Introduction of a prehospital critical incident monitoring system--pilot project results.

Science.gov (United States)

Stella, Julian; Davis, Anna; Jennings, Paul; Bartley, Bruce

2008-01-01

Hospital medical incident monitoring improves preventable morbidity and mortality rates. Error management systems have been adopted widely in this setting. Data relating to incident monitoring in the prehospital setting is limited. Implementation of an incident monitoring process in a prehospital setting. This is a prospective, descriptive study of the pilot phase of the implementation of an incident monitoring process in a regional prehospital setting, with a focus on trauma care. Paramedics and emergency department staff submitted anonymous incident reports, and a chart review was performed on patients who met major trauma criteria. Selected trauma cases were analyzed by a structured interview/debriefing process to elucidate undocumented incidents. A project committee coded and logged all incidents and developed recommendations. Of 4,429 ambulance responses, 41 cases were analyzed. Twenty-four (58.5%; 95% CI = 49.7-67.4%) were reported anonymously, and the rest were major trauma patients. A total of 77 incidents were identified (mean per case = 1.8; CI = 1.03-2.57). Anonymous cases revealed 26 incidents (mean = 1.1; CI = 0.98-1.22); eight trauma debriefings revealed 38 incidents (mean = 4.8; CI = 0.91-8.69) and nine trauma chart reviews revealed 13 incidents (mean = 1.6; CI = 1.04-2.16). A total of 56 of 77 (72.7%; CI = 65.5-80.0%) incidents related to system inadequacies, and 15 (57.7%; CI = 46.7-68.6%) anonymously reported incidents related to resource problems. A total of 35 of 77 (45.5%; CI = 40.4-50.5%) incidents had minimal or no impact on the patients' outcomes. Thirty-four of 77 (44.2%; CI = 39.3-49.1%) incidents were considered mitigated by circumstance. Incident monitoring led to generalized feedback in most cases (65 of 77; 84.4%; CI = 77.6-91.3%); in three cases (3.9%; CI = 3.7-4.1%), specific education occurred; two cases were reported to an external body (2.6%; CI = 2.5-2.7%); three cases resulted in remedial action (3.9%; CI = 3.7-4.1%); four for

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.

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.

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

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

Science.gov (United States)

Loop, Carole

2013-01-01

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

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.

Computer Security Incident Response Team Effectiveness: A Needs Assessment.

Science.gov (United States)

Van der Kleij, Rick; Kleinhuis, Geert; Young, Heather

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 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.

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.

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

Police Response to Children Present at Domestic Violence Incidents.

Science.gov (United States)

Swerin, Danielle D; Bostaph, Lisa Growette; King, Laura L; Gillespie, Lane Kirkland

2018-01-01

Police response to domestic violence (DV) has continued to change and expand over the past several decades. Although DV was originally considered a private matter, it now represents one of the most common calls for service received by police agencies. While police response to DV incidents has improved substantially, intervention when children are present remains an undeveloped area of research and practice. The present study examined 345 police reports from an agency in the Northwestern United States to explore police response to DV incidents when children are present. Regression analyses indicated that child presence was a statistically significant predictor of victim-directed intervention, victim-directed follow-up, and arrest although in differing directions. While child presence increased the odds of victim-directed intervention and victim-directed follow-up, it decreased the odds of arrest. Findings further indicated that the frequency of police interaction with children present at DV incidents was minimal. Based on these findings, recommendations for policy and practice are discussed.

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

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

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...

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 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.

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

Designing System Reforms: Using a Systems Approach to Translate Incident Analyses into Prevention Strategies

Science.gov (United States)

Goode, Natassia; Read, Gemma J. M.; van Mulken, Michelle R. H.; Clacy, Amanda; Salmon, Paul M.

2016-01-01

Advocates of systems thinking approaches argue that accident prevention strategies should focus on reforming the system rather than on fixing the “broken components.” However, little guidance exists on how organizations can translate incident data into prevention strategies that address the systemic causes of accidents. This article describes and evaluates a series of systems thinking prevention strategies that were designed in response to the analysis of multiple incidents. The study was undertaken in the led outdoor activity (LOA) sector in Australia, which delivers supervised or instructed outdoor activities such as canyoning, sea kayaking, rock climbing and camping. The design process involved workshops with practitioners, and focussed on incident data analyzed using Rasmussen's AcciMap technique. A series of reflection points based on the systemic causes of accidents was used to guide the design process, and the AcciMap technique was used to represent the prevention strategies and the relationships between them, leading to the creation of PreventiMaps. An evaluation of the PreventiMaps revealed that all of them incorporated the core principles of the systems thinking approach and many proposed prevention strategies for improving vertical integration across the LOA system. However, the majority failed to address the migration of work practices and the erosion of risk controls. Overall, the findings suggest that the design process was partially successful in helping practitioners to translate incident data into prevention strategies that addressed the systemic causes of accidents; refinement of the design process is required to focus practitioners more on designing monitoring and feedback mechanisms to support decisions at the higher levels of the system. PMID:28066296

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.

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

Addressing the gap between public health emergency planning and incident response

OpenAIRE

Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

2013-01-01

Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods:?This study was conducted using critical case study methodology consisting of document review and 18 k...

Command Resiliency: An Adaptive Response Strategy for Complex Incidents

National Research Council Canada - National Science Library

Pfeifer, Joseph W

2005-01-01

.... Unless organizations develop a resilient response strategy that can adapt organizational and operational elements to respond to new terrorist incidents, they will find themselves with the same...

The national response plan and radioactive incident monitoring network (RIMNET)

International Nuclear Information System (INIS)

Jones, M.W.

1989-01-01

The Department of the Environment is responsible through Her Majesty's Inspectorate of Pollution for co-ordination of the Government's response to overseas nuclear incidents. This paper describes the contingency arrangements that have been set up for this purpose. (author)

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

Dependence on incident angle of solid state detector response to gamma-rays

International Nuclear Information System (INIS)

Yamanishi, Hirokuni; Yamaguchi, Satarou; Yamaguchi, Takayuki; Ueki, Kohtaro

2002-01-01

The shape and size of a NaI(Tl) scintillator that should maximize response variation with γ-ray incident angle was estimated by analytical model calculation. It proved that, even for gamma rays of energy exceeding 1 MeV, a slab detector measuring 50 cm x 50 cm x 5 cm thick should present a ratio of at least 4 between maximum and minimum responses against incidence at different angles. For a sample case of 60 keV gamma rays, estimation of the incident angle dependence by means of Monte Carlo simulation agreed well with experiment using a CZT detector. The counts from photo-electric peak varied with incident angle roughly along a sine curve. The foregoing finding served as basis for proposing a practical direction finder for γ-ray source operating on the principle of determining the source direction from variations in count with incident angle. (author)

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...

Prerequisites for building a computer security incident response capability

CSIR Research Space (South Africa)

Mooi, M

2015-08-01

Full Text Available . 1]. 2) Handbook for Computer Security Incident Response Teams (CSIRTs) [18] (CMU-SEI): Providing guidance on building and running a CSIRT, this handbook has a particular focus on the incident handling service [18, p. xv]. In addition, a basic CSIRT... stream_source_info Mooi_2015.pdf.txt stream_content_type text/plain stream_size 41092 Content-Encoding UTF-8 stream_name Mooi_2015.pdf.txt Content-Type text/plain; charset=UTF-8 Prerequisites for building a computer...

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

Addressing the gap between public health emergency planning and incident response

Science.gov (United States)

Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

2013-01-01

Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response. PMID:28228983

A critical incident reporting system in anaesthesia.

Science.gov (United States)

Madzimbamuto, F D; Chiware, R

2001-01-01

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

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)

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

Science.gov (United States)

Gorton, Dan

2014-09-01

The article introduces the use of probabilistic risk assessment for modeling the incident response process of online financial services. The main contribution is the creation of incident response trees, using event tree analysis, which provides us with a visual tool and a systematic way to estimate the probability of a successful incident response process against the currently known risk landscape, making it possible to measure the balance between front-end and back-end security measures. The model is presented using an illustrative example, and is then applied to the incident response process of a Swedish bank. Access to relevant data is verified and the applicability and usability of the proposed model is verified using one year of historical data. Potential advantages and possible shortcomings are discussed, referring to both the design phase and the operational phase, and future work is presented. © 2014 Society for Risk Analysis.

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

Intravaginal lactic Acid bacteria modulated local and systemic immune responses and lowered the incidence of uterine infections in periparturient dairy cows.

Directory of Open Access Journals (Sweden)

Qilan Deng

Full Text Available The objective of this investigation was to evaluate whether intravaginal infusion of a lactic acid bacteria (LAB cocktail around parturition could influence the immune response, incidence rate of uterine infections, and the overall health status of periparturient dairy cows. One hundred pregnant Holstein dairy cows were assigned to 1 of the 3 experimental groups as follows: 1 one dose of LAB on wk -2 and -1, and one dose of carrier (sterile skim milk on wk +1 relative to the expected day of parturition (TRT1; 2 one dose of LAB on wk -2, -1, and +1 (TRT2, and 3 one dose of carrier on wk -2, -1, and +1 (CTR. The LAB were a lyophilized culture mixture composed of Lactobacillus sakei FUA3089, Pediococcus acidilactici FUA3138, and Pediococcus acidilactici FUA3140 with a cell count of 108-109 cfu/dose. Blood samples and vaginal mucus were collected once a week from wk -2 to +3 and analyzed for content of serum total immunoglobulin G (IgG, lipopolysaccharide-binding protein (LBP, serum amyloid A (SAA, haptoglobin (Hp, tumor necrosis factor (TNF, interleukin (IL-1, IL-6, and vaginal mucus secretory IgA (sIgA. Clinical observations including rectal temperature, vaginal discharges, retained placenta, displaced abomasum, and laminitis were monitored from wk -2 to +8 relative to calving. Results showed that intravaginal LAB lowered the incidence of metritis and total uterine infections. Intravaginal LAB also were associated with lower concentrations of systemic LBP, an overall tendency for lower SAA, and greater vaginal mucus sIgA. No differences were observed for serum concentrations of Hp, TNF, IL-1, IL-6 and total IgG among the treatment groups. Administration with LAB had no effect on the incidence rates of other transition cow diseases. Overall intravaginal LAB lowered uterine infections and improved local and systemic immune responses in the treated transition dairy cows.

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)

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)

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-08-15

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

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

International Nuclear Information System (INIS)

Montgomery, Logan; Kildea, John

2016-01-01

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

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

OpenAIRE

Terblanche, Lourie; van Wyk, André

2014-01-01

Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...

Analysis of general aviation single-pilot IFR incident data obtained from the NASA Aviation Safety Reporting System

Science.gov (United States)

Bergeron, H. P.

1983-01-01

An analysis of incident data obtained from the NASA Aviation Safety Reporting System (ASRS) has been made to determine the problem areas in general aviation single-pilot IFR (SPIFR) operations. The Aviation Safety Reporting System data base is a compilation of voluntary reports of incidents from any person who has observed or been involved in an occurrence which was believed to have posed a threat to flight safety. This paper examines only those reported incidents specifically related to general aviation single-pilot IFR operations. The frequency of occurrence of factors related to the incidents was the criterion used to define significant problem areas and, hence, to suggest where research is needed. The data was cataloged into one of five major problem areas: (1) controller judgment and response problems, (2) pilot judgment and response problems, (3) air traffic control (ATC) intrafacility and interfacility conflicts, (4) ATC and pilot communication problems, and (5) IFR-VFR conflicts. In addition, several points common to all or most of the problems were observed and reported. These included human error, communications, procedures and rules, and work load.

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.

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

Real-time incident detection using social media data.

Science.gov (United States)

2016-05-09

The effectiveness of traditional incident detection is often limited by sparse sensor coverage, and reporting incidents to emergency response systems : is labor-intensive. This research project mines tweet texts to extract incident information on bot...

Energy systems evaluation of potential for incidents having health or safety impact

International Nuclear Information System (INIS)

Speas, I.G.

1986-01-01

The paper discusses the results of safety surveys of Martin Marietta Energy Systems - operated nuclear facilities. The purpose was to identify potential incidents that could cause large numbers of casualties, evaluate existing prevention/response actions, and identify possible improvements. The survey findings indicate the potential for an accident with consequences similar to those at Bhopal, India, is essentially non-existent

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…

Successful emergency operations and the Incident Command System

International Nuclear Information System (INIS)

Montgomery, M.

1994-01-01

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

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

Science.gov (United States)

2017-03-01

Analysts. Cognitive prompts can reduce overconfidence and information bias. One such strategy is the “Five-Why Analysis,” developed by Toyota and used...building trust among CSIRTs and MTS members (including those from other CSIRTs and agencies), as well as developing an environment of psychological safety...recommendations for optimal CSIRT performance. 15. SUBJECT TERMS Cyber Incident Response, Response Teams, Cognitive Task Analysis 16. SECURITY

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.

The Role of the International Atomic Energy Agency in a Response to Nuclear and Radiological Incidents and Emergencies

Energy Technology Data Exchange (ETDEWEB)

Buglova, E.; Baciu, F., E-mail: E.Buglova@iaea.org [International Atomic Energy Agency (IAEA), Department of Nuclear Safety and Security, Wagramer Strasse 5, P.O. Box 100, 1400 Vienna (Austria)

2014-10-15

Full text: The role of the International Atomic Energy Agency (IAEA) in a response to nuclear and radiological incidents and emergencies has been defined and further expanded through the IAEA Statute, the Convention on Early Notification of a Nuclear Accident, the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency, the Convention on Physical Protection of Nuclear Material, IAEA safety standards, relevant decisions by Policy Making Organs of the IAEA, inter-agency agreements and other documents such as the IAEA Action Plan on Nuclear Safety. The IAEA Secretariat fulfils its roles through the Agency's Incident and Emergency System (IES) and the Incident and Emergency Centre (IEC). The IEC is the global focal point for international preparedness and response to nuclear and radiological safety or security related incidents, emergencies, threats or events of media interest and for coordination of International assistance. During a response the IEC performs and facilitates for Member States many specific functions which include: prompt notification; official information exchange; assessment of potential consequences; prognosis of emergency progression; provision, facilitation and coordination of International assistance; provision of timely, accurate and easily understandable public information; coordination of inter-agency response at the International level. Through officially designated contact points of Member States the IEC is able to communicate at any time with national authorities to ensure the prompt and successful sharing of information and resources. The IEC routinely performs internal exercising of all aspects of the IAEA response and in cooperation with Member States, the IAEA organizes and facilitates the conduct of large scale international exercises to practice cooperation and coordination. This presentation outlines in detail the specific functions of the IAEA IEC during a response. (author)

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...

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...

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

Directory of Open Access Journals (Sweden)

Terblanche, Lourie

2014-04-01

Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.

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.

Maximum Credible Incidents

CERN Document Server

Strait, J

2009-01-01

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

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

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 ...

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.

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.

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.

Modular telerobot control system for accident response

Science.gov (United States)

Anderson, Richard J. M.; Shirey, David L.

1999-08-01

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 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-frame teleoperation, autonomous tool changeout and dual manipulator control have been incorporated. The final system incorporates twenty-two separate modules and implements seven different behavior modes. This paper describes the integration of SMART into the ARMMS system.

Immune responsiveness and incidence of reticulum cell sarcoma in long-term syngeneic radiation chimeras

International Nuclear Information System (INIS)

Adorini, L.; Gorini, G.; Covelli, V.; Ballardin, E.; di Michele, A.; Bassani, B.; Metalli, P.; Doria, G.

1976-01-01

Long-term syngeneic radiation chimeras displayed a very low incidence of reticulum cell sarcoma as compared with control mice. Immune reactivity of these animals was studied in vivo by anti-dinitrophenyl antibody titer and affinity and in vitro by mitotic responsiveness to phytohemagglutinin, concanavalin A and lipopolysaccharide. Antibody titer and affinity as well as the response to T lectins were found to be increased in chimeras. These results were attributed to increased function of mature T2 cells, which could explain the reduced incidence of reticulum cell sarcoma in chimeras

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

International Nuclear Information System (INIS)

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

1990-03-01

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

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

International Nuclear Information System (INIS)

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

2016-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-05-15

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

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.

Angular response characterization of the Martin Marietta Energy Systems, Inc., personnel dosimeter

International Nuclear Information System (INIS)

Ahmed, A.B.; McMahan, K.L.; Colwell, D.S.

1993-08-01

An evaluation of the Martin Marietta Energy Systems, Inc., personnel dosimeter to radiation incident from non-perpendicular angles was carried out to meet the Department of Energy Laboratory Accreditation Program (DOELAP) requirements. Dosimeters were exposed to six different radiation sources. For each source, dosimeters were rotated about their horizontal and vertical axes at seven different angles each. Raw readings were processed through the dose calculation algorithm used for routine personnel dosimetry to determine dose equivalent values. Dose equivalent responses relative to zero degree incident angle were found to be within ± 20% for M150, K-59 and 137 Cs photons when the incident angle was 60 degree or less. For low-energy photon irradiations (M30 and K-16), responses for angles other than perpendicular incidence are generally unpredictable. Reasons include: (1) failure of dose calculation algorithm to identify the radiation field correctly due to unusual element ratios; and (2) at extreme angles (± 85 degree), the dosimeter design (in relation to the irradiation geometry) becomes the limiting factor in producing reproducible results. Response to 204 Tl beta particles decreases rapidly with increasing angle of incidence

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

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...

Short communication: Association of disease incidence and adaptive immune response in Holstein dairy cows.

Science.gov (United States)

Thompson-Crispi, K A; Hine, B; Quinton, M; Miglior, F; Mallard, B A

2012-07-01

The objective of this study was to use previously calculated estimated breeding values for cell- (CMIR) and antibody-mediated immune responses (AMIR) to determine associations between immune response (IR) and economically important diseases of dairy cattle. In total, 699 Holsteins were classified as high, average, or low for CMIR, AMIR, and overall IR (combined CMIR and AMIR), and associations with mastitis, metritis, ketosis, displaced abomasums, and retained fetal membranes were determined. The incidence of mastitis was higher among average cows as compared with cows classified as high AMIR [odds ratio (OR)=2.5], high CMIR (OR=1.8), or high IR (OR=1.8). Low-CMIR cows had a higher incidence of metritis (OR=11.3) and low-IR cows had a higher incidence of displaced abomasum (OR=4.1) and retained fetal membrane (OR=2.8) than did average responders. Results of this study show that cows classified as high immune responders have lower occurrence of disease, suggesting that breeding cattle for enhanced IR may be a feasible approach to decrease the incidence of infectious and metabolic diseases in the dairy industry. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

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)

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

Science.gov (United States)

Nyenswah, Tolbert

The 2014-2016 epidemic of Ebola virus disease occurred in a region with a recent history of civil war, unstable health systems, and widespread poverty. Despite these contextual challenges, the national Ebola response in Liberia controlled transmission under strong leadership that was able to rapidly coordinate activities, to manage local and international players, and to adapt upon recognizing missteps. Such leadership has persisted to improve public health capacity in post-Ebola Liberia. This article highlights the progress made toward developing a resilient health security system with capacity to prevent, detect, and respond to disease threats before they reach epidemic level. In particular, Liberia's development of a Global Health Security Agenda roadmap, a Joint External Evaluation (JEE) report for International Health Regulation (2005) core capacities, and recent establishment of a National Public Health Institute are described. To better protect the country's population and the greater global community from health threats, emerging institutions and policies in Liberia will depend on leadership and governance that draws from the successes and lessons learned during the Ebola outbreak. The author provides insight based on his role as incident manager of Liberia's Ebola response.

Analysis for the amplitude oscillatory movements of the ship in response to the incidence wave

Science.gov (United States)

Chiţu, M. G.; Zăgan, R.; Manea, E.

2015-11-01

Event of major accident navigation near offshore drilling rigs remains unacceptably high, known as the complications arising from the problematic of the general motions of the ship sailing under real sea. Dynamic positioning system is an effective instrument used on board of the ships operating in the extraction of oil and gas in the continental shelf of the seas and oceans, being essential that the personnel on board of the vessel can maintain position and operating point or imposed on a route with high precision. By the adoption of a strict safety in terms of handling and positioning of the vessel in the vicinity of the drilling platform, the risk of accidents can be reduced to a minimum. Possibilities in anticipation amplitudes of the oscillatory movements of the ships navigating in real sea, is a challenge for naval architects and OCTOPUS software is a tool used increasingly more in this respect, complementing navigational facilities offered by dynamic positioning systems. This paper presents a study on the amplitudes of the oscillations categories of supply vessels in severe hydro meteorological conditions of navigation. The study provides information on the RAO (Response Amplitude Operator) response operator of the ship, for the amplitude of the roll movements, in some incident wave systems, interpreted using the energy spectrum Jonswap and whose characteristics are known (significant height of the wave, wave period, pulsation of the wave). Ship responses are analyzed according to different positioning of the ship in relation to the wave front (incident angle ranging from 10 to 10 degree from 0 to 180), highlighting the value of the ship roll motion amplitude. For the study, was used, as a tool for modeling and simulation, the features offered by OCTOPUS software that allows the study of the computerized behavior of the ship on the waves, in the real conditions of navigation. Program library was used for both the vessel itself and navigation modeling

Making sense in the edge of chaos : a framework for effective initial response efforts to large-scale incidents

OpenAIRE

Renaud, Cynthia E.

2010-01-01

CHDS State/Local Approved for public release; distribution is unlimited A review of response efforts to 9/11 revealed considerable challenges to resolving an event of this magnitude. To cope with these challenges, the federal government created the National Incident Management System (NIMS), an organizational structure intended to manage resources and channel communication between disparate agencies working together to solve a catastrophic crisis. Yet, first responders who have bee...

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

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

Energy Technology Data Exchange (ETDEWEB)

Stenner, Robert D.

2007-04-24

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

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...

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

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...

Answering the request for emergency assistance worldwide. The Incident and Emergency Centre (IEC)

International Nuclear Information System (INIS)

2007-01-01

In 2005, the IAEA announced the establishment of a fully integrated Incident and Emergency Centre (IEC). The functions of the IEC include coordinating prompt assistance to requesting States in the case of a nuclear security incident. As the global focal point for international preparedness, communication and response to nuclear and radiological incidents or emergencies irrespective of their cause, the IEC stands at the centre of coordinating effective and efficient activities worldwide. The IEC's work includes the evaluation of emergency plans and assistance in their development. The Centre also develops accident classifications based on plant conditions and supports effective communication between neighbouring countries. In addition, it develops various response procedures and facilitates national exercises on response to reactor emergencies. This includes training a broad range of IAEA staff to respond to emergencies as well as training of external experts. Response to incidents and emergencies can involve the exchange of information, provision of advice and/or the coordination of field response. In order to coordinate a global response, the IEC hosts a Response Assistance Network (RANET) under which Member States, Parties to the Emergency Conventions and relevant international organizations are able to register their response capabilities. This network aims to facilitate assistance in case of a nuclear or radiological incident or emergency in a timely and effective manner. An important component of the global emergency response system is the notification and reporting arrangements and systems operated by the IEC. The IEC operates systems that are reliable and secure. Member States, Non-Member States and international organizations have historically reported events and requests for assistance to the IAEA through the ENATOM arrangements using the ENAC web site, phone or fax. Under these arrangements, States have nominated Competent Authorities and National Warning

Resources planning for radiological incidents management

Science.gov (United States)

Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.

2017-01-01

Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.

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.

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.

Annual incidence and standardized incidence ratio of cerebrovascular accidents in patients with systemic lupus erythematosus.

Science.gov (United States)

Mok, C C; Ho, L Y; To, C H

2009-01-01

To study the annual incidence and standardized incidence ratio (SIR) of cerebrovascular accident (CVA) in patients with systemic lupus erythematosus (SLE). The annual incidence of CVA from 1999 to 2007 in a longitudinal cohort of SLE patients was calculated each year and compared with that of the regional population within the same study period. Age-specific SIRs and outcome of CVA in SLE patients were also studied. In 2007, there were 490 SLE patients in our cohort. The mean annual incidence of CVA between 1999 and 2007 was 6.45/1000 patients and no obvious trend over time was observed. Of the 20 CVAs in patients with SLE, 18 (90%) were ischaemic stroke whereas two (10%) were haemorrhagic stroke. The mean SIR of all types of CVA in SLE patients was 2.02 [95% confidence interval (CI) 1.30-3.81; p = 0.002]. The SIR of ischaemic stroke decreased with age and the stroke incidence was no longer significantly higher than that of the population in patients aged >or= 60 years. Haemorrhagic stroke occurred mainly in younger SLE patients. The duration of hospitalization and the mortality rate for CVA was non-significantly higher in SLE than in non-SLE patients. The incidence of CVA in SLE remained constant over the 8 years between 1999 and 2007. Younger SLE patients are at substantially increased risk of CVA compared to age-matched population. The duration of hospitalization and the mortality rate for CVA are similar in SLE and non-SLE patients.

An International Comparison of the Instigation and Design of Health Registers in the Epidemiological Response to Major Environmental Health Incidents.

Science.gov (United States)

Behbod, Behrooz; Leonardi, Giovanni; Motreff, Yvon; Beck, Charles R; Yzermans, Joris; Lebret, Erik; Muravov, Oleg I; Bayleyegn, Tesfaye; Wolkin, Amy Funk; Lauriola, Paolo; Close, Rebecca; Crabbe, Helen; Pirard, Philippe

Epidemiological preparedness is vital in providing relevant, transparent, and timely intelligence for the management, mitigation, and prevention of public health impacts following major environmental health incidents. A register is a set of records containing systematically collected, standardized data about individual people. Planning for a register of people affected by or exposed to an incident is one of the evolving tools in the public health preparedness and response arsenal. We compared and contrasted the instigation and design of health registers in the epidemiological response to major environmental health incidents in England, France, Italy, the Netherlands, and the United States. Consultation with experts from the 5 nations, supplemented with a review of gray and peer-reviewed scientific literature to identify examples where registers have been used. Populations affected by or at risk from major environmental health incidents in England, France, Italy, the Netherlands, and the United States. Nations were compared with respect to the (1) types of major incidents in their remit for considering a register; (2) arrangements for triggering a register; (3) approaches to design of register; (4) arrangements for register implementation; (5) uses of registers; and (6) examples of follow-up studies. Health registers have played a key role in the effective public health response to major environmental incidents, including sudden chemical, biological, radiological, or nuclear, as well as natural, more prolonged incidents. Value has been demonstrated in the early and rapid deployment of health registers, enabling the capture of a representative population. The decision to establish a health register must ideally be confirmed immediately or soon after the incident using a set of agreed criteria. The establishment of protocols for the instigation, design, and implementation of health registers is recommended as part of preparedness activities. Key stakeholders must be

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

Science.gov (United States)

Connell, Linda J.; Reynard, William D.

1993-01-01

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

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.

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.

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

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)

Cancer incidence in atomic bomb survivors. Part IV: Comparison of cancer incidence and mortality

International Nuclear Information System (INIS)

Ron, E.; Preston, D.L.; Mabuchi, Kiyohiko; Thompson, D.E.; Soda, Midori

1994-01-01

This report compares cancer incidence and mortality among atomic bomb survivors in the Radiation Effects Research Foundation Life Span Study (LSS) cohort. Because the incidence data are derived from the Hiroshima and Nagasaki tumor registries, case ascertainment is limited to the time (1958-1987) and geographic restrictions (Hiroshima and Nagasaki) of the registries, whereas mortality data are available from 1950-1987 anywhere in Japan. With these conditions, there were 9,014 first primary incident cancer cases identified among LSS cohort members compared with 7,308 deaths for which cancer was listed as the underlying cause of death on death certificates. When deaths were limited to those occurring between 1958-1987 in Hiroshima or Nagasaki, there were 3,155 more incident cancer cases overall, and 1,262 more cancers of the digestive system. For cancers of the oral cavity and pharynx, skin, breast, female and male genital organs, urinary system and thyroid, the incidence series was at least twice as large as the comparable mortality series. Although the incidence and mortality data are dissimilar in many ways, the overall conclusions regarding which solid cancers provide evidence of a significant dose response generally confirm the mortality findings. When either incidence or mortality data are evaluated, significant excess risks are observed for all solid cancers, stomach, colon, liver (when it is defined as primary liver cancer or liver cancer not otherwise specified on the death certificate), lung, breast, ovary and urinary bladder. No significant radiation effect is seen for cancers of the pharynx, rectum, gallbladder, pancreas, nose, larynx, uterus, prostate or kidney in either series. There is evidence of a significant excess of nonmelanoma skin cancer in the incidence data, but not in the mortality series. 19 refs., 2 figs., 10 tabs

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.

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)

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

Science.gov (United States)

Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.

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.

Occupational Safety and Health System for Workers Engaged in Emergency Response Operations in the USA.

Science.gov (United States)

Toyoda, Hiroyuki; Kubo, Tatsuhiko; Mori, Koji

2016-12-03

To study the occupational safety and health systems used for emergency response workers in the USA, we performed interviews with related federal agencies and conducted research on related studies. We visited the Federal Emergency Management Agency (FEMA) and National Institute for Occupational Safety and Health (NIOSH) in the USA and performed interviews with their managers on the agencies' roles in the national emergency response system. We also obtained information prepared for our visit from the USA's Occupational Safety and Health Administration (OSHA). In addition, we conducted research on related studies and information on the website of the agencies. We found that the USA had an established emergency response system based on their National Incident Management System (NIMS). This enabled several organizations to respond to emergencies cooperatively using a National Response Framework (NRF) that clarifies the roles and cooperative functions of each federal agency. The core system in NIMS was the Incident Command System (ICS), within which a Safety Officer was positioned as one of the command staff supporting the commander. All ICS staff were required to complete a training program specific to their position; in addition, the Safety Officer was required to have experience. The All-Hazards model was commonly used in the emergency response system. We found that FEMA coordinated support functions, and OSHA and NIOSH, which had specific functions to protect workers, worked cooperatively under NRF. These agencies employed certified industrial hygienists that play a professional role in safety and health. NIOSH recently executed support activities during disasters and other emergencies. The USA's emergency response system is characterized by functions that protect the lives and health of emergency response workers. Trained and experienced human resources support system effectiveness. The findings provided valuable information that could be used to improve the

Computer-Based Support of Decision Making Processes during Biological Incidents

Directory of Open Access Journals (Sweden)

Karel Antos

2010-04-01

Full Text Available The paper describes contextual analysis of a general system that should provide a computerized support of decision making processes related to response operations in case of a biological incident. This analysis is focused on information systems and information resources perspective and their integration using appropriate tools and technology. In the contextual design the basic modules of BioDSS system are suggested and further elaborated. The modules deal with incident description, scenarios development and recommendation of appropriate countermeasures. Proposals for further research are also included.

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

Science.gov (United States)

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

2015-01-01

The purpose of this paper is to explore sensemaking of incidents by health care professionals through an analysis of the role of professional identity in narratives of incidents. Using insights from social identity theory, the authors argue that incidents may create a threat of professional identity, and that professionals make use of identity management strategies in response to this identity threat. The paper draws on a qualitative analysis of incident narratives in 14 semi-structured interviews with physicians, nurses, and residents at a Dutch specialist hospital. The authors used an existing framework of identity management strategies to categorize the narratives. The analysis yielded two main results. First, nurses and residents employed multiple types of identity management strategies simultaneously, which points to the possible benefit of combining different strategies. Second, physicians used the strategy of patronization of other professional groups, a specific form of downward comparison. The authors discuss the implications of the findings in terms of the impact of identity management strategies on the perpetuation of hierarchical differences in health care. The authors argue that efforts to manage incident handling may profit from considering social identity processes in sensemaking of incidents. This is the first study that systematically explores how health care professionals use identity management strategies to maintain a positive professional identity in the face of incidents. This study contributes to research on interdisciplinary cooperation in health care.

Developing a highway emergency response plan for incidents involving hazardous materials, second edition, March 1992

International Nuclear Information System (INIS)

Anon.

1992-01-01

This provides minimum guidelines for developing an emergency response plan for incidents involving hazardous liquid hydrocarbons, such as gasoline and crude oil, transported in MC 306/DOT 406 and MC 307/DOT 407 aluminum cargo tanks and for coordinating and cooperating with local, state, and federal officials. This publication covers response plan priorities, personnel training, special equipment, media relations, environmental relations, and post-response activities. The apprendixes to this recommended practice outline a highway emergency response plan and suggest a procedure for removing liquid hydrocarbons from overturned cargo tanks and righting the tank vehicles

Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

Energy Technology Data Exchange (ETDEWEB)

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

2016-08-09

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

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

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

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

Directory of Open Access Journals (Sweden)

Ştefan Gheorghe PENTIUC

2011-01-01

Full Text Available This information system was made for its use by the staff responsible for random distribution of cases to the courts. The Information System of Resolution of Procedural Incidents and Management of the Modifications Made to the Electronic Court Registration consists of three new developed modules: the management module is a Web application which chronicles the modifications made in the electronic court registration, regarding the random assignment of cases,the resolution of procedural incidents, which is a Web service whose logic implements a logic Semantic Web application and the module of confirming judges which is a windows service running on the judges’ workstations. The Web service implements a Semantic Web application which processes the knowledgebase achieved through OWL ontology (Ontology Web Language by applying inferences leading to the correct solution. If this does not solve the problem, a set of associated Jena rules are used to infer and generate new knowledge. It also uses the SPARQL(SPARQL Protocol and RDF Query Language language that allows queries on the knowledge,similar to the classic query languages of databases. The novelty of the new conceived, designed and implemented system consists in accessing the domain knowledge as a web service to solve the procedural incidents occurred in electronic court registration.

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

Science.gov (United States)

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

2018-01-26

The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.

The role of the NEA incident reporting system in trend and pattern studies

International Nuclear Information System (INIS)

Ishack, G.; Iwabuchi, H.

1990-01-01

When the Incident Reporting System of the OECD Nuclear Energy Agency (NEA-IRS) was first instituted in 1980, Members recognized the fact that since the data thus collected only pertains to significant safety-related incidents, the system cannot be used for in-depth statistical analyses. Rather, the NEA-IRS is best suited, in addition to single event assessments, to studies that provide indications related to system, component or human performance; these indications could also initiate trend analyses on more complete data bases. Examples are the generic studies on the Loss of Containment Functions (completed last year) and the Loss of Residual Heat Removal (due for completion this year), and the studies related to the human factor. Another type of use of the IRS data was started last year by the NEA Principal Working Group 1 on Operating Experience and Human Factors (PWG 1) in response to the encouragement of the OECD/NEA Committee on the Safety of Nuclear Installations (CSNI), to make the best use of Operating Experience, notably of information disseminated through the NEA-IRS. These applications consisted of scanning the IRS data base for events that could be of interest to specialized domains such as radiation protection, fracture mechanics and fire protection. In the paragraphs which follow, some highlights of the results of these scans are presented (reference is made at the end of this paper to the reports detailing the results of these applications)

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

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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.

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

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

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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.

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)

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

Science.gov (United States)

Tucker, J B

1997-08-06

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

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

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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.

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

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

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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.

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.

[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.

Medication Incidents Related to Automated Dose Dispensing in Community Pharmacies and Hospitals - A Reporting System Study

Science.gov (United States)

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

2014-01-01

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

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...

State Methods for a Cyber Incident

Science.gov (United States)

2012-03-01

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

A five-year history of hazardous materials incidents in Chester County, PA

International Nuclear Information System (INIS)

Shorten, C.V.; McNamara, J.

1993-01-01

The Emergency Planning and Community Right-to-Know Act (EPCRA) of 1986 established Local Emergency Planning Committees (LEPCs) to oversee emergency response planning at the community level. In Pennsylvania, each county was assigned its own LEPC, and Chester County held its first LEPC meeting on October 15, 1987. From the data of that meeting through September 1992, 300 hazardous materials incidents have been reported. The majority of these incidents were met with fire department response, but several warranted response by hazardous materials teams. This report presents an analysis of the database of reported hazardous materials incidents in Chester County, including chemical identification, amount released, type of response, location, and trends. Over 235 of the reported spills were either gasoline, diesel fuel, home heating oil, or kerosene, often in five to 50 gallon amounts from transportation accidents. A number of extremely hazardous substance (EHS) incidents were reported, however, including sulfuric acid, chlorine, ammonia, phosphorus, formaldehyde, bromine, methyl mercaptan, and hydrofluoric acid. The most commonly released EHS's were ammonia and chlorine. The number of hazardous materials incidents reported in Chester County increased from only 14 in 1988 to 95 in 1991, with 67 in 1992 through September. This dramatic increase is attributable to both increased reporting and an increased number of incidents. This database clearly indicates both the success of EPCRA reporting system and the magnitude of hazardous materials incidents in this part of Pennsylvania

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

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/.

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)

Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents.

Science.gov (United States)

DeFraia, G S

2015-07-01

Psychologically traumatic workplace events (known as critical incidents) occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. 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 incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

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

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.

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.

Aplanatic grazing incidence diffraction grating: a new optical element

International Nuclear Information System (INIS)

Hettrick, M.C.

1986-01-01

We present the theory of a grazing incidence reflection grating capable of imaging at submicron resolution. The optic is mechanically ruled on a spherical or cylindrical surface with varied groove spacings, delivering diffraction-limited response and a wide field of view at a selected wavelength. Geometrical aberrations are calculated on the basis of Fermat's principle, revealing significant improvements over a grazing incidence mirror. Aplanatic and quasi-aplanatic versions of the grating have applications in both imaging and scanning microscopes, microprobes, collimators, and telescopes. A 2-D crossed system of such gratings, similar to the grazing incidence mirror geometry of Kirkpatrick and Baez, could potentially provide spatial resolutions of --200 A

Poster - 27: Incident Learning Practices in Ontario

Energy Technology Data Exchange (ETDEWEB)

Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina [The Ottawa Hospital Cancer Centre, Mississauga Halton/Central West Regional Cancer Center, Odette Cancer Centre, Cancer Care Ontario (Canada)

2016-08-15

Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

Poster - 27: Incident Learning Practices in Ontario

International Nuclear Information System (INIS)

Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina

2016-01-01

Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

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.

Literature review on medical incident command.

Science.gov (United States)

Rimstad, Rune; Braut, Geir Sverre

2015-04-01

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

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

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.

Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents

Directory of Open Access Journals (Sweden)

GS DeFraia

2015-07-01

Full Text Available Background: Psychologically traumatic workplace events (known as critical incidents occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. Objective: To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. 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 incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Results: Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Conclusion: Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

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.

[Results of provisional use of a system for voluntary anonymous reporting of incidents that threaten patient safety in the emergency medical services of Asturias].

Science.gov (United States)

Galván Núñez, Pablo; Santander Barrios, María Dolores; Villa Álvarez, María Cristina; Castro Delgado, Rafael; Alonso Lorenzo, Julio C; Arcos González, Pedro

2016-06-01

To describe the reported incidents and adverse events in the emergency medical services of Asturias, Spain, and assess their consequences, delays caused, and preventability. Prospective, observational study of incidents reported by the staff of the emergency medical services of Asturias after implementation of a system devised by the researchers. Incident reports were received for 0.48% (95% CI, 0.41%-0.54%) of the emergencies attended. Patient safety was compromised in 74.7% of the reported incidents. Problems arising in the emergency response coordination center (ERCC) accounted for 37.6% of the incidents, transport problems for 13.4%, vehicular problems for 10.8%, and communication problems for 8.8%. Seventy percent of the reported incidents caused delays in care; 55% of the reported incidents that put patients at risk (according to severity assessment code ratings) corresponded to problems related to human or material resources. A total of 88.1% of the incidents reported were considered avoidable. Some type of intervention was required to attenuate the effects of 46.2% of the adverse events reported. The measures that staff members most often proposed to prevent adverse events were to increase human and material resources (28.3%), establish protocols (14.5%), and comply with quality of care recommendations (9.7%). It is important to promote a culture of safety and incident reporting among health care staff in Asturias given the number of serious adverse events. Reporting is necessary for understanding the errors made and taking steps to prevent them. The ERCC is the point in the system where incidents are particularly likely to appear and be noticed and reported.

The design of a new criticality incident detection and alarm system

International Nuclear Information System (INIS)

Nobes, T.S.

1999-01-01

This paper presents a general review of criticality and its detection. After a brief description of what a criticality incident involves, an outline is given of detection methods and warning systems. (author)

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

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

Research of the system response of neutron double scatter imaging for MLEM reconstruction

Energy Technology Data Exchange (ETDEWEB)

Zhang, M., E-mail: wyj2013@163.com [Northwest Institute of Nuclear Technology, Xi’an 710024 (China); State Key Laboratory of Intense Pulsed Radiation-Simulation and Effect, Xi’an 710024 (China); Peng, B.D.; Sheng, L.; Li, K.N.; Zhang, X.P.; Li, Y.; Li, B.K.; Yuan, Y.; Wang, P.W.; Zhang, X.D.; Li, C.H. [Northwest Institute of Nuclear Technology, Xi’an 710024 (China); State Key Laboratory of Intense Pulsed Radiation-Simulation and Effect, Xi’an 710024 (China)

2015-03-01

A Maximum Likelihood image reconstruction technique has been applied to neutron scatter imaging. The response function of the imaging system can be obtained by Monte Carlo simulation, which is very time-consuming if the number of image pixels and particles is large. In this work, to improve time efficiency, an analytical approach based on the probability of neutron interaction and transport in the detector is developed to calculate the system response function. The response function was applied to calculate the relative efficiency of the neutron scatter imaging system as a function of the incident neutron energy. The calculated results agreed with simulations by the MCNP5 software. Then the maximum likelihood expectation maximization (MLEM) reconstruction method with the system response function was used to reconstruct data simulated by Monte Carlo method. The results showed that there was good consistency between the reconstruction position and true position. Compared with back-projection reconstruction, the improvement in image quality was obvious, and the locations could be discerned easily for multiple radiation point sources.

Surface Movement Incidents Reported to the NASA Aviation Safety Reporting System

Science.gov (United States)

Connell, Linda J.; Hubener, Simone

1997-01-01

Increasing numbers of aircraft are operating on the surface of airports throughout the world. Airport operations are forecast to grow by more that 50%, by the year 2005. Airport surface movement traffic would therefore be expected to become increasingly congested. Safety of these surface operations will become a focus as airport capacity planning efforts proceed toward the future. Several past events highlight the prevailing risks experienced while moving aircraft during ground operations on runways, taxiways, and other areas at terminal, gates, and ramps. The 1994 St. Louis accident between a taxiing Cessna crossing an active runway and colliding with a landing MD-80 emphasizes the importance of a fail-safe system for airport operations. The following study explores reports of incidents occurring on an airport surface that did not escalate to an accident event. The Aviation Safety Reporting System has collected data on surface movement incidents since 1976. This study sampled the reporting data from June, 1993 through June, 1994. The coding of the data was accomplished in several categories. The categories include location of airport, phase of ground operation, weather /lighting conditions, ground conflicts, flight crew characteristics, human factor considerations, and airport environment. These comparisons and distributions of variables contributing to surface movement incidents can be invaluable to future airport planning, accident prevention efforts, and system-wide improvements.

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…

Tactical and operational response to major incidents: feasibility and reliability of skills assessment using novel virtual environments.

Science.gov (United States)

Cohen, Daniel; Sevdalis, Nick; Patel, Vishal; Taylor, Michael; Lee, Henry; Vokes, Mick; Heys, Mick; Taylor, David; Batrick, Nicola; Darzi, Ara

2013-07-01

To determine feasibility and reliability of skills assessment in a multi-agency, triple-site major incident response exercise carried out in a virtual world environment. Skills assessment was carried out across three scenarios. The pre-hospital scenario required paramedics to triage and treat casualties at the site of an explosion. Technical skills assessment forms were developed using training syllabus competencies and national guidelines identified by pre-hospital response experts. Non-technical skills were assessed using a seven-point scale previously developed for use by pre-hospital paramedics. The two in-hospital scenarios, focusing on a trauma team leader and a silver/clinical major incident co-ordinator, utilised the validated Trauma-NOTECHS scale to assess five domains of performance. Technical competencies were assessed using an ATLS-style competency scale for the trauma scenario. For the silver scenario, the assessment document was developed using competencies described from a similar role description in a real-life hospital major incident plan. The technical and non-technical performance of all participants was assessed live by two experts in each of the three scenarios and inter-assessor reliability was computed. Participants also self-assessed their performance using identical proformas immediately after the scenarios were completed. Self and expert assessments were correlated (assessment cross-validation). Twenty-three participants underwent all scenarios and assessments. Performance assessments were feasible for both experts as well as the participants. Non-technical performance was generally scored higher than technical performance. Very good inter-rater reliability was obtained between expert raters across all scenarios and both technical and non-technical aspects of performance (reliability range 0.59-0.90, Psassessment in technical skills across all three scenarios (correlation range 0.52-0.84, Psskills. This study establishes feasibility and

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

Oblique incidence effects in direct x-ray detectors: A first-order approximation using a physics-based analytical model

International Nuclear Information System (INIS)

Badano, Aldo; Freed, Melanie; Fang Yuan

2011-01-01

Purpose: The authors describe the modifications to a previously developed analytical model of indirect CsI:Tl-based detector response required for studying oblique x-ray incidence effects in direct semiconductor-based detectors. This first-order approximation analysis allows the authors to describe the associated degradation in resolution in direct detectors and compare the predictions to the published data for indirect detectors. Methods: The proposed model is based on a physics-based analytical description developed by Freed et al. [''A fast, angle-dependent, analytical model of CsI detector response for optimization of 3D x-ray breast imaging systems,'' Med. Phys. 37(6), 2593-2605 (2010)] that describes detector response functions for indirect detectors and oblique incident x rays. The model, modified in this work to address direct detector response, describes the dependence of the response with x-ray energy, thickness of the transducer layer, and the depth-dependent blur and collection efficiency. Results: The authors report the detector response functions for indirect and direct detector models for typical thicknesses utilized in clinical systems for full-field digital mammography (150 μm for indirect CsI:Tl and 200 μm for a-Se direct detectors). The results suggest that the oblique incidence effect in a semiconductor detector differs from that in indirect detectors in two ways: The direct detector model produces a sharper overall PRF compared to the response corresponding to the indirect detector model for normal x-ray incidence and a larger relative increase in blur along the x-ray incidence direction compared to that found in indirect detectors with respect to the response at normal incidence angles. Conclusions: Compared to the effect seen in indirect detectors, the direct detector model exhibits a sharper response at normal x-ray incidence and a larger relative increase in blur along the x-ray incidence direction with respect to the blur in the

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.

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.)

Falling-incident detection and throughput enhancement in a multi-camera video-surveillance system.

Science.gov (United States)

Shieh, Wann-Yun; Huang, Ju-Chin

2012-09-01

For most elderly, unpredictable falling incidents may occur at the corner of stairs or a long corridor due to body frailty. If we delay to rescue a falling elder who is likely fainting, more serious consequent injury may occur. Traditional secure or video surveillance systems need caregivers to monitor a centralized screen continuously, or need an elder to wear sensors to detect falling incidents, which explicitly waste much human power or cause inconvenience for elders. In this paper, we propose an automatic falling-detection algorithm and implement this algorithm in a multi-camera video surveillance system. The algorithm uses each camera to fetch the images from the regions required to be monitored. It then uses a falling-pattern recognition algorithm to determine if a falling incident has occurred. If yes, system will send short messages to someone needs to be noticed. The algorithm has been implemented in a DSP-based hardware acceleration board for functionality proof. Simulation results show that the accuracy of falling detection can achieve at least 90% and the throughput of a four-camera surveillance system can be improved by about 2.1 times. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

Contributory factors in surgical incidents as delineated by a confidential reporting system.

Science.gov (United States)

Mushtaq, F; O'Driscoll, C; Smith, Fct; Wilkins, D; Kapur, N; Lawton, R

2018-05-01

Background Confidential reporting systems play a key role in capturing information about adverse surgical events. However, the value of these systems is limited if the reports that are generated are not subjected to systematic analysis. The aim of this study was to provide the first systematic analysis of data from a novel surgical confidential reporting system to delineate contributory factors in surgical incidents and document lessons that can be learned. Methods One-hundred and forty-five patient safety incidents submitted to the UK Confidential Reporting System for Surgery over a 10-year period were analysed using an adapted version of the empirically-grounded Yorkshire Contributory Factors Framework. Results The most common factors identified as contributing to reported surgical incidents were cognitive limitations (30.09%), communication failures (16.11%) and a lack of adherence to established policies and procedures (8.81%). The analysis also revealed that adverse events were only rarely related to an isolated, single factor (20.71%) - with the majority of cases involving multiple contributory factors (79.29% of all cases had more than one contributory factor). Examination of active failures - those closest in time and space to the adverse event - pointed to frequent coupling with latent, systems-related contributory factors. Conclusions Specific patterns of errors often underlie surgical adverse events and may therefore be amenable to targeted intervention, including particular forms of training. The findings in this paper confirm the view that surgical errors tend to be multi-factorial in nature, which also necessitates a multi-disciplinary and system-wide approach to bringing about improvements.

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)

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

Science.gov (United States)

DeFraia, Gary S

2013-01-01

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

CMSMAP : oil, chemical, search and rescue, and marine emergency response crisis management system

International Nuclear Information System (INIS)

Anderson, E.L.; Howlett, E.; Galagan, C.; Giguere, T.; Wee, F.; Chong, J.

2002-01-01

This paper describes a newly developed Crisis Management System (CMS) which makes it possible to view oil and chemical spills on the seafloor. The CMS is designed to run in a network environment, so that multiple stations can be used cooperatively to respond to a spill incident. It was developed by the Maritime and Port Authority in Singapore and represents a singular integration of a ship's bridge simulator hardware and software. It incorporates numerical models and emergency response software. The CMS is installed in a specifically designed building at the Singapore Polytechnic University, and is integrated with two shipping bridge simulators. One user interface has access to models dealing with oil spills, chemical spills, search and rescues, marine emergencies, and nuclear disasters. The interface is linked to a response management system. The entire system is used to train response personnel to marine emergencies. The histories and costs of planned response activities are described and logged for reference purposes. Estimates of damages associated with spills can be obtained. Alternative response plans can also be determined. Further research in 2002 will focus on developing real time response. 3 refs., 6 figs

Security System Responsive to Optical Fiber Having Bragg Grating

Science.gov (United States)

Gary, Charles K. (Inventor); Ozcan, Meric (Inventor)

1997-01-01

An optically responsive electronic lock is disclosed comprising an optical fiber serving as a key and having Bragg gratings placed therein. Further, an identification system is disclosed which has the optical fiber serving as means for tagging and identifying an object. The key or tagged object is inserted into a respective receptacle and the Bragg gratings cause the optical fiber to reflect a predetermined frequency spectra pattern of incident light which is detected by a decoder and compared against a predetermined spectrum to determine if an electrical signal is generated to either operate the lock or light a display of an authentication panel.

Rapid response systems.

Science.gov (United States)

Lyons, Patrick G; Edelson, Dana P; Churpek, Matthew M

2018-07-01

Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. Articles written in English and published in PubMed. Rapid response systems are heterogeneous, with important differences among afferent and efferent arms. Clinically meaningful outcomes may include unexpected mortality, in-hospital cardiac arrest, length of stay, cost, and processes of care at end of life. Both positive and negative interventional studies have been published, although the two largest randomized trials involving rapid response systems - the Medical Early Response and Intervention Trial (MERIT) and the Effect of a Pediatric Early Warning System on All-Cause Mortality in Hospitalized Pediatric Patients (EPOCH) trial - did not find a mortality benefit with these systems, albeit with important limitations. Advances in monitoring technologies, risk assessment strategies, and behavioral ergonomics may offer opportunities for improvement. Rapid responses may improve some meaningful outcomes, although these findings remain controversial. These systems may also improve care for patients at the end of life. Rapid response systems are expected to continue evolving with novel developments in monitoring technologies, risk prediction informatics, and work in human factors. Copyright © 2018 Elsevier B.V. All rights reserved.

The on scene command and control system (OSC2) : an integrated incident command system (ICS) forms-database management system and oil spill trajectory and fates model

International Nuclear Information System (INIS)

Anderson, E.; Galagan, C.; Howlett, E.

1998-01-01

The On Scene Command and Control (OSC 2 ) system is an oil spill modeling tool which was developed to combine Incident Command System (ICS) forms, an underlying database, an integrated geographical information system (GIS) and an oil spill trajectory and fate model. The first use of the prototype OSC 2 system was at a PREP drill conducted at the U.S. Coast Guard Marine Safety Office, San Diego, in April 1998. The goal of the drill was to simulate a real-time response over a 36-hour period using the Unified Command System. The simulated spill was the result of a collision between two vessels inside San Diego Bay that caused the release of 2,000 barrels of fuel oil. The hardware component of the system which was tested included three notebook computers, two laser printers, and a poster printer. The field test was a success but it was not a rigorous test of the system's capabilities. The map display was useful in quickly setting up the ICS divisions and groups and in deploying resources. 6 refs., 1 tab., 5 figs

The Incidence of Primary Systemic Vasculitis in Jerusalem: A 20-year Hospital-based Retrospective Study.

Science.gov (United States)

Nesher, Gideon; Ben-Chetrit, Eli; Mazal, Bracha; Breuer, Gabriel S

2016-06-01

The incidence of primary systemic vasculitides varies among different geographic regions and ethnic origins. The aim of this study was to examine the incidence rates of vasculitides in the Jerusalem Jewish population, and to examine possible trends in incidence rates over a 20-year period. The clinical databases of inpatients at the 2 medical centers in Jerusalem were searched for patients with vasculitis diagnosed between 1990-2009. Individual records were then reviewed by one of the authors. The significance of trends in incidence rates throughout the study period was evaluated by Pearson correlation coefficient. The average annual incidence rate of polyarteritis nodosa was 3.6/million adults (95% CI 1.6-4.7). Incidence rates did not change significantly during this period (r = 0.39, p = 0.088). The incidence of granulomatosis with polyangiitis (GPA) was 4.1 (2.2-5.9) for the whole period, during which it increased significantly (r = 0.53, p Jerusalem are in the lower range of global incidence rates. While GPA and MPA incidence are increasing, GCA incidence is decreasing.

MO-G-BRE-06: Metrics of Success: Measuring Participation and Attitudes Related to Near-Miss Incident Learning Systems

Energy Technology Data Exchange (ETDEWEB)

Nyflot, MJ; Kusano, AS; Zeng, J; Carlson, JC; Novak, A; Sponseller, P; Jordan, L; Kane, G; Ford, EC [University of Washington, Seattle, WA (United States)

2014-06-15

Purpose: Interest in incident learning systems (ILS) for improving safety and quality in radiation oncology is growing, as evidenced by the upcoming release of the national ILS. However, an institution implementing such a system would benefit from quantitative metrics to evaluate performance and impact. We developed metrics to measure volume of reporting, severity of reported incidents, and changes in staff attitudes over time from implementation of our institutional ILS. Methods: We analyzed 2023 incidents from our departmental ILS from 2/2012–2/2014. Incidents were prospectively assigned a near-miss severity index (NMSI) at multidisciplinary review to evaluate the potential for error ranging from 0 to 4 (no harm to critical). Total incidents reported, unique users reporting, and average NMSI were evaluated over time. Additionally, departmental safety attitudes were assessed through a 26 point survey adapted from the AHRQ Hospital Survey on Patient Safety Culture before, 12 months, and 24 months after implementation of the incident learning system. Results: Participation in the ILS increased as demonstrated by total reports (approximately 2.12 additional reports/month) and unique users reporting (0.51 additional users reporting/month). Also, the average NMSI of reports trended lower over time, significantly decreasing after 12 months of reporting (p<0.001) but with no significant change at months 18 or 24. In survey data significant improvements were noted in many dimensions, including perceived barriers to reporting incidents such as concern of embarrassment (37% to 18%; p=0.02) as well as knowledge of what incidents to report, how to report them, and confidence that these reports were used to improve safety processes. Conclusion: Over a two-year period, our departmental ILS was used more frequently, incidents became less severe, and staff confidence in the system improved. The metrics used here may be useful for other institutions seeking to create or evaluate

MO-G-BRE-06: Metrics of Success: Measuring Participation and Attitudes Related to Near-Miss Incident Learning Systems

International Nuclear Information System (INIS)

Nyflot, MJ; Kusano, AS; Zeng, J; Carlson, JC; Novak, A; Sponseller, P; Jordan, L; Kane, G; Ford, EC

2014-01-01

Purpose: Interest in incident learning systems (ILS) for improving safety and quality in radiation oncology is growing, as evidenced by the upcoming release of the national ILS. However, an institution implementing such a system would benefit from quantitative metrics to evaluate performance and impact. We developed metrics to measure volume of reporting, severity of reported incidents, and changes in staff attitudes over time from implementation of our institutional ILS. Methods: We analyzed 2023 incidents from our departmental ILS from 2/2012–2/2014. Incidents were prospectively assigned a near-miss severity index (NMSI) at multidisciplinary review to evaluate the potential for error ranging from 0 to 4 (no harm to critical). Total incidents reported, unique users reporting, and average NMSI were evaluated over time. Additionally, departmental safety attitudes were assessed through a 26 point survey adapted from the AHRQ Hospital Survey on Patient Safety Culture before, 12 months, and 24 months after implementation of the incident learning system. Results: Participation in the ILS increased as demonstrated by total reports (approximately 2.12 additional reports/month) and unique users reporting (0.51 additional users reporting/month). Also, the average NMSI of reports trended lower over time, significantly decreasing after 12 months of reporting (p<0.001) but with no significant change at months 18 or 24. In survey data significant improvements were noted in many dimensions, including perceived barriers to reporting incidents such as concern of embarrassment (37% to 18%; p=0.02) as well as knowledge of what incidents to report, how to report them, and confidence that these reports were used to improve safety processes. Conclusion: Over a two-year period, our departmental ILS was used more frequently, incidents became less severe, and staff confidence in the system improved. The metrics used here may be useful for other institutions seeking to create or evaluate

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.

Radiological incident preparedness for community hospitals: a demonstration project.

Science.gov (United States)

Jafari, Mary Ellen

2010-08-01

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

To Take Care of Them: An Ethical Case Study of the Canal Incident

Science.gov (United States)

2013-06-14

opinions, emotional responses, and systems such as ethical relativism ,87 divine command theory,88 utilitarianism,89 deontology,90 and virtue ethics .91...TO TAKE CARE OF THEM: AN ETHICAL CASE STUDY OF THE CANAL INCIDENT A... ETHICAL CASE STUDY OF THE CANAL INCIDENT 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Emmitt Maxwell Furner II 5d. PROJECT

Measurable improvement in patient safety culture: A departmental experience with incident learning.

Science.gov (United States)

Kusano, Aaron S; Nyflot, Matthew J; Zeng, Jing; Sponseller, Patricia A; Ermoian, Ralph; Jordan, Loucille; Carlson, Joshua; Novak, Avrey; Kane, Gabrielle; Ford, Eric C

2015-01-01

Rigorous use of departmental incident learning is integral to improving patient safety and quality of care. The goal of this study was to quantify the impact of a high-volume, departmental incident learning system on patient safety culture. A prospective, voluntary, electronic incident learning system was implemented in February 2012 with the intent of tracking near-miss/no-harm incidents. All incident reports were reviewed weekly by a multiprofessional team with regular department-wide feedback. Patient safety culture was measured at baseline with validated patient safety culture survey questions. A repeat survey was conducted after 1 and 2 years of departmental incident learning. Proportional changes were compared by χ(2) or Fisher exact test, where appropriate. Between 2012 and 2014, a total of 1897 error/near-miss incidents were reported, representing an average of 1 near-miss report per patient treated. Reports were filed by a cross section of staff, with the majority of incidents reported by therapists, dosimetrists, and physicists. Survey response rates at baseline and 1 and 2 years were 78%, 80%, and 80%, respectively. Statistically significant and sustained improvements were noted in several safety metrics, including belief that the department was openly discussing ways to improve safety, the sense that reports were being used for safety improvement, and the sense that changes were being evaluated for effectiveness. None of the surveyed dimensions of patient safety culture worsened. Fewer punitive concerns were noted, with statistically significant decreases in the worry of embarrassment in front of colleagues and fear of getting colleagues in trouble. A comprehensive incident learning system can identify many areas for improvement and is associated with significant and sustained improvements in patient safety culture. These data provide valuable guidance as incident learning systems become more widely used in radiation oncology. Copyright © 2015

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

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

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

Committee's report on ruthenium fall-out incident

International Nuclear Information System (INIS)

Borkowski, C.J.; Crawford, J.H.; Livingston, R.; Ritchie, R.H.; Rupp, A.F.; Taylor, E.H.

1983-07-01

Investigations of the fall-out incident of November 11 and 12, 1959, by responsible parties (Health Physics Division and Operations Division personnel) established beyond reasonable doubt that the incident had its origin in the expulsion of particles, heavily contaminated with ruthenium, which had been detached from the walls of the electric fan housing and ducts in the off-gas system associated with the brick stack. All available evidence indicates that the particles were loosened during maintenance work on the exhaust damper and the bearings of the electric fan and were carried up the stack in two bursts as particulate fall-out when this fan was put back into service. Radiographic and chemical analysis showed the activity to be almost entirely ruthenium (Ru 106 ) and its daughter rhodium (Rh 106 ) with very little, if any, strontium being present. This report summarizes the findings and sets forth the conclusions and recommendations of the Committee asked to investigate the incident

Improving patient safety: how and why incidences occur in nursing care

Directory of Open Access Journals (Sweden)

Maria Cecilia Toffoletto

2013-10-01

Full Text Available The present investigation was a cross-sectional, quantitative research study analyzing incidents associated with nursing care using a root-cause methodological analysis. The study was conducted in a public hospital intensive care unit (ICU in Santiago de Chile and investigated 18 incidents related to nursing care that occurred from January to March of 2012. The sample was composed of six cases involving medications and the self-removal of therapeutic devices. The contributing factors were related to the tasks and technology, the professional work team, the patients, and the environment. The analysis confirmed that the cases presented with similar contributing factors, thereby indicating that the vulnerable aspects of the system are primarily responsible for the incidence occurrence. We conclude that root-cause analysis facilitates the identification of these vulnerable points. Proactive management in system-error prevention is made possible by recommendations.

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

Energy Technology Data Exchange (ETDEWEB)

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

2006-07-01

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

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

International Nuclear Information System (INIS)

Guidry, R.J.

2006-01-01

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

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.

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...

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 ...

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2009-09-01

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

Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database.

Science.gov (United States)

Cooper, Jennifer; Edwards, Adrian; Williams, Huw; Sheikh, Aziz; Parry, Gareth; Hibbert, Peter; Butlin, Amy; Donaldson, Liam; Carson-Stevens, Andrew

2017-09-01

A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%-47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others' behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture. © 2017 Annals of Family Medicine, Inc.

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.

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

Oil Notifications: Emergency Response Notification System (ERNS) fact sheet

International Nuclear Information System (INIS)

1992-04-01

The Emergency Response Notification System (ERNS) is a national computer database which provides the only centralized mechanism for documenting and verifying incident notification information as initially reported to the National Response Center (NRC), the U.S. Environmental Protection Agency (EPA), and to a limited extent, the U.S. Coast Guard (USCG). The initial notification data may be followed up with updated information from various Federal, State and local response authorities, as appropriate. ERNS contains data that can be used to analyze release notifications, support emergency planning efforts, and assist decision makers in developing spill prevention programs. The fact sheet provides summary information on notifications of releases of oil reported in accordance with the Clean Water Act (CWA). Under Section 311 of the CWA, discharges of oil which: (1) cause a sheen to appear on the surface of the water; (2) violate applicable water quality standards; or (3) cause sludge or emulsion to be deposited beneath the surface of the water or adjoining shoreline, must be reported to the NRC

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

Tunable optical response at the plasmon-polariton frequency in dielectric-graphene-metamaterial systems

Science.gov (United States)

Calvo-Velasco, D. M.; Porras-Montenegro, N.

2018-04-01

By using the scattering matrix formalism, it is studied the optical properties of one dimensional photonic crystals made of multiple layers of dielectric and uniaxial anisotropic single negative electric metamaterial with Drude type responses, with inclusions of graphene in between the dielectric-dielectric interfaces (DGMPC). The transmission spectra for transverse electric (TE) and magnetic (TM) polarization are presented as a function of the incidence angle, the graphene chemical potential, and the metamaterial plasma frequencies. It is found for the TM polarization the tunability of the DGMPC optical response with the graphene chemical potential, which can be observed by means of transmission or reflexion bands around the metamaterial plasmon-polariton frequency, with bandwidths depending on both the incidence angle and the metamaterial plasma frequency. Also, the transmission band is observed when losses in the metamaterial slabs are considered for finite systems. The conditions for the appearance of these bands are shown analytically. We consider this work contributes to open new possibilities to the design of photonic devices with DGMPCs.

System of medical response to radiation emergency after a terror attack in China

International Nuclear Information System (INIS)

Liu, Y.; Wang, Z.

2005-01-01

Full text: Nuclear or radiological accident is an unintended or unexpected event occurring with a radiation source or during a practice involving ionizing radiation, which may result in significant human exposure and/or material damage. Recent events involving terrorist activities have focused attention on the radiological threats. The full spectrum of radiological threats from terrorist spans the deliberate dispersal of radioactive material to the detonation of a nuclear weapon. While the most likely threat is the dispersal of radioactive materials, the use of a crude nuclear weapon against a major city cannot be dismissed. Radiological incident response requires functions similar to non-radiological incident response. Radiation emergency system in China has been established for radiological emergency preparedness and response. National coordination committee of radiation emergency has been setup in 1994, which consist of 17 ministries. The ministry is responsible for the medical assistance for radiation emergency. Chinese Center for Medical Response to Radiation Emergency (CCMRRE) was established in 1992, based on the National Institute for Radiological Protection, China CDC (NIRP, China CDC). The CCMRRE has been as one liaison institutes of WHO/REMPAN and functions as a national and professional institute for medical assistance in radiation accidents and terrorist events involving radioactive material. Under Provincial Committee of Radiation Emergency, there are local organizations of medical assistance in radiation emergency. The organizations carry out the first aid, regional clinic treatment, radiation protection and radiation monitory in nuclear accidents and radiological accidents. (author)

The incidence of necrotizing enterocolitis is increased following probiotic administration to preterm pigs

DEFF Research Database (Denmark)

Cilieborg, Malene Skovsted; Thymann, Thomas; Siggers, Richard Harvey

2011-01-01

with controls (n = 14). All pigs received parenteral nutrition for 2 d followed by enteral formula feeding until tissue collection on d 5. Compared with control pigs, intestinal weight was lower and NEC incidence was higher in both groups given probiotics (64–67 vs. 14%; P... immature gut immune system and low NEC incidence in the control group. It remains to be determined whether similar adverse responses to probiotics occur in preterm infants...

Nonbronchial systemic arteries: incidence and endovascular interventional management for hemoptysis

International Nuclear Information System (INIS)

Jiang Sen; Zhu Xiaohua; Sun Xiwen; You Zhengqian; Ma Jun; Yu Dong; Peng Gang; Jie Bing; Sun Chunyi

2009-01-01

Objective: To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsibly NBSA for hemoptysis. Methods: The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectasis in 41 (1 case with post-lobectomy and 1 case with post-ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results: Seventy-three patients (52.5%) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 case with post-ligation of patent ductus arteriosus, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n=88), internal thoracic arteries (n=27), inferior phrenic arteries (n=21), proper esophageal arteries (n=20), lateral thoracic arteries (n=9), subscapular arteries (n=7), costocervical trunks (n=5) and thyrocervical trunks (n=4). Main responsible NBSA were posterior intercostal arteries (n=75) and branches of subclavian and axillary artery (n=44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n=16) and inferior phrenic arteries (n=17) in bronchiectasis. The clinical

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.

A quantification of the effectiveness of EPID dosimetry and software-based plan verification systems in detecting incidents in radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Bojechko, Casey; Phillps, Mark; Kalet, Alan; Ford, Eric C., E-mail: eford@uw.edu [Department of Radiation Oncology, University of Washington, 1959 N. E. Pacific Street, Seattle, Washington 98195 (United States)

2015-09-15

Purpose: Complex treatments in radiation therapy require robust verification in order to prevent errors that can adversely affect the patient. For this purpose, the authors estimate the effectiveness of detecting errors with a “defense in depth” system composed of electronic portal imaging device (EPID) based dosimetry and a software-based system composed of rules-based and Bayesian network verifications. Methods: The authors analyzed incidents with a high potential severity score, scored as a 3 or 4 on a 4 point scale, recorded in an in-house voluntary incident reporting system, collected from February 2012 to August 2014. The incidents were categorized into different failure modes. The detectability, defined as the number of incidents that are detectable divided total number of incidents, was calculated for each failure mode. Results: In total, 343 incidents were used in this study. Of the incidents 67% were related to photon external beam therapy (EBRT). The majority of the EBRT incidents were related to patient positioning and only a small number of these could be detected by EPID dosimetry when performed prior to treatment (6%). A large fraction could be detected by in vivo dosimetry performed during the first fraction (74%). Rules-based and Bayesian network verifications were found to be complimentary to EPID dosimetry, able to detect errors related to patient prescriptions and documentation, and errors unrelated to photon EBRT. Combining all of the verification steps together, 91% of all EBRT incidents could be detected. Conclusions: This study shows that the defense in depth system is potentially able to detect a large majority of incidents. The most effective EPID-based dosimetry verification is in vivo measurements during the first fraction and is complemented by rules-based and Bayesian network plan checking.

Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China

Directory of Open Access Journals (Sweden)

Weili Duan

2015-07-01

Full Text Available In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs is a significant issue in China. An emergency response system (ERS was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency.

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.

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

Directory of Open Access Journals (Sweden)

Márcia de Nazaré Oliveira Ribeiro

2015-04-01

Full Text Available Conventional pruning is a very common practice for pruning rose cultivars in Brazil. However, few Brazilian producers known any other efficient plant training method for roses, namely “lateral stem bending” or “arching technique”, which involves bending the branches of the rosebush in order to increase the photosynthetic rate of the plant. As well as plant training, the use of fertilizers must also be done carefully in order to obtain high quality roses. Biofertilizers are recommended because of their multiple effects: fertilizer, protein synthesis stimulant, insect repellent, and disease controller. The aim of this study was to assess the plant training system and management of organic fertilizer on the incidence and severity of disease in the ‘Osiana’ and ‘Carola’ roses. The ‘Osiana’ rosebushes received three concentrations (0%, 5%, and 15% of foliar biofertilizer applied monthly to the leaves together with two plant conduction methods (conventional pruning and lateral stem bending. ‘Carola’ roses were treated with three types of fertilizer (chemical fertilizer on the soil + bokashi on the soil, chemical fertilizer on the soil + foliar FishfertilÒand chemical fertilization on the soil without applying organic fertilizers every two weeks, together with 2 plant conduction systems (conventional pruning and lateral stem bending. The additional treatments in ‘Carola’ roses were composed of two organic fertilizers (Bokashi and foliar Fishfertil® and chemical fertilization with lateral pruning. The incidence and severity of disease in these plants during the experiment were assessed over 5 months. For the ‘Osiana’ rose, the incidence and severity of disease were not influenced by fertilizer management or plant training methods. For the ‘Carola’ roses, the different types of fertilizer caused different responses according to the plant training system used, with the biofertilizer Fishfertil® reducing the incidence

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...

Developing a hazmat incident evaluation program

International Nuclear Information System (INIS)

Williams, D.L.; Kaikumba, F.

1991-01-01

This paper reports that all communities are at risk of experiencing a hazardous materials incident, whether in transportation or at a fixed facility (such as petroleum refineries, oil fields, processing plants, etc.). However, many communities are unprepared to cope with this emergency. Administrators of state agencies and local response organizations often face fierce competition for tax dollars in support of their hazardous materials emergency response programs. Historically, little statistical information has been available to support their call for additional budget dollars in the areas of personnel, training, and equipment. It is difficult to plan for an emergency when you have little understanding of the risks, the frequency of incidents, the type of chemicals generally involved, and other vital information. The Illinois Hazardous Materials Incident Evaluation Program was designed to address the state and local needs, and position government and industry in a more responsive and proactive mode. The result is a program that works

Hazardous materials incidents on major highways -- A case study

International Nuclear Information System (INIS)

McElhaney, M.S.

1995-01-01

Personnel from both the public and private sectors have been involved for many years in pre-planning for hazardous materials releases at fixed installations all over the world. As a result of several major petroleum releases during marine transportation, oil companies, private contractors and government agencies have been preparing contingency plans for oil spills and other petroleum product releases in marine settings. Various industry groups have also developed plans for railway and pipeline disasters. These response plans are of varying quality, complexity and usefulness. Organizations such as plant emergency response teams, government agencies, contract response and clean-up crews and fire departments use these plans as a basis for training and resource allocation, hopefully becoming familiar enough with them that the plans are truly useful when product releases occur. Planners and emergency responders to hazardous materials releases must overcome some of the deficiencies which have long stood in the way of efficient and effective response and mitigation efforts. Specifically they must recognize and involve all resources with which they may respond or interact during an incident. This involvement should begin with the planning stages and carry through to training and emergency response and recovery efforts. They must ensure that they adopt and utilize a common command and control system and that all potential resources know this system thoroughly and train together before the incident occurs. It is only through incorporating these two factors that may successfully combat the ever growing number of unwanted product releases occurring in the more difficult realm of transportation

Error-Based Accidents and Security Incidents in Nuclear Materials Management

International Nuclear Information System (INIS)

Pond, Daniel J.; Greitzer, Frank L.

2005-01-01

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

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

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…

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.

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

The role of poison control centers in CBRN incidents

International Nuclear Information System (INIS)

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

2009-01-01

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

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)

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)

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

Seismic Response of Power Transmission Tower-Line System Subjected to Spatially Varying Ground Motions

Directory of Open Access Journals (Sweden)

Li Tian

2010-01-01

Full Text Available The behavior of power transmission tower-line system subjected to spatially varying base excitations is studied in this paper. The transmission towers are modeled by beam elements while the transmission lines are modeled by cable elements that account for the nonlinear geometry of the cables. The real multistation data from SMART-1 are used to analyze the system response subjected to spatially varying ground motions. The seismic input waves for vertical and horizontal ground motions are also generated based on the Code for Design of Seismic of Electrical Installations. Both the incoherency of seismic waves and wave travel effects are accounted for. The nonlinear time history analytical method is used in the analysis. The effects of boundary conditions, ground motion spatial variations, the incident angle of the seismic wave, coherency loss, and wave travel on the system are investigated. The results show that the uniform ground motion at all supports of system does not provide the most critical case for the response calculations.

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…

Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

Science.gov (United States)

Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

2016-02-09

This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

International Nuclear Information System (INIS)

Wilpert, B.

1994-01-01

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

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.).

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

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.

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.

Teachers' Critical Incidents: Ethical Dilemmas in Teaching Practice

Science.gov (United States)

Shapira-Lishchinsky, Orly

2011-01-01

The aim of this study is to explore ethical dilemmas in critical incidents and the emerged responses that these incidents elicit. Most teachers try to suppress these incidences because of the unpleasant feelings they evoke. Fifty teachers participated in the study. A three-stage coding process derived from grounded theory was utilized. A taxonomy…

The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies.

Science.gov (United States)

Rees, Frances; Doherty, Michael; Grainge, Matthew J; Lanyon, Peter; Zhang, Weiya

2017-11-01

The aim was to review the worldwide incidence and prevalence of SLE and variation with age, sex, ethnicity and time. A systematic search of MEDLINE and EMBASE search engines was carried out using Medical Subject Headings and keyword search terms for Systemic Lupus Erythematosus combined with incidence, prevalence and epidemiology in August 2013 and updated in September 2016. Author, journal, year of publication, country, region, case-finding method, study period, number of incident or prevalent cases, incidence (per 100 000 person-years) or prevalence (per 100 000 persons) and age, sex or ethnic group-specific incidence or prevalence were collected. The highest estimates of incidence and prevalence of SLE were in North America [23.2/100 000 person-years (95% CI: 23.4, 24.0) and 241/100 000 people (95% CI: 130, 352), respectively]. The lowest incidences of SLE were reported in Africa and Ukraine (0.3/100 000 person-years), and the lowest prevalence was in Northern Australia (0 cases in a sample of 847 people). Women were more frequently affected than men for every age and ethnic group. Incidence peaked in middle adulthood and occurred later for men. People of Black ethnicity had the highest incidence and prevalence of SLE, whereas those with White ethnicity had the lowest incidence and prevalence. There appeared to be an increasing trend of SLE prevalence with time. There are worldwide differences in the incidence and prevalence of SLE that vary with sex, age, ethnicity and time. Further study of genetic and environmental risk factors may explain the reasons for these differences. More epidemiological studies in Africa are warranted. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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.

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)

Artificial phototropism based on a photo-thermo-responsive hydrogel

Science.gov (United States)

Gopalakrishna, Hamsini

Solar energy is leading in renewable energy sources and the aspects surrounding the efforts to harvest light are gaining importance. One such aspect is increasing the light absorption, where heliotropism comes into play. Heliotropism, the ability to track the sun across the sky, can be integrated with solar cells for more efficient photon collection and other optoelectronic systems. Inspired by plants, which optimize incident sunlight in nature, several researchers have made artificial heliotropic and phototropic systems. This project aims to design, synthesize and characterize a material system and evaluate its application in a phototropic system. A gold nanoparticle (Au NP) incorporated poly(N-isopropylacrylamide) (PNIPAAm) hydrogel was synthesized as a photo-thermo-responsive material in our phototropic system. The Au NPs generate heat from the incident via plasmonic resonance to induce a volume phase change of the thermo-responsive hydrogel PNIPAAm. PNIPAAm shrinks or swells at temperature above or below 32°C. Upon irradiation, the Au NP-PNIPAAm micropillar actuates, specifically bending toward the incident light and precisely following the varying incident angle. Swelling ratio tests, bending angle tests with a static incident light and bending tests with varying angles were carried out on hydrogel samples with varying Au NP concentrations. Swelling ratios ranging from 1.45 to 2.9 were recorded for pure hydrogel samples and samples with very low Au NP concentrations. Swelling ratios of 2.41 and 3.37 were calculated for samples with low and high concentrations of Au NPs, respectively. A bending of up to 88° was observed in Au NP-hydrogel pillars with a low Au NP concentration with a 90° incident angle. The light tracking performance was assessed by the slope of the pillar Bending angle (response angle) vs. Incident light angle plot. A slope of 1 indicates ideal tracking with top of the pillar being normal to the incident light, maximizing the photon

A global model of malaria climate sensitivity: comparing malaria response to historic climate data based on simulation and officially reported malaria incidence

Directory of Open Access Journals (Sweden)

Edlund Stefan

2012-09-01

Full Text Available Abstract Background The role of the Anopheles vector in malaria transmission and the effect of climate on Anopheles populations are well established. Models of the impact of climate change on the global malaria burden now have access to high-resolution climate data, but malaria surveillance data tends to be less precise, making model calibration problematic. Measurement of malaria response to fluctuations in climate variables offers a way to address these difficulties. Given the demonstrated sensitivity of malaria transmission to vector capacity, this work tests response functions to fluctuations in land surface temperature and precipitation. Methods This study of regional sensitivity of malaria incidence to year-to-year climate variations used an extended Macdonald Ross compartmental disease model (to compute malaria incidence built on top of a global Anopheles vector capacity model (based on 10 years of satellite climate data. The predicted incidence was compared with estimates from the World Health Organization and the Malaria Atlas. The models and denominator data used are freely available through the Eclipse Foundation’s Spatiotemporal Epidemiological Modeller (STEM. Results Although the absolute scale factor relating reported malaria to absolute incidence is uncertain, there is a positive correlation between predicted and reported year-to-year variation in malaria burden with an averaged root mean square (RMS error of 25% comparing normalized incidence across 86 countries. Based on this, the proposed measure of sensitivity of malaria to variations in climate variables indicates locations where malaria is most likely to increase or decrease in response to specific climate factors. Bootstrapping measures the increased uncertainty in predicting malaria sensitivity when reporting is restricted to national level and an annual basis. Results indicate a potential 20x improvement in accuracy if data were available at the level ISO 3166–2

Contaminated Mexican steel incident

International Nuclear Information System (INIS)

1985-01-01

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

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

Critical incidents: exploring theory policy and practice

OpenAIRE

Beeke, Matthew A.

2011-01-01

Responding to critical incidents in school communities has become an established part of the practice of educational psychologists (EPs). Despite this the EP professional journal literature is sparse, the last major study being conducted by Houghton in 1996. Within a mixed methods design this study aimed to explore various aspects of EP practice in response to critical incidents. Firstly, critical incident policy and EP journal literature was examined to provide a definition...

Overview and Evaluation of a Smoke Modeling System and other Tools used during Wildfire Incident Deployments

Science.gov (United States)

ONeill, S. M.; Larkin, N. K.; Martinez, M.; Rorig, M.; Solomon, R. C.; Dubowy, J.; Lahm, P. W.

2017-12-01

Specialists operationally deployed to wildfires to forecast expected smoke conditions for the public use many tools and information. These Air Resource Advisors (ARAs) are deployed as part of the Wildland Fire Air Quality Response Program (WFAQRP) and rely on smoke models, monitoring data, meteorological information, and satellite information to produce daily Smoke Outlooks for a region impacted by smoke from wildfires. These Smoke Outlooks are distributed to air quality and health agencies, published online via smoke blogs and other social media, and distributed by the Incident Public Information Officer (PIO), and ultimately to the public. Fundamental to these operations are smoke modeling systems such as the BlueSky Smoke Modeling Framework, which combines fire activity information, mapped fuel loadings, consumption and emissions models, and air quality/dispersion models such as HYSPLIT to produce predictions of PM2.5 concentrations downwind of wildland fires. Performance of this system at a variety of meteorological resolutions, fire initialization information, and vertical allocation of emissions is evaluated for the Summer of 2015 when over 400,000 hectares burned in the northwestern US state of Washington and 1-hr average fine particulate matter (PM2.5) concentrations exceeded 700 μg/m3. The performance of the system at the 12-km, 4-km, and 1.33-km resolutions is evaluated using 1-hr average PM2.5 measurements from permanent monitors and temporary monitors deployed specifically for wildfires by ARAs on wildfire incident command teams. At the higher meteorological resolution (1.33-km) the terrain features are more detailed, showing better valley structures and in general, PM2.5 concentrations were greater in the valleys with the 1.33-km meteorological domain than with the 4-km domain.

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.

Strengthening Capacity to Respond to Computer Security Incidents ...

International Development Research Centre (IDRC) Digital Library (Canada)

... in the form of spam, improper access to confidential data and cyber theft. ... These teams are usually known as computer security incident response teams ... regional capacity for preventing and responding to cyber security incidents in Latin ...

Sectorial Group for Incident Analyses (GSAI)

International Nuclear Information System (INIS)

Galles, Q.; Gamo, J. M.; Jorda, M.; Sanchez-Garrido, P.; Lopez, F.; Asensio, L.; Reig, J.

2013-01-01

In 2008, the UNESA Nuclear Energy Committee (CEN) proposed the creation of a working group formed by experts from all Spanish NPPs with the purpose of jointly analyze relevant incidents occurred in each one of the plants. This initiative was a response to a historical situation in which the exchange of information on incidents between the Spanish NPP's was below the desired level. In june 2009, UNESA's Guide CEN-29 established the performance criteria for the so called Sectorial Group for Incident Analyses (GSAI), whose activity would be coordinated by the UNESA's Group for Incident Analyses (GSAI), whose activity would be coordinated by the UNESA's Group of Operating Experience, under the Operations Commission (COP). (Author)

[Ethical Debates Related to the Allocation of Medical Resources During the Response to the Mass Casualty Incident at Formosa Fun Coast Water Park].

Science.gov (United States)

Tang, Jing-Shia; Chen, Chia-Jung; Huang, Mei-Chih

2017-02-01

Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources. The present article focused on the 2015 explosion at Formosa Fun Coast, a recreational water park in Bali, New Taipei City, Taiwan as a way to explore the dilemma over the triage and resource allocation for casualties with burns over 90% and 50-60% of their bodies. The principles of utilitarianism and deontology in Western medicine were used to discuss the reasons and rationale behind the allocation of medical resources during this incident. Confucianism, a philosophical mindset that significantly influences Taiwanese society today, was then discussed to describe the "miracles" that happened during the incident, including the acquisition of assistance from the public and medical professionals. External supplies and professional help (social resources) were provided voluntarily after this incident, which had a profound impact on both the immediate response and the longer-term recovery efforts.

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

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

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

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

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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.

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.

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.

Critical incidents during prehospital cardiopulmonary resuscitation: what are the problems nobody wants to talk about?

Science.gov (United States)

Hohenstein, Christian; Rupp, Peter; Fleischmann, Thomas

2011-02-01

We wanted to identify incidents that led or could have led to patient harm during prehospital cardiopulmonary resuscitation. A nationwide anonymous and Internet-based critical incident reporting system gave the data. During a 4-year period we received 548 reports of which 74 occurred during cardiopulmonary resuscitation. Human error was responsible for 85% of the incidents, whereas equipment failure contributed to 15% of the reports. Equipment failure was considered to be preventable in 61% of all the cases, whereas incidents because of human error could have been prevented in almost all the cases. In most cases, prevention can be accomplished by simple strategies with the Poka-Yoke technique. Insufficient training of emergency medical service physicians in Germany requires special attention. The critical incident reports raise concerns regarding the level of expertize provided by emergency medical service doctors.

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.

Skin bank development and critical incident response.

Science.gov (United States)

Hamilton, Kellie T; Herson, Marisa R

2011-05-01

The Donor Tissue Bank of Victoria (DTBV), situated in Melbourne, Australia developed a skin banking program in 1994. It remains Australia's only operational skin bank, processing cryopreserved human cadaveric skin for the treatment of burns. The demand for allograft skin in Australia has steadily increased since the development of the program. The bank has been involved in the provision of skin for a number of critical incidences or disasters both in Australia and overseas. Demand always exceeds supply, and in the absence of other local skin banks, the DTBV has needed to develop strategies to enable increased provision of allograft skin nationally.

The management of radiation treatment error through incident learning

International Nuclear Information System (INIS)

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

2010-01-01

Purpose: To assess efficacy of an incident learning system in the management of error in radiation treatment. Materials and methods: We report an incident learning system implementation customized for radiation therapy where any 'unwanted or unexpected change from normal system behaviour that causes or has the potential to cause an adverse effect to persons or equipment' is reported, investigated and learned from. This system thus captures near-miss (potential) and actual events. Incidents are categorized according to severity, type and origin. Results: Our analysis spans a period of 3 years with an average accrual of 11.6 incidents per week. We found a significant reduction in actual incidents of 28% and 47% in the second and third year when compared to the first year (p < 0.001), which we attribute to the many interventions prompted by the analysis of incidents reported. We also saw a similar significant reduction in incidents generated at the treatment unit correlating with the introduction of direct treatment parameter transfer and electronic imaging (p < 0.001). Conclusions: Implementation of an incident learning system has helped us to establish a just environment where all staff members report deviations from normal system behaviour and thus generate evidence to initiate safety improvements.

IMI - An information system for effective Multidisciplinary Incident Management

NARCIS (Netherlands)

Lee, M.D.E. van der; Vugt, M. van der

2004-01-01

The field of crisis response and disaster management can be characterized, upon many other factors, by distributed operations, not daily routine work and multidisciplinary aspects. In designing and developing information systems for crisis response these factors need special attention. On behalf of

Acute Chemical Incidents With Injured First Responders, 2002-2012.

Science.gov (United States)

Melnikova, Natalia; Wu, Jennifer; Yang, Alice; Orr, Maureen

2018-04-01

IntroductionFirst responders, including firefighters, police officers, emergency medical services, and company emergency response team members, have dangerous jobs that can bring them in contact with hazardous chemicals among other dangers. Limited information is available on responder injuries that occur during hazardous chemical incidents. We analyzed 2002-2012 data on acute chemical incidents with injured responders from 2 Agency for Toxic Substances and Disease Registry chemical incident surveillance programs. To learn more about such injuries, we performed descriptive analysis and looked for trends. The percentage of responders among all injured people in chemical incidents has not changed over the years. Firefighters were the most frequently injured group of responders, followed by police officers. Respiratory system problems were the most often reported injury, and the respiratory irritants, ammonia, methamphetamine-related chemicals, and carbon monoxide were the chemicals more often associated with injuries. Most of the incidents with responder injuries were caused by human error or equipment failure. Firefighters wore personal protective equipment (PPE) most frequently and police officers did so rarely. Police officers' injuries were mostly associated with exposure to ammonia and methamphetamine-related chemicals. Most responders did not receive basic awareness-level hazardous material training. All responders should have at least basic awareness-level hazardous material training to recognize and avoid exposure. Research on improving firefighter PPE should continue. (Disaster Med Public Health Preparedness. 2018;12:211-221).

College law enforcement and security department responses to alcohol-related incidents: a national study.

Science.gov (United States)

Bernat, Debra H; Lenk, Kathleen M; Nelson, Toben F; Winters, Ken C; Toomey, Traci L

2014-08-01

Campus police and security personnel are often the first to respond to alcohol-related incidents on campus. The purpose of this study is to examine how campus law enforcement and security respond to alcohol-related incidents, and how consequences and communication differ based on characteristics of the incident. Directors of campus police/security from 343 colleges across the United States completed a survey regarding usual practice following serious, underage, and less serious alcohol incidents on and off campus. Campus law enforcement and security most commonly reported contacting campus officials. A minority reported issuing citations and referring students to the health center. Enforcement actions were more commonly reported for serious and underage incidents than for less serious incidents. Large (vs. small) colleges, public (vs. private) colleges, and those located in small (vs. large) towns more consistently reported taking actions against drinkers. Understanding how campus police and security respond to alcohol-related incidents is essential for reducing alcohol-related problems on college campuses. Copyright © 2014 by the Research Society on Alcoholism.

A parameter quantifying radiation damping of bay oscillations excited by incident tsunamis

Science.gov (United States)

Endoh, Takahiro; Inazu, Daisuke; Waseda, Takuji; Hibiya, Toshiyuki

2018-04-01

The transient response of a bay with a narrow mouth to incident tsunamis is interpreted as the convolution of the input signal with the impulse response obtained by an inverse Fourier transform of the response curve of the oscillatory system with one degree of freedom. The rate of radiation damping associated with energy escaping seaward through the bay mouth is expressed in terms of the quality factor Q, which determines the decaying envelope of the impulse response. The value of Q of the resonant peak is approximated by the ratio of the resonant frequency ω0 to the bandwidth between frequencies at which the power spectral density of sea level within the bay drops to half of the peak value. Since the shape of the frequency power spectrum during the tsunami event is almost similar to that in the normal state in the neighborhood of ω0, Q can be estimated from sea level datasets in the normal state. Although the amplitude and phase of the impulse response need to be adjusted using the first crest or trough of the observed leading wave, this approach proves to work well in examining the transient responses of Miyako Bay and Kushimoto Bay on the Japanese Pacific coast to incident tsunamis.

Nervous System and Intracranial Tumour Incidence by Ethnicity in England, 2001–2007: A Descriptive Epidemiological Study

Science.gov (United States)

Maile, Edward J.; Barnes, Isobel; Finlayson, Alexander E.; Sayeed, Shameq; Ali, Raghib

2016-01-01

Background There is substantial variation in nervous system and intracranial tumour incidence worldwide. UK incidence data have limited utility because they group these diverse tumours together and do not provide data for individual ethnic groups within Blacks and South Asians. Our objective was to determine the incidence of individual tumour types for seven individual ethnic groups. Methods We used data from the National Cancer Intelligence Network on tumour site, age, sex and deprivation to identify 42,207 tumour cases. Self-reported ethnicity was obtained from the Hospital Episode Statistics database. We used mid-year population estimates from the Office for National Statistics. We analysed tumours by site using Poisson regression to estimate incidence rate ratios comparing non-White ethnicities to Whites after adjustment for sex, age and deprivation. Results Our study showed differences in tumour incidence by ethnicity for gliomas, meningiomas, pituitary tumours and cranial and paraspinal nerve tumours. Relative to Whites; South Asians, Blacks and Chinese have a lower incidence of gliomas (pethnicities. Blacks have a higher incidence of pituitary tumours relative to Whites (pethnicities. Conclusions We present incidence data of individual tumour types for seven ethnic groups. Current understanding of the aetiology of these tumours cannot explain our results. These findings suggest avenues for further work. PMID:27135830

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.

Secure Utilization of Beacons and UAVs in Emergency Response Systems for Building Fire Hazard.

Science.gov (United States)

Seo, Seung-Hyun; Choi, Jung-In; Song, Jinseok

2017-09-25

An intelligent emergency system for hazard monitoring and building evacuation is a very important application area in Internet of Things (IoT) technology. Through the use of smart sensors, such a system can provide more vital and reliable information to first-responders and also reduce the incidents of false alarms. Several smart monitoring and warning systems do already exist, though they exhibit key weaknesses such as a limited monitoring coverage and security, which have not yet been sufficiently addressed. In this paper, we propose a monitoring and emergency response method for buildings by utilizing beacons and Unmanned Aerial Vehicles (UAVs) on an IoT security platform. In order to demonstrate the practicability of our method, we also implement a proof of concept prototype, which we call the UAV-EMOR (UAV-assisted Emergency Monitoring and Response) system. Our UAV-EMOR system provides the following novel features: (1) secure communications between UAVs, smart sensors, the control server and a smartphone app for security managers; (2) enhanced coordination between smart sensors and indoor/outdoor UAVs to expand real-time monitoring coverage; and (3) beacon-aided rescue and building evacuation.

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

Science.gov (United States)

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

2017-09-01

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

Aplanatic telescopes based on Schwarzschild optical configuration: from grazing incidence Wolter-like x-ray optics to Cherenkov two-mirror normal incidence telescopes

Science.gov (United States)

Sironi, Giorgia

2017-09-01

At the beginning of XX century Karl Schwarzschild defined a method to design large-field aplanatic telescopes based on the use of two aspheric mirrors. The approach was then refined by Couder (1926) who, in order to correct for the astigmatic aberration, introduced a curvature of the focal plane. By the way, the realization of normal-incidence telescopes implementing the Schwarzschild aplanatic configuration has been historically limited by the lack of technological solutions to manufacture and test aspheric mirrors. On the other hand, the Schwarzschild solution was recovered for the realization of coma-free X-ray grazing incidence optics. Wolter-like grazing incidence systems are indeed free of spherical aberration, but still suffer from coma and higher order aberrations degrading the imaging capability for off-axis sources. The application of the Schwarzschild's solution to X-ray optics allowed Wolter to define an optical system that exactly obeys the Abbe sine condition, eliminating coma completely. Therefore these systems are named Wolter-Schwarzschild telescopes and have been used to implement wide-field X-ray telescopes like the ROSAT WFC and the SOHO X-ray telescope. Starting from this approach, a new class of X-ray optical system was proposed by Burrows, Burg and Giacconi assuming polynomials numerically optimized to get a flat field of view response and applied by Conconi to the wide field x-ray telescope (WFXT) design. The Schwarzschild-Couder solution has been recently re-discovered for the application to normal-incidence Cherenkov telescopes, thanks to the suggestion by Vassiliev and collaborators. The Italian Institute for Astrophysics (INAF) realized the first Cherenkov telescope based on the polynomial variation of the Schwarzschild configuration (the so-called ASTRI telescope). Its optical qualification was successfully completed in 2016, demonstrating the suitability of the Schwarzschild-like configuration for the Cherenkov astronomy requirements

Radioactive material (RAM) accident/incident data analysis program

International Nuclear Information System (INIS)

Emerson, E.L.; McClure, J.D.

1985-03-01

This report describes the development of the Radioactive Material Transportation Accident/Incident Data Base (RAM-AIDB), which contains information on the occurrences of transportation accidents and incidents, for radioactive materials (RAM) that are involved in the process of transportation, loading and unloading operation, or temporary storage. These transportation operations are in support of the nuclear fuel cycle for electrical energy generation. This study analyzes in some detail basic accident/incident statistical data, RAM packaging accident response data, and the health effects associated with RAM transport accidents/incidents. This report presents a summary of US RAM transport accident/incident experience for the period 1971 through December 1981. In addition, a sample annual summary of accident/incident experience is presented for the calendar year 1981

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

Science.gov (United States)

He, Ying; Johnson, Chris

2017-12-01

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

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

Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident.

Science.gov (United States)

Wachira, Benjamin W; Abdalla, Ramadhani O; Wallis, Lee A

2014-10-01

At approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital. This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.

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

Science.gov (United States)

Jensen, Jessica; Youngs, George

2015-04-01

This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

British Columbia inland oil spill response plan

International Nuclear Information System (INIS)

2005-01-01

This paper presents an outline of the organization, procedures and duties of the provincial government in response to inland oil spills stemming from pipeline or tank-farm rupture, train derailment and vehicle accidents in British Columbia. Provincial response strategies were reviewed, along with their relationships to various policies and standards. Public, infrastructure and environmental protection were identified as key factors. Incident notification procedures were detailed, including outlines of roles, event criteria and call for incident management teams. Agreements and cost recovery issues were examined. The characteristics of site response were reviewed, including details of communications, tactical planning, and unified command among local and federal governments. The role of First Nations and responsible parties was also addressed. Details of shore cleanup, wildlife rescue, decontamination, and waste handling strategies were presented. The organization, missions and duties for an incident management team were outlined, along with a summary of operational guidelines and information on team positions and the establishment of joint information centres. The involvement of cooperating agencies was examined. An incident command system was also presented, including details of planning, operations, logistics, and organization. A checklist of individual duties was provided, with details of responsibilities, safety issues and general instructions for all team members. tabs., figs

Development of Incident Report Database for Organizational Learning

Science.gov (United States)

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

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

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.

Responses of three-dimensional flow to variations in the angle of incident wind and profile form of dunes: Greenwich Dunes, Prince Edward Island, Canada

Science.gov (United States)

Walker, Ian J.; Hesp, Patrick A.; Davidson-Arnott, Robin G. D.; Bauer, Bernard O.; Namikas, Steven L.; Ollerhead, Jeff

2009-04-01

This study reports the responses of three-dimensional near-surface airflow over a vegetated foredune to variations in the conditions of incident flow during an 8-h experiment. Two parallel measurement transects were established on morphologically different dune profiles: i) a taller, concave-convex West foredune transect with 0.5-m high, densely vegetated (45%), seaward incipient foredune, and ii) a shorter, concave-straight East foredune transect with lower, sparsely vegetated (14%) seaward incipient foredune. Five stations on each transect from the incipient dune to the crest were equipped with ultrasonic anemometers at 0.6 and 1.65 m height and logged at 1 Hz. Incident conditions were recorded from a 4-m tower over a flat beach. Winds increased from 6 m s - 1 to > 20 m s - 1 and were generally obliquely onshore (ENE, 73°). Three sub-events and the population of 10-minute averages of key properties of flow ( U, W, S, CV U) from all sample locations on the East transect ( n = 235) are examined to identify location- and profile-specific responses over 52° of the incident direction of flow (from 11 to 63° onshore). Topographic steering and forcing cause major deviations in the properties and vectors of near-surface flow from the regional wind. Topographic forcing on the concave-straight dune profile increases wind speed and steadiness toward the crest, with speed-up values to 65% in the backshore. Wind speed and steadiness of flow are least responsive to changes in incident angle in the backshore because of stagnation of flow and are most responsive at the lower stoss under pronounced streamline compression. On the steeper concave-convex profile, speed and steadiness decrease toward the crest because of stagnation of flow at the toe and flow expansion at the slope inflection point on the lower stoss. Net downward vertical velocity occurs over both profiles, increases toward the crest, and reflects enhanced turbulent momentum conveyance toward the surface. All of

Fires in rooms containing electrical components - incident planning, fire fighting tactics, risks

International Nuclear Information System (INIS)

Magnusson, Tommy; Ottosson, Jan; Lindskog, BertiI; Soederquist Bende, Evy; Eriksson, Fredrik; Haffling, Stefan

2006-12-01

On July 1, 2005 a fire occurred within an electrical switch room at Forsmark Nuclear Power Plant. At the evaluation of the incident it was identified that the pre-fire plans did not give sufficient information in order to make the appropriate decisions. Questions raised based on the incident are how decisions are made and orders are delegated with respect to the incident command, which fire fighting tactic should be used, which types of extinguishing media should be used, what are the risks with respect to safety of staff and safety of the reactor. Lessons learned from the fire at Forsmark were that pre-incident planning was at hand but the information was not sufficient to make the correct initial decisions that might be critical for life and property. One of the most crucial ingredients in all safety related work is to utilize previous experience in order to maintain a high degree of safety. Lessons learnt are also the foundation on which the ability to construct or create strong barriers against a certain fault phenomena, fault mechanism or type of initial event. In the case of nuclear processes, fire is considered as an important and critical initial event which has to be recognized in a number of cases in order to maintain a safe process. The likelihood for a fire to represent an initial event should not be underestimated and can therefore not be neglected, probabilistically or deterministically, unless the inherent safety systems can not control the event in an acceptable manner. Regardless of safety measures and lessons learnt from previous experiences in the construction and the operation of the nuclear facility, fires can occur. Previous experiences point out that process system, e.g. systems that are part of the turbine, are more frequently subject to fire incidents compared to ordinary safety systems. Fires in electrical components, often electrical cabinets, can be difficult to handle and to extinguish quickly. This report presents the background work

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

[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.

Emergency Preparedness and Response. Working to Protect People, Society and the Environment

International Nuclear Information System (INIS)

2013-01-01

The IEC develops safety standards and guidelines relating to preparedness for, and response to, nuclear or radiological incidents and emergencies, independently of the cause, and technical documents and training materials for the application of those standards. The IEC also provides training and services to assist Member States in strengthening and maintaining their regional, national, local and on-site response capabilities. An extra resource to the IAEA's response system is foreseen through the Response and Assistance Network (RANET), which represents a network of registered national capabilities in different EPR areas. Its objectives are the provision of requested international assistance, the harmonization of emergency assistance capabilities and the relevant exchange of information and feedback of experience. Important components of the global emergency response system are the notification and reporting arrangements and secure and reliable communication systems operated around the clock by the IEC. States and international organizations report events and submit requests for assistance to the IAEA through the Unified System for Information Exchange on Incidents and Emergencies (USIE) web site, by phone or by fax. Member States (and a few non-Member States) have nominated competent authorities and National Warning Points who are able to receive, convey and quickly provide authoritative information on incidents and emergencies

A scoring system for ascertainment of incident stroke; the Risk Index Score (RISc).

Science.gov (United States)

Kass-Hout, T A; Moyé, L A; Smith, M A; Morgenstern, L B

2006-01-01

The main objective of this study was to develop and validate a computer-based statistical algorithm that could be translated into a simple scoring system in order to ascertain incident stroke cases using hospital admission medical records data. The Risk Index Score (RISc) algorithm was developed using data collected prospectively by the Brain Attack Surveillance in Corpus Christi (BASIC) project, 2000. The validity of RISc was evaluated by estimating the concordance of scoring system stroke ascertainment to stroke ascertainment by physician and/or abstractor review of hospital admission records. RISc was developed on 1718 randomly selected patients (training set) and then statistically validated on an independent sample of 858 patients (validation set). A multivariable logistic model was used to develop RISc and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analyses. The higher the value of RISc, the higher the patient's risk of potential stroke. The study showed RISc was well calibrated and discriminated those who had potential stroke from those that did not on initial screening. In this study we developed and validated a rapid, easy, efficient, and accurate method to ascertain incident stroke cases from routine hospital admission records for epidemiologic investigations. Validation of this scoring system was achieved statistically; however, clinical validation in a community hospital setting is warranted.

Physicians' and Nurses' Perceptions of and Attitudes Toward Incident Reporting in Palestinian Hospitals.

Science.gov (United States)

Rashed, Anan; Hamdan, Motasem

2015-06-22

Underreporting of incidents that happen in health care services undermines the ability of the systems to improve patient safety. This study assessed the attitudes of physicians and nurses toward incident reporting and the factors influencing reporting in Palestinian hospitals. It also examined clinicians' views about the preferred features of incident reporting system. Cross-sectional self-administered survey of 475 participants, 152 physicians and 323 nurses, from 11 public hospitals in the West Bank; response rate, 81.3%. There was a low level of event reporting among participants in the past year (40.3%). Adjusted for sex and age, physicians were 2.1 times more likely to report incidents than nurses (95% confidence interval, 1.32-3.417; P = 0.002). Perceived main barriers for reporting were grouped under lack of proper structure for reporting, prevalence of blame, and punitive environment. The clinicians indicated fear of administrative sanctions, social and legal liability, and of their competence being questioned (P > 0.05). Getting help for patients, learning from mistakes, and ethical obligation were equally indicated motivators for reporting (P > 0.05). Meanwhile, clinicians prefer formal reporting (77.8%) of all type of errors (65.5%), disclosure of reporters (52.7%), using reports to improve patient safety (80.3%), and willingness to report to immediate supervisors (57.6%). Clinicians acknowledge the importance of reporting incidents; however, prevalence of punitive culture and inadequate reporting systems are key barriers. Improving feedback about reported errors, simplifying procedures, providing clear guidelines on what and who should report, and avoiding blame are essential to enhance reporting. Moreover, health care organizations should consider the opinions of the clinicians in developing reporting systems.

Wind emergency response system

International Nuclear Information System (INIS)

Garrett, A.J.; Buckner, M.R.; Mueller, R.A.

1981-01-01

The WIND system is an automated emergency response system for real-time predictions of the consequences of liquid and airborne releases from SRP. The system consists of a minicomputer and associated peripherals necessary for acquisition and handling of large amounts of meteorological data from a local tower network and the National Weather Service. The minicomputer uses these data and several predictive models to assess the impact of accidental releases. The system is fast and easy to use, and output is displayed both in tabular form and as trajectory map plots for quick interpretation. The rapid response capabilities of the WIND system have been demonstrated in support of SRP operations

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 �

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 �

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

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.

Incidence of childhood linear scleroderma and systemic sclerosis in the UK and Ireland.

Science.gov (United States)

Herrick, Ariane L; Ennis, Holly; Bhushan, Monica; Silman, Alan J; Baildam, Eileen M

2010-02-01

Childhood scleroderma encompasses a rare, poorly understood spectrum of conditions. Our aim was to ascertain the incidence of childhood scleroderma in its different forms in the UK and Ireland, and to describe the age, sex, and ethnicity of the cases. The members of 5 specialist medical associations including pediatricians, dermatologists, and rheumatologists were asked to report all cases of abnormal skin thickening suspected to be localized (including linear) scleroderma or systemic sclerosis (SSc) in children scleroderma and 7 (7%) with SSc. This gave an incidence rate per million children per year of 3.4 (95% confidence interval [95% CI] 2.7-4.1) for localized scleroderma, including an incidence rate of 2.5 (95% CI 1.8-3.1) for linear scleroderma, and 0.27 (95% CI 0.1-0.5) for SSc. Of the 87 localized cases, 62 (71%) had linear disease. Of localized disease cases, 55 (63%) were female, 71 (82%) were classified as white British, and the patients' mean age when first seen in secondary care was 10.4 years. Of the 7 SSc cases, all were female, 6 (86%) were white British, and the mean age when first seen was 12.1 years. The median delay between onset and being first seen was 13.1 months for localized scleroderma and 7.2 months for SSc. These data provide additional estimates of the incidence of this rare disorder and its subforms.

Decline in overall, smear-negative and HIV-positive TB incidence while smear-positive incidence stays stable in Guinea-Bissau 2004-2011

DEFF Research Database (Denmark)

Lemvik, G; Rudolf, F; Vieira, F

2014-01-01

OBJECTIVE: To calculate Tuberculosis (TB) incidence rates in Guinea-Bissau over an 8-year period. METHODS: Since 2003, a surveillance system has registered all TB cases in six suburban districts of Bissau. In this population-based prospective follow-up study, 1205 cases of pulmonary TB were...... identified between January 2004 and December 2011. Incidence rates were calculated using census data from the Bandim Health and Demographic Surveillance System (HDSS). RESULTS: The overall incidence of pulmonary TB was 279 per 100 000 person-years of observation; the male incidence being 385, and the female...... 191. TB incidence rates increased significantly with age in both sexes, regardless of smear or HIV status. Despite a peak with unknown cause of 352 per 100 000 in 2007, the overall incidence of pulmonary TB declined over the period. The incidence of HIV infected TB cases declined significantly from...

On the incidence and prevalence of child maltreatment: a research agenda

OpenAIRE

Jud, Andreas; Fegert, J?rg M.; Finkelhor, David

2016-01-01

Research on child maltreatment epidemiology has primarily been focused on population surveys with adult respondents. Far less attention has been paid to analyzing reported incidents of alleged child maltreatment and corresponding agency responses. This type of research is however indispensable to know how well a child protection system works and if the most vulnerable are identified and served. Notable findings of child maltreatment epidemiological research are summarized and directions for f...

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

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

Science.gov (United States)

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

2009-06-01

Preparation is essential to cope with the challenge of providing optimal care when there is a sudden, unexpected surge of casualties due to a disaster or major incident. By definition, the requirements of such cases exceed the standard care facilities of hospitals in qualitative or quantitative respects and interfere with the care of regular patients. To meet the growing demands to be prepared for disasters, a permanent facility to provide structured, prepared relief in such situations was developed. A permanent but reserved Major Incident Hospital (MIH) has been developed through cooperation between a large academic medical institution, a trauma center, a military hospital, and the National Poison Information Centre (NVIC). The infrastructure, organization, support systems, training and systematic working methods of the MIH are designed to create order in a chaotic, unexpected situation and to optimize care and logistics in any possible scenario. Focus points are: patient flow and triage, registration, communication, evaluation and training. Research and the literature are used to identify characteristic pitfalls due to the chaos associated with and the unexpected nature of disasters, and to adapt our organization. At the MIH, the exceptional has become the core business, and preparation for disaster and large-scale emergency care is a daily occupation. An Emergency Response Protocol enables admittance to the normally dormant hospital of up to 100 (in exceptional cases even 300) patients after a start-up time of only 15 min. The Patient Barcode Registration System (PBR) with EAN codes guarantees quick and adequate registration of patient data in order to facilitate good medical coordination and follow-up during a major incident. The fact that the hospital is strictly reserved for this type of care guarantees availability and minimizes impact on normal care. When it is not being used during a major incident, there is time to address training and research

Classification of medication incidents associated with information technology.

Science.gov (United States)

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

2014-02-01

Information technology (IT) plays a pivotal role in improving patient safety, but can also cause new problems for patient safety. This study analyzed the nature and consequences of a large sample of IT-related medication incidents, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents submitted to the Dutch central medication incidents registration (CMR) reporting system were analyzed from the perspective of the healthcare professional with the Magrabi classification. During classification new terms were added, if necessary. The principal source of the IT-related problem, nature of error. Additional measures: consequences of incidents, IT systems, phases of the medication process. From March 2010 to February 2011 the CMR received 4161 incidents: 1643 (39.5%) from community pharmacies and 2518 (60.5%) from hospitals. Eventually one of six incidents (16.1%, n=668) were related to IT; in community pharmacies more incidents (21.5%, n=351) were related to IT than in hospitals (12.6%, n=317). In community pharmacies 41.0% (n=150) of the incidents were about choosing the wrong medicine. Most of the erroneous exchanges were associated with confusion of medicine names and poor design of screens. In hospitals 55.3% (n=187) of incidents concerned human-machine interaction-related input during the use of computerized prescriber order entry. These use problems were also a major problem in pharmacy information systems outside the hospital. A large sample of incidents shows that many of the incidents are related to IT, both in community pharmacies and hospitals. The interaction between human and machine plays a pivotal role in IT incidents in both settings.

Reporting Helicopter Emergency Medical Services in Major Incidents

DEFF Research Database (Denmark)

Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

2016-01-01

OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...... variables were determined by consensus. These variables were formatted in a template with 4 main categories: HEMS background information, the major incident characteristics relevant to HEMS, the HEMS response to the major incident, and the key lessons learned. CONCLUSION: Based on opinions from European...

Mass casualty incidents: are NHS staff prepared? An audit of one NHS foundation trust.

Science.gov (United States)

Milkhu, C S; Howell, D C J; Glynne, P A; Raptis, D; Booth, H L; Langmead, L; Datta, V K

2008-09-01

Lack of knowledge of an NHS trust's major incident policies by clinical staff may result in poorly coordinated responses during a mass casualty incident (MCI). To audit knowledge of the major incident policy by clinical staff working in a central London major acute NHS trust designated to receive casualties on a 24-h basis during a MCI. A 12-question proforma was distributed to 307 nursing and medical staff in the hospital, designed to assess their knowledge of the major incident policy. Completed proformas were collected over a 2-month period between December 2006 and February 2007. A reply rate of 34% was obtained, with a reasonable representation from all disciplines ranging from nurses to consultants. Despite only 41% having read the policy in full, 70% knew the correct immediate action to take if informed of major incident activation. 76% knew the correct stand-down procedure. 56% knew the correct reporting point but less than 25% knew that an action card system was utilised. Nurses had significantly (p<0.01) more awareness of the policy than doctors. In view of the heightened terrorist threat in London, knowledge of major incident policy is essential. The high percentage of positive responses relating to immediate and stand-down actions reflects the rolling trust-wide MCI education programme and the organisational memory of the trust following several previous MCI in the capital. There is still scope for an improvement in awareness, however, particularly concerning knowledge of action cards, which are now displayed routinely throughout clinical areas and will be incorporated into induction packs.

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.

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

Science.gov (United States)

2015-09-01

as an ever more popular method of exploiting hosts. Because the Internet is used for things like ecommerce , trading, voting, government, services...HTTP hypertext transfer protocol IE Internet Explorer IMAP Internet message access protocol IOC indicators of compromise IP Internet protocol MD5...notification of detection. These questions not only deal with how an incident is detected, but with the detection system itself. Things like whether

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.

Advantages and disadvantages of the Belgian not-only-fault system for medical incidents.

Science.gov (United States)

Vandersteegen, Tom; Marneffe, Wim; Vandijck, Dominique

2017-02-01

In 2010, the Belgian compensation system for medical incidents was reformed, in order to overcome some important deficiencies of court procedures. This resulted in a not-only-fault compensation system, following the establishment of the Fund for Medical Accidents (FMA). This paper seeks to clarify the main advantages and disadvantages of this reform. After all, the legislator paid little attention to the impact on physicians, who also seem to be insufficiently informed. However, currently the FMA experiences a significant delay in processing compensation requests. The true effects of the not-only-fault system for patients and physicians as well as for health care quality therefore still remain unclear today.

Natural background radiation and oncologic disease incidence

International Nuclear Information System (INIS)

Burenin, P.I.

1982-01-01

Cause and effect relationships between oncologic disease incidence in human population and environmental factors are examined using investigation materials of Soviet and foreign authors. The data concerning US white population are adduced. The role and contribution of natural background radiation oncologic disease prevalence have been determined with the help of system information analysis. The probable damage of oncologic disease is shown to decrease as the background radiation level diminishes. The linear nature of dose-response relationspip has been established. The necessity to include the life history of the studied population along with environmental factors in epidemiological study under conditions of multiplicity of cancerogenesis causes is emphasized

The Response of the Ocean Thermal Skin Layer to Variations in Incident Infrared Radiation

Science.gov (United States)

Wong, Elizabeth W.; Minnett, Peter J.

2018-04-01

Ocean warming trends are observed and coincide with the increase in concentrations of greenhouse gases in the atmosphere resulting from human activities. At the ocean surface, most of the incoming infrared (IR) radiation is absorbed within the top micrometers of the ocean's surface where the thermal skin layer (TSL) exists. Thus, the incident IR radiation does not directly heat the upper few meters of the ocean. This paper investigates the physical mechanism between the absorption of IR radiation and its effect on heat transfer at the air-sea boundary. The hypothesis is that given the heat lost through the air-sea interface is controlled by the TSL, the TSL adjusts in response to variations in incident IR radiation to maintain the surface heat loss. This modulates the flow of heat from below and hence controls upper ocean heat content. This hypothesis is tested using the increase in incoming longwave radiation from clouds and analyzing vertical temperature profiles in the TSL retrieved from sea-surface emission spectra. The additional energy from the absorption of increasing IR radiation adjusts the curvature of the TSL such that the upward conduction of heat from the bulk of the ocean into the TSL is reduced. The additional energy absorbed within the TSL supports more of the surface heat loss. Thus, more heat beneath the TSL is retained leading to the observed increase in upper ocean heat content.

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

NARCIS (Netherlands)

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

2012-01-01

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

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.

The Three-Mile Island incident

International Nuclear Information System (INIS)

Davies, L.M.

1979-10-01

A description is given of the engineering design principles of the PWR (Pressurized Water Reactor) of the Three Mile Island-2 power plant. The successive stages of the incident are recounted, with diagrammatic illustrations, and graphs showing the reactor coolant system parameters at various times after the incident. The consequential events and core damage are discussed. (U.K.)

Discriminating electromagnetic radiation based on angle of incidence

Science.gov (United States)

Hamam, Rafif E.; Bermel, Peter; Celanovic, Ivan; Soljacic, Marin; Yeng, Adrian Y. X.; Ghebrebrhan, Michael; Joannopoulos, John D.

2015-06-16

The present invention provides systems, articles, and methods for discriminating electromagnetic radiation based upon the angle of incidence of the electromagnetic radiation. In some cases, the materials and systems described herein can be capable of inhibiting reflection of electromagnetic radiation (e.g., the materials and systems can be capable of transmitting and/or absorbing electromagnetic radiation) within a given range of angles of incidence at a first incident surface, while substantially reflecting electromagnetic radiation outside the range of angles of incidence at a second incident surface (which can be the same as or different from the first incident surface). A photonic material comprising a plurality of periodically occurring separate domains can be used, in some cases, to selectively transmit and/or selectively absorb one portion of incoming electromagnetic radiation while reflecting another portion of incoming electromagnetic radiation, based upon the angle of incidence. In some embodiments, one domain of the photonic material can include an isotropic dielectric function, while another domain of the photonic material can include an anisotropic dielectric function. In some instances, one domain of the photonic material can include an isotropic magnetic permeability, while another domain of the photonic material can include an anisotropic magnetic permeability. In some embodiments, non-photonic materials (e.g., materials with relatively large scale features) can be used to selectively absorb incoming electromagnetic radiation based on angle of incidence.

Systems analysis of clinical incidents as a basis for improvement the quality of medical care delivered to patients with arterial hypertension

OpenAIRE

Posnenkova O.M.; Kiselev A.R.; Popova Y.V.; Volkova E.N.; Gridnev V.I.

2014-01-01

Background — Systems analysis of clinical incidents – is a relatively novel approach to medical care quality improvement. Its basis is studying of healthcare system with use of modeling. The purpose of the present work was to compare the potential value of different modeling methods, which implemented in systems analysis of clinical incidents, and form the basis for improvement the quality of medical care delivered to patients with arterial hypertension (AH). Material and Methods — Thre...

Incidence Rate of Community-Acquired Sepsis Among Hospitalized Acute Medical Patients-A Population-Based Survey

DEFF Research Database (Denmark)

Henriksen, Daniel Pilsgaard; Laursen, Christian B; Jensen, Thøger Gorm

2015-01-01

to the hospital. DESIGN:: Population-based survey. SETTING:: Medical emergency department from September 1, 2010, to August 31, 2011. PATIENTS:: All patients were manually reviewed using a structured protocol in order to identify the presence of infection. Vital signs and laboratory values were collected...... to define the presence of systemic inflammatory response syndrome and organ dysfunction. MEASUREMENTS AND MAIN RESULTS:: Incidence rate of sepsis of any severity. Among 8,358 admissions to the medical emergency department, 1,713 patients presented with an incident admission of sepsis of any severity, median...... on symptoms and clinical findings at arrival, incidence rates of patients admitted to a medical emergency department with sepsis and severe sepsis are more frequent than previously reported based on discharge diagnoses....

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

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.

The incidence of ventilator-associated pneumonia using the PneuX System with or without elective endotracheal tube exchange: A pilot study

Directory of Open Access Journals (Sweden)

Blunt Mark

2011-03-01

Full Text Available 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 collected from 53 sequential patients. Nine (17% patients were initially intubated with the PneuX System and 44 (83% patients underwent elective exchange to the PneuX System. There were no episodes of VAP while the PneuX System was in situ. On an intention to treat basis, the incidence VAP was 1.8%. There were no complications from, or failure of, subglottic secretion drainage during the study. Conclusions Our study demonstrates that a low incidence of VAP is possible using the PneuX System. Our study also demonstrates that elective exchange and intermittent subglottic secretion drainage can be performed reliably and safely using the PneuX System.

Criticality incident detection assessment methodology

International Nuclear Information System (INIS)

Haley, Richard M.; Warburton, Simon J.; Bowden, Russell L.

2003-01-01

In the United Kingdom, all nuclear facilities that handle, treat or store fissile material require a Criticality Incident Detection and Alarm System (CIDAS) to be installed, unless a case is made for the omission of such a system. Where it is concluded that a CIDAS is required, the primary objective is the reliable detection of criticality and the initiation of prompt evacuation of plant workers from the vicinity of the incident. This paper will examine and compare various methods that can be used to demonstrate that a CIDAS will satisfy the detection criterion. The paper will focus on fit-for-purpose and cost-effective methods for the assessment of gamma-based systems. In the experience of the authors this is particularly useful in demonstrating the efficacy of existing systems in operational plant. (author)

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.

An 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 NRO'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

The Deployable Operations Group: A Model for a National Unified Interagency Rapid Response Command

National Research Council Canada - National Science Library

Cooper, Eric M

2008-01-01

.... Since the attacks, nationwide preparedness efforts have established numerous federal rapid response teams, which are coordinated during a federal interagency response under the National Incident Management System...

A Good IDS Response Protocol of MANET Containment Strategies

Science.gov (United States)

Cheng, Bo-Chao; Chen, Huan; Tseng, Ryh-Yuh

Much recent research concentrates on designing an Intrusion Detection System (IDS) to detect the misbehaviors of the malicious node in MANET with ad-hoc and mobility natures. However, without rapid and appropriate IDS response mechanisms performing follow-up management services, even the best IDS cannot achieve the desired primary goal of the incident response. A competent containment strategy is needed to limit the extent of an attack in the Incident Response Life Cycle. Inspired by the T-cell mechanisms in the human immune system, we propose an efficient MANET IDS response protocol (T-SecAODV) that can rapidly and accurately disseminate alerts of the malicious node attacks to other nodes so as to modify their AODV routing tables to isolate the malicious nodes. Simulations are conducted by the network simulator (Qualnet), and the experiment results indicate that T-SecAODV is able to spread alerts steadily while greatly reduce faulty rumors under simultaneous multiple malicious node attacks.

Traffic control concepts for incident clearance

Science.gov (United States)

2009-01-01

This document discusses various aspects of traffic control for incidents with the focus on the traffic control roles and responsibilities of the responders as well as the safety of the responders and the motoring public. It also recognizes that activ...

29 CFR 1915.505 - Fire response.

Science.gov (United States)

2010-07-01

... accomplished; (3) Set up an incident management system to coordinate and direct fire response functions...-2000 Standard on Protective Ensemble for Structural Fire Fighting (incorporated by reference, see... for Proximity Fire Fighting (incorporated by reference, see § 1915.5). (6) Personal Alert Safety...

The Brazilian emergency response system

International Nuclear Information System (INIS)

Santos, Raul dos

1997-01-01

With the objective of improving the response actions to potential or real emergency situations generated by radiological or nuclear accidents, the Brazilian National Nuclear Energy Commission (CNEN) installed an integrated response system on a 24 hours basis. All the natiowide notifications on events that may start an emergency situation are converged to this system. Established since July 1990, this system has received around 300 notifications in which 5% were classified as potential emergency situation. (author)

What are incident reports telling us? A comparative study at two Australian hospitals of medication errors identified at audit, detected by staff and reported to an incident system.

Science.gov (United States)

Westbrook, Johanna I; Li, Ling; Lehnbom, Elin C; Baysari, Melissa T; Braithwaite, Jeffrey; Burke, Rosemary; Conn, Chris; Day, Richard O

2015-02-01

To (i) compare medication errors identified at audit and observation with medication incident reports; (ii) identify differences between two hospitals in incident report frequency and medication error rates; (iii) identify prescribing error detection rates by staff. Audit of 3291 patient records at two hospitals to identify prescribing errors and evidence of their detection by staff. Medication administration errors were identified from a direct observational study of 180 nurses administering 7451 medications. Severity of errors was classified. Those likely to lead to patient harm were categorized as 'clinically important'. Two major academic teaching hospitals in Sydney, Australia. Rates of medication errors identified from audit and from direct observation were compared with reported medication incident reports. A total of 12 567 prescribing errors were identified at audit. Of these 1.2/1000 errors (95% CI: 0.6-1.8) had incident reports. Clinically important prescribing errors (n = 539) were detected by staff at a rate of 218.9/1000 (95% CI: 184.0-253.8), but only 13.0/1000 (95% CI: 3.4-22.5) were reported. 78.1% (n = 421) of clinically important prescribing errors were not detected. A total of 2043 drug administrations (27.4%; 95% CI: 26.4-28.4%) contained ≥ 1 errors; none had an incident report. Hospital A had a higher frequency of incident reports than Hospital B, but a lower rate of errors at audit. Prescribing errors with the potential to cause harm frequently go undetected. Reported incidents do not reflect the profile of medication errors which occur in hospitals or the underlying rates. This demonstrates the inaccuracy of using incident frequency to compare patient risk or quality performance within or across hospitals. New approaches including data mining of electronic clinical information systems are required to support more effective medication error detection and mitigation. © The Author 2015. Published by Oxford University Press in association

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

OpenAIRE

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

2012-01-01

The growing sophistication and frequency of cyber attacks force modern companies to be prepared beforehand for potential cyber security incidents and data leaks. A proper incident disclosure strategy can significantly improve timeliness and effectiveness of incident response activities, reduce legal fines, and restore confidence and trust of a company's key stakeholders. In this paper, four factors that shape organizational preferences regarding incident information disclosure are introduced....

Early hybrid approach and enteral feeding algorithm could reduce the incidence of necrotising enterocolitis in neonates with ductus-dependent systemic circulation.

Science.gov (United States)

Manuri, Lucia; Morelli, Stefano; Agati, Salvatore; Saitta, Michele B; Oreto, Lilia; Mandraffino, Giuseppe; Iannace, Enrico; Iorio, Fiore S; Guccione, Paolo

2017-01-01

The reported incidence of necrotising enterocolitis in neonates with complex CHD with ductus-dependent systemic circulation ranges from 6.8 to 13% despite surgical treatment; the overall mortality is between 25 and 97%. The incidence of gastrointestinal complications after hybrid palliation for neonates with ductus-dependent systemic circulation still has to be defined, but seems comparable with that following the Norwood procedure. We reviewed the incidence of gastrointestinal complications in a series of 42 consecutive neonates with ductus-dependent systemic circulation, who received early hybrid palliation associated with a standardised feeding protocol. The median age and birth weight at the time of surgery were 3 days (with a range from 1 to 10 days) and 3.07 kg (with a range from 1.5 to 4.5 kg), respectively. The median ICU length of stay was 7 days (1-70 days), and the median hospital length of stay was 16 days (6-70 days). The median duration of mechanical ventilation was 3 days. Hospital mortality was 16% (7/42). In the postoperative period, 26% of patients were subjected to early extubation, and all of them received treatment with systemic vasodilatory agents. Feeding was started 6 hours after extubation according to a dedicated feeding protocol. After treatment, none of our patients experienced any grade of necrotising enterocolitis or major gastrointestinal adverse events. Our experience indicates that the combination of an "early hybrid approach", systemic vasodilator therapy, and dedicated feeding protocol adherence could reduce the incidence of gastrointestinal complications in this group of neonates. Fast weaning from ventilatory support, which represents a part of our treatment strategy, could be associated with low incidence of necrotising enterocolitis.

Measuring the Impact of Online Evidence Retrieval Systems using Critical Incidents & Journey Mapping.

Science.gov (United States)

Westbrook, Johanna I; Coiera, Enrico W; Braithwaite, Jeffrey

2005-01-01

Online evidence retrieval systems are one potential tool in supporting evidence-based practice. We have undertaken a program of research to investigate how hospital-based clinicians (doctors, nurses and allied health professionals) use these systems, factors influencing use and their impact on decision-making and health care delivery. A central component of this work has been the development and testing of a broad range of evaluation techniques. This paper provides an overview of the results obtained from three stages of this evaluation and details the results derived from the final stage which sought to test two methods for assessing the integration of an online evidence system and its impact on decision making and patient care. The critical incident and journey mapping techniques were applied. Semi-structured interviews were conducted with 29 clinicians who were experienced users of the online evidence system. Clinicians were asked to described recent instances in which the information obtained using the online evidence system was especially helpful with their work. A grounded approach to data analysis was taken producing three categories of impact. The journey mapping technique was adapted as a method to describe and quantify clinicians' integration of CIAP into their practice and the impact of this on patient care. The analogy of a journey is used to capture the many stages in this integration process, from introduction to the system to full integration into everyday clinical practice with measurable outcomes. Transcribed interview accounts of system use were mapped against the journey stages and scored. Clinicians generated 85 critical incidents and one quarter of these provided specific examples of system use leading to improvements in patient care. The journey mapping technique proved to be a useful method for providing a quantification of the ways and extent to which clincians had integrated system use into practice, and insights into how information

HIV incidence in Asia: a review of available data and assessment of the epidemic.

Science.gov (United States)

Dokubo, E Kainne; Kim, Andrea A; Le, Linh-Vi; Nadol, Patrick J; Prybylski, Dimitri; Wolfe, Mitchell I

2013-01-01

Rates of new HIV infections in Asia are poorly characterized, likely resulting in knowledge gaps about infection trends and the most important areas to target for interventions. We conducted a systematic review of peer-reviewed English language publications and conference abstracts on HIV incidence in thirteen countries - Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Taiwan, Thailand, and Vietnam. We obtained data on HIV incidence rate, incidence estimation method, population, and risk factors for incident infection. Our search yielded 338 unique incidence estimates from 70 published articles and 41 conference abstracts for eight countries. A total of 138 (41%) were obtained from prospective cohort studies and 106 (31%) were from antibody-based tests for recent infection. High HIV incidence rates were observed among commercial sex workers (0.4-27.8 per 100 person-years), people who inject drugs (0.0-43.6 per 100 person-years) and men who have sex with men (0.7-15.0 per 100 person-years). Risk factors for incident HIV infection include brothel-based sex work and cervicitis among commercial sex workers; young age, frequent injection use and sharing needles or syringes among people who inject drugs; multiple male sexual partners, receptive anal intercourse and syphilis infection among men who have sex with men. In the countries with available data, incidence rates were highest in key populations and varied widely by incidence estimation method. Established surveillance systems that routinely monitor trends in HIV incidence are needed to inform prevention planning, prioritize resources, measure impact, and improve the HIV response in Asia.

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2018-03-01

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

Incidence Rate and Distribution of Common Cancers among Iranian Children

Directory of Open Access Journals (Sweden)

Salman Khazaei

2017-01-01

Full Text Available Background: Geographic differences in the incidence of cancers may suggest unique genetic or environmental exposures that impact the risk of acquiring cancer. This research aims to determine the incidence rate and geographical distribution of common cancers among Iranian children. Methods: In this ecological study, we extracted data that pertained to the incidence rate of common cancers among children from reports by the National Registry of Cancer and Disease Control and Prevention in 2008. A map of the cancer incidence rates was designed by using geographic information system. Results:The most common cancer sites among children were the hematology system, brain and central nervous system, and lymph nodes. The central provinces had the lowest cancer incidences. Conclusion: The considerable variation in incidence of childhood cancers in Iran suggests a possible potential environmental risk factor or genetic background related to this increased risk among children.

Rural and urban distribution of trauma incidents in Scotland.

Science.gov (United States)

Morrison, J J; McConnell, N J; Orman, J A; Egan, G; Jansen, J O

2013-02-01

Trauma systems reduce mortality and improve functional outcomes from injury. Regional trauma networks have been established in several European regions to address longstanding deficiencies in trauma care. A perception of the geography and population distribution as challenging has delayed the introduction of a trauma system in Scotland. The characteristics of trauma incidents attended by the Scottish Ambulance Service were analysed, to gain a better understanding of the geospatial characteristics of trauma in Scotland. Data on trauma incidents collected by the Scottish Ambulance Service between November 2008 and October 2010 were obtained. Incident location was analysed by health board region, rurality and social deprivation. The results are presented as number of patients, average annual incidence rates and relative risks. Of the 141,668 incidents identified, 72·1 per cent occurred in urban regions. The risk of being involved in an incident was similar across the most populous regions, and decreased slightly with increasing rurality. Social deprivation was associated with greater numbers and risk. A total of 53·1 per cent of patients were taken to a large general hospital, and 38·6 per cent to a teaching hospital; the distribution was similar for the subset of incidents involving patients with physiological derangements. The majority of trauma incidents in Scotland occur in urban and deprived areas. A regionalized system of trauma care appears plausible, although the precise configuration of such a system requires further study. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

SPS Machine Protection Incident in 2009

CERN Document Server

Wenninger, J

2009-01-01

During the 008 SPS run a single machine operation incident happened on June 27th when a high intensity CNGS beam was lost in a dipole of sextant 1 following a time system ‘freeze’. The vacuum chamber was punctured over a length of over 10 cm, and the vacuum in the affected sector rose to atmospheric pressure. The dipole was exchanged June 30th. This note describes the incident in detail and presents the measures taken to avoid a similar incident in the future.

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.

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

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

International Nuclear Information System (INIS)

Kapoor, R; Palta, J; Hagan, M; Burkett, D; Leidholdt, E

2016-01-01

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

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

National Response Framework

Science.gov (United States)

2013-05-01

community who may be affected by incidents and as a potential means of supporting response efforts. This includes those with household pets , service and...plans should also include provisions for their animals, including household pets or service animals. During an actual disaster, emergency, or threat...welfare of their employees in the workplace . In addition, some businesses play an essential role in protecting critical infrastructure systems and

National Toxic Substance Incidents Program (NTSIP)

Centers for Disease Control (CDC) Podcasts

2011-02-03

This podcast gives an overview of the three components of the National Toxic Substance Incidents Program: state surveillance, national database, and response teams.  Created: 2/3/2011 by Agency for Toxic Substances and Disease Registry.   Date Released: 2/3/2011.

Incidents/accidents classification and reporting in Statoil.

Science.gov (United States)

Berentsen, Rune; Holmboe, Rolf H

2004-07-26

Based on requirements in the new petroleum regulations from Norwegian Petroleum Directorate (NPD) and the realisation of a need to improve and rationalise the routines for reporting and follow up of incidents, Statoil Exploration & Production Norway (Statoil E&P Norway) has formulated a new strategy and process for handling of incidents/accidents. The following past experiences serve as basis for the changes made to incident reporting in Statoil E&P Norway; too much resources were spent on a comprehensive handling and analysis of a vast amount of incidents with less importance for the safety level, taking the focus away from the more severe and important issues at hand, the assessment of "Risk Factor", i.e. the combination of recurrence frequency and consequence, was difficult to use. The high degree of subjectivity involved in the determination of the "Risk Factor" (in particular the estimation of the recurrence frequency) resulted in poor data quality and lack of consistency in the data material. The new system for categorisation and handling of undesirable incidents was established in January 2002. The intention was to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), with a thorough handling and follow-up. This is reflected throughout the handling of the serious incidents, all the way from immediate notification of the incident, through investigation and follow-up of corrective and preventive actions. Simultaneously, it was also an objective to rationalise/simplify the handling of less serious incidents. These incidents are, however, subjected to analyses twice a year in order to utilize the learning opportunity that they also provide. A year after the introduction of this new system for categorisation and follow-up of undesirable incidents, Statoil's experiences are predominantly good; the intention to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), has been met, the data

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

Science.gov (United States)

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

2018-06-01

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

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

Science.gov (United States)

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

2009-01-01

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

Worldwide Increasing Incidences of Cutaneous Malignant Melanoma

International Nuclear Information System (INIS)

Godar, D. E.

2011-01-01

The incidence of cutaneous malignant melanoma (CMM) has been increasing at a steady rate in fair-skinned populations around the world for decades. Scientists are not certain why CMM has been steadily increasing, but strong, intermittent UVB (290-320 nm) exposures, especially sunburn episodes, probably initiate, CMM, while UVA (321-400 nm) passing through glass windows in offices and cars probably promotes it. The CMM incidence may be increasing at an exponential rate around the world, but it definitely decreases with increasing latitude up to∼ 50 degree N where it reverses and increases with the increasing latitude. The inversion in the incidence of CMM may occur because there is more UVA relative to UVB for most of the year at higher latitudes. If windows, allowing UVA to enter our indoor-working environment and cars, are at least partly responsible for the increasing incidence of CMM, then UV filters can be applied to reduce the rate of increase worldwide.

Worldwide Increasing Incidences of Cutaneous Malignant Melanoma

Directory of Open Access Journals (Sweden)

Dianne E. Godar

2011-01-01

Full Text Available The incidence of cutaneous malignant melanoma (CMM has been increasing at a steady rate in fair-skinned populations around the world for decades. Scientists are not certain why CMM has been steadily increasing, but strong, intermittent UVB (290–320 nm exposures, especially sunburn episodes, probably initiate, CMM, while UVA (321–400 nm passing through glass windows in offices and cars probably promotes it. The CMM incidence may be increasing at an exponential rate around the world, but it definitely decreases with increasing latitude up to ~50°N where it reverses and increases with the increasing latitude. The inversion in the incidence of CMM may occur because there is more UVA relative to UVB for most of the year at higher latitudes. If windows, allowing UVA to enter our indoor-working environment and cars, are at least partly responsible for the increasing incidence of CMM, then UV filters can be applied to reduce the rate of increase worldwide.

Systemic increased immune response to Nocardia brasiliensis co-exists with local immunosuppressive microenvironment.

Science.gov (United States)

Salinas-Carmona, Mario Cesar; Rosas-Taraco, Adrian Geovanni; Welsh, Oliverio

2012-10-01

Human diseases produced by pathogenic actinomycetes are increasing because they may be present as opportunistic infections. Some of these microbes cause systemic infections associated with immunosuppressive conditions, such as chemotherapy for cancer, immunosuppressive therapy for transplant, autoimmune conditions, and AIDS; while others usually cause localized infection in immunocompetent individuals. Other factors related to this increase in incidence are: antibiotic resistance, not well defined taxonomy, and a delay in isolation and identification of the offending microbe. Examples of these infections are systemic disease and brain abscesses produced by Nocardia asteroides or the located disease by Nocardia brasiliensis, named actinomycetoma. During the Pathogenic Actinomycetes Symposium of the 16th International Symposium on Biology of Actinomycetes (ISBA), held in Puerto Vallarta, Mexico, several authors presented recent research on the mechanisms by which N. brasiliensis modulates the immune system to survive in the host and advances in medical treatment of human actinomycetoma. Antibiotics and antimicrobials that are effective against severe actinomycetoma infections with an excellent therapeutic outcome and experimental studies of drugs that show promising bacterial inhibition in vivo and in vitro were presented. Here we demonstrate a systemic strong acquired immune response in humans and experimental mice at the same time of a local dominance of anti inflammatory cytokines environment. The pathogenic mechanisms of some actinomycetes include generation of an immunosuppressive micro environment to evade the protective immune response. This information will be helpful in understanding pathogenesis and to design new drugs for treatment of actinomycetoma.

Voice Response Systems Technology.

Science.gov (United States)

Gerald, Jeanette

1984-01-01

Examines two methods of generating synthetic speech in voice response systems, which allow computers to communicate in human terms (speech), using human interface devices (ears): phoneme and reconstructed voice systems. Considerations prior to implementation, current and potential applications, glossary, directory, and introduction to Input Output…

Effect of Emergency Argon on FCF Operational Incidents

International Nuclear Information System (INIS)

Solbrig, Charles

2011-01-01

The following report presents analyses of operational incidents which are considered in the safety analysis of the FCF argon cell and the effect that the operability of the emergency argon system has on the course of these incidents. The purpose of this study is to determine if the emergency argon system makes a significant difference in ameliorating the course of these incidents. Six incidents were considered. The following three incidents were analyzed. These are: 1. Cooling failing on 2. Vacuum Pump Failing on 3. Argon Supplies Failing on. In the remaining three incidents, the emergency argon supply would have no effect on the course of these transients since it would not come on during these incidents. The transients are 1. Loss of Cooling 2. Loss of power (Differs from above by startup delay till the Diesel Generators come on.) 3. Cell rupture due to an earthquake or other cause. The analyses of the first three incidents are reported on in the next three sections. This report is issued realizing the control parameters used may not be optimum, and additional modeling must be done to model the inertia of refrigeration system, but the major conclusion concerning the need for the emergency argon system is still valid. The timing of some events may change with a more accurate model but the differences between the transients with and without emergency argon will remain the same. Some of the parameters assumed in the analyses are Makeup argon supply, 18 cfm, initiates when pressure is = -6 iwg., shuts off when pressure is = -3.1 iwg. 170,000 ft3 supply. Min 1/7th always available, can be cross connected to HFEF argon supply dewar. Emergency argon supply, 900 cfm, initiates when pressure is = -8 iwg. shuts off when pressure is =-4 iwg. reservoir 220 ft3, refilled when tank farm pressure reduces to 1050 psi which is about 110 ft3.

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

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.

A Qualitative Study of Individual and Peer Factors Related to Effective Nonviolent versus Aggressive Responses to Problem Situations among Adolescents with High Incidence Disabilities

Science.gov (United States)

Sullivan, Terri N.; Helms, Sarah W.; Bettencourt, Amie F.; Sutherland, Kevin; Lotze, Geri M.; Mays, Sally; Wright, Stephen; Farrell, Albert D.

2012-01-01

To enhance the positive adjustment of youths with high incidence disabilities, a better understanding of the factors that influence their use of effective responses in challenging situations is needed. In this qualitative study, adolescents described individual and peer factors that would influence their use of effective nonviolent or aggressive…

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...

Dose-response relationship of neutrons and γ rays to leukemia incidence among atomic bomb survivors in Hiroshima and Nagasaki by type of leukemia, 1950--1971

International Nuclear Information System (INIS)

Ishimaru, T.; Otake, M.; Ichimaru, M.

1979-01-01

The incidence of leukemia during 1950 to 1971 in a fixed mortality sample of atomic bomb survivors in Hiroshima and Nagasaki was analyzed as a function of neutron and γ kerma and marrow doses. Two dose-response models were tested for acute leukemia, chronic granulocytic leukemia, and all types of leukemia, respectively. Each model postulates that the leukemia incidence depends upon the sum of separate risks imposed by γ and neutron doses. In Model I the risk from both types of radiation is assumed to be directly proportional to the respective doses, while Model II assumes that whereas the risk from neutrons is directly proportional to the dose, the risk from γ rays is proportional to dose-squared. The analysis demonstrated that the dose-response of the two types of leukemia differed by type of radiation. The data suggested that the response of acute leukemia was best explained by Model II, while the response of chronic granulocytic leukemia depended almost linearly upon neutron dose alone, because the regression coefficients associated with γ radiation for both Models I and II were not significant. The relative biological effectiveness (RBE) of neutrons in relation to γ rays for incidence of acute leukemia was estimated to be approximately 30/(Dn)/sup 1/2/ [95% confidence limits; 17/(Dn)/sup 1/2/ approx. 54/(Dn)/sup 1/2/] for kerma and 32/(Dn)/sup 1/2/ [95% confidence limits; 18/(Dn)/sup 1/2/ approx. 58/(Dn)/sup 1/2/] for marrow dose (Dn = neutron dose). If acute and chronic granulocytic leukemias are considered together as all types of leukemia, Model II appears to fit the data slightly better than Model I, but neither model is statistically rejected by the data

The Role of Emergency Medical Service in CBR Incidents

International Nuclear Information System (INIS)

Castulik, P.

2007-01-01

Majority of Emergency Medical Services (EMS) have daily extensive experience with rescue of casualties having trauma injuries, resulting from conventional incidents. In the case of non-conventional incidents involving chemical, bacteriological or radiological (CBR) hazardous materials operational scene for all responders is begin to be more complicated due contamination of casualties, equipment and environment. Especially EMS personnel and receiving staff at the hospital have to work under very demanding condition due to burden of personal protective equipment (PPE) and awareness to avoiding cross-contamination during handling casualties. Those conditions require significantly different approaches for search and rescue of victims from incident site, through transportation and effective treatment at medical facilities. In cases when chemicals will be major hazard materials, the speed of rescue and treatment of victims is a major challenge. Each minute matter, and any delay of response could seriously complicated saving of lives and successful recovery of exposed victims. Success in rescue victims is finally measured thorough the ability of the first responders to save people... ALIVE..., no matter what surrounding condition is. The presentation is providing a view and suggestions on more rapid immediate medical response during non-conventional incidents. It names basic concept based on preparedness, early identification of CBR hazards through signs and symptoms of casualties, priorities of rescue procedures and care on-site, needs of decontamination, rapid evacuation casualties from a scene and immediate hospital response.(author)

Incident reporting culture: scale development with validation and reliability and assessment of hospital nurses in Taiwan.

Science.gov (United States)

Chiang, Hui-Ying; Hsiao, Ya-Chu; Lin, Shu-Yuan; Lee, Huan-Fang

2011-08-01

To examine the psychometric validity and reliability of the incident reporting culture questionnaire (IRCQ; in Chinese) following an exploration of the reporting culture perceived by hospital nurses in Taiwan. Scale development with psychometric examination and a cross-sectional study. Ten teaching hospitals. A total of 1064 nurses participated with an average response rate of 83% between November 2008 and June 2009. The factorial construct, criterion-related validity, homogeneity and stability of the IRCQ were evaluated. The nurses' perceptions of the IRCQ were also explored. The four-factor structure of the 20-item IRCQ had satisfactory construct validity (explained variance: 49.37%), criterion-related validity (r = 0.42; P = 0.001), reliability (Cronbach's alpha: 0.83) and stability (3-week-interval correlation: r = 0.80; P = 0.001). These factors included 'application of learning from errors', 'readiness to provide feedback on incident reports', 'collegial atmospheres of unpleasantness and punishment' (CA) and 'incident management: confidential and system driven'. The nurses perceived a moderate overall reporting culture (mean positive response = 49.25%; range: 67.2-24.94%). They weakly agreed on the CA factor of five items (mean positive response = 24.94%; range: 33.0-17.2%). This study provides empirical evidence for the psychometric properties of the IRCQ and the reporting culture which nurses perceive in Taiwan. To Taiwanese nurses, the reporting culture within their work environments especially as it relates to coworker relations, inter-professional collaboration and non-punitive atmosphere is their major concern. Healthcare administrators should consider nurses' perceptions related to incident reporting when managing underreporting issues.

Emergency response during the radiological control of scraps in Cuba

International Nuclear Information System (INIS)

Ramos Viltre, Enma O.; Cardenas Herrera, Juan; Dominguez Ley, Orlando; Capote Ferrera, Eduardo; Fernandez Gomez, Isis M.; Caveda Ramos, Celia; Carrazana, Jorge; Barroso Perez, Idelisa

2008-01-01

In the last few years, in the international scene, incidents have been reported due to the presence of radioactive materials in the scrap. This reality has motivated the adoption of measures of radiological security, due to the implications that these incidents have for the public and the environment, as well as for the international trade. Among theses actions is the implementation of the radiological control of scrap, with the additional requirement that this control has to be implemented in the framework of a Quality Management Program.Taking into account the international experience, our institution designed and organized in 2002 a national service for the radiological monitoring of scrap, being the clients the main exporting and trading enterprises of this material in the country. During these years, several contaminated materials have been detected, causing incidents that activated the radiological emergency response system. In this sense, since some years ago, our country has been working in the implementation of a national and ministerial system for facing and mitigating the consequences of accidental radiological situations, conjugating efforts and wills from different national institutions with the leadership of the Center of Radiation Protection and Hygiene (CPHR) and the Center of Nuclear Security (CNSN) in correspondence with the social responsibility assigned to the them. These incidents propitiate to have not only a system of capacity and quick response oriented to limit the exposure of people, to control the sources, to mitigate the consequences of the accident and to reestablish the conditions of normality, but also a previous adequate planning that guarantees the speed and effectiveness of it. In these work the experiences reached by the specialists of the CPHR from Cuba during the occurrence of an incident in the execution of the service of radiological monitoring of scraps are exposed. (author)

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

Critical incident monitoring in anaesthesia.

Science.gov (United States)

Choy, Y C

2006-12-01

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

A Meta-Analysis of the Incidence of Patient-Reported Dysphagia After Anterior Cervical Decompression and Fusion with the Zero-Profile Implant System.

Science.gov (United States)

Yang, Yi; Ma, Litai; Liu, Hao; Xu, MangMang

2016-04-01

Dysphagia is a well-known complication following anterior cervical surgery. It has been reported that the Zero-profile Implant System can decrease the incidence of dysphagia following surgery, however, dysphagia after anterior cervical decompression and fusion (ACDF) with the Zero-profile Implant System remains controversial. Previous studies only focus on small sample sizes. The objective of this study was to determine the incidence of dysphagia after ACDF with the Zero-profile Implant System. Studies were collected from PubMed, EMBASE, the Cochrane library and the China Knowledge Resource Integrated Database using the keywords "Zero-profile OR Zero-p) AND (dysphagia OR [swallowing dysfunction]". The software STATA (Version 13.0) was used for statistical analysis. Statistical heterogeneity across the various trials, a test of publication bias and sensitivity analysis was performed. 30 studies with a total of 1062 patients were included in this meta-analysis. The occurrence of post-operative transient dysphagia ranged from 0 to 76 % whilst the pooled incidence was 15.6 % (95 % CI, 12.6, 18.5 %). 23 studies reported no persistent dysphagia whilst seven studies reported persistent dysphagia ranging from 1 to 7 %). In summary, the present study observed a low incidence of both transient and persistent dysphagia after ACDF using the Zero-profile Implant System. Most of the dysphagia was mild and gradually decreased during the following months. Moderate or severe dysphagia was uncommon. Future randomized controlled multi-center studies and those focusing on the mechanisms of dysphagia and methods to reduce its incidence are required.

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

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

Exploring the Buruli Ulcer Incidence across a socio-ecological landscape in Ghana

Science.gov (United States)

Naithani, K. J.; Konzelman, C.; Tschakert, P.; Smithwick, E. A. H.

2016-12-01

The Buruli Ulcer (BU) disease is one of the most prevalent, but poorly understood mycobacterial infections in the world. Fundamental ecological aspects of the disease causing bacteria (Mycobacterium ulcerans) are not understood completely, but its emergence is attributed to unidentified thresholds in human and natural systems. We explored the network of these interactions across socio-ecological landscapes of Ghana to understand the movement of bacteria and the emergence of BU in response to climate, disturbance, social and economic factors. We chose five communities, three endemic and two control, and explored the correlations of disease incidence with climate, landscape disturbance, water quality and social factors using path analysis. Our results show that water quality is strongly linked to disease emergence with high alkalinity, PO43-, NH4+, F, Mn, S, Cd, Fe, Pb, and Se were associated with higher disease incidents and high Cu concentration was associated with low or healthy communities. Contrary to previous studies, arsenic concentration in water was not linked to higher disease incidence. Water quality was linked to climate, type of mining, and agricultural practices. Higher annual precipitation and lower air temperature were found linked to higher disease incidence across communities. Our exploratory work provides insight into how human land use, social practices, demographics, and climatic factors influence the BU disease spread.

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.

A self-report critical incident assessment tool for army night vision goggle helicopter operations.

Science.gov (United States)

Renshaw, Peter F; Wiggins, Mark W

2007-04-01

The present study sought to examine the utility of a self-report tool that was designed as a partial substitute for a face-to-face cognitive interview for critical incidents involving night vision goggles (NVGs). The use of NVGs remains problematic within the military environment, as these devices have been identified as a factor in a significant proportion of aircraft accidents and incidents. The self-report tool was structured to identify some of the cognitive features of human performance that were associated with critical incidents involving NVGs. The tool incorporated a number of different levels of analysis, ranging from specific behavioral responses to broader cognitive constructs. Reports were received from 30 active pilots within the Australian Army using the NVG Critical Incident Assessment Tool (NVGCIAT). The results revealed a correspondence between specific types of NVG-related errors and elements of the Human Factors Analysis and Classification System (HFACS). In addition, uncertainty emerged as a significant factor associated with the critical incidents that were recalled by operators. These results were broadly consistent with previous research and provide some support for the utility of subjective assessment tools as a means of extracting critical incident-related data when face-to-face cognitive interviews are not possible. In some circumstances, the NVGCIAT might be regarded as a substitute cognitive interview protocol with some level of diagnosticity.

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…

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.

Functional analysis of controbloc incidents

International Nuclear Information System (INIS)

Gouffon, A.; Jorel, M.

1992-11-01

The subject of the present paper is the survey jointly carried out in 1989 by the IPSN Safety Analysis Department and the Firm BERTIN and Co. on significant incidents related to the Controbloc system equipping the EDF 1300 MWe PWR power plants in France. This survey consisted in a general review of Controbloc operating problems, together with analysis of the safety consequences of the incidents discussed. The survey enabled improvements to be recommended in this respect and provided a basis for safety analysis

Tracing and analytical results of the dioxin contamination incident in 2008 originating from the Republic of Ireland.

Science.gov (United States)

Heres, L; Hoogenboom, R; Herbes, R; Traag, W; Urlings, B

2010-12-01

High levels of dioxins (PCDD/Fs) in pork were discovered in France and the Netherlands at the end of 2008. The contamination was rapidly traced back to a feed stock in the Republic of Ireland (RoI). Burning oil, used for the drying of bakery waste, appeared to be contaminated with PCBs. Consequently, very high levels up to 500 pg TEQ g⁻¹ fat were found in pork. The congener pattern clearly pointed to PCB-oil as a source, but the ratio between the non-dioxin-like indicator PCBs (PCBs 28, 52, 101, 138, 152 and 180) and PCDD/Fs was much lower than observed during the Belgian incident, thereby limiting the suitability of indicator PCBs as a marker for the presence of dioxins and dioxin-like PCBs. This paper describes the tracking and tracing of the incident, the public-private cooperation, the surveillance activities and its results. A major lesson to be learned from this incident is the importance of good private food safety systems. In this incident, it was the private surveillance systems that identified the origin of contamination within 10 days after the first signal of increased dioxin levels in a product. On the other hand, retrospective analyses showed that signals were missed that could have led to an earlier detection of the incident and the source. Above all, the incident would not have occurred when food safety assurance systems had been effectively implemented in the involved feed chain. It is discussed that besides primary responsibility for effective private food safety systems, the competent authorities have to supervise whether the food safety procedures are capable of coping with these kinds of complex food safety issues, while private food companies need to implement the law, and public authorities should supervise and enforce them. Finally, it is discussed whether the health risks derived from consumption of the contaminated batches of meat may have been underestimated during the incident due to the unusually high intake of dioxins.

Taxonometric Applications in Radiotherapy Incident Analysis

International Nuclear Information System (INIS)

Dunscombe, Peter B.; Ekaette, Edidiong U.; Lee, Robert C.; Cooke, David L.

2008-01-01

Recent publications in both the scientific and the popular press have highlighted the risks to which patients expose themselves when entering a healthcare system. Patient safety issues are forcing us to, not only acknowledge that incidents do occur, but also actively develop the means for assessing and managing the risks of such incidents. To do this, we ideally need to know the probability of an incident's occurrence, the consequences or severity for the patient should it occur, and the basic causes of the incident. A structured approach to the description of failure modes is helpful in terms of communication, avoidance of ambiguity, and, ultimately, decision making for resource allocation. In this report, several classification schemes or taxonomies for use in risk assessment and management are discussed. In particular, a recently developed approach that reflects the activity domains through which the patient passes and that can be used as a basis for quantifying incident severity is described. The estimation of incident severity, which is based on the concept of the equivalent uniform dose, is presented in some detail. We conclude with a brief discussion on the use of a defined basic-causes table and how adding such a table to the reports of incidents can facilitate the allocation of resources

Patient safety incident reporting: a qualitative study of thoughts and perceptions of experts 15 years after 'To Err is Human'.

Science.gov (United States)

Mitchell, Imogen; Schuster, Anne; Smith, Katherine; Pronovost, Peter; Wu, Albert

2016-02-01

One of the key recommendations of the Institute of Medicine's (IOM) report, To Err is Human, 15 years ago was for greater attention to incident reporting in healthcare, analogous to the role it has played in aviation and other high-risk industries. With the passage of time and maturation of the patient safety field, we conducted semistructured interviews with 11 international patient safety experts with knowledge of the US healthcare and meeting at least one of the following criteria: (1) involved in the development of the IOM's recommendations, (2) responsible for the design and/or implementation of national or regional incident reporting systems, (3) conducted research on patient safety/incident reporting at a national level. Five key challenges emerged to explain why incident reporting has not reached its potential: poor processing of incident reports (triaging, analysis, recommendations), inadequate engagement of doctors, insufficient subsequent visible action, inadequate funding and institutional support of incident reporting systems and inadequate usage of evolving health information technology. Leading patient safety experts acknowledge the current challenges of incident reports. The future of incident reporting lies in targeted incident reporting, effective triaging and robust analysis of the incident reports and meaningful engagement of doctors. Incident reporting must be coupled with visible, sustainable action and linkage of incident reports to the electronic health record. If the healthcare industry wants to learn from its mistakes, miss or near miss events, it will need to take incident reporting as seriously as the health budget. 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/

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)

Incidence and survival in non-hereditary amyloidosis in Sweden

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Hemminki Kari

2012-11-01

Full Text Available Abstract Background Amyloidosis is a heterogeneous disease caused by deposition of amyloid fibrils in organs and thereby interfering with physiological functions. Hardly any incidence data are available and most survival data are limited to specialist clinics. Methods Amyloidosis patients were identified from the Swedish Hospital Discharge and Outpatients Registers from years 2001 through 2008. Results The incidence of non-hereditary amyloidosis in 949 patients was 8.29 per million person-years and the diagnostic age with the highest incidence was over 65 years. Secondary systemic amyloidosis showed an incidence of 1 per million and a female excess and the largest number of subsequent rheumatoid arthritis deaths; the median survival was 4 years. However, as rheumatoid arthritis deaths also occurred in other diagnostic subtypes, the incidence of secondary systemic amyloidosis was likely to be about 2.0 per million. The median survival of patients with organ-limited amyloidosis was 6 years. Most myeloma deaths occurred in patients diagnosed with unspecified or ‘other’ amyloidosis. These subtypes probably accounted for most of immunoglobulin light chain (AL amyloidosis cases; the median survival time was 3 years. Conclusions The present diagnostic categorization cannot single out AL amyloidosis in the Swedish discharge data but, by extrapolation from myeloma cases, an incidence of 3.2 per million could be ascribed to AL amyloidosis. Similarly, based on rheumatoid arthritis death rates, an incidence of 2.0 could be ascribed to secondary systemic amyloidosis.

Incidence and prevalence of epilepsy in Denmark

DEFF Research Database (Denmark)

Christensen, Jakob; Vestergaard, Mogens; Pedersen, Marianne G

2007-01-01

registered with epilepsy between 1977 and 2002. RESULTS: Between 1977 and 2002 the average incidence of epilepsy was 68.8 new epilepsy patients per 100,000 person-years at risk. However, the incidence changed with calendar time and increased steeply from 1990 to 1995, probably due to changes in diagnostic...... system and inclusion of outpatients. From 1995 to 2002 the incidence rate was reasonable constant with an average of 83.3 new cases per 100,000 person-years at risk, except for patients over 60 years of age where we observed an increase in incidence with calendar time. The age-specific incidence rates...... declined from a high level in children to a low level between 20 and 40 years of age, and thereafter a gradual increase was seen. The incidence rate was slightly higher in men than in women except for the age range 10-20 years. About 2% of the population was diagnosed with epilepsy at some point during...

SU-F-T-462: Lessons Learned From a Machine Incident Reporting System

International Nuclear Information System (INIS)

Sutlief, S; Hoisak, J

2016-01-01

Purpose: Linear accelerators must operate with minimal downtime. Machine incident logs are a crucial tool to meet this requirement. They providing a history of service and demonstrate whether a fix is working. This study investigates the information content of a large department linear accelerator incident log. Methods: Our department uses an electronic reporting system to provide immediate information to both key department staff and the field service department. This study examines reports for five linac logs during 2015. The report attributes for analysis include frequency, level of documentation, who solved the problem, and type of fix used. Results: Of the reports, 36% were documented as resolved. In another 25% the resolution allowed treatment to proceed although the reported problem recurred within days. In 5% only intermediate troubleshooting was documented. The remainder lacked documentation. In 60% of the reports, radiation therapists resolved the problem, often by clearing the appropriate faults or reinitializing a software or hardware service. 22% were resolved by physics and 10% by field service engineers. The remaining 8% were resolved by IT, Facilities, or resolved spontaneously. Typical fixes, in order of scope, included clearing the fault and moving on, closing and re-opening the patient session or software, cycling power to a sub-unit, recalibrating a device (e.g., optical surface imaging), and calling in Field Service (usually resolving the problem through maintenance or component replacement). Conclusion: The reports with undocumented resolution represent a missed opportunity for learning. Frequency of who resolves a problem scales with the proximity of the person’s role (therapist, physicist, or service engineer), which is inversely related to the permanence of the resolution. Review of lessons learned from machine incident logs can form the basis for guidance to radiation therapists and medical physicists to minimize equipment downtime and

SU-F-T-462: Lessons Learned From a Machine Incident Reporting System

Energy Technology Data Exchange (ETDEWEB)

Sutlief, S; Hoisak, J [University of California, San Diego, La Jolla, CA (United States)

2016-06-15

Purpose: Linear accelerators must operate with minimal downtime. Machine incident logs are a crucial tool to meet this requirement. They providing a history of service and demonstrate whether a fix is working. This study investigates the information content of a large department linear accelerator incident log. Methods: Our department uses an electronic reporting system to provide immediate information to both key department staff and the field service department. This study examines reports for five linac logs during 2015. The report attributes for analysis include frequency, level of documentation, who solved the problem, and type of fix used. Results: Of the reports, 36% were documented as resolved. In another 25% the resolution allowed treatment to proceed although the reported problem recurred within days. In 5% only intermediate troubleshooting was documented. The remainder lacked documentation. In 60% of the reports, radiation therapists resolved the problem, often by clearing the appropriate faults or reinitializing a software or hardware service. 22% were resolved by physics and 10% by field service engineers. The remaining 8% were resolved by IT, Facilities, or resolved spontaneously. Typical fixes, in order of scope, included clearing the fault and moving on, closing and re-opening the patient session or software, cycling power to a sub-unit, recalibrating a device (e.g., optical surface imaging), and calling in Field Service (usually resolving the problem through maintenance or component replacement). Conclusion: The reports with undocumented resolution represent a missed opportunity for learning. Frequency of who resolves a problem scales with the proximity of the person’s role (therapist, physicist, or service engineer), which is inversely related to the permanence of the resolution. Review of lessons learned from machine incident logs can form the basis for guidance to radiation therapists and medical physicists to minimize equipment downtime and

Phenomenological modelling of second cancer incidence for radiation treatment planning

International Nuclear Information System (INIS)

Pfaffenberger, Asja; Oelfke, Uwe; Schneider, Uwe; Poppe, Bjoern

2009-01-01

It is still an unanswered question whether a relatively low dose of radiation to a large volume or a higher dose to a small volume produces the higher cancer incidence. This is of interest in view of modalities like IMRT or rotation therapy where high conformity to the target volume is achieved at the cost of a large volume of normal tissue exposed to radiation. Knowledge of the shape of the dose response for radiation-induced cancer is essential to answer the question of what risk of second cancer incidence is implied by which treatment modality. This study therefore models the dose response for radiation-induced second cancer after radiation therapy of which the exact mechanisms are still unknown. A second cancer risk estimation tool for treatment planning is presented which has the potential to be used for comparison of different treatment modalities, and risk is estimated on a voxel basis for different organs in two case studies. The presented phenomenological model summarises the impact of microscopic biological processes into effective parameters of mutation and cell sterilisation. In contrast to other models, the effective radiosensitivities of mutated and non-mutated cells are allowed to differ. Based on the number of mutated cells present after irradiation, the model is then linked to macroscopic incidence by summarising model parameters and modifying factors into natural cancer incidence and the dose response in the lower-dose region. It was found that all principal dose-response functions discussed in the literature can be derived from the model. However, from the investigation and due to scarcity of adequate data, rather vague statements about likelihood of dose-response functions can be made than a definite decision for one response. Based on the predicted model parameters, the linear response can probably be rejected using the dynamics described, but both a flattening response and a decrease appear likely, depending strongly on the effective cell

Engineering risk assessment for emergency disposal projects of sudden water pollution incidents.

Science.gov (United States)

Shi, Bin; Jiang, Jiping; Liu, Rentao; Khan, Afed Ullah; Wang, Peng

2017-06-01

Without an engineering risk assessment for emergency disposal in response to sudden water pollution incidents, responders are prone to be challenged during emergency decision making. To address this gap, the concept and framework of emergency disposal engineering risks are reported in this paper. The proposed risk index system covers three stages consistent with the progress of an emergency disposal project. Fuzzy fault tree analysis (FFTA), a logical and diagrammatic method, was developed to evaluate the potential failure during the process of emergency disposal. The probability of basic events and their combination, which caused the failure of an emergency disposal project, were calculated based on the case of an emergency disposal project of an aniline pollution incident in the Zhuozhang River, Changzhi, China, in 2014. The critical events that can cause the occurrence of a top event (TE) were identified according to their contribution. Finally, advices on how to take measures using limited resources to prevent the failure of a TE are given according to the quantified results of risk magnitude. The proposed approach could be a potential useful safeguard for the implementation of an emergency disposal project during the process of emergency response.

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.)

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.

Estimating cardiovascular disease incidence from prevalence: a spreadsheet based model

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Xue Feng Hu

2017-01-01

Full Text Available Abstract Background Disease incidence and prevalence are both core indicators of population health. Incidence is generally not as readily accessible as prevalence. Cohort studies and electronic health record systems are two major way to estimate disease incidence. The former is time-consuming and expensive; the latter is not available in most developing countries. Alternatively, mathematical models could be used to estimate disease incidence from prevalence. Methods We proposed and validated a method to estimate the age-standardized incidence of cardiovascular disease (CVD, with prevalence data from successive surveys and mortality data from empirical studies. Hallett’s method designed for estimating HIV infections in Africa was modified to estimate the incidence of myocardial infarction (MI in the U.S. population and incidence of heart disease in the Canadian population. Results Model-derived estimates were in close agreement with observed incidence from cohort studies and population surveillance systems. This method correctly captured the trend in incidence given sufficient waves of cross-sectional surveys. The estimated MI declining rate in the U.S. population was in accordance with the literature. This method was superior to closed cohort, in terms of the estimating trend of population cardiovascular disease incidence. Conclusion It is possible to estimate CVD incidence accurately at the population level from cross-sectional prevalence data. This method has the potential to be used for age- and sex- specific incidence estimates, or to be expanded to other chronic conditions.

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.

An integrated system for physical protection

International Nuclear Information System (INIS)

Kumar, Ranajit

2001-01-01

An Integrated Physical Protection System (IPPS) was developed for the consolidation of all sub systems, sensors and elements related to physical protection for an efficient and effective security environment of a facility. An effective physical protection system discharges the functions of detection, delay, communication, response, access control etc. IPPS performs, controls and monitors all the above functionality and helps in taking quick action on occurrence of unusual incidents by instantly reporting the incident in easily understandable audio, video, graphical and textual format and also by initiating automatic interactions among sub-systems

Sources of ionizing radiation, radioactive or nuclear materials out of control. National system of response in Slovakia

International Nuclear Information System (INIS)

Auxtova, L.; Adamek, P.; Moravecb, R.; Melich, M.

2003-01-01

In this paper authors deals with the Customs inspection of radioactive materials - present situation as well as with situation after accession of the Slovak Republic process to European Union (EU). he actual response system to incidents with orphan sources or radioactive material occurring in metal scrap, illicit trafficking and disused sources out of control is laid down on the following scheme. The national strategy is aimed to establish a more effective responding system preventing further illegal trafficking with regard to the acceding process which will require for new member states joining EU proper arrangements in improving the safety of radiation sources over the life-cycle to ensure the effective functioning in the conditions of the Slovak Republic's membership in the European Union

Magnetic-Field-Response Measurement-Acquisition System

Science.gov (United States)

Woodward, Stanley E.; Shams, Qamar A.; Fox, Robert L.; Taylor, Bryant D.

2006-01-01

A measurement-acquisition system uses magnetic fields to power sensors and to acquire measurements from sensors. The system alleviates many shortcomings of traditional measurement-acquisition systems, which include a finite number of measurement channels, weight penalty associated with wires, use limited to a single type of measurement, wire degradation due to wear or chemical decay, and the logistics needed to add new sensors. Eliminating wiring for acquiring measurements can alleviate potential hazards associated with wires, such as damaged wires becoming ignition sources due to arcing. The sensors are designed as electrically passive inductive-capacitive or passive inductive-capacitive-resistive circuits that produce magnetic-field-responses. One or more electrical parameters (inductance, capacitance, and resistance) of each sensor can be variable and corresponds to a measured physical state of interest. The magnetic-field- response attributes (frequency, amplitude, and bandwidth) of the inductor correspond to the states of physical properties for which each sensor measures. For each sensor, the measurement-acquisition system produces a series of increasing magnetic-field harmonics within a frequency range dedicated to that sensor. For each harmonic, an antenna electrically coupled to an oscillating current (the frequency of which is that of the harmonic) produces an oscillating magnetic field. Faraday induction via the harmonic magnetic fields produces an electromotive force and therefore a current in the sensor. Once electrically active, the sensor produces its own harmonic magnetic field as the inductor stores and releases magnetic energy. The antenna of the measurement- acquisition system is switched from a transmitting to a receiving mode to acquire the magnetic-field response of the sensor. The rectified amplitude of the received response is compared to previous responses to prior transmitted harmonics, to ascertain if the measurement system has detected a

The Prevalence of Painful Incidents among Young Recreational Gymnasts

OpenAIRE

Coates, Chrystal; McMurtry, C Meghan; Lingley-Pottie, Patricia; McGrath, Patrick J

2010-01-01

BACKGROUND: Although children experience pain during their daily life, research has generally focused on medical pain. Sport-related pain has not been widely studied in children and research has not examined the occurrence of painful incidents in gymnastics. The prevalence of painful incidents among children in recreational gymnastics classes and accompanying coach responses were recorded.METHODS: Sixty-one children between five and 10 years of age were observed at a gymnastics club. A checkl...

The Institutional System of Economic Agents’ Social Responsibility

Directory of Open Access Journals (Sweden)

Frolova Elena, A.

2015-12-01

Full Text Available In this paper it was made an attempt to analyse the main characteristics of the institutional system of economic agents social responsibility. The institutional system can be described as a complex of norms, rules, regulations and enforcement mechanisms in the context of interactions and communications of economic agents. The institutional nature of social responsibility allow to solve social dilemmas through the internalization of social responsibility norms and creating social value orientations, which are determine the prosocial behaviour of economic agents. The institutional system of social responsibility was described from the methodological institutionalism point of view. Analysing this phenomenon we are required to develop research on the objects of this system (norms, regulations, behaviour, on the subjects of this system (persons, business, government and on the institutional mechanisms (internalization of social responsibility norms, promoting prosocial behaviour, adaptation and transformation of the social responsibility norms aimed to ensure the understanding of origin and significance of social responsibility for modern society.

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

Science.gov (United States)

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

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

Burn Incidence and Treatment in the U.S.

Science.gov (United States)

... News and Activities Media Contact Us Disaster Response Burn Incidence Fact Sheet Home / Who We Are / Media / ... hospitals with specialized services provided by “burn centers.” Burn Injuries Receiving Medical Treatment: 486,000 This general ...

Modelling structural systems for transient response analysis

International Nuclear Information System (INIS)

Melosh, R.J.

1975-01-01

This paper introduces and reports success of a direct means of determining the time periods in which a structural system behaves as a linear system. Numerical results are based on post fracture transient analyses of simplified nuclear piping systems. Knowledge of the linear response ranges will lead to improved analysis-test correlation and more efficient analyses. It permits direct use of data from physical tests in analysis and simplication of the analytical model and interpretation of its behavior. The paper presents a procedure for deducing linearity based on transient responses. Given the forcing functions and responses of discrete points of the system at various times, the process produces evidence of linearity and quantifies an adequate set of equations of motion. Results of use of the process with linear and nonlinear analyses of piping systems with damping illustrate its success. Results cover the application to data from mathematical system responses. The process is successfull with mathematical models. In loading ranges in which all modes are excited, eight digit accuracy of predictions are obtained from the equations of motion deduced. Small changes (less than 0.01%) in the norm of the transfer matrices are produced by manipulation errors for linear systems yielding evidence that nonlinearity is easily distinguished. Significant changes (greater than five %) are coincident with relatively large norms of the equilibrium correction vector in nonlinear analyses. The paper shows that deducing linearity and, when admissible, quantifying linear equations of motion from transient response data for piping systems can be achieved with accuracy comparable to that of response data

Food Safety Incidents, Collateral Damage and Trade Policy Responses: China-Canada Agri-Food Trade

OpenAIRE

Liu, Huanan; Hobbs, Jill E.; Kerr, William A.

2008-01-01

As markets become globalized, food safety policy and international trade policy are increasingly intertwined. Globalization also means that food safety incidents are widely reported internationally. One result is that food safety incidents can negatively impact products where no food safety issue exists as consumers lose trust in both foreign and domestic food safety institutions. While the policy framework for dealing with directly effected imported foods is well understood, how to deal with...

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.

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

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

The effect of incident tuberculosis on immunological response of HIV patients on highly active anti-retroviral therapy at the university of Gondar hospital, northwest Ethiopia: a retrospective follow-up study.

Science.gov (United States)

Assefa, Abate; Gelaw, Baye; Getnet, Gebeyaw; Yitayew, Gashaw

2014-08-27

Human immunodeficiency virus (HIV) infection is usually complicated by high rates of tuberculosis (TB) co-infection. Impaired immune response has been reported during HIV/TB co-infection and may have significant effect on anti-retroviral therapy (ART). TB/HIV co - infection is a major public health problem in Ethiopia. Therefore, the aim of the study was to assess the effect of TB incidence on immunological response of HIV patients during ART. A retrospective follow-up study was conducted among adult HIV patients who started ART at the University of Gondar Hospital. Changes in CD4+ T - lymphocyte count and incident TB episodes occurring during 42 months of follow up on ART were assessed. Life table was used to estimate the cumulative immunologic failure. Kaplan-Meier curve was used to compare survival curves between the different categories. Cox-proportional hazard model was employed to examine predictors of immunological failure. Among 400 HIV patients, 89(22.2%) were found to have immunological failure with a rate of 8.5 per 100 person-years (PY) of follow-up. Incident TB developed in 26(6.5%) of patients, with an incidence rate of 2.2 cases per 100 PY. The immunological failure rate was high (20.1/100PY) at the first year of treatment. At multivariate analysis, Cox regression analysis showed that baseline CD4+ T - cell count immunological failure. There was borderline significant association with incident TB (AHR 2.2; 95%CI: 0.94 - 5.09, p = 0.06). The risk of immunological failure was significantly higher (38.5%) among those with incident TB compared with TB - free (21.1%) (Log rank p = 0.036). High incidence of immunological failure occurred within the first year of initiating ART. The proportions of patients with impaired immune restoration were higher among patients with incident TB. Lower baseline CD4+ T - cells count of immunological failure. The result highlighted the beneficial effects of earlier initiation of ART on CD4+ T - cell count recovery.

Urbanisation and the incidence of eating disorders.

NARCIS (Netherlands)

Son, G.E. van; Hoeken, D. van; Bartelds, A.I.M.; Furth, E.F. van; Hoek, H.W.

2006-01-01

The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose response

Urbanisation and the incidence of eating disorders

NARCIS (Netherlands)

Van Son, Gabrielle E.; Van Hoeken, Daphne; Bartelds, Aad I. M.; Van Furth, Eric F.; Hoek, Hans W.

2006-01-01

The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose-response

Emergency planning and response preparedness in Slovenia

International Nuclear Information System (INIS)

Martincic, R.; Frlin-Lubi, A.; Usenicnik, B.

2000-01-01

Disasters do occur and so do nuclear or radiological accidents. Experience has shown that advance emergency response preparedness is essential in order to mitigate the consequences of an accident. In Slovenia, the Civil Protection Organization is the responsible authority for emergency preparedness and response to any kind of disasters. The Krko Nuclear Power Plant is the only nuclear power plant in Slovenia. To date the plant has operated safely and no serious incidents have been recorded. Slovenia nevertheless, maintains a high level of emergency preparedness, which is reflected in the area of prevention and safety and in the area of emergency response preparedness. The emergency management system for nuclear emergencies is incorporated into an overall preparedness and response system. The paper presents an overview of nuclear or radiological emergency response preparedness in Slovenia and its harmonization with the international guidelines. (author)

Epidemiology of systemic sclerosis: incidence, prevalence, survival, risk factors, malignancy, and environmental triggers.

Science.gov (United States)

Barnes, Jammie; Mayes, Maureen D

2012-03-01

To identify the recent data regarding prevalence, incidence, survival, and risk factors for systemic sclerosis (SSc) and to compare these data to previously published findings. SSc disease occurrence data are now available for Argentina, Taiwan, and India and continue to show wide variation across geographic regions. The survival rate is negatively impacted by older age of onset, male sex, scleroderma renal crisis, pulmonary fibrosis, pulmonary arterial hypertension, cancer, and antitopoisomerase and anti-U1 antibodies. It appears that silica exposure confers an increased risk for developing scleroderma, but this exposure accounts for a very small proportion of male patients. Smoking is not associated with increased SSc susceptibility. Malignancies are reported in scleroderma at an increased rate, but the magnitude of this risk and the type of cancer vary among reports. Prevalence and incidence of SSc appears to be greater in populations of European ancestry and lower in Asian groups. Exposure to silica dust appears to be an environmental trigger, but this only accounts for a small proportion of male cases. Evidence for increased risk of neoplasia is suggestive, but the magnitude of the risk and the types of malignancies vary among reports.

Organic Scintillator Detector Response Simulations with DRiFT

Energy Technology Data Exchange (ETDEWEB)

Andrews, Madison Theresa [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bates, Cameron Russell [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mckigney, Edward Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rising, Michael Evan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Pinilla, Maria Isabel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Solomon, Jr., Clell Jeffrey [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sood, Avneet [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-12-19

Accurate detector modeling is a requirement to design systems in many non-proliferation scenarios; by determining a Detector’s Response Function (DRF) to incident radiation, it is possible characterize measurements of unknown sources. DRiFT is intended to post-process MCNP® output and create realistic detector spectra. Capabilities currently under development include the simulation of semiconductor, gas, and (as is discussed in this work) scintillator detector physics. Energy spectra and pulse shape discrimination (PSD) trends for incident photon and neutron radiation have been reproduced by DRiFT.

Incident Duration Modeling Using Flexible Parametric Hazard-Based Models

Directory of Open Access Journals (Sweden)

Ruimin Li

2014-01-01

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

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.

Plutonium Reclamation Facility incident response project progress report

International Nuclear Information System (INIS)

Austin, B.A.

1997-01-01

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

Incidence of disability pensions among slaughterhouse workers in Denmark. With special regard to diagnosis of the musculo-skeletal system

DEFF Research Database (Denmark)

Hansen, N S; Jeune, B

1982-01-01

The objective of this study was to examine whether slaughterhouse workers (SW) in Denmark have a higher incidence of disability than expected in comparison with the general population and the sub-group of the population that is gainfully employed, especially with regard to pensions awarded...... are calculated on the basis of age-specific incidence rates among all actively employed people. Problems of the study design and selection bias are discussed to facilitate the interpretation of results. A possible deleterious effect of meatpacking on the musculo-skeletal system calls for further investigation....

Risk assessment of several incidents in nuclear waste management facilities

International Nuclear Information System (INIS)

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

1981-01-01

Regarding surface facilities two incidents of MAVA (failure of the filter in the exhaust gas system, fire in the bituminization system) and one incident in the Krypton storage and regarding underground systems the water inlet in the pit building have been evaluated. According to the calculations only the two nuclides Tc-99 and J-129 can involve a considerable exposure. The barrier system of overlying rocks and the pit system as a whole is largely redundant and diverse. (DG) [de

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

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.

Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

Directory of Open Access Journals (Sweden)

Jih-Shuin Jerng

Full Text Available There have been concerns about the workplace interpersonal conflict (WIC among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs.We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship and the three properties (disagreement, interference, and negative emotion, and analyzed relevant data.Of the 147 incidents with WIC, the most common related processes were patient transfer (20%, laboratory tests (17%, surgery (16% and medical imaging (16%. All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9% also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57% were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%, and the majority (67% of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064. The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1% than not on it (17.0%. The distributions of worker job types were similar between those with and without negative emotion (p = 0.125.The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

Science.gov (United States)

Jerng, Jih-Shuin; Huang, Szu-Fen; Liang, Huey-Wen; Chen, Li-Chin; Lin, Chia-Kuei; Huang, Hsiao-Fang; Hsieh, Ming-Yuan; Sun, Jui-Sheng

2017-01-01

There have been concerns about the workplace interpersonal conflict (WIC) among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS) widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs. We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship) and the three properties (disagreement, interference, and negative emotion), and analyzed relevant data. Of the 147 incidents with WIC, the most common related processes were patient transfer (20%), laboratory tests (17%), surgery (16%) and medical imaging (16%). All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9%) also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57%) were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%), and the majority (67%) of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064). The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1%) than not on it (17.0%). The distributions of worker job types were similar between those with and without negative emotion (p = 0.125). The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

Towards tuberculosis elimination: an action framework for low-incidence countries.

LENUS (Irish Health Repository)

2015-04-01

This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions.

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