorganic frameworks. The functions of ion-responsive drug delivery systems were categorized to controlled drug release, site-specific drug release, in situ gelation, prolonged retention at the target sites, and enhancement of drug permeation. Administration of the formulations via oral, ophthalmic, transdermal, and nasal routes has showed significant advantages in the recent literatures. Many kinds of drug delivery systems responding to ions have been reported recently for several administration routes. Improvement and advancement of these systems can maximize drugs potential and contribute to patients in the world. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  12. A Knowledge-based System for Estimating Incident Clearance Duration for Maryland : I-95 a Case Study for the Project of MD-17-SHA/UM/4-19 : “Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment”

    Science.gov (United States)

    2017-12-01

    For the incident response operations to be appreciated by the general public, it is essential that responsible highway agencies be capable of providing the estimated clearance duration of a detected incident at the level sufficiently reliable for mot...

  13. 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.

  14. Developing a real-time incident decision support system (IDSS) for the freight industry.

    Science.gov (United States)

    2015-01-01

    Our nation's economy is highly dependent on reliable and cost-effective truck-freight : transportation. Delays to truck movement are of particular concern to the nation. Building upon : our previous effort, we developed an Incident Decision Support S...

  15. Bayesian inference-based environmental decision support systems for oil spill response strategy selection.

    Science.gov (United States)

    Davies, Andrew J; Hope, Max J

    2015-07-15

    Contingency plans are essential in guiding the response to marine oil spills. However, they are written before the pollution event occurs so must contain some degree of assumption and prediction and hence may be unsuitable for a real incident when it occurs. The use of Bayesian networks in ecology, environmental management, oil spill contingency planning and post-incident analysis is reviewed and analysed to establish their suitability for use as real-time environmental decision support systems during an oil spill response. It is demonstrated that Bayesian networks are appropriate for facilitating the re-assessment and re-validation of contingency plans following pollutant release, thus helping ensure that the optimum response strategy is adopted. This can minimise the possibility of sub-optimal response strategies causing additional environmental and socioeconomic damage beyond the original pollution event. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    NARCIS (Netherlands)

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

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

  17. 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…

  18. The safeguards active response inventory system (SARIS)

    International Nuclear Information System (INIS)

    Carlson, R.L.; Hairston, L.A.; O'Callaghan, P.B.; Grambihler, A.J.; Ruemmler, W.P.

    1987-01-01

    The Safeguards Active Response Inventory System (SARIS) is a computerized accountability system developed for nuclear materials control that incorporates elements of process monitoring, criticality safety, physical inventory and safeguards. It takes data from the process operations, stores it in an on-line database and translates the information into the formats needed by the various users. It traces the material through the process from feed to product; including recycle, waste and scraps streams. It models the process as the material changes form to ensure that artificial losses are not created. It automatically generates input to Nuclear Materials Management and Safeguards System (NMMSS), performs checks to prevent the possibility of a criticality accident, prepares an audit trail for Safeguards, prints labels for nuclear material containers, and produces DOE/NRC 741 forms. SARIS has been installed at three laboratories across the country

  19. Analysis of Pump-Turbine S Instability and Reverse Waterhammer Incidents in Hydropower Systems

    Energy Technology Data Exchange (ETDEWEB)

    Pejovic, Dr. Stanislav [University of Toronto; Zhang, Qin Fen [ORNL; Karney, Professor Byran W. [University of Toronto; Gajic, Prof. Aleksandar [University of Belgrade, Belgrade, Serbia

    2011-01-01

    Hydraulic systems continually experience dynamic transients or oscillations which threaten the hydroelectric plant from extreme water hammer pressures or resonance. In particular, the minimum pressure variations downstream of the turbine runner during the load rejection or other events may cause dangerous water column separation and subsequent rejoinder. Water column separation can be easily observed from the measurements of site transient tests, and has indeed caused serious historical damages to the machine and water conveyance system. Several technical issues regarding water column separation in draft tubes, including S instability of turbine characteristic curves, numerical instability and uncertainty of computer programs, are discussed here through case studies and available model and site test data. Catastrophic accidents experienced at a Kaplan turbine and in a long tailrace tunnel project, as well as other troubles detected in a more timely fashion, are revisited in order to demonstrate the severity of reverse water hammer. However, as there is no simple design solutions for such complex systems, this paper emphasizes that the design of hydraulic systems is always difficult, difficulties that are compounded when the phenomena in question are non-linear (water hammer), dynamic (involving wave interaction and complex devices of turbines, controls, and electrical systems), and non-monotonic (severity of response is seldom simply connected to severity of load as with vibrations and resonance, and the complexity of transient loads), and thus may lead to high economic and safety challenges and consequences.

  20. [Patient safety -- mission for the future: The importance of Critical Incident Reporting Systems (CIRS) in clinical practice].

    Science.gov (United States)

    Maas, Matthias; Güß, Tim

    2014-07-01

    Every day patients experience harm due to errors and complications. To improve this situation, patient safety is increasingly becoming important in the treatment process. One aspect to increase patient safety is the Critical Incident Reporting System (CIRS). Observers and members of the care team are given the opportunity to anonymously report critical incidents and thus allow an analysis by an evaluation team. The goal is not to sanction the behavior of an individual, but to identify particular structural and organizational sources of error and to derive improvements. © Georg Thieme Verlag Stuttgart · New York.

  1. Incidences and Risk Factors of Organ Manifestations in the Early Course of Systemic Sclerosis: A Longitudinal EUSTAR Study.

    Directory of Open Access Journals (Sweden)

    Veronika K Jaeger

    Full Text Available Systemic sclerosis (SSc is a rare and clinically heterogeneous autoimmune disorder characterised by fibrosis and microvascular obliteration of the skin and internal organs. Organ involvement mostly manifests after a variable period of the onset of Raynaud's phenomenon (RP. We aimed to map the incidence and predictors of pulmonary, cardiac, gastrointestinal (GI and renal involvement in the early course of SSc.In the EUSTAR cohort, patients with early SSc were identified as those who had a visit within the first year after RP onset. Incident SSc organ manifestations and their risk factors were assessed using Kaplan-Meier methods and Cox regression analysis.Of the 695 SSc patients who had a baseline visit within 1 year after RP onset, the incident non-RP manifestations (in order of frequency were: skin sclerosis (75% GI symptoms (71%, impaired diffusing capacity for monoxide40mmHg (14%, and renal crisis (3%. In the heart, incidence rates were highest for diastolic dysfunction, followed by conduction blocks and pericardial effusion. While the main baseline risk factor for a short timespan to develop FVC impairment was diffuse skin involvement, for PAPsys>40mmHg it was higher patient age. The main risk factors for incident cardiac manifestations were anti-topoisomerase autoantibody positivity and older age. Male sex, anti-RNA-polymerase-III positivity, and older age were risk factors associated with incident renal crisis.In SSc patients presenting early after RP onset, approximately half of all incident organ manifestations occur within 2 years and have a simultaneous rather than a sequential onset. These findings have implications for the design of new diagnostic and therapeutic strategies aimed to 'widen' the still very narrow 'window of opportunity'. They may also enable physicians to counsel and manage patients presenting early in the course of SSc more accurately.

  2. Residential relocation by older adults in response to incident cardiovascular health events : A case-crossover analysis

    NARCIS (Netherlands)

    Lovasi, G.; Richardson, J.M.; Rodriguez, C.J.; Kop, W.J.; Ahmed, A.; Brown, A.F.; Greenlee, H.; Siscovick, D.S.

    2014-01-01

    Objective. We use a case-crossover analysis to explore the association between incident cardiovascular events and residential relocation to a new home address. Methods. We conducted an ambidirectional case-crossover analysis to explore the association between incident cardiovascular events and

  3. The role of the LLNL Atmospheric Release Advisory Capability in a FRMAC response to a nuclear power plant incident

    International Nuclear Information System (INIS)

    Baskett, R.L.; Sullivan, T.J.; Ellis, J.S.; Foster, C.S.

    1994-01-01

    The Federal Radiological Emergency Response Plan (FRERP) can provide several emergency response resources in response to a nuclear power plant (NPP) accident if requested by a state or local agency. The primary FRERP technical resources come from the US Department of Energy's (DOE) Federal Radiological Monitoring and Assessment Center (FRMAC). Most of the FRMAC assets are located at the DOE Remote Sensing Laboratory (RSL) at Nellis Air Force Base, Las Vegas, Nevada. In addition, the primary atmospheric dispersion modeling and dose assessment asset, the Atmospheric Release Advisory Capability (ARAC) is located at Lawrence Livermore National Laboratory (LLNL) in Livermore, California. In the early stages of a response, ARAC relies on its automatic worldwide meteorological data acquisition via the Air Force Global Weather Center (AFGWC). The regional airport data are supplemented with data from on-site towers and sodars and the National Oceanographic ampersand Atmospheric Administration's (NOAA) field-deployable real-time rawinsonde system. ARAC is prepared with three-dimensional regional-scale diagnostic dispersion model to simulate the complex mixed fission product release from a reactor accident. The program has been operational for 18 years and is presently developing its third generation system. The current modernization includes faster central computers, a new site workstation system. The current modernization includes faster central computers, a new site workstation system, improvements in its diagnostic dispersion models, addition of a new hybrid-particle source term, and implementation of a mesoscale prognostic model. AS these new capabilities evolve, they will be integrated into the FRMAC's field-deployable assets

  4. Book Review: System Forensics, Investigation, and Response

    Directory of Open Access Journals (Sweden)

    Nate Keith

    2012-06-01

    Full Text Available Vacca, J. R. and Rudolph, K. (2011. System Forensics, Investigation, and Response. Sudbury, MA: Jones and Bartlett Learning. 339 + xv pages, ISBN: 978-0-7637-9134-6, US$89.95.Reviewed by Nate Keith, MBA, (natejkeith@gmail.comI recently expressed an interest to a respected colleague in finding a way to “give back” to the forensic community. He suggested writing a review for a text he recently received and provide feedback to the community. It is my intent to present an objective analysis of System Forensics, Investigation, and Response.Written by John R. Vacca and K Rudolph, this book is part of the Jones and Bartlett Learning Information Systems Security & Assurance Series.  Both Vacca and Rudolph have considerable experience in the information technology field as is demonstrated by the back cover notes: “John R. Vacca is an information technology consultant and internationally known best-selling author based in Pomeroy, Ohio.  Since 1982, he has written 62 books and more than 600 articles in the areas of advanced storage, computer security, and aerospace technology.(see PDF for full review

  5. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M; Hoffmann, Barbara; Esmail, Aneez

    2015-09-01

    Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety. To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary care. A literature review looking at the purpose, design and requirements of an incident reporting system (IRS) was used to update an existing incident reporting system, widely used in Germany. Then, an international expert panel with knowledge on IRS developed the criteria for the design of a new web-based incident reporting system for European primary care. A small demonstration project was used to create a web-based reporting system, to be made freely available for practitioners and researchers. The expert group compiled recommendations regarding the desirable features of an incident reporting system for European primary care. These features covered the purpose of reporting, who should be involved in reporting, the mode of reporting, design considerations, feedback mechanisms and preconditions necessary for the implementation of an IRS. A freely available web-based reporting form was developed, based on these criteria. It can be modified for local contexts. Practitioners and researchers can use this system as a means of recording patient safety incidents in their locality and use it as a basis for learning from errors. The LINNEAUS collaboration has provided a freely available incident reporting system that can be modified for a local context and used throughout Europe.

  6. The risk of incident type 2 diabetes in a Korean metabolically healthy obese population: the role of systemic inflammation.

    Science.gov (United States)

    Jung, Chang Hee; Lee, Min Jung; Kang, Yu Mi; Jang, Jung Eun; Leem, Jaechan; Hwang, Jenie Yoonoo; Kim, Eun Hee; Park, Joong-Yeol; Kim, Hong-Kyu; Lee, Woo Je

    2015-03-01

    This study sought to investigate whether the metabolically healthy obese (MHO) phenotype is associated with an increased risk of incident type 2 diabetes in a Korean population and, if so, whether systemic inflammation affects this risk in MHO individuals. The study population comprised 36 135 Koreans without type 2 diabetes. Participants were stratified by body mass index (cutoff value, 25.0 kg/m(2)) and metabolic health state (assessed using Adult Treatment Panel-III criteria). High-sensitive C-reactive protein (hsCRP) was used as a surrogate marker of systemic inflammation. Subjects were classified into low (ie, hsCRP systemic inflammation groups. During a median followup of 36.5 months (range, 4.8-81.7 mo), 635 of the 36 135 individuals (1.8%) developed type 2 diabetes. The MHO group had a significantly higher risk of incident type 2 diabetes (multivariate-adjusted hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.16-2.11) than the metabolically healthy nonobese (MHNO) group. However, the risk of the MHO group varied according to the degree of systemic inflammation. Compared with the MHNO/low systemic inflammation group, the risk of type 2 diabetes in the MHO/low systemic inflammation group was not significantly elevated (multivariate-adjusted HR, 1.61; 95% CI, 0.77-3.34). However, the MHO/high systemic inflammation group had an elevated risk of incident type 2 diabetes (multivariate-adjusted HR, 3.73; 95% CI 2.36-5.88). MHO subjects show a substantially higher risk of incident type 2 diabetes than MHNO subjects. The level of systemic inflammation partially explains this increased risk.

  7. The association of remotely sensed outdoor fine particulate matter with cancer incidence of respiratory system in the USA.

    Science.gov (United States)

    Al-Hamdan, Ashraf Z; Albashaireh, Reem N; Al-Hamdan, Mohammad Z; Crosson, William L

    2017-05-12

    This study aimed to assess the association between exposure to fine particulate matter (PM 2.5 ) and respiratory system cancer incidence in the US population (n = 295,404,580) using a satellite-derived estimate of PM 2.5 concentrations. Linear and logistic regression analyses were performed to determine whether PM 2.5 was related to the odds of respiratory system cancer (RSC) incidence based on gender and race. Positive linear regressions were found between PM 2.5 concentrations and the age-adjusted RSC incidence rates for all groups (Males, Females, Whites, and Blacks) except for Asians and American Indians. The linear relationships between PM 2.5 and RSC incidence rate per 1 μg/m 3 PM 2.5 increase for Males, Females, Whites, Blacks, and all categories combined had slopes of, respectively, 7.02 (R 2 = 0.36), 2.14 (R 2 = 0.14), 3.92 (R 2 = 0.23), 5.02 (R 2 = 0.21), and 4.15 (R 2 = 0.28). Similarly, the logistic regression odds ratios per 10 μg/m 3 increase of PM 2.5 were greater than one for all categories except for Asians and American Indians, indicating that PM 2.5 is related to the odds of RSC incidence. The age-adjusted odds ratio for males (OR = 2.16, 95% CI = 1.56-3.01) was higher than that for females (OR = 1.50, 95% CI = 1.09-2.06), and it was higher for Blacks (OR = 2.12, 95% CI = 1.43-3.14) than for Whites (OR = 1.72, 95% CI = 1.23-2.42). The odds ratios for all categories were attenuated with the inclusion of the smoking covariate, reflecting the effect of smoking on RSC incidence besides PM 2.5 .

  8. Incidence and risk factors for central nervous system relapse in children and adolescents with acute lymphoblastic leukemia

    Science.gov (United States)

    Cancela, Camila Silva Peres; Murao, Mitiko; Viana, Marcos Borato; de Oliveira, Benigna Maria

    2012-01-01

    Background Despite all the advances in the treatment of childhood acute lymphoblastic leukemia, central nervous system relapse remains an important obstacle to curing these patients. This study analyzed the incidence of central nervous system relapse and the risk factors for its occurrence in children and adolescents with acute lymphoblastic leukemia. Methods This study has a retrospective cohort design. The studied population comprised 199 children and adolescents with a diagnosis of acute lymphoblastic leukemia followed up at Hospital das Clinicas, Universidade Federal de Minas Gerais (HC-UFMG) between March 2001 and August 2009 and submitted to the Grupo Brasileiro de Tratamento de Leucemia da Infância - acute lymphoblastic leukemia (GBTLI-LLA-99) treatment protocol. Results The estimated probabilities of overall survival and event free survival at 5 years were 69.5% (± 3.6%) and 58.8% (± 4.0%), respectively. The cumulative incidence of central nervous system (isolated or combined) relapse was 11.0% at 8 years. The estimated rate of isolated central nervous system relapse at 8 years was 6.8%. In patients with a blood leukocyte count at diagnosis ≥ 50 x 109/L, the estimated rate of isolated or combined central nervous system relapse was higher than in the group with a count 50 x 109/L at diagnosis seems to be a significant prognostic factor for a higher incidence of central nervous system relapse in childhood acute lymphoblastic leukemia. PMID:23323068

  9. Analysis of Aviation Safety Reporting System Incident Data Associated with the Technical Challenges of the System-Wide Safety and Assurance Technologies Project

    Science.gov (United States)

    Withrow, Colleen A.; Reveley, Mary S.

    2015-01-01

    The Aviation Safety Program (AvSP) System-Wide Safety and Assurance Technologies (SSAT) Project asked the AvSP Systems and Portfolio Analysis Team to identify SSAT-related trends. SSAT had four technical challenges: advance safety assurance to enable deployment of NextGen systems; automated discovery of precursors to aviation safety incidents; increasing safety of human-automation interaction by incorporating human performance, and prognostic algorithm design for safety assurance. This report reviews incident data from the NASA Aviation Safety Reporting System (ASRS) for system-component-failure- or-malfunction- (SCFM-) related and human-factor-related incidents for commercial or cargo air carriers (Part 121), commuter airlines (Part 135), and general aviation (Part 91). The data was analyzed by Federal Aviation Regulations (FAR) part, phase of flight, SCFM category, human factor category, and a variety of anomalies and results. There were 38 894 SCFM-related incidents and 83 478 human-factorrelated incidents analyzed between January 1993 and April 2011.

  10. The Safeguards Active Response Inventory System (SARIS)

    International Nuclear Information System (INIS)

    Carlson, R.L.

    1985-04-01

    The Safeguards Active Response Inventory System (SARIS) was developed by Westinghouse Hanford Company (WHC) to perform material control and accountability on all the nuclear material under WHC's jurisdiction. SARIS has been in operation for four and one-half years. It has reduced physical inventory plant shutdown time from several days to a few hours. The user-friendly interface has proven successful, as the training time for a new operator is only two to three hours; also errors have been dramatically reduced. The modeling features of SARIS have reduced the reported inventory difference and provide better information for measurement of scrap and waste. The audit files have been usefull in resolving data entry errors and the backup features have averted several potential problems. SARIS as a computerized accountability system has replaced manual record keeping with a consequent increase in productivity. 4 refs

  11. The incidence of radioepidermitis and the dose-response relationship in parotid gland cancer patients treated with 125I seed brachytherapy. Incidence of radioepidermitis and the dose-response relationship

    Energy Technology Data Exchange (ETDEWEB)

    Mao, Ming-Hui; Zheng, Lei; Gao, Hong; Zhang, Jie; Liu, Shu-ming; Huang, Ming-wei; Shi, Yan [Peking University School and Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, Beijing (China); Zhang, Jian-Guo [Peking University School and Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, Beijing (China); Fujian Provincial Hospital, Fujian (China)

    2014-09-09

    We studied the incidence and dose-response relationship of radioepidermitis in parotid gland carcinoma patients treated with [{sup 125}I] seed brachytherapy in the hopes of designing an optimized pre-implant treatment plan that would reduce the incidence and severity of radioepidermitis in patients receiving this therapy. Between January 2007 and May 2010, 100 parotid gland cancer patients were treated postoperatively with [{sup 125}I] seed brachytherapy. The matched peripheral dose (MPD) was 80-140 Gy, and [{sup 125}I] seed activity was 0.7-0.8 mCi. The mean dose delivered to the skin was calculated in the post-implant CT on day 0 following implantation. Grades of acute and late dermatitis were evaluated at 2, 6, 12, and 18 months post-implantation. Most patients experienced grade 0-2 acute and late skin side effects (86 and 97 %, respectively), though a small subset developed severe complications. Most grade 1-3 effects resolved within 6 months of implantation, though some grade 1-3 effects and all grade 4 effects remained unchanged throughout the 18-month follow-up period. Grade 3 and 4 effects were most prominent (75 and 25 %, respectively) with doses of 110-140 Gy; doses higher than 140 Gy produced only grade 4 effects. [{sup 125}I] seed brachytherapy produced acceptable levels of acute and late radioepidermitis with a good clinical outcome. A mean dose under 100 Gy delivered to the skin was safe, though doses of 110-140 Gy should be given with caution and extra monitoring; doses greater than 140 Gy are dangerous and likely to produce grade 4-5 effects. (orig.) [German] Wir untersuchten die Inzidenz und die Dosis-Wirkung-Beziehung bei Patienten mit Ohrspeicheldruesenkrebs, die mit [{sup 125}I]-Seed-Brachytherapie behandelt wurden, in der Hoffnung, eine optimierte praeimplantologische Behandlung zu entwickeln, welche die Inzidenz und Schwere der Radioepidermitis bei Patienten, die diese Therapie erhalten haben, reduziert. Zwischen Januar 2007 und Mai 2010

  12. Neuroendocrine and Immune System Responses with Spaceflights

    Science.gov (United States)

    Tipton, Charles M.; Greenleaf, John E.; Jackson, Catherine G. R.

    1996-01-01

    Despite the fact that the first human was in space during 1961 and individuals have existed in a microgravity environment for more than a year, there are limited spaceflight data available on the responses of the neuroendocrine and immune systems. Because of mutual interactions between these respective integrative systems, it is inappropriate to assume that the responses of one have no impact on functions of the other. Blood and plasma volume consistently decrease with spaceflight; hence, blood endocrine and immune constituents will be modified by both gravitational and measurement influences. The majority of the in-flight data relates to endocrine responses that influence fluids and electrolytes during the first month in space. Adrenocorticotropin (ACTH), aldo-sterone. and anti-diuretic hormone (ADH) appear to be elevated with little change in the atrial natriuretic peptides (ANP). Flight results longer than 60 d show increased ADH variability with elevations in angiotensin and cortisol. Although post-flight results are influenced by reentry and recovery events, ACTH and ADH appear to be consistently elevated with variable results being reported for the other hormones. Limited in-flight data on insulin and growth hormone levels suggest they are not elevated to counteract the loss in muscle mass. Post-flight results from short- and long-term flights indicate that thyroxine and insulin are increased while growth hormone exhibits minimal change. In-flight parathyroid hormone (PTH) levels are variable for several weeks after which they remain elevated. Post-flight PTH was increased on missions that lasted either 7 or 237 d, whereas calcitonin concentrations were increased after 1 wk but decreased after longer flights. Leukocytes are elevated in flights of various durations because of an increase in neutrophils. The majority of post-flight data indicates immunoglobulin concentrations are not significantly changed from pre-flight measurements. However, the numbers of T

  13. Incidence and Risk Factors of Stroke or Systemic Embolism in Patients With Atrial Fibrillation and Heart Failure

    DEFF Research Database (Denmark)

    Iguchi, Moritake; Tezuka, Yuji; Ogawa, Hisashi

    2018-01-01

    BACKGROUND: Heart failure (HF) is a heterogeneous syndrome, but the effect of the type and severity of HF on the incidence of stroke or systemic embolism (SE) in atrial fibrillation (AF) patients is unclear.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF ...... of HF in patients with AF. The incidence of stroke/SE was markedly increased in the 30 days after admission for HF, but compensated 'stable' HF did not appear to confer an independent risk.......BACKGROUND: Heart failure (HF) is a heterogeneous syndrome, but the effect of the type and severity of HF on the incidence of stroke or systemic embolism (SE) in atrial fibrillation (AF) patients is unclear.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF....... On multivariate analysis, the incidence of stroke/SE was not associated with pre-existing HF (hazard ratio (HR), 1.24; 95% confidence interval (CI), 0.92-1.64) or each criterion for the definition of pre-existing HF, but was associated with high B-type natriuretic peptide (BNP) or N-terminal proBNP levels (above...

  14. Genetic Predictors of Response to Systemic Therapy in Esophagogastric Cancer.

    Science.gov (United States)

    Janjigian, Yelena Y; Sanchez-Vega, Francisco; Jonsson, Philip; Chatila, Walid K; Hechtman, Jaclyn F; Ku, Geoffrey Y; Riches, Jamie C; Tuvy, Yaelle; Kundra, Ritika; Bouvier, Nancy; Vakiani, Efsevia; Gao, Jianjiong; Heins, Zachary J; Gross, Benjamin E; Kelsen, David P; Zhang, Liying; Strong, Vivian E; Schattner, Mark; Gerdes, Hans; Coit, Daniel G; Bains, Manjit; Stadler, Zsofia K; Rusch, Valerie W; Jones, David R; Molena, Daniela; Shia, Jinru; Robson, Mark E; Capanu, Marinela; Middha, Sumit; Zehir, Ahmet; Hyman, David M; Scaltriti, Maurizio; Ladanyi, Marc; Rosen, Neal; Ilson, David H; Berger, Michael F; Tang, Laura; Taylor, Barry S; Solit, David B; Schultz, Nikolaus

    2018-01-01

    The incidence of esophagogastric cancer is rapidly rising, but only a minority of patients derive durable benefit from current therapies. Chemotherapy as well as anti-HER2 and PD-1 antibodies are standard treatments. To identify predictive biomarkers of drug sensitivity and mechanisms of resistance, we implemented prospective tumor sequencing of patients with metastatic esophagogastric cancer. There was no association between homologous recombination deficiency defects and response to platinum-based chemotherapy. Patients with microsatellite instability-high tumors were intrinsically resistant to chemotherapy but more likely to achieve durable responses to immunotherapy. The single Epstein-Barr virus-positive patient achieved a durable, complete response to immunotherapy. The level of ERBB2 amplification as determined by sequencing was predictive of trastuzumab benefit. Selection for a tumor subclone lacking ERBB2 amplification, deletion of ERBB2 exon 16, and comutations in the receptor tyrosine kinase, RAS, and PI3K pathways were associated with intrinsic and/or acquired trastuzumab resistance. Prospective genomic profiling can identify patients most likely to derive durable benefit to immunotherapy and trastuzumab and guide strategies to overcome drug resistance. Significance: Clinical application of multiplex sequencing can identify biomarkers of treatment response to contemporary systemic therapies in metastatic esophagogastric cancer. This large prospective analysis sheds light on the biological complexity and the dynamic nature of therapeutic resistance in metastatic esophagogastric cancers. Cancer Discov; 8(1); 49-58. ©2017 AACR. See related commentary by Sundar and Tan, p. 14 See related article by Pectasides et al., p. 37 This article is highlighted in the In This Issue feature, p. 1 . ©2017 American Association for Cancer Research.

  15. Aviation System Analysis Capability Quick Response System Report

    Science.gov (United States)

    Roberts, Eileen; Villani, James A.; Ritter, Paul

    1998-01-01

    The purpose of this document is to present the additions and modifications made to the Aviation System Analysis Capability (ASAC) Quick Response System (QRS) in FY 1997 in support of the ASAC ORS development effort. This document contains an overview of the project background and scope and defines the QRS. The document also presents an overview of the Logistics Management Institute (LMI) facility that supports the QRS, and it includes a summary of the planned additions to the QRS in FY 1998. The document has five appendices.

  16. Mastitis incidence and milk quality in organic dairy farms which use suckling systems in calf rearing.

    NARCIS (Netherlands)

    Wagenaar, J.P.; Smolders, E.A.A.

    2008-01-01

    In order to identify important factors influencing animal health and general disease resistance, detailed qualitative and quantitative farm data were collected from 99 organic dairy farms in the Netherlands. Mastitis incidence and milk quality were focal points of the data collection. In this paper

  17. S.A.C.I.: Incident Combat Support System; S.A.C.I.: Sistema de Apoio ao Combate de Incidentes

    Energy Technology Data Exchange (ETDEWEB)

    Macedo, Antonio R.L. [ARMTEC Tecnologia em Robotica, Fotrtaleza, CE (Brazil); Macedo, Antonio R.M. [Universidade de Fortaleza, CE (Brazil)

    2004-07-01

    The incidents that occur in the petrochemical industry are extremely dangerous, because of the range of temperature that it reaches and the radius of the explosion. For this reason the S.A.C.I. that is an Incident's Combat Support System was developed. The purpose of this paper is to present the complete operational capability of this machine, and also some of the construction design calculations. It is a controlled-by-distance robot that carries one water cannon that generates fog, stream or foam with a limit pressure of 125 psi. It works within 90 m from the operator, has 3 degrees of freedom and a minimum autonomy of 3 hours. Before this prototype was made, only the United Kingdom by Qinetiq and the Japan by the Tokyo Fire Department had this technology. This prototype is around 70% of the investment of the ones in the market. The tests shown in the paper were made in the training bunker of Ceara's Military Fire Corp. Headquarters and in an arena in the Gloria Marine in Rio de Janeiro. The results of this project is a national product that improves the incident's combat response time, saving the most important resource, that is the human been. (author)

  18. Lessons learnt from the development of the Patient Safety Incidents Reporting an Learning System for the Spanish National Health System: SiNASP.

    Science.gov (United States)

    Vallejo-Gutiérrez, Paula; Bañeres-Amella, Joaquim; Sierra, Eduardo; Casal, Jesús; Agra, Yolanda

    2014-01-01

    To describe the development process and characteristics of a patient safety incidents reporting system to be implemented in the Spanish National Health System, based on the context and the needs of the different stakeholders. Literature review and analysis of most relevant reporting systems, identification of more than 100 stakeholder's (patients, professionals, regional governments representatives) expectations and requirements, analysis of the legal context, consensus of taxonomy, development of the software and pilot test. Patient Safety Events Reporting and Learning system (Sistema de Notificación y Aprendizajepara la Seguridad del Paciente, SiNASP) is a generic reporting system for all types of incidents related to patient safety, voluntary, confidential, non punitive, anonymous or nominative with anonimization, system oriented, with local analysis of cases and based on the WHO International Classification for Patient Safety. The electronic program has an on-line form for reporting, a software to manage the incidents and improvement plans, and a scoreboard with process indicators to monitor the system. The reporting system has been designed to respond to the needs and expectations identified by the stakeholders, taking into account the lessons learned from the previous notification systems, the characteristics of the National Health System and the existing legal context. The development process presented and the characteristics of the system provide a comprehensive framework that can be used for future deployments of similar patient safety systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  19. Developing a patient safety incident classification system for primary care. A literature review and Delphi-survey by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Klemp, Kerstin; Dovey, Susan; Valderas, Jose M; Rohe, Julia; Godycki-Cwirko, Maciek; Elliott, Phillip; Beyer, Martin; Gerlach, Ferdin M; Hoffmann, Barbara

    2015-09-01

    Despite awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there has been little effort to establish an incident classification system that is generally applicable to patient safety data in European primary care. To describe the development of a patient safety incident classification system for primary care. A systematic review was followed by an expert group discussion and a modified Delphi survey, to provide consensus statements. We developed a classification system providing a mechanism for classifying patient safety incidents across Europe, taking into account the varying organizational arrangements that exist for primary care. It takes into account organizational processes and outcomes related to patient safety incidents and can supplement existing classification systems. Classification systems are key tools in the analysis of patient safety incidents. A system that has relevance for primary care is now available.

  20. An analysis of critical incidents relevant to pediatric anesthesia reported to the UK National Reporting and Learning System, 2006-2008.

    Science.gov (United States)

    MacLennan, Andrew I; Smith, Andrew F

    2011-08-01

    We aimed to identify and analyze critical incidents relating to pediatric anesthesia from the National Reporting and Learning System (NRLS) in England and Wales. Critical incident reporting plays a key role in learning from problems and so enhancing patient safety. There has been no previous analysis of pediatric anesthetic incidents in the NRLS. We obtained potentially relevant records from the UK National Patient Safety Agency. Eligible incidents were classified according to patient age, degree of harm sustained, and clinical category. A total of 606 incidents met the inclusion criteria. Six deaths were reported and 48 incidents resulted in severe harm. In many reports, sufficient detail was lacking for a full understanding of what had happened. However, the broad focus of the NRLS revealed a wide spectrum of clinical and organizational incidents relating to pediatric anesthesia. Medication issues predominated (35.6%), notably inadvertent duplication of dosing in operating theater and ward. Airway/ventilation incidents formed 18.8% of the total, cardiovascular incidents 5.9%, and equipment-related incidents (failure or unavailability) 15.7%. Communication and organizational problems made up 8.6% of reports. We make a number of recommendations for practice. In addition, anesthetists should be encouraged to take ownership and contribute high-quality descriptions of incidents to national systems. © 2010 Blackwell Publishing Ltd.

  1. Respiratory Effects and Systemic Stress Response Following ...

    Science.gov (United States)

    Previous studies have demonstrated that exposure to the pulmonary irritant ozone causes myriad systemic metabolic and pulmonary effects attributed to sympathetic and hypothalamus-pituitary-adrenal (HPA) axis activation, which are exacerbated in metabolically impaired models. We examined respiratory and systemic effects following exposure to a sensory irritant acrolein to elucidate the systemic and pulmonary consequences in healthy and diabetic rat models. Male Wistar and Goto Kakizaki (GK) rats, a nonobese type II diabetic Wistar-derived model, were exposed by inhalation to 0, 2, or 4 ppm acrolein, 4 h/d for 1 or 2 days. Exposure at 4 ppm significantly increased pulmonary and nasal inflammation in both strains with vascular protein leakage occurring only in the nose. Acrolein exposure (4 ppm) also caused metabolic impairment by inducing hyperglycemia and glucose intolerance (GK > Wistar). Serum total cholesterol (GKs only), low-density lipoprotein (LDL) cholesterol (both strains), and free fatty acids (GK > Wistar) levels increased; however, no acrolein-induced changes were noted in branched-chain amino acid or insulin levels. These responses corresponded with a significant increase in corticosterone and modest but insignificant increases in adrenaline in both strains, suggesting activation of the HPA axis. Collectively, these data demonstrate that acrolein exposure has a profound effect on nasal and pulmonary inflammation, as well as glucose and lipid metabolis

  2. Emergency Response Data System (ERDS) implementation

    International Nuclear Information System (INIS)

    Jolicoeur, J.

    1991-06-01

    The US Nuclear Regulatory Commission has begun implementation of the Emergency Response Data System (ERDS) to upgrade its ability to acquire data from nuclear power plants in the event of an emergency at the plant. ERDS provides a direct real-time transfer of data from licensee plant computers to the NRC Operations Center. The system has been designed to be activated by the licensee during an emergency which has been classified at an ALERT or higher level. The NRC portion of ERDS will receive the data stream, sort and file the data. The users will include the NRC Operations Center, the NRC Regional Office of the affected plant, and if requested the States which are within the ten mile EPZ of the site. The currently installed Emergency Notification System will be used to supplement ERDS data. This report provides the minimum guidance for implementation of ERDS at licensee sites. It is intended to be used for planning implementation under the current voluntary program as well as for providing the minimum standards for implementing the proposed ERDS rule. 4 refs., 3 figs

  3. Emergency Response Data System (ERDS) implementation

    International Nuclear Information System (INIS)

    Jolicoeur, J.

    1990-04-01

    The US Nuclear Regulatory Commission has begun implementation of the Emergency Response Data System (ERDS) to upgrade its ability to acquire data from nuclear power plants in the event of an emergency at the plant. ERDS provides a direct real-time transfer of data from licensee plant computers to the NRC Operations Center. The system has been designed to be activated by the licensee during an emergency which has been classified at an ALERT or higher level. The NRC portion of ERDS will receive the data stream, sort and file the data. The users will include the NRC Operations Center, the NRC Regional Office of the affected plant, and if requested the States which are within the ten mile EPZ of the site. The currently installed Emergency Notification System will be used to supplement ERDS data. This report provides the minimum guidance for implementation of ERDS at licensee sites. It is intended to be used for planning implementation under the current voluntary program as well as for providing the minimum standards for implementing the proposed ERDS rule

  4. Automated data system for emergency meteorological response

    International Nuclear Information System (INIS)

    Kern, C.D.

    1975-01-01

    The Savannah River Plant (SRP) releases small amounts of radioactive nuclides to the atmosphere as a consequence of the production of radioisotopes. The potential for larger accidental releases to the atmosphere also exists, although the probability for most accidents is low. To provide for emergency meteorological response to accidental releases and to conduct research on the transport and diffusion of radioactive nuclides in the routine releases, a series of high-quality meteorological sensors have been located on towers in and about SRP. These towers are equipped with instrumentation to detect and record temperature and wind turbulence. Signals from the meterological sensors are brought by land-line to the SRL Weather Center-Analysis Laboratory (WC-AL). At the WC-AL, a Weather Information and Display (WIND) system has been installed. The WIND system consists of a minicomputer with graphical displays in the WC-AL and also in the emergency operating center (EOC) of SRP. In addition, data are available to the system from standard weat []er teletype services, which provide both routine surface weather observations and routine upper air wind and temperature observations for the southeastern United States. Should there be an accidental release to the atmosphere, available recorded data and computer codes would allow the calculation and display of the location, time, and downwind concentration of the atmospheric release. These data are made available to decision makers in near real-time to permit rapid decisive action to limit the consequences of such accidental releases. (auth)

  5. Causes of General Aviation Weather-Related, Non-Fatal Incidents: Analysis Using NASA Aviation Safety Reporting System Data

    Science.gov (United States)

    2010-09-01

    Certified Flight Instructor-Instrument CFIT Controlled flight into terrain FAA U.S. Federal Aviation Administration FBO Fixed-base operator FSS Flight...William R. Knecht Michael Lenz Civil Aerospace Medical Institute Federal Aviation Administration Oklahoma City, OK 73125 September 2010 Final Report...Causes of General Aviation Weather- Related, Non-Fatal Incidents: Analysis Using NASA Aviation Safety Reporting System Data DOT/FAA/AM-10/13 Office

  6. Calculation of nuclear data for incident energies to 200 MeV with the FKK-GNASH code system

    International Nuclear Information System (INIS)

    Chadwick, M.B.; Young, P.G.

    1993-02-01

    We describe how the FKK-GNASH code system has been extended to calculate nucleon-induced reactions up to 200 MeV, and used to predict (p,xn) and (p,xp) cross sections on 208 Pb at incident energies of 25, 45, 80 and 160 MeV, for an intermediate energy code intercomparison. Details of the reaction mechanisms calculated by FKK-GNASH are given, and the calculational procedure is described

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

    Directory of Open Access Journals (Sweden)

    Caj Holm

    2006-11-01

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

  8. Bohai and Yellow Sea Oil Spill Prediction System and Its Application to Huangdao ‘11.22’ Oil Spill Incident

    Science.gov (United States)

    Li, Huan; Li, Yan; Li, Cheng; Li, Wenshan; Wang, Guosong; Zhang, Song

    2017-08-01

    Marine oil spill has deep negative effect on both marine ecosystem and human activities. In recent years, due to China’s high-speed economic development, the demand for crude oil is increasing year by year in China, and leading to the high risk of marine oil spill. Therefore, it is necessary that promoting emergency response on marine oil spill in China and improving oil spill prediction techniques. In this study, based on oil spill model and GIS platform, we have developed the Bohai and Yellow sea oil spill prediction system. Combining with high-resolution meteorological and oceanographic forecast results, the system was applied to predict the drift and diffusion process of Huangdao ‘11.22’ oil spill incident. Although the prediction can’t be validated by some SAR images due to the lack of satellite observations, it still provided effective and referable oil spill behavior information to Maritime Safety Administration.

  9. Enhanced Chemical Incident Response Plan (ECIRP). Appendix F, remediation analysis with Decision Support Tools (DSTs) for wide-area chemical hazards.

    Energy Technology Data Exchange (ETDEWEB)

    Hassig, Nancy L. (Pacific Northwest National Laboratory, Richland, WA); Pulsipher, Brent A. (Pacific Northwest National Laboratory, Richland, WA); Foltz, Greg W.; Hoette, Trisha Marie

    2011-07-01

    The Defense Threat Reduction Agency (DTRA) commissioned an assessment of the Consequence Management (CM) plans in place on military bases for response to a chemical attack. The effectiveness of the CM plans for recovering from chemical incidents was modeled using a multiple Decision Support Tools (DSTs). First, a scenario was developed based on an aerial dispersion of a chemical agent over a wide-area of land. The extent of contamination was modeled with the Hazard Prediction and Assessment Capability (HPAC) tool. Subsequently, the Analyzer for Wide Area Restoration Effectiveness (AWARE) tool was used to estimate the cost and time demands for remediation based on input of contamination maps, sampling and decontamination resources, strategies, rates and costs. The sampling strategies incorporated in the calculation were designed using the Visual Sample Plan (VSP) tool. Based on a gaps assessment and the DST remediation analysis, an Enhanced Chemical Incident Response Plan (ECIRP) was developed.

  10. Common Variants in 40 Genes Assessed for Diabetes Incidence and Response to Metformin and Lifestyle Intervention in the Diabetes Prevention Program

    Science.gov (United States)

    Jablonski, Kathleen A.; McAteer, Jarred B.; de Bakker, Paul I.W.; Franks, Paul W.; Pollin, Toni I.; Hanson, Robert L.; Saxena, Richa; Fowler, Sarah; Shuldiner, Alan R.; Knowler, William C.; Altshuler, David; Florez, Jose C.

    2010-01-01

    OBJECTIVE Genome-wide association studies have begun to elucidate the genetic architecture of type 2 diabetes. We examined whether single nucleotide polymorphisms (SNPs) identified through targeted complementary approaches affect diabetes incidence in the at-risk population of the Diabetes Prevention Program (DPP) and whether they influence a response to preventive interventions. RESEARCH DESIGN AND METHODS We selected SNPs identified by prior genome-wide association studies for type 2 diabetes and related traits, or capturing common variation in 40 candidate genes previously associated with type 2 diabetes, implicated in monogenic diabetes, encoding type 2 diabetes drug targets or drug-metabolizing/transporting enzymes, or involved in relevant physiological processes. We analyzed 1,590 SNPs for association with incident diabetes and their interaction with response to metformin or lifestyle interventions in 2,994 DPP participants. We controlled for multiple hypothesis testing by assessing false discovery rates. RESULTS We replicated the association of variants in the metformin transporter gene SLC47A1 with metformin response and detected nominal interactions in the AMP kinase (AMPK) gene STK11, the AMPK subunit genes PRKAA1 and PRKAA2, and a missense SNP in SLC22A1, which encodes another metformin transporter. The most significant association with diabetes incidence occurred in the AMPK subunit gene PRKAG2 (hazard ratio 1.24, 95% CI 1.09–1.40, P = 7 × 10−4). Overall, there were nominal associations with diabetes incidence at 85 SNPs and nominal interactions with the metformin and lifestyle interventions at 91 and 69 mostly nonoverlapping SNPs, respectively. The lowest P values were consistent with experiment-wide 33% false discovery rates. CONCLUSIONS We have identified potential genetic determinants of metformin response. These results merit confirmation in independent samples. PMID:20682687

  11. Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observational studies

    NARCIS (Netherlands)

    Gijsbers, L.; Ding, E.L.; Malik, Vasanti; Goede, de J.; Geleijnse, J.M.; Soedamah-Muthu, S.S.

    2016-01-01

    BACKGROUND: A growing number of cohort studies suggest a potential role of dairy consumption in type 2 diabetes (T2D) prevention. The strength of this association and the amount of dairy needed is not clear. OBJECTIVE: We performed a meta-analysis to quantify the associations of incident T2D with

  12. Incidence and prevalence of hypercholesterolemia in Portugal: a systemic review. Part II.

    Science.gov (United States)

    Costa, João; Borges, Margarida; Oliveira, Eduardo; Gouveia, Miguel; Carneiro, António Vaz

    2003-05-01

    Over 50% of the mortality and disability caused by ischemic heart disease and stroke could be avoided by controlling individual risk factors (hypertension, hypercholesterolemia, smoking and obesity). The ignorance of the extent and impact of hypercholesterolemia (HC) in Portugal prompted us to undertake this systematic review of the prevalence and incidence of hyperlipidemia in Portugal, based exclusively on work published nationally. We included every study published in the country that could provide data on the prevalence or incidence of hypercholesterolemia. The search strategy included an electronic search of national and international biomedical databases (Medline, Index Revistas Médicas Portuguesas, the Portuguese Directorate-General for Health and the Portuguese National School of Public Health), screening of reference lists from the individual studies, and personal contacts with institutions, groups and authors (such as the Portuguese Foundation of Cardiology). The data--recorded in electronic format--was collected independently by two of the authors (JC and MB), with consensus achieved with a third (AVC) when there were differences in the study coding. We could only identify one paper on the incidence of HC in Portugal, which gave an incidence of 559 new cases per 100,000 inhabitants, increasing with age up to 54 years for men and 64 years for women. There was a higher incidence in men than in women up to the age of 54, but at more advanced ages this relationship was reversed. Prevalence studies on HC included 53,445 individuals overall, with sample size lower than 1000 in most of the individual studies. The most frequently used criterion for HC was > 200 mg/dL, with the mean level being higher in most studies. We calculated the mean prevalence for several cut-off points (190 mg/dL: 63.8%; 200 mg/dL: 56.7%; 240 mg/dL: 31.7%; 250 mg/dL: 21%). Due to the heterogeneity of the data, these results are to be interpreted with caution, even though they are

  13. IAEA/NEA incident reporting system (IRS). Reporting guidelines. Feedback from safety related operating experience for nuclear power plants

    International Nuclear Information System (INIS)

    1998-01-01

    The Incident Reporting System (IRS) is an international system jointly operated by the International Atomic Energy Agency (IAEA) and the Nuclear Energy Agency of the Organisation for Economic Cooperation and Development (OECD/NEA). The fundamental objective of the IRS is to contribute to improving the safety of commercial nuclear power plants (NPPs) which are operated worldwide. This objective can be achieved by providing timely and detailed information on both technical and human factors related to events of safety significance which occur at these plants. The purpose of these guidelines, which supersede the previous IAEA Safety Series No. 93 (Part II) and the NEA IRS guidelines, is to describe the system and to give users the necessary background and guidance to enable them to produce IRS reports meeting a high standard of quality while retaining the high efficiency of the system expected by all Member States operating nuclear power plants. These guidelines have been jointly developed and approved by the NEA/IAEA

  14. Extension of a nuclear reaction calculation code CCONE toward higher incident energies. Multiple preequilibrium emission, and spectrum in laboratory system

    International Nuclear Information System (INIS)

    Iwamoto, Osamu

    2013-01-01

    A nuclear reaction calculation code CCONE, which was developed for nuclear data evaluation for JENDL/AC-2008 and JENDL-4, has been upgraded to improve the prediction accuracy for calculated cross sections at nucleon incident energies higher than 20 MeV. Multiple particle emission, in which nucleons and complex particles up to α-particle are involved, from pre-equilibrium reaction process was implemented based on the sequential-decay calculations for all produced exciton states within the framework of the two-component exciton model. The effect of velocity-change of particle-emitting nuclei on the multiple emission in preequilibrium and compound processes, which was not included in the previous evaluations, was taken into account to obtain spectra in the laboratory system using an average velocity approximation for each composite/compound nucleus. Calculated nucleon emission spectra at nucleon incident energies from 20 to 200 MeV were compared with experimental and evaluated data for the proton- and neutron-induced reactions on 27 Al. The present results are in good agreement with experimental data. It was found that their predictions were better than those of JENDL/HE-2007 especially for low emission energies at high incident energies. (author)

  15. Predictive risk factors for systemic inflammatory response syndrome following ureteroscopic laser lithotripsy.

    Science.gov (United States)

    Uchida, Yusuke; Takazawa, Ryoji; Kitayama, Sachi; Tsujii, Toshihiko

    2017-07-10

    The objective of this study was to investigate risk factors for the development of systemic inflammatory response syndrome following ureteroscopic laser lithotripsy. We retrospectively collected data of 469 patients who underwent ureteroscopic laser lithotripsy at our single institution from February 2008 to June 2016. Details for the patient, the stone, and the surgical factors that potentially contributed to postoperative infection were extracted. Using a logistic regression model, we analyzed how the clinical factors affected the incidence of systemic inflammatory response syndrome. Twenty-seven patients (5.7%) were postoperatively diagnosed with systemic inflammatory response syndrome; of these, 25 patients were diagnosed within 24 h after ureteroscopy. One patient required intensive care unit admission, but no death was reported. A preoperative stent was significantly associated with postoperative systemic inflammatory response syndrome only on univariate analysis, and the reasons for stenting were varied. Multivariate analysis revealed that obstructive pyelonephritis, a positive preoperative bladder urine culture result, and female gender were significantly associated with postoperative systemic inflammatory response syndrome. Patients who experienced obstructive pyelonephritis preceding ureteroscopic laser lithotripsy or had a positive preoperative bladder urine culture result were at an increased risk of systemic inflammatory response syndrome despite receiving appropriate preoperative antibiotic therapy. Regarding the impact of a preoperative stent on postoperative infection, further investigation focusing on reasons for stenting is needed.

  16. SU-E-T-469: Implementation of VAs Web-Based Radiotherapy Incident Reporting and Analysis System (RIRAS)

    Energy Technology Data Exchange (ETDEWEB)

    Kapoor, R; Palta, J; Hagan, M [Veteran Health Administration, Richmond, Virginia (United States); Virginia Commonwealth University, Richmond, VA (United States); Malik, G [TSG Innovations Inc. (United States)

    2015-06-15

    Purpose: This Web-based Radiotherapy Incident Reporting and Analysis System (RIRAS) is a tool to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: VA’s National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and good-catch data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. This VA-Intranet based software design has made use of dataset taxonomies and data dictionaries defined in AAPM/ASTRO reports on error reporting. We used proven industrial and medical event reporting techniques to avoid several common problems faced in effective data collection such as incomplete data due to data entry fatigue by the reporters, missing data due to data difficult to obtain or not familiar to most reporters, missing reports due to fear of reprisal etc. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The analysis reports with corrective, learning actions are shared with the reporter/facility and made public to the community (after deidentification) as part of the learning process. Results: Till date 50 incident/good catches have been reported in RIRAS and we have completed analysis on 100% of these reports. This is done due to the fact that each reported incidents is investigated and a complete analysis/patient-safety-work-product report is generated by radiation oncology domain-experts. Conclusions Because of the completeness of the data, the system has enabled us to analyze process steps and track trends of major errors which in the future will lead to implementing system wide process improvement steps and safe standard operating procedures for each radiotherapy treatment modality/technique and fulfills our goal of

  17. SU-E-T-469: Implementation of VAs Web-Based Radiotherapy Incident Reporting and Analysis System (RIRAS)

    International Nuclear Information System (INIS)

    Kapoor, R; Palta, J; Hagan, M; Malik, G

    2015-01-01

    Purpose: This Web-based Radiotherapy Incident Reporting and Analysis System (RIRAS) is a tool to improve quality of care for radiation therapy patients. This system is an important facet of continuing effort by our community to maintain and improve safety of radiotherapy.Material and Methods: VA’s National Radiation Oncology Program office has embarked on a program to electronically collect adverse events and good-catch data of radiation treatment of over 25,000 veterans treated with radiotherapy annually. This VA-Intranet based software design has made use of dataset taxonomies and data dictionaries defined in AAPM/ASTRO reports on error reporting. We used proven industrial and medical event reporting techniques to avoid several common problems faced in effective data collection such as incomplete data due to data entry fatigue by the reporters, missing data due to data difficult to obtain or not familiar to most reporters, missing reports due to fear of reprisal etc. This system encompasses the entire feedback loop of reporting an incident, analyzing it for salient details, and developing interventions to prevent it from happening again. The analysis reports with corrective, learning actions are shared with the reporter/facility and made public to the community (after deidentification) as part of the learning process. Results: Till date 50 incident/good catches have been reported in RIRAS and we have completed analysis on 100% of these reports. This is done due to the fact that each reported incidents is investigated and a complete analysis/patient-safety-work-product report is generated by radiation oncology domain-experts. Conclusions Because of the completeness of the data, the system has enabled us to analyze process steps and track trends of major errors which in the future will lead to implementing system wide process improvement steps and safe standard operating procedures for each radiotherapy treatment modality/technique and fulfills our goal of

  18. Multiple Failure Response Procedure System, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Currently, flight controllers are often tasked with generating responses to multiple failures when they occur. However, during future space missions, flight...

  19. Tracking Polychlorinated Biphenyls (PCB) after an incident along a river system - Case study Elbe River

    Science.gov (United States)

    Kleisinger, Carmen; Dietrich, Stephan; Kehl, Nora; Claus, Evelyn; Schubert, Birgit

    2017-04-01

    In spring 2015, extremely high concentrations of Polychlorinated Biphenyls (PCB) well above the long-term average were detected in suspended particulate matter (SPM) within the River Elbe. They were released due to abrasive blasting of the old coating from a bridge in the upper part of the River, approximately 50 km upstream of the first measurement site. PCBs are persistent organic pollutants, preferentially bound to fine-grained fractions of the SPM. Results from monitoring of contaminants in SPM along the Elbe indicate the further dispersal of the PCB-contaminated sediments. These measurements include yearly investigations on PCB concentrations in sediments in the inner reaches of the Elbe, an additional longitudinal survey in 2015 and monthly monitoring of PCBs in SPM at stations along the river including the Elbe estuary (Germany). The Elbe estuary is of major economic importance since Hamburg harbour, one of the largest harbours in Europe, is located there. Maintaining the harbour includes dredging and, i.a., relocating large amounts of the dredged material within the water body. High PCB concentrations in sediments could lead to restrictions on the relocation of these sediments. This study aims at tracking the fate of PCB contaminated material released from the point source of the incident site along the whole river stretch and at estimating its impact on the quality of sediments and consequently on dredging activities in the estuary. The ratio of high (PCB 138, 152 and 180) versus low (PCB 28, 52, 101) chlorinated PCB congeners proved to be a suitable tracer to distinguish the PCB load released by the incident from the long-term background signals. As Delor 106/Clophen A60, which contains approx. 90% hexa- to decachloric congeners, was an additive in the coating of the bridge, the pattern of PCBs released by the incident is dominated by the highly chlorinated PCB-congeners PCB 138, 153 and 180. At the tidal weir Geesthacht, the entrance to the estuary, an

  20. Effect of sunflower climbing bean intercroping system on insect pest incidence and crop productivity

    International Nuclear Information System (INIS)

    Tuey, R.K.; Koros, I.; Wanyonyi, W.

    2001-01-01

    Intercropping of sunflower and climping beans were evaluated for pest incidence and yield advantages during the main season of 2000/2001 at KARI-NPBRC, Njoro. Three sunflower varieties, Fedha, Record, PAN-7553 and three climbing beans varieties, Puebla, Omukingi and Flora were laid out in a complete randomised block design with four replications. Sunflower was spaced at 75 x 30 cm while the climbing beans were spaced at 50 x 37.5 cm. Assessment of pest damage on various treatments commenced 17 days after planting. Results showed that low plant germination was mainly a result of dry weather and taht cutworm damage was insignificant. There was a sunflower x climbing bean variety interaction, which regulated the aphid infestation of the climbing beans. Sunflower variety PAN-7553 recorded significantly (P<0.01) more pecked heads than the other two varieties. (author)

  1. Development of a new scoring system to predict 5-year incident diabetes risk in middle-aged and older Chinese.

    Science.gov (United States)

    Han, Xu; Wang, Jing; Li, Yaru; Hu, Hua; Li, Xiulou; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Wei, Sheng; Wang, Youjie; Liang, Yuan; Zhang, Xiaomin; Guo, Huan; Pan, An; Yang, Handong; Wu, Tangchun; He, Meian

    2018-01-01

    The aim of this study was to develop a new risk score system to predict 5-year incident diabetes risk among middle-aged and older Chinese population. This prospective study included 17,690 individuals derived from the Dongfeng-Tongji cohort. Participants were recruited in 2008 and were followed until October 2013. Incident diabetes was defined as self-reported clinician diagnosed diabetes, fasting glucose ≥7.0 mmol/l, or the use of insulin or oral hypoglycemic agent. A total of 1390 incident diabetic cases were diagnosed during the follow-up period. β-Coefficients were derived from Cox proportional hazard regression model and were used to calculate the risk score. The diabetes risk score includes BMI, fasting glucose, hypertension, hyperlipidemia, current smoking status, and family history of diabetes. The β-coefficients of these variables ranged from 0.139 to 1.914, and the optimal cutoff value was 1.5. The diabetes risk score was calculated by multiplying the β-coefficients of the significant variables by 10 and rounding to the nearest integer. The score ranges from 0 to 36. The area under the receiver operating curve of the score was 0.751. At the optimal cutoff value of 15, the sensitivity and specificity were 65.6 and 72.9%, respectively. Based upon these risk factors, this model had the highest discrimination compared with several commonly used diabetes prediction models. The newly established diabetes risk score with six parameters appears to be a reliable screening tool to predict 5-year risk of incident diabetes in a middle-aged and older Chinese population.

  2. Improving patient safety and quality: what are the challenges and gaps in introducing an integrated electronic adverse incident and recording system within health care industry?

    Science.gov (United States)

    Walsh, Kerry; Antony, Jiju

    2007-01-01

    The purpose of this paper is to present the challenges and gaps in using an electronic adverse incident recording and reporting system from a commercial supplier to an acute health care setting. The paper used action diary, documentation and triangulation to obtain an understanding of the challenges and gaps. The paper provides health care with further understanding of the complexity, challenges and gaps of using an electronic adverse incident recording system to improve patient safety. This paper explains the important views of clinicians and managers in relation to improving patient safety by using an electronic adverse incident management system.

  3. A fault isolation method based on the incidence matrix of an augmented system

    Science.gov (United States)

    Chen, Changxiong; Chen, Liping; Ding, Jianwan; Wu, Yizhong

    2018-03-01

    A new approach is proposed for isolating faults and fast identifying the redundant sensors of a system in this paper. By introducing fault signal as additional state variable, an augmented system model is constructed by the original system model, fault signals and sensor measurement equations. The structural properties of an augmented system model are provided in this paper. From the viewpoint of evaluating fault variables, the calculating correlations of the fault variables in the system can be found, which imply the fault isolation properties of the system. Compared with previous isolation approaches, the highlights of the new approach are that it can quickly find the faults which can be isolated using exclusive residuals, at the same time, and can identify the redundant sensors in the system, which are useful for the design of diagnosis system. The simulation of a four-tank system is reported to validate the proposed method.

  4. Incidence of systemic lupus erythematosus in a population-based cohort using revised 1997 American College of Rheumatology and the 2012 Systemic Lupus International Collaborating Clinics classification criteria.

    Science.gov (United States)

    Ungprasert, P; Sagar, V; Crowson, C S; Amin, S; Makol, A; Ernste, F C; Osborn, T G; Moder, K G; Niewold, T B; Maradit-Kremers, H; Ramsey-Goldman, R; Chowdhary, V R

    2017-03-01

    In 2012, the Systemic Lupus International Collaborating Clinics (SLICC) group published a new set of classification criteria for systemic lupus erythematosus (SLE). Studies applying these criteria to real-life scenarios have found either equal or greater sensitivity and equal or lower specificity to the 1997 ACR classification criteria (ACR 97). Nonetheless, there are no studies that have used the SLICC 12 criteria to investigate the incidence of lupus. We used the resource of the Rochester Epidemiology Project to identify incident SLE patients in Olmsted County, Minnesota, from 1993 to 2005, who fulfilled the ACR 97 or SLICC 12 criteria. A total of 58 patients met criteria by SLICC 12 and 44 patients met criteria by ACR 97. The adjusted incidence of 4.9 per 100,000 person-years by SLICC 12 was higher than that by ACR 97 (3.7 per 100,000 person-years, p = 0.04). The median duration from the appearance of first criterion to fulfillment of the criteria was shorter for the SLICC 12 than for ACR 97 (3.9 months vs 8.1 months). The higher incidence by SLICC 12 criteria came primarily from the ability to classify patients with renal-limited disease, the expansion of the immunologic criteria and the expansion of neurologic criteria.

  5. The IAEAs incident and emergency centre: the global focal point for nuclear and radiological emergency preparedness and response

    International Nuclear Information System (INIS)

    Buglova, E.

    2016-01-01

    The continuous use of nuclear power to generate electricity and the continued threat of radioactive materials being used for nefarious reasons reminds us of the importance to stay prepared to respond to nuclear or radiological emergencies. Stringent nuclear safety and nuclear security requirements, the training of personnel, operational checks and legal frameworks cannot always prevent radiation-related emergencies. Though these events can range in severity, each has the potential to cause harm to the public, employees, patients, property and the environment. Until the Chernobyl nuclear accident in 1986, there was no international information exchange system. Immediately following that accident, the international community negotiated the so-called Emergency Conventions to ensure that the country suffering an accident with an international transboundary release of radioactive material would issue timely, authenticated information, while the States that could field technical support, would do so in a coordinated fashion. The Conventions also place specific legal obligations on the International Atomic energy Agency (IAEA) with regard to emergency preparedness and response. (Author)

  6. The IAEAs incident and emergency centre: the global focal point for nuclear and radiological emergency preparedness and response

    Energy Technology Data Exchange (ETDEWEB)

    Buglova, E.

    2016-08-01

    The continuous use of nuclear power to generate electricity and the continued threat of radioactive materials being used for nefarious reasons reminds us of the importance to stay prepared to respond to nuclear or radiological emergencies. Stringent nuclear safety and nuclear security requirements, the training of personnel, operational checks and legal frameworks cannot always prevent radiation-related emergencies. Though these events can range in severity, each has the potential to cause harm to the public, employees, patients, property and the environment. Until the Chernobyl nuclear accident in 1986, there was no international information exchange system. Immediately following that accident, the international community negotiated the so-called Emergency Conventions to ensure that the country suffering an accident with an international transboundary release of radioactive material would issue timely, authenticated information, while the States that could field technical support, would do so in a coordinated fashion. The Conventions also place specific legal obligations on the International Atomic energy Agency (IAEA) with regard to emergency preparedness and response. (Author)

  7. The response of wavelength shifting panels in large water Cherenkov systems

    International Nuclear Information System (INIS)

    Bakich, A.M.; Peak, L.S.

    1986-01-01

    This paper describes a series of tests performed with a panel Bicron wavelength shifting acrylic plastic (BC-480) coupled to an EMI 9623B photomultiplier tube. The aim was to effectively increase the cathode coverage and its sensitivity to incident Cherenkov radiation, so that such a system could be employed in a solar neutrino detector. Measurements of the uniformity and effective efficiency of the system have been made and compared with the results of various simulation runs. The effects of side mirrors, back reflector, water interface and possible shaping of the panel to enhance its response are also assessed. (orig.)

  8. Error response test system and method using test mask variable

    Science.gov (United States)

    Gender, Thomas K. (Inventor)

    2006-01-01

    An error response test system and method with increased functionality and improved performance is provided. The error response test system provides the ability to inject errors into the application under test to test the error response of the application under test in an automated and efficient manner. The error response system injects errors into the application through a test mask variable. The test mask variable is added to the application under test. During normal operation, the test mask variable is set to allow the application under test to operate normally. During testing, the error response test system can change the test mask variable to introduce an error into the application under test. The error response system can then monitor the application under test to determine whether the application has the correct response to the error.

  9. Biomechanics of subdural hemorrhage in American football: review of the literature in response to rise in incidence.

    Science.gov (United States)

    Forbes, Jonathan A; Zuckerman, Scott; Abla, Adib A; Mocco, J; Bode, Ken; Eads, Todd

    2014-02-01

    The number of catastrophic head injuries recorded during the 2011 football season was the highest since data collection began in 1984--the vast majority of these cases were secondary to subdural hemorrhage (SDH). The incidence of catastrophic head injury continues to rise: the average yearly incidence from 2008 to 2012 was 238% that of the average yearly incidence from 1998 to 2002. Greater than 95% of the football players who suffered catastrophic head injury during this period were age 18 or younger. Currently, the helmet industry utilizes a standard based on data obtained at Wayne State University approximately 50 years ago that seeks to limit severity index--a surrogate marker of translational acceleration. In this manuscript, we utilize a focused review of the literature to better characterize the biomechanical factors associated with SDH following collisions in American football and discuss these data in the context of current helmet standard. Review of the literature indicates the rotational acceleration (RA) threshold above which the risk of SDH becomes appreciable is approximately 5,000 rad/s(2). This value is not infrequently surmounted in typical high school football games. In contrast, translational accelerations (TAs) experienced during even elite-level impacts in football are not of sufficient magnitude to result in SDH. This information raises important questions about the current helmet standard--in which the sole objective is limitation of TA. Further studies will be necessary to better define whether helmet constructs and quality assurance standards designed to limit RA will also help to decrease the risk of catastrophic head injury in American football.

  10. The Mechanical Response of Multifunctional Battery Systems

    Science.gov (United States)

    Tsutsui, Waterloo

    The current state of the art in the field of the mechanical behavior of electric vehicle (EV) battery cells is limited to quasi-static analysis. The lack of published data in the dynamic mechanical behavior of EV battery cells blinds engineers and scientists with the uncertainty of what to expect when EVs experience such unexpected events as intrusions to their battery systems. To this end, the recent occurrences of several EVs catching fire after hitting road debris even make this topic timelier. In order to ensure the safety of EV battery, it is critical to develop quantitative understanding of battery cell mechanical behavior under dynamic compressive loadings. Specifically, the research focuses on the dynamic mechanical loading effect on the standard "18650" cylindrical lithium-ion battery cells. In the study, the force-displacement and voltage-displacement behavior of the battery cells were analyzed experimentally at two strain rates, two state-of-charges, and two unit-cell configurations. The results revealed the strain rate sensitivity of their mechanical responses with the solid sacrificial elements. When the hollow sacrificial cells are used, on the other hand, effect was negligible up to the point of densification strength. Also, the high state-of-charge appeared to increase the stiffness of the battery cells. The research also revealed the effectiveness of the sacrificial elements on the mechanical behavior of a unit cell that consists of one battery cell and six sacrificial elements. The use of the sacrificial elements resulted in the delayed initiation of electric short circuit. Based on the analysis of battery behavior at the cell level, granular battery assembly, a battery pack, was designed and fabricated. The behavior of the granular battery assembly was analyzed both quasistatically and dynamically. Building on the results of the research, various research plans were proposed. Through conducting the research, we sought to answer the following

  11. Multiple Failure Response Procedure System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — When an ISHM module identifies a single failure, an associated response procedure, developed and validated in advance, can be selected for execution to verify the...

  12. Office of Civilian Response Deployment Tracking System

    Data.gov (United States)

    US Agency for International Development — The purpose of OCR DTS is to establish, manage and track relevant Civilian Response Corps teams for deployment by sector experience, training, education etc.

  13. Endemic influences of political regimes, healthcare systems, and preferences on the frequencies and incidences of nephropathies in eastern Saxony, Germany
.

    Science.gov (United States)

    Sedaghat, Sam; Heshmati, Eleène Sahmila; Frese, Thomas; Rasche, Wilma Gertrud; Barinka, Filip; Fahr, Florian; Beige, Joachim; Schiekofer, Stephan; Rasche, Franz Maximilian

    2017-12-01

    The possible confounding influence of investigator-related preferences, available histological techniques, and healthcare systems on the frequencies and incidences of primary and secondary nephropathies was evaluated in this long-term observation. The observation time from 1983 to 2010 was divided in regard to the political regimes: a) prior to and after German reunification: German Democratic Republic (GDR, period 1 from 1983 to 1990)/Federal Republic of Germany (FRG, period 2 from 1990 to 2010); and the two heads of the division of nephrology, b) conductor 1 (1983 - 2006) and conductor 2 (2006 - 2010). 467 kidney biopsies at the University Hospital of Leipzig were included in our analysis. In period 1, due to the unavailability of immunofluorescence methods, mesangioproliferative glomerulonephritis (MesP) was the most dominating nephropathy. In period 2, IgA nephropathy (IgAN) was the most common nephropathy (17%). IgAN was followed by crescentic glomerulonephritis (13%), hypertensive nephropathy (10%), minimal-change disease, and membranous glomerulonephritis (each 9%). From period 1 to period 2, MesP/IgAN (62% to 16%), membranoproliferative glomerulonephritis and postinfectious glomerulonephritis decreased significantly (p < 0.05). IgAN decreased significantly (p < 0.05) from conductor 1 to conductor 2 (21% to 6%), while diabetic nephropathy significantly increased. Focal-segmental glomerulosclerosis (FSGS) had the highest incidence rate with 1.0, followed by IgAN with 0.8 (per 100,000 per year). In a nearly ethnically identical cohort, we have demonstrated that confounding factors, e.g., healthcare systems and preferences of conductors, have a strong influence - more than 10-fold variance - on frequency and incidence on the spectrum of nephropathies.
.

  14. IEA Response System for Oil Supply Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-15

    Emergency response to oil supply disruptions has remained a core mission of the International Energy Agency since its founding in 1974. This information pamphlet explains the decisionmaking process leading to an IEA collective action, the measures available -- focusing on stockdraw -- and finally, the historical background of major oil supply disruptions and the IEA response to them. It also demonstrates the continuing need for emergency preparedness, including the growing importance of engaging key transition and emerging economies in dialogue about energy security.

  15. IEA Response System for Oil Supply Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-12-15

    Emergency response to oil supply disruptions has remained a core mission of the International Energy Agency since its founding in 1974. This information pamphlet explains the decisionmaking process leading to an IEA collective action, the measures available -- focusing on stockdraw -- and finally, the historical background of major oil supply disruptions and the IEA response to them. It also demonstrates the continuing need for emergency preparedness, including the growing importance of engaging key transition and emerging economies in dialogue about energy security.

  16. A System for Disaster Response Process Management

    OpenAIRE

    Saeed, Muhammad Rizwan

    2012-01-01

    During a disaster, public safety organizations face a very dynamic and continuously changing situation with unforeseen challenges and unexpected events. The main problem in disaster response management lies at the coordination and collaboration of activities of different organizations involved, both at the inter- and intra-organization level. Current practices and process management approaches have several limitations and are not suitable for managing disaster response processes. Our develope...

  17. Incident Management: Process into Practice

    Science.gov (United States)

    Isaac, Gayle; Moore, Brian

    2011-01-01

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

  18. Evaluating the Reliability of Emergency Response Systems for Large-Scale Incident Operations

    Science.gov (United States)

    2010-01-01

    effort depended on the efforts of a number of individuals beyond the research team. Two of our RAND colleagues, Jeremiah Goulka and Angel Martinez ...Avon Refinery Martinez , CA Feb. 23, 1999, Report No. 99-014-I-CA, 2001. U.S. Chemical Safety and Hazard Investigation Board, Investigation Report...2008. As of May 27, 2010: http://hamptonroads.com/2008/05/norfolk-southern-set-fight-epa-lawsuit-ceo-tells-shareholders Rudolph, Jenny W., and

  19. Dissociating response systems: erasing fear from memory.

    Science.gov (United States)

    Soeter, Marieke; Kindt, Merel

    2010-07-01

    In addition to the extensive evidence in animals, we previously showed that disrupting reconsolidation by noradrenergic blockade produced amnesia for the original fear response in humans. Interestingly, the declarative memory for the fear association remained intact. These results asked for a solid replication. Moreover, given the constructive nature of memories, the intact recollection of the fear association could eventually 'rebuild' the fear memory, resulting in the spontaneous recovery of the fear response. Yet, perseverance of the amnesic effects would have substantial clinical implications, as even the most effective treatments for psychiatric disorders display high percentages of relapse. Using a differential fear conditioning procedure in humans, we replicated our previous findings by showing that administering propranolol (40mg) prior to memory reactivation eliminated the startle fear response 24h later. But most importantly, this effect persisted at one month follow-up. Notably, the propranolol manipulation not only left the declarative memory for the acquired contingency untouched, but also skin conductance discrimination. In addition, a close association between declarative knowledge and skin conductance responses was found. These findings are in line with the supposed double dissociation of fear conditioning and declarative knowledge relative to the amygdala and hippocampus in humans. They support the view that skin conductance conditioning primarily reflects contingency learning, whereas the startle response is a rather specific measure of fear. Furthermore, the results indicate the absence of a causal link between the actual knowledge of a fear association and its fear response, even though they often operate in parallel. Interventions targeting the amygdalar fear memory may be essential in specifically and persistently dampening the emotional impact of fear. From a clinical and ethical perspective, disrupting reconsolidation points to promising

  20. WE-G-BRA-03: Developing a Culture of Patient Safety Utilizing the National Radiation Oncology Incident Learning System (ROILS)

    Energy Technology Data Exchange (ETDEWEB)

    Hasson, B; Workie, D; Geraghty, C [Anne Arundel Medical Center, Annapolis, MD (United States)

    2015-06-15

    Purpose: To transition from an in-house incident reporting system to a ROILS standards system with the intent to develop a safety focused culture in the Department and enroll in ROILS. Methods: Since the AAPM Safety Summit (2010) several safety and reporting systems have been implemented within the Department. Specific checklists and SBAR reporting systems were introduced. However, the active learning component was lost due to reporting being viewed with distrust and possible retribution.To Facilitate introducing ROILS each leader in the Department received a copy of the ROILS participation guide. Four specific tasks were assigned to each leader: develop a reporting tree, begin the ROILS based system, facilitate adopting ROILS Terminology, and educate the staff on expectations of safety culture. Next, the ROILS questions were broken down into area specific questions (10–15) per departmental area. Excel spreadsheets were developed for each area and setup for error reporting entries. The Role of the Process Improvement Committee (PI) has been modified to review and make recommendations based on the ROILS entries. Results: The ROILS based Reporting has been in place for 4 months. To date 64 reports have been entered. Since the adoption of ROILS the reporting of incidents has increased from 2/month to 18/month on average. Three reports had a dosimetric effect on the patient (<5%) dose variance. The large majority of entries have been Characterized as Processes not followed or not sure how to Characterize, and Human Behavior. Conclusion: The majority of errors are typo’s that create confusion. The introduction of the ROILS standards has provided a platform for making changes to policies that increase patient safety. The goal is to develop a culture that sees reporting at a national level as a safe and effective way to improve our safety, and to dynamically learn from other institutions reporting.

  1. Incidence of Systemic Fungal Infection and Related Mortality Following Severe Burns

    Science.gov (United States)

    2008-01-01

    infectious complications remain a major contributor to morbidity and mortality. Improvements in topical antimicrobial therapy, systemic antimicrobial ...with mold activity for treating wounds, and implementation of appropriate systemic antifungal therapy may improve outcome for severely injured burn...had Mucor, 7 patients had Fusarium, 3 patients had Alternaria, 4 patients had Penicillium , 2 patients had Cladosporium, 2 patients had Trichsoporon, 1

  2. Developing a patient safety incident classification system for primary care. A literature review and Delphi-survey by the LINNEAUS collaboration on patient safety in primary care

    OpenAIRE

    Klemp, Kerstin; Dovey, Susan; Valderas, Jose M; Rohe, Julia; Godycki-Cwirko, Maciek; Elliott, Phillip; Beyer, Martin; Gerlach, Ferdin M.; Hoffmann, Barbara

    2015-01-01

    ABSTRACT Background: Despite awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there has been little effort to establish an incident classification system that is generally applicable to patient safety data in European primary care. Objective: To describe the development of a patient safety incident classification system for primary care. Methods: A systematic review was followed by an expert group discussion and a modified Delp...

  3. Model-Data Fusion and Adaptive Sensing for Large Scale Systems: Applications to Atmospheric Release Incidents

    Science.gov (United States)

    Madankan, Reza

    All across the world, toxic material clouds are emitted from sources, such as industrial plants, vehicular traffic, and volcanic eruptions can contain chemical, biological or radiological material. With the growing fear of natural, accidental or deliberate release of toxic agents, there is tremendous interest in precise source characterization and generating accurate hazard maps of toxic material dispersion for appropriate disaster management. In this dissertation, an end-to-end framework has been developed for probabilistic source characterization and forecasting of atmospheric release incidents. The proposed methodology consists of three major components which are combined together to perform the task of source characterization and forecasting. These components include Uncertainty Quantification, Optimal Information Collection, and Data Assimilation. Precise approximation of prior statistics is crucial to ensure performance of the source characterization process. In this work, an efficient quadrature based method has been utilized for quantification of uncertainty in plume dispersion models that are subject to uncertain source parameters. In addition, a fast and accurate approach is utilized for the approximation of probabilistic hazard maps, based on combination of polynomial chaos theory and the method of quadrature points. Besides precise quantification of uncertainty, having useful measurement data is also highly important to warranty accurate source parameter estimation. The performance of source characterization is highly affected by applied sensor orientation for data observation. Hence, a general framework has been developed for the optimal allocation of data observation sensors, to improve performance of the source characterization process. The key goal of this framework is to optimally locate a set of mobile sensors such that measurement of textit{better} data is guaranteed. This is achieved by maximizing the mutual information between model predictions

  4. Pilot program: NRC severe reactor accident incident response training manual: Public protective actions: Predetermined criteria and initial actions

    International Nuclear Information System (INIS)

    Martin, J.A. Jr.; McKenna, T.J.; Miller, C.W.; Hively, L.M.; Sharpe, R.W.; Giitter, J.G.; Watkins, R.M.

    1987-02-01

    This pilot training manual has been written to fill the need for a general text on NRC response to reactor accidents. The manual is intended to be the foundation for a course for all NRC response personnel. Public Protective Actions - Predetermined Criteria and Initial Actions is the fourth in a series of volumes that collectively summarize the US Nuclear Regulatory Commission (NRC) emergency response during severe power reactor accidents and provide necessary background information. This volume reviews public protective action criteria and objectives, their bases and implementation, and the expected public response. Each volume serves, respectively, as the text for a course of instruction in a series of courses for NRC response personnel. These materials do not provide guidance or license requirements for NRC licensees. Each volume is accompanied by an appendix of slides that can be used to present this material. The slides are called out in the text

  5. Information sharing for traffic incident management.

    Science.gov (United States)

    2009-01-01

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

  6. Wheelchair incidents

    NARCIS (Netherlands)

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

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Fei Li

    2018-01-01

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

  8. Role of the Yersinia pestis yersiniabactin iron acquisition system in the incidence of flea-borne plague.

    Directory of Open Access Journals (Sweden)

    Florent Sebbane

    2010-12-01

    Full Text Available Plague is a flea-borne zoonosis caused by the bacterium Yersinia pestis. Y. pestis mutants lacking the yersiniabactin (Ybt siderophore-based iron transport system are avirulent when inoculated intradermally but fully virulent when inoculated intravenously in mice. Presumably, Ybt is required to provide sufficient iron at the peripheral injection site, suggesting that Ybt would be an essential virulence factor for flea-borne plague. Here, using a flea-to-mouse transmission model, we show that a Y. pestis strain lacking the Ybt system causes fatal plague at low incidence when transmitted by fleas. Bacteriology and histology analyses revealed that a Ybt-negative strain caused only primary septicemic plague and atypical bubonic plague instead of the typical bubonic form of disease. The results provide new evidence that primary septicemic plague is a distinct clinical entity and suggest that unusual forms of plague may be caused by atypical Y. pestis strains.

  9. BEAP profiles as rapid test system for status analysis and early detection of process incidents in biogas plants.

    Science.gov (United States)

    Refai, Sarah; Berger, Stefanie; Wassmann, Kati; Hecht, Melanie; Dickhaus, Thomas; Deppenmeier, Uwe

    2017-03-01

    A method was developed to quantify the performance of microorganisms involved in different digestion levels in biogas plants. The test system was based on the addition of butyrate (BCON), ethanol (ECON), acetate (ACON) or propionate (PCON) to biogas sludge samples and the subsequent analysis of CH 4 formation in comparison to control samples. The combination of the four values was referred to as BEAP profile. Determination of BEAP profiles enabled rapid testing of a biogas plant's metabolic state within 24 h and an accurate mapping of all degradation levels in a lab-scale experimental setup. Furthermore, it was possible to distinguish between specific BEAP profiles for standard biogas plants and for biogas reactors with process incidents (beginning of NH 4 + -N inhibition, start of acidification, insufficient hydrolysis and potential mycotoxin effects). Finally, BEAP profiles also functioned as a warning system for the early prediction of critical NH 4 + -N concentrations leading to a drop of CH 4 formation.

  10. Modeling retrospective attribution of responsibility to hazard-managing institutions: an example involving a food contamination incident.

    Science.gov (United States)

    Johnson, Branden B; Hallman, William K; Cuite, Cara L

    2015-03-01

    Perceptions of institutions that manage hazards are important because they can affect how the public responds to hazard events. Antecedents of trust judgments have received far more attention than antecedents of attributions of responsibility for hazard events. We build upon a model of retrospective attribution of responsibility to individuals to examine these relationships regarding five classes of institutions that bear responsibility for food safety: producers (e.g., farmers), processors (e.g., packaging firms), watchdogs (e.g., government agencies), sellers (e.g., supermarkets), and preparers (e.g., restaurants). A nationally representative sample of 1,200 American adults completed an Internet-based survey in which a hypothetical scenario involving contamination of diverse foods with Salmonella served as the stimulus event. Perceived competence and good intentions of the institution moderately decreased attributions of responsibility. A stronger factor was whether an institution was deemed (potentially) aware of the contamination and free to act to prevent or mitigate it. Responsibility was rated higher the more aware and free the institution. This initial model for attributions of responsibility to impersonal institutions (as opposed to individual responsibility) merits further development. © 2014 Society for Risk Analysis.

  11. Conventional estimating method of earthquake response of mechanical appendage system

    International Nuclear Information System (INIS)

    Aoki, Shigeru; Suzuki, Kohei

    1981-01-01

    Generally, for the estimation of the earthquake response of appendage structure system installed in main structure system, the method of floor response analysis using the response spectra at the point of installing the appendage system has been used. On the other hand, the research on the estimation of the earthquake response of appendage system by the statistical procedure based on probability process theory has been reported. The development of a practical method for simply estimating the response is an important subject in aseismatic engineering. In this study, the method of estimating the earthquake response of appendage system in the general case that the natural frequencies of both structure systems were different was investigated. First, it was shown that floor response amplification factor was able to be estimated simply by giving the ratio of the natural frequencies of both structure systems, and its statistical property was clarified. Next, it was elucidated that the procedure of expressing acceleration, velocity and displacement responses with tri-axial response spectra simultaneously was able to be applied to the expression of FRAF. The applicability of this procedure to nonlinear system was examined. (Kako, I.)

  12. Body Mass Index, Abdominal Fatness, and Heart Failure Incidence and Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.

    Science.gov (United States)

    Aune, Dagfinn; Sen, Abhijit; Norat, Teresa; Janszky, Imre; Romundstad, Pål; Tonstad, Serena; Vatten, Lars J

    2016-02-16

    Obesity has been associated with increased risk of heart failure, but whether overweight also increases risk is unclear. It is also unclear whether abdominal adiposity is more strongly associated with heart failure risk than general adiposity. We conducted a systematic review and meta-analysis of prospective studies to clarify the strength and shape of the dose-response relationship between general and abdominal adiposity and the risk of heart failure. PubMed and Embase databases were searched up to October 10, 2014. Summary relative risks were calculated using random-effects models. A total of 28 studies (27 publications) were included. Twenty-three prospective studies with >15 905 incident cases among 647 388 participants were included in the analysis of body mass index and heart failure incidence, and 4 studies were included for heart failure mortality. The summary relative risk for a 5-unit increment in body mass index was 1.41 (95% confidence interval, 1.34-1.47; I(2)=83%) for heart failure incidence and 1.26 (95% confidence interval, 0.85-1.87; I(2)=95%) heart failure mortality. Although the test for nonlinearity was significant (Pfailure. © 2016 American Heart Association, Inc.

  13. Influence of commercial laying hen housing systems on the incidence and identification of Salmonella and Campylobacter.

    Science.gov (United States)

    Jones, D R; Guard, J; Gast, R K; Buhr, R J; Fedorka-Cray, P J; Abdo, Z; Plumblee, J R; Bourassa, D V; Cox, N A; Rigsby, L L; Robison, C I; Regmi, P; Karcher, D M

    2016-05-01

    The housing of laying hens is important for social, industrial, and regulatory aspects. Many studies have compared hen housing systems on the research farm, but few have fully examined commercial housing systems and management strategies. The current study compared hens housed in commercial cage-free aviary, conventional cage, and enriched colony cage systems. Environmental and eggshell pool samples were collected from selected cages/segments of the housing systems throughout the production cycle and monitored for Salmonella and Campylobacter prevalence. At 77 wk of age, 120 hens per housing system were examined for Salmonella and Campylobacter colonization in the: adrenal glands, spleen, ceca, follicles, and upper reproductive tract. All isolates detected from environmental swabs, eggshell pools, and tissues were identified for serotype. Two predominant Salmonella were detected in all samples:S.Braenderup andS.Kentucky.Campylobacter coli and C. jejuni were the only Campylobacter detected in the flocks. Across all housing systems, approximately 7% of hens were colonized with Salmonella, whereas >90% were colonized with Campylobacter Salmonella Braenderup was the isolate most frequently detected in environmental swabs (PCampylobacter jejuni was the isolate most frequently found in environmental swabs (P<0.01), while housing system impacted the prevalence of C. coli and jejuniin ceca (P<0.0001). The results of this study provide a greater understanding of the impact of hen housing systems on hen health and product safety. Additionally, producers and academia can utilize the findings to make informed decisions on hen housing and management strategies to enhance hen health and food safety. Published by Oxford University Press on behalf of Poultry Science Association 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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

    OpenAIRE

    Ritchie, Stephen G.; Prosser, Neil A.

    1992-01-01

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

  15. Does the implementation of an electronic prescribing system create unintended medication errors? A study of the sociotechnical context through the analysis of reported medication incidents

    Directory of Open Access Journals (Sweden)

    Hodson James

    2011-05-01

    Full Text Available Abstract Background Even though electronic prescribing systems are widely advocated as one of the most effective means of improving patient safety, they may also introduce new risks that are not immediately obvious. Through the study of specific incidents related to the processes involved in the administration of medication, we sought to find out if the prescribing system had unintended consequences in creating new errors. The focus of this study was a large acute hospital in the Midlands in the United Kingdom, which implemented a Prescribing, Information and Communication System (PICS. Methods This exploratory study was based on a survey of routinely collected medication incidents over five months. Data were independently reviewed by two of the investigators with a clinical pharmacology and nursing background respectively, and grouped into broad types: sociotechnical incidents (related to human interactions with the system and non-sociotechnical incidents. Sociotechnical incidents were distinguished from the others because they occurred at the point where the system and the professional intersected and would not have occurred in the absence of the system. The day of the week and time of day that an incident occurred were tested using univariable and multivariable analyses. We acknowledge the limitations of conducting analyses of data extracted from incident reports as it is widely recognised that most medication errors are not reported and may contain inaccurate data. Interpretation of results must therefore be tentative. Results Out of a total of 485 incidents, a modest 15% (n = 73 were distinguished as sociotechnical issues and thus may be unique to hospitals that have such systems in place. These incidents were further analysed and subdivided into categories in order to identify aspects of the context which gave rise to adverse situations and possible risks to patient safety. The analysis of sociotechnical incidents by time of day and day of

  16. Implementation of distributed computing system for emergency response and contaminant spill monitoring

    International Nuclear Information System (INIS)

    Ojo, T.O.; Sterling, M.C.Jr.; Bonner, J.S.; Fuller, C.B.; Kelly, F.; Page, C.A.

    2003-01-01

    The availability and use of real-time environmental data greatly enhances emergency response and spill monitoring in coastal and near shore environments. The data would include surface currents, wind speed, wind direction, and temperature. Model predictions (fate and transport) or forensics can also be included. In order to achieve an integrated system suitable for application in spill or emergency response situations, a link is required because this information exists on many different computing platforms. When real-time measurements are needed to monitor a spill, the use of a wide array of sensors and ship-based post-processing methods help reduce the latency in data transfer between field sampling stations and the Incident Command Centre. The common thread linking all these modules is the Transmission Control Protocol/Internet Protocol (TCP/IP), and the result is an integrated distributed computing system (DCS). The in-situ sensors are linked to an onboard computer through the use of a ship-based local area network (LAN) using a submersible device server. The onboard computer serves as both the data post-processor and communications server. It links the field sampling station with other modules, and is responsible for transferring data to the Incident Command Centre. This link is facilitated by a wide area network (WAN) based on wireless broadband communications facilities. This paper described the implementation of the DCS. The test results for the communications link and system readiness were also included. 6 refs., 2 tabs., 3 figs

  17. Dissociating response systems: erasing fear from memory

    NARCIS (Netherlands)

    Soeter, A.C.; Kindt, M.

    2010-01-01

    In addition to the extensive evidence in animals, we previously showed that disrupting reconsolidation by noradrenergic blockade produced amnesia for the original fear response in humans. Interestingly, the declarative memory for the fear association remained intact. These results asked for a solid

  18. Incidence of Vertebral Fractures in Women with Systemic Lupus Erythematosus After 8 Years of Follow-Up.

    Science.gov (United States)

    García-Carrasco, Mario; Mendoza-Pinto, Claudia; León-Vázquez, María de la Luz; Méndez-Martínez, Socorro; Etchegaray-Morales, Ivet; Montiel-Jarquín, Álvaro; Enriquez-Guerra, Miguel Angel; Muñóz-Guarneros, Margarita; Gálvez-Romero, José Luis; Soto-Santillán, Pamela; Cervera, Ricard

    2017-09-01

    The aim of this study was to evaluate possible associations between potential risk factors and the occurrence of established vertebral fractures (VF) in Mexican patients with systemic lupus erythematosus (SLE). Consecutive patients with SLE were enrolled in a prospective, observational study from 2006 to 2015. Information on potential risk factors, including demographics, clinical data, and bone mineral density (BMD) at the lumbar spine and hip on dual-energy X-ray absorptiometry was collected at baseline and follow-up. Semiquantitative analysis was used to determine incident VF on lateral thoracic and lumbar radiographs, defined as any vertebral body graded normal at baseline and at least mildly deformed (20-25% reduction or more in any vertebral height) during follow-up. Differences in baseline characteristics were assessed in patients with and without new radiographic VF. Of 110 SLE patients included, with a median follow-up of 8 (IQR 8-9) years, 22 (20%) had radiographic VF at baseline; 35 (32%) patients had a new VF. The annual incidence rate of new morphometric VF was 3.5 (95% CI 2.4-4.91) per 100 patient/years. Most fractures were mild or moderate and biconcave shaped. Incident VF were significantly associated with baseline BMD at the total hip and longer disease duration. Cumulative glucocorticoid dose, postmenopausal status, and previous prevalent VF were not associated with VF. In this SLE cohort in daily clinical practice, new VF were frequently present in SLE patients, especially those with longer disease duration and low-hip BMD.

  19. Incidence proportion of and risk factors for AIDS patients diagnosed with HIV dementia, central nervous system toxoplasmosis, and cryptococcal meningitis.

    Science.gov (United States)

    Wang, F; So, Y; Vittinghoff, E; Malani, H; Reingold, A; Lewis, E; Giordano, J; Janssen, R

    1995-01-01

    We undertook this study to determine the incidence proportion of and risk factors for AIDS patients diagnosed with human immunodeficiency virus (HIV) dementia, central nervous system (CNS) toxoplasmosis, and cryptococcal meningitis. A historical cohort of 487 consecutive inpatients with AIDS treated by San Francisco General Hospital inpatient and outpatient services entered the study. We abstracted all available records for demographic information, diagnoses, and dates of death and estimated the incidence proportion of AIDS patients diagnosed with major CNS complications using the Kaplan-Meier method. We used the Cox proportional hazards model to analyze the effect of demographic factors on the hazard (risk per unit time) of diagnosis with these CNS conditions. The estimated incidence proportion of patients diagnosed with HIV dementia within 1 and 2 years of AIDS diagnosis increased from 0.10 to 0.18. Corresponding proportions were 0.10 and 0.19 for CNS toxoplasmosis and 0.10 and 0.14 for cryptococcal meningitis. Only HIV dementia was independently associated with increasing age at AIDS diagnosis (relative hazard [RH] of 2.75 for ages 41-50 [95% confidence interval, 1.08-6.98]; RH of 4.73 for ages > 50 [95% confidence interval, 1.41-15.87]) and with injection drug use (RH of 2.03; 95% confidence interval, 1.19-3.47). HIV dementia, CNS toxoplasmosis, and cryptococcal meningitis are about equally common complications in patients with AIDS, but only HIV dementia is associated with increasing age at AIDS diagnosis and injection drug use.

  20. Pulmonary contusion primes systemic innate immunity responses.

    Science.gov (United States)

    Hoth, J Jason; Martin, R S; Yoza, Barbara K; Wells, Jonathan D; Meredith, J W; McCall, Charles E

    2009-07-01

    Traumatic injury may result in an exaggerated response to subsequent immune stimuli such as nosocomial infection. This "second hit" phenomenon and molecular mechanism(s) of immune priming by traumatic lung injury, specifically, pulmonary contusion, remain unknown. We used an animal model of pulmonary contusion to determine whether the injury resulted in priming of the innate immune response and to test the hypothesis that resuscitation fluids could attenuate the primed response to a second hit. Male, 8 to 9 weeks, C57/BL6 mice with a pulmonary contusion were challenged by a second hit of intratracheal administration of the Toll-like receptor 4 agonist, lipopolysaccharide (LPS, 50 microg) 24 hours after injury (injury + LPS). Other experimental groups were injury + vehicle or LPS alone. A separate group was injured and resuscitated by 4 cc/kg of hypertonic saline (HTS) or Lactated Ringer's (LR) resuscitation before LPS challenge. Mice were killed 4 hours after LPS challenge and blood, bronchoalveolar lavage, and tissue were isolated and analyzed. Data were analyzed using one-way analysis of variance with Bonferroni multiple comparison posttest for significant differences (*p < or = 0.05). Injury + LPS showed immune priming observed by lung injury histology and increased bronchoalveolar lavage neutrophilia, lung myeloperoxidase and serum IL-6, CXCL1, and MIP-2 levels when compared with injury + vehicle or LPS alone. After injury, resuscitation with HTS, but not Lactated Ringer's was more effective in attenuating the primed response to a second hit. Pulmonary contusion primes innate immunity for an exaggerated response to a second hit with the Toll-like receptor 4 agonist, LPS. We observed synergistic increases in inflammatory mediator expression in the blood and a more severe lung injury in injured animals challenged with LPS. This priming effect was reduced when HTS was used to resuscitate the animal after lung contusion.

  1. DOE's Computer Incident Advisory Capability (CIAC)

    Energy Technology Data Exchange (ETDEWEB)

    Schultz, E.

    1990-09-01

    Computer security is essential in maintaining quality in the computing environment. Computer security incidents, however, are becoming more sophisticated. The DOE Computer Incident Advisory Capability (CIAC) team was formed primarily to assist DOE sites in responding to computer security incidents. Among CIAC's other responsibilities are gathering and distributing information to DOE sites, providing training workshops, coordinating with other agencies, response teams, and vendors, creating guidelines for incident handling, and developing software tools. CIAC has already provided considerable assistance to DOE sites faced with virus infections and worm and hacker attacks, has issued over 40 information bulletins, and has developed and presented a workshop on incident handling. CIAC's experience in helping sites has produced several lessons learned, including the need to follow effective procedures to avoid virus infections in small systems and the need for sound password management and system administration in networked systems. CIAC's activity and scope will expand in the future. 4 refs.

  2. Information Systems Security: Whose Responsibility? | Senzige ...

    African Journals Online (AJOL)

    Explosive growth in use of information systems for all manner of applications in all walks of life has made provision of proper security essential. Users must have confidence that information systems will operate as intended without unanticipated failures or problems. Issues concerning privacy, availability, confidentiality and ...

  3. Communication report regarding the incident on the residual heat removal system at the nuclear power plant of Civaux May 12, 1998

    International Nuclear Information System (INIS)

    Chadeyron, Philippe

    1999-01-01

    The RRA (Residual Heat Removal System) of unit I had a leak of 280 m 3 while the reactor was shutdown for a period of 5 days, for normal start up tests. The leak was caused by a crack in a weld on a pipe of 25 cm in diameter. The liquid was completely contained within the Reactor Building containment; absolutely nothing leaked outside of the Reactor Building. This incident was classified level 2 on the INES scale. The Communication Immediately following the Incident showed that the efforts towards transparency were rewarding. A few months after the incident, hindsight helps, we can say that the media management of the RRA incident on, May 12th was in the image of its technical management, that is to say well mastered, and outside of the incident itself close to perfect. Obviously, the work we did during crisis exercises reaped its rewards. What is missing to advance to the next level? Maybe a bit of psychology, to attempt to surmise what a leak of radioactive water could represent in the public's eyes as well as the Media's who ignore the 'safety culture' (back-up trains etc.) and who still have fresh in their memories the Chernobyl accident. The vital Experience Feedback we collected and that of the Nuclear Industry since it exists incident after incident, even if immeasurable progress has been made (Civaux is a good example) our technical culture remains a hinderence towards a good estimation of the emotional level that such an incident can cause. Otherwise said, we still have progress to make on measuring the impact of an incident, not on the technical consequences nor the seriousness, but on the psychological impact it may have on the public. Beyond the crisis, this incident also showed how essential it is to dare talking about incidents and Safety Culture before intervening. The intimate enemy of Nuclear Energy is above all the relative ignorance in which the population finds itself. We still have work to do

  4. Incidence of waterborne lead in private drinking water systems in Virginia.

    Science.gov (United States)

    Pieper, Kelsey J; Krometis, Leigh-Anne H; Gallagher, Daniel L; Benham, Brian L; Edwards, Marc

    2015-09-01

    Although recent studies suggest contamination by bacteria and nitrate in private drinking water systems is of increasing concern, data describing contaminants associated with the corrosion of onsite plumbing are scarce. This study reports on the analysis of 2,146 samples submitted by private system homeowners. Almost 20% of first draw samples submitted contained lead concentrations above the United States Environmental Protection Agency action level of 15 μg/L, suggesting that corrosion may be a significant public health problem. Correlations between lead, copper, and zinc suggested brass components as a likely lead source, and dug/bored wells had significantly higher lead concentrations as compared to drilled wells. A random subset of samples selected to quantify particulate lead indicated that, on average, 47% of lead in the first draws was in the particulate form, although the occurrence was highly variable. While flushing the tap reduced lead below 15 μg/L for most systems, some systems experienced an increase, perhaps attributable to particulate lead or lead-bearing components upstream of the faucet (e.g., valves, pumps). Results suggest that without including a focus on private as well as municipal systems it will be very difficult to meet the existing national public health goal to eliminate elevated blood lead levels in children.

  5. The Systemic Pro-Inflammatory Response in Sepsis

    NARCIS (Netherlands)

    de Jong, Hanna Katrien; van der Poll, Tom; Wiersinga, Willem Joost

    2010-01-01

    The systemic inflammatory response syndrome (SIRS) is the predominantly cytokine-mediated, pro-inflammatory response of the host to invading pathogens and is considered the hallmark sign of sepsis. Molecular components of this response can be divided into cytokines, plasma cascades and acute phase

  6. The incidence and features of systemic reactions to skin prick tests.

    Science.gov (United States)

    Sellaturay, Priya; Nasser, Shuaib; Ewan, Pamela

    2015-09-01

    Skin prick testing (SPT) has been regarded as a safe procedure with few systemic reactions. To evaluate the rate of systemic reactions and their associations after SPT in the largest population to date. In this study reactions were recorded prospectively in a specialist UK allergy clinic for 6 years (2007-2013). An estimated 31,000 patients underwent SPT. Twenty-four patients (age range 7 months to 56 years, mean 23.5 years, 17 female patients, 12 with asthma) had systemic reactions. The rate of systemic reactions to SPT was 0.077%. The likely allergens causing the reaction were foods (18; peanut, 7; walnut, 1; Brazil nut, 2; pistachio, 1; lupin, 1; cow's milk, 2; shrimp, 1; spinach, 1; legume, 1; soy, 1), aeroallergens (4; rabbit, 1; rat, 1; ragwort, 1; grass pollen, 1), wasp venom (1), and Tazocin (1). The causative SPT wheal was larger than 8 mm in 75%. The reaction to Tazocin was severe, with anaphylaxis occurring minutes after SPT. Reactions were treated immediately in the clinic and did not require further medical care. In this largest single-center study, the rate of systemic reactions after SPT was 77 per 100,000 patients. It is the first study to identify foods as a common and important cause (75%), with nuts posing the highest risk. This study reports the first systemic reaction to venom SPT and the first anaphylactic reaction after drug SPT. There was an association with a history of severe reactions and large skin test reaction. There are risks, albeit small, when undertaking SPT. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-04-01

    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent research institute were used. The protocol for reports from major accidents and disaster was used to standardize the reporting [Lennquist, in Int J Disaster Med 1(1):79-86, 2003]. The emergency services were quickly at the scene. The different levels of pre-hospital management performed a tight coordination. However, miscommunication led to confusion in the registration and tracking of patients. In total, 49 persons needed medical treatment, 46 were treated in the MIH. Because of (possible) inhalation injury nine patients needed mechanical ventilation and nine patients were hospitalized to exclude delayed onset of pulmonary symptoms. No incident related deaths occurred. The intensive care unit of the MIH was initially understaffed despite the efforts of the automated calling system and switchboard operators. The handwritten registration of incoming staff was incomplete and should be performed digitally. Some staff members were unfamiliar with the MIH procedures. The medical chart appeared too extensive. Miscommunication between chain partners resulted in the delayed sharing of (semi) medical information. The different levels of incident managers performed a tight coordination. The MIH demonstrated its potency to provide emergency care for 46 patients and 9 intubated patients. No deaths or persistent disabilities occurred. Areas of improvement were recognized both in the pre-hospital as the hospital phase.

  8. Hydrogen detection systems leak response codes

    International Nuclear Information System (INIS)

    Desmas, T.; Kong, N.; Maupre, J.P.; Schindler, P.; Blanc, D.

    1990-01-01

    A loss in tightness of a water tube inside a Steam Generator Unit of a Fast Reactor is usually monitored by hydrogen detection systems. Such systems have demonstrated in the past their ability to detect a leak in a SGU. However, the increase in size of the SGU or the choice of ferritic material entails improvement of these systems in order to avoid secondary leak or to limit damages to the tube bundle. The R and D undertaken in France on this subject is presented. (author). 11 refs, 10 figs

  9. Estimating and mapping the incidence of dengue and chikungunya in Honduras during 2015 using Geographic Information Systems (GIS).

    Science.gov (United States)

    Zambrano, Lysien I; Sierra, Manuel; Lara, Bredy; Rodríguez-Núñez, Iván; Medina, Marco T; Lozada-Riascos, Carlos O; Rodríguez-Morales, Alfonso J

    Geographical information systems (GIS) use for development of epidemiological maps in dengue has been extensively used, however not in other emerging arboviral diseases, nor in Central America. Surveillance cases data (2015) were used to estimate annual incidence rates of dengue and chikungunya (cases/100,000 pop) to develop the first maps in the departments and municipalities of Honduras. The GIS software used was Kosmo Desktop 3.0RC1 ® . Four thematic maps were developed according departments, municipalities, diseases incidence rates. A total of 19,289 cases of dengue and 85,386 of chikungunya were reported (median, 726 cases/week for dengue and 1460 for chikungunya). Highest peaks were observed at weeks 25th and 27th, respectively. There was association between progression by weeks (p37%, both). Use of GIS-based epidemiological maps allow to guide decisions-taking for prevention and control of diseases that still represents significant issues in the region and the country, but also in emerging conditions. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  10. Incidence and predictors of cutaneous manifestations during the early course of systemic sclerosis

    DEFF Research Database (Denmark)

    Wirz, Elina G; Jaeger, Veronika K; Allanore, Yannick

    2016-01-01

    OBJECTIVES: To longitudinally map the onset and identify risk factors for skin sclerosis and digital ulcers (DUs) in patients with systemic sclerosis (SSc) from an early time point after the onset of Raynaud's phenomenon (RP) in the European Scleroderma Trials and Research (EUSTAR) cohort. METHOD...

  11. Modeling the Effects of a Transportation Security Incident on the Commercial Container Transportation System

    Science.gov (United States)

    2009-09-01

    handling system. Transport Reviews: A Transnational Transdisciplinary Journal , 25 (2), 181–199. Danskin, J. W. (1967). The Theory of Max-Min. New York...review of the state of the art . Analytical Studies in Transport Economics, MIT Press, 161–206. Infrastructure. (n.d.). In The American Heritage

  12. Incidences and Risk Factors of Organ Manifestations in the Early Course of Systemic Sclerosis

    DEFF Research Database (Denmark)

    Jaeger, Veronika K; Wirz, Elina G; Allanore, Yannick

    2016-01-01

    OBJECTIVE: Systemic sclerosis (SSc) is a rare and clinically heterogeneous autoimmune disorder characterised by fibrosis and microvascular obliteration of the skin and internal organs. Organ involvement mostly manifests after a variable period of the onset of Raynaud's phenomenon (RP). We aimed...

  13. Optimization of multi-response dynamic systems integrating multiple ...

    African Journals Online (AJOL)

    Optimization of multi-response dynamic systems integrating multiple regression and Taguchi's dynamic signal-to-noise ratio concept. ... Assuming a linear association exists between the response and signal variables, Taguchi offered a two-stage route for optimizing a dynamic system: maximize the dynamic signal-to noise ...

  14. Responsive triggering systems for delivery in chronic wound healing.

    Science.gov (United States)

    Morey, Mangesh; Pandit, Abhay

    2018-03-02

    Non-communicable diseases including cancer, cardiovascular disease, diabetes, and neuropathy are chronic in nature. Treatment of these diseases with traditional delivery systems is limited due to lack of site-specificity, non-spatiotemporal release and insufficient doses. Numerous responsive delivery systems which respond to both physiological and external stimuli have been reported in the literature. However, effective strategies incorporating a multifactorial approach are required to control these complex wounds. This can be achieved by fabricating spatiotemporal release systems, multimodal systems or dual/multi-stimuli responsive delivery systems loaded with one or more bioactive components. Critically, these next generation stimuli responsive delivery systems that are at present not feasible are required to treat chronic wounds. This review provides a critical assessment of recent developments in the field of responsive delivery systems, highlighting their limitations and providing a perspective on how these challenges can be overcome. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Systemic and microcirculatory responses to progressive hemorrhage

    NARCIS (Netherlands)

    Dubin, Arnaldo; Pozo, Mario Omar; Ferrara, Gonzalo; Murias, Gastón; Martins, Enrique; Canullán, Carlos; Canales, Héctor Saul; Kanoore Edul, Vanina Siham; Estenssoro, Elisa; Ince, Can

    2009-01-01

    To compare systemic hemodynamics with microcirculatory changes at different vascular beds during progressive hemorrhage. University-based research laboratory. Twelve anesthetized, mechanically ventilated sheep. Sheep were randomly assigned to HEMORRHAGE or CONTROL group. In the HEMORRHAGE group (n =

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-05-01

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

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  18. When falsified medicines enter the supply chain: description of an incident in Kenya and lessons learned for rapid response.

    Science.gov (United States)

    Cohn, Jennifer; von Schoen-Angerer, Tido; Jambert, Elodie; Arreghini, Guido; Childs, Michelle

    2013-01-01

    Falsified and substandard medicines present serious concerns for public health. We describe an event that occurred in late 2011 involving falsified antiretroviral medicines found in the supplies of Médecins Sans Frontières (MSF) projects in Kenya. We discuss factors contributing to these falsified medicines entering the supply chain as well as the response by MSF and others. We make recommendations to help defend against future episodes of entry of falsified medicines into the supply chain as well as comments on appropriate responses in cases of falsified medicines.

  19. Radiological incidents in radiotherapy

    International Nuclear Information System (INIS)

    Hobzova, L.; Novotny, J.

    2008-01-01

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

  20. Incidence, Mechanisms, and Severity of Game-Related High School Football Injuries across Artificial Turf Systems of Various Infill Weight

    Science.gov (United States)

    Meyers, Michael Clinton

    2016-01-01

    Objectives: Today’s new generations of artificial turf are increasingly being installed to duplicate or exceed playing characteristics of natural grass. Rather than playing on the polyethylene turf fibers, shoe: surface interaction actually occurs between the cleat and the various proprietary sand/rubber infill composites of varying weight. At this time, the influence of surface infill weight on football trauma is unknown. Therefore, this study was conducted to quantify incidence, mechanisms, and severity of game-related high school football trauma across artificial turf systems of various infill weight. Methods: Artificial turf systems were divided into four sand/rubber infill weight groups based on lbs per square foot: (A) > 9.0, (B) 6.0 - 8.9, (C) 3.1 - 5.9 and, (D) 0.0 - 3.0. A total of 52 high schools participating across four states over 5 competitive seasons were evaluated for injury incidence, injury category, time of injury, injury time loss, player position, injury mechanism and situation, primary type of injury, injury grade and anatomical location, field location at time of injury, injury severity, head, shoulder, and lower extremity trauma, elective imaging and surgical procedures, cleat design, turf age, and environmental factors. Results: Of the 1,467 high school games documented, 494 games (33.7%) were played on infill (A), 404 (27.5%) on infill (B), 379 (25.8%) on infill (C), and 190 (13.0%) on infill (D). A total of 3,741 injuries were documented, with significantly lower total injury incidence rates (IIR), [18.4 (95% CI, 18.0-18.7) vs 27.5 (26.8-27.9) vs 33.5 (32.7-34.0) and 23.7 (22.7-24.4)], substantial IIRs [3.4 (95% CI, 3.0-3.8) vs 6.6 (6.2-7.1), 8.5 (8.2-8.9) and 6.5 (5.8-7.1)], trauma from shoe: surface interaction during contact [4.6 (95% CI, 4.1-5.0) vs 7.5 (7.0-7.9), 6.4 (5.9-6.9) and 6.9 (6.2-7.5)], playing surface impact trauma [2.4 (95% CI, 2.1-2.8) vs 4.9 (4.4-5.4), 6.1 (5.6-6.6) and 4.4 (3.7-5.1)], and less total elective imaging

  1. Response Based Emergency Control System for Power System Transient Stability

    Directory of Open Access Journals (Sweden)

    Huaiyuan Wang

    2015-11-01

    Full Text Available A transient stability control system for the electric power system composed of a prediction method and a control method is proposed based on trajectory information. This system, which is independent of system parameters and models, can detect the transient stability of the electric power system quickly and provide the control law when the system is unstable. Firstly, system instability is detected by the characteristic concave or convex shape of the trajectory. Secondly, the control method is proposed based on the analysis of the slope of the state plane trajectory when the power system is unstable. Two control objectives are provided according to the methods of acquiring the far end point: one is the minimal cost to restore the system to a stable state; the other one is the minimal cost to limit the maximum swing angle. The simulation indicates that the mentioned transient stability control system is efficient.

  2. Comparing non-safety with safety device sharps injury incidence data from two different occupational surveillance systems.

    Science.gov (United States)

    Mitchell, A H; Parker, G B; Kanamori, H; Rutala, W A; Weber, D J

    2017-06-01

    The United States Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard as amended by the Needlestick Safety and Prevention Act requiring the use of safety-engineered medical devices to prevent needlesticks and sharps injuries has been in place since 2001. Injury changes over time include differences between those from non-safety compared with safety-engineered medical devices. This research compares two US occupational incident surveillance systems to determine whether these data can be generalized to other facilities and other countries either with legislation in place or considering developing national policies for the prevention of sharps injuries among healthcare personnel. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  3. [Problems of the health system in Mexican states with high incidence of maternal mortality].

    Science.gov (United States)

    Rouvier, Mariel; González-Block, Miguel Ángel; Sesia, Paola; Becerril-Montekio, Víctor

    2013-04-01

    To identify and prioritize problems in states' health systems which limit the efficacy of interventions to prevent maternal mortality. We made a conceptual mapping of priority problems perceived as such by communities of practice (COP) in four states with high ratios of maternal mortality in Mexico. Then, the four COP reviewed the literature and refined their formulation of previously identified problems. Priority problems focused on emergency obstetric care (EmOC), specifically: inadequate financial resources (Guerrero), substandard training among available EmOC providers (State of Mexico), inefficiencies in existing EmOC networks (Oaxaca) and inadequate knowledge of, and/or compliance to, standard EmOC protocols (Veracruz). The literature review confirmed the pertinence of problems previously identified by COP through conceptual mapping. CONCLUSIONS. The four COP showed a high level of congruency between their original perception of problems in the states' health systems and international scientific evidence. Identified problems and their reformulation based on evidence help identify solutions adaptable to local contexts.

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

    Science.gov (United States)

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

    2012-02-01

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

  5. Integrating data from the UK national reporting and learning system with work domain analysis to understand patient safety incidents in community pharmacy

    OpenAIRE

    Phipps, Denham L.; Tam, W. Vanessa; Ashcroft, Darren

    2017-01-01

    OBJECTIVES: To explore the combined use of a critical incident database and work domain analysis to understand patient safety issues in a health-care setting. METHOD: A retrospective review was conducted of incidents reported to the UK National Reporting and Learning System (NRLS) that involved community pharmacy between April 2005 and August 2010. A work domain analysis of community pharmacy was constructed using observational data from 5 community pharmacies, technical documentation, and a ...

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

    Science.gov (United States)

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

    2016-02-01

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

  7. New Scenarios for Audience Response Systems in University Lectures

    Science.gov (United States)

    Schön, Daniel; Kopf, Stephan; Klinger, Melanie; Guthier, Benjamin

    2016-01-01

    Mobile devices like smartphones and tablet PCs are widely used among university students and can be used for audience response systems (clicker systems) to improve teaching. Modern implementations of these systems are no longer limited to plain multiple-choice questions, but enable the lecturers to perform a variety of teaching scenarios. We…

  8. Retrospective and emergency dosimetry in response to radiological incidents and nuclear mass-casualty events: A review

    International Nuclear Information System (INIS)

    Bailiff, I.K.; Sholom, S.; McKeever, S.W.S.

    2016-01-01

    of a radiation incident. Hence attention has focused on biological or physical materials they may have in their possession that could be used as surrogate dosimeters. For EPR measurements, in particular, this includes material within the body (such as bone or tooth biopsy) requiring invasive procedures, but also materials collected non-invasively (such as clippings taken from finger- or toenails) and artefacts within their personal belongings (such as electronic devices of which smart phones are the most common). For luminescence measurements, attention has also focused on components within electronic devices, including smartphones, and a wide range of other personal belongings such as paper and other polymer-based materials (including currency, clothing, bank cards, etc.). The paper reviews progress made using both EPR and luminescence techniques, along with their current limitations. For the longer-established approach of retrospective dosimetry, luminescence has been the most extensively applied method and, by employing minerals found in construction materials, it consequently is employed in dosimetry using structures within the environment. Recent developments in its application to large-scale radiation releases are discussed, including the atomic bomb detonations at Hiroshima and Nagasaki, fallout from the Chernobyl reactor and atmospheric nuclear bomb tests within the Semipalatinsk Nuclear Test Site and fluvially transported pollution within the Techa River basin due to releases from the Mayak facility. The developments made in applying OSL and TL techniques are discussed in the context of these applications. EPR measurements with teeth have also provided benchmark values to test the dosimetry models used for Chernobyl liquidators (clean-up workers), residents of Semipalatinsk Nuclear Tests Sites and inhabitants of the Techa River basin. For both emergency and retrospective dosimetry applications, computational techniques employing radiation transport

  9. 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

  10. Hypersensitivity Responses in the Central Nervous System

    DEFF Research Database (Denmark)

    Khorooshi, Reza; Asgari, Nasrin; Mørch, Marlene Thorsen

    2015-01-01

    of pathology in neuromyelitis optica (NMO), a central nervous system (CNS) demyelinating disease where activated neutrophils infiltrate, unlike in MS. The most widely used model for MS, experimental autoimmune encephalomyelitis, is an autoantigen-immunized disease that can be transferred to naive animals......Immune-mediated tissue damage or hypersensitivity can be mediated by autospecific IgG antibodies. Pathology results from activation of complement, and antibody-dependent cellular cytotoxicity, mediated by inflammatory effector leukocytes include macrophages, natural killer cells, and granulocytes...... injection of antibody and complement to the CNS, or experimental manipulations to induce BBB breakdown. We here review studies in MS and NMO that elucidate roles for IgG and complement in the induction of BBB breakdown, astrocytopathy, and demyelinating pathology. These studies point to significance of T...

  11. Systemic lupus erythematosus in an African Caribbean population: incidence, clinical manifestations, and survival in the Barbados National Lupus Registry.

    Science.gov (United States)

    Flower, Cindy; Hennis, Anselm J M; Hambleton, Ian R; Nicholson, George D; Liang, Matthew H

    2012-08-01

    To assess the epidemiology, clinical features, and outcomes of systemic lupus erythematosus (SLE) in the predominantly African Caribbean population of Barbados. A national registry of all patients diagnosed with SLE was established in 2007. Complete case ascertainment was facilitated by collaboration with the island's sole rheumatology service, medical practitioners, and the lupus advocacy group. Informed consent was required for inclusion. Between January 1, 2000 and December 31, 2009, there were 183 new cases of SLE (98% African Caribbean) affecting 172 women and 11 men for unadjusted annual incidence rates of 12.21 (95% confidence interval [95% CI] 10.46-14.18) and 0.84 (95% CI 0.42-1.51) per 100,000 person-years, respectively. Excluding pediatric cases (ages <18 years), the unadjusted incidence rate among women was 15.14 per 100,000 person-years. The principal presenting manifestations were arthritis (84%), nephritis (47%), pleuritis (41.5%), malar rash (36.4%), and discoid lesions (33.1%). Antinuclear antibody positivity was 95%. The overall 5-year survival rate was 79.9% (95% CI 69.6-87.1), decreasing to 68% in patients with nephritis. A total of 226 persons with SLE were alive at the end of the study for point prevalences of 152.6 (95% CI 132.8-174.5) and 10.1 (95% CI 5.4-17.2) per 100,000 among women and men, respectively. Rates of SLE in Barbadian women are among the highest reported to date, with clinical manifestations similar to African American women and high mortality. Further study of this population and similar populations of West African descent might assist our understanding of environmental, genetic, and health care issues underpinning disparities in SLE. Copyright © 2012 by the American College of Rheumatology.

  12. Incidence and Outcomes of Central Nervous System Hemophagocytic Lymphohistiocytosis Relapse after Reduced-Intensity Conditioning Hematopoietic Stem Cell Transplantation.

    Science.gov (United States)

    Lounder, Dana T; Khandelwal, Pooja; Chandra, Sharat; Jordan, Michael B; Kumar, Ashish R; Grimley, Michael S; Davies, Stella M; Bleesing, Jack J; Marsh, Rebecca A

    2017-05-01

    Hemophagocytic lymphohistiocytosis (HLH) is an immune regulatory disorder that commonly presents with central nervous system (CNS) involvement. The only cure for genetic HLH is hematopoietic stem cell transplantation (HSCT), typically treated with reduced-intensity conditioning (RIC) regimens. We sought to estimate the incidence of CNS relapse after RIC HSCT, determine risk factors, and evaluate outcomes. We performed a retrospective chart review of 94 consecutive children and young adults with primary HLH who received RIC HSCT. CNS relapse within 1 year after transplantation was diagnosed by review of clinical symptoms, cerebral spinal fluid (CSF), and radiologic findings. Four (4.25%) patients developed symptoms of possible CNS HLH after HSCT and 3 patients were diagnosed. Eight patients underwent screening lumbar puncture because of history of active CNS disease at the onset of the conditioning regimen and 4 had evidence of continued disease. The overall incidence of CNS relapse and continued CNS disease after RIC HSCT was 8%. All patients with CNS disease after HSCT responded to CNS-directed therapy. Whole blood donor chimerism at the time of CNS relapse was low at 1% to 34%, but it remained high at 88% to 100% for patients with continued CNS disease. Overall survival for patients with CNS relapse was 50%, compared with 75% for patients without CNS disease (P = .079). Our data suggest that a low level of donor chimerism or active CNS disease at the time of transplantation increase the risk of CNS HLH after HSCT. Surveillance CSF evaluation after allogeneic RIC HSCT should be considered in patients with risk factors and CNS-directed treatment should be initiated if appropriate. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  13. A Retroactive-Burst Framework for Automated Intrusion Response System

    Directory of Open Access Journals (Sweden)

    Alireza Shameli-Sendi

    2013-01-01

    Full Text Available The aim of this paper is to present an adaptive and cost-sensitive model to prevent security intrusions. In most automated intrusion response systems, response selection is performed locally based on current threat without using the knowledge of attacks history. Another challenge is that a group of responses are applied without any feedback mechanism to measure the response effect. We address these problems through retroactive-burst execution of responses and a Response Coordinator (RC mechanism, the main contributions of this work. The retroactive-burst execution consists of several burst executions of responses with, at the end of each burst, a mechanism for measuring the effectiveness of the applied responses by the risk assessment component. The appropriate combination of responses must be considered for each burst execution to mitigate the progress of the attack without necessarily running the next round of responses, because of the impact on legitimate users. In the proposed model, there is a multilevel response mechanism. To indicate which level is appropriate to apply based on the retroactive-burst execution, we get help from a Response Coordinator mechanism. The applied responses can improve the health of Applications, Kernel, Local Services, Network Services, and Physical Status. Based on these indexes, the RC gives a general overview of an attacker’s goal in a distributed environment.

  14. Pulpo-dentin complex response after direct capping with self-etch adhesive systems.

    Science.gov (United States)

    Nowicka, Alicja; Parafiniuk, Miroslaw; Lipski, Mariusz; Lichota, Damian; Buczkowska-Radlinska, Jadwiga

    2012-01-01

    The purpose of the present study was to evaluate morphologically the response of feline teeth pulp to direct pulp capping with two different self-etch adhesive systems. Twenty-four cavities in feline teeth were mechanically exposed and assigned to one of two experimental groups: AdheSE + Tetric Ceram (the ASE group), or Adper Prompt L-Pop + Filtek Supreme (the APLP group). There was also a control group Dycal Ca(OH)(2) liner + Amalgam (the CH group eight teeth), and six teeth were used as an intact control group. The animals were sacrificed after 40 days. The teeth were removed and processed for standard histological evaluation, using a scoring system for inflammatory cell response, pulp tissue disorganisation, reparative tissue formation, and the presence of bacteria. Statistical analysis revealed no significant differences between the ASE and APLP self-etching resin systems during the observation period. The majority of the specimens presented inflammatory pulp response with tissue disorganisation and a lack of dentinal bridge formation. CH capping resulted in a significantly smaller inflammatory pulp response and a considerably higher incidence of reparative dentin formation. ASE and APLP were comparably effective as direct pulp capping materials, but their application resulted in significantly greater pulp tissue damage than CH capping. Further in vivo human studies are necessary to determine which adhesive resin systems should be clinically used for direct pulp capping without incurring severe damage to the pulpal tissue.

  15. Integrating Data From the UK National Reporting and Learning System With Work Domain Analysis to Understand Patient Safety Incidents in Community Pharmacy.

    Science.gov (United States)

    Phipps, Denham L; Tam, W Vanessa; Ashcroft, Darren M

    2017-03-01

    To explore the combined use of a critical incident database and work domain analysis to understand patient safety issues in a health-care setting. A retrospective review was conducted of incidents reported to the UK National Reporting and Learning System (NRLS) that involved community pharmacy between April 2005 and August 2010. A work domain analysis of community pharmacy was constructed using observational data from 5 community pharmacies, technical documentation, and a focus group with 6 pharmacists. Reports from the NRLS were mapped onto the model generated by the work domain analysis. Approximately 14,709 incident reports meeting the selection criteria were retrieved from the NRLS. Descriptive statistical analysis of these reports found that almost all of the incidents involved medication and that the most frequently occurring error types were dose/strength errors, incorrect medication, and incorrect formulation. The work domain analysis identified 4 overall purposes for community pharmacy: business viability, health promotion and clinical services, provision of medication, and use of medication. These purposes were served by lower-order characteristics of the work system (such as the functions, processes and objects). The tasks most frequently implicated in the incident reports were those involving medication storage, assembly, or patient medication records. Combining the insights from different analytical methods improves understanding of patient safety problems. Incident reporting data can be used to identify general patterns, whereas the work domain analysis can generate information about the contextual factors that surround a critical task.

  16. Nationwide Study of Humidifier Disinfectant Lung Injury in South Korea, 1994-2011. Incidence and Dose-Response Relationships.

    Science.gov (United States)

    Paek, Domyung; Koh, Younsuck; Park, Dong-Uk; Cheong, Hae-Kwan; Do, Kyung-Hyun; Lim, Chae-Man; Hong, Soo-Jong; Kim, Yong-Hwa; Leem, Jong-Han; Chung, Kyu Hyuck; Choi, Ye-Yong; Lee, Jong-Hyeon; Lim, Sin-Ye; Chung, Eun-Hee; Cho, Young Ah; Chae, Eun Jin; Joh, Joon-Sung; Yoon, Yup; Lee, Kyu-Hong; Choi, Bo Youl; Gwack, Jin

    2015-12-01

    Humidifier disinfectant lung injury is an acute lung disease attributed to recurrent inhalation of certain disinfectant aerosols emitted from room humidifiers. An outbreak of this toxic lung injury occurred in South Korea from 1995 until all humidifier disinfectant products were recalled from the consumer market by the government in 2011. A nationwide study was conducted to ascertain and classify all potential cases of humidifier disinfectant lung injury in Korea and to assess dose-response relationships. By several mechanisms, clinicians and the general public were invited to report all suspected cases of humidifier disinfectant lung injury to public health officials in South Korea. A committee was convened to define diagnostic criteria based on pathologic, radiologic, and clinical findings for index cases, combined with assessment of environmental exposure to humidifier disinfectants. Clinical review and environmental assessments were performed and later combined to determine overall likelihood of disease for each study participant, classified as definite, probable, possible, or unlikely. Survival time from exposure to onset of symptoms was analyzed to assess dose-response relationships. Three broad categories of risk factors were examined: (1) biological susceptibility, (2) temporal cycle of exposure and recovery, and (3) spatial conditions and density of disinfectant. Of 374 possible cases identified and reviewed, 329 were unanimously classified by the diagnostic committee, as follows: 117 definite, 34 probable, 38 possible and 140 unlikely cases. A total of 62 individuals with definite or probable disease died. Risk factors examined for polyhexamethyleneguanidine phosphate exposure that were found to be significant in shortening survival included age 4 years or younger at onset, use of disinfectant for 7 days per week, airborne density of 800 μg/m(3) or more of disinfectant, and daily exposure 11 or more hours in duration. Dose-response analysis indicated

  17. Privacy Impact Assessment for the Enforcement Action Response System

    Science.gov (United States)

    The Enforcement Action Response System collects waste transaction information, and liability determination information. Learn how this data is collected, how it will be used, access to the data, the purpose of data collection, and record retention policies

  18. Designing effective questions for classroom response system teaching

    Science.gov (United States)

    Beatty, Ian D.; Gerace, William J.; Leonard, William J.; Dufresne, Robert J.

    2006-01-01

    Classroom response systems can be powerful tools for teaching physics. Their efficacy depends strongly on the quality of the questions. Creating effective questions is difficult and differs from creating exam and homework problems. Each classroom response system question should have an explicit pedagogic purpose consisting of a content goal, a process goal, and a metacognitive goal. Questions can be designed to fulfill their purpose through four complementary mechanisms: directing students' attention, stimulating specific cognitive processes, communicating information to the instructor and students via classroom response system-tabulated answer counts, and facilitating the articulation and confrontation of ideas. We identify several tactics that are useful for designing potent questions and present four "makeovers" to show how these tactics can be used to convert traditional physics questions into more powerful questions for a classroom response system.

  19. Systemic inflammatory responses following welding inhalation challenge test

    Directory of Open Access Journals (Sweden)

    Paula Kauppi

    2015-01-01

    Conclusions: Exposure to MS and SS welding fume resulted in a mild systemic inflammatory response. The particle concentration from the breathing zones correlated with the measurements inside the welding face shields.

  20. Learner Response System: Evaluation Report and Executive Summary

    Science.gov (United States)

    Wiggins, Meg; Sawtell, Mary; Jerrim, John

    2017-01-01

    This Learner Response System (LRS) intervention involves the use of electronic handheld devices that allow teachers and pupils to provide immediate feedback during lessons. For example, pupils can respond to a question using the device and responses are immediately visible to the teacher, or they can work through problems on the device at their…

  1. Responses of the Autonomic Nervous System to Flavors

    NARCIS (Netherlands)

    Wijk, de René A.; Boesveldt, Sanne

    2016-01-01

    Multisensory flavor perception plays an important role in decision-making, for instance for food products. Autonomic nervous system (ANS) responses, such as heart rate and skin conductance responses, towards such flavor stimuli may provide insights into processes related to consumer acceptance

  2. Influência de sistemas de plantio e armadilha adesiva na incidência de Frankliniella williamsi Hood na cultura do milho = Influence of planting systems and adhesive trap on the incidence of Frankliniella williamsi Hood in crop maize

    Directory of Open Access Journals (Sweden)

    Fernando Alves de Albuquerque

    2006-07-01

    Full Text Available Esta pesquisa objetivou avaliar a influência de diferentes sistemas de plantio de milho e o efeito de armadilha adesiva na incidência de Frankliniella williamsi Hood. Os tratamentos consistiram no plantio direto do milho sobre aveia dessecada com glyphosate, aveia tombada, aveia roçada e plantas daninhas, aveia incorporada e plantio convencional. Alguns tratamentos foram associados a armadilha adesiva de coloração azul, colocada horizontalmente no centro da parcela. Verificou-se que tanto a presença de armadilha quanto os diferentes sistemas de plantio influíram significativamente na infestação das plantas de milho pelo tripes, sendo que os tratamentos “aveia dessecada” e “aveia roçada e plantas daninhas” apresentaram menor incidência do inseto, com esse efeito diminuindo com o desenvolvimento das plantas.This research aimed to evaluate the influence of different systems of corn planting and the effect of adhesive trap on the incidence ofFrankliniella williamsi. The treatments consisted of sowing the corn seed directly on oats dried by glyphosate, tilt oats, cut oats and weeds, incorporated oats, and also conventional planting. Some treatments were associated with adhesive trap of blue coloration, puthorizontally in the center of the plot. Results showed that the presence of traps, as well as the different planting systems influenced significantly on the thrips infestation, and the treatmentswith "dry oats" and "cut oats and weeds" presented smaller incidence of the insect with a decreasing effect along the plants growth.

  3. Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

    Science.gov (United States)

    2012-01-01

    Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM) and the Italian workers’ compensation authority (INAIL) archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%); 91.2% (1,482) of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates). The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed. PMID:22545679

  4. Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

    Directory of Open Access Journals (Sweden)

    Marinaccio Alessandro

    2012-07-01

    Full Text Available Abstract Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational. In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM and the Italian workers’ compensation authority (INAIL archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%; 91.2% (1,482 of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates. The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed.

  5. Systems biology of neutrophil differentiation and immune response

    DEFF Research Database (Denmark)

    Theilgaard-Mönch, Kim; Porse, Bo T; Borregaard, Niels

    2005-01-01

    Systems biology has emerged as a new scientific field, which aims at investigating biological processes at the genomic and proteomic levels. Recent studies have unravelled aspects of neutrophil differentiation and immune responses at the systems level using high-throughput technologies....... These studies have identified a plethora of novel effector proteins stored in the granules of neutrophils. In addition, these studies provide evidence that neutrophil differentiation and immune response are governed by a highly coordinated transcriptional programme that regulates cellular fate and function...

  6. METALert - an emergency response system for China for heavy metals in the environment

    Science.gov (United States)

    Joris, Ingeborg; Seuntjens, Piet; Dams, Jef; Desmet, Nele; Van Looy, Stijn; Raymaekers, Jens; Decorte, Lieve; Raben, Ingrid; Thijssen, Chris; Zhang, Hongzhen; Dong, Jingqi; Zhang, Qianwen

    2016-04-01

    The rapid industrialisation and economic growth of China has resulted in a mirrored increase of environmental issues and threats, which make the updating of the current environmental emergency response protocols very important. Heavy metal pollution accidents with high environmental risks are happening more frequently than ever in recent years. Despite efforts made by the authorites in respect to the formulation of sound policy, efficient technical methods and regulations for dealing with appropriate responses to emergency environmental incidents related to heavy metal pollution are still lacking. METALert is a generic Emergency Response System (ERS) for accidental pollution incidents caused by key heavy metal related industries in China and developed to support China in achieving its environmental targets. The METALert tool is based on environmental models for forecasting, simulation and visualisation of dispersion of heavy metal pollution in water, air and soil. The tool contains a generic database with scenarios for accidental release of metals in typical accidents related to the five key heavy metal industries in China. The tool can calculate the impact of an accident in water, air and soil and is evaluated and demonstrated for a river basin in the Chenzhou area, an important heavy metal mining area in China. The setup of the tool, the background models and the application in Chenzhou will be presented.

  7. Implementation of an industrial systems-engineering approach to reduce the incidence of methicillin-resistant Staphylococcus aureus infection.

    Science.gov (United States)

    Muder, Robert R; Cunningham, Candace; McCray, Ellesha; Squier, Cheryl; Perreiah, Peter; Jain, Rajiv; Sinkowitz-Cochran, Ronda L; Jernigan, John A

    2008-08-01

    To measure the effectiveness of an industrial systems-engineering approach to a methicillin-resistant Staphylococcus aureus (MRSA) prevention program. Before-after intervention study. An intensive care unit (ICU) and a surgical unit that was not an ICU in the Pittsburgh Veterans Administration hospital. All patients admitted to the study units. We implemented an MRSA infection control program that consisted of the following 4 elements: (1) the use of standard precautions for all patient contact, with emphasis on hand hygiene; (2) the use of contact precautions for interactions with patients known to be infected or colonized with MRSA; (3) the use of active surveillance cultures to identify patients who were asymptomatically colonized with MRSA; and (4) use of an industrial systems-engineering approach, the Toyota Production System, to facilitate consistent and reliable adherence to the infection control program. The rate of healthcare-associated MRSA infection in the surgical unit decreased from 1.56 infections per 1,000 patient-days in the 2 years before the intervention to 0.63 infections per 1,000 patient-days in the 4 years after the intervention (a 60% reduction; P = .003). The rate of healthcare-associated MRSA infection in the ICU decreased from 5.45 infections per 1,000 patient-days in the 2 years before to the intervention to 1.35 infections per 1,000 patient-days in the 3 years after the intervention (a 75% reduction; P = .001). The combined estimate for reduction in the incidence of infection after the intervention in the 2 units was 68% (95% confidence interval, 50%-79%; P systems-engineering approach can be adapted to facilitate consistent and reliable adherence to MRSA infection prevention practices in healthcare facilities.

  8. The systemic angiogenic response during bone healing.

    Science.gov (United States)

    Weiss, Stefan; Zimmermann, Gerald; Pufe, Thomas; Varoga, Deike; Henle, Philipp

    2009-07-01

    Angiogenesis is known to be a critical and closely regulated step during bone formation and fracture healing driven by a complex interaction of various cytokines. Delays in bone healing or even nonunion might therefore be associated with altered concentrations of specific angiogenic factors. These alterations might in turn be reflected by changes in serum concentrations. To determine physiological time courses of angiogenic cytokines during fracture healing as well as possible changes associated with failed consolidation, we prospectively collected serum samples from patients who had sustained surgical treatment for a long bone fracture. Fifteen patients without fracture healing 4 months after surgery (nonunion group) were matched to a collective of 15 patients with successful healing (union group). Serum concentrations of angiogenin (ANG), angiopoietin 2 (Ang-2), basic fibroblast growth factor (bFGF), platelet derived growth factor AB (PDGF-AB), pleiotrophin (PTN) and vascular endothelial growth factor (VEGF) were measured using enzyme linked immunosorbent assays over a period of 24 weeks. Compared to reference values of healthy uninjured controls serum concentrations of VEGF, bFGF and PDGF were increased in both groups. Peak concentrations of these cytokines were reached during early fracture healing. Serum concentrations of bFGF and PDGF-AB were significantly higher in the union group at 2 and 4 weeks after the injury when compared to the nonunion group. Serum concentrations of ANG and Ang-2 declined steadily from the first measurement in normal healing fractures, while no significant changes over time could be detected for serum concentrations of these factures in nonunion patients. PTN serum levels increased asymptotically over the entire investigation in timely fracture healing while no such increase could be detected during delayed healing. We conclude that fracture healing in human subjects is accompanied by distinct changes in systemic levels of specific

  9. Physical activity and incident type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Smith, Andrea D; Crippa, Alessio; Woodcock, James; Brage, Søren

    2016-12-01

    Inverse associations between physical activity (PA) and type 2 diabetes mellitus are well known. However, the shape of the dose-response relationship is still uncertain. This review synthesises results from longitudinal studies in general populations and uses non-linear models of the association between PA and incident type 2 diabetes. A systematic literature search identified 28 prospective studies on leisure-time PA (LTPA) or total PA and risk of type 2 diabetes. PA exposures were converted into metabolic equivalent of task (MET) h/week and marginal MET (MMET) h/week, a measure only considering energy expended above resting metabolic rate. Restricted cubic splines were used to model the exposure-disease relationship. Our results suggest an overall non-linear relationship; using the cubic spline model we found a risk reduction of 26% (95% CI 20%, 31%) for type 2 diabetes among those who achieved 11.25 MET h/week (equivalent to 150 min/week of moderate activity) relative to inactive individuals. Achieving twice this amount of PA was associated with a risk reduction of 36% (95% CI 27%, 46%), with further reductions at higher doses (60 MET h/week, risk reduction of 53%). Results for the MMET h/week dose-response curve were similar for moderate intensity PA, but benefits were greater for higher intensity PA and smaller for lower intensity activity. Higher levels of LTPA were associated with substantially lower incidence of type 2 diabetes in the general population. The relationship between LTPA and type 2 diabetes was curvilinear; the greatest relative benefits are achieved at low levels of activity, but additional benefits can be realised at exposures considerably higher than those prescribed by public health recommendations.

  10. Leisure-time physical activity and incident metabolic syndrome: a systematic review and dose-response meta-analysis of cohort studies.

    Science.gov (United States)

    Zhang, Dongdong; Liu, Xuejiao; Liu, Yu; Sun, Xizhuo; Wang, Bingyuan; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Yin, Lei; Zhao, Jingzhi; Shi, Yuanyuan; Zhang, Ming; Hu, Dongsheng

    2017-10-01

    Leisure-time physical activity (LTPA) has been suggested to reduce risk of metabolic syndrome (MetS). However, a quantitative comprehensive assessment of the dose-response association between LTPA and incident MetS has not been reported. We performed a meta-analysis of studies assessing the risk of MetS with LTPA. MEDLINE via PubMed and EMBase databases were searched for relevant articles published up to March 13, 2017. Random-effects models were used to estimate the summary relative risk (RR) of MetS with LTPA. Restricted cubic splines were used to model the dose-response association. We identified 16 articles (18 studies including 76,699 participants and 13,871 cases of MetS). We found a negative linear association between LTPA and incident MetS, with a reduction of 8% in MetS risk per 10 metabolic equivalent of task (MET) h/week increment. According to the restricted cubic splines model, risk of MetS was reduced 10% with LTPA performed according to the basic guideline-recommended level of 150min of moderate PA (MPA) per week (10METh/week) versus inactivity (RR=0.90, 95% CI 0.86-0.94). It was reduced 20% and 53% with LTPA at twice (20METh/week) and seven times (70METh/week) the basic recommended level (RR=0.80, 95% CI 0.74-0.88 and 0.47, 95% CI 0.34-0.64, respectively). Our findings provide quantitative data suggesting that any amount of LTPA is better than none and that LTPA substantially exceeding the current LTPA guidelines is associated with an additional reduction in MetS risk. Copyright © 2017. Published by Elsevier Inc.

  11. Coffee intake and the incident risk of cognitive disorders: A dose-response meta-analysis of nine prospective cohort studies.

    Science.gov (United States)

    Wu, Lei; Sun, Dali; He, Yao

    2017-06-01

    Previous epidemiological studies have provided inconsistent conclusions on the impact of coffee consumption in the developing of cognitive disorders. However, no previous meta-analysis has pooled the evidence from the prospective cohort studies to assess the influence of coffee drinking and its potential dose-response patterns on the risk of developing cognitive disorders specifically. Two databases (PubMed and Embase) were searched for evidence of cohort studies from inception to February 2016. We used a generic inverse-variance method with a random-effects model to pool the fully adjusted relative risks (RRs) and the corresponding 95% confidence intervals (CIs). In the dose-response analyses, a generalized least-squares trend estimation model was applied to computing the study-specific slopes. Nine prospective cohort studies involving 34,282 participants were included in our study. The duration of follow-up years ranged from 1.3 to 28. Compared with coffee was inversely linked with the occurrence of cognitive disorders (i.e., Alzheimer's disease, dementia, cognitive decline, and cognitive impairment), and the pooled RR (95% CI) was 0.82 (0.71, 0.94) with evidence of non-significant heterogeneity (I 2  = 25%). Non-significant differences were presented for the association between coffee consumption (>3 vs. coffee consumption. A "J-shaped" association was presented between coffee intake and incident cognitive disorders, with the lowest risk of incident cognitive disorders at a daily consumption level of 1-2 cups of coffee. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  12. Response Time Analysis of Distributed Web Systems Using QPNs

    Directory of Open Access Journals (Sweden)

    Tomasz Rak

    2015-01-01

    Full Text Available A performance model is used for studying distributed Web systems. Performance evaluation is done by obtaining load test measurements. Queueing Petri Nets formalism supports modeling and performance analysis of distributed World Wide Web environments. The proposed distributed Web systems modeling and design methodology have been applied in the evaluation of several system architectures under different external loads. Furthermore, performance analysis is done to determine the system response time.

  13. Transformation Planning of Ecotourism Systems to Invigorate Responsible Tourism

    OpenAIRE

    Yun Eui Choi; Minsun Doh; Samuel Park; Jinhyung Chon

    2017-01-01

    The purpose of this study is to introduce transformation plans that can stimulate responsible ecotourism by using systems thinking to solve ecotourism problems in Korea. Systems thinking is a research method used to understand the operating mechanisms of the variables that influence an entire system, in order to identify its problems. The four types of ecotourism systems are classified as follows: low-infrastructure and resident-initiated, high-infrastructure and resident-initiated, high-infr...

  14. Computer model of cardiovascular control system responses to exercise

    Science.gov (United States)

    Croston, R. C.; Rummel, J. A.; Kay, F. J.

    1973-01-01

    Approaches of systems analysis and mathematical modeling together with computer simulation techniques are applied to the cardiovascular system in order to simulate dynamic responses of the system to a range of exercise work loads. A block diagram of the circulatory model is presented, taking into account arterial segments, venous segments, arterio-venous circulation branches, and the heart. A cardiovascular control system model is also discussed together with model test results.

  15. Self-Optimizing Photoelectrochemical Growth of Nanopatterned Se–Te Films in Response to the Spectral Distribution of Incident Illumination

    Energy Technology Data Exchange (ETDEWEB)

    Carim, Azhar I. [Division of Chemistry and Chemical; Batara, Nicolas A. [Division of Chemistry and Chemical; Premkumar, Anjali [Division of Chemistry and Chemical; Atwater, Harry A. [Division of Chemistry and Chemical; Lewis, Nathan S. [Division of Chemistry and Chemical

    2015-09-02

    Photoelectrochemical growth of Se–Te films spontaneously produces highly ordered, nanoscale lamellar morphologies with periodicities that can be tuned by varying the illumination wavelength during deposition. This phenomenon has been characterized further herein by determining the morphologies of photoelectrodeposited Se–Te films in response to tailored spectral illumination profiles. Se–Te films grown under illumination from four different sources, having similar average wavelengths but having spectral bandwidths that spanned several orders of magnitude, all nevertheless produced similar structures which had a single, common periodicity as quantitatively identified via Fourier analysis. Film deposition using simultaneous illumination from two narrowband sources, which differed in average wavelength by several hundred nanometers, resulted in a structure with only a single periodicity intermediate between the periods observed when either source alone was used. This single periodicity could be varied by manipulating the relative intensity of the two sources. An iterative model that combined full-wave electromagnetic effects with Monte Carlo growth simulations, and that considered only the fundamental light-material interactions during deposition, was in accord with the morphologies observed experimentally. Simulations of light absorption and concentration in idealized lamellar arrays, in conjunction with all of the available data, additionally indicated that a self-optimization of the periodicity of the nanoscale pattern, resulting in the maximization of the anisotropy of interfacial light absorption in the three-dimensional structure, is consistent with the observed growth process of such films.

  16. Numerical Study on Dynamic Response of a Horizontal Layered-Structure Rock Slope under a Normally Incident Sv Wave

    Directory of Open Access Journals (Sweden)

    Zhifa Zhan

    2017-07-01

    Full Text Available Several post-earthquake investigations have indicated that the slope structure plays a leading role in the stability of rock slopes under dynamic loads. In this paper, the dynamic response of a horizontal layered-structure rock slope under harmonic Sv wave is studied by making use of the Fast Lagrangian Analysis of Continua method (FLAC. The suitability of FLAC for studying wave transmission across rock joints is validated through comparison with analytical solutions. After parametric studies on Sv wave transmission across the horizontal layered-structure rock slope, it is found that the acceleration amplification coefficient η, which is defined as the ratio of the acceleration at the monitoring point to the value at the toe, wavily increases with an increase of the height along the slope surface. Meanwhile, the fluctuation weakens with normalized joint stiffness K increasing and enhances with normalized joint spacing ξ increasing. The acceleration amplification coefficient of the slope crest ηcrest does not monotonously increase with the increase of ξ, but decreases with the increase of K. Additionally, ηcrest is more sensitive to ξ compared to K. From the contour figures, it can also be found that the contour figures of η take on rhythm, and the effects of ξ on the acceleration amplification coefficient are more obvious compared to the effects on K.

  17. Optical response of hybrid semiconductor quantum dot-metal nanoparticle system: Beyond the dipole approximation

    Science.gov (United States)

    Mohammadzadeh, Atefeh; Miri, MirFaez

    2018-01-01

    We study the response of a semiconductor quantum dot-metal nanoparticle system to an external field E 0 cos ( ω t ) . The borders between Fano, double peaks, weak transition, strong transition, and bistability regions of the phase diagram move considerably as one regards the multipole effects. The exciton-induced transparency is an artifact of the dipole approximation. The absorption of the nanoparticle, the population inversion of the quantum dot, the upper and lower limits of intensity where bistability occurs, the characteristic time to reach the steady state, and other features of the hybrid system change due to the multipole effects. The phase diagrams corresponding to the fields parallel and perpendicular to the axis of system are quite distinguishable. Thus, both the intensity and the polarization of the incident field can be used to control the system. In particular, the incident polarization can be used to switch on and switch off the bistable behavior. For applications such as miniaturized bistable devices and nanosensors sensitive to variations of the dielectric constant of the surrounding medium, multipole effects must be considered.

  18. Investigation of air cleaning system response to accident conditions

    International Nuclear Information System (INIS)

    Andrae, R.W.; Bolstad, J.W.; Foster, R.D.; Gregory, W.S.; Horak, H.L.; Idar, E.S.; Martin, R.A.; Ricketts, C.I.; Smith, P.R.; Tang, P.K.

    1980-01-01

    Air cleaning system response to the stress of accident conditions are being investigated. A program overview and hghlight recent results of our investigation are presented. The program includes both analytical and experimental investigations. Computer codes for predicting effects of tornados, explosions, fires, and material transport are described. The test facilities used to obtain supportive experimental data to define structural integrity and confinement effectiveness of ventilation system components are described. Examples of experimental results for code verification, blower response to tornado transients, and filter response to tornado and explosion transients are reported

  19. Dietary Protein Sources and Incidence of Breast Cancer: A Dose-Response Meta-Analysis of Prospective Studies

    Directory of Open Access Journals (Sweden)

    Jing Wu

    2016-11-01

    Full Text Available Protein is important to the human body, and different sources of protein may have different effects on the risk of breast cancer. Thus, we conducted a meta-analysis to investigate the association between different dietary protein sources and breast cancer risk. PubMed and several databases were searched until December 2015. Relevant articles were retrieved according to specific searching criteria. Forty-six prospective studies were included. The summary relative risk (RR for highest versus lowest intake was 1.07 (95% confidence interval (CI 1.01–1.14, I2 = 34.6% for processed meat, 0.92 (95% CI 0.84–1.00, I2 = 0% for soy food, 0.93 (95% CI 0.85–1.00, I2 = 40.1% for skim milk, and 0.90 (95% CI 0.82–1.00, I2 = 0% for yogurt. Similar conclusions were obtained in dose-response association for each serving increase: total red meat (RR: 1.07; 95% CI 1.01–1.14, I2 = 7.1%, fresh red meat (RR: 1.13; 95% CI 1.01–1.26, I2 = 56.4%, processed meat (RR: 1.09; 95% CI 1.02–1.17, I2 = 11.8%, soy food (RR: 0.91; 95% CI 0.84–1.00, I2 = 0%, and skim milk (RR: 0.96; 95% CI 0.92–1.00, I2 = 11.9%. There was a null association between poultry, fish, egg, nuts, total milk, and whole milk intake and breast cancer risk. Higher total red meat, fresh red meat, and processed meat intake may be risk factors for breast cancer, whereas higher soy food and skim milk intake may reduce the risk of breast cancer.

  20. SIgA response and incidence of upper respiratory tract infections during intensified training in youth basketball players

    Directory of Open Access Journals (Sweden)

    H Moraes

    2016-12-01

    Full Text Available The aim of the present study was to examine the effect of an intensified training phase followed by a tapering phase on the salivary immunoglobulin A concentration and on the upper respiratory tract infection (URTI symptoms in young male basketball players. The session rating of perceived exertion method was used to quantify the internal training load, and the Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. The Yo-Yo IR1 test and saliva collection were carried out at the beginning of the study (T1, after the intensified phase (T2, and after tapering (T3. A higher internal training load was observed for the intensified phase compared with the tapering phase (t=19.10; p<0.001, and a significant decrease in salivary immunoglobulin A concentration was detected (F=7.48; p=0.004 at T3 compared to T1 (p=0.02 and T2 (p=0.05. However, there was no significant difference between phases for severity of URTI (χ2= 2.83; p=0.242. The Yo-Yo IR1 test performance increased from T2 and T3 compared to T1 (F=58.24; p<0.001. There was no significant effect of aerobic fitness level on salivary immunoglobulin A response (F=1.095; p=0.344. In summary, the present findings suggest that an intensified training load followed by a tapering period negatively affects the mucosal immune function with no significant change in severity of URTI in young basketball players.

  1. The brain's response to the human voice depends on the incidence of autistic traits in the general population.

    Directory of Open Access Journals (Sweden)

    Yuko Yoshimura

    Full Text Available Optimal brain sensitivity to the fundamental frequency (F0 contour changes in the human voice is important for understanding a speaker's intonation, and consequently, the speaker's attitude. However, whether sensitivity in the brain's response to a human voice F0 contour change varies with an interaction between an individual's traits (i.e., autistic traits and a human voice element (i.e., presence or absence of communicative action such as calling has not been investigated. In the present study, we investigated the neural processes involved in the perception of F0 contour changes in the Japanese monosyllables "ne" and "nu." "Ne" is an interjection that means "hi" or "hey" in English; pronunciation of "ne" with a high falling F0 contour is used when the speaker wants to attract a listener's attention (i.e., social intonation. Meanwhile, the Japanese concrete noun "nu" has no communicative meaning. We applied an adaptive spatial filtering method to the neuromagnetic time course recorded by whole-head magnetoencephalography (MEG and estimated the spatiotemporal frequency dynamics of event-related cerebral oscillatory changes in beta band during the oddball paradigm. During the perception of the F0 contour change when "ne" was presented, there was event-related de-synchronization (ERD in the right temporal lobe. In contrast, during the perception of the F0 contour change when "nu" was presented, ERD occurred in the left temporal lobe and in the bilateral occipital lobes. ERD that occurred during the social stimulus "ne" in the right hemisphere was significantly correlated with a greater number of autistic traits measured according to the Autism Spectrum Quotient (AQ, suggesting that the differences in human voice processing are associated with higher autistic traits, even in non-clinical subjects.

  2. Incidência e aspectos clínico-laboratoriais do Lúpus eritematoso sistêmico em cidade do Sul do Brasil Incidence and clinical-laboratory aspects of systemic lupus erythematosus in a Southern brazilian city

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Kenji Nakashima

    2011-06-01

    Full Text Available INTRODUÇÃO: Estudos epidemiológicos brasileiros sobre o lúpus eritematoso sistêmico (LES são bastante escassos e os dados existentes hoje são praticamente todos de literatura internacional. OBJETIVOS: Determinar a incidência e algumas características clínicas e laboratoriais de pacientes com LES em Cascavel, Paraná - Brasil. PACIENTES E MÉTODOS: Os dados foram coletados entre agosto de 2007 e julho de 2008 em todos os serviços de saúde do município que possuíam atendimentos na especialidade de Reumatologia: um hospital universitário, um ambulatório público e três clínicas privadas da cidade. RESULTADOS: Foram identificados 14 pacientes com diagnóstico de LES, resultando em uma incidência estimada de 4,8 casos/100.000 habitantes/ano. Todos os pacientes eram do sexo feminino, com média de idade de 41,5 anos. A faixa etária com maior incidência foi a de 30 - 39 anos e 92,8% apresentaram quatro ou mais dos 11 critérios do American College of Rheumatology (ACR para o diagnóstico de LES. O tratamento farmacológico dos pacientes também foi avaliado e mostrou estar de acordo com o Consenso Brasileiro para o tratamento de LES. CONCLUSÃO: A incidência obtida em Cascavel/PR está próxima das incidências observadas em estudos internacionais.INTRODUCTION: Brazilian epidemiological studies on systemic lupus erythematosus (SLE are scarce, and currently available data originate almost entirely from international literature. OBJECTIVES: To determine the incidence and some clinical and laboratory characteristics of patients with SLE in the municipality of Cascavel, state of Paraná, Brazil. PATIENTS AND METHODS: Data were collected from August 2007 to July 2008 in all health services of Cascavel providing health care in rheumatology: a university-affiliated hospital, a public outpatient clinic, and three private clinics. RESULTS: The study identified 14 patients diagnosed with SLE, which resulted in an estimated incidence of 4

  3. Response of MDOF strongly nonlinear systems to fractional Gaussian noises

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Mao-Lin; Zhu, Wei-Qiu, E-mail: wqzhu@zju.edu.cn [Department of Mechanics, State Key Laboratory of Fluid Power and Mechatronic Systems, Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, Zhejiang University, Hangzhou 310027 (China)

    2016-08-15

    In the present paper, multi-degree-of-freedom strongly nonlinear systems are modeled as quasi-Hamiltonian systems and the stochastic averaging method for quasi-Hamiltonian systems (including quasi-non-integrable, completely integrable and non-resonant, completely integrable and resonant, partially integrable and non-resonant, and partially integrable and resonant Hamiltonian systems) driven by fractional Gaussian noise is introduced. The averaged fractional stochastic differential equations (SDEs) are derived. The simulation results for some examples show that the averaged SDEs can be used to predict the response of the original systems and the simulation time for the averaged SDEs is less than that for the original systems.

  4. Dose-response Relationship of Serum Uric Acid with Metabolic Syndrome and Non-alcoholic Fatty Liver Disease Incidence: A Meta-analysis of Prospective Studies.

    Science.gov (United States)

    Liu, Zhengtao; Que, Shuping; Zhou, Lin; Zheng, Shusen

    2015-09-23

    Emerging evidence has shown that serum uric acid (SUA) elevation might cause metabolic derangements, including metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD); however, magnitude of the risk has not been quantified. We searched PubMed, EMBASE, and ISI databases for relevant studies through 10 May 2015. Prospective studies reporting the risk of SUA elevation on the incidence of MetS/NAFLD were enrolled. Pooled HR of MetS was 1.55 (95%CI: 1.40-1.70) for the highest versus lowest SUA categories, and 1.05 (95%CI: 1.04-1.07) per incremental increased in SUA of 1 mg/dl. The pooled HR of MetS in younger women was higher than age-matched men and older women (1.17 vs. 1.05 and 1.04, respectively, P metabolic disorders for linear trend between its elevation and MetS/NAFLD incidence. SUA-lowering therapy is a potential strategy for preventing systemic/hepatic metabolic abnormalities.

  5. Cisto ovariano em vacas de leite: incidência, resposta à aplicação de GnRH e desempenho reprodutivo Ovarian cysts in lactating dairy cows: incidence, response to GnRH, and reproductive performance

    Directory of Open Access Journals (Sweden)

    R.M. Santos

    2009-06-01

    Full Text Available A incidência de cistos ovarianos, a resposta ao tratamento com GnRH e os efeitos da ocorrência de cisto no desempenho reprodutivo e na taxa de descarte foram determinados em vacas lactantes da raça Holandesa. Vacas lactantes (n=333 foram avaliadas semanalmente por ultrassonografia a partir da quarta semana pós-parto, visando à detecção de corpos lúteos (CL e de folículos ovarianos maiores que 10mm. Na sétima semana pós-parto, as vacas foram classificadas: em ciclando (n=248; presença de CL em um dos exames ultrassonográficos; em anestro (n=54; ausência de CL e de folículos >25mm e com cisto (n=31; ausência de CL e presença de estruturas >25mm, quando foram distribuídas em: grupo-controle (n=16; sem tratamento e grupo-tratamento (n=15; vacas que receberam uma aplicação de GnRH. A taxa de cura foi de 60,0% no grupo das vacas tratadas e de 87,5% no grupo-controle. As vacas com cistos apresentaram maior intervalo parto-primeira inseminação artificial (PThe incidence of ovarian cysts, response to GnRH treatment, and effects on reproductive performance and culling rate of Holstein cows were determined. Ovaries of lactating cows (n=333, were weekly monitored by ultrasound, beginning at fourth week postpartum, to determine the presence of corpus luteum (CL and follicles greater than 10mm. In the seventh week the cows were classified as cycling (n=248; presence of corpus luteum (CL in one of the ultrasound evaluations; anovulatory (n=54; absence of CL and follicles less than 25mm, and cystic (n=31; absence of CL and presence of structures greater than 25mm. The cysts cows were distributed in two groups in the seventh week: control group (n=16; without treatment and treatment group (n=15; cows received one GnRH injection. The recovery rate was 60.0% in treated cows and 87.5% in control cows. The cystic cows had longer average interval from parturition to first AI (P<0.05; 91.4±8.3 vs. 77.8±2.5, higher number of services per

  6. A review of effective flood forecasting, warning and response system ...

    African Journals Online (AJOL)

    Last mentioned are the reason for absence in South Africa of a formal flood forecast, warning and response system (FFWRS). In most cases where a flood warning system exists, there is evidence that it is insufficient, mainly because of a lack of knowledge and understanding of a well-functioning, appropriate FFWRS.

  7. Response of a dryland fluvial system to climate–tectonic ...

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Earth System Science; Volume 125; Issue 6. Response of a dryland fluvial system to climate–tectonic perturbations during the Late Quaternary: Evidence from Rukmawati River basin, Kachchh, western India. Archana Das Falguni Bhattacharya B K Rastogi Gaurav Chauhan Mamata Ngangom ...

  8. Stochastic response of nonlinear system in probability domain

    Indian Academy of Sciences (India)

    Keywords. Stochastic average procedure; nonlinear single-DOF system; probability density function. Abstract. A stochastic averaging procedure for obtaining the probability density function (PDF) of the response for a strongly nonlinear single-degree-of-freedom system, subjected to both multiplicative and additive random ...

  9. Stochastic response of nonlinear system in probability domain

    Indian Academy of Sciences (India)

    Stochastic average procedure; nonlinear single-DOF system; proba- bility density function. 1. Introduction. Stochastic response analysis of nonlinear systems has been extensively studied in the fre- quency, time and probability domains. In the frequency domain, the stochastic linearization technique is generally used for ...

  10. Automatic diagnosis of alarms: a system to improve operator emergency response

    International Nuclear Information System (INIS)

    Olson, H.P.; Gimmy, K.L.; Nomm, E.; Finley, R.H.

    1980-01-01

    A system is being developed at the Savannah River Plant to help reactor operators respond to multiple alarms in a developing incident situation. The need for such systems has becme evident in recent years, particularly after the Three Mile Island incident

  11. Oesophageal temperature monitoring and incidence of oesophageal lesions after pulmonary vein isolation using a remote robotic navigation system.

    Science.gov (United States)

    Rillig, Andreas; Meyerfeldt, Udo; Birkemeyer, Ralf; Wiest, Stefan; Sauer, Bernd M; Staritz, Martin; Jung, Werner

    2010-05-01

    Oesophageal lesions (EL), a potential complication after pulmonary vein isolation (PVI), have been described recently. A new remote robotic navigation system (RNS; Hansen Medical) provides enhanced catheter stability along with more effective lesion placement. The aim of this prospective study was to evaluate temperature monitoring and incidence of EL when using RNS with an irrigated tip radiofrequency catheter for PVI. Circumferential PVI using RNS was performed in 73 patients (pts) with paroxysmal (n = 46, 63%) and persistent atrial fibrillation. An oesophageal temperature probe was placed in 58 (79.5%) pts and was integrated in the 3D-map (NavX). Power was limited to 25 W at the posterior wall, and in the case of an increase in temperature power was limited to 20 W. Endoscopy was performed in 42 pts within 24 h after PVI. In 44 of 58 (75.9%) pts, a significant rise in temperature (>39 degrees C) was observed. In 6 of 42 (14.3%) pts, an EL was found during endoscopy. In patients with EL, the body mass index (BMI) was significantly lower than in pts without EL (24.1 +/- 2.0 vs. 29.0 +/- 5.8, P = 0.047). The BMI of all patients with EL was manual ablation. Patients with lower BMI (<26) are at higher risk for EL.

  12. The incidence of ventilator-associated pneumonia using the PneuX System with or without elective endotracheal tube exchange: A pilot study

    OpenAIRE

    Doyle, Alex; Fletcher, Andrew; Carter, Joseph; Blunt, Mark; Young, Peter

    2011-01-01

    Abstract Background The PneuX System is a novel endotracheal tube and tracheal seal monitor, which has been designed to minimise the aspiration of oropharyngeal secretions. We aimed to determine the incidence of ventilator-associated pneumonia (VAP) in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System. Findings In this retrospective observational study, data was co...

  13. Immune response induction in the central nervous system

    DEFF Research Database (Denmark)

    Owens, Trevor; Babcock, Alicia

    2002-01-01

    The primary function of the immune response is protection of the host against infection with pathogens, including viruses. Since viruses can infect any tissue of the body, including the central nervous system (CNS), it is logical that cells of the immune system should equally have access to all...... tissues. Nevertheless, the brain and spinal cord are noted for their lack of immune presence. Relative to other organ systems, the CNS appears immunologically privileged. Furthermore, when immune responses do occur in the CNS, they are frequently associated with deleterious effects such as inflammatory...

  14. External-stimuli responsive systems for cancer theranostic

    Directory of Open Access Journals (Sweden)

    Jianhui Yao

    2016-10-01

    Full Text Available The upsurge of novel nanomaterials and nanotechnologies has inspired the researchers who are striving for designing safer and more efficient drug delivery systems for cancer therapy. Stimuli responsive nanomaterial offered an alternative to design controllable drug delivery system on account of its spatiotemporally controllable properties. Additionally, external stimuli (light, magnetic field and ultrasound could develop into theranostic applications for personalized medicine use because of their unique characteristics. In this review, we give a brief overview about the significant progresses and challenges of certain external-stimuli responsive systems that have been extensively investigated in drug delivery and theranostics within the last few years.

  15. Risk factors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position.

    Science.gov (United States)

    Tabei, Tadashi; Ito, Hiroki; Usui, Kimitsugu; Kuroda, Shinnosuke; Kawahara, Takashi; Terao, Hideyuki; Fujikawa, Atsushi; Makiyama, Kazuhide; Yao, Masahiro; Matsuzaki, Junichi

    2016-08-01

    To identify risk factors of developing systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position for renal stone treatment. We retrospectively analyzed 370 consecutive patients who underwent endoscopic combined intrarenal surgery procedures in the modified Valdivia position to treat renal stones. Antibiotic therapy based on preoperative urine cultures was administered to all patients from induction of anesthesia until at least postoperative day 3. Postoperative systemic inflammation response syndrome was diagnosed if the patient met two or more systemic inflammation response syndrome criteria. A multivariate logistic regression model with backward selection was used to evaluate the relationships between the incidence of systemic inflammation response syndrome after endoscopic combined intrarenal surgery and other clinical factors. Of the 370 patients, 61 patients (16.5%) were diagnosed with systemic inflammation response syndrome after endoscopic combined intrarenal surgery. Significant differences were found between the non-systemic inflammation response syndrome and systemic inflammation response syndrome groups with regard to female sex (29.8% vs 44.3%, P = 0.027), history of febrile urinary tract infection (16.5% vs 32.8%, P = 0.015) and number of involved calyces (2.68 vs 4.1, P systemic inflammation response syndrome: the number of involved calyces (P = 0.017), stone surface area (P = 0.021) and history of febrile urinary tract infection (P = 0.005). The number of involved calyces larger than four, stone surface area >500 mm(2) and a history of febrile urinary tract infection independently predicted the development of systemic inflammation response syndrome after endoscopic combined intrarenal surgery. This is the first study to identify the independent predictors of systemic inflammation response syndrome after endoscopic combined intrarenal surgery in the modified Valdivia position. © 2016 The

  16. Th17/Treg imbalance induced by increased incidence of atherosclerosis in patients with systemic lupus erythematosus (SLE).

    Science.gov (United States)

    Zhu, Mengya; Mo, Hanyou; Li, Dong; Luo, Xiaohong; Zhang, Lihua

    2013-07-01

    The objective of the study was to investigate whether the immunological factors in patients with Systemic Lupus Erythematosus (SLE) and a high incidence of atherosclerosis correlate with a Th17/Treg imbalance. All cases were recruited from the Affiliated Hospital of Guilin Medical University: a random sample of 42 cases with SLE and atherosclerosis, 39 positive control cases with SLE alone with no anomalies detected via coronary artery angiography or carotid color Doppler ultrasound examination, as well as 45 normal controls based on physical examination were included. The serum expression levels of IL-10, IL-17, IL-6, TNF-α, Th17, Th17 cell transcription factor RORγt, and Treg cell transcription factor Foxp3 were measured in each group of patients. Correlations among Th17/Treg, their secreted cell factors, transcription factors, SLE, and SLE with concurrent atherosclerosis (SLE + AS) were analyzed. The results are as follows: (1) total cholesterol and triacylglycerol levels in the SLE and SLE + AS groups were higher than those in the control group (P < 0.05 and P < 0.01); (2) serum IL-10 in the SLE + AS group was lower than the SLE and control groups; however, serum IL-17 and IL-6 levels in the SLE + AS group were elevated compared to the SLE and control groups (average P < 0.01); (3) the percentage of Treg cells in the SLE + AS patients was lower than those found in the SLE and control groups; in contrast, percentages of serum Th17 cells in SLE + AS patients were higher than the SLE and control groups (average P < 0.01); (4) FoxP3 expression in the SLE + AS group was lower than levels observed in the SLE and control groups (average P < 0.05); in contrast, RORγt expression in the SLE + AS group was higher than levels found in the SLE and control groups (average P < 0.05). The abnormal balance between Th17 cells and Treg cells in SLE + AS patients has obvious implications for Th17 migration. The results suggest that Th17 cell proportion and function can be

  17. Mobile Detection Assessment and Response Systems (MDARS): A Force Protection, Physical Security Operational Success

    National Research Council Canada - National Science Library

    Shoop, Brian; Johnston, Michael; Goehring, Richard; Moneyhun, Jon; Skibba, Brian

    2006-01-01

    ... & barrier assessment payloads. Its functions include surveillance, security, early warning, incident first response and product and barrier status primarily focused on a depot/munitions security mission at structured/semi-structured facilities...

  18. Evaluation of the integrated disease surveillance and response system for infectious diseases control in northern Ghana.

    Science.gov (United States)

    Adokiya, Martin Nyaaba; Awoonor-Williams, John Koku; Barau, Inuwa Yau; Beiersmann, Claudia; Mueller, Olaf

    2015-02-04

    Well-functioning surveillance systems are crucial for effective disease control programs. The Integrated Disease Surveillance and Response (IDSR) strategy was developed and adopted in 1998 for Africa as a comprehensive public health approach and subsequently, Ghana adopted the IDSR technical guidelines in 2002. Since 2012, the IDSR data is reported through the new District Health Information Management System II (DHIMS2) network. The objective was to evaluate the Integrated Disease Surveillance and Response (IDSR) system in northern Ghana. This was an observational study using mixed methods. Weekly and monthly IDSR data on selected infectious diseases were downloaded and analyzed for 2011, 2012 and 2013 (the years before, of and after DHIMS2 implementation) from the DHIMS2 databank for the Upper East Region (UER) and for two districts of UER. In addition, key informant interviews were conducted among local and regional health officers on the functioning of the IDSR. Clinically diagnosed malaria was the most prevalent disease in UER, with an annual incidence rate close to 1. Around 500 suspected HIV/AIDS cases were reported each year. The highest incidence of cholera and meningitis was reported in 2012 (257 and 392 cases respectively). Three suspected cases of polio and one suspected case of guinea worm were reported in 2013. None of the polio and guinea worm cases and only a fraction of the reported cases of the other diseases were confirmed. A major observation was the large and inconclusive difference in reported cases when comparing weekly and monthly reports. This can be explained by the different reporting practice for the sub-systems. Other challenges were low priority for surveillance, ill-equipped laboratories, rare supervision and missing feedback. The DHIMS2 has improved the availability of IDSR reports, but the quality of data reported is not sufficient. Particularly the inconsistencies between weekly and monthly data need to be addressed. Moreover

  19. Modulation of systemic immune responses through commensal gastrointestinal microbiota.

    Directory of Open Access Journals (Sweden)

    Kyle M Schachtschneider

    Full Text Available Colonization of the gastrointestinal (GI tract is initiated during birth and continually seeded from the individual's environment. Gastrointestinal microorganisms play a central role in developing and modulating host immune responses and have been the subject of investigation over the last decades. Animal studies have demonstrated the impact of GI tract microbiota on local gastrointestinal immune responses; however, the full spectrum of action of early gastrointestinal tract stimulation and subsequent modulation of systemic immune responses is poorly understood. This study explored the utility of an oral microbial inoculum as a therapeutic tool to affect porcine systemic immune responses. For this study a litter of 12 pigs was split into two groups. One group of pigs was inoculated with a non-pathogenic oral inoculum (modulated, while another group (control was not. DNA extracted from nasal swabs and fecal samples collected throughout the study was sequenced to determine the effects of the oral inoculation on GI and respiratory microbial communities. The effects of GI microbial modulation on systemic immune responses were evaluated by experimentally infecting with the pathogen Mycoplasma hyopneumoniae. Coughing levels, pathology, toll-like receptors 2 and 6, and cytokine production were measured throughout the study. Sequencing results show a successful modulation of the GI and respiratory microbiomes through oral inoculation. Delayed type hypersensitivity responses were stronger (p = 0.07, and the average coughing levels and respiratory TNF-α variance were significantly lower in the modulated group (p<0.0001 and p = 0.0153, respectively. The M. hyopneumoniae infection study showed beneficial effects of the oral inoculum on systemic immune responses including antibody production, severity of infection and cytokine levels. These results suggest that an oral microbial inoculation can be used to modulate microbial communities, as well as

  20. Peculiarities of the Self-Action of Inclined Wave Beams Incident on a Discrete System of Optical Fibers

    Science.gov (United States)

    Litvak, A. G.; Mironov, V. A.; Skobelev, S. A.; Smirnov, L. A.

    2018-01-01

    Based on a discrete nonlinear Schrödinger equation (DNSE), we studied analytically and numerically the peculiarities of the self-action of one-dimensional quasi-optic wave beams injected into a spatially inhomogeneous medium consisting of a set of equidistant mutually coupled optical fibers. A variational approach allowing the prediction of the global evolution of localized fields with the initially plane phase front was developed. The self-consistent equations are obtained for the main parameters of such beams (the position of the center of mass, the effective width, and linear and quadratic phase-front corrections) in the aberrationless approximation. The case of radiation incident on a periodic system of nonlinear optical fibers at an angle to the axis oriented along them is analyzed in detail. It is shown that for the radiation power exceeding a critical value, the self-focusing of the wave field is observed, which is accompanied by the shift of the intensity maximum followed by the concentration of the main part of radiation only in one of the structural elements of the array under study. In this case, the beams propagate along paths considerably different from linear and the direction of their propagation changes compared to the initial direction. Asymptotic expressions are found that allow us to estimate the self-focusing length and to determine quite accurately the final position of a point with the maximum field amplitude after radiation trapping a channel. The results of the qualitative study of the possible self-channeling regimes for wave beams in a system of weakly coupled optical fibers in the aberrationless approximation are compared with the results of direct numerical simulations within the DNSE framework.

  1. Responses of an isolation system with distinct multiple frequencies

    International Nuclear Information System (INIS)

    Wu, Ting-shu; Seidensticker, R.W.

    1991-01-01

    Base isolation systems are generally designed with a single natural frequency. A major concern for these isolation systems is that, if the dominant frequency of a future earthquake is equal or close to the system's natural frequency, the ground motion will be greatly amplified because of resonance,and the superstructure would suffer severe damages. This paper present an isolation system designed with two distinct frequencies. Its responses to different ground motions, including a harmonic motion, show that no excessive amplification will occur. Adoption of this isolation system would greatly enhance the safety of an isolated superstructure against future strong earthquakes. 3 refs., 4 figs., 2 tabs

  2. Effect of diets containing potato protein or soya bean meal on the incidence of spontaneously-occurring subclinical necrotic enteritis and the physiological response in broiler chickens.

    Science.gov (United States)

    Fernando, P S; Rose, S P; Mackenzie, A M; Silva, S S P

    2011-02-01

    1. An experiment was conducted to compare and explain the incidence of spontaneously occurring subclinical necrotic enteritis in broiler chickens that were fed on two practical broiler diets that differed in the major protein concentrates (soya bean meal or potato protein concentrates) and examine the relationships between the severity of the disease and the growth performance and physiological responses of the chickens. 2. A total of 840, 20-d-old birds were randomly allocated to 12 pens. Two maize-based nutritionally complete diets that either contained some potato protein or soya bean meal as the major protein supplement were fed for 16 d. Twelve birds were randomly sampled from each pen at the end of the feeding period and their blood sampled and intestinal tracts and livers dissected. 3. The birds fed on the potato protein diet had a significantly 7·7% lower feed intake and a significantly 7·8% lower growth rate compared with the birds fed on the soya-based diet. There were no significant differences in feed conversion efficiency or mortality. There were no differences in the determined apparent metabolisable energy concentrations, however, the apparent dry matter digestibility of the potato protein diet was significantly higher than that of the soya based diet and the apparent crude protein digestibility of the potato protein diet was significantly lower. 4. A significantly higher alpha toxin antibody titre was found in the birds fed on the potato protein diet compared with those fed on the soya protein diet. There was a significantly increased incidence of hepatic lesions in the birds fed on the potato protein diet compared with the birds fed on the soya diet. The mean incidence of intestinal necroses tended to be greater in the birds fed on the potato protein diet (23·6%) compared with the birds fed on the soya-based diet (15·3%). 5. There was a significant linear relationship between ileal digesta sialic acid concentration and serum alpha toxin

  3. Critical incident stress management.

    Science.gov (United States)

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

    2000-10-01

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

  4. Benefits of Demand Side Response in Providing Frequency Response Service in the Future GB Power System

    Directory of Open Access Journals (Sweden)

    Fei eTeng

    2015-08-01

    Full Text Available The demand for ancillary service is expected to increase significantly in the future GB electricity system due to high penetration of wind. In particular, the need for frequency response, required to deal with sudden frequency drops following a loss of generator, will increase because of the limited inertia capability of wind plants. This paper quantifies the requirements for primary frequency response and analyses the benefits of frequency response provision from DSR. The results show dramatic changes in frequency response requirements driven by high penetration of wind. Case studies carried out by using an advanced stochastic generation scheduling model suggest that the provision of frequency response from DSR could greatly reduce the system operation cost, wind curtailment and carbon emissions in the future GB system characterised by high penetration of wind. Furthermore, the results demonstrate that the benefit of DSR shows significant diurnal and seasonal variation, whereas an even more rapid (instant delivery of frequency response from DSR could provide significant additional value. Our studies also indicate that the competing technologies to DSR, namely battery storage and more flexible generation could potentially reduce its value by up to 35%, still leaving significant room to deploy DSR as frequency response provider.

  5. Transformation Planning of Ecotourism Systems to Invigorate Responsible Tourism

    Directory of Open Access Journals (Sweden)

    Yun Eui Choi

    2017-12-01

    Full Text Available The purpose of this study is to introduce transformation plans that can stimulate responsible ecotourism by using systems thinking to solve ecotourism problems in Korea. Systems thinking is a research method used to understand the operating mechanisms of the variables that influence an entire system, in order to identify its problems. The four types of ecotourism systems are classified as follows: low-infrastructure and resident-initiated, high-infrastructure and resident-initiated, high-infrastructure and government-initiated and low-infrastructure and government-initiated. These systems vary based on the need for tourism facilities and the form of governance. Each type of system is analyzed using the systems thinking process (dynamic thinking, causal thinking, feedback thinking, strategic thinking at representative ecotourism sites in Jeollanam-do and the following transformation plans are proposed to improve the responsibility at the tourism sites: First, local residents will develop a system to manage and operate ecotourism ventures and establish cooperative governance structures to strengthen the local capacity. Second, ecotourism operators will improve the quality of their educational and interpretative programs and tourist information platforms in order to raise awareness of the responsibilities of ecotourists. Third, ecotourism systems that are improved through ecotourists’ and tour operators' heightened senses of responsibility can sustain ecotourism independently. These transformation plans can be applied to policy proposals for revitalizing ecotourism, to guidelines for improving community resilience and to biological habitat protection plans. This study is meaningful in that it discusses the role of stakeholders in ecotourism planning and promoting responsible tourism and their role in utilizing and conserving natural resources accordingly.

  6. Trade-off between responsiveness and noise suppression in biomolecular system responses to environmental cues.

    Directory of Open Access Journals (Sweden)

    Alexander V Ratushny

    2011-06-01

    Full Text Available When living systems detect changes in their external environment their response must be measured to balance the need to react appropriately with the need to remain stable, ignoring insignificant signals. Because this is a fundamental challenge of all biological systems that execute programs in response to stimuli, we developed a generalized time-frequency analysis (TFA framework to systematically explore the dynamical properties of biomolecular networks. Using TFA, we focused on two well-characterized yeast gene regulatory networks responsive to carbon-source shifts and a mammalian innate immune regulatory network responsive to lipopolysaccharides (LPS. The networks are comprised of two different basic architectures. Dual positive and negative feedback loops make up the yeast galactose network; whereas overlapping positive and negative feed-forward loops are common to the yeast fatty-acid response network and the LPS-induced network of macrophages. TFA revealed remarkably distinct network behaviors in terms of trade-offs in responsiveness and noise suppression that are appropriately tuned to each biological response. The wild type galactose network was found to be highly responsive while the oleate network has greater noise suppression ability. The LPS network appeared more balanced, exhibiting less bias toward noise suppression or responsiveness. Exploration of the network parameter space exposed dramatic differences in system behaviors for each network. These studies highlight fundamental structural and dynamical principles that underlie each network, reveal constrained parameters of positive and negative feedback and feed-forward strengths that tune the networks appropriately for their respective biological roles, and demonstrate the general utility of the TFA approach for systems and synthetic biology.

  7. Trade-off between responsiveness and noise suppression in biomolecular system responses to environmental cues.

    Science.gov (United States)

    Ratushny, Alexander V; Shmulevich, Ilya; Aitchison, John D

    2011-06-01

    When living systems detect changes in their external environment their response must be measured to balance the need to react appropriately with the need to remain stable, ignoring insignificant signals. Because this is a fundamental challenge of all biological systems that execute programs in response to stimuli, we developed a generalized time-frequency analysis (TFA) framework to systematically explore the dynamical properties of biomolecular networks. Using TFA, we focused on two well-characterized yeast gene regulatory networks responsive to carbon-source shifts and a mammalian innate