WorldWideScience

Sample records for included harms alerts

  1. Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

    Science.gov (United States)

    Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

    2013-01-01

    Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (ppatient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

  2. Harmful Waste Process

    International Nuclear Information System (INIS)

    Ki, Mun Bong; Lee, Shi Jin; Park, Jun Seok; Yoon, Seok Pyo; Lee, Jae Hyo; Jo, Byeong Ryeol

    2008-08-01

    This book gives descriptions of processing harmful waste, including concerned law and definition of harmful waste, current conditions and generation of harmful waste in Korea, international condition of harmful waste, minimizing of generation of harmful waste, treatment and storage. It also tells of basic science for harmful waste disposal with physics, chemistry, combustion engineering, microbiology and technique of disposal such as physical, chemical, biological process, stabilizing and solidification, incineration and waste in landfill.

  3. Sensor Alerting Capability

    Science.gov (United States)

    Henriksson, Jakob; Bermudez, Luis; Satapathy, Goutam

    2013-04-01

    There is a large amount of sensor data generated today by various sensors, from in-situ buoys to mobile underwater gliders. Providing sensor data to the users through standardized services, language and data model is the promise of OGC's Sensor Web Enablement (SWE) initiative. As the amount of data grows it is becoming difficult for data providers, planners and managers to ensure reliability of data and services and to monitor critical data changes. Intelligent Automation Inc. (IAI) is developing a net-centric alerting capability to address these issues. The capability is built on Sensor Observation Services (SOSs), which is used to collect and monitor sensor data. The alerts can be configured at the service level and at the sensor data level. For example it can alert for irregular data delivery events or a geo-temporal statistic of sensor data crossing a preset threshold. The capability provides multiple delivery mechanisms and protocols, including traditional techniques such as email and RSS. With this capability decision makers can monitor their assets and data streams, correct failures or be alerted about a coming phenomena.

  4. Estuarine and marine diets of out-migrating Chinook Salmon smolts in relation to local zooplankton populations, including harmful blooms

    Science.gov (United States)

    Chittenden, C. M.; Sweeting, R.; Neville, C. M.; Young, K.; Galbraith, M.; Carmack, E.; Vagle, S.; Dempsey, M.; Eert, J.; Beamish, R. J.

    2018-01-01

    Changes in food availability during the early marine phase of wild Chinook Salmon (O. tshawytscha) are being investigated as a cause of their recent declines in the Salish Sea. The marine survival of hatchery smolts, in particular, has been poor. This part of the Salish Sea Marine Survival Project examined the diet of young out-migrating Chinook Salmon for four consecutive years in the Cowichan River estuary and in Cowichan Bay, British Columbia, Canada. Local zooplankton communities were monitored during the final year of the study in the Cowichan River estuary, Cowichan Bay, and eastward to the Salish Sea to better understand the bottom-up processes that may be affecting Chinook Salmon survival. Rearing environment affected body size, diet, and distribution in the study area. Clipped smolts (hatchery-reared) were larger than the unclipped smolts (primarily naturally-reared), ate larger prey, spent very little time in the estuary, and disappeared from the bay earlier, likely due to emigration or mortality. Their larger body size may be a disadvantage for hatchery smolts if it necessitates their leaving the estuary prematurely to meet energy needs; the onset of piscivory began at a forklength of approximately 74 mm, which was less than the average forklength of the clipped fish in this study. The primary zooplankton bloom occurred during the last week of April/first week of May 2013, whereas the main release of hatchery-reared Chinook Salmon smolts occurs each year in mid-May-this timing mismatch may reduce their survival. Gut fullness was correlated with zooplankton biomass; however, both the clipped and unclipped smolts were not observed in the bay until the bloom of harmful Noctiluca was finished-20 days after the maximum recorded zooplankton abundance. Jellyfish medusa flourished in nearshore areas, becoming less prevalent towards the deeper waters of the Salish Sea. The sizable presence of Noctiluca and jellyfish in the zooplankton blooms may be repelling

  5. A new CERN Alerter mechanism

    CERN Multimedia

    2007-01-01

    A new version of the CERN Alerter used for sending urgent messages was installed in July on all centrally managed NICE computers. This latest version is based on RSS (Really Simple Syndication) and all alerts are now displayed in an Internet Explorer window (see the picture). You can print the window by right-clicking on the alert background and selecting the Print option from the menu. If the message is not urgent, then the alert will only appear as a "balloon" window the following morning or at next logon. Non-Windows computers can also subscribe to this service by using their browser as an RSS reader (Really Simple Syndication). All recent web browsers can act as RSS readers, including Firefox and Safari. Simply subscribe to the following RSS feed: http://cern.ch/cernalerts/alerts.aspx to see all messages sent by the central services. More information on the CERN Alerter is available at: https://cern.ch/winservices/Help/?kbid=060810. Documentation on reading RSS feeds fr...

  6. A new CERN Alerter mechanism

    CERN Multimedia

    2007-01-01

    A new version of the CERN Alerter used for sending urgent messages was installed in July on all centrally managed NICE computers. This latest version is based on RSS (Really Simple Syndication) and all alerts are now displayed in an Internet Explorer window (see picture). You can print the window by right-clicking on the alert background and selecting the Print option from the menu. If the message is not urgent, the alert will only appear as a "balloon" window the following morning or at next log-on. Non-Windows computers can also subscribe to this service by using their browser as an RSS reader. All recent web browsers can act as RSS readers, including Firefox and Safari. Simply subscribe to the following RSS feed: http://cern.ch/cernalerts/alerts.aspx to see all messages sent by the central services. More information on the CERN Alerter is available at: https://cern.ch/winservices/Help/?kbid=060810. Documentation on reading RSS fee...

  7. Wearable PPG sensor based alertness scoring system.

    Science.gov (United States)

    Dey, Jishnu; Bhowmik, Tanmoy; Sahoo, Saswata; Tiwari, Vijay Narayan

    2017-07-01

    Quantifying mental alertness in today's world is important as it enables the person to adopt lifestyle changes for better work efficiency. Miniaturized sensors in wearable devices have facilitated detection/monitoring of mental alertness. Photoplethysmography (PPG) sensors through Heart Rate Variability (HRV) offer one such opportunity by providing information about one's daily alertness levels without requiring any manual interference from the user. In this paper, a smartwatch based alertness estimation system is proposed. Data collected from PPG sensor of smartwatch is processed and fed to machine learning based model to get a continuous alertness score. Utility functions are designed based on statistical analysis to give a quality score on different stages of alertness such as awake, long sleep and short duration power nap. An intelligent data collection approach is proposed in collaboration with the motion sensor in the smartwatch to reduce battery drainage. Overall, our proposed wearable based system provides a detailed analysis of alertness over a period in a systematic and optimized manner. We were able to achieve an accuracy of 80.1% for sleep/awake classification along with alertness score. This opens up the possibility for quantifying alertness levels using a single PPG sensor for better management of health related activities including sleep.

  8. Alert Exchange Process Protocol

    Science.gov (United States)

    Groen, Frank

    2015-01-01

    The National Aeronautics and Space Administration of the United States of America (NASA), and the European Space Agency (ESA), and the Japanese Aerospace Exploration Agency (JAXA), acknowledging that NASA, ESA and JAXA have a mutual interest in exchanging Alerts and Alert Status Lists to enhance the information base for each system participant while fortifying the general level of cooperation between the policy agreement subscribers, and each Party will exchange Alert listings on regular basis and detailed Alert information on a need to know basis to the extent permitted by law.

  9. Toxic substances alert program

    Science.gov (United States)

    Junod, T. L.

    1978-01-01

    A toxicity profile is provided, of 187 toxic substances procured by NASA Lewis Research Center during a 3 1/2 year period, including 27 known or suspected carcinogens. The goal of the program is to assure that the center's health and safety personnel are aware of the procurement and use of toxic substances and to alert and inform the users of these materials as to the toxic characteristics and the control measures needed to ensure their safe use. The program also provides a continuing record of the toxic substances procured, who procured them, what other toxic substances the user has obtained in the past, and where similar materials have been used elsewhere at the center.

  10. Alerts and Advisories

    Science.gov (United States)

    ... in Select Bottles of Muscle Strength and Nighttime Recovery Product Because of Undeclared Milk Allergen on The Label ( FDA 04/06/18 ) Independent Nutrition, Inc Issues Allergy Alert On Undeclared Milk in ...

  11. Medical alert bracelet (image)

    Science.gov (United States)

    People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will be able to find. Medical identification products can help ensure proper treatment in an ...

  12. DDBS DB Alert

    Data.gov (United States)

    Social Security Administration — Data store used by the database area for monitoring of database objects. It is used to generate alerts that the DBAs investigate to determine if any action needs to...

  13. Lower alert rates by clustering of related drug interaction alerts

    NARCIS (Netherlands)

    Heringa, M.; Siderius, Hidde; Schreudering, A.; De Smet, Peter Agm; Bouvy, M.L.

    OBJECTIVE: We aimed to investigate to what extent clustering of related drug interaction alerts (drug-drug and drug-disease interaction alerts) would decrease the alert rate in clinical decision support systems (CDSSs). METHODS: We conducted a retrospective analysis of drug interaction alerts

  14. Alertness management : strategic naps in operational settings

    Science.gov (United States)

    1995-01-01

    Managing fatigue in complex operational settings requires attention to multiple factors, including hours of service, scheduling, education and training, countermeasures, technology, and research. Alertness-management strategies can be used to promote...

  15. Self-harm.

    Science.gov (United States)

    Skegg, Keren

    The term self-harm is commonly used to describe a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial cutting in response to intolerable tension. As with suicide, rates of self-harm vary greatly between countries. 5-9% of adolescents in western countries report having self-harmed within the previous year. Risk factors include socioeconomic disadvantage, and psychiatric illness--particularly depression, substance abuse, and anxiety disorders. Cultural aspects of some societies may protect against suicide and self-harm and explain some of the international variation in rates of these events. Risk of repetition of self-harm and of later suicide is high. More than 5% of people who have been seen at a hospital after self-harm will have committed suicide within 9 years. Assessment after self-harm includes careful consideration of the patient's intent and beliefs about the lethality of the method used. Strong suicidal intent, high lethality, precautions against being discovered, and psychiatric illness are indicators of high suicide risk. Management after self-harm includes forming a trusting relationship with the patient, jointly identifying problems, ensuring support is available in a crisis, and treating psychiatric illness vigorously. Family and friends may also provide support. Large-scale studies of treatments for specific subgroups of people who self-harm might help to identify more effective treatments than are currently available. Although risk factors for self-harm are well established, aspects that protect people from engaging in self-harm need to be further explored.

  16. Te Ira Tangata: A Zelen randomised controlled trial of a treatment package including problem solving therapy compared to treatment as usual in Maori who present to hospital after self harm

    Directory of Open Access Journals (Sweden)

    Wikiriwhi Karen

    2011-05-01

    Full Text Available Abstract Background Maori, the indigenous people of New Zealand, who present to hospital after intentionally harming themselves, do so at a higher rate than non-Maori. There have been no previous treatment trials in Maori who self harm and previous reviews of interventions in other populations have been inconclusive as existing trials have been under powered and done on unrepresentative populations. These reviews have however indicated that problem solving therapy and sending regular postcards after the self harm attempt may be an effective treatment. There is also a small literature on sense of belonging in self harm and the importance of culture. This protocol describes a pragmatic trial of a package of measures which include problem solving therapy, postcards, patient support, cultural assessment, improved access to primary care and a risk management strategy in Maori who present to hospital after self harm using a novel design. Methods We propose to use a double consent Zelen design where participants are randomised prior to giving consent to enrol a representative cohort of patients. The main outcome will be the number of Maori scoring below nine on the Beck Hopelessness Scale. Secondary outcomes will be hospital repetition at one year; self reported self harm; anxiety; depression; quality of life; social function; and hospital use at three months and one year. Discussion A strength of the study is that it is a pragmatic trial which aims to recruit Maori using a Maori clinical team and protocol. It does not exclude people if English is not their first language. A potential limitation is the analysis of the results which is complex and may underestimate any effect if a large number of people refuse their consent in the group randomised to problem solving therapy as they will effectively cross over to the treatment as usual group. This study is the first randomised control trial to explicitly use cultural assessment and management. Trial

  17. The ACCESS study a Zelen randomised controlled trial of a treatment package including problem solving therapy compared to treatment as usual in people who present to hospital after self-harm: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Parag Varsha

    2011-05-01

    Full Text Available Abstract Background People who present to hospital after intentionally harming themselves pose a common and important problem. Previous reviews of interventions have been inconclusive as existing trials have been under powered and done on unrepresentative populations. These reviews have however indicated that problem solving therapy and regular written communications after the self-harm attempt may be an effective treatment. This protocol describes a large pragmatic trial of a package of measures which include problem solving therapy, regular written communication, patient support, cultural assessment, improved access to primary care and a risk management strategy in people who present to hospital after self-harm using a novel design. Methods We propose to use a double consent Zelen design where participants are randomised prior to giving consent to enrol a large representative cohort of patients. The main outcome will be hospital attendance following repetition of self-harm, in the 12 months after recruitment with secondary outcomes of self reported self-harm, hopelessness, anxiety, depression, quality of life, social function and hospital use at three months and one year. Discussion A strength of the study is that it is a pragmatic trial which aims to recruit large numbers and does not exclude people if English is not their first language. A potential limitation is the analysis of the results which is complex and may underestimate any effect if a large number of people refuse their consent in the group randomised to problem solving therapy as they will effectively cross over to the treatment as usual group. However the primary analysis is a true intention to treat analysis of everyone randomised which includes both those who consent and do not consent to participate in the study. This provides information about how the intervention will work in practice in a representative population which is a major advance in this study compared to what has

  18. Project "Hypertension Alert."

    Science.gov (United States)

    Sailors, Emma Lou

    1983-01-01

    "Hypertension Alert," a 1979-80 blood pressure screening-awareness project of the Yonkers, New York Public Schools, is described. Data is analyzed in tables for ethnic composition, and range of blood pressure readings for the high school, junior high school, and elementary school students tested. (Author/JMK)

  19. Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.

    Science.gov (United States)

    Wright, Adam; Aaron, Skye; Seger, Diane L; Samal, Lipika; Schiff, Gordon D; Bates, David W

    2018-05-15

    Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

  20. 75 FR 67201 - Flightcrew Alerting

    Science.gov (United States)

    2010-11-02

    ... two different senses for warning and caution alerts. Identifying an alert and determining corrective... pilots to the urgency that should be associated with the meaning of these colors, which could increase... consistent and standardized color usage is desirable to ensure the pilot understands the urgency of an alert...

  1. An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol-related harm including violence in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Moore Simon C

    2012-06-01

    Full Text Available Abstract Background To assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation. Methods An exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises’ customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews. Results The process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises. Conclusions It is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability. Trial registration UKCRN 7090; ISRCTN: 80875696

  2. CEI-PEA Alert, Summer 2006

    Science.gov (United States)

    Center for Educational Innovation - Public Education Association, 2006

    2006-01-01

    The "CEI-PEA Alert" is an advocacy newsletter that deals with topics of interest to all concerned with the New York City public schools. This issue includes: (1) Practical Skills & High Academic Standards: Career Technical Education; (2) Parents: Help Your Children Gain "Soft Skills" for the Workforce; (3) Culinary Arts…

  3. Regulatory alerts for dietary supplements in Canada and the United States, 2005-13.

    Science.gov (United States)

    Abe, Andrew M; Hein, Darren J; Gregory, Philip J

    2015-06-01

    Dietary supplement regulatory alerts published by the Food and Drug Administration (FDA) and Health Canada were evaluated and characterized. FDA MedWatch and Health Canada websites were reviewed to identify regulatory alerts regarding dietary supplements from January 1, 2005, through December 31, 2013. Alerts were analyzed to identify product characteristics that may be predictive of product quality issues and potential patient harm. A total of 1560 dietary supplement-related regulatory alerts were identified. Of those, 1287 (83%) were identified through Health Canada, and 273 (18%) were identified through FDA MedWatch. The country of origin of dietary supplements associated with regulatory alerts was not provided in most regulatory alerts; however, when their origin was provided, the United States was the most common. Dietary supplements intended for sexual enhancement were the subject of 33% of all regulatory alerts identified. Products purchased online were the most likely to be associated with a regulatory alert. Dietary supplements intended for sexual enhancement, weight loss, and bodybuilding or athletic performance appeared to pose the greatest risk for patient harm due to product contamination with a pharmaceutical such as a phosphodiesterase-5 inhibitor or sibutramine. Analysis of Canadian and U.S. regulatory alerts concerning dietary supplements revealed that more than 80% of the composite alerts were issued by Health Canada. The most common intended uses of supplements for which alerts were issued were sexual enhancement, weight loss, and bodybuilding or athletic performance. The most common reason for alerts was the presence of a pharmaceutical contaminant. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. Alert Messaging in the CMS Distributed Workflow System

    International Nuclear Information System (INIS)

    Maxa, Zdenek

    2012-01-01

    WMAgent is the core component of the CMS workload management system. One of the features of this job managing platform is a configurable messaging system aimed at generating, distributing and processing alerts: short messages describing a given alert-worthy information or pathological condition. Apart from the framework's sub-components running within the WMAgent instances, there is a stand-alone application collecting alerts from all WMAgent instances running across the CMS distributed computing environment. The alert framework has a versatile design that allows for receiving alert messages also from other CMS production applications, such as PhEDEx data transfer manager. We present implementation details of the system, including its Python implementation using ZeroMQ, CouchDB message storage and future visions as well as operational experiences. Inter-operation with monitoring platforms such as Dashboard or Lemon is described.

  5. IR panoramic alerting sensor concepts and applications

    Science.gov (United States)

    de Jong, Arie N.; Schwering, Piet B. W.

    2003-09-01

    During the last decade, protection of military and civilian operational platforms against weapons like guns, grenades, missiles, Unmanned Combat Aerial (and surface) Vehicles (UCAV's) and mines, has been an issue of increased importance due to the improved kill-probability of these threats. The standard countermeasure package of armour, guns, decoys, jammers, camouflage nets and smokes is inadequate when not accompanied by a suitable sensor package, primarily consisting of an alerting device, triggering consecutive steps in the countermeasure-chain. In this process of alert four different detection techniques are considered: pre-alert, giving the directions of possible attack, detection of an action of attack, identification of the threat and finally the precise localization (3-D). The design of the alerting device is greatly depending on the platform, on which it will be used, the associated and affordable cost and the nature of the threat. A number of sensor packages, considered, developed and evaluated at TNO-FEL is presented for simple, medium size and large and expensive platforms. In recent years the requirements for these sensors have become more and more strigent due to the growing number of scenarios. The attack can practically be from any direction, implying the need for a large Field of Regard (FOR), the attack range can vary considerably and the type of threat can be very diverse, implying great flexibility and dynamic range and rapid response of the sensor. Especially the localization at short ranges is a challenging issue. Various configurations including advantages and drawbacks are discussed.

  6. The relations between de-alerting nuclear force and nuclear strategy

    International Nuclear Information System (INIS)

    Li Zhimin

    2001-01-01

    De-alerting nuclear force is a hot-point issue in recent years. The relations between de-alerting and strategy (including nuclear force, target doctrine and use principle et al.), stability, advanced conventional force and NMD of the United States are analyzed, the impact of de-alerting on Chinese nuclear force were discussed and the proposal of de-alerting by stages is presented

  7. Helping Self-Harming Students

    Science.gov (United States)

    Selekman, Matthew D.

    2009-01-01

    Approximately 14 to 17 percent of adolescents today self-harm, deliberately cutting, burning, or bruising themselves. Most self-harming adolescents use the behavior as a coping strategy to get immediate relief from emotional distress or other stressors in their lives. Stressors include fitting in with peers, activity and homework overload, fears…

  8. Rapid deployable global sensing hazard alert system

    Science.gov (United States)

    Cordaro, Joseph V; Tibrea, Steven L; Shull, Davis J; Coleman, Jerry T; Shuler, James M

    2015-04-28

    A rapid deployable global sensing hazard alert system and associated methods of operation are provided. An exemplary system includes a central command, a wireless backhaul network, and a remote monitoring unit. The remote monitoring unit can include a positioning system configured to determine a position of the remote monitoring unit based on one or more signals received from one or more satellites located in Low Earth Orbit. The wireless backhaul network can provide bidirectional communication capability independent of cellular telecommunication networks and the Internet. An exemplary method includes instructing at least one of a plurality of remote monitoring units to provide an alert based at least in part on a location of a hazard and a plurality of positions respectively associated with the plurality of remote monitoring units.

  9. Provider and pharmacist responses to warfarin drug–drug interaction alerts: a study of healthcare downstream of CPOE alerts

    Science.gov (United States)

    Boro, Maureen S; Korman, Nancy E; Davoren, J Ben

    2011-01-01

    Objective To categorize the appropriateness of provider and pharmacist responses to warfarin critical drug–drug interaction (cDDI) alerts, assess responses and actions to the cDDI, and determine the occurrence of warfarin adverse drug events (ADE) after alerts. Design An 18-month, retrospective study of acute care admissions at a single Veterans Affairs medical center using computerized provider order entry (CPOE). Measurements Patients included had at least one warfarin cDDI alert. Chart reviews included baseline laboratory values and demographics, provider actions, patient outcomes, and associated factors, including other interacting medications and number of simultaneously processed alerts. Results 137 admissions were included (133 unique patients). Amiodarone, vitamin E in a multivitamin, sulfamethoxazole, and levothyroxine accounted for 75% of warfarin cDDI. Provider responses were clinically appropriate in 19.7% of admissions and pharmacist responses were appropriate in 9.5% of admissions. There were 50 ADE (36.6% of admissions) with warfarin; 80% were rated as having no or mild clinical effect. An increased number of non-critical alerts at the time of the reference cDDI alert was the only variable associated with an inappropriate provider response (p=0.01). Limitations This study was limited by being a retrospective review and the possibility of confounding variables, such as other interacting medications. Conclusion The large number of CPOE alerts may lead to inappropriate responses by providers and pharmacists. The high rate of ADE suggests a need for improved medication management systems for patients on warfarin. This study highlights the possibility of alert fatigue contributing to the high prevalence of inappropriate alert over-ride text responses. PMID:22037888

  10. Real-time alerts and reminders using information systems.

    Science.gov (United States)

    Wanderer, Jonathan P; Sandberg, Warren S; Ehrenfeld, Jesse M

    2011-09-01

    Adoption of information systems throughout the hospital environment has enabled the development of real-time physiologic alerts and clinician reminder systems. These clinical tools can be made available through the deployment of anesthesia information management systems (AIMS). Creating usable alert systems requires understanding of technical considerations. Various successful implementations are reviewed, encompassing cost reduction, improved revenue capture, timely antibiotic administration, and postoperative nausea and vomiting prophylaxis. Challenges to the widespread use of real-time alerts and reminders include AIMS adoption rates and the difficulty in choosing appropriate areas and approaches for information systems support. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Education and Training Module in Alertness Management

    Science.gov (United States)

    Mallis, M. M.; Brandt, S. L.; Oyung, R. L.; Reduta, D. D.; Rosekind, M. R.

    2006-01-01

    The education and training module (ETM) in alertness management has now been integrated as part of the training regimen of the Pilot Proficiency Awards Program ("WINGS") of the Federal Aviation Administration. Originated and now maintained current by the Fatigue Countermeasures Group at NASA Ames Research Center, the ETM in Alertness Management is designed to give pilots the benefit of the best and most recent research on the basics of sleep physiology, the causes of fatigue, and strategies for managing alertness during flight operations. The WINGS program is an incentive program that encourages pilots at all licensing levels to participate in recurrent training, upon completion of which distinctive lapel or tie pins (wings) and certificates of completion are awarded. In addition to flight training, all WINGS applicants must attend at least one FAA-sponsored safety seminar, FAA-sanctioned safety seminar, or industry recurrent training program. The Fatigue Countermeasures Group provides an FAA-approved industry recurrent training program through an on-line General Aviation (GA) WINGS ETM in alertness management to satisfy this requirement. Since 1993, the Fatigue Countermeasures Group has translated fatigue and alertness information to operational environments by conducting two-day ETM workshops oriented primarily toward air-carrier operations subject to Part 121 of the Federal Aviation Regulations pertaining to such operations. On the basis of the information presented in the two-day ETM workshops, an ETM was created for GA pilots and was transferred to a Web-based version. To comply with the requirements of the WINGS Program, the original Web-based version has been modified to include hypertext markup language (HTML) content that makes information easily accessible, in-depth testing of alertness-management knowledge, new interactive features, and increased informational resources for GA pilots. Upon successful completion of this training module, a participant

  12. Harmful Algal Blooms

    Science.gov (United States)

    Graham, Jennifer L.

    2007-01-01

    What are Harmful Algal Blooms (HABs)? Freshwater and marine harmful algal blooms (HABs) can occur anytime water use is impaired due to excessive accumulations of algae. HAB occurrence is affected by a complex set of physical, chemical, biological, hydrological, and meteorological conditions making it difficult to isolate specific causative environmental factors. Potential impairments include reduction in water quality, accumulation of malodorous scums in beach areas, algal production of toxins potent enough to poison both aquatic and terrestrial organisms, and algal production of taste-and-odor compounds that cause unpalatable drinking water and fish. HABs are a global problem, and toxic freshwater and (or) marine algae have been implicated in human and animal illness and death in over 45 countries worldwide and in at least 27 U.S. States (Yoo and others, 1995; Chorus and Bartram, 1999; Huisman and others, 2005).

  13. Gaia Science Alerts: Early Validation Phase Data from Gaia

    Science.gov (United States)

    Walton, Nicholas; Hodgkin, Simon; van Leeuwen, Floor

    2015-08-01

    The ESA Gaia satellite launched Dec 2013, and after successful completion of its in orbit commissioning in July 2014, begun routine operations, with the aim to accurately measure the astrometric and astrophysical properties of more than a billion stars in our Milky Way.As a significant by product of its observational scanning law, where each point on the sky is observed multiple times (~80 revisits on average) over the nominal 5 year mission, Gaia has significant utility in detecting new transients, both flux (e.g. Supernovae, Flare stars) and positional (e.g. Asteroids).We will present the current status of the Gaia Photometric Science Alerts (PSA) system that has been developed within the Gaia DPAC. The PSA pipeline provides a quick look analysis of the daily data stream from Gaia, and identifies new photometric alerts, from analysis of the object photometric and the low resolution spectro-photometric data. Via a set of filters, those identified as astrophysical in nature, are published to the community. The information provided currently includes positional and flux information.The Gaia Alerts working group has organised a significant early stage followup campaign, providing access to a wide variety of followup facilities. These have been used to provide classification spectra of the Gaia alert candidates, with the early phase data confirming that the alerts issued are indeed largely astrophysical transients, with only a small contamination rate.The presentation will address the early phase issues that have been addressed in localising and classifying alerts in the early phase of Gaia observations (for instance, how lack of early knowledge of the sky as seen by Gaia was mitigated by reference to external image data), and how the alert rate published by the PSA will ramp up towards the end of 2015, with the availability of more Gaia sky data.Information concerning the Gaia alerts system can be found at http://gaia.ac.uk/selected-gaia-science-alerts

  14. The Common Alerting Protocol (CAP) adaption in National Early Warning Alerting Systems of China

    Science.gov (United States)

    Li, Chao

    2017-04-01

    The Common Alerting Protocol (CAP) [1] is an XML-based data format for exchanging public warnings and emergencies between alerting technologies. In China, from local communities to entire nations, there was a patchwork of specialized hazard public alerting systems. And each system was often designed just for certain emergency situations and for certain communications media. Application took place in the NEWAS (National Early Warning Alerting Systems) [2]project where CAP serves as central message to integrate all kind of hazard situations, including the natural calamity, accident disaster, public health emergency , social safety etc. Officially operated on May 2015, NEWAS now has completed docking work with 14 departments including civil administration, safety supervision, forestry, land, water conservancy, earthquake, traffic, meteorology, agriculture, tourism, food and drug supervision, public security and oceanic administration. Thus, several items in CAP has been modified, redefined and extended according to the various grading standards and publishing strategies, as well as the characteristics of Chinese Geocoding. NEWAS successfully delivers information to end users through 4 levels (i.e. State, province, prefecture and county) structure and by various means. [1] CAP, http://www.oasis-emergency.org/cap [2] http://www.12379.cn/

  15. Islam and harm reduction.

    Science.gov (United States)

    Kamarulzaman, A; Saifuddeen, S M

    2010-03-01

    Although drugs are haram and therefore prohibited in Islam, illicit drug use is widespread in many Islamic countries throughout the world. In the last several years increased prevalence of this problem has been observed in many of these countries which has in turn led to increasing injecting drug use driven HIV/AIDS epidemic across the Islamic world. Whilst some countries have recently responded to the threat through the implementation of harm reduction programmes, many others have been slow to respond. In Islam, The Quran and the Prophetic traditions or the Sunnah are the central sources of references for the laws and principles that guide the Muslims' way of life and by which policies and guidelines for responses including that of contemporary social and health problems can be derived. The preservation and protection of the dignity of man, and steering mankind away from harm and destruction are central to the teachings of Islam. When viewed through the Islamic principles of the preservation and protection of the faith, life, intellect, progeny and wealth, harm reduction programmes are permissible and in fact provide a practical solution to a problem that could result in far greater damage to the society at large if left unaddressed. Copyright (c) 2009. Published by Elsevier B.V.

  16. Self-harm and overcrowding among prisoners in Geneva, Switzerland.

    Science.gov (United States)

    Wolff, Hans; Casillas, Alejandra; Perneger, Thomas; Heller, Patrick; Golay, Diane; Mouton, Elisabeth; Bodenmann, Patrick; Getaz, Laurent

    2016-01-01

    Prison institutional conditions affect risk for self-harm among detainees. In particular, prison overcrowding may increase the likelihood of self-harm by creating competition for resources, space, and enhancing a "deprivation state." The purpose of this paper is to examine the association between overcrowding and prisoner acts of self-harm. This cross-sectional study took place at Geneva's pre-trial prison (capacity:376) between 2006 and 2014. Outcomes were acts of self-harm that required medical attention, and self-strangulation/hanging events (combined into one group, as these are difficult to differentiate). Dichotomous predictors were overcrowding index- annual mean daily population divided by capacity ( > 200 percent vs prison change in gender, area of origin, foreign residency, religion, or psychiatric treatment. The present study is limited by the definition and identification of self-harm. The distinction between self-strangulation and self-hanging, and the precise classification of an intent to die is difficult to make in practice, especially with limited prison data records available. The relevant literature addresses the complexity of the association between non-suicidal and suicidal behavior. Despite this, the combined category self-strangulations/hangings gives some indication of severe self-harm events, especially since the methodology of categorization employed was consistent throughout the entire period of the study. Other limitations include the small sample size and the lack of individual patient data and prison data to help control for confounding factors. Despite these drawbacks, pertinent data (socio-demographics and number of prisoners treated for mental health and drug abuse) remained stable over the years. Thus, there are no apparent changes in the inmate population that could be linked to an increase in self-harm. High-security placements and mean prisoner stay have increased over time, with a decrease in staff to prisoner ratio - and these

  17. Monitoring alert and drowsy states by modeling EEG source nonstationarity

    Science.gov (United States)

    Hsu, Sheng-Hsiou; Jung, Tzyy-Ping

    2017-10-01

    Objective. As a human brain performs various cognitive functions within ever-changing environments, states of the brain characterized by recorded brain activities such as electroencephalogram (EEG) are inevitably nonstationary. The challenges of analyzing the nonstationary EEG signals include finding neurocognitive sources that underlie different brain states and using EEG data to quantitatively assess the state changes. Approach. This study hypothesizes that brain activities under different states, e.g. levels of alertness, can be modeled as distinct compositions of statistically independent sources using independent component analysis (ICA). This study presents a framework to quantitatively assess the EEG source nonstationarity and estimate levels of alertness. The framework was tested against EEG data collected from 10 subjects performing a sustained-attention task in a driving simulator. Main results. Empirical results illustrate that EEG signals under alert versus drowsy states, indexed by reaction speeds to driving challenges, can be characterized by distinct ICA models. By quantifying the goodness-of-fit of each ICA model to the EEG data using the model deviation index (MDI), we found that MDIs were significantly correlated with the reaction speeds (r  =  -0.390 with alertness models and r  =  0.449 with drowsiness models) and the opposite correlations indicated that the two models accounted for sources in the alert and drowsy states, respectively. Based on the observed source nonstationarity, this study also proposes an online framework using a subject-specific ICA model trained with an initial (alert) state to track the level of alertness. For classification of alert against drowsy states, the proposed online framework achieved an averaged area-under-curve of 0.745 and compared favorably with a classic power-based approach. Significance. This ICA-based framework provides a new way to study changes of brain states and can be applied to

  18. The DOPA decarboxylase (DDC) gene is associated with alerting attention.

    Science.gov (United States)

    Zhu, Bi; Chen, Chuansheng; Moyzis, Robert K; Dong, Qi; Chen, Chunhui; He, Qinghua; Li, Jin; Li, Jun; Lei, Xuemei; Lin, Chongde

    2013-06-03

    DOPA decarboxylase (DDC) is involved in the synthesis of dopamine, norepinephrine and serotonin. It has been suggested that genes involved in the dopamine, norepinephrine, and cholinergic systems play an essential role in the efficiency of human attention networks. Attention refers to the cognitive process of obtaining and maintaining the alert state, orienting to sensory events, and regulating the conflicts of thoughts and behavior. The present study tested seven single nucleotide polymorphisms (SNPs) within the DDC gene for association with attention, which was assessed by the Attention Network Test to detect three networks of attention, including alerting, orienting, and executive attention, in a healthy Han Chinese sample (N=451). Association analysis for individual SNPs indicated that four of the seven SNPs (rs3887825, rs7786398, rs10499695, and rs6969081) were significantly associated with alerting attention. Haplotype-based association analysis revealed that alerting was associated with the haplotype G-A-T for SNPs rs7786398-rs10499695-rs6969081. These associations remained significant after correcting for multiple testing by max(T) permutation. No association was found for orienting and executive attention. This study provides the first evidence for the involvement of the DDC gene in alerting attention. A better understanding of the genetic basis of distinct attention networks would allow us to develop more effective diagnosis, treatment, and prevention of deficient or underdeveloped alerting attention as well as its related prevalent neuropsychiatric disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Harmful Algal Blooms (HABs)

    Science.gov (United States)

    ... toxins that may harm or kill fish and marine animals. Humans who eat shellfish contaminated with HAB toxins ... toxins that may harm or kill fish and marine animals. Humans who eat shellfish containing toxins produced by ...

  20. Automated attendance management and alert system | Rahim ...

    African Journals Online (AJOL)

    Automated attendance management and alert system. ... Journal of Fundamental and Applied Sciences ... AAMAS provides various functions, from managing and recording students' attendance record, to sending automatic alerts to students ...

  1. Self-harm

    Science.gov (United States)

    Self-harm refers to a person's harming their own body on purpose. About 1 in 100 people hurts himself or herself in this way. More females hurt themselves than males. A person who self-harms usually does not mean to kill himself or herself. But they are at higher risk of attempting suicide if they do ...

  2. Kombucha--toxicity alert.

    Science.gov (United States)

    The Kombucha mushroom, also known as Manchurian mushroom, is a mail-order product touted to lower blood pressure and raise T-cell counts. No controlled trials have been conducted to test these claims. Aspergillus, a mold that may grow on the Kombucha mushroom, attacks the brain and may be fatal to persons with weakened immune systems. Reported toxicity reactions have included stomach problems and yeast infections. Taking Kombucha in combination with other drugs may affect the drugs potency.

  3. Les lanceurs d’alerte

    OpenAIRE

    Foegle, Jean-Philippe

    2014-01-01

    Le lanceur ou « donneur » d'alerte, ou, en langue anglaise, whistleblower est défini par l'assemblée parlementaire du conseil de l'Europe (Résolution 1729 (2010), §1) comme « toute personne soucieuse qui tire la sonnette d’alarme afin de faire cesser des agissements pouvant représenter un risque pour autrui ». Le présent mémoire vise, en menant une étude comparée France-Etats-Unis du droit encadrant le phénomène du « lancement d'alerte », à cerner les éléments principaux de la notion. Le prem...

  4. Deliberate Self Harm Behavior

    Directory of Open Access Journals (Sweden)

    Fatma Gul Helvaci Celik

    2017-06-01

    Full Text Available The deliberate self-harm behaviour which defined as attempting to own body resulting in tisue damage without conscious desire of peolple to die, is a major public health problem worldwide. The causes of deliberate self- harm, risk factors, the relationship between mental disorders and treatment strategies are not fully known. Deliberate self- harm can be observed together with psychiatric disorders such as borderline personality disorder, histrionic personality disorder, eating disorders and mood disorders. Also, deliberate self-harm must be distinguished from suicidal behavior. Psychologi-cal trauma has been suggested as a risk factor for deliberate self- harm behavior. Trauma and traumatic events have long been associated with deliberate self- harm behavior. The aim of this review article is to investigate the etiology and epidemiology of deliberate self-harm behaviour and relationship between psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000: 209-226

  5. A Novel Design for Drug-Drug Interaction Alerts Improves Prescribing Efficiency.

    Science.gov (United States)

    Russ, Alissa L; Chen, Siying; Melton, Brittany L; Johnson, Elizabette G; Spina, Jeffrey R; Weiner, Michael; Zillich, Alan J

    2015-09-01

    Drug-drug interactions (DDIs) are common in clinical care and pose serious risks for patients. Electronic health records display DDI alerts that can influence prescribers, but the interface design of DDI alerts has largely been unstudied. In this study, the objective was to apply human factors engineering principles to alert design. It was hypothesized that redesigned DDI alerts would significantly improve prescribers' efficiency and reduce prescribing errors. In a counterbalanced, crossover study with prescribers, two DDI alert designs were evaluated. Department of Veterans Affairs (VA) prescribers were video recorded as they completed fictitious patient scenarios, which included DDI alerts of varying severity. Efficiency was measured from time-stamped recordings. Prescribing errors were evaluated against predefined criteria. Efficiency and prescribing errors were analyzed with the Wilcoxon signed-rank test. Other usability data were collected on the adequacy of alert content, prescribers' use of the DDI monograph, and alert navigation. Twenty prescribers completed patient scenarios for both designs. Prescribers resolved redesigned alerts in about half the time (redesign: 52 seconds versus original design: 97 seconds; p<.001). Prescribing errors were not significantly different between the two designs. Usability results indicate that DDI alerts might be enhanced by facilitating easier access to laboratory data and dosing information and by allowing prescribers to cancel either interacting medication directly from the alert. Results also suggest that neither design provided adequate information for decision making via the primary interface. Applying human factors principles to DDI alerts improved overall efficiency. Aspects of DDI alert design that could be further enhanced prior to implementation were also identified.

  6. A mobile care system with alert mechanism.

    Science.gov (United States)

    Lee, Ren-Guey; Chen, Kuei-Chien; Hsiao, Chun-Chieh; Tseng, Chwan-Lu

    2007-09-01

    Hypertension and arrhythmia are chronic diseases, which can be effectively prevented and controlled only if the physiological parameters of the patient are constantly monitored, along with the full support of the health education and professional medical care. In this paper, a role-based intelligent mobile care system with alert mechanism in chronic care environment is proposed and implemented. The roles in our system include patients, physicians, nurses, and healthcare providers. Each of the roles represents a person that uses a mobile device such as a mobile phone to communicate with the server setup in the care center such that he or she can go around without restrictions. For commercial mobile phones with Bluetooth communication capability attached to chronic patients, we have developed physiological signal recognition algorithms that were implemented and built-in in the mobile phone without affecting its original communication functions. It is thus possible to integrate several front-end mobile care devices with Bluetooth communication capability to extract patients' various physiological parameters [such as blood pressure, pulse, saturation of haemoglobin (SpO2), and electrocardiogram (ECG)], to monitor multiple physiological signals without space limit, and to upload important or abnormal physiological information to healthcare center for storage and analysis or transmit the information to physicians and healthcare providers for further processing. Thus, the physiological signal extraction devices only have to deal with signal extraction and wireless transmission. Since they do not have to do signal processing, their form factor can be further reduced to reach the goal of microminiaturization and power saving. An alert management mechanism has been included in back-end healthcare center to initiate various strategies for automatic emergency alerts after receiving emergency messages or after automatically recognizing emergency messages. Within the time

  7. [Self-harming behaviour].

    Science.gov (United States)

    Kool, Nienke; Pollen, Wim; van Meijel, Berno

    2010-01-01

    To gain a better understanding of self-harm, a 28-year-old female patient and a 19-year-old female patient with self-harming behaviour are presented. The first patient refused treatment of cut wounds when the doctor enquired about the reason for self-harm. The second patient was referred for mental health care. These cases illustrate the complexity of this behaviour for the patient and the caregiver. Self-harm is often a symbol of underlying problems and serves multiple psychological functions. It is mostly used by patients to cope with unbearable emotions for which they have no other solution. The self-harm invokes different feelings in caregivers which tend to influence the attitude of the caregiver towards the patient. It is very important that caregivers are aware of their feelings and use them professionally. People who self-harm should not be judged, but treated respectfully and attention should be paid to their suffering.

  8. Harm reduction principles for healthcare settings

    Directory of Open Access Journals (Sweden)

    Mary Hawk

    2017-10-01

    Full Text Available Abstract Background Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Methods Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. Results We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. Conclusion This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of

  9. Harm reduction principles for healthcare settings.

    Science.gov (United States)

    Hawk, Mary; Coulter, Robert W S; Egan, James E; Fisk, Stuart; Reuel Friedman, M; Tula, Monique; Kinsky, Suzanne

    2017-10-24

    Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health

  10. False alerts in air traffic control conflict alerting system: is there a "cry wolf" effect?

    Science.gov (United States)

    Wickens, Christopher D; Rice, Stephen; Keller, David; Hutchins, Shaun; Hughes, Jamie; Clayton, Krisstal

    2009-08-01

    The aim is to establish the extent to which the high false-alarm rate of air traffic control midair conflict alerts is responsible for a "cry wolf' effect-where true alerts are not responded to and all alerts are delayed in their response. Some aircraft collisions have been partly attributed to the cry wolf effect, and in other domains (health care and systems monitoring), there is a causal connection between false-alarm rate and cry wolf behavior. We hypothesized that a corresponding relationship exists in air traffic control (ATC). Aircraft track and alert system behavior data surrounding 495 conflict alerts were analyzed to identify true and false alerts, trajectory type, and controller behavior. Forty-five percent of the alerts were false, ranging from 0.28 to 0.58. Although centers with more false alerts contributed to more nonresponses, there was no evidence that these were nonresponses to true alerts or that response times were delayed in those centers. Instead, controllers showed desirable anticipatory behavior by issuing trajectory changes prior to the alert. Those trajectory pairs whose conflicts were more difficult to visualize induced more reliance on, and less compliance with, the alerting system. The high false-alarm rate does not appear to induce cry wolf behavior in the context of en route ATC conflict alerts. There is no need to substantially modify conflict alert algorithms, but the conflict alert system may be modified to address difficult-to-visualize conflicts.

  11. Sex-work harm reduction.

    Science.gov (United States)

    Rekart, Michael L

    2005-12-17

    Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.

  12. Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program - Recommendations for Public Alerts Via Cell Phones

    Science.gov (United States)

    DeGroot, R. M.; Long, K.; Strauss, J. A.

    2017-12-01

    The United States Geological Survey (USGS) and its partners are developing the ShakeAlert Earthquake Early Warning System for the West Coast of the United States. To be an integral part of successful implementation, ShakeAlert engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education and communication efforts. The ShakeAlert Joint Committee for Communication, Education, and Outreach (JCCEO), is identifying, developing, and cultivating partnerships with ShakeAlert stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on ShakeAlert, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive a ShakeAlert warning. In February 2017, the JCCEO convened the Warning Message Focus Group (WMFG) to provide findings and recommendations to the Alliance for Telecommunications Industry Solutions on the use of earthquake early warning message content standards for public alerts via cell phones. The WMFG represents communications, education, and outreach stakeholders from various sectors including ShakeAlert regional coordinators, industry, emergency managers, and subject matter experts from the social sciences. The group knowledge was combined with an in-depth literature review to ensure that all groups who could receive the message would be taken into account. The USGS and the participating states and agencies acknowledge that the implementation of ShakeAlert is a collective effort requiring the participation of hundreds of

  13. Sleepiness and alertness in American industries

    International Nuclear Information System (INIS)

    Coleman, R.M.; Dillingham, J.; Dement, W.C.

    1989-01-01

    Recent evidence that industrial accidents may be caused in part by shiftworkers' lack of alertness has caused growing concern at the US Nuclear Regulatory Commission and within the scientific community. The purpose of the study reported in this paper was threefold: (1) Is sleepiness on the job specific to utility plants? (2) Are performance and safety problems caused by sleepiness specific to utility plants? (3) Are specific shift schedules associated with a higher prevalence of sleepiness? Findings indicate sleepiness on the job among shiftworkers is a widespread problem, not limited to the nuclear power industry. The most common solution in American industry is to overstaff each shift and discipline sleeping employees. Results show this is not effective. A more proactive solution is recommended including some of the following: (1) Provide employees education to assist adjustment to shiftwork. (2) Design and implement shift schedules that are more compatible with human physiological capabilities. (3) Allow officially sanctioned napping on shift as is done in Japan. (4) Divide 6-, 8-, or 12-h shifts into smaller blocks of 2 to 3 h of primary duty. (5) make the environment where employees work more conductive to alertness. (6) Develop a firehouse type of schedule where some employees sleep throughout the night, but are awakened if operational problems arise. (7) Provide incentives to employees to adjust their life style to the night shift and reward them with time off

  14. Sleepiness and alertness in American industries

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, R.M.; Dillingham, J.; Dement, W.C.

    1989-01-01

    Recent evidence that industrial accidents may be caused in part by shiftworkers' lack of alertness has caused growing concern at the US Nuclear Regulatory Commission and within the scientific community. The purpose of the study reported in this paper was threefold: (1) Is sleepiness on the job specific to utility plants (2) Are performance and safety problems caused by sleepiness specific to utility plants (3) Are specific shift schedules associated with a higher prevalence of sleepiness Findings indicate sleepiness on the job among shiftworkers is a widespread problem, not limited to the nuclear power industry. The most common solution in American industry is to overstaff each shift and discipline sleeping employees. Results show this is not effective. A more proactive solution is recommended including some of the following: (1) Provide employees education to assist adjustment to shiftwork. (2) Design and implement shift schedules that are more compatible with human physiological capabilities. (3) Allow officially sanctioned napping on shift as is done in Japan. (4) Divide 6-, 8-, or 12-h shifts into smaller blocks of 2 to 3 h of primary duty. (5) make the environment where employees work more conductive to alertness. (6) Develop a firehouse type of schedule where some employees sleep throughout the night, but are awakened if operational problems arise. (7) Provide incentives to employees to adjust their life style to the night shift and reward them with time off.

  15. Harm minimization among teenage drinkers

    DEFF Research Database (Denmark)

    Jørgensen, Morten Hulvej; Curtis, Tine; Christensen, Pia Haudrup

    2007-01-01

    AIM: To examine strategies of harm minimization employed by teenage drinkers. DESIGN, SETTING AND PARTICIPANTS: Two periods of ethnographic fieldwork were conducted in a rural Danish community of approximately 2000 inhabitants. The fieldwork included 50 days of participant observation among 13....... In regulating the social context of drinking they relied on their personal experiences more than on formalized knowledge about alcohol and harm, which they had learned from prevention campaigns and educational programmes. CONCLUSIONS: In this study we found that teenagers may help each other to minimize alcohol...

  16. CISN ShakeAlert Earthquake Early Warning System Monitoring Tools

    Science.gov (United States)

    Henson, I. H.; Allen, R. M.; Neuhauser, D. S.

    2015-12-01

    CISN ShakeAlert is a prototype earthquake early warning system being developed and tested by the California Integrated Seismic Network. The system has recently been expanded to support redundant data processing and communications. It now runs on six machines at three locations with ten Apache ActiveMQ message brokers linking together 18 waveform processors, 12 event association processes and 4 Decision Module alert processes. The system ingests waveform data from about 500 stations and generates many thousands of triggers per day, from which a small portion produce earthquake alerts. We have developed interactive web browser system-monitoring tools that display near real time state-of-health and performance information. This includes station availability, trigger statistics, communication and alert latencies. Connections to regional earthquake catalogs provide a rapid assessment of the Decision Module hypocenter accuracy. Historical performance can be evaluated, including statistics for hypocenter and origin time accuracy and alert time latencies for different time periods, magnitude ranges and geographic regions. For the ElarmS event associator, individual earthquake processing histories can be examined, including details of the transmission and processing latencies associated with individual P-wave triggers. Individual station trigger and latency statistics are available. Detailed information about the ElarmS trigger association process for both alerted events and rejected events is also available. The Google Web Toolkit and Map API have been used to develop interactive web pages that link tabular and geographic information. Statistical analysis is provided by the R-Statistics System linked to a PostgreSQL database.

  17. Bar Code Medication Administration Technology: Characterization of High-Alert Medication Triggers and Clinician Workarounds.

    Science.gov (United States)

    Miller, Daniel F; Fortier, Christopher R; Garrison, Kelli L

    2011-02-01

    Bar code medication administration (BCMA) technology is gaining acceptance for its ability to prevent medication administration errors. However, studies suggest that improper use of BCMA technology can yield unsatisfactory error prevention and introduction of new potential medication errors. To evaluate the incidence of high-alert medication BCMA triggers and alert types and discuss the type of nursing and pharmacy workarounds occurring with the use of BCMA technology and the electronic medication administration record (eMAR). Medication scanning and override reports from January 1, 2008, through November 30, 2008, for all adult medical/surgical units were retrospectively evaluated for high-alert medication system triggers, alert types, and override reason documentation. An observational study of nursing workarounds on an adult medicine step-down unit was performed and an analysis of potential pharmacy workarounds affecting BCMA and the eMAR was also conducted. Seventeen percent of scanned medications triggered an error alert of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages. Clinician override reasons for alerts were documented in only 23% of administrations. Observational studies assessing for nursing workarounds revealed a median of 3 clinician workarounds per administration. Specific nursing workarounds included a failure to scan medications/patient armband and scanning the bar code once the dosage has been removed from the unit-dose packaging. Analysis of pharmacy order entry process workarounds revealed the potential for missed doses, duplicate doses, and doses being scheduled at the wrong time. BCMA has the potential to prevent high-alert medication errors by alerting clinicians through alert messages. Nursing and pharmacy workarounds can limit the recognition of optimal safety outcomes and therefore workflow processes

  18. Deliberate self harm in children.

    Science.gov (United States)

    Krishnakumar, P; Geeta, M G; Riyaz, A

    2011-05-01

    To study the nature of deliberate self-harm (DSH) in children and to identify the associated factors. Child Guidance Clinic attached to the Department of Pediatrics of a teaching hospital in South India. Children with history of deliberate self harm who were referred to the CGC for psychological evaluation during a 10 year period. Children and parents were interviewed together and separately and details regarding age, sex, family and school environment, stresses and nature of self harm were documented. Psychiatric diagnosis was made based on DSM IV diagnostic criteria. Among the 30 children included in the study, 21 were boys and 9 were girls. Majority of children were between the ages of 11 and 13 years, the youngest being 6 years old. 76%of children had history of acute stressful life events and 62%of them had chronic ongoing stress. 62%of children had stress in the family and 41%had stress at school. Stress in the family included death of a parent, conflicts with parents or siblings, mental illness in the family, parental alcoholism and parental disharmony. Stress at school included conflicts with classmates, punishment or negative comments by teachers and learning problems. Psychiatric disorders were present in 52%of children, the commonest being depressive disorder. The commonest mode of DSH was self poisoning, and rat poison (zinc phosphide) was the commonest substance used. Deliberate self harm occurs in young children and the risk factors are comparable to those in adolescents.

  19. FAB (Functionally Alert Behavior Strategies) to Improve Self-Control

    Science.gov (United States)

    Pagano, John

    2015-01-01

    This paper describes the FAB (Functionally Alert Behavior) Strategies approach to improve behavior in children and adolescents with complex behavioral challenges. FAB Strategies include evidence-based environmental adaptations, sensory modulation, positive behavioral support, and physical self-regulation strategies. FAB Strategies can be used by…

  20. Sky alert! when satellites fail

    CERN Document Server

    Johnson, Les

    2013-01-01

    How much do we depend on space satellites? Defense, travel, agriculture, weather forecasting, mobile phones and broadband, commerce...the list seems endless. But what would our live be like if the unimaginable happened and, by accident or design, those space assets disappeared? Sky Alert! explores what our world would be like, looking in turn at areas where the loss could have catastrophic effects. The book - demonstrates our dependence on space technology and satellites; - outlines the effect on our economy, defense, and daily lives if satellites and orbiting spacecraft were destroyed; - illustrates the danger of dead satellites, spent rocket stages, and space debris colliding with a functioning satellites; - demonstrates the threat of dramatically increased radiation levels associated with geomagnetic storms; - introduces space as a potential area of conflict between nations.

  1. Auditory alert systems with enhanced detectability

    Science.gov (United States)

    Begault, Durand R. (Inventor)

    2008-01-01

    Methods and systems for distinguishing an auditory alert signal from a background of one or more non-alert signals. In a first embodiment, a prefix signal, associated with an existing alert signal, is provided that has a signal component in each of three or more selected frequency ranges, with each signal component in each of three or more selected level at least 3-10 dB above an estimated background (non-alert) level in that frequency range. The alert signal may be chirped within one or more frequency bands. In another embodiment, an alert signal moves, continuously or discontinuously, from one location to another over a short time interval, introducing a perceived spatial modulation or jitter. In another embodiment, a weighted sum of background signals adjacent to each ear is formed, and the weighted sum is delivered to each ear as a uniform background; a distinguishable alert signal is presented on top of this weighted sum signal at one ear, or distinguishable first and second alert signals are presented at two ears of a subject.

  2. 47 CFR 80.1111 - Distress alerting.

    Science.gov (United States)

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates...

  3. 21 CFR 26.20 - Alert system.

    Science.gov (United States)

    2010-04-01

    ... PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN... Provisions for Pharmaceutical Good Manufacturing Practices § 26.20 Alert system. (a) The details of an alert... concerning quality, which could necessitate additional controls or suspension of the distribution of the...

  4. Harmful algal blooms

    Digital Repository Service at National Institute of Oceanography (India)

    Bhat, S.R.; PrabhaDevi; DeSouza, L.; Verlecar, X.N.; Naik, C.G.

    as harmful algal bloom. Bloom formation is a natural process and it enhances biological productivity, but turns worrisome when caused by toxic species, leading to massive fish mortalities and hazards to human health. Incidences of'red tide' are increasing...

  5. Cutting and Self-Harm

    Science.gov (United States)

    ... Your feelings Feeling sad Cutting and self-harm Cutting and self-harm Self-harm, sometimes called self- ... There are many types of self-injury, and cutting is one type that you may have heard ...

  6. Evaluation of Visual Alerts in the Maritime Domain

    National Research Council Canada - National Science Library

    Roberts, Shelley; Foster-Hunt, Tara

    2008-01-01

    .... As the auditory modality is overloaded in the current alerting system, one method of potentially reducing perceptual overload is to replace auditory alerts with alerts presented in the visual domain...

  7. Alertness function of thalamus in conflict adaptation.

    Science.gov (United States)

    Wang, Xiangpeng; Zhao, Xiaoyue; Xue, Gui; Chen, Antao

    2016-05-15

    Conflict adaptation reflects the ability to improve current conflict resolution based on previously experienced conflict, which is crucial for our goal-directed behaviors. In recent years, the roles of alertness are attracting increasing attention when discussing the generation of conflict adaptation. However, due to the difficulty of manipulating alertness, very limited progress has been made in this line. Inspired by that color may affect alertness, we manipulated background color of experimental task and found that conflict adaptation significantly presented in gray and red backgrounds but did not in blue background. Furthermore, behavioral and functional magnetic resonance imaging results revealed that the modulation of color on conflict adaptation was implemented through changing alertness level. In particular, blue background eliminated conflict adaptation by damping the alertness regulating function of thalamus and the functional connectivity between thalamus and inferior frontal gyrus (IFG). In contrast, in gray and red backgrounds where alertness levels are typically high, the thalamus and the right IFG functioned normally and conflict adaptations were significant. Therefore, the alertness function of thalamus is determinant to conflict adaptation, and thalamus and right IFG are crucial nodes of the neural circuit subserving this ability. Present findings provide new insights into the neural mechanisms of conflict adaptation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Automated acute kidney injury alerts.

    Science.gov (United States)

    Kashani, Kianoush B

    2018-05-02

    Acute kidney injury (AKI) is one of the most common and probably one of the more consequential complications of critical illnesses. Recent information indicates that it is at least partially preventable; however, progress in its prevention, management, and treatment has been hindered by the scarcity of knowledge for effective interventions, inconsistencies in clinical practices, late identification of patients at risk for or with AKI, and limitations of access to best practices for prevention and management of AKI. Growing use of electronic health records has provided a platform for computer science to engage in data mining and processing, not only for early detection of AKI but also for the development of risk-stratification strategies and computer clinical decision-support (CDS) systems. Despite promising perspectives, the literature regarding the impact of AKI electronic alerts and CDS systems has been conflicting. Some studies have reported improvement in care processes and patient outcomes, whereas others have shown no effect on clinical outcomes and yet demonstrated an increase in the use of resources. These discrepancies are thought to be due to multiple factors that may be related to technology, human factors, modes of delivery of information to clinical providers, and level of expectations regarding the impact on patient outcomes. This review appraises the current body of knowledge and provides some outlines regarding research into and clinical aspects of CDS systems for AKI. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  9. Climate Adaptation and Harmful Algal Blooms

    Science.gov (United States)

    EPA supports local, state and tribal efforts to maintain water quality. A key element of its efforts is to reduce excess nutrient pollution and the resulting adverse impacts, including harmful algal blooms.

  10. Adoption of medication alert systems in hospital outpatient departments in Taiwan.

    Science.gov (United States)

    Kuo, Yu-Chun; Cheng, Shou-Hsia

    2017-06-01

    The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Solar radiation alert system : final report.

    Science.gov (United States)

    2009-03-01

    The Solar Radiation Alert (SRA) system continuously evaluates measurements of high-energy protons made by instruments on GOES satellites. If the measurements indicate a substantial elevation of effective dose rates at aircraft flight altitudes, the C...

  12. Radiation Alert Immediate Disclosure, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Invocon's Radiation Alert Immediate Disclosure (RAID) system is a miniature, low-power, real-time, active radiation badge. It is designed for monitoring personnel,...

  13. Gérer et alerter

    Directory of Open Access Journals (Sweden)

    Valérie November

    2009-03-01

    Full Text Available Sur la base de deux événements d’inondation ayant touché récemment, dans des contextes politiques, organisationnels et hydrologiques bien différents, de nouveaux quartiers d’habitation, cet article rend compte des pratiques des acteurs impliqués dans des situations d’alerte et de crise en Suisse. Le recensement des acteurs – à travers leur rôle et leur place dans les mécanismes de préparation, d’alerte et de gestion –, ainsi que l’inventaire des documents mobilisés par ceux-ci, ont été réalisés dans les deux cas. Cette analyse a permis d’évaluer la gestion des événements, de déceler les changements organisationnels qui ont suivi les crises et de connaître la conception et le degré de formalisation du risque dont étaient dotés les différents acteurs avant et après les inondations. Plus encore, l’analyse a documenté les nouveaux processus d’alerte et de prévision qui ont été mis en place suite aux événements. Il s’avère ainsi que les épisodes d’inondation agissent de façon décisive sur la production de connaissances, à un degré variable selon les acteurs. Ces épisodes révèlent aussi parfois l’existence de connaissances « en attente » qui ne sont pas encore intégrées dans les procédures institutionnelles. Tant du point de vue de la prévision que de la gestion de la crise, ils permettent aussi de tester les canaux de l’information et de combler les déficits d’organisation, de collaboration et de sécurisation des dispositifs de communication. En outre, les risques et les crises liés aux inondations modifient les dynamiques et les politiques territoriales, conséquences du réajustement des réseaux d’acteurs. La mise en place de dispositifs d’intervention et de gestion de crise se montre cependant plus efficace que la refonte des dispositifs d’aménagement, généralement longue. Toutefois, la mémoire des événements se dégradant avec le temps, une inscription

  14. Cutting Class Harms Grades

    Science.gov (United States)

    Taylor, Lewis A., III

    2012-01-01

    An accessible business school population of undergraduate students was investigated in three independent, but related studies to determine effects on grades due to cutting class and failing to take advantage of optional reviews and study quizzes. It was hypothesized that cutting classes harms exam scores, attending preexam reviews helps exam…

  15. "No Harm Done"

    DEFF Research Database (Denmark)

    Bloomfield, Kim

    2016-01-01

    It has been difficult to secure funding in Denmark to conduct research on third party harm from alcohol. The author relates her experiences in this area and challenges Danish society to examine how other societies have begun to examine this problem....

  16. Designing a Free Academic Early Alert System

    Directory of Open Access Journals (Sweden)

    Adam C Welch

    2016-10-01

    Full Text Available This manuscript describes the development and implementation of a cloud-based, academic early alert system using Google Sheets. It was written for a non-computer savvy person to be able to develop the early alert system. By creating a Master Sheet and using the syntax from the share function of Google Sheets, a unique sheet can be created for each advisor that limits information sharing of their specific advisees. By adding a Google Form to the sheet, advisor interventions can be captured that reflect interventions made as a result of the early alert sheet. Approximately 52% of students were identified on the early alert sheet by having at least one non-passing score on an exam. There were 35-50% of faculty advisors who documented their interventions in the sheet. The template and coding used to develop this academic early alert sheet may be applied to other central documentation needs, such as professionalism early alert. Conflict of Interest Dr. Welch reports owning stock in Alphabet, Inc, however, was not involved in the selection of Google as the preferred platform at this institution.   Type: Note

  17. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Ship Security Alert System (SSAS). 80.277... Security Alert System (SSAS). (a) Vessels equipped with a Ship Security Alert System pursuant to the Safety..., “RTCM Standard 11020.0—Ship Security Alert Systems (SSAS) using the Cospas-Sarsat System,” Version 1.0...

  18. Seismic Activity: Public Alert and Warning: Legal Implications

    Science.gov (United States)

    Zocchetti, D.

    2007-12-01

    As science and technology evolve in ways that increase our ability to inform the public of potentially destructive seismic activity, there are significant legal issues for consideration. Even though countries and even states within the United States have differing legal tenets that could either change or at least re-shape the outcome of specific legal questions that this session will be pondering, there are fundamental legal principals that will permeate. It is often said that the law lags behind society and in particular its technological developments. No doubt in the area of warning the public of impending destructive forces of nature or society, the law will need to do some catching up. The law is probably adequately developed for at least some preliminary discussion of the key issues. No matter the legal scheme, if there is a failure or perceived failure in the system to warn people of a pending emergencies, albeit an earthquake, tsunami, or other predictable event, those who are harmed or believe they are harmed will seek relief under the law. Every day there are situations wherein the failure to warn or to adequately warn is key, such as with faulty or defective consumer products, escaped prisoners, and police high-speed vehicle chases. With alert and warning systems for disaster, however, we have a unique set of facts. Generally, the systems and their failures occur during emergencies or at least during situations under apparently exigent circumstances when the disaster's predictability is widely recognized as less than 100 percent. The law, in particular United States tort law, has been particularly lenient when people and organizations are operating during compressed timeframes and their actions are generally considered necessary to address circumstances relative to public safety. The legal system has been forgiving when the actor that failed or appeared to fail was government. The courts have liberally applied the principal of sovereign immunity to

  19. Red alert. The worldwide dangers of nuclear power

    Energy Technology Data Exchange (ETDEWEB)

    Cook, J

    1986-01-01

    The book 'Red Alert' considers the problems and hazards of nuclear power. The politics behind the nuclear power programmes in the United Kingdom and other countries are examined, along with the sequence of events in Britain which led to the building of the Magnox and Advanced Gas-Cooled nuclear reactors. Health hazards of radiation, radioactive waste management, nuclear weapons programmes, and radiation accidents including the Chernobyl accident, are also discussed. (U.K.).

  20. Digital Self-Harm Among Adolescents.

    Science.gov (United States)

    Patchin, Justin W; Hinduja, Sameer

    2017-12-01

    Despite increased media and scholarly attention to digital forms of aggression directed toward adolescents by their peers (e.g., cyberbullying), very little research has explored digital aggression directed toward oneself. "Digital self-harm" is the anonymous online posting, sending, or otherwise sharing of hurtful content about oneself. The current study examined the extent of digital self-harm among adolescents. Survey data were obtained in 2016 from a nationally representative sample of 5,593 American middle and high school students (12-17 years old). Logistic regression analysis was used to identify correlates of participation in digital self-harm. Qualitative responses were also reviewed to better understand motivations for digital self-harm. About 6% of students have anonymously posted something online about themselves that was mean. Males were significantly more likely to report participation (7.1% compared to 5.3%). Several statistically significant correlates of involvement in digital self-harm were identified, including sexual orientation, experience with school bullying and cyberbullying, drug use, participation in various forms of adolescent deviance, and depressive symptoms. Digital self-harm is a new problem that demands additional scholarly attention. A deeper inquiry as to the motivations behind this behavior, and how it correlates to offline self-harm and suicidal ideation, can help direct mental health professionals toward informed prevention approaches. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Effects of chewing gum and time-on-task on alertness and attention.

    Science.gov (United States)

    Allen, A P; Smith, A P

    2012-07-01

    Chewing gum has been shown to reliably increase subjective alertness whereas the effects on attention are more variable. It has been suggested that chewing gum only enhances attention when the person has been performing a task for some time. The current research aimed to investigate if time-on-task trends enhancing effects of chewing gum could be observed in alertness and attention during and following chewing. Study 1 used tests of reported mood, including reported mood, and tests of attention (categoric search, focussed attention, simple reaction time, and vigilance). These tasks were performed shortly after the start of chewing. Study 2 examined effects of previous and current chewing on reported alertness and the attention tests. Study 1 showed that chewing gum increased reported alertness and hedonic tone and improved performance on the categoric search task. Chewing gum maintained reported alertness across sessions in study 2. In the first experimental session of study 2 gum improved categoric search performance, and during the second session gum broadened focus of attention and quickened vigilance reaction time. This effect on vigilance reaction time was moderated by time-on-task, with an initial negative effect being replaced by a positive effect. The results confirm the robust effect of chewing gum on reported alertness and show that changes in the effects of chewing gum on attention require further investigation. Future research may also determine underlying mechanisms for an alerting effect.

  2. Is Personality Associated with Secondhand Harm from Drinking?

    Science.gov (United States)

    Davis MacNevin, Parnell; Thompson, Kara; Teehan, Michael; Stuart, Heather; Stewart, Sherry

    2017-09-01

    Prior research suggests more than 70% of undergraduates have experienced harm from other students' drinking. This study built on the literature by, first, investigating whether secondhand harm cluster into latent factors that reflect distinct but related types of harm. Second, given the paucity of research examining factors that increase students' vulnerability to secondhand harm, we examined dimensions from Castellanos-Ryan and Conrod's 4-factor personality model for alcohol disorders (impulsivity [IMP], sensation seeking [SS], hopelessness [HOP], anxiety sensitivity [AS]) as predictors of secondhand harm exposure. We also investigated the possible mediating role of students' own problematic alcohol use in explaining personality-secondhand harm relationships. An online survey was administered to 1,537 first-year Canadian undergraduates (68% women). Problematic alcohol use was measured by the Alcohol Use Disorders Identification Test, and personality was measured by the Substance Use Risk Profile Scale. Eleven secondhand harm items were included. The secondhand harm clustered into 3 distinct but related factors: "strains" (e.g., interruption of sleep or study), "threats" (e.g., harassment or assault), and "interpersonal harm" (e.g., arguments with peers). Sixty-eight percent of respondents reported strains, 44% threats, and 64% interpersonal harm, and 35% reported experiencing all 3 types of harm, in the last term. All 4 personality dimensions were independently associated with greater secondhand harm exposure. HOP was directly associated with threats and interpersonal harm, and AS was directly associated with all 3 types of harm. SS and IMP were both indirectly associated with all 3 types of harm through students' own problematic alcohol use. In addition, IMP was directly related to threats. The prevalence of secondhand harm from alcohol is high among undergraduates. Findings suggest that distinct personality risks may predispose students to experience secondhand

  3. Sounding the Alert: Designing an Effective Voice for Earthquake Early Warning

    Science.gov (United States)

    Burkett, E. R.; Given, D. D.

    2015-12-01

    The USGS is working with partners to develop the ShakeAlert Earthquake Early Warning (EEW) system (http://pubs.usgs.gov/fs/2014/3083/) to protect life and property along the U.S. West Coast, where the highest national seismic hazard is concentrated. EEW sends an alert that shaking from an earthquake is on its way (in seconds to tens of seconds) to allow recipients or automated systems to take appropriate actions at their location to protect themselves and/or sensitive equipment. ShakeAlert is transitioning toward a production prototype phase in which test users might begin testing applications of the technology. While a subset of uses will be automated (e.g., opening fire house doors), other applications will alert individuals by radio or cellphone notifications and require behavioral decisions to protect themselves (e.g., "Drop, Cover, Hold On"). The project needs to select and move forward with a consistent alert sound to be widely and quickly recognized as an earthquake alert. In this study we combine EEW science and capabilities with an understanding of human behavior from the social and psychological sciences to provide insight toward the design of effective sounds to help best motivate proper action by alert recipients. We present a review of existing research and literature, compiled as considerations and recommendations for alert sound characteristics optimized for EEW. We do not yet address wording of an audible message about the earthquake (e.g., intensity and timing until arrival of shaking or possible actions), although it will be a future component to accompany the sound. We consider pitch(es), loudness, rhythm, tempo, duration, and harmony. Important behavioral responses to sound to take into account include that people respond to discordant sounds with anxiety, can be calmed by harmony and softness, and are innately alerted by loud and abrupt sounds, although levels high enough to be auditory stressors can negatively impact human judgment.

  4. A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety.

    Science.gov (United States)

    Page, N; Baysari, M T; Westbrook, J I

    2017-09-01

    To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness. Twenty-three studies describing 32 alerts classified into 11 alert categories were identified. The most common alert categories studied were drug-condition interaction (n=6), drug-drug interaction alerts (n=6) and corollary order alerts (n=6). All 23 papers investigated the effect of the intervention alert on at least one outcome measure of prescriber behavior. Just over half of the studies (53%, n=17) reported a statistically significant beneficial effect from the intervention alert; 34% (n=11) reported no statistically significant effect, and 6% (n=2) reported a significant detrimental effect. Two studies also evaluated the effect of alerts on patient outcome measures; neither finding that patient outcomes significantly improved following alert implementation (6%, n=2). The greatest volume of evidence relates to three alert categories: drug-condition, drug-drug and corollary order alerts. Of these, drug-condition alerts had the greatest number of studies reporting positive effects (five out of six studies). Only two of six studies of drug-drug interaction and one of six of corollary alerts reported positive benefits. The current evidence-base does not show a clear indication that particular categories of alerts are more effective than others. While the majority of alert categories were shown to improve outcomes in some studies, there were also many cases where outcomes did not improve. This lack of evidence hinders decisions

  5. Evidence behind FDA alerts for drugs with adverse cardiovascular effects: implications for clinical practice.

    Science.gov (United States)

    Rackham, Daniel M; C Herink, Megan; Stevens, Ian G; Cardoza, Natalie M; Singh, Harleen

    2014-01-01

    The U.S. Food and Drug Administration (FDA) periodically publishes Drug Safety Communications and Drug Alerts notifying health care practitioners and the general public of important information regarding drug therapies following FDA approval. These alerts can result in both positive and negative effects on patient care. Most clinical trials are not designed to detect long-term safety end points, and postmarketing surveillance along with patient reported events are often instrumental in signaling the potential harmful effect of a drug. Recently, many cardiovascular (CV) safety announcements have been released for FDA-approved drugs. Because a premature warning could discourage a much needed treatment or prompt a sudden discontinuation, it is essential to evaluate the evidence supporting these FDA alerts to provide effective patient care and to avoid unwarranted changes in therapy. Conversely, paying attention to these warnings in cases involving high-risk patients can prevent adverse effects and litigation. This article reviews the evidence behind recent FDA alerts for drugs with adverse CV effects and discusses the clinical practice implications. © 2013 Pharmacotherapy Publications, Inc.

  6. Casting light on harm reduction

    DEFF Research Database (Denmark)

    Jourdan, Michael

    2009-01-01

    Background: Harm reduction is commonly regarded as complementary to other drug problem responses - as the fourth tier. Yet even core examples of harm reduction such as the provision of injection equipment and methadone treatment has over and over encountered considerable opposition, and harm redu...

  7. Alcohol harm reduction in Europe

    DEFF Research Database (Denmark)

    Herring, Rachel; Betsy, Thom; Beccaria, Franca

    2010-01-01

    The EMCDDA’s 10th scientific monograph, entitled Harm reduction: evidence, impacts and challenges provides a comprehensive overview of the harm reduction field. Part I of the monograph looks back at the emergence of harm reduction approaches and their diffusion, and explores the concept from diff...

  8. Designing a Free Academic Early Alert System

    OpenAIRE

    Adam C Welch; Adam Greever; Carmen Linne

    2016-01-01

    This manuscript describes the development and implementation of a cloud-based, academic early alert system using Google Sheets. It was written for a non-computer savvy person to be able to develop the early alert system. By creating a Master Sheet and using the syntax from the share function of Google Sheets, a unique sheet can be created for each advisor that limits information sharing of their specific advisees. By adding a Google Form to the sheet, advisor interventions can be captured tha...

  9. Wireless Sensor Node for Autonomous Monitoring and Alerts in Remote Environments

    Science.gov (United States)

    Monacos, Steve P. (Inventor); Panangadan, Anand V. (Inventor)

    2015-01-01

    A method, apparatus, system, and computer program products provides personal alert and tracking capabilities using one or more nodes. Each node includes radio transceiver chips operating at different frequency ranges, a power amplifier, sensors, a display, and embedded software. The chips enable the node to operate as either a mobile sensor node or a relay base station node while providing a long distance relay link between nodes. The power amplifier enables a line-of-sight communication between the one or more nodes. The sensors provide a GPS signal, temperature, and accelerometer information (used to trigger an alert condition). The embedded software captures and processes the sensor information, provides a multi-hop packet routing protocol to relay the sensor information to and receive alert information from a command center, and to display the alert information on the display.

  10. Harm mediates the disgust-immorality link.

    Science.gov (United States)

    Schein, Chelsea; Ritter, Ryan S; Gray, Kurt

    2016-09-01

    Many acts are disgusting, but only some of these acts are immoral. Dyadic morality predicts that disgusting acts should be judged as immoral to the extent that they seem harmful. Consistent with this prediction, 3 studies reveal that perceived harm mediates the link between feelings of disgust and moral condemnation-even for ostensibly harmless "purity" violations. In many cases, accounting for perceived harm completely eliminates the link between disgust and moral condemnation. Analyses also reveal the predictive power of anger and typicality/weirdness in moral judgments of disgusting acts. The mediation of disgust by harm holds across diverse acts including gay marriage, sex acts, and religious blasphemy. Revealing the endogenous presence and moral relevance of harm within disgusting-but-ostensibly harmless acts argues against modular accounts of moral cognition such as moral foundations theory. Instead, these data support pluralistic conceptions of harm and constructionist accounts of morality and emotion. Implications for moral cognition and the concept of "purity" are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  11. [Health alert management and emerging risk].

    Science.gov (United States)

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  12. Understanding the context of network traffic alerts

    NARCIS (Netherlands)

    Cappers, B.C.M.; van Wijk, J.J.; Best, D.M.; Staheli, D.; Prigent, N.; Engle, S.; Harrison, L.

    2016-01-01

    For the protection of critical infrastructures against complex virus attacks, automated network traffic analysis and deep packet inspection are unavoidable. However, even with the use of network intrusion detection systems, the number of alerts is still too large to analyze manually. In addition,

  13. Alerting or Somnogenic Light: Pick Your Color

    Science.gov (United States)

    Bourgin, Patrice; Hubbard, Jeffrey

    2016-01-01

    In mammals, light exerts pervasive effects on physiology and behavior in two ways: indirectly through clock synchronization and the phase adjustment of circadian rhythms, and directly through the promotion of alertness and sleep, respectively, in diurnal and nocturnal species. A recent report by Pilorz and colleagues describes an even more complex role for the acute effects of light. In mice, blue light acutely causes behavioral arousal, whereas green wavelengths promote sleep. These opposing effects are mediated by melanopsin-based phototransduction through different neural pathways. These findings reconcile nocturnal and diurnal species through a common alerting response to blue light. One can hypothesize that the opposite responses to natural polychromatic light in night- or day-active animals may reflect higher sensitivity of nocturnal species to green, and diurnals to blue wavelengths, resulting in hypnogenic and alerting effects, respectively. Additional questions remain to be clarified. How do different light wavelengths affect other behaviors such as mood and cognition? How do those results apply to humans? How does light pose either a risk or benefit, depending on whether one needs to be asleep or alert? Indeed, in addition to timing, luminance levels, and light exposure duration, these findings stress the need to understand how best to adapt the color spectrum of light to our needs and to take this into account for the design of daily lighting concepts—a key challenge for today’s society, especially with the emergence of LED light technology. PMID:27525420

  14. Alerting or Somnogenic Light: Pick Your Color.

    Directory of Open Access Journals (Sweden)

    Patrice Bourgin

    2016-08-01

    Full Text Available In mammals, light exerts pervasive effects on physiology and behavior in two ways: indirectly through clock synchronization and the phase adjustment of circadian rhythms, and directly through the promotion of alertness and sleep, respectively, in diurnal and nocturnal species. A recent report by Pilorz and colleagues describes an even more complex role for the acute effects of light. In mice, blue light acutely causes behavioral arousal, whereas green wavelengths promote sleep. These opposing effects are mediated by melanopsin-based phototransduction through different neural pathways. These findings reconcile nocturnal and diurnal species through a common alerting response to blue light. One can hypothesize that the opposite responses to natural polychromatic light in night- or day-active animals may reflect higher sensitivity of nocturnal species to green, and diurnals to blue wavelengths, resulting in hypnogenic and alerting effects, respectively. Additional questions remain to be clarified. How do different light wavelengths affect other behaviors such as mood and cognition? How do those results apply to humans? How does light pose either a risk or benefit, depending on whether one needs to be asleep or alert? Indeed, in addition to timing, luminance levels, and light exposure duration, these findings stress the need to understand how best to adapt the color spectrum of light to our needs and to take this into account for the design of daily lighting concepts-a key challenge for today's society, especially with the emergence of LED light technology.

  15. 77 FR 41331 - Commercial Mobile Alert System

    Science.gov (United States)

    2012-07-13

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 10 [PS Docket No. 07-287; FCC 08-164] Commercial... with the Commission's Commercial Mobile Alert System (CMS), Second Report and Order (``CMAS Second..., for a period of three years, the information collection requirements relating to the Commercial Mobile...

  16. FACT. Flare alerts from blazar monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Dorner, Daniela [Universitaet Wuerzburg (Germany); Bretz, Thomas [RWTH Aachen (Germany); Collaboration: FACT-Collaboration

    2015-07-01

    One of the major goals of the First G-APD Cherenkov Telescope is the longterm monitoring of bright TeV blazars. For more than three years, FACT has observed the blazars Mrk 421 and Mrk 501 and a few other sources on a regular basis. To understand these highly variable objects, simultaneous data at different wavelengths are very useful. FACT is not only taking part in multi-wavelength campaigns, but also sending alerts to other instruments in case of enhanced flux, to study flares within the multi-wavelength frame. To send fast alerts, an automatic quick look analysis was set up on site. Once the data are written on disk, they are automatically processed, and the analysis results are published on a website where other observers can monitor the activity of the source in the very high energy band. In addition, alerts are sent in case the flux is higher than a certain predefined value. In 2014, more than five alerts have been sent. Results from three years of monitoring are presented.

  17. Stimulated reporting: the impact of US food and drug administration-issued alerts on the adverse event reporting system (FAERS).

    Science.gov (United States)

    Hoffman, Keith B; Demakas, Andrea R; Dimbil, Mo; Tatonetti, Nicholas P; Erdman, Colin B

    2014-11-01

    The US Food and Drug Administration (FDA) uses the Adverse Event Reporting System (FAERS) to support post-marketing safety surveillance programs. Currently, almost one million case reports are submitted to FAERS each year, making it a vast repository of drug safety information. Sometimes cited as a limitation of FAERS, however, is the assumption that "stimulated reporting" of adverse events (AEs) occurs in response to warnings, alerts, and label changes that are issued by the FDA. To determine the extent of "stimulated reporting" in the modern-day FAERS database. One hundred drugs approved by the FDA between 2001 and 2010 were included in this analysis. FDA alerts were obtained by a comprehensive search of the FDA's MedWatch and main websites. Publicly available FAERS data were used to assess the "primary suspect" AE reporting pattern for up to four quarters before, and after, the issuance of an FDA alert. A few drugs did demonstrate "stimulated reporting" trends. A majority of the drugs, however, showed little evidence for significant reporting changes associated with the issuance of alerts. When we compared the percentage changes in reporting after an FDA alert with those after a sham "control alert", the overall reporting trends appeared to be quite similar. Of 100 drugs analyzed for short-term reporting trends, 21 real alerts and 25 sham alerts demonstrated an increase (greater than or equal to 1 %) in reporting. The long-term analysis of 91 drugs showed that 24 real alerts and 28 sham alerts demonstrated a greater than or equal to 1 % increase. Our results suggest that most of modern day FAERS reporting is not significantly affected by the issuance of FDA alerts.

  18. Assessing harmful effects in systematic Reviews

    Directory of Open Access Journals (Sweden)

    Woolacott Nerys F

    2004-07-01

    Full Text Available Abstract Background Balanced decisions about health care interventions require reliable evidence on harms as well as benefits. Most systematic reviews focus on efficacy and randomised trials, for which the methodology is well established. Methods to systematically review harmful effects are less well developed and there are few sources of guidance for researchers. We present our own recent experience of conducting systematic reviews of harmful effects and make suggestions for future practice and further research. Methods We described and compared the methods used in three systematic reviews. Our evaluation focused on the review question, study designs and quality assessment. Results One review question focused on providing information on specific harmful effects to furnish an economic model, the other two addressed much broader questions. All three reviews included randomised and observational data, although each defined the inclusion criteria differently. Standard methods were used to assess study quality. Various practical problems were encountered in applying the study design inclusion criteria and assessing quality, mainly because of poor study design, inadequate reporting and the limitations of existing tools. All three reviews generated a large volume of work that did not yield much useful information for health care decision makers. The key areas for improvement we identified were focusing the review question and developing methods for quality assessment of studies of harmful effects. Conclusions Systematic reviews of harmful effects are more likely to yield information pertinent to clinical decision-making if they address a focused question. This will enable clear decisions to be made about the type of research to include in the review. The methodology for assessing the quality of harmful effects data in systematic reviews requires further development.

  19. Control-room operator alertness and performance in nuclear power plants

    International Nuclear Information System (INIS)

    Baker, T.l.; Campbell, S.C.; Linder, K.D.; Moore-Ede, M.C

    1990-02-01

    All industries requiring round-the-clock operation must deal with the potential problem of impaired alertness, especially among those who work night shifts. In the nuclear power industry, maintaining optimal alertness and performance of control room operators at all times of day is critical. Many of the toot causes of reduced alertness are straightforward and can be easily remedied with tangible solutions; this manual both discusses the reasons for the problem and suggests solutions. The manual surveys factors that influence operator alertness and performance, including shift schedules, caffeine and alcohol use, diet and family lifestyle factors, the control room enviornment, staffing and overtime practices, and work task design. Specific recommendations are made in each of these areas. The project team, consisting of experts on managing round-the-clock operations and scientists who study human alertness and performance, prepared this manual using the latest scientific research and direct input from shift supervisors and operators via interviews, on-site observation, and questionnaires distributed to every nuclear power station. The material contained within is relevant to shiftwork managers, shift supervisors, and operators, each of whom plays a vital role in maintaining optimal alertness and performance on the job. 90 refs., 35 figs

  20. MedWatch Safety Alerts for Human Medical Products

    Data.gov (United States)

    U.S. Department of Health & Human Services — MedWatch alerts provide timely new safety information on human drugs, medical devices, vaccines and other biologics, dietary supplements, and cosmetics. The alerts...

  1. The effect of phasic auditory alerting on visual perception

    DEFF Research Database (Denmark)

    Petersen, Anders; Petersen, Annemarie Hilkjær; Bundesen, Claus

    2017-01-01

    /no-alerting design with a pure accuracy-based single-letter recognition task. Computational modeling based on Bundesen’s Theory of Visual Attention was used to examine the effect of phasic alertness on visual processing speed and threshold of conscious perception. Results show that phasic auditory alertness affects...

  2. The effect of phasic auditory alerting on visual perception.

    Science.gov (United States)

    Petersen, Anders; Petersen, Annemarie Hilkjær; Bundesen, Claus; Vangkilde, Signe; Habekost, Thomas

    2017-08-01

    Phasic alertness refers to a short-lived change in the preparatory state of the cognitive system following an alerting signal. In the present study, we examined the effect of phasic auditory alerting on distinct perceptual processes, unconfounded by motor components. We combined an alerting/no-alerting design with a pure accuracy-based single-letter recognition task. Computational modeling based on Bundesen's Theory of Visual Attention was used to examine the effect of phasic alertness on visual processing speed and threshold of conscious perception. Results show that phasic auditory alertness affects visual perception by increasing the visual processing speed and lowering the threshold of conscious perception (Experiment 1). By manipulating the intensity of the alerting cue, we further observed a positive relationship between alerting intensity and processing speed, which was not seen for the threshold of conscious perception (Experiment 2). This was replicated in a third experiment, in which pupil size was measured as a physiological marker of alertness. Results revealed that the increase in processing speed was accompanied by an increase in pupil size, substantiating the link between alertness and processing speed (Experiment 3). The implications of these results are discussed in relation to a newly developed mathematical model of the relationship between levels of alertness and the speed with which humans process visual information. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Environmentally harmful subventions in the Federal Republic of Germany. Updating for the year 2016

    International Nuclear Information System (INIS)

    Koeder, Lea; Burger, Andreas

    2016-12-01

    The contribution on environmentally harmful subventions in the Federal Republic of Germany (Updating for the year 2016) includes the following issues: Why the reduction of environmentally harmful subventions is necessary; subventions and related processes; international initiatives for the reduction of environmentally harmful subventions, routes for the reduction of environmentally harmful subventions.

  4. From Demonstration System to Prototype: ShakeAlert Beta Users Provide Feedback to Improve Alert Delivery

    Science.gov (United States)

    Strauss, J. A.; Vinci, M.; Steele, W. P.; Allen, R. M.; Hellweg, M.

    2013-12-01

    Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds to minutes of warning prior to ground shaking at a given location. The goal and purpose of such a system is to reduce the damage, costs, and casualties resulting from an earthquake. A prototype earthquake early warning system (ShakeAlert) is in development by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, and the USGS. Events are published to the UserDisplay--ShakeAlert's Java based graphical interface, which is being tested by a small group of beta users throughout California. The beta users receive earthquake alerts in real-time and are providing feedback on their experiences. For early warning alerts to be useful, people, companies, and institutions must know beforehand what actions they will perform when they receive the information. Beta user interactions allow the ShakeAlert team to discern: which alert delivery options are most effective, what changes would make the UserDisplay more useful in a pre-disaster situation, and most importantly, what actions users plan to take for various scenarios. We also collect feedback detailing costs of implementing actions and challenges within the beta user organizations, as well as anticipated benefits and savings. Thus, creating a blueprint for a fully operational system that will meet the needs of the public. New California users as well as the first group of Pacific Northwest users are slated to join the ShakeAlert beta test group in the fall of 2013.

  5. AMDIS Case Conference: Intrusive Medication Safety Alerts.

    Science.gov (United States)

    Graham, J; Levick, D; Schreiber, R

    2010-01-01

    Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center's dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves.

  6. AMDIS Case Conference: Intrusive Medication Safety Alerts

    OpenAIRE

    Graham, J.; Levick, D.; Schreiber, R.

    2010-01-01

    Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center’s dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves.

  7. Commercial Mobile Alert Service (CMAS) Scenarios

    Science.gov (United States)

    2012-05-01

    Commercial Mobile Alert Service (CMAS) Scenarios The WEA Project Team May 2012 SPECIAL REPORT CMU/SEI-2012-SR-020 CERT® Division, Software ...Homeland Security under Contract No. FA8721-05-C-0003 with Carnegie Mellon University for the operation of the Software Engineering Institute, a federally...DISTRIBUTES IT “AS IS.” References herein to any specific commercial product, process, or service by trade name, trade mark, manufacturer, or otherwise

  8. Static Analysis Alert Audits: Lexicon and Rules

    Science.gov (United States)

    2016-11-04

    1 Audit Rules and Lexicon Date 00, 2016 © 2016 Carnegie Mellon University [DISTRIBUTION STATEMENT A] This material has been approved for public...DISTRIBUTION STATEMENT A] This material has been approved for public release and unlimited distribution. REV-03.18.2016.0 Static Analysis Alert Audits ...Lexicon And Rules William Snavely 2 Audit Rules and Lexicon Date 00, 2016 © 2016 Carnegie Mellon University [DISTRIBUTION STATEMENT A] This material

  9. Feasibility of seismic alert systems in India

    International Nuclear Information System (INIS)

    Chauhan, P.K.S.; Pandey, Y.

    2012-01-01

    Natural disasters like flood, earthquakes and cyclones are very frequent in India since historical times. As far as the casualties are concerned, globally earthquakes are second in the list after the flood. The loss of property due to these earthquakes is huge and enormous. In the light of the present knowledge base, earthquake prediction is far from being a reality. An early earthquake warning has potential to save the precious human lives. In the present day scenario seismic instrumentation and telecommunication permits the implementation of seismic alert system (SAS) based on the real-time measurement of ground motions near the source. SAS is capable of providing a warning of several seconds before the arrival of destructive seismic waves caused by a large earthquake. SAS is successfully operational in many countries of the world. In a country, like India where earthquakes are taking heavy toll on the human lives and property, seismic alert system may prove to be very important step in natural hazard mitigation strategy. In this paper, an attempt has been made to compute the available alarm time before the destructive earthquake waves reaches to the cities like Delhi, Lucknow, Patna and Kolkata taking Himalaya as the source and feasibility of seismic alert system in Indian scenario. (author)

  10. An IDS Alerts Aggregation Algorithm Based on Rough Set Theory

    Science.gov (United States)

    Zhang, Ru; Guo, Tao; Liu, Jianyi

    2018-03-01

    Within a system in which has been deployed several IDS, a great number of alerts can be triggered by a single security event, making real alerts harder to be found. To deal with redundant alerts, we propose a scheme based on rough set theory. In combination with basic concepts in rough set theory, the importance of attributes in alerts was calculated firstly. With the result of attributes importance, we could compute the similarity of two alerts, which will be compared with a pre-defined threshold to determine whether these two alerts can be aggregated or not. Also, time interval should be taken into consideration. Allowed time interval for different types of alerts is computed individually, since different types of alerts may have different time gap between two alerts. In the end of this paper, we apply proposed scheme on DAPRA98 dataset and the results of experiment show that our scheme can efficiently reduce the redundancy of alerts so that administrators of security system could avoid wasting time on useless alerts.

  11. European rating of drug harms

    NARCIS (Netherlands)

    van Amsterdam, Jan; Nutt, David; Phillips, Lawrence; van den Brink, Wim

    2015-01-01

    The present paper describes the results of a rating study performed by a group of European Union (EU) drug experts using the multi-criteria decision analysis model for evaluating drug harms. Forty drug experts from throughout the EU scored 20 drugs on 16 harm criteria. The expert group also assessed

  12. Alerts Visualization and Clustering in Network-based Intrusion Detection

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Dr. Li [University of Tennessee; Gasior, Wade C [ORNL; Dasireddy, Swetha [University of Tennessee

    2010-04-01

    Today's Intrusion detection systems when deployed on a busy network overload the network with huge number of alerts. This behavior of producing too much raw information makes it less effective. We propose a system which takes both raw data and Snort alerts to visualize and analyze possible intrusions in a network. Then we present with two models for the visualization of clustered alerts. Our first model gives the network administrator with the logical topology of the network and detailed information of each node that involves its associated alerts and connections. In the second model, flocking model, presents the network administrator with the visual representation of IDS data in which each alert is represented in different color and the alerts with maximum similarity move together. This gives network administrator with the idea of detecting various of intrusions through visualizing the alert patterns.

  13. Workplace lighting for improving alertness and mood in daytime workers.

    Science.gov (United States)

    Pachito, Daniela V; Eckeli, Alan L; Desouky, Ahmed S; Corbett, Mark A; Partonen, Timo; Rajaratnam, Shantha Mw; Riera, Rachel

    2018-03-02

    Exposure to light plays a crucial role in biological processes, influencing mood and alertness. Daytime workers may be exposed to insufficient or inappropriate light during daytime, leading to mood disturbances and decreases in levels of alertness. To assess the effectiveness and safety of lighting interventions to improve alertness and mood in daytime workers. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, seven other databases; ClinicalTrials.gov and the World Health Organization trials portal up to January 2018. We included randomised controlled trials (RCTs), and non-randomised controlled before-after trials (CBAs) that employed a cross-over or parallel-group design, focusing on any type of lighting interventions applied for daytime workers. Two review authors independently screened references in two stages, extracted outcome data and assessed risk of bias. We used standardised mean differences (SMDs) and 95% confidence intervals (CI) to pool data from different questionnaires and scales assessing the same outcome across different studies. We combined clinically homogeneous studies in a meta-analysis. We used the GRADE system to rate quality of evidence. The search yielded 2844 references. After screening titles and abstracts, we considered 34 full text articles for inclusion. We scrutinised reports against the eligibility criteria, resulting in the inclusion of five studies (three RCTs and two CBAs) with 282 participants altogether. These studies evaluated four types of comparisons: cool-white light, technically known as high correlated colour temperature (CCT) light versus standard illumination; different proportions of indirect and direct light; individually applied blue-enriched light versus no treatment; and individually applied morning bright light versus afternoon bright light for subsyndromal seasonal affective disorder.We found no studies comparing one level of illuminance versus another.We found two CBA

  14. Generator replacement is associated with an increased rate of ICD lead alerts.

    Science.gov (United States)

    Lovelock, Joshua D; Cruz, Cesar; Hoskins, Michael H; Jones, Paul; El-Chami, Mikhael F; Lloyd, Michael S; Leon, Angel; DeLurgio, David B; Langberg, Jonathan J

    2014-10-01

    Lead malfunction is an important cause of morbidity and mortality in patients with an implantable cardioverter-defibrillator (ICD). We have shown that the failure of recalled high-voltage leads significantly increases after ICD generator replacement. However, generator replacement has not been recognized as a predictor of lead failure in general. The purpose of this study is to assess the effect of ICD generator exchange on the rate of ICD lead alerts. A time-dependent Cox proportional hazards model was used to analyze a database of remotely monitored ICDs. The model assessed the impact of generator exchange on the rate of lead alerts after ICD generator replacement. The analysis included 60,219 patients followed for 37 ± 19 months. The 5-year lead survival was 99.3% (95% confidence interval 99.2%-99.4%). Of 60,219 patients, 7458 patients (12.9%) underwent ICD generator exchange without lead replacement. After generator replacement, the rate of lead alerts was more than 5-fold higher than in controls with leads of the same age without generator replacement (hazard ratio 5.19; 95% confidence interval 3.45-7.84). A large number of lead alerted within 3 months of generator replacement. Lead alerts were more common in patients with single- vs dual-chamber ICDs and in younger patients. Sex was not associated with lead alerts. Routine generator replacement is associated with a 5-fold higher risk of lead alert compared to age-matched leads without generator replacement. This suggests the need for intense surveillance after generator replacement and the development of techniques to minimize the risk of lead damage during generator replacement. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  15. Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

    Science.gov (United States)

    Cheung, Gary; Foster, Gisele; de Beer, Wayne; Gee, Susan; Hawkes, Tracey; Rimkeit, Sally; Tan, Yu Mwee; Merry, Sally; Sundram, Frederick

    2017-08-01

    A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected. The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months. Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.

  16. PleurAlert: an augmented chest drainage system with electronic sensing, automated alerts and internet connectivity.

    Science.gov (United States)

    Leeson, Cory E; Weaver, Robert A; Bissell, Taylor; Hoyer, Rachel; McClain, Corinne; Nelson, Douglas A; Samosky, Joseph T

    2012-01-01

    We have enhanced a common medical device, the chest tube drainage container, with electronic sensing of fluid volume, automated detection of critical alarm conditions and the ability to automatically send alert text messages to a nurse's cell phone. The PleurAlert system provides a simple touch-screen interface and can graphically display chest tube output over time. Our design augments a device whose basic function dates back 50 years by adding technology to automate and optimize a monitoring process that can be time consuming and inconvenient for nurses. The system may also enhance detection of emergency conditions and speed response time.

  17. MyEEW: A Smartphone App for the ShakeAlert System

    Science.gov (United States)

    Strauss, J. A.; Allen, S.; Allen, R. M.; Hellweg, M.

    2015-12-01

    Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds warning prior to ground shaking at a user's location. The goal and purpose of such a system is to reduce, or minimize, the damage, costs, and casualties resulting from an earthquake. A demonstration earthquake early warning system (ShakeAlert) is undergoing testing in the United States by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, the USGS, and beta users in California and the Pacific Northwest. The UC Berkeley Seismological Laboratory has created a smartphone app called MyEEW, which interfaces with the ShakeAlert system to deliver early warnings to individual users. Many critical facilities (transportation, police, and fire) have control rooms, which could run a centralized interface, but our ShakeAlert Beta Testers have also expressed their need for mobile options. This app augments the basic ShakeAlert Java desktop applet by allowing workers off-site (or merely out of hearing range) to be informed of coming hazards. MyEEW receives information from the ShakeAlert system to provide users with real-time information about shaking that is about to happen at their individual location. It includes a map, timer, and earthquake information similar to the Java desktop User Display. The app will also feature educational material to help users craft their own response and resiliency strategies. The app will be open to UC Berkeley Earthquake Research Affiliates members for testing in the near future.

  18. Relationship between alertness, performance, and body temperature in humans

    Science.gov (United States)

    Wright, Kenneth P Jr; Hull, Joseph T.; Czeisler, Charles A.

    2002-01-01

    Body temperature has been reported to influence human performance. Performance is reported to be better when body temperature is high/near its circadian peak and worse when body temperature is low/near its circadian minimum. We assessed whether this relationship between performance and body temperature reflects the regulation of both the internal biological timekeeping system and/or the influence of body temperature on performance independent of circadian phase. Fourteen subjects participated in a forced desynchrony protocol allowing assessment of the relationship between body temperature and performance while controlling for circadian phase and hours awake. Most neurobehavioral measures varied as a function of internal biological time and duration of wakefulness. A number of performance measures were better when body temperature was elevated, including working memory, subjective alertness, visual attention, and the slowest 10% of reaction times. These findings demonstrate that an increased body temperature, associated with and independent of internal biological time, is correlated with improved performance and alertness. These results support the hypothesis that body temperature modulates neurobehavioral function in humans.

  19. 76 FR 5387 - Guidance for Industry and Food and Drug Administration Staff; “`Harmful and Potentially Harmful...

    Science.gov (United States)

    2011-01-31

    ... of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville... harmful constituents, including smoke constituents, to health in each tobacco product by brand and by quantity in each brand and subbrand.'' The guidance discusses the meaning of the term ``harmful and...

  20. ToxAlerts: a Web server of structural alerts for toxic chemicals and compounds with potential adverse reactions.

    Science.gov (United States)

    Sushko, Iurii; Salmina, Elena; Potemkin, Vladimir A; Poda, Gennadiy; Tetko, Igor V

    2012-08-27

    The article presents a Web-based platform for collecting and storing toxicological structural alerts from literature and for virtual screening of chemical libraries to flag potentially toxic chemicals and compounds that can cause adverse side effects. An alert is uniquely identified by a SMARTS template, a toxicological endpoint, and a publication where the alert was described. Additionally, the system allows storing complementary information such as name, comments, and mechanism of action, as well as other data. Most importantly, the platform can be easily used for fast virtual screening of large chemical datasets, focused libraries, or newly designed compounds against the toxicological alerts, providing a detailed profile of the chemicals grouped by structural alerts and endpoints. Such a facility can be used for decision making regarding whether a compound should be tested experimentally, validated with available QSAR models, or eliminated from consideration altogether. The alert-based screening can also be helpful for an easier interpretation of more complex QSAR models. The system is publicly accessible and tightly integrated with the Online Chemical Modeling Environment (OCHEM, http://ochem.eu). The system is open and expandable: any registered OCHEM user can introduce new alerts, browse, edit alerts introduced by other users, and virtually screen his/her data sets against all or selected alerts. The user sets being passed through the structural alerts can be used at OCHEM for other typical tasks: exporting in a wide variety of formats, development of QSAR models, additional filtering by other criteria, etc. The database already contains almost 600 structural alerts for such endpoints as mutagenicity, carcinogenicity, skin sensitization, compounds that undergo metabolic activation, and compounds that form reactive metabolites and, thus, can cause adverse reactions. The ToxAlerts platform is accessible on the Web at http://ochem.eu/alerts, and it is constantly

  1. Reducing Alcohol Harm. International Benchmark

    Science.gov (United States)

    2008-01-01

    last 10 years.12 Apart from the cost of medical care, the cost of alcohol use can also be associated with absenteeism and property damage. Alcohol...related harms cost British industry approximately £2 billion a year13 and the NHS about £1.7 billion a year14. Alcohol affects labour and productivity...Harmful drinking, Factsheet, June (2007). 15 “ Absenteeism due to drink”, Healthcare Today Magazine, September 19th, 2007. (Accessed on 19/09/07, at

  2. Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.

    Science.gov (United States)

    Hoste, Eric A J; Kashani, Kianoush; Gibney, Noel; Wilson, F Perry; Ronco, Claudio; Goldstein, Stuart L; Kellum, John A; Bagshaw, Sean M

    2016-01-01

    Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15(th) Acute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert. Following an extensive, non-systematic literature search, we used a modified Delphi process to reach consensus regarding several aspects of the utilization of AKI e-alerts. Topics discussed in this workgroup included progress in evidence base practices, the characteristics of an optimal e-alert, the measures of efficacy and effectiveness, and finally what responses would be considered best practices following AKI e-alerts. Authors concluded that the current evidence for e-alert system efficacy, although growing, remains insufficient. Technology and human-related factors were found to be crucial elements of any future investigation or implementation of such tools. The group also concluded that implementation of such systems should not be done without a vigorous plan to evaluate the efficacy and effectiveness of e-alerts. Efficacy and effectiveness of e-alerts should be measured by context-specific process and patient outcomes. Finally, the group made several suggestions regarding the clinical decision support that should be considered following successful e-alert implementation. This paper reflects the findings of a non-systematic review and expert opinion. We recommend implementation of the findings of this workgroup report for use of AKI e-alerts.

  3. Disease spreading with epidemic alert on small-world networks

    International Nuclear Information System (INIS)

    Han, Xiao-Pu

    2007-01-01

    Base on two-dimension small-world networks, a susceptible-infected model with epidemic alert is proposed in this Letter. In this model, if some parts of the network are alarmed as dangerous, a fraction of edges between the alarmed parts and others will be removed, and two cases of alerting rules that the degree and frequency of contacts kept unchanged are considered respectively. The numerical simulations show that the spreading velocity is reduced by the accurate and timely epidemic alert, and the more accurate and timely, the stronger the deceleration effect. This model indicates that to broadcast epidemic alert timely is helpful and necessary in the control of epidemic spreading, and in agreement with the general view of epidemic alert. This work is helpful to understand the effects of epidemic alert on disease spreading

  4. Electronic Immunization Alerts and Spillover Effects on Other Preventive Care.

    Science.gov (United States)

    Kim, Julia M; Rivera, Maria; Persing, Nichole; Bundy, David G; Psoter, Kevin J; Ghazarian, Sharon R; Miller, Marlene R; Solomon, Barry S

    2017-08-01

    The impact of electronic health record (EHR) immunization clinical alert systems on the delivery of other preventive services remains unknown. We assessed for spillover effects of an EHR immunization alert on delivery of 6 other preventive services, in children 18 to 30 months of age needing immunizations. We conducted a secondary data analysis, with additional primary data collection, of a randomized, historically controlled trial to improve immunization rates with EHR alerts, in an urban, primary care clinic. No significant differences were found in screening for anemia, lead, development, nutrition, and injury prevention counseling in children prompting EHR immunization alerts (n = 129), compared with controls (n = 135). Significant increases in oral health screening in patients prompting EHR alerts (odds ratio = 4.8, 95% CI = 1.8-13.0) were likely due to practice changes over time. An EHR clinical alert system targeting immunizations did not have a spillover effect on the delivery of other preventive services.

  5. Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

    DEFF Research Database (Denmark)

    Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara

    2017-01-01

    of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk......], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers......’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account...

  6. Defining and redefining harm reduction in the Lao context

    Directory of Open Access Journals (Sweden)

    Sychareun Vanphanom

    2012-07-01

    Full Text Available Abstract The response to drug use in Laos has focused on reducing opium supply (supply reduction and rates of drug use (demand reduction. However, recently there is increased interest among government counterparts to discuss and develop broader responses to injecting drug use (IDU including the introduction of harm reduction programs. The concept of harm reduction has just been introduced to Lao PDR and as yet there is no agreement on a definition of the concept. We highlight here a range of issues that remain controversial in Lao PDR in the HIV, drug use and harm reduction discourse, the definition of 'harm reduction' and related terms; and the scope of harm reduction. This was a qualitative study, consisting of in-depth interviews with 27 law enforcement and 8 health officers who work in the fields of HIV and/or drug control about their understanding of HIV related to drug use, and concepts of harm reduction. Content analysis was performed to identify the coding, categories and themes. We found that law enforcement officers in particular had limited understanding about harm reduction and the feasibility and appropriateness of harm reduction services in the Lao context. Harm reduction should be a core element of a public health response to HIV where drug use and IDU exists. Recommendations include the necessity of increasing the awareness of harm reduction among law enforcement officers and providing appropriate evidence to support the needs of harm reduction policy and programs. HIV prevention and treatment strategies should be integrated within existing social and cultural frameworks, working with the task force for HIV/IDU and other government counterparts.

  7. Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.

    Science.gov (United States)

    Klerman, Elizabeth B; Beckett, Scott A; Landrigan, Christopher P

    2016-09-13

    In 2011 the U.S. Accreditation Council for Graduate Medical Education began limiting first year resident physicians (interns) to shifts of ≤16 consecutive hours. Controversy persists regarding the effectiveness of this policy for reducing errors and accidents while promoting education and patient care. Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, we quantitatively compared predictions for traditional intern schedules to those that limit work to ≤ 16 consecutive hours. We simulated two traditional schedules and three novel schedules using the mathematical model. The traditional schedules had extended duration work shifts (≥24 h) with overnight work shifts every second shift (including every third night, Q3) or every third shift (including every fourth night, Q4) night; the novel schedules had two different cross-cover (XC) night team schedules (XC-V1 and XC-V2) and a Rapid Cycle Rotation (RCR) schedule. Predicted objective performance and subjective alertness for each work shift were computed for each individual's schedule within a team and then combined for the team as a whole. Our primary outcome was the amount of time within a work shift during which a team's model-predicted objective performance and subjective alertness were lower than that expected after 16 or 24 h of continuous wake in an otherwise rested individual. The model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either the traditional Q3 or Q4 schedules. Three proposed schedules that eliminate extended shifts may improve performance and alertness compared with traditional Q3 or Q4 schedules. Predicted times of worse performance and alertness were at night, which is also a time when supervision of trainees is lower. Mathematical modeling provides a quantitative comparison approach with potential to aid

  8. Operator alertness and performance on 8-hour and 12-hour work shifts

    International Nuclear Information System (INIS)

    Baker, T.L.; Campbell, S.S.; Dawson, D.; Moore-Ede, M.

    1989-01-01

    Recently, much attention has been paid to the alertness and performance problems of rotational shiftworkers in the nuclear power industry. Growing awareness of higher rates of human errors and accidents on night shifts and reports of operations personnel falling asleep on the job have contributed to the heightened interest in this subject. The industry is now considering the effects of different shift rotation systems, including evaluation of the most recent of industry trends in shift scheduling-schedules that include 12 hour work shifts. Surveys show that within the past 5 years about 20% of commercially operational nuclear power plants have instituted schedules that use only 12 hour shifts, or schedules using a combination of 8-hour and 12-hour shifts. Many more plants routinely use 12-hour work shifts during plant outages and refueling operations. In response to this growing trend, the NRC has funded research which is a first attempt to compare alertness, operator performance, and sleep-wake patterns in subjects working simulated 8-hour and 12-hour shifts at the Human Alertness Research Center (HARC), located at the Institute of Circadian Physiology in Boston, MA. This paper will describe in greater detail the design of the study, measurement techniques for alertness and sleep, work routine, work task performance measures, and cognitive performance test protocols. It will review the role of circadian factors in human alertness and performance, and discuss previous research findings in this area. It will discuss other variables that are known to influence human alertness in the workplace, such as caffeine, alcohol, and working environment. The physiological basis for shift worker sleep problems will be explained in the context of the ongoing research project at HARC. Finally, the paper presents previous research on shift work and fatigue which may be relevant to a comparison of 8-hour and 12-hour shifts

  9. Harmful effects of ultraviolet radiation

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    Tanning for cosmetic purposes by sunbathing or by using artificial tanning devices is widespread. The hazards associated with exposure to ultraviolet radiation are of concern to the medical profession. Depending on the amount and form of the radiation, as well as on the skin type of the individual exposed, ultraviolet radiation causes erythema, sunburn, photodamage (photoaging), photocarcinogenesis, damage to the eyes, alteration of the immune system of the skin, and chemical hypersensitivity. Skin cancers most commonly produced by ultraviolet radiation are basal and squamous cell carcinomas. There also is much circumstantial evidence that the increase in the incidence of cutaneous malignant melanoma during the past half century is related to increased sun exposure, but this has not been proved. Effective and cosmetically acceptable sunscreen preparations have been developed that can do much to prevent or reduce most harmful effects to ultraviolet radiation if they are applied properly and consistently. Other safety measures include (1) minimizing exposure to ultraviolet radiation, (2) being aware of reflective surfaces while in the sun, (3) wearing protective clothing, (4) avoiding use of artificial tanning devices, and (5) protecting infants and children

  10. Alerts in mobile healthcare applications: requirements and pilot study.

    Science.gov (United States)

    Kafeza, Eleanna; Chiu, Dickson K W; Cheung, S C; Kafeza, Marina

    2004-06-01

    Recent advances in mobile technologies have greatly extended traditional communication technologies to mobile devices. At the same time, healthcare environments are by nature "mobile" where doctors and nurses do not have fixed workspaces. Irregular and exceptional events are generated in daily hospital routines, such as operations rescheduling, laboratory/examination results, and adverse drug events. These events may create requests that should be delivered to the appropriate person at the appropriate time. Those requests that are classified as urgent are referred to as alerts. Efficient routing and monitoring of alerts are keys to quality and cost-effective healthcare services. Presently, these are generally handled in an ad hoc manner. In this paper, we propose the use of a healthcare alert management system to handle these alert messages systematically. We develop a model for specifying alerts that are associated with medical tasks and a set of parameters for their routing. We design an alert monitor that matches medical staff and their mobile devices to receive alerts, based on the requirements of these alerts. We also propose a mechanism to handle and reroute, if necessary, an alert message when it has not been acknowledged within a specific deadline.

  11. Generating Artificial Snort Alerts and Implementing SELK: The Snort-Elasticsearch-Logstash-Kibana Stack

    Science.gov (United States)

    2017-09-01

    classification system with 38 classifications for alerts. These include things such as “trojan- activity”, “shellcode-detect”, “denial-of-service...Abbreviations, and Acronyms ARL US Army Research Laboratory CIDR classless inter-domain routing IP Internet Protocol NIDS network intrusion

  12. Swift Burst Alert Telescope (BAT) Instrument Response

    International Nuclear Information System (INIS)

    Parsons, A.; Barthelmy, S.; Cummings, J.; Gehrels, N.; Hullinger, D.; Krimm, H.; Markwardt, C.; Tueller, J.; Fenimore, E.; Palmer, D.; Sato, G.; Takahashi, T.; Nakazawa, K.; Okada, Y.; Takahashi, H.; Suzuki, M.; Tashiro, M.

    2004-01-01

    The Burst Alert Telescope (BAT), a large coded aperture instrument with a wide field-of-view (FOV), provides the gamma-ray burst triggers and locations for the Swift Gamma-Ray Burst Explorer. In addition to providing this imaging information, BAT will perform a 15 keV - 150 keV all-sky hard x-ray survey based on the serendipitous pointings resulting from the study of gamma-ray bursts, and will also monitor the sky for transient hard x-ray sources. For BAT to provide spectral and photometric information for the gamma-ray bursts, the transient sources and the all-sky survey, the BAT instrument response must be determined to an increasingly greater accuracy. This paper describes the spectral models and the ground calibration experiments used to determine the BAT response to an accuracy suitable for gamma-ray burst studies

  13. NAPS as an Alertness Management Strategy

    Science.gov (United States)

    Rosekind, Mark R.; Smith, Roy M.; Miller, Donna L.; Co, Elizabeth L.; Gregory, Kevin B.; Gander, Philippa H.; Lebacqz, J. Victor

    2001-01-01

    Today, 24-hour operations are necessary to meet the demands of our society and the requirements of our industrialized global economy. These around-the-clock demands pose unique physiological challenges for the humans who remain central to safe and productive operations. Optimal alertness and performance are critical factors that are increasingly challenged by unusual, extended, or changing work/rest schedules. Technological advancements and automated systems can exacerbate the challenges faced by the human factor in these environments. Shift work, transportation demands, and continuous operations engender sleep loss and circadian disruption. Both of these physiological factors can lead to increased sleepiness, decreased performance, and a reduced margin of safety. These factors can increase vulnerability to incidents and accidents in operational settings. The consequences can have both societal effects (e.g., major destructive accidents such as Three Mile Island, Exxon Valdez, Bhopal) and personal effects (e.g., an accident driving home after a night shift).

  14. Stability of alert survivable forces during reductions

    Energy Technology Data Exchange (ETDEWEB)

    Canavan, G.H.

    1998-01-01

    The stability of current and projected strategic forces are discussed within a framework that contains elements of current US and Russian analyses. For current force levels and high alert, stability levels are high, as are the levels of potential strikes, due to the large forces deployed. As force levels drop towards those of current value target sets, the analysis becomes linear, concern shifts from stability to reconstitution, and survivable forces drop out. Adverse marginal costs generally provide disincentives for the reduction of vulnerable weapons, but the exchange of vulnerable for survivable weapons could reduce cost while increasing stability even for aggressive participants. Exchanges between effective vulnerable and survivable missile forces are studied with an aggregated, probabilistic model, which optimizes each sides` first and determines each sides` second strikes and costs by minimizing first strike costs.

  15. Green Roofs: Federal Energy Management Program (FEMP) Federal Technology Alert

    Energy Technology Data Exchange (ETDEWEB)

    Scholz-Barth, K.; Tanner, S.

    2004-09-01

    In a ''green roof,'' a layer of vegetation (e.g., a roof garden) covers the surface of a roof to provide shade, cooler indoor and outdoor temperatures, and effective storm-water management to reduce runoff. The main components are waterproofing, soil, and plants. There are two basic kinds: intensive and extensive. An intensive green roof often features large shrubs and trees, and it can be expensive to install and maintain. An extensive green roof features shallow soil and low-growing, horizontally spreading plants that can thrive in the alpine conditions of many rooftops. These plants do not require a lot of water or soil, and they can tolerate a significant amount of exposure to the sun and wind. This Federal Technology Alert focuses on the benefits, design, and implementation of extensive green roofs and includes criteria for their use on federal facilities.

  16. 77 FR 33661 - Review of the Emergency Alert System

    Science.gov (United States)

    2012-06-07

    ... Commission's Review of the Emergency Alert System, Fifth Report and Order (Order). This document is... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 11 [EB Docket No. 04-296; FCC 12-7] Review of the Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule; announcement of...

  17. Development of an integrated campus security alerting system ...

    African Journals Online (AJOL)

    This work presents an integrated alerting system which uses both the Internet Protocol (IP) cameras and micro-switches for monitoring security situations thereby providing an immediate alerting signal to the security personnel. The system has the input unit, processing unit, control unit and the power supply unit as its ...

  18. A new method for determining a sector alert

    Science.gov (United States)

    2008-09-29

    The Traffic Flow Management System (TFMS) currently declares an alert for any 15-minute interval in which the predicted demand exceeds the Monitor/Alert Parameter (MAP) for any airport, sector, or fix. For a sector, TFMS predicts the demand for each ...

  19. Validation of the CME Geomagnetic forecast alerts under COMESEP alert system

    Science.gov (United States)

    Dumbovic, Mateja; Srivastava, Nandita; Khodia, Yamini; Vršnak, Bojan; Devos, Andy; Rodriguez, Luciano

    2017-04-01

    An automated space weather alert system has been developed under the EU FP7 project COMESEP (COronal Mass Ejections and Solar Energetic Particles: http://comesep.aeronomy.be) to forecast solar energetic particles (SEP) and coronal mass ejection (CME) risk levels at Earth. COMESEP alert system uses automated detection tool CACTus to detect potentially threatening CMEs, drag-based model (DBM) to predict their arrival and CME geo-effectiveness tool (CGFT) to predict their geomagnetic impact. Whenever CACTus detects a halo or partial halo CME and issues an alert, DBM calculates its arrival time at Earth and CGFT calculates its geomagnetic risk level. Geomagnetic risk level is calculated based on an estimation of the CME arrival probability and its likely geo-effectiveness, as well as an estimate of the geomagnetic-storm duration. We present the evaluation of the CME risk level forecast with COMESEP alert system based on a study of geo-effective CMEs observed during 2014. The validation of the forecast tool is done by comparing the forecasts with observations. In addition, we test the success rate of the automatic forecasts (without human intervention) against the forecasts with human intervention using advanced versions of DBM and CGFT (self standing tools available at Hvar Observatory website: http://oh.geof.unizg.hr). The results implicate that the success rate of the forecast is higher with human intervention and using more advanced tools. This work has received funding from the European Commission FP7 Project COMESEP (263252). We acknowledge the support of Croatian Science Foundation under the project 6212 „Solar and Stellar Variability".

  20. Party drugs - use and harm reduction.

    Science.gov (United States)

    Frei, Matthew

    2010-08-01

    Party drug use, the intermittent use of stimulants, ecstasy and so-called 'designer drugs' at dance parties or 'raves', is now part of the culture of many young Australians. This article discusses the risks associated with the use of 'party drugs' and describes an useful approach to general practitioner assessment and management of patients who may be using party drugs. Party drug use is associated with a range of harms, including risks associated with behaviour while drug affected, toxicity and overdose, mental health complications and physical morbidity. Multiple substance use, particularly combining sedatives, further amplifies risk. If GPs have some understanding of these drugs and their effects, they are well placed to provide an effective intervention in party drug users by supporting the reduction of harm.

  1. A Multiscale Mapping Assessment of Lake Champlain Cyanobacterial Harmful Algal Blooms

    Directory of Open Access Journals (Sweden)

    Nathan Torbick

    2015-09-01

    Full Text Available Lake Champlain has bays undergoing chronic cyanobacterial harmful algal blooms that pose a public health threat. Monitoring and assessment tools need to be developed to support risk decision making and to gain a thorough understanding of bloom scales and intensities. In this research application, Landsat 8 Operational Land Imager (OLI, Rapid Eye, and Proba Compact High Resolution Imaging Spectrometer (CHRIS images were obtained while a corresponding field campaign collected in situ measurements of water quality. Models including empirical band ratio regressions were applied to map chlorophylla and phycocyanin concentrations; all sensors performed well with R2 and root-mean-square error (RMSE ranging from 0.76 to 0.88 and 0.42 to 1.51, respectively. The outcomes showed spatial patterns across the lake with problematic bays having phycocyanin concentrations >25 μg/L. An alert status metric tuned to the current monitoring protocol was generated using modeled water quality to illustrate how the remote sensing tools can inform a public health monitoring system. Among the sensors utilized in this study, Landsat 8 OLI holds the most promise for providing exposure information across a wide area given the resolutions, systematic observation strategy and free cost.

  2. Applying the Toyota Production System: using a patient safety alert system to reduce error.

    Science.gov (United States)

    Furman, Cathie; Caplan, Robert

    2007-07-01

    In 2002, Virginia Mason Medical Center (VMMC) adapted the Toyota Production System, also known as lean manufacturing. To translate the techniques of zero defects and stopping the line into health care, the Patient Safety Alert (PSA) system requires any employee who encounters a situation that is likely to harm a patient to make an immediate report and to cease any activity that could cause further harm (stopping the line). IMPLEMENTING THE PSA SYSTEM--STOPPING THE LINE: If any VMMC employee's practice or conduct is deemed capable of causing harm to a patient, a PSA can cause that person to be stopped from working until the problem is resolved. A policy statement, senior executive commitment, dedicated resources, a 24-hour hotline, and communication were all key features of implementation. As of December 2006, 6,112 PSA reports were received: 20% from managers, 8% from physicians, 44% from nurses, and 23% from nonclinical support personnel, for example. The number of reports received per month increased from an average of 3 in 2002 to 285 in 2006. Most reports were processed within 24 hours and were resolved within 2 to 3 weeks. Implementing the PSA system has drastically increased the number of safety concerns that are resolved at VMMC, while drastically reducing the time it takes to resolve them. Transparent discussion and feedback have helped promote staff acceptance and participation.

  3. Harm reduction as a strategy for supporting people who self-harm on mental health wards: the views and experiences of practitioners.

    Science.gov (United States)

    James, Karen; Samuels, Isaac; Moran, Paul; Stewart, Duncan

    2017-05-01

    Harm reduction has had positive outcomes for people using sexual health and substance misuse services. Clinical guidance recommends these approaches may be appropriately adopted by mental health practitioners when managing some people who self-harm. There has, however, been very little research in this area. We explored practitioners' views of harm reduction as a strategy for supporting people who self-harm. The Self Harm Antipathy Scale (SHAS) was administered to a random sample of 395 mental health practitioners working on 31 wards in England, semi-structured interviews were then conducted with 18 survey respondents. Practitioners who had implemented the approach reported positive outcomes including a reduction in incidence and severity of self-harm and a perceived increase in empowerment of service users. Practitioners with no experience of using harm reduction were concerned that self-harm would increase in severity, and were unsure how to assess and manage risk in people under a harm reduction care plan. Some fundamentally disagreed with the principle of harm reduction for self-harm because it challenged their core beliefs about the morality of self-harm, or the ethical and potential legal ramifications of allowing individuals to harm themselves. This study was conducted solely with practitioners working on inpatient units. The majority of staff interviewed had no experience of harm reduction and so their concerns may not reflect challenges encountered by practitioners in clinical practice. Harm reduction is being used to support people who self-harm within inpatient psychiatry and some practitioners report potential benefits of this approach. However, this raises particularly complex practical, ethical and legal issues and further research is needed to assess the safety, acceptability and efficacy of the approach. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  4. A case study of pediatric asthma alerts from the beacon community program in cincinnati: technology is just the first step.

    Science.gov (United States)

    Trudnak, Tara; Mansour, Mona; Mandel, Keith; Sauers, Hadley; Pandzik, Gerry; Donisi, Carl; Fairbrother, Gerry

    2014-01-01

    The Beacon Community in Cincinnati, Ohio was an innovative, community-wide initiative to use technology to transform care. One important feature was the development of regional alerts to notify practices when patients were hospitalized or seen in the emergency department. The purpose of this paper is to describe the way in which technology engages the improvement process, and to describe the early stages of learning how to use technology to enhance quality improvement. We interviewed key Beacon leaders as well as providers and office staff in selected practices. We also collected preliminary data from practices that reflected handling of alerts, including the number of asthma related alerts received and followed up. Regional alerts, supplied by the community-wide health information exchange, were a significant addition to the quality improvement effort in that they enabled practices to identify and follow up with additional children at risk. An important finding was the substantial effort at the practice level to integrate technology into ongoing patient care. Developing the technology for community wide alerts represented a significant endeavor in the Cincinnati Beacon Community. However, the technology was just the first step. Despite extra effort and time required on the part of individual practices, they reported that the value of having alerts was high. Hospital and ED visits represent some of the most costly aspects of care, and an efficient process for intervening with children using these costly services was seen as of significant value.

  5. Overview of harm reduction in prisons in seven European countries.

    Science.gov (United States)

    Sander, Gen; Scandurra, Alessio; Kamenska, Anhelita; MacNamara, Catherine; Kalpaki, Christina; Bessa, Cristina Fernandez; Laso, Gemma Nicolás; Parisi, Grazia; Varley, Lorraine; Wolny, Marcin; Moudatsou, Maria; Pontes, Nuno Henrique; Mannix-McNamara, Patricia; Libianchi, Sandro; Antypas, Tzanetos

    2016-10-07

    While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.

  6. Weathering product-harm crises

    NARCIS (Netherlands)

    Cleeren, K.; Dekimpe, M.G.; Helsen, K.

    2008-01-01

    To counter the negative effects of a product-harm crisis, brands hope to capitalize on their equity, and often use advertising as a communication device to regain customers’ lost trust. We study how consumer characteristics and advertising influence consumers’ first-purchase decisions for two

  7. Managing Product-Harm Crises

    NARCIS (Netherlands)

    H.J. van Heerde (Harald); K. Helsen; M.G. Dekimpe (Marnik)

    2005-01-01

    textabstractProduct-harm crises are among a firm’s worst nightmares. Since marketing investments may be instrumental to convince consumers to purchase the firm's products again, it is important to provide an adequate measurement of the effectiveness of these investments, especially after the crisis.

  8. Earthquake Early Warning ShakeAlert System: Testing and certification platform

    Science.gov (United States)

    Cochran, Elizabeth S.; Kohler, Monica D.; Given, Douglas; Guiwits, Stephen; Andrews, Jennifer; Meier, Men-Andrin; Ahmad, Mohammad; Henson, Ivan; Hartog, Renate; Smith, Deborah

    2017-01-01

    Earthquake early warning systems provide warnings to end users of incoming moderate to strong ground shaking from earthquakes. An earthquake early warning system, ShakeAlert, is providing alerts to beta end users in the western United States, specifically California, Oregon, and Washington. An essential aspect of the earthquake early warning system is the development of a framework to test modifications to code to ensure functionality and assess performance. In 2016, a Testing and Certification Platform (TCP) was included in the development of the Production Prototype version of ShakeAlert. The purpose of the TCP is to evaluate the robustness of candidate code that is proposed for deployment on ShakeAlert Production Prototype servers. TCP consists of two main components: a real‐time in situ test that replicates the real‐time production system and an offline playback system to replay test suites. The real‐time tests of system performance assess code optimization and stability. The offline tests comprise a stress test of candidate code to assess if the code is production ready. The test suite includes over 120 events including local, regional, and teleseismic historic earthquakes, recentering and calibration events, and other anomalous and potentially problematic signals. Two assessments of alert performance are conducted. First, point‐source assessments are undertaken to compare magnitude, epicentral location, and origin time with the Advanced National Seismic System Comprehensive Catalog, as well as to evaluate alert latency. Second, we describe assessment of the quality of ground‐motion predictions at end‐user sites by comparing predicted shaking intensities to ShakeMaps for historic events and implement a threshold‐based approach that assesses how often end users initiate the appropriate action, based on their ground‐shaking threshold. TCP has been developed to be a convenient streamlined procedure for objectively testing algorithms, and it has

  9. A process-based model for the definition of hydrological alert systems in landslide risk mitigation

    Directory of Open Access Journals (Sweden)

    M. Floris

    2012-11-01

    Full Text Available The definition of hydrological alert systems for rainfall-induced landslides is strongly related to a deep knowledge of the geological and geomorphological features of the territory. Climatic conditions, spatial and temporal evolution of the phenomena and characterization of landslide triggering, together with propagation mechanisms, are the key elements to be considered. Critical steps for the development of the systems consist of the identification of the hydrological variable related to landslide triggering and of the minimum rainfall threshold for landslide occurrence.

    In this paper we report the results from a process-based model to define a hydrological alert system for the Val di Maso Landslide, located in the northeastern Italian Alps and included in the Vicenza Province (Veneto region, NE Italy. The instability occurred in November 2010, due to an exceptional rainfall event that hit the Vicenza Province and the entire NE Italy. Up to 500 mm in 3-day cumulated rainfall generated large flood conditions and triggered hundreds of landslides. During the flood, the Soil Protection Division of the Vicenza Province received more than 500 warnings of instability phenomena. The complexity of the event and the high level of risk to infrastructure and private buildings are the main reasons for deepening the specific phenomenon occurred at Val di Maso.

    Empirical and physically-based models have been used to identify the minimum rainfall threshold for the occurrence of instability phenomena in the crown area of Val di Maso landslide, where a retrogressive evolution by multiple rotational slides is expected. Empirical models helped in the identification and in the evaluation of recurrence of critical rainfall events, while physically-based modelling was essential to verify the effects on the slope stability of determined rainfall depths. Empirical relationships between rainfall and landslide consist of the calculation of rainfall

  10. TJC: HCOs need to be on alert for HIT problems related to sociotechnical factors, take steps to improve safety culture, process, and leadership.

    Science.gov (United States)

    2015-06-01

    Noting that too many errors related to health information technology (HIT) are resulting in adverse consequences, The Joint Commission (TJC) has issued a Sentinel Event Alert, urging health care providers to take steps to improve their safety culture, approach to process improvement, and leadership in this area. In this latest alert, the accrediting agency is taking particular aim at risks posed by sociotechnical factors--or the ways in which HIT is implemented and used. Experts say that many of these risks are, in fact, exemplified at a higher level in the emergency setting, where providers are under constant pressure to see more patients and move them though the system faster. In an analysis of 3,375 sentinel events that resulted in permanent patient harm or death between January 1, 2010, and June 20, 2013, The Joint Commission (TJC) found that 120 events included HIT-related contributing factors. Many of the problems cited by TJC relate to orders or medicines being prescribed for the wrong patients. These can result from toggling errors or pop-up screens where providers are asked to click on the appropriate patient or medicine, and they mistakenly click on the wrong selection. In the ED, experts recommend the creation of a multidisciplinary performance improvement group to continuously monitor the ED information system (EDIS), recognize problems, and work with the vendor to resolve them. Also important is a quick and easy way for providers to report HIT-related problems. Experts add that emergency providers need to be fully engaged in the process of selecting HIT that they will be using, and that health care organizations should arrange for usability assessments before purchasing HIT.

  11. Correlated colour temperature of morning light influences alertness and body temperature.

    Science.gov (United States)

    Te Kulve, Marije; Schlangen, Luc; Schellen, Lisje; Souman, Jan L; van Marken Lichtenbelt, Wouter

    2018-03-01

    Though several studies have reported human alertness to be affected by the intensity and spectral composition of ambient light, the mechanism behind this effect is still largely unclear, especially for daytime exposure. Alerting effects of nocturnal light exposure are correlated with melatonin suppression, but melatonin levels are generally low during the day. The aim of this study was to explore the alerting effect of light in the morning for different correlated colour temperature (CCT) values, as well as its interaction with ambient temperature. Body temperature and perceived comfort were included in the study as possible mediating factors. In a randomized crossover design, 16 healthy females participated in two sessions, once under 2700K and once under 6500K light (both 55lx). Each session consisted of a baseline, a cool, a neutral and a warm thermal environment. Alertness as measured in a reaction time task was lower for the 6500K exposure, while subjective sleepiness was not affected by CCT. Also, core body temperature was higher under 6500K. Skin temperature parameters and perceived comfort were positively correlated with subjective sleepiness. Reaction time correlated with heat loss, but this association did not explain why the reaction time was improved for 2700K. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Perceptual evaluation of visual alerts in surveillance videos

    Science.gov (United States)

    Rogowitz, Bernice E.; Topkara, Mercan; Pfeiffer, William; Hampapur, Arun

    2015-03-01

    Visual alerts are commonly used in video monitoring and surveillance systems to mark events, presumably making them more salient to human observers. Surprisingly, the effectiveness of computer-generated alerts in improving human performance has not been widely studied. To address this gap, we have developed a tool for simulating different alert parameters in a realistic visual monitoring situation, and have measured human detection performance under conditions that emulated different set-points in a surveillance algorithm. In the High-Sensitivity condition, the simulated alerts identified 100% of the events with many false alarms. In the Lower-Sensitivity condition, the simulated alerts correctly identified 70% of the targets, with fewer false alarms. In the control condition, no simulated alerts were provided. To explore the effects of learning, subjects performed these tasks in three sessions, on separate days, in a counterbalanced, within subject design. We explore these results within the context of cognitive models of human attention and learning. We found that human observers were more likely to respond to events when marked by a visual alert. Learning played a major role in the two alert conditions. In the first session, observers generated almost twice as many False Alarms as in the No-Alert condition, as the observers responded pre-attentively to the computer-generated false alarms. However, this rate dropped equally dramatically in later sessions, as observers learned to discount the false cues. Highest observer Precision, Hits/(Hits + False Alarms), was achieved in the High Sensitivity condition, but only after training. The successful evaluation of surveillance systems depends on understanding human attention and performance.

  13. Self-indicating radiation alert dosemeter (SIRAD)

    International Nuclear Information System (INIS)

    Riel, G. K.; Winters, P.; Patel, G.; Patel, P.

    2006-01-01

    In an event of a nuclear or dirty bomb explosion and a radiological accident, there is a need for self-indicating instant radiation dosemeter for monitoring radiation exposure. The self-indicating instant radiation alert dosemeter (SIRAD) is a credit card size radiation dosemeter for monitoring ionising radiation from a few hundredths of a Gray to a few Gray. It is always active and is ready to use. It needs no battery. The dosemeter develops colour instantly upon exposure, and the colour intensifies with dose. It has a colour chart so that the dose on the active element may be read by matching its colour with the chart that is printed next to it on the card. However, in this work, the dose is measured by the optical density of the element. The dosemeter cannot be reset. The response changes by 3 y at room temperature. It contains no hazardous materials. The dosemeter would meet the requirements of instantly monitoring high dose in an event of a nuclear or dirty bomb explosion or a radiation accident. (authors)

  14. Self-indicating radiation alert dosemeter (SIRAD).

    Science.gov (United States)

    Riel, Gordon K; Winters, Patrick; Patel, Gordhan; Patel, Paresh

    2006-01-01

    In an event of a nuclear or dirty bomb explosion and a radiological accident, there is a need for self-indicating instant radiation dosemeter for monitoring radiation exposure. The self-indicating instant radiation alert dosemeter (SIRAD) is a credit card size radiation dosemeter for monitoring ionising radiation from a few hundredths of a Gray to a few Gray. It is always active and is ready to use. It needs no battery. The dosemeter develops colour instantly upon exposure, and the colour intensifies with dose. It has a colour chart so that the dose on the active element may be read by matching its colour with the chart that is printed next to it on the card. However, in this work, the dose is measured by the optical density of the element. The dosemeter cannot be reset. The response changes by 3 y at room temperature. It contains no hazardous materials. The dosemeter would meet the requirements of instantly monitoring high dose in an event of a nuclear or dirty bomb explosion or a radiation accident.

  15. Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.

    Science.gov (United States)

    Lacson, Ronilda; O'Connor, Stacy D; Sahni, V Anik; Roy, Christopher; Dalal, Anuj; Desai, Sonali; Khorasani, Ramin

    2016-07-01

    Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impact of ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports. The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (pcommunicated reports with non-critical results remained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test). A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting the system did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm. 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/

  16. Global Fund investments in harm reduction from 2002 to 2009

    DEFF Research Database (Denmark)

    Bridge, Jamie; Hunter, Benjamin M; Atun, Rifat

    2012-01-01

    Injecting drug use has been documented in 158 countries and is a major contributor to HIV epidemics. People who inject drugs have poor and inequitable access to HIV services. The Global Fund to Fight AIDS, Tuberculosis and Malaria is the leading multilateral donor for HIV programmes and encourage...... applicants to include harm reduction interventions in their proposals. This study is the first detailed analysis of Global Fund investments in harm reduction interventions....

  17. A comparison of blue light and caffeine effects on cognitive function and alertness in humans.

    Science.gov (United States)

    Beaven, C Martyn; Ekström, Johan

    2013-01-01

    The alerting effects of both caffeine and short wavelength (blue) light have been consistently reported. The ability of blue light to enhance alertness and cognitive function via non-image forming neuropathways have been suggested as a non-pharmacological countermeasure for drowsiness across a range of occupational settings. Here we compare and contrast the alerting and psychomotor effects of 240 mg of caffeine and a 1-h dose of ~40 lx blue light in a non-athletic population. Twenty-one healthy subjects performed a computer-based psychomotor vigilance test before and after each of four randomly assigned trial conditions performed on different days: white light/placebo; white light/240 mg caffeine; blue light/placebo; blue light/240 mg caffeine. The Karolinska Sleepiness Scale was used to assess subjective measures of alertness. Both the caffeine only and blue light only conditions enhanced accuracy in a visual reaction test requiring a decision and an additive effect was observed with respect to the fastest reaction times. However, in a test of executive function, where a distraction was included, caffeine exerted a negative effect on accuracy. Furthermore, the blue light only condition consistently outperformed caffeine when both congruent and incongruent distractions were presented. The visual reactions in the absence of a decision or distraction were also enhanced in the blue light only condition and this effect was most prominent in the blue-eyed participants. Overall, blue light and caffeine demonstrated distinct effects on aspects of psychomotor function and have the potential to positively influence a range of settings where cognitive function and alertness are important. Specifically, despite the widespread use of caffeine in competitive sporting environments, the possible impact of blue light has received no research attention.

  18. A comparison of blue light and caffeine effects on cognitive function and alertness in humans.

    Directory of Open Access Journals (Sweden)

    C Martyn Beaven

    Full Text Available The alerting effects of both caffeine and short wavelength (blue light have been consistently reported. The ability of blue light to enhance alertness and cognitive function via non-image forming neuropathways have been suggested as a non-pharmacological countermeasure for drowsiness across a range of occupational settings. Here we compare and contrast the alerting and psychomotor effects of 240 mg of caffeine and a 1-h dose of ~40 lx blue light in a non-athletic population. Twenty-one healthy subjects performed a computer-based psychomotor vigilance test before and after each of four randomly assigned trial conditions performed on different days: white light/placebo; white light/240 mg caffeine; blue light/placebo; blue light/240 mg caffeine. The Karolinska Sleepiness Scale was used to assess subjective measures of alertness. Both the caffeine only and blue light only conditions enhanced accuracy in a visual reaction test requiring a decision and an additive effect was observed with respect to the fastest reaction times. However, in a test of executive function, where a distraction was included, caffeine exerted a negative effect on accuracy. Furthermore, the blue light only condition consistently outperformed caffeine when both congruent and incongruent distractions were presented. The visual reactions in the absence of a decision or distraction were also enhanced in the blue light only condition and this effect was most prominent in the blue-eyed participants. Overall, blue light and caffeine demonstrated distinct effects on aspects of psychomotor function and have the potential to positively influence a range of settings where cognitive function and alertness are important. Specifically, despite the widespread use of caffeine in competitive sporting environments, the possible impact of blue light has received no research attention.

  19. Report: Management Alert - Salary Increases for Certain Administratively Determined Positions

    Science.gov (United States)

    Report #18-N-0154, April 16, 2018. The purpose of this alert is to notify the EPA of certain factual info while our audit of the Office of the Administrator's (present and prior administrations) use of administratively determined positions continues.

  20. Office of Child Support and Enforcement (OCSE) State Wage Alerts

    Data.gov (United States)

    Social Security Administration — The OCSE State Wage Alert is a quarterly match which detects SSI overpayments by identifying unreported wage and unemployment data provided to the Office of Child...

  1. Usability of Smartphones for dose alerts

    International Nuclear Information System (INIS)

    Kaireit, T.; Stamm, G.; Wacker, F.K.; Hoeschen, C.

    2013-01-01

    Purpose: Smartphone apps for measuring ionizing radiation use the capability of (CMOS) camera chips to detect not only perceivable light but also electromagnetic wave radiation. The present study evaluates the accuracy of hardware and software and defines possible applications for the detection of X-ray radiation fields. Materials and Methods: 2 apps and 2 different devices were tested in comparison with a calibrated ionization chamber and a personal electronic dosimeter. A calibration curve was determined for dose rates between 12 700 μSv/h and 5.7 μSv/h generated by a C-arm system. Results: The measured scattered radiation produced by an Alderson-Rando phantom ranged from 117 μSv/h (at a distance of 2 m) to 5910 μSv/h (at a distance of 0.3 m) and was 1.4 times less than the values of the ionization chamber. The exposure rate for the operator's thyroid was within 4200 - 4400 μSv/h. We found a strong dependence of the measurements on the angulation of the Smartphone, especially for short distances from the phantom (at a distance of 0.3 m, a 45 rotation downwards in a vertical direction caused a decrease from 3000 μSv/h to 972 μSv/h, while an upwards rotation resulted in an increase to 5000 μSv/h). For a distance of 1 m, this effect was remarkably smaller. Conclusion: Smartphones can be used to detect ionizing radiation but showed limited accuracy and are heavily dependent on the angulation of the device. Qualitative measurements and utilization for dose alerts are possible. (orig.)

  2. [Usability of smartphones for dose alerts].

    Science.gov (United States)

    Kaireit, T; Stamm, G; Hoeschen, C; Wacker, F K

    2013-06-01

    Smartphone apps for measuring ionizing radiation use the capability of (CMOS) camera chips to detect not only perceivable light but also electromagnetic wave radiation. The present study evaluates the accuracy of hardware and software and defines possible applications for the detection of X-ray radiation fields. 2 apps and 2 different devices were tested in comparison with a calibrated ionization chamber and a personal electronic dosimeter. A calibration curve was determined for dose rates between 12 700 µSv/h and 5.7 µSv/h generated by a C-arm system. The measured scattered radiation produced by an Alderson-Rando phantom ranged from 117 µSv/h (at a distance of 2 m) to 5910 µSv/h (at a distance of 0.3 m) and was 1.4 times less than the values of the ionization chamber. The exposure rate for the operator's thyroid was within 4200 - 4400 µSv/h. We found a strong dependence of the measurements on the angulation of the Smartphone, especially for short distances from the phantom (at a distance of 0.3 m, a 45° rotation downwards in a vertical direction caused a decrease from 3000 µSv/h to 972 µSv/h, while an upwards rotation resulted in an increase to 5000 µSv/h). For a distance of 1 m, this effect was remarkably smaller. Smartphones can be used to detect ionizing radiation but showed limited accuracy and are heavily dependent on the angulation of the device. Qualitative measurements and utilization for dose alerts are possible. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Acute alerting effects of light: A systematic literature review.

    Science.gov (United States)

    Souman, Jan L; Tinga, Angelica M; Te Pas, Susan F; van Ee, Raymond; Vlaskamp, Björn N S

    2018-01-30

    Periodic, well timed exposure to light is important for our health and wellbeing. Light, in particular in the blue part of the spectrum, is thought to affect alertness both indirectly, by modifying circadian rhythms, and directly, giving rise to acute effects. We performed a systematic review of empirical studies on direct, acute effects of light on alertness to evaluate the reliability of these effects. In total, we identified 68 studies in which either light intensity, spectral distribution, or both were manipulated, and evaluated the effects on behavioral measures of alertness, either subjectively or measured in reaction time performance tasks. The results show that increasing the intensity of polychromatic white light has been found to increase subjective ratings of alertness in a majority of studies, though a substantial proportion of studies failed to find significant effects, possibly due to small sample sizes or high baseline light intensities. The effect of the color temperature of white light on subjective alertness is less clear. Some studies found increased alertness with higher color temperatures, but other studies reported no detrimental effects of filtering out the short wavelengths from the spectrum. Similarly, studies that used monochromatic light exposure showed no systematic pattern for the effects of blue light compared to longer wavelengths. Far fewer studies investigated the effects of light intensity or spectrum on alertness as measured with reaction time tasks and of those, very few reported significant effects. In general, the small sample sizes used in studies on acute alerting effects of light make it difficult to draw definitive conclusions and better powered studies are needed, especially studies that allow for the construction of dose-response curves. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Alert management for home healthcare based on home automation analysis.

    Science.gov (United States)

    Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

    2010-01-01

    Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

  5. Pregnancy Cravings Can Harm Your Oral Health

    Science.gov (United States)

    ... 2018 About | Contact InfoBites Quick Reference Learn more Oral Health and Overal Health Gum Disease and Cardiovascular Health ... your desktop! more... Pregnancy Cravings Can Harm Your Oral Health Article Chapters Pregnancy Cravings Can Harm Your Oral ...

  6. Evaluation of Different Methods for Identification of Structural Alerts Using Chemical Ames Mutagenicity Data Set as a Benchmark.

    Science.gov (United States)

    Yang, Hongbin; Li, Jie; Wu, Zengrui; Li, Weihua; Liu, Guixia; Tang, Yun

    2017-06-19

    Identification of structural alerts for toxicity is useful in drug discovery and other fields such as environmental protection. With structural alerts, researchers can quickly identify potential toxic compounds and learn how to modify them. Hence, it is important to determine structural alerts from a large number of compounds quickly and accurately. There are already many methods reported for identification of structural alerts. However, how to evaluate those methods is a problem. In this paper, we tried to evaluate four of the methods for monosubstructure identification with three indices including accuracy rate, coverage rate, and information gain to compare their advantages and disadvantages. The Kazius' Ames mutagenicity data set was used as the benchmark, and the four methods were MoSS (graph-based), SARpy (fragment-based), and two fingerprint-based methods including Bioalerts and the fingerprint (FP) method we previously used. The results showed that Bioalerts and FP could detect key substructures with high accuracy and coverage rates because they allowed unclosed rings and wildcard atom or bond types. However, they also resulted in redundancy so that their predictive performance was not as good as that of SARpy. SARpy was competitive in predictive performance in both training set and external validation set. These results might be helpful for users to select appropriate methods and further development of methods for identification of structural alerts.

  7. In Silico Prediction of Chemical Toxicity for Drug Design Using Machine Learning Methods and Structural Alerts

    Science.gov (United States)

    Yang, Hongbin; Sun, Lixia; Li, Weihua; Liu, Guixia; Tang, Yun

    2018-02-01

    For a drug, safety is always the most important issue, including a variety of toxicities and adverse drug effects, which should be evaluated in preclinical and clinical trial phases. This review article at first simply introduced the computational methods used in prediction of chemical toxicity for drug design, including machine learning methods and structural alerts. Machine learning methods have been widely applied in qualitative classification and quantitative regression studies, while structural alerts can be regarded as a complementary tool for lead optimization. The emphasis of this article was put on the recent progress of predictive models built for various toxicities. Available databases and web servers were also provided. Though the methods and models are very helpful for drug design, there are still some challenges and limitations to be improved for drug safety assessment in the future.

  8. In Silico Prediction of Chemical Toxicity for Drug Design Using Machine Learning Methods and Structural Alerts

    Directory of Open Access Journals (Sweden)

    Hongbin Yang

    2018-02-01

    Full Text Available During drug development, safety is always the most important issue, including a variety of toxicities and adverse drug effects, which should be evaluated in preclinical and clinical trial phases. This review article at first simply introduced the computational methods used in prediction of chemical toxicity for drug design, including machine learning methods and structural alerts. Machine learning methods have been widely applied in qualitative classification and quantitative regression studies, while structural alerts can be regarded as a complementary tool for lead optimization. The emphasis of this article was put on the recent progress of predictive models built for various toxicities. Available databases and web servers were also provided. Though the methods and models are very helpful for drug design, there are still some challenges and limitations to be improved for drug safety assessment in the future.

  9. In Silico Prediction of Chemical Toxicity for Drug Design Using Machine Learning Methods and Structural Alerts.

    Science.gov (United States)

    Yang, Hongbin; Sun, Lixia; Li, Weihua; Liu, Guixia; Tang, Yun

    2018-01-01

    During drug development, safety is always the most important issue, including a variety of toxicities and adverse drug effects, which should be evaluated in preclinical and clinical trial phases. This review article at first simply introduced the computational methods used in prediction of chemical toxicity for drug design, including machine learning methods and structural alerts. Machine learning methods have been widely applied in qualitative classification and quantitative regression studies, while structural alerts can be regarded as a complementary tool for lead optimization. The emphasis of this article was put on the recent progress of predictive models built for various toxicities. Available databases and web servers were also provided. Though the methods and models are very helpful for drug design, there are still some challenges and limitations to be improved for drug safety assessment in the future.

  10. Bituminization of biologically harmful wastes

    International Nuclear Information System (INIS)

    Freund, M.; Magyar, M.; Mozes, G.; Csikos, R.; Kristof, M.; Toth, L.; Hima, G.

    1977-01-01

    The invention claims the bitumenization of biologically harmful wastes, such as industrial wastes containing radioactive materials. These wastes containing water are transported from sludge basins, this either by gravity or by mechanical stirrino. into a suitably adapted absorption zone or to several parallel zones filled with bitumen heated to 100 to 250 degC. An inert gas is forced into the system foaming the zone contents. The foam phase is decomposed by the action of heat while water is evaporated and condensed. Bitumen containing dry matter of the radioactive wastes is discharged from the bottom part of the absorption zone and stored in a tank. (Kr)

  11. [Dutch parliament legitimizes harmful quackery].

    Science.gov (United States)

    van Dam, Frits S A M; Renckens, Cees N M

    2010-01-01

    The Dutch parliament has recently accepted a tax law in which certain groups of alternative therapists can be exempt from VAT. To be eligible for this VAT exemption, the disciplines to which the therapists belong have to meet certain training requirements. In this article it is contended, in agreement with the Royal College of Physicians in the UK, that statutory regulation is inappropriate for disciplines whose therapies are neither of proved benefit nor appropriately tested. It legitimizes harmful therapies. This is illustrated by two serious accidents, previously described in this journal, caused by a chiropractor and a craniosacral therapist.

  12. Effects of an alert system on implantable cardioverter defibrillator-related anxiety

    DEFF Research Database (Denmark)

    Duru, Firat; Dorian, Paul; Favale, Stefano

    2010-01-01

    failing to receive needed therapy for the same reason. New devices include programmable vibrating patient notifiers (PN), which, by warning patients of a possible device dysfunction, might lower device-related anxiety. PAtient NOtifier feature for Reduction of Anxiety: a Multicentre ICD study (PANORAMIC......) is a multicentre, randomized, clinical trial designed to examine the effects of the awareness of an active vibrating alert system on device-related anxiety....

  13. Dexterous robotic manipulation of alert adult Drosophila for high-content experimentation.

    Science.gov (United States)

    Savall, Joan; Ho, Eric Tatt Wei; Huang, Cheng; Maxey, Jessica R; Schnitzer, Mark J

    2015-07-01

    We present a robot that enables high-content studies of alert adult Drosophila by combining operations including gentle picking; translations and rotations; characterizations of fly phenotypes and behaviors; microdissection; or release. To illustrate, we assessed fly morphology, tracked odor-evoked locomotion, sorted flies by sex, and dissected the cuticle to image neural activity. The robot's tireless capacity for precise manipulations enables a scalable platform for screening flies' complex attributes and behavioral patterns.

  14. Speech Auditory Alerts Promote Memory for Alerted Events in a Video-Simulated Self-Driving Car Ride.

    Science.gov (United States)

    Nees, Michael A; Helbein, Benji; Porter, Anna

    2016-05-01

    Auditory displays could be essential to helping drivers maintain situation awareness in autonomous vehicles, but to date, few or no studies have examined the effectiveness of different types of auditory displays for this application scenario. Recent advances in the development of autonomous vehicles (i.e., self-driving cars) have suggested that widespread automation of driving may be tenable in the near future. Drivers may be required to monitor the status of automation programs and vehicle conditions as they engage in secondary leisure or work tasks (entertainment, communication, etc.) in autonomous vehicles. An experiment compared memory for alerted events-a component of Level 1 situation awareness-using speech alerts, auditory icons, and a visual control condition during a video-simulated self-driving car ride with a visual secondary task. The alerts gave information about the vehicle's operating status and the driving scenario. Speech alerts resulted in better memory for alerted events. Both auditory display types resulted in less perceived effort devoted toward the study tasks but also greater perceived annoyance with the alerts. Speech auditory displays promoted Level 1 situation awareness during a simulation of a ride in a self-driving vehicle under routine conditions, but annoyance remains a concern with auditory displays. Speech auditory displays showed promise as a means of increasing Level 1 situation awareness of routine scenarios during an autonomous vehicle ride with an unrelated secondary task. © 2016, Human Factors and Ergonomics Society.

  15. Trichloroacetic Acid Ingestion: Self-Harm Attempt

    Directory of Open Access Journals (Sweden)

    E. R. Black

    2017-01-01

    Full Text Available Objective. Trichloroacetic acid (TCAA, or trichloroethanoic acid, is a chemical analogue of acetic acid where three methyl group hydrogen atoms are replaced by chlorine. TCAAs are also abbreviated and referred to as TCAs, causing confusion with the psychiatric antidepressant drug class, especially among patients. TCAAs exist in dermatological treatments such as chemical peels or wart chemoablation medication. TCAA ingestion or overdose can cause gastric irritation symptoms including vomiting, diarrhea, or lassitude. This symptomatology is less severe than TCA overdose, where symptoms may include elevated body temperature, blurred vision, dilated pupils, sleepiness, confusion, seizures, rapid heart rate, and cardiac arrest. Owing to the vast difference in symptoms, the need for clinical intervention differs greatly. While overdose of either in a self-harm attempt can warrant psychiatric hospital admission, the risk of death in TCAA ingestion is far less. Case Report. A patient ingested TCAA in the form of a commercially available dermatological chemical peel as a self-harm attempt, thinking that it was a more injurious TCA. Conclusion. Awareness among physicians, particularly psychiatrists, regarding this relatively obscure chemical compound (TCAA and its use by suicidal patients mistakenly believing it to be a substance that can be significantly more lethal (TCA, is imperative.

  16. Nonsuicidal Self-Harm among Community Adolescents: Understanding the "Whats" and "Whys" of Self-Harm

    Science.gov (United States)

    Laye-Gindhu, Aviva; Schonert-Reichl, Kimberly A.

    2005-01-01

    This study examines self-harm in a community sample of adolescents. More specifically, the study identifies the prevalence and types of self-harm, elucidates the nature and underlying function of self-harm, and evaluates the relation of psychological adjustment, sociodemographic, and health-risk variables to self-harm. Self-report questionnaires…

  17. IP Telephony Based Danger Alert Communication System and Its Implementation

    Directory of Open Access Journals (Sweden)

    Filip Rezac

    2012-01-01

    Full Text Available The paper deals with development of a web application allowing to deliver pre-recorded voice messages by using SIP generator. The developed application is a part of complex system, which has been evolved in Dpt. of Telecommunications, Technical University of Ostrava for last three years. Our intent is focused on disaster management, the message, which should be delivered within specified time span, is typed in the application and text-to-speech module ensures its transormation to a speech format, after that a particular scenario or warned area is selected and a target group is automatically unloaded. For this purpose, we have defined XML format for delivery of phone numbers which are located in the target area and these numbers are obtained from mobile BTS's (Base transmission stations. The advantage of this aproach lies in controlled delivery and finally the list of unanswered calls is exported and these users are informed via SMS. In the paper, the core of the danger alert system is described including algorithms of the voice message delivery.

  18. Swift Burst Alert Telescope Data Products and Analysis Software

    International Nuclear Information System (INIS)

    Krimm, Hans A.; Barbier, Louis M.; Barthelmy, Scott D.; Cummings, Jay R.; Gehrels, Neil; Parsons, Ann M.; Tueller, Jack; Fenimore, Edward E.; Palmer, David M.; Hullinger, Derek D.; Markwardt, Craig B.

    2004-01-01

    The Burst Alert Telescope (BAT) on the Swift gamma-ray burst mission serves as the GRB trigger for Swift as well as a sensitive imaging telescope for the energy range of 15-150 keV. All BAT data products will be available to the astronomical community along with a complete set of analysis tools. Gamma-ray burst data products include rapid discovery messages delivered immediately via the GRB Coordinates Network, and event-by-event data from which light curves and spectra of the burst are generated. During nominal operations, the instrument provides accumulated survey histograms with 5-minute time sampling and appropriate energy resolution. These survey accumulations are analyzed in a pipeline to detect new sources and derive light curves of known sources. The 5-minute surveys will also be combined to produce the BAT all sky hard X-ray survey. In addition, the instrument accumulates high time resolution light curves of the brightest BAT sources in multiple energy bands, which are merged into a source light curve database on the ground. The BAT science data products and analysis tools will be described in this paper

  19. Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting

    Directory of Open Access Journals (Sweden)

    Andrew M. Harrison

    2017-03-01

    Full Text Available Background Electronic Health Record (EHR-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148 and 51% (N = 156 from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5 and median 2 min (N = 80 from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting.

  20. Space Debris Alert System for Aviation

    Science.gov (United States)

    Sgobba, Tommaso

    2013-09-01

    Despite increasing efforts to accurately predict space debris re-entry, the exact time and location of re-entry is still very uncertain. Partially, this is due to a skipping effect uncontrolled spacecraft may experience as they enter the atmosphere at a shallow angle. Such effect difficult to model depends on atmospheric variations of density. When the bouncing off ends and atmospheric re-entry starts, the trajectory and the overall location of surviving fragments can be precisely predicted but the time to impact with ground, or to reach the airspace, becomes very short.Different is the case of a functional space system performing controlled re-entry. Suitable forecasts methods are available to clear air and maritime traffic from hazard areas (so-called traffic segregation).In US, following the Space Shuttle Columbia accident in 2003, a re-entry hazard areas location forecast system was putted in place for the specific case of major malfunction of a Reusable Launch Vehicles (RLV) at re-entry. The Shuttle Hazard Area to Aircraft Calculator (SHAAC) is a system based on ground equipment and software analyses and prediction tools, which require trained personnel and close coordination between the organization responsible for RLV operation (NASA for Shuttle) and the Federal Aviation Administration. The system very much relies on the operator's capability to determine that a major malfunction has occurred.This paper presents a US pending patent by the European Space Agency, which consists of a "smart fragment" using a GPS localizer together with pre- computed debris footprint area and direct broadcasting of such hazard areas.The risk for aviation from falling debris is very remote but catastrophic. Suspending flight over vast swath of airspace for every re-entering spacecraft or rocket upper stage, which is a weekly occurrence, would be extremely costly and disruptive.The Re-entry Direct Broadcasting Alert System (R- DBAS) is an original merging and evolution of the Re

  1. Crew Factors in Flight Operations XV: Alertness Management in General Aviation Education Module

    Science.gov (United States)

    Rosekind, Mark R.; Co, Elizabeth L.; Neri, David F.; Oyung, Raymond L.; Mallis, Melissa M.; Cannon, Mary M. (Technical Monitor)

    2002-01-01

    Regional operations encompass a broad range of pilots and equipment. This module is intended to help all those involved in regional aviation, including pilots, schedulers, dispatchers, maintenance technicians, policy makers, and others, to understand the physiological factors underlying fatigue, how flight operations affect fatigue, and what can be done to counteract fatigue and maximize alertness and performance in their operations. The overall purpose of this module is to promote aviation safety, performance, and productivity. It is intended to meet three specific objectives: (1) to explain the current state of knowledge about the physiological mechanisms underlying fatigue; (2) to demonstrate how this knowledge can be applied to improving flight crew sleep, performance, and alertness; and (3) to offer strategies for alertness management. Aviation Safety Reporting System (ASRS) and National Transportation Safety Board (NISH) reports are used throughout this module to demonstrate that fatigue is a safety issue in the regional operations community. The appendices at the end of this module include the ASRS reports used for the examples contained in this publication, brief introductions to sleep disorders and relaxation techniques, summaries of relevant NASA publications, and a list of general readings on sleep, sleep disorders, and circadian rhythms.

  2. Crew Factors in Flight Operations XIV: Alertness Management in Regional Flight Operations Education Module

    Science.gov (United States)

    Rosekind, Mark R.; Co, Elizabeth L.; Neri, David F.; Oyung, Raymond L.; Mallis, Melissa M.

    2002-01-01

    Regional operations encompass a broad range of pilots and equipment. This module is intended to help all those involved in regional aviation, including pilots, schedulers, dispatchers, maintenance technicians, policy makers, and others, to understand the physiological factors underlying fatigue, how flight operations affect fatigue, and what can be done to counteract fatigue and maximize alertness and performance in their operations. The overall purpose of this module is to promote aviation safety, performance, and productivity. It is intended to meet three specific objectives: (1) to explain the current state of knowledge about the physiological mechanisms underlying fatigue; (2) to demonstrate how this knowledge can be applied to improving flight crew sleep, performance, and alertness; and (3) to offer strategies for alertness management. Aviation Safety Reporting System (ASRS) and National Transportation Safety Board (NISH) reports are used throughout this module to demonstrate that fatigue is a safety issue in the regional operations community. The appendices at the end of this module include the ASRS reports used for the examples contained in this publication, brief introductions to sleep disorders and relaxation techniques, summaries of relevant NASA publications, and a list of general readings on sleep, sleep disorders, and circadian rhythms.

  3. Mobile Traffic Alert and Tourist Route Guidance System Design Using Geospatial Data

    Science.gov (United States)

    Bhattacharya, D.; Painho, M.; Mishra, S.; Gupta, A.

    2017-09-01

    The present study describes an integrated system for traffic data collection and alert warning. Geographical information based decision making related to traffic destinations and routes is proposed through the design. The system includes a geospatial database having profile relating to a user of a mobile device. The processing and understanding of scanned maps, other digital data input leads to route guidance. The system includes a server configured to receive traffic information relating to a route and location information relating to the mobile device. Server is configured to send a traffic alert to the mobile device when the traffic information and the location information indicate that the mobile device is traveling toward traffic congestion. Proposed system has geospatial and mobile data sets pertaining to Bangalore city in India. It is envisaged to be helpful for touristic purposes as a route guidance and alert relaying information system to tourists for proximity to sites worth seeing in a city they have entered into. The system is modular in architecture and the novelty lies in integration of different modules carrying different technologies for a complete traffic information system. Generic information processing and delivery system has been tested to be functional and speedy under test geospatial domains. In a restricted prototype model with geo-referenced route data required information has been delivered correctly over sustained trials to designated cell numbers, with average time frame of 27.5 seconds, maximum 50 and minimum 5 seconds. Traffic geo-data set trials testing is underway.

  4. MOBILE TRAFFIC ALERT AND TOURIST ROUTE GUIDANCE SYSTEM DESIGN USING GEOSPATIAL DATA

    Directory of Open Access Journals (Sweden)

    D. Bhattacharya

    2017-09-01

    Full Text Available The present study describes an integrated system for traffic data collection and alert warning. Geographical information based decision making related to traffic destinations and routes is proposed through the design. The system includes a geospatial database having profile relating to a user of a mobile device. The processing and understanding of scanned maps, other digital data input leads to route guidance. The system includes a server configured to receive traffic information relating to a route and location information relating to the mobile device. Server is configured to send a traffic alert to the mobile device when the traffic information and the location information indicate that the mobile device is traveling toward traffic congestion. Proposed system has geospatial and mobile data sets pertaining to Bangalore city in India. It is envisaged to be helpful for touristic purposes as a route guidance and alert relaying information system to tourists for proximity to sites worth seeing in a city they have entered into. The system is modular in architecture and the novelty lies in integration of different modules carrying different technologies for a complete traffic information system. Generic information processing and delivery system has been tested to be functional and speedy under test geospatial domains. In a restricted prototype model with geo-referenced route data required information has been delivered correctly over sustained trials to designated cell numbers, with average time frame of 27.5 seconds, maximum 50 and minimum 5 seconds. Traffic geo-data set trials testing is underway.

  5. Optimizing the response to surveillance alerts in automated surveillance systems.

    Science.gov (United States)

    Izadi, Masoumeh; Buckeridge, David L

    2011-02-28

    Although much research effort has been directed toward refining algorithms for disease outbreak alerting, considerably less attention has been given to the response to alerts generated from statistical detection algorithms. Given the inherent inaccuracy in alerting, it is imperative to develop methods that help public health personnel identify optimal policies in response to alerts. This study evaluates the application of dynamic decision making models to the problem of responding to outbreak detection methods, using anthrax surveillance as an example. Adaptive optimization through approximate dynamic programming is used to generate a policy for decision making following outbreak detection. We investigate the degree to which the model can tolerate noise theoretically, in order to keep near optimal behavior. We also evaluate the policy from our model empirically and compare it with current approaches in routine public health practice for investigating alerts. Timeliness of outbreak confirmation and total costs associated with the decisions made are used as performance measures. Using our approach, on average, 80 per cent of outbreaks were confirmed prior to the fifth day of post-attack with considerably less cost compared to response strategies currently in use. Experimental results are also provided to illustrate the robustness of the adaptive optimization approach and to show the realization of the derived error bounds in practice. Copyright © 2011 John Wiley & Sons, Ltd.

  6. Infant Responsiveness, Alertness, Hemoglobin and Growth in Rural Sidama, Ethiopia

    Science.gov (United States)

    Aubuchon-Endsley, Nicki L.; Grant, Stephanie L.; Thomas, David G.; Kennedy, Tay S.; Berhanu, Getenesh; Stoecker, Barbara J.; Hubbs-Tait, Laura; Hambidge, K. Michael

    2011-01-01

    Several recent studies have supported relations between infant behavior (alertness and responsiveness) and nutrition (e.g. Dempsey 2008, Wachs et al 2005) in addition to investigating infant behavior within the context of changes in iron status over time (e.g. Black et al. 2004, Murray-Kolb & Beard 2009). Existing research is typically limited to investigation of the effects of a single vitamin or mineral and no studies have been found that examined the influence that early alertness and responsiveness have on growth in early infancy, despite the fact that relations between behavior and nutritional status may be bidirectional (Hulthén 2003). The current study used a sample of Ethiopian infants and investigated anthropometrics, hemoglobin, the frequency of alertness, and the frequency of responsiveness at 6 and 9 months of age. Six-month weight-for-age predicted 9-month frequency of alertness, while 6-month hemoglobin predicted 9-month frequency of responsiveness. Compared to responsive infants, non-responsive infants at 6 months remained more non-responsive at 9 months, though weight-for-age for both groups converged at 9 months. Results support relations between nutrition and behavior (alertness and responsiveness) and provide evidence of a potentially useful tool (the Laboratory Temperament Assessment Battery [Lab-TAB]) that was adapted to evaluate these relations in Ethiopia. PMID:22233352

  7. Quality of prescription of high-alert medication and patient safety in pediatric emergency

    Directory of Open Access Journals (Sweden)

    V. Vieira de Melo

    2014-01-01

    Full Text Available Objective: Verify the importance of compliance by prescribed doses of high-alert medications in unit of pediatric emergency in patient safety. Method: This was a cross-sectional descriptive study conducted in a unit of pediatric emergency, for March to April of 2012. This study included all prescriptions that contained at least one high-alert medication, excluding all of others. The data were analyzed using Microsoft Office Excel® version 2007, and the study was approved by the Research Ethics Committee of the Hospital. Results: This study included prescriptions for 100 patients with a mean age of 5.2 ± 4.2 years. Were identified 983 (40.1% high-alert medications (21 different, with predominance of injectable solutions (834, 84,8%, and of these 727 (73.95% were electrolytes. The analysis of the dose was possible for 641 electrolytes and 104 non-electrolytes, being the dose inadequacies observed for some medications. Was observed concentration absent to 189 (18.9% prescribed medications, these with liquid pharmaceutical form or aerosol. Was observed also the absence of maximum dose for 8 (36.3% prescribed drugs “if necessary”. Conclusión: The inadequacies of doses of high-alert medications identified in this study may compromise patient safety, demonstrating the importance of knowledge of multidisciplinary health care team by this subject, in this context, it is noteworthy that the acting of a clinical pharmacist together with the health multidisciplined team can contributes with the review of drug prescriptions, reducing potential errors and collaborating with patient safety.

  8. Wireless alerting system using vibration for vehicles dashboard

    Science.gov (United States)

    Raj, Sweta; Rai, Shweta; Magaramagara, Wilbert; Sivacoumar, R.

    2017-11-01

    This paper aims at improving the engine life of any vehicle through a continuous measurement and monitoring of vital engine operational parameters and providing an effective alerting to drivers for any abnormality. Vehicles currently are using audio and visible alerting signals through alarms and light as a warning to the driver but these are not effective in noisy environments and during daylight. Through the use of the sense of feeling a driver can be alerted effectively. The need to no other vehicle parameter needs to be aided through the mobile display (phone).Thus a system is designed and implements to measure engine temperature, RPM, Oil level and Coolant level using appropriate sensors and a wireless communication (Bluetooth) is established to actuate a portable vibration control device and to read the different vehicle sensor readings through an android application for display and diagnosis.

  9. Dynamic malware containment under an epidemic model with alert

    Science.gov (United States)

    Zhang, Tianrui; Yang, Lu-Xing; Yang, Xiaofan; Wu, Yingbo; Tang, Yuan Yan

    2017-03-01

    Alerting at the early stage of malware invasion turns out to be an important complement to malware detection and elimination. This paper addresses the issue of how to dynamically contain the prevalence of malware at a lower cost, provided alerting is feasible. A controlled epidemic model with alert is established, and an optimal control problem based on the epidemic model is formulated. The optimality system for the optimal control problem is derived. The structure of an optimal control for the proposed optimal control problem is characterized under some conditions. Numerical examples show that the cost-efficiency of an optimal control strategy can be enhanced by adjusting the upper and lower bounds on admissible controls.

  10. Alert Workplace From Healthcare Workers' Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings.

    Science.gov (United States)

    Sagah Zadeh, Rana; Shepley, Mardelle; Sadatsafavi, Hessam; Owora, Arthur Hamie; Krieger, Ana C

    2018-04-01

    This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness, improving alertness, and therefore optimizing workplace safety. Reduced alertness is a common issue in healthcare work environments and is associated with impaired cognitive performance and decision-making ability as well as increased errors and injuries. We surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively. In order by frequency of endorsement: dietary intervention; physical mobility; cognitive, sensory, or social stimulation; personal lifestyle strategies; and rest/nap opportunities were reported as behavioral strategies used to address workplace alertness. Compared to other environmental features, daylight and thermal comfort were perceived to be more important to addressing workplace alertness ( p based guidelines is needed to address sleepiness and alertness to improve workplace safety in healthcare facilities.

  11. The agile alert system for gamma-ray transients

    International Nuclear Information System (INIS)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Fioretti, V.; Tavani, M.; Argan, A.; Trois, A.; Scalise, E.; Parmiggiani, N.; Beneventano, D.; Chen, A. W.; Vercellone, S.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Longo, F.; Pellizzoni, A.

    2014-01-01

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

  12. The agile alert system for gamma-ray transients

    Energy Technology Data Exchange (ETDEWEB)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Fioretti, V. [INAF/IASF-Bologna, Via Gobetti 101, I-40129 Bologna (Italy); Tavani, M.; Argan, A.; Trois, A.; Scalise, E. [INAF/IASF-Roma, Via del Fosso del Cavaliere 100, I-00133 Roma (Italy); Parmiggiani, N.; Beneventano, D. [University of Modena and Reggio Emilia, Dipartimento di Science e Metodi dell' Ingegneria (Italy); Chen, A. W. [INAF/IASF-Milano, Via E. Bassini 15, I-20133 Milano (Italy); Vercellone, S. [School of Physics, University of the Witwatersrand, Johannesburg Wits 2050 (South Africa); Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P. [INAF/IASF-Palermo, Via U. La Malfa 153, I-90146 Palermo (Italy); Longo, F. [ASI-ASDC, Via G. Galilei, I-00044 Frascati (Roma) (Italy); Pellizzoni, A. [INFN Trieste, I-34127 Trieste (Italy); and others

    2014-01-20

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

  13. The AGILE Alert System for Gamma-Ray Transients

    Science.gov (United States)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Tavani, M.; Parmiggiani, N.; Fioretti, V.; Chen, A. W.; Vercellone, S.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Beneventano, D.; Argan, A.; Trois, A.; Scalise, E.; Longo, F.; Pellizzoni, A.; Pucella, G.; Colafrancesco, S.; Conforti, V.; Tempesta, P.; Cerone, M.; Sabatini, P.; Annoni, G.; Valentini, G.; Salotti, L.

    2014-01-01

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

  14. Investigation into the value of trained glycaemia alert dogs to clients with type I diabetes.

    Science.gov (United States)

    Rooney, Nicola J; Morant, Steve; Guest, Claire

    2013-01-01

    Previous studies have suggested that some pet dogs respond to their owners' hypoglycaemic state. Here, we show that trained glycaemia alert dogs placed with clients living with diabetes afford significant improvements to owner well-being. We investigated whether trained dogs reliably respond to their owners' hypoglycaemic state, and whether owners experience facilitated tightened glycaemic control, and wider psychosocial benefits. Since obtaining their dog, all seventeen clients studied reported positive effects including reduced paramedic call outs, decreased unconscious episodes and improved independence. Owner-recorded data showed that dogs alerted their owners, with significant, though variable, accuracy at times of low and high blood sugar. Eight out of the ten dogs (for which owners provided adequate records) responded consistently more often when their owner's blood sugars were reported to be outside, than within, target range. Comparison of nine clients' routine records showed significant overall change after obtaining their dogs, with seven clients recording a significantly higher proportion of routine tests within target range after obtaining a dog. HbA1C showed a small, non significant reduction after dog allocation. Based on owner-reported data we have shown, for the first time, that trained detection dogs perform above chance level. This study points to the potential value of alert dogs, for increasing glycaemic control, client independence and consequent quality of life and even reducing the costs of long-term health care.

  15. Investigation into the value of trained glycaemia alert dogs to clients with type I diabetes.

    Directory of Open Access Journals (Sweden)

    Nicola J Rooney

    Full Text Available Previous studies have suggested that some pet dogs respond to their owners' hypoglycaemic state. Here, we show that trained glycaemia alert dogs placed with clients living with diabetes afford significant improvements to owner well-being. We investigated whether trained dogs reliably respond to their owners' hypoglycaemic state, and whether owners experience facilitated tightened glycaemic control, and wider psychosocial benefits. Since obtaining their dog, all seventeen clients studied reported positive effects including reduced paramedic call outs, decreased unconscious episodes and improved independence. Owner-recorded data showed that dogs alerted their owners, with significant, though variable, accuracy at times of low and high blood sugar. Eight out of the ten dogs (for which owners provided adequate records responded consistently more often when their owner's blood sugars were reported to be outside, than within, target range. Comparison of nine clients' routine records showed significant overall change after obtaining their dogs, with seven clients recording a significantly higher proportion of routine tests within target range after obtaining a dog. HbA1C showed a small, non significant reduction after dog allocation. Based on owner-reported data we have shown, for the first time, that trained detection dogs perform above chance level. This study points to the potential value of alert dogs, for increasing glycaemic control, client independence and consequent quality of life and even reducing the costs of long-term health care.

  16. Mutagenic and carcinogenic structural alerts and their mechanisms of action.

    Science.gov (United States)

    Plošnik, Alja; Vračko, Marjan; Dolenc, Marija Sollner

    2016-09-01

    Knowing the mutagenic and carcinogenic properties of chemicals is very important for their hazard (and risk) assessment. One of the crucial events that trigger genotoxic and sometimes carcinogenic effects is the forming of adducts between chemical compounds and nucleic acids and histones. This review takes a look at the mechanisms related to specific functional groups (structural alerts or toxicophores) that may trigger genotoxic or epigenetic effects in the cells. We present up-to-date information about defined structural alerts with their mechanisms and the software based on this knowledge (QSAR models and classification schemes).

  17. Hanford Site Emergency Alerting System siren testing report

    International Nuclear Information System (INIS)

    Weidner, L.B.

    1997-01-01

    The purpose of the test was to determine the effective coverage of the proposed upgrades to the existing Hanford Site Emergency Alerting System (HSEAS). The upgrades are to enhance the existing HSEAS along the Columbia River from the Vernita Bridge to the White Bluffs Boat Launch as well as install a new alerting system in the 400 Area on the Hanford Site. Five siren sites along the Columbia River and two sites in the 400 Area were tested to determine the site locations that will provide the desired coverage

  18. Non-suicidal reasons for self-harm: A systematic review of self-reported accounts.

    Science.gov (United States)

    Edmondson, Amanda J; Brennan, Cathy A; House, Allan O

    2016-02-01

    Self-harm is a major public health problem yet current healthcare provision is widely regarded as inadequate. One of the barriers to effective healthcare is the lack of a clear understanding of the functions self-harm may serve for the individual. The aim of this review is to identify first-hand accounts of the reasons for self-harm from the individual's perspective. A systematic review of the literature reporting first-hand accounts of the reasons for self-harm other than intent to die. A thematic analysis and 'best fit' framework synthesis was undertaken to classify the responses. The most widely researched non-suicidal reasons for self-harm were dealing with distress and exerting interpersonal influence. However, many first-hand accounts included reasons such as self-validation, and self-harm to achieve a personal sense of mastery, which suggests individuals thought there were positive or adaptive functions of the act not based only on its social effects. Associations with different sub-population characteristics or with the method of harm were not available from most studies included in the analysis. Our review identified a number of themes that are relatively neglected in discussions about self-harm, which we summarised as self-harm as a positiveexperience and defining the self. These self-reported "positive" reasons may be important in understanding and responding especially to repeated acts of self-harm. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Environmentally harmful subventions in the Federal Republic of Germany. Updating for the year 2016; Umweltschaedliche Subventionen in Deutschland. Aktualisierte Ausgabe 2016

    Energy Technology Data Exchange (ETDEWEB)

    Koeder, Lea; Burger, Andreas

    2016-12-15

    The contribution on environmentally harmful subventions in the Federal Republic of Germany (Updating for the year 2016) includes the following issues: Why the reduction of environmentally harmful subventions is necessary; subventions and related processes; international initiatives for the reduction of environmentally harmful subventions, routes for the reduction of environmentally harmful subventions.

  20. Impact of the recent recession on self-harm: Longitudinal ecological and patient-level investigation from the Multicentre Study of Self-harm in England.

    Science.gov (United States)

    Hawton, Keith; Bergen, Helen; Geulayov, Galit; Waters, Keith; Ness, Jennifer; Cooper, Jayne; Kapur, Navneet

    2016-02-01

    Economic recessions are associated with increases in suicide rates but there is little information for non-fatal self-harm. To investigate the impact of the recent recession on rates of self-harm in England and problems faced by patients who self-harm. Analysis of data from the Multicentre Study of Self-harm in England for 2001-2010 and local employment statistics for Oxford, Manchester and Derby, including interrupted time series analyses to estimate the effect of the recession on rates of self-harm. Rates of self-harm increased in both genders in Derby and in males in Manchester in 2008-2010, but not in either gender in Oxford, results which largely followed changes in general population unemployment. More patients who self-harm were unemployed in 2008-10 compared to before the recession. The proportion in receipt of sickness or disability allowances decreased. More patients of both genders had employment and financial problems in 2008-2010 and more females also had housing problems, changes which were also largely found in employed patients. We have assumed that the recession began in 2008 and information on problems was only available for patients having a psychosocial assessment. Increased rates of self-harm were found in areas where there were greater rises in rates of unemployment. Work, financial and housing problems increased in people who self-harmed. Changes in welfare benefits may have contributed. None. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Harm reduction through a social justice lens.

    Science.gov (United States)

    Pauly, Bernadette

    2008-02-01

    People who are street involved such as those experiencing homelessness and drug use face multiple inequities in health and access to health care. Morbidity and mortality are significantly increased among those who are street involved. Incorporation of a harm reduction philosophy in health care has the potential to shift the moral context of health care delivery and enhance access to health care services. However, harm reduction with a primary focus on reducing the harms of drug use fails focus on the harms associated with the context of drug use such as homelessness, violence and poverty. Ethical analysis of the underlying values of harm reduction and examination of different conceptions of justice are discussed as a basis for action that addresses a broad range of harms associated with drug use. Theories of distributive justice that focus primarily on the distribution of material goods are limited as theoretical frameworks for addressing the root causes of harm associated with drug use. Social justice, reconceptualised and interpreted through a critical lens as described by Iris Marion Young, is presented as a promising alternative ethical framework. A critical reinterpretation of social justice leads to insights that can illuminate structural inequities that contribute to the harms associated with the context of drug use. Such an approach provides promise as means of informing policy that aims to reduce a broad range of harms associated with drug use such as homelessness and poverty.

  2. Harmful Algal Blooms and Public Health.

    Science.gov (United States)

    Grattan, Lynn M; Holobaugh, Sailor; Morris, J Glenn

    2016-07-01

    The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels.

  3. Harmful Algal Blooms and Public Health

    Science.gov (United States)

    Grattan, Lynn M.; Holobaugh, Sailor; Morris, J. Glenn

    2015-01-01

    The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels. PMID:27616971

  4. How people who self-harm negotiate the inpatient environment: the mental healthcare workers perspective.

    Science.gov (United States)

    Thomas, J B; Haslam, C O

    2017-09-01

    lead to a continuation of distress and subsequent potentially harmful attempts to manage distress. Staff described experiencing a struggle for control in preventing self-harm, leading to increasingly harmful methods of self-harm. Alternatively some staff were able to support service-users with distress management. We discuss factors influencing which of these 'paths' service-users followed. Implications Considerations for care planning including understanding self-harm, using individualized care planning and attending to barriers are outlined with the ultimate aim of reducing distress and the impact of prevention of self-harm. © 2017 John Wiley & Sons Ltd.

  5. Geo-targeted Weather Alerts Coming to Millions of Mobile Devices

    Science.gov (United States)

    Gerber, M.

    2011-12-01

    The Personal Localized Alert Network (PLAN), aka Commercial Mobile Alert System (CMAS), is readying for roll out and will be broadcasting emergency public alerts to millions of cell phones by the middle of 2012. Learn how the National Weather Serivce (NWS) is supplying PLAN with geo-referenced weather alert information in the industry standard Common Alerting Protocol (CAP) format and how you can access this same information for integration with mobile devices, other consumer electronics, and decision support systems. Information will also be provided on the NWS' new collaborative venue that encourages wide participation in the evolution and use of NWS CAP alerts in a variety of applications.

  6. PREP advertisement features affect smokers' beliefs regarding potential harm.

    Science.gov (United States)

    Strasser, A A; Tang, K Z; Tuller, M D; Cappella, J N

    2008-09-01

    The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. To determine the effect of altering advertisement features on smokers' beliefs of the harm exposure from a PREP. A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a "red" condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a "no text" condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using "incorrect," "unsure" and "correct" as outcomes, and advertisement type and covariates as predictors, was used for analyses. Participants randomised to the "no text" advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer. Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

  7. Gambling Harm and Crime Careers.

    Science.gov (United States)

    May-Chahal, Corinne; Humphreys, Leslie; Clifton, Alison; Francis, Brian; Reith, Gerda

    2017-03-01

    Incarcerated populations across the world have been found to be consistently and significantly more vulnerable to problem gambling than general populations in the same countries. In an effort to gain a more specific understanding of this vulnerability the present study applied latent class analysis and criminal career theory to gambling data collected from a sample of English and Scottish, male and female prisoners (N = 1057). Theoretical links between gambling and crime were tested through three hypotheses: (1) that prisoners in the UK would have higher rates of problem gambling behaviour than the national population; (2) that if the link between gambling and crime is coincidental, gambling behaviour would be highly prevalent in an offending population, and (3) if connections between gambling behaviour and offending are co-symptomatic a mediating factor would show a strong association. The first of these was supported, the second was not supported and the third was partially supported. Latent class analysis found six gambling behaviour clusters measured by responses to the Problem Gambling Severity Index, primarily distinguished by loss chasing behaviour. Longitudinal offending data drawn from the Police National Computer database found four criminal career types, distinguished by frequency and persistence over time. A significant association was found between higher level loss chasing and high rate offending in criminal careers suggesting that impulse control may be a mediating factor for both gambling harm and criminal careers.

  8. Emergency staff reactions to suicidal and self-harming patients.

    Science.gov (United States)

    Pompili, Maurizio; Girardi, Paolo; Ruberto, Amedeo; Kotzalidis, Giorgio D; Tatarelli, Roberto

    2005-08-01

    Staff in the emergency departments of hospitals are reported as being negative or ambivalent toward suicidal or self-harming individuals. According to the literature, these patients are subjected to stigmatization and lack of empathy. This phenomenon has been linked to a decreased quality of care offered to these individuals and to missing an important opportunity to prevent further suicidal behavior or repetition of deliberate self-harm. Also, protocols, proper guidelines and education for the emergency staff call for a revision and an implementation. In this paper, evidence suggesting staff attitudes toward suicidal and self-harming patients is reviewed. An overview of related issues such as clinical judgment, the use of scales and nurses' role is also included in this report.

  9. Adolescent self-harm and risk factors.

    Science.gov (United States)

    Zhang, Jixiang; Song, Jianwei; Wang, Jing

    2016-12-01

    This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.

  10. Real-time Seismic Alert System of NIED

    Science.gov (United States)

    Horiuchi, S.; Fujinawa, Y.; Negishi, H.; Matsumoto, T.; Fujiwara, H.; Kunugi, T.; Hayashi, Y.

    2001-12-01

    An extensive seismic network has been constructed nationwide composed of hi-sensitivity seismographic network, broadband seismographic network and strong motion seismographic network. All these data from some 3,000 sites belonging to NIED, JMA and universities are to be accumulated and distributed through NIED to any scientists and engineering through INTERNET under the coordination of the National Seismic Research Committee of MEXT. As a practical application of those data we are now developing a real-time seismic alert information system for the purpose of providing short-term warning of imminent strong grounds motions from major earthquakes from several seconds to a few days. The contents of information are seismic focal parameters (several seconds), seismic fault plane solutions (some 10 seconds), after-shock activities (several minutes-a few days ). The fundamental fault parameters are used to build specific information at sites for particular users for use of triggering automated and /or half-automated responses. The most important application is an immediate estimate of expected shaking distribution and damages in a district using synthetic database and site effects for local governments to initial proper measures of hazard mitigation. Another application is estimation of arrival time and shaking strength at any individual site for human lives to be safeguarded. The system could also start an automatic electrical isolation and protection of computer systems, protection of hazardous chronic systems, transportation systems and so on. The information are corrected successively as seismic ground motion are received at a larger number of sites in time with the result that more accurate and more sophisticated earthquake information is transmitted to any user. Besides the rapid determination of seismic parameters, one of essential items in this alert system is the data transmission means. The data transmission is chosen to assure negligibly small delay of data

  11. Do repeated rumble strip hits improve driver alertness?

    NARCIS (Netherlands)

    Watling, C.N.; Akerstedt, T.; Kecklund, L.G.; Anund, A.

    2016-01-01

    Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective

  12. 44 CFR 208.36 - Reimbursement for Alert.

    Science.gov (United States)

    2010-10-01

    ... § 208.41 of this part. (4) Food and beverages for Task Force Members and Support Specialists when DHS does not provide meals during the Alert. DHS will limit food and beverage reimbursement to the amount... where such food and beverages were provided, multiplied by the number of personnel who received them. (b...

  13. Global Trade Alert | CRDI - Centre de recherches pour le ...

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

    Global Trade Alert (GTA) will provide information in real time on national measures taken during the current global economic downturn that are likely to discriminate against foreign commerce. GTA will complement and go beyond World Trade Organization (WTO) and World Bank monitoring initiatives by identifying affected ...

  14. Patient Blood Pressure and Pulse Rate Monitoring With an Alert ...

    African Journals Online (AJOL)

    2012-12-01

    Dec 1, 2012 ... an Alert System Using the Omron 790it Blood Pressure. Monitor ... detailed medical information on the vital signs of patients and will save many lives that may be lost. Keywords: Omron .... at rest, in beats per minute (BPM):.

  15. Testing and Performance of UFFO Burst Alert & Trigger Telescope

    DEFF Research Database (Denmark)

    Rípa, Jakub; Bin Kim, Min; Lee, Jik

    2014-01-01

    The Ultra-Fast Flash Observatory pathfinder (UFFO-p) is a new space mission dedicated to detect Gamma-Ray Bursts (GRBs) and rapidly follow their afterglows in order to provide early optical/ultraviolet measurements. A GRB location is determined in a few seconds by the UFFO Burst Alert & Trigger t...

  16. 47 CFR 80.1114 - False distress alerts.

    Science.gov (United States)

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1114 False distress alerts. The provisions of §§ 80.334 and 80.335 apply to...

  17. 47 CFR 80.1113 - Transmission of a distress alert.

    Science.gov (United States)

    2010-10-01

    ... Section 80.1113 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1113 Transmission of a distress alert. (a) The...

  18. Comparing alertness and injury severity following motor vehicular ...

    African Journals Online (AJOL)

    Background: From casual observation of injury patterns in Motor Vehicular Accidents (MVAs), it was sometimes observed that if the victim had been more alert and reacts protectively, injury severity might be reduced. Protective response is often expected to minimize the severity of injuries. Objective: To determine the ...

  19. Abonnez-vous aux alertes de financement | CRDI - Centre de ...

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

    Afrique subsaharienne. Si vous ne voulez plus recevoir les alertes de financement, vous pouvez toujours vous désabonner. Ce que nous faisons · Financement · Ressources · À propos du CRDI. Savoir. Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site. Abonnez-vous à notre bulletin pour recevoir les ...

  20. Alerting, Orienting, and Executive Attention in Children with ADHD

    Science.gov (United States)

    Mullane, Jennifer C.; Corkum, Penny V.; Klein, Raymond M.; McLaughlin, Elizabeth N.; Lawrence, Michael A.

    2011-01-01

    Objective: This study evaluated the alerting, orienting, and executive attention abilities of children with ADHD and their typically developing (TD) peers using a modified version of the adult attention network test (ANT-I). Method: A total of 25 children with ADHD, Combined Type (ADHD-C, mean age = 9.20 years), 20 children with ADHD,…

  1. RSS based CERN Alerter. Information broadcast to all CERN offices.

    CERN Multimedia

    Otto, R

    2007-01-01

    Nearly every large organization uses a tool to broadcast messages and information across the internal campus (messages like alerts announcing interruption in services or just information about upcoming events). These tools typically allow administrators (operators) to send "targeted" messages which are sent only to specific groups of users or computers, e/g only those located in a specified building or connected to a particular computing service. CERN has a long history of such tools: CERNVMS€™s SPM_quotMESSAGE command, Zephyr and the most recent the NICE Alerter based on the NNTP protocol. The NICE Alerter used on all Windows-based computers had to be phased out as a consequence of phasing out NNTP at CERN. The new solution to broadcast information messages on the CERN campus continues to provide the service based on cross-platform technologies, hence minimizing custom developments and relying on commercial software as much as possible. The new system, called CERN Alerter, is based on RSS (Really Simpl...

  2. Fibre optic microarrays for the detection and enumeration of harmful ...

    African Journals Online (AJOL)

    Harmful algal blooms (HABs) are a serious threat to coastal resources, causing impacts ranging from the contamination of seafood products with potent toxins to mortalities of wild and farmed fish and other marine animals. As the threat from HABs has expanded, new approaches have become necessary, including ...

  3. Mental health nurses' attitudes toward self-harm: Curricular ...

    African Journals Online (AJOL)

    David G. Shaw

    Mental health curriculum. Interpretative phenomenological analysis. Nurses ... This paper reports on a qualitative study into the attitudes of ... There are a couple of published accounts based on ... the stimulus is self-harm and the health professional (nurse) ... iours, including sex and exercise (Connor & Norman, 2005).

  4. What’s the Harm? Harms in Research with Adults with Intellectual Disability

    Science.gov (United States)

    McDonald, Katherine E.; Conroy, Nicole E.; Olick, Robert S.

    2017-01-01

    Scientific advances can improve the lives of adults with intellectual disability, yet concerns that research participation may impose harm impede scientific progress. What counts as harmful can be subjective and perceptions of harm may vary among stakeholders. We studied perspectives on the harmfulness of research events among adults with intellectual disability, family members and friends, disability service providers, researchers, and Institutional Review Board members. We found considerable variance. For example, adults with intellectual disability see exclusion from research as more harmful, but most psychosocial harms as less significant than others. All stakeholders agree that having someone else make the participation decision is harmful. Findings provide insights into the concept of harm and ethical research with adults with intellectual disability. PMID:28095059

  5. [Importance of health CRM in pandemics and health alerts].

    Science.gov (United States)

    Cubillas, Juan José; Ramos, María Isabel; Feito, Francisco R; González, José María; Gersol, Rafael; Ramos, María Belén

    2015-05-01

    The aim of this article is to demonstrate the importance of the role a health CRM can play in a pandemic or health alert. During the influenza-A pandemic, Salud Responde played a very important role. Its main objective was to establish protocols and citizens advice lines that would avoid patients with mild influenza-A symptoms going to health centre. A triage system was developed around the Siebel CRM (software tool) to achieve this objective. This allowed the Salud Responde staff to establish the severity of the patient depending on the symptoms and the risk factors of the patient, as well as being able to inform, give health advice or refer the patient to medical centres if necessary. All patients (a total of 56,497) who were attended by Salud Responde within its influenza-A service portfolio have been included. Patients who were attended by Salud Responde. The data have been extracted from the Salud Responde data base. Salud Responde attended to 56,497 patients during the influenza-A pandemic, of whom 48,287 patients did not require health care. Salud Responde attended to 56,497 patients, of whom 48,287 patients did not require health care. Apart from any financial savings that this could entail, it contributed to minimising the pandemic, avoiding the patient having to go to a health centre to receive medical care or information, and prevented, to a great extent, the flooding of casualty departments. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  6. Evaluation of health alerts from an early illness warning system in independent living.

    Science.gov (United States)

    Rantz, Marilyn J; Scott, Susan D; Miller, Steven J; Skubic, Marjorie; Phillips, Lorraine; Alexander, Greg; Koopman, Richelle J; Musterman, Katy; Back, Jessica

    2013-06-01

    Passive sensor networks were deployed in independent living apartments to monitor older adults in their home environments to detect signs of impending illness and alert clinicians so they can intervene and prevent or delay significant changes in health or functional status. A retrospective qualitative deductive content analysis was undertaken to refine health alerts to improve clinical relevance to clinicians as they use alerts in their normal workflow of routine care delivery to older adults. Clinicians completed written free-text boxes to describe actions taken (or not) as a result of each alert; they also rated the clinical significance (relevance) of each health alert on a scale of 1 to 5. Two samples of the clinician's written responses to the health alerts were analyzed after alert algorithms had been adjusted based on results of a pilot study using health alerts to enhance clinical decision-making. In the first sample, a total of 663 comments were generated by seven clinicians in response to 385 unique alerts; there are more comments than alerts because more than one clinician rated the same alert. The second sample had a total of 142 comments produced by three clinicians in response to 88 distinct alerts. The overall clinical relevance of the alerts, as judged by the content of the qualitative comments by clinicians for each alert, improved from 33.3% of the alerts in the first sample classified as clinically relevant to 43.2% in the second. The goal is to produce clinically relevant alerts that clinicians find useful in daily practice. The evaluation methods used are described to assist others as they consider building and iteratively refining health alerts to enhance clinical decision making.

  7. Bee Alert: Africanized Honey Bee Facts

    OpenAIRE

    Lazaneo, Vincent

    2002-01-01

    Information on how to “bee prepared” for the movement of the Africanized honey bee into California. Includes tips on how to identify Africanized honey bees, bee-proofing your home, and what to do if stung.

  8. Mammography screening. Benefits, harms, and informed choice

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl

    2013-01-01

    exaggerates benefits, participation is directly recommended, and the harms are downplayed or left out, despite agreement that the objective is informed choice. This raises an ethical discussion concerning autonomy versus paternalism, and the difficulty in weighing benefits against harms. Finally, financial...

  9. Alcohol and self-harm in Anuradhapura

    DEFF Research Database (Denmark)

    Sørensen, Jane Brandt; Jayasena, Chandima; Agampodi, Thilini Chanchala

    the personal network of the drinker and lead to secondary traumatization. This can appear as emotional distress, financial difficulties and lead to domestic violence and in some cases self-harm and suicide. This interplay between alcohol and self-harm was investigated in individuals, families and communities...

  10. Harm and the Boundaries of Disease.

    Science.gov (United States)

    McGivern, Patrick; Sorial, Sarah

    2017-08-01

    What is the relationship between harm and disease? Discussions of the relationship between harm and disease typically suffer from two shortcomings. First, they offer relatively little analysis of the concept of harm itself, focusing instead on examples of clear cases of harm such as death and dismemberment. This makes it difficult to evaluate such accounts in borderline cases, where the putative harms are less severe. Second, they assume that harm-based accounts of disease must be understood normatively rather than naturalistically, in the sense that they are inherently value based. This makes such accounts vulnerable to more general objections of normative accounts of disease. Here we draw on an influential account of harm from the philosophy of law to develop a harm-based account of disease that overcomes both of these shortcomings. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Physical harm due to chronic substance use

    NARCIS (Netherlands)

    van Amsterdam, Jan; Pennings, Ed; Brunt, Tibor; van den Brink, Wim

    2013-01-01

    Chronic use at high dose of illicit drugs, alcohol and tobacco is associated with physical disease. The relative physical harm of these substances has not been described before, but will benefit the guiding of policy measures about licit and illicit substances. The physical harm of 19 addictive

  12. Protective role of plants against harmful radiation

    Energy Technology Data Exchange (ETDEWEB)

    Gautam, Shreesh Kumar; Kumar, Pawan; Singh, Abhishek; Kumar, Vikas; Bharti, Navaldey [Department of Applied Plant Science-Horticulture, Babasaheb Bhimrao Ambedkar University, Lucknow (India)

    2012-07-01

    The rapid technological advancement has increased human exposure to ionizing radiations enormously. Ionizing radiations produces deleterious effects in the living organisms. Widespread use of radiation in diagnosis therapy, industry, energy sector and inadvertent exposure during air and space travel, nuclear accidents and nuclear terror attacks requires safeguard against human exposures. Lead shielding and other physical measures can be used in such situations but with difficulty to manage; thus pharmacological intervention could be the most prudent strategy to protect humans against the harmful effect of ionizing radiations. These pharmacological agents are radioprotectives; The development of radioprotective agents has been the subject of intense research in view of their potential for use within a radiation environment. However, no ideal, safe synthetic radio protectors are available to date, so the search for alternative sources including plants has been ongoing. In Ayurveda, the traditional Indian system of medicine, several plants have been used to treat free radical-mediated ailments and, therefore, it is logical to expect that such plants may also render some protection against radiation damage. This all is due to antioxidant enzymes, nitroxides, and melatonin, antiemetic, anti-inflammatory. haemopoitic and immunostimulant compounds. Some of the plants which are found to be radioprotective are Centella asiatica, Ginkgo biloba, Hippophae rhamnoides, Ocimum sanctum, Podophyllurn hexandrum, Tinospora cordifolia, Emblica officinalis, Phyllanthus amarus, etc. So there is an urgent need to identify and characterize the many of the plants in relation to the radioprotection. Besides these medicinal plants there are also some fruits and vegetables which are having good response against harmful radiations such as Kiwifruit Actinidia deliciosa (Actinidaceae), Cape Gooseberry Physalis peruviana (Solanaceae). They protect against the radiation-induced damage by

  13. Protective role of plants against harmful radiation

    International Nuclear Information System (INIS)

    Gautam, Shreesh Kumar; Kumar, Pawan; Singh, Abhishek; Kumar, Vikas; Bharti, Navaldey

    2012-01-01

    The rapid technological advancement has increased human exposure to ionizing radiations enormously. Ionizing radiations produces deleterious effects in the living organisms. Widespread use of radiation in diagnosis therapy, industry, energy sector and inadvertent exposure during air and space travel, nuclear accidents and nuclear terror attacks requires safeguard against human exposures. Lead shielding and other physical measures can be used in such situations but with difficulty to manage; thus pharmacological intervention could be the most prudent strategy to protect humans against the harmful effect of ionizing radiations. These pharmacological agents are radioprotectives; The development of radioprotective agents has been the subject of intense research in view of their potential for use within a radiation environment. However, no ideal, safe synthetic radio protectors are available to date, so the search for alternative sources including plants has been ongoing. In Ayurveda, the traditional Indian system of medicine, several plants have been used to treat free radical-mediated ailments and, therefore, it is logical to expect that such plants may also render some protection against radiation damage. This all is due to antioxidant enzymes, nitroxides, and melatonin, antiemetic, anti-inflammatory. haemopoitic and immunostimulant compounds. Some of the plants which are found to be radioprotective are Centella asiatica, Ginkgo biloba, Hippophae rhamnoides, Ocimum sanctum, Podophyllurn hexandrum, Tinospora cordifolia, Emblica officinalis, Phyllanthus amarus, etc. So there is an urgent need to identify and characterize the many of the plants in relation to the radioprotection. Besides these medicinal plants there are also some fruits and vegetables which are having good response against harmful radiations such as Kiwifruit Actinidia deliciosa (Actinidaceae), Cape Gooseberry Physalis peruviana (Solanaceae). They protect against the radiation-induced damage by

  14. Perceptions of Harm to Children Exposed to Secondhand Aerosol From Electronic Vapor Products, Styles Survey, 2015.

    Science.gov (United States)

    Nguyen, Kimberly H; Tong, Van T; Marynak, Kristy; King, Brian A

    2017-05-25

    The US Surgeon General has concluded that e-cigarette aerosol is not harmless and can contain harmful and potentially harmful chemicals, including nicotine. We assessed factors associated with adults' perceptions of harm related to children's exposure to secondhand aerosol from electronic vapor products (EVPs). Data came from the 2015 Styles, an Internet panel survey of US adults aged 18 years or older (n = 4,127). Respondents were asked whether they believe aerosol from other people's EVPs causes children harm. Harm perceptions were assessed overall and by cigarette smoking, EVP use, and sociodemographic characteristics. Multinomial logistic regression was used to assess odds of perceived harm. Overall, 5.3% of adults responded that secondhand EVP exposure caused "no harm" to children, 39.9% responded "little harm" or "some harm," 21.5% responded "a lot of harm," and 33.3% responded "don't know." Odds of "no harm" response were greater among men than among women, current and former cigarette smokers than among never smokers, and current and former EVP users than among never users; odds were lower among non-Hispanic blacks, Hispanics, and non-Hispanic other races than among non-Hispanic whites. Odds of responding "don't know" were greater among men, current cigarette smokers, and current and former EVP users; odds were lower among those aged 45 to 64 years than those aged 18 to 24 years and lower among non-Hispanic other races and Hispanics than non-Hispanic whites. Two-fifths of US adults believe that children's exposure to secondhand EVP aerosol causes some or little harm, while one-third do not know whether it causes harm. Efforts are warranted to educate the public about the health risks of secondhand EVP aerosol, particularly for children.

  15. Out of the blue: Untangling the association between impulsivity and planning in self-harm.

    Science.gov (United States)

    Rawlings, Jodie; Shevlin, Mark; Corcoran, Rhiannon; Morriss, Richard; Taylor, Peter James

    2015-09-15

    Planned and unplanned acts of self-harm may have distinct clinical and psychological correlates. Trait impulsivity is one factor that might be expected to determine whether self-harm is planned. Research so far has focussed on suicide attempts and little is known about how individuals engaging in planned and unplanned acts of self-harm differ. The aim of the current study was to examine how individuals who report planned self-harm, unplanned self-harm, and no self-harm differ in terms of impulsivity and affective symptoms (depression, anxiety, and activated mood). An online survey of University students (n = 1350) was undertaken including measures of impulsivity, affective symptoms and self-harm. Analyses made use of a multinomial logistic regression model with affective and cognitive forms of impulsivity estimated as latent variables. Trait affective impulsivity, but not cognitive, was a general risk factor for whether self-harm occurred. There was no evidence of differences between planned and unplanned self-harm. Affective symptoms of depression and anxiety mediated the relationship between affective impulsivity and self-harm. The study was cross-sectional, relied on a student sample which may not generalise to other populations. Trait affective impulsivity is associated with self-harm but it appears to be mediated by depression and anxiety symptoms. The exact relationships between trait affective impulsivity, depression, anxiety and self-harm require further longitudinal research in clinical populations but might lead to improved risk assessment and new therapeutic approaches to self-harm. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Self-Harm among Young People Detained in the Youth Justice System in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Lushan V. Hettiarachchi

    2018-01-01

    Full Text Available Self-harm is prevalent in incarcerated adults, yet comparatively few studies of self-harm in detained youth (and even fewer in low- and middle-income countries have been published. We examined the prevalence and correlates of self-harm in a sample of 181 young people (mean age 15.0 years, SD = 2.3 detained in the youth justice system in Sri Lanka. Structured face-to-face questionnaires assessed demographic characteristics, family and social background, substance use, self-harm history (including frequency, method, and intention, bullying victimization, physical and sexual abuse (victimization and perpetration, and exposure to self-harm/suicide by others. Seventy-seven participants (43% reported a lifetime history of self-harm, 19 of whom (25% who reported doing so with suicidal intent. Fifty participants (65% of those with a history of self-harm reported engaging in self-harm impulsively, with no prior planning. A history of self-harm was associated with being female, prior sexual abuse victimization, prior exposure to self-harm by friends, and a lifetime history of self-harm ideation. High rates of substance use, bullying victimization, parental incarceration, and exposure to suicide were reported across the sample. Young people detained in the youth justice system in Sri Lanka are a vulnerable group with high rates of self-harm, substance use, and psychosocial risk factors. Strategies for identifying and preventing self-harm, and targeted psychological interventions designed specifically to address impulsivity, may contribute to more positive outcomes in this marginalised population.

  17. [Harmful practices affecting women's health].

    Science.gov (United States)

    1990-07-01

    The harmful practices discussed in this article are based on case histories form the Central Maternity in Niamey, yet these practices universally affect women throughout Africa. Nutritional taboos are aimed at certain diseases such as measles, diarrhea, dysentery, malnutrition and anemia and consumption of foods rich in proteins and lipids are forbidden. Children are forbidden from eating eggs; pregnant women are forbidden from eating fruits and vegetables because of the fear of hemorrhaging from the sugar content in the fruit; camel meat is forbidden for fear of extending the pregnancy. Female circumcision, a dangerous practice, especially during childbirth, causes many medical problems that remain permanent. Adolescent pregnancy and marriages are practiced to avoid delinquency among children; yet such practices take place because of arranged marriages for a dowry to young men or to older rich men and these forced marriages to adolescents are the causes of increases in divorce, prostitution and desertion. These young marriages have serious consequences on the health status of the mother and the infant, often leading to maternal and infant death. The high level of fertility in Niger is a response to the social structure of the family. It is a patrilineal system that encourages women to have many children, especially sons. In Niger, pregnancy is surrounded by supernatural and mysterious forces, where a child is the intervention for ancestral spirits. In Islam a child is considered a "Gift of God". A woman is expected to work until the delivery of her baby otherwise she is jeered by her neighbors. During delivery women are not expected to cry or show any pain for fear of dishonoring her family irregardless of any medical compilations she faces. Women in Africa are exploited as free labor, deteriorate and age rapidly, are generally illiterate and are not protected under any laws.

  18. Deprivation as un-experienced harm?

    DEFF Research Database (Denmark)

    Keerus, Külli; Gjerris, Mickey; Röcklinsberg, Helena

    2017-01-01

    Tom Regan encapsulated his principle of harm as a prima facie direct duty not to harm experiencing subjects of a life. However, his consideration of harm as deprivation, one example of which is loss of freedom, can easily be interpreted as a harm, which may not be experienced by its subject....... This creates a gap between Regan’s criterion for moral status and his account of what our duties are. However, in comparison with three basic paradigms of welfare known in nonhuman animal welfare science, Regan’s understanding coheres with a modified version of a feelings-based paradigm: not only the immediate...... feelings of satisfaction, but also future opportunities to have such feelings, must be taken into account. Such an interpretation is compatible with Regan’s understanding of harm as deprivation. The potential source of confusion, however, lies in Regan’s own possible argumentative mistakes....

  19. Best practices: an electronic drug alert program to improve safety in an accountable care environment.

    Science.gov (United States)

    Griesbach, Sara; Lustig, Adam; Malsin, Luanne; Carley, Blake; Westrich, Kimberly D; Dubois, Robert W

    2015-04-01

    The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events. Once the medication safety concern is identified, it is reviewed to evaluate whether an alert warrants sending prescribers a communication that identifies individual patients or a general communication to all physicians describing the safety concern. Instead of basing its decisions regarding clinician notification about drug alerts on subjective criteria, the Marshfield Clinic's DSAP uses an internally developed scoring system. The scoring system includes criteria developed from previous drug alerts, such as level of evidence, size of population affected, severity of adverse event identified or targeted, litigation risk, available alternatives, and potential for duration of medication use. Each of the 6 criteria is assigned a weight and is scored based upon the content and severity of the alert received.  In its first 12 months, the program targeted 6 medication safety concerns involving the following medications: topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Baseline and follow-up prescribing data were gathered on the targeted medications. Follow-up review of prescribing data demonstrated that the DSAP provided quality up-to-date safety information that led to changes in drug therapy and to decreases in potential adverse drug events. In aggregate, nearly 10,000 total

  20. V-Alert: Description and Validation of a Vulnerable Road User Alert System in the Framework of a Smart City.

    Science.gov (United States)

    Hernandez-Jayo, Unai; De-la-Iglesia, Idoia; Perez, Jagoba

    2015-07-29

    V-Alert is a cooperative application to be deployed in the frame of Smart Cities with the aim of reducing the probability of accidents involving Vulnerable Road Users (VRU) and vehicles. The architecture of V-Alert combines short- and long-range communication technologies in order to provide more time to the drivers and VRU to take the appropriate maneuver and avoid a possible collision. The information generated by mobile sensors (vehicles and cyclists) is sent over this heterogeneous communication architecture and processed in a central server, the Drivers Cloud, which is in charge of generating the messages that are shown on the drivers' and cyclists' Human Machine Interface (HMI). First of all, V-Alert has been tested in a simulated scenario to check the communications architecture in a complex scenario and, once it was validated, all the elements of V-Alert have been moved to a real scenario to check the application reliability. All the results are shown along the length of this paper.

  1. Emergency Communications: The Emergency Alert System (EAS) and All-Hazard Warnings

    National Research Council Canada - National Science Library

    Moore, Linda K; Reese, Shawn

    2005-01-01

    ... tested. Much has been accomplished in recent years but the current hodgepodge of warning and alert systems is inadequate for fully alerting the public about terrorist attacks or natural disasters...

  2. Virus Alert: Ten Steps to Safe Computing.

    Science.gov (United States)

    Gunter, Glenda A.

    1997-01-01

    Discusses computer viruses and explains how to detect them; discusses virus protection and the need to update antivirus software; and offers 10 safe computing tips, including scanning floppy disks and commercial software, how to safely download files from the Internet, avoiding pirated software copies, and backing up files. (LRW)

  3. Mile-A-Minute (Pest Alert)

    Science.gov (United States)

    Denise Binion; William Jackson

    2009-01-01

    Mile-a-minute weed (Persicaria perfoliata (L.) H. Gross, formerly Polygonum perfoliatum, L.) is an annual vine in the Polygonaceae or Buckwheat family. It is native to eastern Asia including India, Bhutan, Nepal, China, Burma, Japan, Korea, Indonesia, Bangladesh, Siberia, the Philippines, New Guinea, the Malay peninsula and the...

  4. Minuteman III Cost Per Alert Hour Analysis

    Science.gov (United States)

    2012-03-22

    Proverbs 16:3 I am eternally grateful for such a lovely wife and vibrant children; without your patience and support, I would...section. 12 Table 1: Alternative CPFH Factors H ild eb ra nt (1 99 0) W al la ce (2 00 0) Ki le y (2 00 1) Py le s (2 00 3) La ub ac he r (2 00 4...Installation Law Enforcement ( LE ) Operations. Installation LE Operations includes enforcing federal, state and military law, enforcing installation

  5. Feasibility and profitability of a radiology department providing trauma US as part of a trauma alert team.

    Science.gov (United States)

    Nunes, L W; Simmons, S; Kozar, R; Kinback, R; Hallowell, M J; Mulhern, C

    2001-01-01

    The purpose of this study was to assess the feasibility and profitability of a radiology department providing a six-point trauma ultrasound (US) examination for abdominal or pelvic free fluid as part of a trauma alert team. The study included 191 trauma alerts, which generated 156 US examinations. A radiologist and a departmental technologist carried beepers and responded to level I and II traumas. A departmental secretary or technologist recorded when the responding technologist exited and re-entered the department and if US was performed. If performed, the US examination evaluated the four abdominal and pelvic quadrants and the suprapubic and subxiphoid regions. For 64 patients, the responding technologist recorded the times of the trauma alert, emergency room arrival, US start and finish, and return to the radiology department. Median response, wait, scan duration, and return times were 2, 8, 5, and 7 minutes, respectively. Median costs for the technician, physician, archiving, transcription, and equipment were $8.17, $30.85, $0.97, $4.80, and $41.22, respectively. Reimbursement per examination averaged $110.60. Sensitivity analyses that varied the time spent (median vs mean), US non-use rate (10%-18%), and years of depreciation (5-7 years) yielded net results ranging from a $36.60 profit to a $6.12 loss per examination. A radiology department can profitably respond to trauma alerts and provide a six-point trauma US examination for free fluid.

  6. Discriminating between true-positive and false-positive clinical mastitis alerts from automatic milking systems

    NARCIS (Netherlands)

    Steeneveld, W.; Gaag, van der L.C.; Ouweltjes, W.; Mollenhorst, H.; Hogeveen, H.

    2010-01-01

    Automatic milking systems (AMS) generate alert lists reporting cows likely to have clinical mastitis (CM). Dutch farmers indicated that they use non-AMS cow information or the detailed alert information from the AMS to decide whether to check an alerted cow for CM. However, it is not yet known to

  7. Self-Alert Training: Volitional Modulation of Autonomic Arousal Improves Sustained Attention

    Science.gov (United States)

    O'Connell, Redmond G.; Bellgrove, Mark A.; Dockree, Paul M.; Lau, Adam; Fitzgerald, Michael; Robertson, Ian H.

    2008-01-01

    The present study examines a new alertness training strategy (Self-Alert Training, SAT) designed to explore the relationship between the top-down control processes governing arousal and sustained attention. In order to maximally target frontal control systems SAT combines a previously validated behavioural self-alerting technique [Robertson, I.…

  8. 75 FR 81556 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Science.gov (United States)

    2010-12-28

    ... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... the public on recommendations for developing new or revised safe harbors and Special Fraud Alerts...

  9. 77 FR 76434 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Science.gov (United States)

    2012-12-28

    ... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-121-N...

  10. 78 FR 78807 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Science.gov (United States)

    2013-12-27

    ... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-122-N...

  11. 75 FR 26269 - Draft Programmatic Environmental Assessment for the Integrated Public Alert and Warning Program's...

    Science.gov (United States)

    2010-05-11

    ... system to alert and warn the American people in situations of war, terrorist attack, natural disaster, or... Order 13407, Public Alert and Warning System, by providing robust and survivable power generation, fuel... of interoperable public alert and warning systems, to identify technologies and standards that...

  12. Project ALERT: Forging New Partnerships to Improve Earth System Science Education for Pre-Service and In-Service Teachers

    Science.gov (United States)

    Metzger, E. P.; Ambos, E. L.; Ng, E. W.; Skiles, J.; Simila, G.; Garfield, N.

    2002-05-01

    Project ALERT (Augmented Learning Environment and Renewable Teaching) was founded in 1998, with funding from NASA and the California State University (CSU), to improve earth system science education for pre-service teachers. Project ALERT has formed linkages between ten campuses of the CSU, which prepares about 60 percent of California's teachers, and two NASA centers, Ames Research Center and the Jet Propulsion Laboratory. ALERT has also fostered alliances between earth science and science education faculty. The combined expertise of Project ALERT's diverse partners has led to a wide array of activities and products, including: 1) incorporation in university classrooms of NASA-developed imagery, data, and educational resources; 2) creation and/or enhancement of several courses that bring earth systems science to pre-service teachers; 3) fellowships for CSU faculty to participate in collaborative research and education projects at the NASA Centers; 4) development of teaching modules on such varied topics as volcanoes, landslides, and paleoclimate; and 5) a central web site that highlights resources for teaching introductory Earth system science. An outgrowth of Project ALERT is the increased interest on the part of CSU earth scientists in education issues. This has catalyzed their participation in other projects, including NASA's Project NOVA, Earth System Science Education Alliance, and Sun-Earth Connection Education Forum, the Digital Library for Earth System Science Education, and the California Science Project. Project ALERT has also expanded to provide professional development opportunities for in-service teachers, as exemplified by its support of the Bay Area Earth Science Institute (BAESI) at San Jose State University. Each year, BAESI offers 10-15 full-day workshops that supply teachers and teachers-to-be with a blend of science concepts and classroom activities, free instructional materials, and the opportunity to earn inexpensive university credit. These

  13. Initial Development and Validation of the BullyHARM: The Bullying, Harassment, and Aggression Receipt Measure

    Science.gov (United States)

    Hall, William J.

    2016-01-01

    This article describes the development and preliminary validation of the Bullying, Harassment, and Aggression Receipt Measure (BullyHARM). The development of the BullyHARM involved a number of steps and methods, including a literature review, expert review, cognitive testing, readability testing, data collection from a large sample, reliability…

  14. Perceived Risk of Harm from Marijuana Use among Youth in the USA.

    Science.gov (United States)

    Danseco, Evangeline R.; Kingery, Paul M.; Coggeshall, Mark

    1999-01-01

    Reviews studies that examined perceived risk or beliefs about harmful effects associated with marijuana use. Perceived risk was construed as consisting of at least four areas (physical harm; parental disapproval; peer disapproval; fear of arrest). Perception of risk varied with several factors including age and gender. Secondary data analysis was…

  15. Suicide Following Deliberate Self-Harm.

    Science.gov (United States)

    Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Gerhard, Tobias; Blanco, Carlos

    2017-08-01

    The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined. Hazard ratios of repeat self-harm and suicide were estimated by Cox proportional hazard models. During the 12 months after nonfatal self-harm, the rate of repeat self-harm was 263.2 per 1,000 person-years and the rate of completed suicide was 439.1 per 100,000 person-years, or 37.2 times higher than in a matched general population cohort. The hazard of suicide was higher after initial self-harm events involving violent as compared with nonviolent methods (hazard ratio=7.5, 95% CI=5.5-10.1), especially firearms (hazard ratio=15.86, 95% CI=10.7-23.4; computed with poisoning as reference), and to a lesser extent after events of patients who had recently received outpatient mental health care (hazard ratio=1.6, 95% CI=1.2-2.0). Compared with self-harm patients using nonviolent methods, those who used violent methods were at significantly increased risk of suicide during the first 30 days after the initial event (hazard ratio=17.5, 95% CI=11.2-27.3), but not during the following 335 days. Adults treated for deliberate self-harm frequently repeat self-harm in the following year. Patients who use a violent method for their initial self-harm, especially firearms, have an exceptionally high risk of suicide, particularly right after the initial event, which highlights the importance of careful assessment and close follow-up of this group.

  16. Dealing with difficult days: Functional coping dynamics in self-harm ideation and enactment.

    Science.gov (United States)

    Nielsen, Emma; Sayal, Kapil; Townsend, Ellen

    2017-01-15

    Self-harm affords people a means of coping. However, little is known about how functional coping dynamics differ between stressful situations in which people self-harm (enactment), think about harming (ideation), or experience no self-harmful thoughts or behaviours. Participants (N = 1,157) aged 16-49 years (M = 18.21, SD = 3.24) with a recent history of self-harm (past 3 months) reported how they coped in response to their most significant recent stressor (3 months). Almost 40% of participants, all of whom had self-harmed in the last 3 months, had no self-harm experience (thoughts or behaviours) in response to their most significant stressor in that time frame. In multivariate analysis, adjusting for symptoms of depression and anxiety, reappraisal coping was predictive of self-harm thoughts. Approach, emotion regulation and reappraisal coping were predictive of self-harm behaviour. Emotion regulation coping differentiated self-harm ideation and enactment groups. The cross-sectional design of the study precludes the ability to make inferences regarding causality. Further, there is no agreed definition of 'recent' self-harm. Taken together, the findings suggest that functional coping dynamics may be differentially associated with self-harm ideation and enactment. This is important, given that understanding the transitions between ideation and enactment has been identified as a critical frontier in suicide prevention. Further, results indicate that seemingly innocuous events may have a profound impact as tipping points for enaction; this has implications for clinical practice, including the co-production of safety plans. Copyright © 2016. Published by Elsevier B.V.

  17. Harm reduction with pharmacotherapy for homeless people with alcohol dependence: protocol for a randomized controlled trial.

    Science.gov (United States)

    Collins, Susan E; Saxon, Andrew J; Duncan, Mark H; Smart, Brian F; Merrill, Joseph O; Malone, Daniel K; Jackson, T Ron; Clifasefi, Seema L; Joesch, Jutta; Ries, Richard K

    2014-07-01

    Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol

  18. Stock Market Fluctuations and Self-Harm among Children and Adolescents in Hong Kong.

    Science.gov (United States)

    Wong, Wilfred Hing-Sang; Lee, James Chun-Yin; Ho, Frederick Ka-Wing; Li, Tim Man-Ho; Ip, Patrick; Chow, Chun-Bong

    2017-06-09

    Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and self-harm among children and adolescents in Hong Kong. Daily self-harm attendance records were retrieved from all 18 local Accident and Emergency Departments (AED) from 2001 to 2012. 4931 children and adolescents who committed self-harm were included. The results indicated positive correlation between daily change in stock market index, Hang Seng Index (∇HSI, per 300 points), and daily self-harm incident risk of children and adolescents, without time lag between the two. The incident risk ratio for ∇HSI was 1.09 ( p = 0.0339) in children and 1.06 ( p = 0.0246) in adolescents. Importantly, non-trading days were found to impose significant protective effect in both groups against self-harm risk. Our results showed that stock market fluctuations were related to self-harm behaviors in children and adolescents. Parents and professionals should be educated about the potential harm of stock market fluctuations and the importance of effective parenting in reducing self-harm among children and adolescents.

  19. Virtue ethics as an alternative to deontological and consequential reasoning in the harm reduction debate.

    Science.gov (United States)

    Christie, Timothy; Groarke, Louis; Sweet, William

    2008-02-01

    There is strong evidence that harm reduction interventions such as Supervised Injection Sites and Needle Exchange Programs prevent many of the negative consequences of problematic substance use. Yet many governments, including the United States and Canada, still do not endorse these interventions, claiming that they do not get people off of drugs and send a mixed message. This paper will analyze objections to harm reduction in light of the ethical theories of John Stuart Mill, Immanuel Kant and Aristotle. The most important ethical issue in the abstinence vs. harm reduction debate is whether harm reduction - because it does not require individuals to either reduce their consumption of illicit substances or to abstain from illicit substance use - can be ethically justified. Harm reduction interventions are clearly justified on Utilitarian grounds because, based on the evidence, such policies would produce the greatest good for the greatest number. However, Kant would not think that the values guiding harm reduction are ethical because the justification of harm reduction interventions focuses exclusively on examining consequences. Virtue Ethics seeks to find the proper balance between harm reduction and abstinence. We claim that the virtue of compassion would provide a defense of harm reduction.

  20. Experienced Harm from Other People's Drinking: A Comparison of Northern European Countries

    Directory of Open Access Journals (Sweden)

    Inger Synnøve Moan

    2015-01-01

    Full Text Available Objective This study addresses how experienced harm from other people's drinking varies between six Northern European countries by comparing 1 the prevalence of experienced harm and 2 the correlates of harm. Method The data comprise 18ȓ69-year olds who participated in general population surveys in Denmark, Finland, Iceland, Norway, Sweden, and Scotland during the period 2008–2013. Comparative data were available on five types of harm: physical abuse, damage of clothes/belongings, verbal abuse, being afraid, and being kept awake at night. Results This study shows that harms from other's drinking are commonly experienced in all six countries. Being kept awake at night is the most common harm, while being physically harmed is the least common. The proportions that reported at least one of the five problems were highest in Finland and Iceland and lowest in Norway, but also relatively low in Sweden. Across countries, the level of harm was highest among young, single, urban residents, and for some countries among women and those who frequently drank to intoxication themselves. Conclusions The study revealed large differences in the prevalence of harm in countries with fairly similar drinking cultures. However, the correlates of such experiences were similar across countries. Possible explanations of the findings are discussed, including differences in study design.

  1. The relationship between alcohol consumption and related harm among young university students.

    Science.gov (United States)

    Hart, Ellen; Burns, Sharyn

    2016-04-01

    Issue addressed Research has shown that Australian university students consume alcohol at a higher level than their peers from the general population and are therefore more likely to witness and experience alcohol-related harm. This study measured the prevalence of alcohol consumption among 18-24-year-old university students and the association between alcohol consumption and witnessed and experienced harms. Methods A random cross-sectional sample of university students aged 18-24 years (n=2466) was recruited via the University Survey Office and through random intercept at campus market day. All participants completed an online survey that included the Alcohol Use Disorders Identification Test, Alcohol Problems Scale and an additional scale measuring witnessed harm. Results Principal Components Analysis revealed three factors within the Alcohol Problems Scale; i.e. Criminal and Aggressive Behaviour, Health and Emotional Harms and Sexual Harms. Students who consume alcohol at high-risk levels were significantly more likely to score highly on each factor, 1.6 times more likely to experience harm and 1.1 times more likely to witness harm than students who consume alcohol at low-risk levels. Conclusions The positive association between alcohol consumption and alcohol-related harm supports previous findings. This study adds previous research through the categorisation of harm into factors. So what? Integrated and comprehensive interventions addressing alcohol consumption among young university students that are informed by evidence-based research can be tailored to ensure that they meet the needs of the target group.

  2. Reduction in alert fatigue in an assisted electronic prescribing system, through the Lean Six Sigma methodology.

    Science.gov (United States)

    Cuéllar Monreal, Mª Jesús; Reig Aguado, Jorge; Font Noguera, Isabel; Poveda Andrés, José Luis

    2017-01-01

    To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed. In order to measure the qualitative indicators, the most frequent alert types were analyzed, as well as the molecules responsible for over 50% of each type of alert. The action by the prescriber was analyzed in a sample of 496 prescriptions that generated such alerts. For each type of alert and molecule, there was a prioritization of the improvements to be implemented according to the alert generated and its quality. A second survey evaluated the pharmacist action for the alerts most highly valued by physicians. The problem, the objective, the work team and the project schedule were defined. A survey was designed in order to understand the opinion of the client about the alert system in the program. Based on the surveys collected (n = 136), the critical characteristics and the quanti/qualitative indicators were defined. Sixty (60) fields in the alert system were modified, corresponding to 32 molecules, and this led to a 28% reduction in the total number of alerts. Regarding quality indicators, false po sitive results were reduced by 25% (p < 0.05), 100% of those alerts ignored with justification were sustained, and there were no significant differences in user adherence to the system. The project improvements and outcomes were reviewed by the work team. LSS methodology has demonstrated being a valid tool for the quantitative and qualitative improvement of the alert system in an Assisted Electronic Prescription Program, thus reducing alert fatigue. Copyright AULA MEDICA EDICIONES 2014

  3. A deep-learning-based emergency alert system

    Directory of Open Access Journals (Sweden)

    Byungseok Kang

    2016-06-01

    Full Text Available Emergency alert systems serve as a critical link in the chain of crisis communication, and they are essential to minimize loss during emergencies. Acts of terrorism and violence, chemical spills, amber alerts, nuclear facility problems, weather-related emergencies, flu pandemics, and other emergencies all require those responsible such as government officials, building managers, and university administrators to be able to quickly and reliably distribute emergency information to the public. This paper presents our design of a deep-learning-based emergency warning system. The proposed system is considered suitable for application in existing infrastructure such as closed-circuit television and other monitoring devices. The experimental results show that in most cases, our system immediately detects emergencies such as car accidents and natural disasters.

  4. Brain-computer interface for alertness estimation and improving

    Science.gov (United States)

    Hramov, Alexander; Maksimenko, Vladimir; Hramova, Marina

    2018-02-01

    Using wavelet analysis of the signals of electrical brain activity (EEG), we study the processes of neural activity, associated with perception of visual stimuli. We demonstrate that the brain can process visual stimuli in two scenarios: (i) perception is characterized by destruction of the alpha-waves and increase in the high-frequency (beta) activity, (ii) the beta-rhythm is not well pronounced, while the alpha-wave energy remains unchanged. The special experiments show that the motivation factor initiates the first scenario, explained by the increasing alertness. Based on the obtained results we build the brain-computer interface and demonstrate how the degree of the alertness can be estimated and controlled in real experiment.

  5. ECG Holter monitor with alert system and mobile application

    Science.gov (United States)

    Teron, Abigail C.; Rivera, Pedro A.; Goenaga, Miguel A.

    2016-05-01

    This paper proposes a new approach on the Holter monitor by creating a portable Electrocardiogram (ECG) Holter monitor that will alert the user by detecting abnormal heart beats using a digital signal processing software. The alarm will be triggered when the patient experiences arrhythmias such as bradycardia and tachycardia. The equipment is simple, comfortable and small in size that fit in the hand. It can be used at any time and any moment by placing three leads to the person's chest which is connected to an electronic circuit. The ECG data will be transmitted via Bluetooth to the memory of a selected mobile phone using an application that will store the collected data for up to 24 hrs. The arrhythmia is identified by comparing the reference signals with the user's signal. The diagnostic results demonstrate that the ECG Holter monitor alerts the user when an arrhythmia is detected thru the Holter monitor and mobile application.

  6. SC-228 Inclusion of DAA Warning Alert for TCAS Interoperability

    Science.gov (United States)

    Fern, Lisa

    2016-01-01

    This white paper summarizes NASA research results that have informed Special Committee 228 (SC-228) discussions and decisions regarding the inclusion of a warning-level alert within the detect and avoid (DAA) alerting structure for unmanned aircraft systems (UAS). For UAS, the removal of the pilot from onboard the aircraft has eliminated the ability of the ground-based pilot in command (PIC) to use out-the-window visual information to make judgments about a potential threat of a loss of well clear with another aircraft. As a result, the DAA traffic display will be the primary source of information that the PIC can use to execute the three primary well clear functions: 1) detect a potential loss of well clear, 2) determine a resolution maneuver, and 3) upload that maneuver to the aircraft via the ground control station (GCS). In addition, pilots are required to coordinate with air traffic control (ATC) prior to maneuvering off of their approved flight plan. In determining an appropriate resolution maneuver to avoid a loss of well clear, the PIC must decide both when and how to maneuver, and both the timeliness and the accuracy (i.e., correctness) of the maneuver are critical to reducing the likelihood and/or severity of a loss of well clear. Alerting information is one of three critical components of the DAA display, along with traffic information elements (e.g., relative heading, speed and altitude) and maneuver guidance. Alerting information and maneuver guidance, in particular, have been found to have a significant impact, both statistically and practically, on pilots' ability to avoid and minimize the severity of losses of well clear While all three display components are key to pilots performing the traffic avoidance task of remaining well clear, in general, alerting information provides crucial information about when a resolution maneuver is required while maneuver guidance assists the pilot in determining how best to maneuver. A fundamental task of the DAA

  7. Microcontroller based driver alertness detection systems to detect drowsiness

    Science.gov (United States)

    Adenin, Hasibah; Zahari, Rahimi; Lim, Tiong Hoo

    2018-04-01

    The advancement of embedded system for detecting and preventing drowsiness in a vehicle is a major challenge for road traffic accident systems. To prevent drowsiness while driving, it is necessary to have an alert system that can detect a decline in driver concentration and send a signal to the driver. Studies have shown that traffc accidents usually occur when the driver is distracted while driving. In this paper, we have reviewed a number of detection systems to monitor the concentration of a car driver and propose a portable Driver Alertness Detection System (DADS) to determine the level of concentration of the driver based on pixelated coloration detection technique using facial recognition. A portable camera will be placed at the front visor to capture facial expression and the eye activities. We evaluate DADS using 26 participants and have achieved 100% detection rate with good lighting condition and a low detection rate at night.

  8. Acute kidney injury: Global health alert

    Directory of Open Access Journals (Sweden)

    Philip Kam Tao Li

    2013-01-01

    Full Text Available Acute kidney injury (AKI is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.

  9. Survey alerts hospital to needs of consumers.

    Science.gov (United States)

    Schoenfeldt, R C; Seale, W B; Hale, A W

    1987-09-01

    Because of rapidly changing developments in the healthcare field, more emphasis is being placed on marketing of hospital services. A hospital's success will depend more and more on strategic planning based on timely and accurate information. In light of this, Lourdes Hospital, Paducah, KY, undertook a survey to evaluate its current performance and to determine a path for the future. The survey found, among other discoveries, that patients want more voice in determining their own treatment; they prefer outpatient treatment when possible, even if it is not covered by insurance; and stress management and health assessment clinics are the most popular extra services a hospital could offer. Physicians surveyed said they wanted more input into the evaluation of new services and equipment at the hospital. The survey also found that most patients either select a hospital in conjunction with their physician or have their physician choose the hospital. The findings led to some major changes at the hospital, including a restructuring of the planning process to get physicians more involved, a new marketing strategy to enhance communication with consumers, and increased outpatient services. The results have given direction to the hospital administration, helped shape advertising, and provided support for certificate-of-need requests.

  10. Conflict resolution and alert zone estimation in air traffic management

    Science.gov (United States)

    Kuo, Vincent Hao-Hung

    The current air traffic control (ATC) system provides separations among all aircraft through pre-defined routes and flight procedures, and active controller participation. In particular, en route separations are achieved by choices of different flight routes, different flight levels, and speed control. During the final descent approach over an extended terminal area, aircraft separations are achieved by speed changes, altitude changes, and path stretching. Recently, a concept of free flight has been proposed for future air traffic management. In the proposed free flight environment, aircraft operators can change flight paths in real time, in order to achieve the best efficiency for the aircraft. Air traffic controllers are only supposed to intervene when situation warrants, to resolve potential conflicts among aircraft. In both cases, there is a region around each aircraft called alert zone. As soon as another aircraft touches the alert zone of own aircraft, either the own aircraft or both aircraft must initiate avoidance maneuvers to resolve a potential conflict. This thesis develops a systematic approach based on nonlinear optimal control theories to estimate alert zones in two aircraft conflict scenarios. Specifically, point-mass aircraft models are used to describe aircraft motions. Separate uses of heading, speed, and altitude control are first examined, and then the synergetic use of two control authorities are studied. Both cooperative maneuvers (in which both aircraft act) and non-cooperative maneuvers (in which the own aircraft acts alone) are considered. Optimal control problems are formulated to minimize the initial relative separation between the two aircraft for all possible initial conditions, subject to the requirement that inter-aircraft separation at any time satisfies the separation requirement. These nonlinear optimal control problems are solved numerically using a collation approach and the NPSOL software line for nonlinear programming. In

  11. Alert-derivative bimodal space power and propulsion systems

    International Nuclear Information System (INIS)

    Houts, M.G.; Ranken, W.A.; Buksa, J.J.

    1994-01-01

    Safe, reliable, low-mass bimodal space power and propulsion systems could have numerous civilian and military applications. This paper discusses potential bimodal systems that could be derived from the ALERT space fission power supply concept. These bimodal concepts have the potential for providing 5 to 10 kW of electrical power and a total impulse of 100 MN-s at an average specific impulse of 770 s. System mass is on the order of 1000 kg

  12. Hurtful Emotions: Understanding Self-Harm

    Science.gov (United States)

    ... Issues Subscribe September 2017 Print this issue Hurtful Emotions Understanding Self-Harm En español Send us your ... help you learn new ways to cope with emotion. See the Wise Choices box for tips on ...

  13. Reducing the harms associated with risk assessments

    International Nuclear Information System (INIS)

    Montague, Peter

    2004-01-01

    Risk assessments are the intellectual products of dedicated public health and environmental professionals. Like many other products, risk assessments carry with them the potential for both good and harm. This paper briefly examines some of the harms to which risk assessments have contributed, and then suggests that the legal 'duty to warn' doctrine offers a logical and practical way to reduce some of these harms. The paper suggests concepts that could be incorporated into warnings accompanying every formal risk assessment as routine 'boiler plate' addenda, just as other potentially harmful products, such as lawn mowers and cook stoves, are accompanied by warnings. Finally, the paper briefly examines the 'Code of Ethics and Standards of Practice for Environmental Professionals' (promulgated by the National Association of Environmental Professionals) and shows that the suggested warnings are consistent with recommended practices for environmental professionals

  14. Detecting the Killer Toxin (Harmful Algal Blooms)

    International Nuclear Information System (INIS)

    Quevenco, Rodolfo

    2011-01-01

    IAEA is stepping up efforts to help countries understand the phenomenon and use more reliable methods for early detection and monitoring so as to limit harmful algal blooms (HABs) adverse effects on coastal communities everywhere.

  15. Thalassiosira mala (Bacillariophyta), a potentially harmful, marine ...

    Indian Academy of Sciences (India)

    Thalassiosira malaitalic> (Bacillariophyta), a potentially harmful, marine diatom from Chilka Lake and other coastal localities of Odisha, India: Nomenclature, ... Department of Biological Science, Florida State University, Tallahassee, FL 32306–4370, USA; Department of Biology, Valdosta State University, Valdosta, GA ...

  16. Harm reduction-the cannabis paradox

    Directory of Open Access Journals (Sweden)

    Melamede Robert

    2005-09-01

    Full Text Available Abstract This article examines harm reduction from a novel perspective. Its central thesis is that harm reduction is not only a social concept, but also a biological one. More specifically, evolution does not make moral distinctions in the selection process, but utilizes a cannabis-based approach to harm reduction in order to promote survival of the fittest. Evidence will be provided from peer-reviewed scientific literature that supports the hypothesis that humans, and all animals, make and use internally produced cannabis-like products (endocannabinoids as part of the evolutionary harm reduction program. More specifically, endocannabinoids homeostatically regulate all body systems (cardiovascular, digestive, endocrine, excretory, immune, nervous, musculo-skeletal, reproductive. Therefore, the health of each individual is dependant on this system working appropriately.

  17. Provider risk factors for medication administration error alerts: analyses of a large-scale closed-loop medication administration system using RFID and barcode.

    Science.gov (United States)

    Hwang, Yeonsoo; Yoon, Dukyong; Ahn, Eun Kyoung; Hwang, Hee; Park, Rae Woong

    2016-12-01

    To determine the risk factors and rate of medication administration error (MAE) alerts by analyzing large-scale medication administration data and related error logs automatically recorded in a closed-loop medication administration system using radio-frequency identification and barcodes. The subject hospital adopted a closed-loop medication administration system. All medication administrations in the general wards were automatically recorded in real-time using radio-frequency identification, barcodes, and hand-held point-of-care devices. MAE alert logs recorded during a full 1 year of 2012. We evaluated risk factors for MAE alerts including administration time, order type, medication route, the number of medication doses administered, and factors associated with nurse practices by logistic regression analysis. A total of 2 874 539 medication dose records from 30 232 patients (882.6 patient-years) were included in 2012. We identified 35 082 MAE alerts (1.22% of total medication doses). The MAE alerts were significantly related to administration at non-standard time [odds ratio (OR) 1.559, 95% confidence interval (CI) 1.515-1.604], emergency order (OR 1.527, 95%CI 1.464-1.594), and the number of medication doses administered (OR 0.993, 95%CI 0.992-0.993). Medication route, nurse's employment duration, and working schedule were also significantly related. The MAE alert rate was 1.22% over the 1-year observation period in the hospital examined in this study. The MAE alerts were significantly related to administration time, order type, medication route, the number of medication doses administered, nurse's employment duration, and working schedule. The real-time closed-loop medication administration system contributed to improving patient safety by preventing potential MAEs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. The effects of Project ALERT one year past curriculum completion.

    Science.gov (United States)

    Ringwalt, Chris L; Clark, Heddy Kovach; Hanley, Sean; Shamblen, Stephen R; Flewelling, Robert L

    2010-06-01

    School-based drug prevention curricula constitute the nation's most prevalent strategy to prevent adolescent drug use. We evaluated the effects of one such curriculum, Project ALERT, on adolescent substance use. In particular, we sought to determine if a single effect on 30-day alcohol use, noted shortly following the completion of the 2-year program, could be detected 1 year later. We also looked for delayed effects on other outcomes of interest, namely lifetime alcohol use, and 30-day and lifetime use of cigarettes, marijuana, and inhalants. We employed a randomized controlled trial that used school as the unit of assignment. Thirty-four schools with grades 6-8 from 11 states completed the study. Seventy-one Project ALERT instructors taught 11 core lessons to sixth graders and 3 booster lessons to seventh graders. Students were assessed prior to the onset of the intervention, as sixth graders, after the completion of the 2-year curriculum, as seventh graders, and again 1 year later as eighth graders. This paper examines data from the pretest and final posttest. Using hierarchical nonlinear modeling, we found that our earlier effect on 30-day alcohol use did not persist. Further, we continued to find no effects for lifetime alcohol use and both the lifetime and 30-day use of cigarettes, marijuana, and inhalants. Our findings do not support the long-term effectiveness of Project ALERT, when delivered to sixth graders.

  19. IP telephony based danger alert communication system and its implementation

    Science.gov (United States)

    Rezac, Filip; Safarik, Jakub; Voznak, Miroslav; Tomala, Karel; Partila, Pavol

    2013-05-01

    This article discusses a danger alert system created as a part of the research project at Department of Telecommunications of Technical University of Ostrava. The aim of the system is to distribute pre-recorded voice messages in order to alert the called party in danger. This article describes individual technologies, which the application uses for its operation as well as issues relating to hardware requirements and transfer line bandwidth load. The article also describes new algorithms, which had to be developed in order to ensure the reliability of the system. Our intent is focused on disaster management, the message, which should be delivered within specified time span, is typed in the application and text-to-speech module ensures its transformation to a speech format, after that a particular scenario or warned area is selected and a target group is automatically unloaded. For this purpose, we have defined XML format for delivery of phone numbers which are located in the target area and these numbers are obtained from mobile BTS's (Base transmission stations). The benefit of such communication compared to others, is the fact, that it uses a phone call and, therefore, it is possible to get feedback who accepted the message and to improve efficiency of alert system. Finally, the list of unanswered calls is exported and these users can be informed via SMS.

  20. AN AUTOMATED NETWORK SECURITYCHECKING AND ALERT SYSTEM: A NEW FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Vivek Kumar Yadav

    2013-09-01

    Full Text Available Network security checking is a vital process to assess and to identify weaknesses in network for management of security. Insecure entry points of a network provide attackers an easy target to access and compromise. Open ports of network components such as firewalls, gateways and end systems are analogues to open gates of a building through which any one can get into. Network scanning is performed to identify insecure entry points in the network components. To find out vulnerabilities on these points vulnerability assessment is performed. So security checking consists of both activities- network scanning as well as vulnerability assessment. A single tool used for the security checking may not give reliable results. This paper presents a framework for assessing the security of a network using multiple Network Scanning and Vulnerability Assessment tools. The proposed framework is an extension of the framework given by Jun Yoon and Wontae Sim [1] which performs vulnerability scanning only. The framework presented here adds network scanning, alerting and reporting system to their framework. Network scanning and vulnerability tools together complement each other and make it amenable for centralized control and management. The reporting system of framework sends an email to the network administrator which contains detailed report (as attachment of security checking process. Alerting system sends a SMS message as an alert to the network administrator in case of severe threats found in the network. Initial results of the framework are encouraging and further work is in progress.

  1. The ACT Alert: preliminary results of a novel protocol to assess geriatric head trauma patients on anticoagulation.

    Science.gov (United States)

    Rittenhouse, Katelyn; Rogers, Amelia; Clark, Elizabeth; Horst, Michael; Adams, William; Bupp, Katherine; Shertzer, Weston; Miller, Jo Ann; Chandler, Roxanne; Rogers, Frederick B

    2015-04-01

    In busy emergency departments (EDs), elderly patients on anticoagulation (AC) sustaining minor injuries who are triaged to a lower priority for evaluation are at risk for potentially serious consequences. We sought to determine if a novel ED protocol prioritizes workup and improves outcome. In a Pennsylvania-verified Level II trauma center, the ACT (AntiCoagulation and Trauma) Alert was implemented in March 2012. Triage parameters include: age 65 years or older, AC agents, Glasgow Coma Score (GCS) 13 or greater, and head trauma 24 hours or less. ACT Alerts are announced overhead in the ED and require assessment by an ED physician, nurse, and phlebotomist in 15 minutes or less. Furthermore, they necessitate Point of Care international normalized ratio (INR) 20 minutes or less and head computed tomography (CT) scan 30 minutes or less. Positive CT findings mandate trauma service consultation. ACT Alert patients from March to December 2012 were compared with ED patients 65 years or older, GCS 13 or greater, on AC with the same chief complaints as ACT Alerts from June 2011 to February 2012 (control). A P value ≤ 0.05 was considered significant. Of 752 study patients, 415 were ACT and 337 were controls. There were no significant differences between groups in age, elevated INR, or head bleeds. ACT patients had significantly shorter median times from ED arrival to INR (ACT 13 minutes vs control 80 minutes; P ACT 35 minutes vs control 65 minutes; P ACT had a significantly shorter median length of stay (LOS) (ACT 3.7 days vs control 5.0 days; P ACT Alert improves ED throughput and reduces hospital LOS while effectively identifying at-risk, mildly head injured geriatric patients on AC.

  2. Harms of unsuccessful donation after circulatory death: An exploratory study.

    Science.gov (United States)

    Taylor, Lauren J; Buffington, Anne; Scalea, Joseph R; Fost, Norman; Croes, Kenneth D; Mezrich, Joshua D; Schwarze, Margaret L

    2018-02-01

    While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face-to-face interviews with family members (N = 15) who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in the donation process. We used qualitative content analysis to characterize the harms of nondonation as perceived by participants. Participants reported a broad spectrum of harms affecting organ recipients, donors, and donor families. Harms included waste of precious life-giving organs and hospital resources, inability to honor the donor's memory and character, and impaired ability for families to make sense of tragedy and cope with loss. Donor families empathized with the initial hope and ultimate despair of potential recipients who must continue their wait on the transplant list. Focus group members reinforced these findings and highlighted the struggle of families to navigate the uncertainty regarding the timing of death during the donation process. While families reported significant harm, many appreciated the donation attempt. These findings highlight the importance of organ donation to donor families and the difficult experiences associated with current processes that could inform development of alternative donation strategies. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. Evolution of helping and harming in heterogeneous groups.

    Science.gov (United States)

    Rodrigues, António M M; Gardner, Andy

    2013-08-01

    Social groups are often composed of individuals who differ in many respects. Theoretical studies on the evolution of helping and harming behaviors have largely focused upon genetic differences between individuals. However, nongenetic variation between group members is widespread in natural populations, and may mediate differences in individuals' social behavior. Here, we develop a framework to study how variation in individual quality mediates the evolution of unconditional and conditional social traits. We investigate the scope for the evolution of social traits that are conditional on the quality of the actor and/or recipients. We find that asymmetries in individual quality can lead to the evolution of plastic traits with different individuals expressing helping and harming traits within the same group. In this context, population viscosity can mediate the evolution of social traits, and local competition can promote both helping and harming behaviors. Furthermore, asymmetries in individual quality can lead to the evolution of competition-like traits between clonal individuals. Overall, we highlight the importance of asymmetries in individual quality, including differences in reproductive value and the ability to engage in successful social interactions, in mediating the evolution of helping and harming behaviors. © 2013 The Author(s). Evolution © 2013 The Society for the Study of Evolution.

  4. Suicide and Self-Harm Related Internet Use.

    Science.gov (United States)

    Padmanathan, Prianka; Biddle, Lucy; Carroll, Robert; Derges, Jane; Potokar, John; Gunnell, David

    2018-05-31

    The rise in Internet use adds a new dimension to suicide prevention. We investigated suicide/self-harm (S/Sh)-related Internet use among patients presenting to hospital with self-harm. We asked 1,198 adult and 315 child and adolescent patients presenting to hospital following self-harm in a city in South West England about Internet use associated with their hospital presentation. Associations between Internet use and sociodemographic and clinical characteristics were investigated using multivariable logistic regression models. Focus groups with clinicians explored the acceptability and utility of asking about Internet use. The prevalence of S/Sh-related Internet use was 8.4% (95% CI: 6.8-10.1%) among adult hospital presentations and 26.0% (95% CI = 21.3-31.2%) among children's hospital presentations. In both samples, S/Sh-related Internet use was associated with higher levels of suicidal intent. Mostly, clinicians found it acceptable to ask about Internet use during psychosocial assessments and believed this could inform perceptions of risk and decision-making. It is unclear whether the findings in this study are applicable to the general self-harm patient population because only those who had psychosocial assessments were included. S/Sh-related Internet use is likely to become increasingly relevant as the Internet-native generation matures. Furthermore, Internet use may be a proxy marker for intent.

  5. Liberal egalitarianism and the harm principle

    OpenAIRE

    Lombardi, Michele; Veneziani, Roberto

    2009-01-01

    This paper analyses Rawls's celebrated difference principle, and its lexicographic extension, in societies with a finite and an infinite number of agents. A unified framework of analysis is set up, which allows one to characterise Rawlsian egalitarian principles by means of a weaker version of a new axiom - the Harm Principle - recently proposed by marven09. This is quite surprising, because the Harm principle is meant to capture a liberal requirement of noninterference and it incorporates no...

  6. Identifying harmful drinking using a single screening question in a psychiatric consultation-liaison population.

    Science.gov (United States)

    Massey, Suena H; Norris, Lorenzo; Lausin, Melissa; Nwaneri, Chinyere; Lieberman, Daniel Z

    2011-01-01

    Harmful drinking is common in medical inpatients, yet commonly missed due in part to time pressures. A screening question about past year heavy drinking recommended by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has been validated in primary care and emergency room settings. We tested the psychometric properties of a modified single screening question (SSQ) in hospitalized patients referred to a consultation-liaison service. A psychiatry attending (n = 40), a psychiatry resident (n = 30) and a medical student (n = 30) administered the SSQ, followed by a self-report 10-item Alcohol Use Disorders Identification Test (AUDIT) to a sample of 100 consultation-liaison patients who were able to give informed consent for participation. Using the AUDIT as a reference, the sensitivity and specificity of the SSQ to detect harmful drinking in this sample were .96 and .82, respectively. Gender differences in specificity were not found. The single question also had a strong correlation with dependence (r(b) = .457, p past year heavy drinking can rapidly identify harmful drinking in alert nonpsychotic consultation-liaison patients. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  7. Authority dependence and judgments of utilitarian harm.

    Science.gov (United States)

    Piazza, Jared; Sousa, Paulo; Holbrook, Colin

    2013-09-01

    Three studies tested the conditions under which people judge utilitarian harm to be authority dependent (i.e., whether its right or wrongness depends on the ruling of an authority). In Study 1, participants judged the right or wrongness of physical abuse when used as an interrogation method anticipated to yield useful information for preventing future terrorist attacks. The ruling of the military authority towards the harm was manipulated (prohibited vs. prescribed) and found to significantly influence judgments of the right or wrongness of inflicting harm. Study 2 established a boundary condition with regards to the influence of authority, which was eliminated when the utility of the harm was definitely obtained rather than forecasted. Finally, Study 3 replicated the findings of Studies 1-2 in a completely different context-an expert committee's ruling about the harming of chimpanzees for biomedical research. These results are discussed as they inform ongoing debates regarding the role of authority in moderating judgments of complex and simple harm. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Energy drinks and adolescents: what's the harm?

    Science.gov (United States)

    Harris, Jennifer L; Munsell, Christina R

    2015-04-01

    Concerns about potential dangers from energy drink consumption by youth have been raised by health experts, whereas energy drink manufacturers claim these products are safe and suitable for marketing to teens. This review summarizes the evidence used to support both sides of the debate. Unlike most beverage categories, sales of energy drinks and other highly caffeinated products continue to grow, and marketing is often targeted to youth under the age of 18 years. These products pose a risk of caffeine toxicity when consumed by some young people, and there is evidence of other troubling physiological and behavioral effects associated with their consumption by youth. The US Food and Drug Administration has indicated it will reexamine the safety of caffeine in the food supply; however, more research is needed to better understand youth consumption of energy drinks and caffeine in general, as well as the long-term effects on health. Meanwhile, policymakers and physician groups have called on energy drink manufacturers to take voluntary action to reduce the potential harm of their products, including placing restrictions on marketing to youth under the age of 18 years. Additional regulatory and legislative options are also being discussed. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Satellite monitoring of cyanobacterial harmful algal bloom ...

    Science.gov (United States)

    Cyanobacterial harmful algal blooms (cyanoHABs) cause extensive problems in lakes worldwide, including human and ecological health risks, anoxia and fish kills, and taste and odor problems. CyanoHABs are a particular concern because of their dense biomass and the risk of exposure to toxins in both recreational waters and drinking source waters. Successful cyanoHAB assessment by satellites may provide a first-line of defense indicator for human and ecological health protection. In this study, assessment methods were developed to determine the utility of satellite technology for detecting cyanoHAB occurrence frequency at locations of potential management interest. The European Space Agency's MEdium Resolution Imaging Spectrometer (MERIS) was evaluated to prepare for the equivalent Sentinel-3 Ocean and Land Colour Imager (OLCI) launched in 2016. Based on the 2012 National Lakes Assessment site evaluation guidelines and National Hydrography Dataset, there were 275,897 lakes and reservoirs greater than 1 hectare in the 48 U.S. states. Results from this evaluation show that 5.6 % of waterbodies were resolvable by satellites with 300 m single pixel resolution and 0.7 % of waterbodies were resolvable when a 3x3 pixel array was applied based on minimum Euclidian distance from shore. Satellite data was also spatially joined to US public water surface intake (PWSI) locations, where single pixel resolution resolved 57% of PWSI and a 3x3 pixel array resolved 33% of

  10. Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

    Directory of Open Access Journals (Sweden)

    Elena Boriani

    2017-07-01

    Full Text Available Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety, human, and ecosystem health (1. In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

  11. [Major influential factors of the micturition alert device dedicated to neurogenic bladders].

    Science.gov (United States)

    Wang, Jianhuo; Hou, Chunlin; Zheng, Xianyou; Xu, Zhen; Wang, Wanhong; Lin, Haodong

    2008-08-01

    To study major influential factors of the micturition alert device dedicated to neurogenic bladders for the product design and clinical application of the device. One ferrite permanent magnet with thickness and diameter of 3 mm and 10 mm, respectively, and three NdFeB permanent magnets with the thickness of 3 mm and diameter of 10, 15 and 20 mm, respectively, were used. The effects of thickness of the abdominal wall as well as the position and type of permanent magnets on the micturition alert device dedicated to neurogenic bladders were measured in vitro simulated test, when the abdominal wall was set to 2, 3, 4, 5, 6, 7, 8 and 9 cm, respectively, and the position of permanent magnets was 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 cm, respectively. The effect of the geomagnetic field on the device was measured under the condition that the thickness of the simulated abdominal wall was set to 2, 3, 4 and 5 cm, respectively, and the position of permanent magnets was 2, 3, 4, 5, 6, 7, 8, 9 and 10 cm, respectively. The value showed in the warning unit was positively correlated with the position of the ferrite permanent magnet only when the thickness of the simulated abdominal wall was 2 cm (r=0.632, P NdFeB permanent magnets was significant (r > 0.622, P NdFeB permanent magnets, but weakened with the increasing thickness of the simulated abdominal wall. The effect of the geomagnetic field was correlated with the exposition of the body, the position of the permanent magnet and the thickness of the abdominal wall. The major influential factors of the micturition alert device dedicated to neurogenic bladder include the magnetism and location of the permanent magnet, the thickness of the abdominal wall and the geomagnetic field. These factors are correlated with and affect each other. Reasonable allocation of these factors may optimize the device.

  12. Faster but not smarter: effects of caffeine and caffeine withdrawal on alertness and performance.

    Science.gov (United States)

    Rogers, Peter J; Heatherley, Susan V; Mullings, Emma L; Smith, Jessica E

    2013-03-01

    Despite 100 years of psychopharmacological research, the extent to which caffeine consumption benefits human functioning remains unclear. To measure the effects of overnight caffeine abstinence and caffeine administration as a function of level of habitual caffeine consumption. Medium-high (n = 212) and non-low (n = 157) caffeine consumers completed self-report measures and computer-based tasks before (starting at 10:30 AM) and after double-blind treatment with either caffeine (100 mg, then 150 mg) or placebo. The first treatment was given at 11:15 AM and the second at 12:45 PM, with post-treatment measures repeated twice between 1:45 PM and 3:30 PM. Caffeine withdrawal was associated with some detrimental effects at 10:30 AM, and more severe effects, including greater sleepiness, lower mental alertness, and poorer performance on simple reaction time, choice reaction time and recognition memory tasks, later in the afternoon. Caffeine improved these measures in medium-high consumers but, apart from decreasing sleepiness, had little effect on them in non-low consumers. The failure of caffeine to increase mental alertness and improve mental performance in non-low consumers was related to a substantial caffeine-induced increase in anxiety/jitteriness that offset the benefit of decreased sleepiness. Caffeine enhanced physical performance (faster tapping speed and faster simple and choice reaction times) in both medium-high and non-low consumers. While caffeine benefits motor performance and tolerance develops to its tendency to increase anxiety/jitteriness, tolerance to its effects on sleepiness means that frequent consumption fails to enhance mental alertness and mental performance.

  13. Revealing the functional neuroanatomy of intrinsic alertness using fMRI: methodological peculiarities.

    Science.gov (United States)

    Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander T; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

    2011-01-01

    Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that--as a methodological artifact--left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing the

  14. Time to Detection with BacT/Alert FA Plus Compared to BacT/Alert FA Blood Culture Media.

    Science.gov (United States)

    Nutman, A; Fisher Even-Tsur, S; Shapiro, G; Braun, T; Schwartz, D; Carmeli, Y

    2016-09-01

    Rapid identification of the causative pathogen in patients with bacteremia allows adjustment of antibiotic therapy and improves patient outcomes. We compared in vitro and real-life time to detection (TTD) of two blood culture media, BacT/Alert FA (FA) and BacT/Alert FA Plus (FA Plus), for the nine most common species of bacterial pathogens recovered from blood samples. Experimental data from simulated cultures was compared with microbiology records of TTD for both culture media with growth of the species of interest in clinical blood cultures. In the experimental conditions, median TTD was 3.8 hours (23.9 %) shorter using FA Plus media. The magnitude of reduction differed between species. Similarly, in real life data, FA Plus had shorter TTD than FA media; however, the difference between culture media was smaller, and median TTD was only 1 hour (8.5 %) less. We found shorter TTD with BacT/Alert FA Plus culture media, both experimentally and in real-life conditions and unrelated to antibiotic neutralization, highlighting the importance of appropriate blood culture media selection.

  15. Non-visual effects of light on melatonin, alertness and cognitive performance: can blue-enriched light keep us alert?

    Directory of Open Access Journals (Sweden)

    Sarah Laxhmi Chellappa

    Full Text Available BACKGROUND: Light exposure can cascade numerous effects on the human circadian process via the non-imaging forming system, whose spectral relevance is highest in the short-wavelength range. Here we investigated if commercially available compact fluorescent lamps with different colour temperatures can impact on alertness and cognitive performance. METHODS: Sixteen healthy young men were studied in a balanced cross-over design with light exposure of 3 different light settings (compact fluorescent lamps with light of 40 lux at 6500K and at 2500K and incandescent lamps of 40 lux at 3000K during 2 h in the evening. RESULTS: Exposure to light at 6500K induced greater melatonin suppression, together with enhanced subjective alertness, well-being and visual comfort. With respect to cognitive performance, light at 6500K led to significantly faster reaction times in tasks associated with sustained attention (Psychomotor Vigilance and GO/NOGO Task, but not in tasks associated with executive function (Paced Visual Serial Addition Task. This cognitive improvement was strongly related with attenuated salivary melatonin levels, particularly for the light condition at 6500K. CONCLUSIONS: Our findings suggest that the sensitivity of the human alerting and cognitive response to polychromatic light at levels as low as 40 lux, is blue-shifted relative to the three-cone visual photopic system. Thus, the selection of commercially available compact fluorescent lights with different colour temperatures significantly impacts on circadian physiology and cognitive performance at home and in the workplace.

  16. Recent self-harm and psychological measures in the emergency department

    Directory of Open Access Journals (Sweden)

    Jason R. Randall

    2014-11-01

    Full Text Available The assessment of self-harm risk is a common, difficult, and perplexing task for many physicians, especially those working in emergency departments (ED. Attempts have been made to determine objective methods for assessing patients with suicidal ideation or self-harm though there is still a lack of knowledge about objective assessments of these patients. A study was conducted where 181 suicidal patients were enrolled in two EDs within the city of Edmonton, Canada. Initial interviews were conducted in the ED which collected basic demographics and medical history as well as psychometric measures including the Beck Hopelessness Scale, Barratt Impulsiveness Scale, Brief Symptom Inventory, Drug Abuse Screening Test 10, and CAGE questionnaire. The results of these measures were compared between those who presented to the ED with self-harm and those who presented only with ideation. Those with recent self-harm scored lower on many of the scales and subscales of distress and impulsivity measured compared to those with no recent self-harm. Possible explanations for this difference include differences in psychological traits between the two groups and possible cathartic effects of self-harm. The lower scores obtained by those that present with self-harm may complicate attempts to use psychometric tools to determine future self-harm risk.

  17. PREP advertisement features affect smokers’ beliefs regarding potential harm

    Science.gov (United States)

    Strasser, Andrew A; Tang, Kathy Z; Tuller, Michael D; Cappella, Joseph N

    2014-01-01

    Background The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. Objective To determine the effect of altering advertisement features on smokers’ beliefs of the harm exposure from a PREP. Methods A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a “red” condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a “no text” condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using “incorrect,” “unsure” and “correct” as outcomes, and advertisement type and covariates as predictors, was used for analyses. Results Participants randomised to the “no text” advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, healthier and make smoking safer. Conclusions Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising. PMID:18768457

  18. Herbal medications - harmless or harmful?

    African Journals Online (AJOL)

    QuickSilver

    sive effects, although these are short-lived (<2hrs in animal studies) and is not recommended for routine use. The main ... Adverse effects include nausea (6%), and bleeding as the allicin also inhibits .... prior to surgery, which is the estimated time for all compounds to be fully metabolised. In practice this is not always ...

  19. Radiation sterilization of harmful algae in water

    International Nuclear Information System (INIS)

    Byung Chull An; Jae-Sung Kim; Seung Sik Lee; Shyamkumar Barampuram; Eun Mi Lee; Byung Yeoup Chung

    2007-01-01

    Complete text of publication follows. Objective: Drinking water, water used in food production and for irrigation, water for fish farming, waste water, surface water, and recreational water have been recently recognized as a vector for the transmission of harmful micro-organisms. The human and animal harmful algae is a waterborne risk to public health and economy because the algae are ubiquitous and persistent in water and wastewater, not completely removed by physical-chemical treatment processes, and relatively resistant to chemical disinfection. Gamma and electron beam radiation technology is of growing in the water industry since it was demonstrated that gamma and electron beam radiation is very effective against harmful algae. Materials and Methods: Harmful algae (Scenedesmus quadricauda(Turpin) Brebisson 1835 (AG10003), Chlorella vulgaris Beijerinck 1896 (AG30007) and Chlamydomonas sp. (AG10061)) were distributed from Korean collection for type cultures (KCTC). Strains were cultured aerobically in Allen's medium at 25□ and 300 umol/m2s for 1 week using bioreactor. We investigated the disinfection efficiency of harmful algae irradiated with gamma (0.05 to 10 kGy for 30 min) and electron beam (1 to 19 kGy for 5 sec) rays. Results and Conclusion: We investigated the disinfection efficiency of harmful algae irradiated with gamma and electron beam rays of 50 to 19000 Gy. We established the optimum sterilization condition which use the gamma and electron beam radiation. Gamma ray disinfected harmful algae at 400 Gy for 30 min. Also, electron beam disinfected at 1000 Gy for 5 sec. This alternative disinfection practice had powerful disinfection efficiency. Hence, the multi-barrier approach for drinking water treatment in which a combination of various disinfectants and filtration technologies are applied for removal and inactivation of different microbial pathogens will guarantee a lower risk of microbial contamination.

  20. Selective reporting bias of harm outcomes within studies: findings from a cohort of systematic reviews.

    Science.gov (United States)

    Saini, Pooja; Loke, Yoon K; Gamble, Carrol; Altman, Douglas G; Williamson, Paula R; Kirkham, Jamie J

    2014-11-21

    To determine the extent and nature of selective non-reporting of harm outcomes in clinical studies that were eligible for inclusion in a cohort of systematic reviews. Cohort study of systematic reviews from two databases. Outcome reporting bias in trials for harm outcomes (ORBIT II) in systematic reviews from the Cochrane Library and a separate cohort of systematic reviews of adverse events. 92 systematic reviews of randomised controlled trials and non-randomised studies published in the Cochrane Library between issue 9, 2012 and issue 2, 2013 (Cochrane cohort) and 230 systematic reviews published between 1 January 2007 and 31 December 2011 in other publications, synthesising data on harm outcomes (adverse event cohort). A 13 point classification system for missing outcome data on harm was developed and applied to the studies. 86% (79/92) of reviews in the Cochrane cohort did not include full data from the main harm outcome of interest of each review for all of the eligible studies included within that review; 76% (173/230) for the adverse event cohort. Overall, the single primary harm outcome was inadequately reported in 76% (705/931) of the studies included in the 92 reviews from the Cochrane cohort and not reported in 47% (4159/8837) of the 230 reviews in the adverse event cohort. In a sample of primary studies not reporting on the single primary harm outcome in the review, scrutiny of the study publication revealed that outcome reporting bias was suspected in nearly two thirds (63%, 248/393). The number of reviews suspected of outcome reporting bias as a result of missing or partially reported harm related outcomes from at least one eligible study is high. The declaration of important harms and the quality of the reporting of harm outcomes must be improved in both primary studies and systematic reviews. © Saini et al 2014.

  1. [The issue of harm reduction in Polish legislation concerning drug addiction. A comparative study].

    Science.gov (United States)

    Sobeyko, Justyna

    2008-01-01

    The aim of work is the assessment of legal permissibility for health and social harm reduction programmes resulting from drug use in the context of the polish legislation on narcotic drug use and drug addiction. The thesis outlines harm reduction programmes implemented worldwide, role of penal code in counteracting both narcotic drug supply and demand, attitude of United Nations and European Union to the drug problem including harm reduction programmes, solutions adopted in the selected European Union member states. The main part of the thesis presents the evolution of polish legislation regarding drug use and analysis of legal permissibility for harm reduction programmes in this context. The conclusion inferred is the statement that implementation of the harm reduction programmes requires a certain minimal depenalisation of the drug use by a legislator and the fact that restrictive legal system impedes programme realization. Thus the thesis postulates depenalisation of small drug quantities for personal use.

  2. Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment.

    Science.gov (United States)

    Salloum, Ramzi G; Louviere, Jordan J; Getz, Kayla R; Islam, Farahnaz; Anshari, Dien; Cho, Yoojin; O'Connor, Richard J; Hammond, David; Thrasher, James F

    2017-07-13

    The US Food and Drug Administration (FDA) has regulatory authority to use inserts to communicate with consumers about harmful and potentially harmful constituents (HPHCs) in tobacco products; however, little is known about the most effective manner for presenting HPHC information. In a discrete choice experiment, participants evaluated eight choice sets, each of which showed two cigarette packages from four different brands and tar levels (high vs low), accompanied by an insert that included between-subject manipulations (ie, listing of HPHCs vs grouping by disease outcome and numeric values ascribed to HPHCs vs no numbers) and within-subject manipulations (ie, 1 of 4 warning topics; statement linking an HPHC with disease vs statement with no HPHC link). For each choice set, participants were asked: (1) which package is more harmful and (2) which motivates them to not smoke; each with a 'no difference' option. Alternative-specific logit models regressed choice on attribute levels. 1212 participants were recruited from an online consumer panel (725 18-29-year-old smokers and susceptible non-smokers and 487 30-64-year-old smokers). Participants were more likely to endorse high-tar products as more harmful than low-tar products, with a greater effect when numeric HPHC information was present. Compared with a simple warning statement, the statement linking HPHCs with disease encouraged quit motivation. Numeric HPHC information on inserts appears to produce misunderstandings that some cigarettes are less harmful than others. Furthermore, brief narratives that link HPHCs to smoking-related disease may promote cessation versus communications that do not explicitly link HPHCs to disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Harm avoidance and disability in old age.

    Science.gov (United States)

    Wilson, Robert S; Buchman, Aron S; Arnold, Steven E; Shah, Raj C; Tang, Yuxiao; Bennett, David A

    2006-01-01

    The relation of personality to disability in old age is not well understood. The authors examined the relation of harm avoidance, a trait indicating a tendency to worry, fear uncertainty, be shy, and tire easily, to disability in a group of 474 older persons without dementia. Participants completed the 35-item Harm Avoidance scale. Disability was assessed with the Rosow-Breslau scale, a self-report measure of physical mobility. Performance-based tests of lower limb functions were also administered from which composite measures of gait, balance, and strength were derived. In a logistic regression model controlled for age, sex, education, and lower limb function, persons with high levels of harm avoidance were nearly three times as likely to report mobility limitations as persons with low levels, and these effects largely reflected fatigability and fear of uncertainty. The association of harm avoidance with disability was not explained or modified by frailty, physical activity, depressive symptoms, neuroticism, extraversion, or cognition. The results suggest that harm avoidance is associated with disability in old age.

  4. What is preventable harm in healthcare? A systematic review of definitions

    Directory of Open Access Journals (Sweden)

    Nabhan Mohammed

    2012-05-01

    Full Text Available Abstract Background Mitigating or reducing the risk of harm associated with the delivery of healthcare is a policy priority. While the risk of harm can be reduced in some instances (i.e. preventable, what constitutes preventable harm remains unclear. A standardized and clear definition of preventable harm is the first step towards safer and more efficient healthcare delivery system. We aimed to summarize the definitions of preventable harm and its conceptualization in healthcare. Methods We conducted a comprehensive electronic search of relevant databases from January 2001 to June 2011 for publications that reported a definition of preventable harm. Only English language publications were included. Definitions were coded for common concepts and themes. We included any study type, both original studies and reviews. Two reviewers screened the references for eligibility and 28% (127/460 were finally included. Data collected from studies included study type, description of the study population and setting, and data corresponding to the outcome of interest. Three reviewers extracted the data. The level of agreement between the reviewers was calculated. Results One hundred and twenty seven studies were eligible. The three most prevalent preventable harms in the included studies were: medication adverse events (33/127 studies, 26%, central line infections (7/127, 6% and venous thromboembolism (5/127, 4%. Seven themes or definitions for preventable harm were encountered. The top three were: presence of an identifiable modifiable cause (58/132 definitions, 44%, reasonable adaptation to a process will prevent future recurrence (30/132, 23%, adherence to guidelines (22/132, 16%. Data on the validity or operational characteristic (e.g., accuracy, reproducibility of definitions were limited. Conclusions There is limited empirical evidence of the validity and reliability of the available definitions of preventable harm, such that no single one is supported by

  5. The Association Between Secondhand Harms From Alcohol and Mental Health Outcomes Among Postsecondary Students.

    Science.gov (United States)

    Thompson, Kara; Davis-MacNevin, Parnell; Teehan, Michael; Stewart, Sherry

    2017-01-01

    There is a paucity of research on the prevalence and consequences of secondhand harms from alcohol. The current study (a) investigated whether secondhand harms can be clustered into latent factors that reflect distinct but related types of harms and (b) examined the associations between experiencing secondhand harms and mental health outcomes, including anxiety, depression, and subjective mental well-being, among first-year Canadian postsecondary students. The moderating effect of living arrangement (i.e., living on campus or not) on the associations was also tested. The sample included 1,885 first-year undergraduate students (49.8% female; mean age = 18.31 years) from three Canadian universities. Exploratory and confirmatory factor analyses were used to determine the factor structure of the harms measure. Path analysis was used to assess the association between harms and mental health outcomes. Models accounted for age, sex, and frequency of heavy drinking. Seventy-one percent of the sample reported experiencing at least one type of secondhand harm. The harms examined clustered into two distinct but related factors: strains (e.g., interrupted sleep) and threats (e.g., being harassed or insulted). Both threats and strains were associated with higher levels of anxiety and depression and poorer subjective well-being. Associations were stronger for threats and did not differ by living arrangement. Experiencing secondhand harms from alcohol, particularly threats, may have negative implications for student mental health over and above students' own drinking. Programs and policies on university campuses targeting both alcohol use and mental health should consider how to reduce both the prevalence and impact of secondhand harms from alcohol on students.

  6. Self-harm - an overview of the tools used to assess non-suicidal self-harming behaviors

    Directory of Open Access Journals (Sweden)

    Drzał-Fiałkiewcz Ewelina

    2017-12-01

    Full Text Available Introduction: Non-Suicidal Self-Injury (NSSI is the deliberate injury to one’s own body intended to cause mental or physical harm to oneself. In view of the growing scale of the NSSI, especially among young people without identifying any other psychiatric disorders, the disorder was included in both DSM-5 and ICD10 as independent diagnostic entity. Many etiopathogenetic hypotheses and research tools assessing various aspects of NSSI have been developed.

  7. [Self-harm vs. harming others: the lived experiences of a dysfunctional family].

    Science.gov (United States)

    Wu, Hsiu-Chin; Lin, Mei-Feng; Yu, Shu-Hua

    2007-10-01

    The purpose of this study was to explore the lived experiences of self-harm and harm to others from the perspective of two adult offspring and a father, the latter of whom was prone to alcohol abuse and domestic violence and had attempted suicide. Written informed consents were obtained from the subjects after a detailed explanation of the research aims and procedures. A qualitative, phenomenological method was applied for the study. Three subjects were interviewed using a semi-structured interview guide designed by the researchers and based on the aims of the study over a six-month period of home care. A qualitative content analysis based on a phenomenological method was used to identify themes in the data. Two main categories emerged: (1) the mutual harm to the couple subsystem, (2) the misplaced parental-child subsystem. Subsequently, two to four themes were identified from each category. These results provide a better analysis and understanding of the perceived experiences of the harm to the spouse, parental, and sibling subsystems. They should also help health professionals to improve awareness of the lived experiences associated with the issues of self-harm and threats of harm to others. This study could serve as a valuable reference in promoting possible prevention strategies aiming at the reduction of self-harm and harm to others in dysfunctional families within the community.

  8. Characteristics of Self-Harm Behaviour among Identified Self-Harming Youth in Care

    Science.gov (United States)

    Grenville, Jeffrey; Goodman, Deborah; Macpherson, Alison K.

    2012-01-01

    The objective of this study was to describe deliberate self-harming (DSH) characteristics in a child-welfare population identified as having threatened or completed self-harm. Secondary data from 621 serious occurrence reports (SOR) that documented 2004-2007 DSH incidents and DSH threats with 252 Canadian youth in care (Y-INC) of the Children's…

  9. Sporotrichosis with Bone Involvement: An Alert to an Occupational Disease

    Directory of Open Access Journals (Sweden)

    Felipe de Carvalho Aguinaga

    2014-04-01

    Full Text Available Sporotrichosis is a subacute or chronic mycosis caused by a fungus of the genus Sporothrix, which is found in soil. It can be acquired by trauma to the skin. Bone and joint lesions are very rare. The city of Rio de Janeiro is undergoing an epidemic transmitted by cats, and this should be an alert for the risk to professionals in contact with these animals. The patient was a veterinarian who developed occupational sporotrichosis with osteoarticular involvement transmitted by a cat during a consultation.

  10. The Low-Level Wind Shear Alert System (LLWSAS)

    Science.gov (United States)

    1980-05-01

    ALERT SYSTEM (LLWSAS). (May R.. a.-ol - 8..’P" Imng Organization Report No, 9, Perfo~ring Or~ni-otlon Ro-r. -andAddress 10. Work Unit No. (TRAIS) Federal...rather than electronic approach. The 2-minute average adheres to recommended International Civil Aviation Organization (ICAO) standards (referernce 14...speed of 140 knots. **Cold front. 80 ’ # 90 0 STRONG CASES: COFF , 1975 80 9STRONG CASES: UNPU1BLISHED 70 60 A STRONG CASES: COFF , et al., 1978 50 \\ 50 -0

  11. Thermal Energy for Space Cooling--Federal Technology Alert

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Daryl R.

    2000-12-31

    Cool storage technology can be used to significantly reduce energy costs by allowing energy-intensive, electrically driven cooling equipment to be predominantly operated during off peak hours when electricity rates are lower. This Federal Technology Alert, which is sponsored by DOE's Federal Energy Management Program (FEMP), describes the basic types of cool storage technologies and cooling system integration options. In addition, it defines the savings potential in the federal sector, presents application advice, and describes the performance experience of specific federal users. The results of a case study of a GSA building using cool storage technology are also provided.

  12. Simulation and Proposed Handover Alert Algorithm for Mobile Communication System

    Directory of Open Access Journals (Sweden)

    Muzhir Shaban Al-Ani

    2009-10-01

    Full Text Available this paper deals with the simulation and presentation of a novel approach to design and implementation of algorithm to realize hand over process for a mobile communication system during mobile network. This algorithm performs the ability of the system to extract important information features about the received signal. When the strength of the received signal is dropped below a certain threshold value then an alert process is activated to achieve the continuity of the transmission due to a ready scan which is existed on time.

  13. Recommendations for international gambling harm-minimisation guidelines: comparison with effective public health policy

    NARCIS (Netherlands)

    Gainsbury, Sally M.; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

    2014-01-01

    Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of

  14. Recommendations for international gambling harm-minimisation guidelines : comparison with effective public health policy

    NARCIS (Netherlands)

    Gainsbury, Sally M; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

    2014-01-01

    Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of

  15. Study on the possibility of assessment of alertness using subsidiary behaviors

    International Nuclear Information System (INIS)

    Hirose, Ayako; Nagasaka, Akihiko

    2003-01-01

    The aim of this study is to explore the possibility of assessment of alertness using subsidiary behaviors. Using the previous experimental data, 8 subjects' subsidiary behaviors, which appeared during 3 monotonous VDU tasks, were picked up by 3 experimenters. These behaviors were classified into 13 categories according to their similarity. As a physiological index, electroencephalogram (EEG), which was known as the most sensitive index for measuring alertness, was measured. To investigate whether the number of these behaviors could be utilized for assessment of alertness, the following studies were carried out: 1) the relationships among the task performance, categorized behaviors and EEG were analyzed to make sure whether alertness had an impact on the task performance and the behaviors, 2) using the task performance, the level of alertness was classified tentatively, then the behaviors that were changed by the classified level of alertness were specified, 3) to testify the possibility of assessment of alertness, discriminant analysis was conducted using the behaviors which were specified above, and 4) quantification analysis III and cross correlation analysis were carried out to explore if the behaviors could estimate a decline in alertness before the performance deteriorated. As the results of the above 4 points, the followings were suggested: 1) some subsidiary behaviors were influenced by alertness, to say nothing of performance, 2) regardless of individual differences, there were some behaviors that were changed by the level of alertness which was tentatively classified in this study, 3) the level of alertness at the point could assess using some behaviors, such as 'rub, pinch, and scratch', 'ease the stiffness', 'postural adjustments', 'movement of eye's and mouth', 'action of low alertness', and 4) some behaviors indicated the premonitory sign of a decline in alertness, the other increased when a decline in alertness had been observed. Also, depends on

  16. Differences in risk factors for self-harm with and without suicidal intent: Findings from the ALSPAC cohort

    Science.gov (United States)

    Mars, Becky; Heron, Jon; Crane, Catherine; Hawton, Keith; Kidger, Judi; Lewis, Glyn; Macleod, John; Tilling, Kate; Gunnell, David

    2014-01-01

    Background There is a lack of consensus about whether self-harm with suicidal intent differs in aetiology and prognosis from non-suicidal self-harm, and whether they should be considered as different diagnostic categories. Method Participants were 4799 members of the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort who completed a postal questionnaire on self-harm with and without suicidal intent at age 16 years. Multinomial logistic regression analyses were used to examine differences in the risk factor profiles of individuals who self-harmed with and without suicidal intent. Results Many risk factors were common to both behaviours, but associations were generally stronger in relation to suicidal self-harm. This was particularly true for mental health problems; compared to those with non-suicidal self-harm, those who had harmed with suicidal intent had an increased risk of depression (OR 3.50[95% CI 1.64, 7.43]) and anxiety disorder (OR 3.50[95% CI 1.72, 7.13]). Higher IQ and maternal education were risk factors for non-suicidal self-harm but not suicidal self-harm. Risk factors that appeared specific to suicidal self-harm included lower IQ and socioeconomic position, physical cruelty to children in the household and parental self-harm. Limitations i) There was some loss to follow-up, ii) difficulty in measuring suicidal intent, iii) we cannot rule out the possibility of reverse causation for some exposure variables, iv) we were unable to identify the subgroup that had only ever harmed with suicidal intent. Conclusion Self-harm with and without suicidal intent are overlapping behaviours but with some distinct characteristics, indicating the importance of fully exploring vulnerability factors, motivations, and intentions in adolescents who self harm. PMID:25108277

  17. Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK.

    Science.gov (United States)

    Kimergård, Andreas; McVeigh, Jim

    2014-06-04

    The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how 'risk environments' produce harm. Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK. Body satisfaction was an important factor when deciding to start the use of anabolic steroids. Many users were unaware of the potential dangers of using drugs from the illicit market, whereas some had adopted a range of strategies to negotiate the hazards relating to the use of adulterated products, including self-experimentation to gauge the perceived efficacy and unwanted effects of these drugs. Viewpoints, first-hand anecdotes, norms and practices among groups of steroid users created boundaries of 'sensible' drug use, but also promoted practices that may increase the chance of harms occurring. Established users encouraged young users to go to harm reduction services but, at the same time, promoted risky injecting practices in the belief that this would enhance the efficacy of anabolic steroids. Current steroid-related viewpoints and practices contribute to the risk environment surrounding the use of these drugs and may undermine the goal of current public health strategies including harm reduction interventions. The level of harms among anabolic steroid users are determined by multiple and intertwining factors, in addition to the harms caused by the pharmacological action or injury and illness associated with incorrect injecting techniques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Investigating Driver Fatigue versus Alertness Using the Granger Causality Network

    Directory of Open Access Journals (Sweden)

    Wanzeng Kong

    2015-08-01

    Full Text Available Driving fatigue has been identified as one of the main factors affecting drivers’ safety. The aim of this study was to analyze drivers’ different mental states, such as alertness and drowsiness, and find out a neurometric indicator able to detect drivers’ fatigue level in terms of brain networks. Twelve young, healthy subjects were recruited to take part in a driver fatigue experiment under different simulated driving conditions. The Electroencephalogram (EEG signals of the subjects were recorded during the whole experiment and analyzed by using Granger-Causality-based brain effective networks. It was that the topology of the brain networks and the brain’s ability to integrate information changed when subjects shifted from the alert to the drowsy stage. In particular, there was a significant difference in terms of strength of Granger causality (GC in the frequency domain and the properties of the brain effective network i.e., causal flow, global efficiency and characteristic path length between such conditions. Also, some changes were more significant over the frontal brain lobes for the alpha frequency band. These findings might be used to detect drivers’ fatigue levels, and as reference work for future studies.

  19. Proposing alerts for pre and pro-haptens (QSAR2016) ...

    Science.gov (United States)

    Predictive testing to identify and characterise substances for their skin sensitisation potential has historically been based on animal tests such as the Local Lymph Node Assay (LLNA). In recent years, regulations in the cosmetics and chemicals sectors has provided a strong impetus to develop and evaluate non-animal alternative methods. The 3 test methods that have undergone extensive development and validation are the direct peptide reactivity assay (DPRA), the KeratinoSensTM and the human Cell Line Activation Test (h-CLAT). Whilst these methods have been shown to perform relatively well in predicting LLNA results (accuracy ~ 80%), a particular concern that has been raised is their ability to predict chemicals that need to be activated to act as sensitisers (either abiotically on the skin (pre-hapten) or metabolically in the skin (pro-hapten)). This study reviewed an EURL ECVAM dataset containing 271 substances for which information was available in the LLNA and for one or more of the three non-animal test methods. The chemical structures of the substances were inspected and each assigned to a reaction mechanistic domain. Fifty-three substances were expected to require activation. Plausible reaction pathways were considered for each of the substances from which three structural alerts were hypothesised: autoxidation to hydroperoxides, aromatic ortho and para-diamino or di phenol derivatives, and aromatic meta-diamino/hydroxy derivatives. For each alert, the av

  20. Towards cross-lingual alerting for bursty epidemic events.

    Science.gov (United States)

    Collier, Nigel

    2011-10-06

    Online news reports are increasingly becoming a source for event-based early warning systems that detect natural disasters. Harnessing the massive volume of information available from multilingual newswire presents as many challanges as opportunities due to the patterns of reporting complex spatio-temporal events. In this article we study the problem of utilising correlated event reports across languages. We track the evolution of 16 disease outbreaks using 5 temporal aberration detection algorithms on text-mined events classified according to disease and outbreak country. Using ProMED reports as a silver standard, comparative analysis of news data for 13 languages over a 129 day trial period showed improved sensitivity, F1 and timeliness across most models using cross-lingual events. We report a detailed case study analysis for Cholera in Angola 2010 which highlights the challenges faced in correlating news events with the silver standard. The results show that automated health surveillance using multilingual text mining has the potential to turn low value news into high value alerts if informed choices are used to govern the selection of models and data sources. An implementation of the C2 alerting algorithm using multilingual news is available at the BioCaster portal http://born.nii.ac.jp/?page=globalroundup.

  1. Electronic alerts and clinician turnover: the influence of user acceptance.

    Science.gov (United States)

    Hysong, Sylvia J; Spitzmuller, Christiane; Espadas, Donna; Sittig, Dean F; Singh, Hardeep

    2014-11-01

    Use of certain components of electronic health records (EHRs), such as EHR-based alerting systems (EASs), might reduce provider satisfaction, a strong precursor to turnover. We examined the impact of factors likely to influence providers' acceptance of an alerting system, designed to facilitate electronic communication in outpatient settings, on provider satisfaction, intentions to quit, and turnover. We conducted a cross-sectional Web-based survey of EAS-related practices from a nationwide sample of primary care providers (PCPs) practicing at Department of Veterans Affairs (VA) medical facilities. Of 5001 invited VA PCPs, 2590 completed the survey. We relied on Venkatesh's Unified Theory of Acceptance and Use of Technology to create survey measures of 4 factors likely to impact user acceptance of EAS: supportive norms, monitoring/ feedback, training, and providers' perceptions of the value (PPOV) of EASs to provider effectiveness. Facility-level PCP turnover was measured via the VA's Service Support Center Human Resources Cube. Hypotheses were tested using structural equation modeling. After accounting for intercorrelations among predictors, monitoring/feedback regarding EASs significantly predicted intention to quit (b = 0.30, P < .01), and PPOV of EASs predicted both overall provider satisfaction (b = 0.58, P < .01) and facility-level provider turnover levels (b = -0.19, P < .05), all without relying on any intervening mechanisms. Design, implementation, and use of EASs might impact provider satisfaction and retention. Institutions should consider strategies to help providers perceive greater value in these clinical tools.

  2. Towards cross-lingual alerting for bursty epidemic events

    Directory of Open Access Journals (Sweden)

    Collier Nigel

    2011-10-01

    Full Text Available Abstract Background Online news reports are increasingly becoming a source for event-based early warning systems that detect natural disasters. Harnessing the massive volume of information available from multilingual newswire presents as many challanges as opportunities due to the patterns of reporting complex spatio-temporal events. Results In this article we study the problem of utilising correlated event reports across languages. We track the evolution of 16 disease outbreaks using 5 temporal aberration detection algorithms on text-mined events classified according to disease and outbreak country. Using ProMED reports as a silver standard, comparative analysis of news data for 13 languages over a 129 day trial period showed improved sensitivity, F1 and timeliness across most models using cross-lingual events. We report a detailed case study analysis for Cholera in Angola 2010 which highlights the challenges faced in correlating news events with the silver standard. Conclusions The results show that automated health surveillance using multilingual text mining has the potential to turn low value news into high value alerts if informed choices are used to govern the selection of models and data sources. An implementation of the C2 alerting algorithm using multilingual news is available at the BioCaster portal http://born.nii.ac.jp/?page=globalroundup.

  3. Universal Safety Distance Alert Device for Road Vehicles

    Directory of Open Access Journals (Sweden)

    Matic Virant

    2016-04-01

    Full Text Available Driving with too short of a safety distance is a common problem in road traffic, often with traffic accidents as a consequence. Research has identified a lack of vehicle-mountable devices for alerting the drivers of trailing vehicles about keeping a sufficient safe distance. The principal requirements for such a device were defined. A conceptual study was performed in order to select the components for the integration of the device. Based on the results of this study, a working prototype of a flexible, self-contained device was designed, built and tested. The device is intended to be mounted on the rear of a vehicle. It uses radar as the primary distance sensor, assisted with a GPS receiver for velocity measurement. A Raspberry Pi single-board computer is used for data acquisition and processing. The alerts are shown on an LED-matrix display mounted on the rear of the host vehicle. The device software is written in Python and provides automatic operation without requiring any user intervention. The tests have shown that the device is usable on almost any motor vehicle and performs reliably in simulated and real traffic. The open issues and possibilities for future improvements are presented in the Discussion.

  4. Alert system for students with visual disabilities at the UTM

    Directory of Open Access Journals (Sweden)

    Marely del Rosario Cruz Felipe

    2018-01-01

    Full Text Available In the transfer of students with visual disabilities at the Technical University of Manabí (UTM accidents have been reported when going through some ramps and other obstacles, especially on rainy days. This article belongs to an investigation into the realization of an alert system for students with visual disabilities. The objective of the implementation of this system is to guide students with visual disabilities on different obstacles that exist in their transfer through the university. To carry out the implementation of this system, the alert systems and the technologies that are currently used as a result of a recording studio in the national and international scope were analyzed, the tools and technologies used in the developed solution are described. (Definition, technologies for the change of people, software, programming languages, etc. that allowed an efficient implementation in a short time of the proposed system by means of RFID (Radio Frequency Identification technology. The above is reflected in the positive orientation for the transfer of 32 students with visual disabilities through the university and by those who have contributed to improving their quality of life.

  5. The paradox of public holidays: Hospital-treated self-harm and associated factors.

    Science.gov (United States)

    Griffin, Eve; Dillon, Christina B; O'Regan, Grace; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

    2017-08-15

    Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors. Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses. A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time. It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician. Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Harm reduction in U.S. tobacco control: Constructions in textual news media.

    Science.gov (United States)

    Eversman, Michael H

    2015-06-01

    U.S. tobacco control has long emphasized abstinence, yet quitting smoking is hard and cessation rates low. Tobacco harm reduction alternatives espouse substituting cigarettes with safer nicotine and tobacco products. Policy shifts embracing tobacco harm reduction have increased media attention, yet it remains controversial. Discourse theory posits language as fluid, and socially constructed meaning as neither absolute nor neutral, elevating certain views over others while depicting "discursive struggle" between them. While an abstinence-based framework dominates tobacco policy, discourse theory suggests constructions of nicotine and tobacco use can change, for example by positioning tobacco harm reduction more favorably. Textual discourse analysis was used to explore constructions of tobacco harm reduction in 478 (308 original) U.S. textual news media articles spanning 1996-2014. Using keyword database sampling, retrieved articles were analyzed first as discrete recording units and then to identify emergent thematic content. Constructions of tobacco harm reduction shifted over this time, revealing tension among industry and policy interests through competing definitions of tobacco harm reduction, depictions of its underlying science, and accounts of regulatory matters including tobacco industry support for harm reduction and desired marketing and taxation legislation. Heightened salience surrounding tobacco harm reduction and electronic cigarettes suggests their greater acceptance in U.S. tobacco control. Various media depictions construct harm reduction as a temporary means to cessation, and conflict with other constructions of it that place no subjective value on continued "safer" tobacco/nicotine use. Constructions of science largely obscure claims of the veracity of tobacco harm reduction, with conflict surrounding appropriate public health benchmarks for tobacco policy and health risks of nicotine use. Taxation policies and e-cigarette pricing relative to

  7. Adolescent self-harm: a school-based study in Northern Ireland.

    Science.gov (United States)

    O'Connor, Rory C; Rasmussen, Susan; Hawton, Keith

    2014-04-01

    The prevalence of adolescent self-harm in Northern Ireland (NI) and its associated factors are unknown. Given the established relationship between conflict and mental health, and NI׳s recent history of conflict, it is important to investigate the factors associated with self-harm in NI. This study aimed to determine the prevalence of self-harm in NI adolescents and the factors associated with it, including exposure to the NI conflict. Observational study of 3596 school pupils employing an anonymous self-report survey. Information was obtained on demographic characteristics, lifestyle, life events and problems, exposure to the NI conflict, social and internet influences, and psychological variables. Self-harm was reported by 10% of respondents. In univariate analyses, exposure to the NI conflict was associated with self-harm alongside established risk factors. In multivariate analyses, bullying and exposure to self-harm were associated with lifetime self-harm in both girls and boys. Alcohol use, drug use, physical and sexual abuse, and self-esteem were also associated with self-harm in girls. In boys, absence of exercise, sexual orientation concerns, anxiety and impulsivity were additional risk factors. The internet/social media and the self-harm of others were also key influences. This is a cross-sectional study. The rate of self-harm was lower than elsewhere in the UK/Ireland. The study highlights the factors which should be considered in terms of risk assessment. In addition to established risk factors, the findings suggest that more research on the legacy of the NI conflict as well as the influence of new technologies warrant urgent attention. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Why Do the Very Old Self-Harm? A Qualitative Study.

    Science.gov (United States)

    Wand, Anne P F; Peisah, Carmelle; Draper, Brian; Brodaty, Henry

    2018-03-15

    To examine the perspectives of people aged 80 years or older who self-harmed regarding their reasons for self-harm and its consequences, and their perceptions of care. A qualitative study using in-depth interviews. Participants were recruited from two teaching hospitals and associated community services. People aged 80 years or older who had self-harmed within the previous month. Structured psychiatric assessment including cognitive testing, DSM-5 diagnosis, and an in-depth qualitative interview focusing upon the reasons for and consequences of self-harm. Narrative enquiry was used to guide the discussion. All interviews were undertaken by a geriatric psychiatrist, audio recorded, transcribed verbatim, and subjected to thematic analysis using N-VIVO. Themes that emerged for the reasons for self-harm included "enough is enough"; "loneliness"; "disintegration of self"; "being a burden"; "cumulative adversity"; "hopelessness and endless suffering"; "helplessness with rejection"; and "the untenable situation". Themes for the consequences of self-harm were "becoming engaged with or distanced from family"; "the problem was solved"; "gaining control"; "I"m worse off now"; "rejection by health professionals"; and "tension in the role of the inpatient clinical environment". Self-harm may communicate a need that cannot otherwise be expressed. An individualized person-centered approach is required to respond to self-harm, including a combination of practical, medical, and psychological approaches as indicated. Involvement of families in the process of understanding the meaning of and responding to self-harm through education and family therapy, as well as education of healthcare professionals beyond risk factor notation may be indicated. Copyright © 2018 American Association for Geriatric Psychiatry. All rights reserved.

  9. Summer heatwaves promote blooms of harmful cyanobacteria

    NARCIS (Netherlands)

    K.D Joehnk; J. Huisman; J. Sharples; B.P. Sommeijer (Ben); P.M. Visser (Petra); J.M. Stroom

    2008-01-01

    htmlabstractDense surface blooms of toxic cyanobacteria in eutrophic lakes may lead to mass mortalities of fish and birds, and provide a serious health threat for cattle, pets, and humans. It has been argued that global warming may increase the incidence of harmful algal blooms. Here, we report on a

  10. Summer heatwaves promote blooms of harmful cyanobacteria

    NARCIS (Netherlands)

    Jöhnk, K.D.; Huisman, J.; Sharples, J.; Sommeijer, B.; Visser, P.M.; Stroom, J.M.

    2008-01-01

    Dense surface blooms of toxic cyanobacteria in eutrophic lakes may lead to mass mortalities of fish and birds, and provide a serious health threat for cattle, pets, and humans. It has been argued that global warming may increase the incidence of harmful algal blooms. Here, we report on a lake

  11. Harmful traditional practices in a newborn

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2014-11-17

    Nov 17, 2014 ... impact of harmful traditional home care practices on ... She was initially on breast milk and water until the tenth day of life ... and zygomatic bone as well as loss of subcutaneous fat. (fig 1). .... ity and protection during the neo-.

  12. Moral Distress, Workplace Health, and Intrinsic Harm.

    Science.gov (United States)

    Weber, Elijah

    2016-05-01

    Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.

  13. Mitigating the Harmful Effects of Violent Television

    Science.gov (United States)

    Rosenkoetter, Lawrence I.; Rosenkoetter, Sharon E.; Ozretich, Rachel A.; Acock, Alan C.

    2004-01-01

    In an effort to minimize the harmful effects of violent TV, a yearlong intervention was undertaken with children in Grades 1 through 3 (N = 177). The classroom-based intervention consisted of 31 brief lessons that emphasized the many ways in which television distorts violence. As hypothesized, the intervention resulted in a reduction in children's…

  14. How Teacher Turnover Harms Student Achievement

    Science.gov (United States)

    Ronfeldt, Matthew; Loeb, Susanna; Wyckoff, James

    2013-01-01

    Researchers and policymakers often assume that teacher turnover harms student achievement, though recent studies suggest this may not be the case. Using a unique identification strategy that employs school-by-grade level turnover and two classes of fixed-effects models, this study estimates the effects of teacher turnover on over 850,000 New York…

  15. Changes in decibel scale wavelength properties of EEG with alertness levels while performing sustained attention tasks.

    Science.gov (United States)

    Arjunan, Sridhar P; Kumar, Dinesh K; Jung, Tzyy-Ping

    2009-01-01

    Loss of alertness can have dire consequences for people controlling motorized equipment or for people in professions such as defense. Electroencephalogram (EEG) is known to be related to alertness of the person, but due to high level of noise and low signal strength, the use of EEG for such applications has been considered to be unreliable. This study reports the fractal analysis of EEG and identifies the use of maximum fractal length (MFL) as a feature that is inversely correlated with the alertness of the subject. The results show that MFL (of only single channel of EEG) indicates the loss of alertness of the individual with mean (inverse) correlation coefficient = 0.82.

  16. The politics of harm reduction in federal prisons.

    Science.gov (United States)

    Watson, Tara Marie

    2014-09-01

    We need to understand better the political barriers to prison-based harm reduction programs. In this paper, I examine the situation in the Correctional Service of Canada (CSC), a federal prison agency with a zero-tolerance drug policy and general opposition to prison needle and syringe programs (PNSPs) and safer tattooing initiatives. This study draws on 16 interviews with former CSC senior officials, former frontline staff, and external stakeholders; CSC policy and practice documents; and testimony from a House of Commons Standing Committee public study. Thematic coding and comparison of texts were used to examine emergent themes of interest. Four interrelated issues were central for understanding the political barriers: a narrower definition of harm reduction used in corrections, both in principle and practice; the Conservative government's tough-on-crime agenda; strong union opposition; and stakeholder perceptions that political constraints will likely persist, including the view that litigation may offer the only way to introduce PNSPs. The system is at an impasse and key questions remain about the importability of harm reduction services into federal prisons. Despite a highly challenging policy environment, moving forward will demand asking new, critical questions and devising more strategic ways of entering the political-operational dialogue that opposes evidence-based programs. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Structure alerts for carcinogenicity, and the Salmonella assay system: a novel insight through the chemical relational databases technology.

    Science.gov (United States)

    Benigni, Romualdo; Bossa, Cecilia

    2008-01-01

    In the past decades, chemical carcinogenicity has been the object of mechanistic studies that have been translated into valuable experimental (e.g., the Salmonella assays system) and theoretical (e.g., compilations of structure alerts for chemical carcinogenicity) models. These findings remain the basis of the science and regulation of mutagens and carcinogens. Recent advances in the organization and treatment of large databases consisting of both biological and chemical information nowadays allows for a much easier and more refined view of data. This paper reviews recent analyses on the predictive performance of various lists of structure alerts, including a new compilation of alerts that combines previous work in an optimized form for computer implementation. The revised compilation is part of the Toxtree 1.50 software (freely available from the European Chemicals Bureau website). The use of structural alerts for the chemical biological profiling of a large database of Salmonella mutagenicity results is also reported. Together with being a repository of the science on the chemical biological interactions at the basis of chemical carcinogenicity, the SAs have a crucial role in practical applications for risk assessment, for: (a) description of sets of chemicals; (b) preliminary hazard characterization; (c) formation of categories for e.g., regulatory purposes; (d) generation of subsets of congeneric chemicals to be analyzed subsequently with QSAR methods; (e) priority setting. An important aspect of SAs as predictive toxicity tools is that they derive directly from mechanistic knowledge. The crucial role of mechanistic knowledge in the process of applying (Q)SAR considerations to risk assessment should be strongly emphasized. Mechanistic knowledge provides a ground for interaction and dialogue between model developers, toxicologists and regulators, and permits the integration of the (Q)SAR results into a wider regulatory framework, where different types of

  18. The Use of Mobile Applications to Monitor Sleep Quality and Alertness during Shift Work in Nurses: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Yeon-Hee Joo

    2015-12-01

    Full Text Available Background and Objective Fatigue or inattentiveness in nurses during shift work affects patient safety. Therefore, sleep quality and alertness during shift work requires monitoring. The aims of this study were to: 1 compare sleep parameters measured using sleep logs and mobile sleep applications and 2 evaluate sleep quality and alertness during shift work using mobile applications. Methods Twenty shift-work nurses voluntarily enrolled in the study. We compared sleep parameters including time in bed (TIB, sleep latency (SL, total sleep time, and wakefulness after sleep onset, recorded using sleep logs and mobile applications. An additional 66 female shift-work nurses voluntarily evaluated their sleep quality and alertness at work using the ‘Sleep Time’ and ‘Math Quiz’ applications. Results TIB was significantly lower in night-shift nurses (328.3 ± 8.9 than in nurses working other shifts (395.3 ± 9.1 min; p < 0.05. SL was significantly lower after a night shift (26.1 ± 1.7 min; p < 0.05 than after a day shift (31.5 ± 1.9 min or a day off (31.0 ± 1.4 min. The Math Quiz scores did not vary by shift type, but sleepiness scores were significantly higher immediately after waking up (5.57 ± 0.15 and during work (4.91 ± 0.14 in night-shift nurses, as compared to other nurses (p < 0.05. Conclusions Mobile applications and sleep logs were both effective in measuring sleep parameters. Most shift-work nurses, particularly those working nights, slept poorly. Mobile sleep and arithmetical applications are objective, reliable, and feasible means of monitoring the sleep quality and alertness of shift-work nurses.

  19. Harm reduction and law enforcement in Vietnam: influences on street policing

    Directory of Open Access Journals (Sweden)

    Jardine Melissa

    2012-07-01

    Full Text Available Abstract Background and rationale The HIV epidemic in Vietnam has from its start been concentrated among injecting drug users. Vietnam instituted the 2006 HIV/AIDS Law which includes comprehensive harm reduction measures, but these are unevenly accepted and inadequately implemented. Ward police are a major determinant of risk for IDUs, required to participate in drug control practices (especially meeting quotas for detention centres which impede support for harm reduction. We studied influences on ward level police regarding harm reduction in Hanoi to learn how to better target education and structural change. Methods After document review, we interviewed informants from government, NGOs, INGOs, multilateral agencies, and police, using semi-structured guides. Topics covered included perceptions of harm reduction and the police role in drug law enforcement, and harm reduction training and advocacy among police. Results Police perceive conflicting responsibilities, but overwhelmingly see their responsibility as enforcing drug laws, identifying and knowing drug users, and selecting those for compulsory detention. Harm reduction training was very patchy, ward police not being seen as important to it; and understanding of harm reduction was limited, tending to reflect drug control priorities. Justification for methadone was as much crime prevention as HIV prevention. Competing pressures on ward police create much anxiety, with performance measures based around drug control; recourse to detention resolves competing pressures more safely. There is much recognition of the importance of discretion, and much use of it to maintain good social order. Policy dissemination approaches within the law enforcement sector were inconsistent, with little communication about harm reduction programs or approaches, and an unfounded assumption that training at senior levels would naturally reach to the street. Discussion Ward police have not been systematically included

  20. Harm reduction and law enforcement in Vietnam: influences on street policing

    Science.gov (United States)

    2012-01-01

    Background and rationale The HIV epidemic in Vietnam has from its start been concentrated among injecting drug users. Vietnam instituted the 2006 HIV/AIDS Law which includes comprehensive harm reduction measures, but these are unevenly accepted and inadequately implemented. Ward police are a major determinant of risk for IDUs, required to participate in drug control practices (especially meeting quotas for detention centres) which impede support for harm reduction. We studied influences on ward level police regarding harm reduction in Hanoi to learn how to better target education and structural change. Methods After document review, we interviewed informants from government, NGOs, INGOs, multilateral agencies, and police, using semi-structured guides. Topics covered included perceptions of harm reduction and the police role in drug law enforcement, and harm reduction training and advocacy among police. Results Police perceive conflicting responsibilities, but overwhelmingly see their responsibility as enforcing drug laws, identifying and knowing drug users, and selecting those for compulsory detention. Harm reduction training was very patchy, ward police not being seen as important to it; and understanding of harm reduction was limited, tending to reflect drug control priorities. Justification for methadone was as much crime prevention as HIV prevention. Competing pressures on ward police create much anxiety, with performance measures based around drug control; recourse to detention resolves competing pressures more safely. There is much recognition of the importance of discretion, and much use of it to maintain good social order. Policy dissemination approaches within the law enforcement sector were inconsistent, with little communication about harm reduction programs or approaches, and an unfounded assumption that training at senior levels would naturally reach to the street. Discussion Ward police have not been systematically included in harm reduction advocacy

  1. Technical implementation plan for the ShakeAlert production system: an Earthquake Early Warning system for the West Coast of the United States

    Science.gov (United States)

    Given, Douglas D.; Cochran, Elizabeth S.; Heaton, Thomas; Hauksson, Egill; Allen, Richard; Hellweg, Peggy; Vidale, John; Bodin, Paul

    2014-01-01

    Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing such an EEW system, called ShakeAlert, for the West Coast of the United States. This document describes the technical implementation of that system, which leverages existing stations and infrastructure of the Advanced National Seismic System (ANSS) regional networks to achieve this new capability. While significant progress has been made in developing the ShakeAlert early warning system, improved robustness of each component of the system and additional testing and certification are needed for the system to be reliable enough to issue public alerts. Major components of the system include dense networks of ground motion sensors, telecommunications from those sensors to central processing systems, algorithms for event detection and alert creation, and distribution systems to alert users. Capital investment costs for a West Coast EEW system are projected to be $38.3M, with additional annual maintenance and operations totaling $16.1M—in addition to current ANSS expenditures for earthquake monitoring. An EEW system is complementary to, but does not replace, other strategies to mitigate earthquake losses. The system has limitations: false and missed alerts are possible, and the area very near to an earthquake epicenter may receive little or no warning. However, such an EEW system would save lives, reduce injuries and damage, and improve community resilience by reducing longer-term economic losses for both public and private entities.

  2. Development of a rational scale to assess the harm of drugs of potential misuse.

    Science.gov (United States)

    Nutt, David; King, Leslie A; Saulsbury, William; Blakemore, Colin

    2007-03-24

    Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.

  3. Mammography screening. Benefits, harms, and informed choice.

    Science.gov (United States)

    Jørgensen, Karsten Juhl

    2013-04-01

    The rationale for breast cancer screening with mammography is deceptively simple: catch it early and reduce mortality from the disease and the need for mastectomies. But breast cancer is a complex problem, and complex problems rarely have simple solutions. Breast screening brings forward the time of diagnosis only slightly compared to the lifetime of a tumour, and screen-detected tumours have a size where metastases are possible. A key question is if screening can prevent metastases, and if the screen-detected tumours are small enough to allow breast conserving surgery rather than mastectomy. A mortality reduction can never justify a medical intervention in its own right, but must be weighed against the harms. Overdiagnosis is the most important harm of breast screening, but has gained wider recognition only in recent years. Screening leads to the detection and treatment of breast cancers that would otherwise never have been detected because they grow very slowly or not at all and would not have been detected in the woman's lifetime in the absence of screening. Screening therefore turns women into cancer patients unnecessarily, with life-long physical and psychological harms. The debate about the justification of breast screening is therefore not a simple question of whether screening reduces breast cancer mortality. This dissertation quantifies the primary benefits and harms of screening mammography. Denmark has an unscreened "control group" because only two geographical regions offered screening over a long time-period, which is unique in an international context. This was used to study breast cancer mortality, overdiagnosis, and the use of mastectomies. Also, a systematic review of overdiagnosis in five other countries allowed us to show that about half of the screen-detected breast cancers are overdiagnosed. An effect on breast cancer mortality is doubtful in today's setting, and overdiagnosis causes an increase in the use of mastectomies. These findings are

  4. Feasibility of dialectical behavior therapy with suicidal and self-harming adolescents with multi-problems: training, adherence, and retention.

    Science.gov (United States)

    Tørmoen, A J; Grøholt, B; Haga, E; Brager-Larsen, A; Miller, A; Walby, F; Stanley, B; Mehlum, L

    2014-01-01

    We evaluated the feasibility of DBT training, adherence, and retention preparing for a randomized controlled trial of Dialectical Behavior Therapy (DBT) adapted for Norwegian adolescents engaging in self-harming behavior and diagnosed with features of borderline personality disorder. Therapists were intensively trained and evaluated for adherence. Adherence scores, treatment retention, and present and previous self-harm were assessed. Twenty-seven patients were included (mean age 15.7 years), all of them with recent self-harming behaviors and at least 3 features of Borderline Personality Disorder. Therapists were adherent and 21 (78%) patients completed the whole treatment. Three subjects reported self-harm at the end of treatment, and urges to self-harm decreased. At follow up, 7 of 10 subjects reported no self-harm. DBT was found to be well accepted and feasible. Randomized controlled trials are required to test the effectiveness of DBT for adolescents.

  5. Professional responsibility and patient retention: alerts for the new dentist.

    Science.gov (United States)

    Maitland, Ronald

    2014-01-01

    Getting to know your patients, well beyond recognition of their specific chief dental complaint, is most important in operating a successful and satisfying practice. In addition to the clinical findings and pertinent history alerts, a good understanding of the person being treated can go a long way toward cementing lasting and rewarding doctor-patient relationships. Almost all new patients to the practice are welcome. However, an occasional "difficult" patient can be identified. This is the patient who you will not be able to satisfy, who cultivates misunderstandings, is unfairly over demanding, wastes office time in innumerable ways and eventually causes great frustration for the dentist. These patients may leave the practice in an unpleasant termination. Concerns of litigation arise, and one must also consider the waste of economic and emotional currency, as well as any other negative repercussions that may result. The dentist should become skilled at early identification of potentially risky, disruptive and problematic persons seeking treatment.

  6. Automated detection of structural alerts (chemical fragments in (ecotoxicology

    Directory of Open Access Journals (Sweden)

    Ronan Bureau

    2013-02-01

    Full Text Available This mini-review describes the evolution of different algorithms dedicated to the automated discovery of chemical fragments associated to (ecotoxicological endpoints. These structural alerts correspond to one of the most interesting approach of in silico toxicology due to their direct link with specific toxicological mechanisms. A number of expert systems are already available but, since the first work in this field which considered a binomial distribution of chemical fragments between two datasets, new data miners were developed and applied with success in chemoinformatics. The frequency of a chemical fragment in a dataset is often at the core of the process for the definition of its toxicological relevance. However, recent progresses in data mining provide new insights into the automated discovery of new rules. Particularly, this review highlights the notion of Emerging Patterns that can capture contrasts between classes of data.

  7. AUTOMATED DETECTION OF STRUCTURAL ALERTS (CHEMICAL FRAGMENTS IN (ECOTOXICOLOGY

    Directory of Open Access Journals (Sweden)

    Alban Lepailleur

    2013-02-01

    Full Text Available This mini-review describes the evolution of different algorithms dedicated to the automated discovery of chemical fragments associated to (ecotoxicological endpoints. These structural alerts correspond to one of the most interesting approach of in silico toxicology due to their direct link with specific toxicological mechanisms. A number of expert systems are already available but, since the first work in this field which considered a binomial distribution of chemical fragments between two datasets, new data miners were developed and applied with success in chemoinformatics. The frequency of a chemical fragment in a dataset is often at the core of the process for the definition of its toxicological relevance. However, recent progresses in data mining provide new insights into the automated discovery of new rules. Particularly, this review highlights the notion of Emerging Patterns that can capture contrasts between classes of data.

  8. Assuring human operator alertness at night in power plants

    International Nuclear Information System (INIS)

    Moore-Ede, M.C.

    1988-01-01

    The human body is not designed for peak alertness and performance at night, nor is it well-equipped to cope with the frequent day-night inversions required by rotating shift work schedules. As a result, the human operator can become the weak link in a complex technological operation such as a nuclear power plant. The high degree of dependence on human operator vigilance, decision-making ability and performance that is required in nuclear power plant operations can conflict with the human sleepiness and error-proneness which naturally occur during the night shift or after extended periods without adequate sleep. An opportunity to address these problems has come from a series of major research advances in basic circadian physiology

  9. FULCRUM - A dam safety management and alert system

    Energy Technology Data Exchange (ETDEWEB)

    Butt, Cameron; Greenaway, Graham [Knight Piesold Ltd., Vancouver, (Canada)

    2010-07-01

    Efficient management of instrumentation, monitoring and inspection data are the keys to safe performance and dam structure stability. This paper presented a data management system, FULCRUM, developed for dam safety management. FULCRUM is a secure web-based data management system which simplifies the process of data collection, processing and analysis of the information. The system was designed to organize and coordinate dam safety management requirements. Geotechnical instrumentation such as piezometers or inclinometers and operating data can be added to the database. Data from routine surveillance and engineering inspection can also be incorporated into the database. The system provides users with immediate access to historical and recent data. The integration of a GIS system allows for rapid assessment of the project site. Customisable alerting protocols can be set to identify and respond quickly to significant changes in operating conditions and potential impacts on dam safety.

  10. Initial Development and Validation of the BullyHARM: The Bullying, Harassment, and Aggression Receipt Measure

    OpenAIRE

    Hall, William J.

    2016-01-01

    This article describes the development and preliminary validation of the Bullying, Harassment, and Aggression Receipt Measure (BullyHARM). The development of the BullyHARM involved a number of steps and methods, including a literature review, expert review, cognitive testing, readability testing, data collection from a large sample, reliability testing, and confirmatory factor analysis. A sample of 275 middle school students was used to examine the psychometric properties and factor structure...

  11. Human-computer interaction for alert warning and attention allocation systems of the multimodal watchstation

    Science.gov (United States)

    Obermayer, Richard W.; Nugent, William A.

    2000-11-01

    The SPAWAR Systems Center San Diego is currently developing an advanced Multi-Modal Watchstation (MMWS); design concepts and software from this effort are intended for transition to future United States Navy surface combatants. The MMWS features multiple flat panel displays and several modes of user interaction, including voice input and output, natural language recognition, 3D audio, stylus and gestural inputs. In 1999, an extensive literature review was conducted on basic and applied research concerned with alerting and warning systems. After summarizing that literature, a human computer interaction (HCI) designer's guide was prepared to support the design of an attention allocation subsystem (AAS) for the MMWS. The resultant HCI guidelines are being applied in the design of a fully interactive AAS prototype. An overview of key findings from the literature review, a proposed design methodology with illustrative examples, and an assessment of progress made in implementing the HCI designers guide are presented.

  12. Protecting air basins from harmful discharges

    Energy Technology Data Exchange (ETDEWEB)

    Yankovskiy, S S

    1983-01-01

    The work is a brief description of the content of the reports delivered at the seminar entitled Protecting the Air Basin from Harmful Discharges of the Machine Building Enterprises, which took place at the All Union Exhibit of the Achievements of the National Economy of the USSR (VDNKh) in 1982. Representatives of different ministries and agencies, scientific research institutes (NII), planning and design and other specialized organizations, institutes of higher learning (vuz) and enterprises from different branches of industry took part in the work of the seminar. The seminar noted measures to eliminate deficiencies which occur in individual enterprises of the branch and measures to improve the work to improve protection of the air basin from harmful discharges of machine building enterprises.

  13. Harmful effects on plants. 2. rev. ed.

    International Nuclear Information System (INIS)

    Hock, B.; Elstner, E.F.

    1988-01-01

    The book deals with accidentally or purposefully induced harmful effects on plants, i.e. eukariyotes and fungi, with emphasis being placed on chemicals as the main pollutants. After discussing the quantification of damage as a prerequisite for detecting, defining, and possibly preventing, damage to plants by toxic substances in the environment, the second part of the book deals with the harmful effects that are purposefully induced, for example in agriculture or horticulture, by employment of pesticides (herbicides or fungicides). In this context, all aspects of uptake, metabolism, and detoxication are discussed, especially referring to the molecular conditions of relevance to a selective elimination of metabolic or developmental processes in the plants, which is explained by the effects of pesticides and antibiotics. Injuries caused by autogenous substances in the plants, upon exceeding a certain amount or dose are also explained, together with effects of physical factors (as e.g. ionizing radiation), or biogenic factors (as e.g. parasites). (ECB) [de

  14. Boundaries between Fair and Harmful Tax Competition

    Directory of Open Access Journals (Sweden)

    Paweł Szwajdler

    2016-12-01

    Full Text Available The aim of this paper is to show boundaries between fair and harmful tax competition. The author analyses OECD’s reports and literature related to the tax competition. In the beginning, the author presents the notion of tax competition and its division into fair and unfair tax competition. Differences between tax heaven and preferential tax regime are also discussed. In the summary, the author highlights that boundaries between fair and harmful tax competition are not obvious, but there are well-known guidelines, which let distinguish above-mentioned issues. The author considers that there are real tax burden, effective exchange of tax information and transparency in the fair tax regime. The author states that taxpayer can do justified tax planning in such tax system.

  15. A Population-Based Study of the Prevalence and Correlates of Self-Harm in Juvenile Detention.

    Directory of Open Access Journals (Sweden)

    Hygiea Casiano

    Full Text Available Suicide is the number one cause of death among incarcerated youth. We examined the demographic and forensic risk factors for self-harm in youth in juvenile detention using a Canadian provincial correctional database.We analyzed data from de-identified youth aged 12 to 18 at the time of their offense who were in custody in a Manitoba youth correctional facility between January 1, 2005 and December 30, 2010 (N = 5,102. Univariate and multivariate logistic regression analyses determined the association between staff-identified self-harm events in custody and demographic and custodial variables. Time to the event was examined based on the admission date and date of event.Demographic variables associated with self-harm included female sex, lower educational achievement, older age, and child welfare involvement. Custodial variables associated with self-harm included higher criminal severity profiles, younger age at first incarceration, longer sentence length, disruptive institutional behavior, and a history of attempting escape. Youth identified at entry as being at risk for suicide were more likely to self-harm. Events tended to occur earlier in the custodial admission.Self-harm events tended to occur within the first 3 months of an admission stay. Youth with more serious offenses and disruptive behaviors were more likely to self-harm. Individuals with problematic custodial profiles were more likely to self-harm. Suicide screening identified youth at risk for self-harm. Strategies to identify and help youth at risk are needed.

  16. Factors influencing perceived effectiveness in dealing with self-harming patients in a sample of emergency department staff.

    Science.gov (United States)

    Egan, Rachel; Sarma, Kiran M; O'Neill, Meena

    2012-12-01

    Past self-harming behavior is one of the most significant predictors of future suicide. Each year in Ireland there are approximately 11,000 presentations of self-harm to emergency departments (EDs) across the country. This study examines predictors of perceived personal effectiveness in dealing with self-harming patients as reported by ED staff. The predictors are derived from past research and are influenced by Bandura's Social Cognitive Theory. One hundred twenty-five ED medical staff (28 doctors and 97 nurses) from five EDs in the West and South of Ireland completed a questionnaire. Predictor variables included in the design, and informed by past research, included knowledge of self-harm and suicidal behavior and confidence in dealing with incidents of self-harm. Standard multiple regression suggested a statistically significant model fit between the two predictors and the criterion variable, accounting for 24% of total variance. Knowledge and Confidence were significant contributors to perceived personal effectiveness in dealing with self-harming patients. Little is known regarding specific factors that influence perceived effectiveness in dealing with self-harming patients in the ED setting. These findings have implications for psycho-education and training content for staff. The findings suggest that increasing knowledge of self-harm and confidence in dealing with self-harming patients can lead to more positive perceived personal effectiveness in responding to clients' needs. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Harmful organisms in urban green areas

    Czech Academy of Sciences Publication Activity Database

    Hanousková, Irena; Boháč, Jaroslav; Sedláček, František; Šerá, Božena; Lepšová, A.; Zacharda, Miloslav

    -, č. 23 (2004), s. 58-68 ISSN 1335-342X R&D Projects: GA MŠk(CZ) OC C11.001 Grant - others:ÚEK AV ČR(CZ) OC C11.001 Program:OC Institutional research plan: CEZ:AV0Z6087904 Keywords : urban green areas, harmful organisms, management, * planning Subject RIV: AP - Urban, Regional and Transport Planning

  18. Turning Off Frequently Overridden Drug Alerts: Limited Opportunities for Doing It Safely

    NARCIS (Netherlands)

    I.H. van der Sijs (Heleen); J.E.C.M. Aarts (Jos); T. van Gelder (Teun); M. Berg (Marc); A.G. Vulto (Arnold)

    2008-01-01

    textabstractObjectives: This study sought to identify opportunities to safely turn off frequently overridden drug-drug interaction alerts (DDIs) in computerized physician order entry (CPOE). Design: Quantitative retrospective analysis of drug safety alerts overridden during 1 month and qualitative

  19. Cooperative Monitoring Center Occasional Paper/9: De-Alerting Strategic Ballistic Missiles

    Energy Technology Data Exchange (ETDEWEB)

    Connell, Leonard W.; Edenburn, Michael W.; Fraley, Stanley K.; Trost, Lawrence C.

    1999-03-01

    This paper presents a framework for evaluating the technical merits of strategic ballistic missile de-alerting measures, and it uses the framework to evaluate a variety of possible measures for silo-based, land-mobile, and submarine-based missiles. De-alerting measures are defined for the purpose of this paper as reversible actions taken to increase the time or effort required to launch a strategic ballistic missile. The paper does not assess the desirability of pursuing a de-alerting program. Such an assessment is highly context dependent. The paper postulates that if de-alerting is desirable and is used as an arms control mechanism, de-alerting measures should satisfy specific cirteria relating to force security, practicality, effectiveness, significant delay, and verifiability. Silo-launched missiles lend themselves most readily to de-alerting verification, because communications necessary for monitoring do not increase the vulnerabilty of the weapons by a significant amount. Land-mobile missile de-alerting measures would be more challenging to verify, because monitoring measures that disclose the launcher's location would potentially increase their vulnerability. Submarine-launched missile de-alerting measures would be extremely challlenging if not impossible to monitor without increasing the submarine's vulnerability.

  20. The Influence of Alertness on Spatial and Nonspatial Components of Visual Attention

    Science.gov (United States)

    Matthias, Ellen; Bublak, Peter; Muller, Hermann J.; Schneider, Werner X.; Krummenacher, Joseph; Finke, Kathrin

    2010-01-01

    Three experiments investigated whether spatial and nonspatial components of visual attention would be influenced by changes in (healthy, young) subjects' level of alertness and whether such effects on separable components would occur independently of each other. The experiments used a no-cue/alerting-cue design with varying cue-target stimulus…

  1. 75 FR 26196 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

    Science.gov (United States)

    2010-05-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Inspector General Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment Suppliers AGENCY: Office of Inspector...) 205-0007. SUPPLEMENTARY INFORMATION: In our publication of the OIG Updated Special Fraud Alert on...

  2. Winter Weather Tips: Understanding Alerts and Staying Safe this Season | Poster

    Science.gov (United States)

    By Jenna Seiss and Kylie Tomlin, Guest Writers, and Ashley DeVine, Staff Writer Maryland residents face the possibility of dangerous winter weather each year—from icy conditions to frigid temperatures. You may be familiar with the different types of winter weather alerts issued by the National Weather Service (NWS), but do you know what each alert means?  

  3. Unintended consequences of reducing QT-alert overload in a computerized physician order entry system

    NARCIS (Netherlands)

    I.H. van der Sijs (Heleen); R. Kowlesar (Ravi); J.E.C.M. Aarts (Jos); M. Berg (Marc); A.G. Vulto (Arnold); T. van Gelder (Teun)

    2009-01-01

    textabstractPurpose: After complaints of too many low-specificity drug-drug interaction (DDI) alerts on QT prolongation, the rules for QT alerting in the Dutch national drug database were restricted in 2007 to obviously QT-prolonging drugs. The aim of this virtual study was to investigate whether

  4. Investigating Visual Alerting in the Maritime Domain; Report on 3 Experiments, With Supporting Documentation

    Science.gov (United States)

    2010-04-01

    opérateurs les états ou événements critiques qui requièrent leur attention. La recherche dont il est question ici vise principalement à alerter...Visual alerting in complex command and control environments. Poster presented at the Human Factors and Ergonomics Society 53rd Annual Meeting, San

  5. 14 CFR 121.360 - Ground proximity warning-glide slope deviation alerting system.

    Science.gov (United States)

    2010-01-01

    ... deviation alerting system. 121.360 Section 121.360 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Equipment Requirements § 121.360 Ground proximity warning-glide slope deviation alerting system. (a) No... system that meets the performance and environmental standards of TSO-C92 (available from the FAA, 800...

  6. 76 FR 28789 - Draft Alert Entitled “Preventing Occupational Respiratory Disease From Dampness in Office...

    Science.gov (United States)

    2011-05-18

    ... NIOSH-238] Draft Alert Entitled ``Preventing Occupational Respiratory Disease From Dampness in Office... Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), announces the availability of a draft Alert entitled ``Preventing Occupational Respiratory Disease from...

  7. Impaired Conflict Resolution and Alerting in Children with ADHD: Evidence from the Attention Network Task (ANT)

    Science.gov (United States)

    Johnson, Katherine A.; Robertson, Ian H.; Barry, Edwina; Mulligan, Aisling; Daibhis, Aoife; Daly, Michael; Watchorn, Amy; Gill, Michael; Bellgrove, Mark A.

    2008-01-01

    Background: An important theory of attention suggests that there are three separate networks that execute discrete cognitive functions. The "alerting" network acquires and maintains an alert state, the "orienting" network selects information from sensory input and the "conflict" network resolves conflict that arises between potential responses.…

  8. School-Based Drug Prevention among At-Risk Adolescents: Effects of ALERT Plus

    Science.gov (United States)

    Longshore, Douglas; Ellickson, Phyllis L.; McCaffrey, Daniel F.; St. Clair, Patricia A.

    2007-01-01

    In a recent randomized field trial, Ellickson et al. found the Project ALERT drug prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth…

  9. Simplify the interpretation of alert lists for clinical mastitis in automatic

    NARCIS (Netherlands)

    Steeneveld, W.; Gaag, van der M.A.; Barkema, H.W.; Hogeveen, H.

    2010-01-01

    Based on sensor measurements, an automatic milking system (AMS) generates mastitis alert lists indicating cows which are likely to have clinical mastitis (CM). Because of the general assumption of equal probabilities of developing CM for all cows, all alerts on the list have the same success rate.

  10. The development of peer educator-based harm reduction programmes in Northern Vietnam.

    Science.gov (United States)

    Walsh, Nick; Gibbie, Tania M; Higgs, Peter

    2008-03-01

    Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

  11. Managing young people with self-harming or suicidal behaviour.

    Science.gov (United States)

    Fisher, Gemma

    2016-02-01

    This literature review aimed to determine the risk factors being used to identify children and young people who are at increased risk of engaging in self-harm and suicidal behaviour, so that optimal care can be provided for this patient group in children's medical ward settings. The two main themes that emerged were mental and neurodevelopmental disorders, and external factors. Management strategies to aid healthcare professionals in caring for this patient group were also identified. The review concludes by highlighting the need to provide healthcare professionals with continuing education about the mental health problems of children and young people, including risk factors and management strategies.

  12. Alertness Modulates Conflict Adaptation and Feature Integration in an Opposite Way

    Science.gov (United States)

    Chen, Jia; Huang, Xiting; Chen, Antao

    2013-01-01

    Previous studies show that the congruency sequence effect can result from both the conflict adaptation effect (CAE) and feature integration effect which can be observed as the repetition priming effect (RPE) and feature overlap effect (FOE) depending on different experimental conditions. Evidence from neuroimaging studies suggests that a close correlation exists between the neural mechanisms of alertness-related modulations and the congruency sequence effect. However, little is known about whether and how alertness mediates the congruency sequence effect. In Experiment 1, the Attentional Networks Test (ANT) and a modified flanker task were used to evaluate whether the alertness of the attentional functions had a correlation with the CAE and RPE. In Experimental 2, the ANT and another modified flanker task were used to investigate whether alertness of the attentional functions correlate with the CAE and FOE. In Experiment 1, through the correlative analysis, we found a significant positive correlation between alertness and the CAE, and a negative correlation between the alertness and the RPE. Moreover, a significant negative correlation existed between CAE and RPE. In Experiment 2, we found a marginally significant negative correlation between the CAE and the RPE, but the correlation between alertness and FOE, CAE and FOE was not significant. These results suggest that alertness can modulate conflict adaptation and feature integration in an opposite way. Participants at the high alerting level group may tend to use the top-down cognitive processing strategy, whereas participants at the low alerting level group tend to use the bottom-up processing strategy. PMID:24250824

  13. Alertness modulates conflict adaptation and feature integration in an opposite way.

    Directory of Open Access Journals (Sweden)

    Peiduo Liu

    Full Text Available Previous studies show that the congruency sequence effect can result from both the conflict adaptation effect (CAE and feature integration effect which can be observed as the repetition priming effect (RPE and feature overlap effect (FOE depending on different experimental conditions. Evidence from neuroimaging studies suggests that a close correlation exists between the neural mechanisms of alertness-related modulations and the congruency sequence effect. However, little is known about whether and how alertness mediates the congruency sequence effect. In Experiment 1, the Attentional Networks Test (ANT and a modified flanker task were used to evaluate whether the alertness of the attentional functions had a correlation with the CAE and RPE. In Experimental 2, the ANT and another modified flanker task were used to investigate whether alertness of the attentional functions correlate with the CAE and FOE. In Experiment 1, through the correlative analysis, we found a significant positive correlation between alertness and the CAE, and a negative correlation between the alertness and the RPE. Moreover, a significant negative correlation existed between CAE and RPE. In Experiment 2, we found a marginally significant negative correlation between the CAE and the RPE, but the correlation between alertness and FOE, CAE and FOE was not significant. These results suggest that alertness can modulate conflict adaptation and feature integration in an opposite way. Participants at the high alerting level group may tend to use the top-down cognitive processing strategy, whereas participants at the low alerting level group tend to use the bottom-up processing strategy.

  14. Effectiveness of National Weather Service heat alerts in preventing mortality in 20 US cities.

    Science.gov (United States)

    Weinberger, Kate R; Zanobetti, Antonella; Schwartz, Joel; Wellenius, Gregory A

    2018-04-09

    Extreme heat is a well-documented public health threat. The US National Weather Service (NWS) issues heat advisories and warnings (collectively, "heat alerts") in advance of forecast extreme heat events. The effectiveness of these alerts in preventing deaths remains largely unknown. To quantify the change in mortality rates associated with heat alerts in 20 US cities between 2001 and 2006. Because NWS heat alerts are issued based on forecast weather and these forecasts are imperfect, in any given location there exists a set of days of similar observed heat index in which heat alerts have been issued for some days but not others. We used a case-crossover design and conditional logistic regression to compare mortality rates on days with versus without heat alerts among such eligible days, adjusting for maximum daily heat index and temporal factors. We combined city-specific estimates into a summary measure using standard random-effects meta-analytic techniques. Overall, NWS heat alerts were not associated with lower mortality rates (percent change in rate: -0.5% [95% CI: -2.8, 1.9]). In Philadelphia, heat alerts were associated with a 4.4% (95% CI: -8.3, -0.3) lower mortality rate or an estimated 45.1 (95% empirical CI: 3.1, 84.1) deaths averted per year if this association is assumed to be causal. No statistically significant beneficial association was observed in other individual cities. Our results suggest that between 2001 and 2006, NWS heat alerts were not associated with lower mortality in most cities studied, potentially missing a valuable opportunity to avert a substantial number of heat-related deaths. These results highlight the need to better link alerts to effective communication and intervention strategies to reduce heat-related mortality. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Benefits and harms in clinical trials of duloxetine for treatment of major depressive disorder

    DEFF Research Database (Denmark)

    Maund, Emma; Tendal, Britta; Hróbjartsson, Asbjørn

    2014-01-01

    , with respect to benefits and major harms. DESIGN: Data on primary efficacy analysis and major harms extracted from each data source and compared. SETTING: Nine randomised placebo controlled trials of duloxetine (total 2878 patients) submitted to the European Medicines Agency (EMA) for marketing approval.......gov and the manufacturer's online clinical trial registry were searched for trial results. RESULTS: Clinical study reports fully described the primary efficacy analysis and major harms (deaths (including suicides), suicide attempts, serious adverse events, and discontinuations because of adverse events). There were minor......, respectively. We also found publication bias in relation to beneficial effects. CONCLUSION: Clinical study reports contained extensive data on major harms that were unavailable in journal articles and in trial registry reports. There were inconsistencies between protocols and clinical study reports and within...

  16. An examination of emergency department nurses' attitudes towards deliberate self-harm in an Irish teaching hospital.

    LENUS (Irish Health Repository)

    McCarthy, Linda

    2010-01-01

    The purpose of this study was to examine emergency department (ED) nurses\\' attitudes towards individuals presenting with deliberate self-harm (DSH), including the relationship between attitudes and factors such as age, academic achievements, length of experience, and self-harm education.

  17. Révision du genre Eurypetalum Harms (Fabaceae, Caesalpinioideae)

    NARCIS (Netherlands)

    Obiang-Mbomio, D.; Breteler, F.J.

    2007-01-01

    Revision of the genus Eurypetalum Harms (Fabaceae, Caesalpinioideae). Th e African genus Eurypetalum Harms (Fabaceae, Caesalpinioideae) of Lower Guinea is revised. Two species, E. tessmannii and E. unijugum, are recognized. Th ey are illustrated and their distributions are mapped. Eurypetalum

  18. Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.

    Directory of Open Access Journals (Sweden)

    Celine Larkin

    Full Text Available BACKGROUND: Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition. OBJECTIVE: This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent. DATA SOURCES: PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form. RESULTS: A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity. CONCLUSIONS: Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode

  19. Assessing the tobacco harm reduction (THR debate: a systematic review

    Directory of Open Access Journals (Sweden)

    Yogi Hendlin

    2018-03-01

    Full Text Available Background Tobacco Harm Reduction (THR has become synonymous with substituting alternative tobacco products for cigarettes. However, there exists much dissension among tobacco control professionals regarding accepting harm reduction methods prolonging nicotine addiction and profiting the tobacco, e-cigarette and pharmaceutical industries. We evaluate the influence of these industries on the academic THR literature and debate. Methods We undertook a comprehensive review of all peer-review papers published on the topic of tobacco harm reduction between 1992 and July 2016. Our initial search yielded 5,172 relevant hits, and after screening, we double-coded 1,067 full-text articles. Codes include the article's stand on THR (weakly or strongly pro-, anti-, or neutral/mixed, major themes, product type, country of author origin, article type (letter/commentary, RTC, longitudinal study, etc., journal quality, and funding source. These results were analyzed in STATA. Results Of the 498 articles we have coded so far, 379 were included. The results show that six percent of all articles are editorials, 36% letters or commentaries, and 21% are non-empirical articles while only 31% are original research and 6% reviews. Thirty-three percent of pro-THR articles disclosed some sort of industry funding. Of these, 30% were funded by the tobacco industry, 22% by the E-cigarette industry and 48% were funded by pharmaceutical industries. Conclusions The THR debate has been influenced by scientists funded by tobacco, electronic-cigarette and surprisingly pharmaceutical industries in the favor of product substitution. Moreover, the majority of this debate is occurring over 'opinion pieces' rather than on the basis of empirical research. Thus, more robust and unbiased scientific evidence is needed to evaluate these alternative products before endorsing them for the public.

  20. Understanding vulnerability to self-harm in times of economic hardship and austerity: a qualitative study.

    Science.gov (United States)

    Barnes, M C; Gunnell, D; Davies, R; Hawton, K; Kapur, N; Potokar, J; Donovan, J L

    2016-02-17

    Self-harm and suicide increase in times of economic recession, but little is known about why people self-harm when in financial difficulty, and in what circumstances self-harm occurs. This study aimed to understand events and experiences leading to the episode of self-harm and to identify opportunities for prevention or mitigation of distress. Participants' homes or university rooms. 19 people who had attended hospital following self-harm in two UK cities and who specifically cited job loss, economic hardship or the impact of austerity measures as a causal or contributory factor. Semistructured, in-depth interviews. Interviews were audio recorded, transcribed and analysed cross-sectionally and as case studies. Study participants described experiences of severe economic hardship; being unable to find employment or losing jobs, debt, housing problems and benefit sanctions. In many cases problems accumulated and felt unresolvable. For others an event, such as a call from a debt collector or benefit change triggered the self-harm. Participants also reported other current or past difficulties, including abuse, neglect, bullying, domestic violence, mental health problems, relationship difficulties, bereavements and low self-esteem. These contributed to their sense of despair and worthlessness and increased their vulnerability to self-harm. Participants struggled to gain the practical help they felt they needed for their economic difficulties or therapeutic support that might have helped with their other co-existing or historically damaging experiences. Economic hardships resulting from the recession and austerity measures accumulated or acted as a 'final straw' to trigger self-harm, often in the context of co-existing or historically damaging life-experiences. Interventions to mitigate these effects should include providing practical advice about economic issues before difficulties become insurmountable and providing appropriate psychosocial support for vulnerable

  1. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

    Directory of Open Access Journals (Sweden)

    Godshall William T

    2006-12-01

    Full Text Available Abstract According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in

  2. Sexual harassment experiences and harmful alcohol use in a military sample: differences in gender and the mediating role of depression.

    Science.gov (United States)

    Gradus, Jaimie L; Street, Amy E; Kelly, Kacie; Stafford, Jane

    2008-05-01

    Researchers and clinicians alike are interested in the effects of sexual harassment on mental health, including associations with problem drinking. The aim of the current investigation was to examine depression symptoms as a mediator of the association between sexual harassment during military service and current harmful alcohol use in a sample of former military personnel, stratified by gender. Using a cross-sectional design, 3,946 former reservists were surveyed regarding their experiences of sexual harassment in the military and their current depression symptoms and harmful alcohol use. Fifty-nine percent of the final sample were female. As expected, women endorsed experiencing sexual harassment more than men, and men endorsed harmful drinking more than women. Sexual harassment was associated with increased depression symptoms among both men and women; however, depression symptoms mediated the association between sexual harassment and harmful alcohol use among women only. Sexual harassment was not a significant predictor of harmful alcohol use among men. The associations between sexual harassment, depression symptoms, and harmful alcohol use differ between men and women in this sample. Consistent with the self-medication hypothesis, sexual harassment is associated with harmful drinking among women, and this association can be accounted for by symptoms of depression. The high prevalence of harmful drinking among men and the lack of an association with sexual harassment suggest that, in this sample, men's harmful drinking is influenced by factors other than sexual harassment.

  3. Heavy Metals in Notifications of Rapid Alert System for Food and Feed

    Science.gov (United States)

    Pigłowski, Marcin

    2018-01-01

    Heavy metals represent the fourth most often notified hazard category in the Rapid Alert System for Food and Feed (RASFF) from 1980–2016. The goal of the study was to examine the similarities in notifications of particular heavy metals within the RASFF year, product category, notifying country, country of origin, notification basis, notification type, distribution status, risk decision, and action taken, taking into account the particular product type, such as food, food contact material, and feed. The data originated from the RASFF database. Cluster analysis on pivot tables was applied using joining and two-way joining methods. Most notifications concerned food, in which the highest number were related to mercury, cadmium, chromium, lead, arsenic, and nickel. Notifications were mainly related to fish and food contact materials, in addition to fruits and vegetables, seafood, and dietetic food. The number of notifications decreased in 2015 and 2016. The majority of products were notified by Italy, Spain, Germany, and France. The notified products originated mainly from China and Spain. The notification was usually based on official controls on the market, as well as border controls. The notification types were mainly information, alert, and border rejections. Products were not frequently distributed due to distribution restriction to the notifying country or the possibility of distribution to the market. A risk decision was not usually made. The taken actions included re-dispatch of products, withdrawal from the market, or destruction. The data on heavy metals from the RASFF database can help European and national authorities in shaping public health. PMID:29461471

  4. Heavy Metals in Notifications of Rapid Alert System for Food and Feed

    Directory of Open Access Journals (Sweden)

    Marcin Pigłowski

    2018-02-01

    Full Text Available Heavy metals represent the fourth most often notified hazard category in the Rapid Alert System for Food and Feed (RASFF from 1980–2016. The goal of the study was to examine the similarities in notifications of particular heavy metals within the RASFF year, product category, notifying country, country of origin, notification basis, notification type, distribution status, risk decision, and action taken, taking into account the particular product type, such as food, food contact material, and feed. The data originated from the RASFF database. Cluster analysis on pivot tables was applied using joining and two-way joining methods. Most notifications concerned food, in which the highest number were related to mercury, cadmium, chromium, lead, arsenic, and nickel. Notifications were mainly related to fish and food contact materials, in addition to fruits and vegetables, seafood, and dietetic food. The number of notifications decreased in 2015 and 2016. The majority of products were notified by Italy, Spain, Germany, and France. The notified products originated mainly from China and Spain. The notification was usually based on official controls on the market, as well as border controls. The notification types were mainly information, alert, and border rejections. Products were not frequently distributed due to distribution restriction to the notifying country or the possibility of distribution to the market. A risk decision was not usually made. The taken actions included re-dispatch of products, withdrawal from the market, or destruction. The data on heavy metals from the RASFF database can help European and national authorities in shaping public health.

  5. 'Desa SIAGA', the 'Alert Village': the evolution of an iconic brand in Indonesian public health strategies.

    Science.gov (United States)

    Hill, Peter S; Goeman, Lieve; Sofiarini, Rahmi; Djara, Maddi M

    2014-07-01

    In 1999, the Ministry of Women's Empowerment in Indonesia worked with advertisers in Jakarta and international technical advisors to develop the concept of 'Suami SIAGA', the 'Alert Husband', confronting Indonesian males with their responsibilities to be aware of their wives' needs and ensure early access if needed to trained obstetrics care. The model was rapidly expanded to apply to the 'Desa SIAGA', the 'Alert Village', with communities assuming the responsibility for awareness of the risks of pregnancy and childbirth, and supporting registered pregnant mothers with funding and transportation for emergency obstetric assistance, and identified blood donors. Based on the participant observation, interviews and documentary analysis, this article uses a systems perspective to trace the evolution of that iconic 'brand' as new national and international actors further developed the concept and its application in provincial and national programmes. In 2010, it underwent a further transformation to become 'Desa Siaga Aktif', a national programme with responsibilities expanded to include the provision of basic health services at village level, and the surveillance of communicable disease, monitoring of lifestyle activities and disaster preparedness, in addition to the management of obstetric emergencies. By tracking the use of this single 'brand', the study provides insights into the complex adaptive system of policy and programme development with its rich interactions between multiple international, national, provincial and sectoral stakeholders, the unpredictable responses to feedback from these actors and their activities and the resultant emergence of new policy elements, new programmes and new levels of operation within the system. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  6. A novel strategy for evaluating the effects of an electronic test ordering alert message: Optimizing cardiac marker use.

    Science.gov (United States)

    Baron, Jason M; Lewandrowski, Kent B; Kamis, Irina K; Singh, Balaji; Belkziz, Sidi M; Dighe, Anand S

    2012-01-01

    Laboratory ordering functions within computerized provider order entry (CPOE) systems typically support the display of electronic alert messages to improve test utilization or implement new ordering policies. However, alert strategies have been shown to vary considerably in their success and the characteristics contributing to an alert's success are poorly understood. Improved methodologies are needed to evaluate alerts and their mechanisms of action. Clinicians order inpatient and emergency department laboratory tests using our institutional CPOE system. We analyzed user interaction data captured by our CPOE system to evaluate how clinicians responded to an alert. We evaluated an alert designed to implement an institutional policy restricting the indications for ordering creatine kinase-MB (CKMB). Within 2 months of alert implementation, CKMB-associated searches declined by 79% with a corresponding decline in CKMB orders. Furthermore, while prior to alert implementation, clinicians searching for CKMB ultimately ordered this test 99% of the time, following implementation, only 60% of CKMB searches ultimately led to CKMB test orders. This difference presumably represents clinicians who reconsidered the need for CKMB in response to the alert, demonstrating the alert's just-in-time advisory capability. In addition, as clinicians repeatedly viewed the alert, there was a "dose-dependant" decrease in the fraction of searches without orders. This presumably reflects the alerting strategy's long-term educational component, as clinicians aware of the new policy will not search for CKMB when not indicated. Our analytic approach provides insight into the mechanism of a CPOE alert and demonstrates that alerts may act through a combination of just-in-time advice and longer term education. Use of this approach when implementing alerts may prove useful to improve the success of a given alerting strategy.

  7. Examining Lead Exposures in California through State-Issued Health Alerts for Food Contamination and an Exposure-Based Candy Testing Program.

    Science.gov (United States)

    Handley, Margaret A; Nelson, Kali; Sanford, Eric; Clarity, Cassidy; Emmons-Bell, Sophia; Gorukanti, Anuhandra; Kennelly, Patrick

    2017-10-26

    In California, the annual number of children under age 6 y of age with blood lead levels (BLL) ≥10μg/dL is estimated at over 1,000 cases, and up to 10,000 cases when BLL between 4.5 and 9.5 μg/dL are included. State-issued health alerts for food contamination provide one strategy for tracking sources of food-related lead exposures. As well, California passed legislation in 2006 for the Food and Drug Branch (FDB) of the state health department to test and identify lead in candy. This report presents health alert data from California over a 14-y period, compares data before and after the candy testing program began, and examines country of origin, ZIP code data, and time from candy testing to release of health alerts for lead-contaminated candies for 2011-2012. After 2007, health alerts issued for lead in candy and food increased significantly. Analysis of candy-testing data indicated that multiple counties and ZIP codes were affected. Seventeen candies with high lead concentrations were identified, resulting in rapid dissemination (food and candy testing programs provides an opportunity to identify and immediately act to remove nonpaint sources of lead affecting children. https://doi.org/10.1289/EHP2582.

  8. Application of Short-Range LIDAR in Early Alerting for Low-Level Windshear and Turbulence at Hong Kong International Airport

    Directory of Open Access Journals (Sweden)

    K. K. Hon

    2014-01-01

    Full Text Available Hong Kong Observatory currently uses a series of meteorological instruments, including long-range LIDAR (light detection and ranging systems, to provide alerting services of low-level windshear and turbulence for Hong Kong International Airport. For some events that are smaller in spatial dimensions and are rapidly changing, such as low altitude windshear and turbulence associated with buildings or man-made structures, it would be necessary to involve meteorological instruments that offer greater spatial resolution. Therefore, the Observatory has set up a short-range LIDAR on the roof of the AsiaWorld-Expo during the summers over the past several years, conducting field research on the feasibility of strengthening early alerting for windshear and turbulence over the north runway’s eastern arrival runway (Runway 25RA and developing an automated early alerting algorithm. This paper takes the pilot reports for Runway 25RA during the 2013 field research as verification samples, using different thresholds for radial wind velocity spatial and temporal changes detected by the short-range LIDAR to calculate the relative operating characteristic (ROC curve, and analyzes its early alerting performance.

  9. Physicians' Perceptions on the usefulness of contextual information for prioritizing and presenting alerts in computerized physician order entry systems

    NARCIS (Netherlands)

    Jung, Martin; Riedmann, Daniel; Hackl, Werner O.; Hoerbst, Alexander; Jaspers, Monique W.; Ferret, Laurie; Lawton, Kitta; Ammenwerth, Elske

    2012-01-01

    Background: One possible approach towards avoiding alert overload and alert fatigue in Computerized Physician Order Entry (CPOE) systems is to tailor their drug safety alerts to the context of the clinical situation. Our objective was to identify the perceptions of physicians on the usefulness of

  10. Advantages and Disadvantages of Educational Email Alerts for Family Physicians: Viewpoint

    Science.gov (United States)

    Badran, Hani; Grad, Roland

    2015-01-01

    Background Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. Objective The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians’ knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants’ suggestions to improve email alert services for CME. Methods We conducted a qualitative descriptive study using the “Knowledge, Attitude, Behavior” model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. Results All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. Conclusions The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts. PMID:25803184

  11. A clinical data warehouse-based process for refining medication orders alerts.

    Science.gov (United States)

    Boussadi, Abdelali; Caruba, Thibaut; Zapletal, Eric; Sabatier, Brigitte; Durieux, Pierre; Degoulet, Patrice

    2012-01-01

    The objective of this case report is to evaluate the use of a clinical data warehouse coupled with a clinical information system to test and refine alerts for medication orders control before they were fully implemented. A clinical decision rule refinement process was used to assess alerts. The criteria assessed were the frequencies of alerts for initial prescriptions of 10 medications whose dosage levels depend on renal function thresholds. In the first iteration of the process, the frequency of the 'exceeds maximum daily dose' alerts was 7.10% (617/8692), while that of the 'under dose' alerts was 3.14% (273/8692). Indicators were presented to the experts. During the different iterations of the process, 45 (16.07%) decision rules were removed, 105 (37.5%) were changed and 136 new rules were introduced. Extensive retrospective analysis of physicians' medication orders stored in a clinical data warehouse facilitates alert optimization toward the goal of maximizing the safety of the patient and minimizing overridden alerts.

  12. Automaticity of phasic alertness: Evidence for a three-component model of visual cueing.

    Science.gov (United States)

    Lin, Zhicheng; Lu, Zhong-Lin

    2016-10-01

    The automaticity of phasic alertness is investigated using the attention network test. Results show that the cueing effect from the alerting cue-double cue-is strongly enhanced by the task relevance of visual cues, as determined by the informativeness of the orienting cue-single cue-that is being mixed (80 % vs. 50 % valid in predicting where the target will appear). Counterintuitively, the cueing effect from the alerting cue can be negatively affected by its visibility, such that masking the cue from awareness can reveal a cueing effect that is otherwise absent when the cue is visible. Evidently, then, top-down influences-in the form of contextual relevance and cue awareness-can have opposite influences on the cueing effect from the alerting cue. These findings lead us to the view that a visual cue can engage three components of attention-orienting, alerting, and inhibition-to determine the behavioral cueing effect. We propose that phasic alertness, particularly in the form of specific response readiness, is regulated by both internal, top-down expectation and external, bottom-up stimulus properties. In contrast to some existing views, we advance the perspective that phasic alertness is strongly tied to temporal orienting, attentional capture, and spatial orienting. Finally, we discuss how translating attention research to clinical applications would benefit from an improved ability to measure attention. To this end, controlling the degree of intraindividual variability in the attentional components and improving the precision of the measurement tools may prove vital.

  13. Advantages and disadvantages of educational email alerts for family physicians: viewpoint.

    Science.gov (United States)

    Badran, Hani; Pluye, Pierre; Grad, Roland

    2015-02-27

    Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians' knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants' suggestions to improve email alert services for CME. We conducted a qualitative descriptive study using the "Knowledge, Attitude, Behavior" model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts.

  14. [Detection of Brucella with an automatic hemoculture system: Bact/Alert].

    Science.gov (United States)

    Casas, J; Partal, Y; Llosá, J; Leiva, J; Navarro, J M; de la Rosa, M

    1994-12-01

    The ability of in vitro and in vivo detection of Brucella spp. with the Bact/Alert system was studied. Three strains of Brucella melitensis and two of Brucella abortus were used. Different dilutions of the five strains were performed in trypticase soy broth (TSB), achieving concentrations of 1 cfu/ml, 5 cfu/ml, 10 cfu/ml and 100 cfu/ml. Ten ml of each dilution and strain were inoculated into 5 aerobic bottles Bact/Alert and 5 biphasic Hemóline bottles. Furthermore, over a 9 month period, 8,216 bottles of Bact/Alert bottles from hospitalized patients and from the emergency department were processed in the authors' laboratory. The mean detection time for Brucella growth was from 2 to 3 days with the Bact/Alert system, and 14 days in the biphasic bottles. Former bottles processed in the authors' laboratory, 11 aerobic bottles belonged to 5 patients in whom brucelosis was confirmed by bloodculture. The Bact/Alert system detected Brucella melitensis in only on bottle at 2.9 days of incubation. In 7 bottles Bact/Alert detected B. melitensis by a blind pass of these bottles at 10 to 20 days of incubation. These results suggest that the Bact/Alert system does not totally solve the diagnosis of brucellosis. Blind passes of the bloodcultures are required.

  15. Generalized Philosophy of Alerting with Applications for Parallel Approach Collision Prevention

    Science.gov (United States)

    Winder, Lee F.; Kuchar, James K.

    2000-01-01

    The goal of the research was to develop formal guidelines for the design of hazard avoidance systems. An alerting system is automation designed to reduce the likelihood of undesirable outcomes that are due to rare failures in a human-controlled system. It accomplishes this by monitoring the system, and issuing warning messages to the human operators when thought necessary to head off a problem. On examination of existing and recently proposed logics for alerting it appears that few commonly accepted principles guide the design process. Different logics intended to address the same hazards may take disparate forms and emphasize different aspects of performance, because each reflects the intuitive priorities of a different designer. Because performance must be satisfactory to all users of an alerting system (implying a universal meaning of acceptable performance) and not just one designer, a proposed logic often undergoes significant piecemeal modification before gamma general acceptance. This report is an initial attempt to clarify the common performance goals by which an alerting system is ultimately judged. A better understanding of these goals will hopefully allow designers to reach the final logic in a quicker, more direct and repeatable manner. As a case study, this report compares three alerting logics for collision prevention during independent approaches to parallel runways, and outlines a fourth alternative incorporating elements of the first three, but satisfying stated requirements. Three existing logics for parallel approach alerting are described. Each follows from different intuitive principles. The logics are presented as examples of three "philosophies" of alerting system design.

  16. A CCTV system with SMS alert (CMDSA): An implementation of pixel processing algorithm for motion detection

    Science.gov (United States)

    Rahman, Nurul Hidayah Ab; Abdullah, Nurul Azma; Hamid, Isredza Rahmi A.; Wen, Chuah Chai; Jelani, Mohamad Shafiqur Rahman Mohd

    2017-10-01

    Closed-Circuit TV (CCTV) system is one of the technologies in surveillance field to solve the problem of detection and monitoring by providing extra features such as email alert or motion detection. However, detecting and alerting the admin on CCTV system may complicate due to the complexity to integrate the main program with an external Application Programming Interface (API). In this study, pixel processing algorithm is applied due to its efficiency and SMS alert is added as an alternative solution for users who opted out email alert system or have no Internet connection. A CCTV system with SMS alert (CMDSA) was developed using evolutionary prototyping methodology. The system interface was implemented using Microsoft Visual Studio while the backend components, which are database and coding, were implemented on SQLite database and C# programming language, respectively. The main modules of CMDSA are motion detection, capturing and saving video, image processing and Short Message Service (SMS) alert functions. Subsequently, the system is able to reduce the processing time making the detection process become faster, reduce the space and memory used to run the program and alerting the system admin instantly.

  17. Measuring emergency department nurses' attitudes towards deliberate self-harm using the Self-Harm Antipathy Scale.

    LENUS (Irish Health Repository)

    Conlon, Mary

    2012-01-31

    The emergency department is an important gateway for the treatment of self-harm patients. Nurses\\' attitudes towards patients who self-harm can be negative and often nurses experience frustration, helplessness, ambivalence and antipathy. Patients are often dissatisfied with the care provided, and meeting with positive or negative attitudes greatly influences whether they seek additional help. A quantitative design was utilised to measure emergency department nurses\\' attitudes towards deliberate self-harm. The \\'Self-Harm Antipathy Scale\\

  18. Does one hour of bright or short-wavelength filtered tablet screenlight have a meaningful effect on adolescents' pre-bedtime alertness, sleep, and daytime functioning?

    Science.gov (United States)

    Heath, Melanie; Sutherland, Cate; Bartel, Kate; Gradisar, Michael; Williamson, Paul; Lovato, Nicole; Micic, Gorica

    2014-05-01

    Electronic media use is prevalent among adolescent populations, as is the frequency of sleeplessness. One mechanism proposed for technology affecting adolescents' sleep is the alerting effects from bright screens. Two explanations are provided. First, screens emit significant amounts of short-wavelength light (i.e. blue), which produces acute alertness and alters sleep timing. Second, later chronotypes are hypothesised to be hypersensitive to evening light. This study analysed the pre-sleep alertness (GO/NOGO task speed, accuracy; subjective sleepiness), sleep (sleep diary, polysomnography), and morning functioning of 16 healthy adolescents (M = 17.4 ± 1.9 yrs, 56% f) who used a bright tablet screen (80 lux), dim screen (1 lux) and a filtered short-wavelength screen (f.lux; 50 lux) for 1 hr before their usual bedtime in a within-subjects protocol. Chronotype was analysed as a continuous between-subjects factor; however, no significant interactions occurred. Significant effects occurred between bright and dim screens for GO/NOGO speed and accuracy. However, the magnitude of these differences was small (e.g. GO/NOGO speed = 23 ms, accuracy = 13%), suggesting minimal clinical significance. No significant effects were found for sleep onset latency, slow-rolling eye movements, or the number of SWS and REM minutes in the first two sleep cycles. Future independent studies are needed to test short (1 hr) vs longer (>2 hrs) screen usage to provide evidence for safe-to-harmful levels of screenlight exposure before adolescents' usual bedtime.

  19. Study supporting the phasing out of environmentally harmful subsidies

    Energy Technology Data Exchange (ETDEWEB)

    Withana, S.; Ten Brink, P.; Franckx, L.; Hirschnitz-Garbers, M.; Mayeres, I.; Oosterhuis, F.; Porsch, L.

    2012-10-15

    The need to reform ineffective or harmful public subsidies has long been recognised and has been a contentious point of discussion for several years. The EU has a long-standing commitment to removing or phasing out environmentally harmful subsidies (EHS). Most recently, the need to phase out EHS is reiterated in the 'Roadmap for a resource efficient Europe' which includes a milestone that 'by 2020 EHS will be phased out, with due regard to the impact on people in need'. Despite several commitments, progress has been slow and subsidies remain an issue in most EU countries. This study focuses specifically on EHS at the level of EU Member States; it identifies key types of EHS and examines cases of existing EHS across a range of environmental sectors and issues, including subsidies from non-action. The study also analyses examples of good practices in the reform of EHS in EU Member States and the lessons that can be learnt from these cases. Finally, based on this analysis, it develops practical recommendations on phasing out and reforming EHS to support the objectives of the Europe 2020 Strategy and the resource efficiency agenda. The study was carried out between January and October 2012 and is based on an analysis of literature and consultation with experts and policy makers. The sectoral cases studied are listed and discussed in the annexes report: agriculture, climate and energy, fisheries, food, forestry, materials, transport, waste, and water.

  20. Harms of prescription opioid use in the United States.

    Science.gov (United States)

    Imtiaz, Sameer; Shield, Kevin D; Fischer, Benedikt; Rehm, Jürgen

    2014-10-27

    Consumption levels of prescription opioids (POs) have increased substantially worldwide, particularly the United States. An emerging perspective implicates increasing consumption levels of POs as the primary system level driving factor behind the observed PO-related harms. As such, the present study aimed to assess the correlations between consumption levels of POs and PO-related harms, including non-medical prescription opioid use (NMPOU), PO-related morbidity and PO-related mortality. Pearson's product-moment correlations were computed using published data from the United States (2001 - 2010). Consumption levels of POs were extracted from the technical reports published by the International Narcotics Control Board, while data for NMPOU was utilized from the National Survey on Drug Use and Health. Additionally, data for PO-related morbidity (substance abuse treatment admissions per 10,000 people) and PO-related mortality (PO overdose deaths per 100,000 people) were obtained from published studies. Consumption levels of POs were significantly correlated with prevalence of NMPOU in the past month (r =0.741, 95% CI =0.208-0.935), past year (r =0.638, 95% CI =0.014-0.904) and lifetime (r =0.753, 95% CI =0.235-0.938), as well as average number of days per person per year of NMPOU among the general population (r =0.900, 95% CI =0.625-0.976) and NMPOU users (r =0.720, 95% CI =0.165-0.929). Similar results were also obtained for PO-related morbidity and PO-related mortality measures. These findings suggest that reducing consumption levels of POs at the population level may be an effective strategy to limit PO-related harms.

  1. Collaborative knowledge acquisition for the design of context-aware alert systems.

    Science.gov (United States)

    Joffe, Erel; Havakuk, Ofer; Herskovic, Jorge R; Patel, Vimla L; Bernstam, Elmer Victor

    2012-01-01

    To present a framework for combining implicit knowledge acquisition from multiple experts with machine learning and to evaluate this framework in the context of anemia alerts. Five internal medicine residents reviewed 18 anemia alerts, while 'talking aloud'. They identified features that were reviewed by two or more physicians to determine appropriate alert level, etiology and treatment recommendation. Based on these features, data were extracted from 100 randomly-selected anemia cases for a training set and an additional 82 cases for a test set. Two staff internists assigned an alert level, etiology and treatment recommendation before and after reviewing the entire electronic medical record. The training set of 118 cases (100 plus 18) and the test set of 82 cases were explored using RIDOR and JRip algorithms. The feature set was sufficient to assess 93% of anemia cases (intraclass correlation for alert level before and after review of the records by internists 1 and 2 were 0.92 and 0.95, respectively). High-precision classifiers were constructed to identify low-level alerts (precision p=0.87, recall R=0.4), iron deficiency (p=1.0, R=0.73), and anemia associated with kidney disease (p=0.87, R=0.77). It was possible to identify low-level alerts and several conditions commonly associated with chronic anemia. This approach may reduce the number of clinically unimportant alerts. The study was limited to anemia alerts. Furthermore, clinicians were aware of the study hypotheses potentially biasing their evaluation. Implicit knowledge acquisition, collaborative filtering and machine learning were combined automatically to induce clinically meaningful and precise decision rules.

  2. The impact of self-harm by young people on parents and families: a qualitative study.

    Science.gov (United States)

    Ferrey, Anne E; Hughes, Nicholas D; Simkin, Sue; Locock, Louise; Stewart, Anne; Kapur, Navneet; Gunnell, David; Hawton, Keith

    2016-01-06

    Little research has explored the full extent of the impact of self-harm on the family. This study aimed to explore the emotional, physical and practical effects of a young person's self-harm on parents and family. We used qualitative methods to explore the emotional, physical and practical effects of a young person's self-harm on their parents and family. We conducted a thematic analysis of thirty-seven semistructured narrative interviews with parents of young people who had self-harmed. After the discovery of self-harm, parents described initial feelings of shock, anger and disbelief. Later reactions included stress, anxiety, feelings of guilt and in some cases the onset or worsening of clinical depression. Social isolation was reported, as parents withdrew from social contact due to the perceived stigma associated with self-harm. Parents also described significant impacts on siblings, ranging from upset and stress to feelings of responsibility and worries about stigma at school. Siblings had mixed responses, but were often supportive. Practically speaking, parents found the necessity of being available to their child often conflicted with the demands of full-time work. This, along with costs of, for example, travel and private care, affected family finances. However, parents generally viewed the future as positive and hoped that with help, their child would develop better coping mechanisms. Self-harm by young people has major impacts on parents and other family members. Clinicians and staff who work with young people who self-harm should be sensitive to these issues and offer appropriate support and guidance for families. 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/

  3. Harm reduction and “Clean” community: can Viet Nam have both?

    Directory of Open Access Journals (Sweden)

    Khuat Thu

    2012-07-01

    Full Text Available Abstract The findings of our research show that while police play multiple roles in the fight against drug-related crime, they often perceived their tasks – especially preventing and controlling drug use on the one hand, and supporting harm reduction on the other – as contradictory, and this creates tensions in their work and relations with their communities. Although they are leaders and implementers of harm reduction, not all police know about it, and some remain skeptical or perceive it as contradictory to their main task of fighting drugs. Methadone treatment is seen by some as in competition with their main task of coordinating conventional drug treatment in the rehabilitation center. The history of drug use and the evolution of discourses on drug use in Viet Nam have created these conflicting pressures on police, and thus created contradictory expectations and led to different views and attitudes of police regarding various harm reduction measures. This might aid understanding why, despite the comprehensive and progressive policies on HIV/AIDS and harm reduction in Viet Nam, it is not easy for police to actively and effectively support and be involved in harm reduction at the ground level. To promote the wider acceptance of harm reduction the concept of community safety must be expanded to include community health; harm reduction must be integrated into the “new society” movement; and laws and policies need further revision to reduce contradiction between current drug laws and HIV laws. Harm reduction guidelines for police and other actors need to be disseminated and supported, embodying better ways of working between sectors, and all sectors in the partnership require support for building capacity to contribute to the overall goal.

  4. Conceptual and methodological issues in studying alcohol’s harm to others

    Directory of Open Access Journals (Sweden)

    Room Robin

    2016-12-01

    Full Text Available While there is a longer history of concern about alcohol’s harm to others, researchers’ interest has intensified in the last few years. The background of variation in concern over time in different societies is outlined. Three main traditions of research have emerged: population survey studies of such harm from the perspective of the ‘other’; analysis of register or case-record data which includes information on the involvement of another’s drinking in the case; and qualitative studies of interactions and experiences involved in particular harms from others’ drinking. In the course of the new spate of studies, many conceptual and methodological issues have arisen, some of which are considered in the paper. The diverse types of harms which have been studied are discussed. The social and personal nature of many of the harms means they do not fit easily into a disability or costing model, raising questions about how they might best be counted and aggregated. Harm from others’ drinking is inherently interactional, and subject to varying definitions of what counts as harm. The attribution to drinking, in the usual situation of conditional causation, is also subject to variation, with moral politics potentially coming into play. For measurement and comparison, account needs to be taken of cultural and individual variations in perceptions and thresholds of what counts as a harm, and attribution to alcohol. The view from the windows of a population survey and of a response agency case register are often starkly different, and research is needed, as an input and spur to policy initiatives, on what influences this difference and whether and how the views might be reconciled.

  5. Sharply Reduced but Still Heavy Self-Harm Burdens in Hubei Province, China, 1990–2015

    Directory of Open Access Journals (Sweden)

    Jingju Pan

    2018-02-01

    Full Text Available The aims of this study were to describe fatal and non-fatal self-harm burdens, as well as burdens from the main preventable risk factors, and to investigate the different suicide methods in Hubei province in central China utilizing data from both Global Burden of Disease Study 2015 and Hubei Disease Surveillance Points system. All self-harm burdens including mortality, years of life lost (YLLs, prevalence, years lived with disability (YLDs, and disability adjusted life-years (DALYs consistently demonstrated downward trends in Hubei from 1990 to 2015, with a bigger decline gap observed among females and narrower decreasing amplitudes among the elderly. Hubei experienced much higher age-standardized rates for self-harm mortality (22.0 per 100,000, YLLs (560.1 per 100,000 and DALYs (563.9 per 100,000 than the national (9.0, 292.3 and 295.0 per 100,000 respectively and global levels (11.5, 453.3 and 457.9 per 100,000 respectively in 2015. Self-harm burdens have begun shifting from females to males and the elderly suffered more self-harm burdens than other age groups. Alcohol use accounted for 20.9% of all self-harm DALYs for males, whereas intimate partner violence accounted for 24.4% of all self-harm DALYs for females. Poisoning, mainly pesticide self-poisoning, was still the most common method of suicide. Effective interventions by multi-sectoral collaboration are urgently needed to reduce the alarmingly heavy self-harm burdens in Hubei.

  6. Neural correlates of conventional and harm/welfare-based moral decision-making.

    Science.gov (United States)

    White, Stuart F; Zhao, Hui; Leong, Kelly Kimiko; Smetana, Judith G; Nucci, Larry P; Blair, R James R

    2017-12-01

    The degree to which social norms are processed by a unitary system or dissociable systems remains debated. Much research on children's social-cognitive judgments has supported the distinction between "moral" (harm/welfare-based) and "conventional" norms. However, the extent to which these norms are processed by dissociable neural systems remains unclear. To address this issue, 23 healthy participants were scanned with functional magnetic resonance imaging (fMRI) while they rated the wrongness of harm/welfare-based and conventional transgressions and neutral vignettes. Activation significantly greater than the neutral vignette baseline was observed in regions implicated in decision-making regions including rostral/ventral medial frontal, anterior insula and dorsomedial frontal cortices when evaluating both harm/welfare-based and social-conventional transgressions. Greater activation when rating harm/welfare-based relative to social-conventional transgressions was seen through much of ACC and bilateral inferior frontal gyrus. Greater activation was observed in superior temporal gyrus, bilateral middle temporal gyrus, left PCC, and temporal-parietal junction when rating social-conventional transgressions relative to harm/welfare-based transgressions. These data suggest that decisions regarding the wrongness of actions, irrespective of whether they involve care/harm-based or conventional transgressions, recruit regions generally implicated in affect-based decision-making. However, there is neural differentiation between harm/welfare-based and conventional transgressions. This may reflect the particular importance of processing the intent of transgressors of conventional norms and perhaps the greater emotional content or salience of harm/welfare-based transgressions.

  7. Effectiveness of policies restricting hours of alcohol sales in preventing excessive alcohol consumption and related harms.

    Science.gov (United States)

    Hahn, Robert A; Kuzara, Jennifer L; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci; Middleton, Jennifer Cook; Lawrence, Briana

    2010-12-01

    Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team's initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms. Published by Elsevier Inc.

  8. Suicidal behavior and self-harm in girls with eating disorders

    Directory of Open Access Journals (Sweden)

    Koutek J

    2016-04-01

    Full Text Available Jiri Koutek, Jana Kocourkova, Iva Dudova Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Comorbid psychopathology, including self-harm and suicidal behavior, is often found in patients with eating disorders. To better understand the reasons for high comorbid psychopathology among eating disorders, self-harm, and suicidal behavior, we examined this comorbidity in female patients hospitalized with eating disorders. In a sample of 47 girls admitted for anorexia nervosa, atypical anorexia nervosa, and bulimia nervosa, 72% had depressive symptoms, 11% had obsessive-compulsive symptoms, 9% had anxiety disorder, 23% had substance abuse, and 57% had disharmonious personality development. Suicidal behavior was present in 60% of patients and self-harm in 49%. Association was found between self-harm and suicidality. In all, 68% of girls with eating disorders had a positive score in the Children’s Depression Inventory questionnaire and 62% of them in the Child Adolescent Suicidal Potential Index questionnaire. Clinical examination of girls with eating disorders should focus on identifying the risk of suicidal behavior and self-harm. Keywords: eating disorders, child, adolescent, self-harm, suicidal behavior

  9. Effectiveness of Policies Restricting Hours of Alcohol Sales in Preventing Excessive Alcohol Consumption and Related Harms

    Science.gov (United States)

    Hahn, Robert A.; Kuzara, Jennifer L.; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S.; Toomey, Traci; Middleton, Jennifer Cook; Lawrence, Briana

    2013-01-01

    Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team’s initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms. PMID:21084080

  10. Correlates of self-harm and suicide attempts in justice-involved young people

    Science.gov (United States)

    Spivak, Benjamin; Borschmann, Rohan; Kinner, Stuart A.; Hachtel, Henning

    2018-01-01

    The purpose of this study was to ascertain the prevalence and correlates of self-harm among young people in detention in Australia. The sample included 215 (177 male; 38 female) young people who were in youth detention in the state of Victoria, Australia. Participants were administered a series of questionnaires related to self-harm, mental health, socio-environmental experiences and behaviours. Overall, one-third (33%) of the sample reported previous self-harm and 12% reported at least one suicide attempt. In a multivariate logistic regression analysis, a history of childhood trauma, contact with mental health services, and low educational interest significantly increased the likelihood of self-harm. Young people who reported a suicide attempt scored significantly higher on the measure of childhood trauma than did youth who had engaged in non-suicidal self-harm. Findings demonstrate a strong connection between childhood traumatic experiences and suicidal behaviours for youth in detention. Trauma histories and mental health concerns must be considered when identifying youth at increased risk of self-harm. PMID:29447289

  11. Implementation Of CAN Based Intelligent Driver Alert System

    Directory of Open Access Journals (Sweden)

    Yin Mar Win Kyaw Myo Maung Maung

    2015-08-01

    Full Text Available This system is an attempt to analyze Intelligent Driver Alert System Using CAN Protocol. CAN Controller Area Network offer an efficient communication protocol among sensors actuators controllers and other nodes in real-time applications and is known for its simplicity reliability and high performance. It has given an effective way by which can increase the car and driver safety. This system presents the development and implementation of a digital driving system for a semi-autonomous vehicle to improve the driver-vehicle interface using microcontroller based data acquisition system that uses ADC to bring all control data from analog to digital format. In this system the signal information like temperature LM35 sensor if the temperature increase above the 60 o C and ultrasonic sensor is adapted to measure the distance between the object and vehicle if obstacle is detected within 75cm from the vehicle the controller gives buzzer to the driver speed measure using RPM sensor if revolution increase up to 1200 per minute controller act and to avoid the maximum revolution and to check the fuel level continuously and display in the percentage if fuel level below 20 percent the controller also gives buzzer to the driver and distance fuel level and temperature continuously display on the LCD.

  12. Alternative Opportunistic Alert Diffusion to Support Infrastructure Failure during Disasters

    Directory of Open Access Journals (Sweden)

    Farouk Mezghani

    2017-10-01

    Full Text Available Opportunistic communications present a promising solution for disaster network recovery in emergency situations such as hurricanes, earthquakes, and floods, where infrastructure might be destroyed. Some recent works in the literature have proposed opportunistic-based disaster recovery solutions, but they have omitted the consideration of mobile devices that come with different network technologies and various initial energy levels. This work presents COPE, an energy-aware Cooperative OPportunistic alErt diffusion scheme for trapped survivors to use during disaster scenarios to report their position and ease their rescue operation. It aims to maintain mobile devices functional for as long as possible for maximum network coverage until reaching proximate rescuers. COPE deals with mobile devices that come with an assortment of networks and aims to perform systematic network interface selection. Furthermore, it considers mobile devices with various energy levels and allows low-energy nodes to hold their charge for longer time with the support of high-energy nodes. A proof-of-concept implementation has been performed to study the doability and efficiency of COPE, and to highlight the lessons learned.

  13. The effect of petroleum spills on permafrost at CFS Alert

    International Nuclear Information System (INIS)

    Haidar, S.; Jarrett, P.

    1997-01-01

    Site investigations have been carried out at two decommissioned tank farm sites at Canadian Forces Station Alert on the northern tip of Ellesmere Island. The purpose was to study the mechanism of spilt fuel movement in frozen ground and its effects on frozen soils. The investigations consisted of sampling to depths below the permafrost table to assess vertical fuel migration, hydrocarbon pollutant concentration and water content. Results showed vertical migration of spilled fuel into permafrost. The migration was attributed to gravity drainage through interconnected air voids in fill material or movement through fissures in the soil induced by thermal contraction. Unweathered contaminants were found below the liners on top of the permafrost, believed to have been caused by holes in the liner. The entrapment of the spilled fuel may have been responsible for the enhanced vertical migration of contaminants observed at these sites. It was concluded that permafrost should not be considered as an impermeable barrier to contaminants with freezing points below 0 degree C. 4 figs

  14. Technical features of a low-cost earthquake alert system

    International Nuclear Information System (INIS)

    Harben, P.

    1991-01-01

    The concept and features of an Earthquake Alert System (EAS) involving a distributed network of strong motion sensors is discussed. The EAS analyzes real-time data telemetered to a central facility and issues an areawide warning of a large earthquake in advance of the spreading elastic wave energy. A low-cost solution to high-cost estimates for installation and maintenance of a dedicated EAS is presented that makes use of existing microseismic stations. Using the San Francisco Bay area as an example, we show that existing US Geological Survey microseismic monitoring stations are of sufficient density to form the elements of a prototype EAS. By installing strong motion instrumentation and a specially developed switching device, strong ground motion can be telemetered in real-time to the central microseismic station on the existing communication channels. When a large earthquake occurs, a dedicated real-time central processing unit at the central microseismic station digitizes and analyzes the incoming data and issues a warning containing location and magnitude estimations. A 50-station EAS of this type in the San Francisco Bay area should cost under $70,000 to install and less than $5,000 annually to maintain

  15. SAFETY ALERT: Electrical insulation defect on safety helmets

    CERN Multimedia

    HSE Unit

    2013-01-01

    Contrarily to the information provided until 31 May 2013, some “Euro Protection” safety helmets do not respect any of the requirements for electrical insulation.   This alert concerns the safety helmets identified under the following SCEM numbers: 50.43.30.050.4 white 50.43.30.060.2 yellow 50.43.30.070.0 blue This amounts up to several hundreds of helmets on the CERN site. People who need to wear an electrically insulated safety helmet for their activities, must from now on acquire a duly insulated item to be found on the CERN store under the following SCEM numbers: 50.43.30.210.6: Petzl Vertex ST Helmet (without vent) 50.43.30.300.1: IDRA Helmet with a visor for electrical work As for the people who do not need to wear an electrically insulated helmet for their activities, they can continue working with the aforementioned helmets. For your information, please take note of the maximum use limit of each helmet: “Euro Protection” Safety Helme...

  16. Brief Report: The Self Harm Questionnaire--A New Tool Designed to Improve Identification of Self Harm in Adolescents

    Science.gov (United States)

    Ougrin, Dennis; Boege, Isabel

    2013-01-01

    The Self Harm Questionnaire (SHQ) aiming at identification of self-harm in adolescents has been developed and piloted in a sample of 12-17 year olds (n = 100). The adolescents were recruited from both in- and outpatient psychiatric services. Concurrent validity of the SHQ was evaluated by comparing the SHQ results with recorded self harm in the…

  17. Harmfulness of smoking among high school students

    Directory of Open Access Journals (Sweden)

    Iwona Rotter

    2013-03-01

    Full Text Available Introduction: The aim of the study was to assess the level of awareness of smoking and non smoking students on harmful impact of nicotine and cigarette smoke on human body. Material and methods: The study was carried out in March 2011 in high schools in Szczecin. Own elaborated questionnaire was used. 288 students from high school, technical college and vocational school were tested. Results: The majority of responders (95,1% claimed that cigarette smoke is harmful both for passive and active smokers. They most often pinpoint the direct cause connected with smoking to pulmonary diseases (264 persons and cancers (240 persons. Almost 90% of students found negative impact of tobacco products on development of fetus of pregnant women. Overwhelming majority of respondents (83,2% feels anxious if it comes to stay in a room filled with smoke. Conclusions: The awareness of high school students on negative influence of smoking on human body is quite satisfactory, but there is still a need for more education in the range of diseases and symptoms connected with smoking.

  18. FACEBOOK AND WHATSAPP: BENEFICIAL OR HARMFUL?

    Directory of Open Access Journals (Sweden)

    Sankalp Raj

    2015-04-01

    Full Text Available New innovations and advances in science and technology in the present day have made considerable and significant changes in the lifestyle of people all around the globe. Communication from one part of the world to another is possible at the hit of a button . Social networking is being rampantly used everywhere and by everybody, be it youngsters or the older generation. Facebook and Whatsapp are the most commonly used means of communication in social networking at present. Smart phones functioning as minicomp uters with fast internet connectivity in the pockets of today’s technosavy generation have made them create and spend most of their time interacting with people in a virtual world. There is an urgent need to understand the dynamics of social media and its effects on the lifestyle of people. Studies documenting the same have been very few. This study was conducted to understand the benefits and harms towards health and academics of MBBS students. This cross - sectional study on 147 MBBS students revealed inter esting findings and opinions of the students. Effects of Facebook and What Sapp on productivity and sleep disturbances due to it were the significant findings of the study. Facebook and Whatsapp can be considered both beneficial and harmful and it solely d epends on how it is being put to use

  19. Perceived harmfulness of substance use: A pilot study

    Directory of Open Access Journals (Sweden)

    Siddharth Sarkar

    2014-01-01

    Full Text Available Background: Harm ratings of substances help in understanding the perception toward substance use and formulating policies. Evidence of such harm ratings by substance users and their caregivers provides a clearer perspective of those who experience and observe such harm closely. Materials and Methods: Substance users and their caregivers were recruited from the Drug De-addiction and Treatment Centre of PGIMER, Chandigarh. Sociodemographic details of the subjects were noted. The subjects were then asked to rate a list of psychoactive preparations according to the harms they thought the preparation caused. The list of substances was developed taking into consideration substance commonly encountered in the geographical area. The harm ratings were transformed on a scale of 0-100. Results: All subjects were males and majority of them were educated above 10 th standard, were not employed and belonged to urban background. Most of them had taken psychoactive substances in their lifetimes but were currently abstinent. Most of the subjects endorsed intravenous drugs as the most harmful, followed by heroin. Beer and chewable tobacco considered the least harmful substances. Greater degree of education was associated with lower harm rankings for heroin, cannabis, dextropropoxyphene, and raw opium; while urban residence was associated with greater harm ratings for cannabis and raw opium. Differences in the harms were perceived for different preparations of the same active compound for alcohol and nicotine. Conclusion: Harm ratings of substances can be a useful guide while formulating policies and allocating resources. Need for further research extending this pilot study is emphasized.

  20. A Systematic Review of Social Media Use to Discuss and View Deliberate Self-Harm Acts.

    Science.gov (United States)

    Dyson, Michele P; Hartling, Lisa; Shulhan, Jocelyn; Chisholm, Annabritt; Milne, Andrea; Sundar, Purnima; Scott, Shannon D; Newton, Amanda S

    2016-01-01

    To conduct a systematic review of studies of social media platforms used by young people to discuss and view deliberate self-harm. 11 electronic databases were searched from January 2000 to January 2012 for primary research; in June 2014 an updated search of Medline was conducted. Grey literature sources were also searched. Search results were screened by two reviewers. Data were extracted by one reviewer and verified by another. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Due to heterogeneity in study objectives and outcomes, results were not pooled; a narrative analysis is presented. 26 studies were included. Most were conducted in Canada or the UK (30.8% each), used qualitative designs (42.3%), and evaluated discussion forums (73.1%). Participants were most often aged 19-21 years (69.2%), female (mean 68.6%), and 19.2% had a documented history of depression. The social media platforms evaluated were commonly supportive and provided a sense of community among users. Support included suggestions for formal treatment, advice on stopping self-harming behavior, and encouragement. Harms included normalizing and accepting self-harming behavior; discussion of motivation or triggers, concealment, suicidal ideation or plans; and live depictions of self-harm acts. Although this evidence is limited by its descriptive nature, studies identify beneficial and detrimental effects for young people using social media to discuss and view deliberate self-harm. The connections users make online may be valuable to explore for therapeutic benefit. Prospective, longitudinal investigations are needed to identify short- and long-term potential harms associated with use.

  1. A Systematic Review of Social Media Use to Discuss and View Deliberate Self-Harm Acts.

    Directory of Open Access Journals (Sweden)

    Michele P Dyson

    Full Text Available To conduct a systematic review of studies of social media platforms used by young people to discuss and view deliberate self-harm.11 electronic databases were searched from January 2000 to January 2012 for primary research; in June 2014 an updated search of Medline was conducted. Grey literature sources were also searched. Search results were screened by two reviewers. Data were extracted by one reviewer and verified by another. Methodological quality was assessed using the Mixed Methods Appraisal Tool.Due to heterogeneity in study objectives and outcomes, results were not pooled; a narrative analysis is presented. 26 studies were included. Most were conducted in Canada or the UK (30.8% each, used qualitative designs (42.3%, and evaluated discussion forums (73.1%. Participants were most often aged 19-21 years (69.2%, female (mean 68.6%, and 19.2% had a documented history of depression. The social media platforms evaluated were commonly supportive and provided a sense of community among users. Support included suggestions for formal treatment, advice on stopping self-harming behavior, and encouragement. Harms included normalizing and accepting self-harming behavior; discussion of motivation or triggers, concealment, suicidal ideation or plans; and live depictions of self-harm acts.Although this evidence is limited by its descriptive nature, studies identify beneficial and detrimental effects for young people using social media to discuss and view deliberate self-harm. The connections users make online may be valuable to explore for therapeutic benefit. Prospective, longitudinal investigations are needed to identify short- and long-term potential harms associated with use.

  2. A Systematic Review of Social Media Use to Discuss and View Deliberate Self-Harm Acts

    Science.gov (United States)

    Dyson, Michele P.; Hartling, Lisa; Shulhan, Jocelyn; Chisholm, Annabritt; Milne, Andrea; Sundar, Purnima; Scott, Shannon D.; Newton, Amanda S.

    2016-01-01

    Objective To conduct a systematic review of studies of social media platforms used by young people to discuss and view deliberate self-harm. Study Design 11 electronic databases were searched from January 2000 to January 2012 for primary research; in June 2014 an updated search of Medline was conducted. Grey literature sources were also searched. Search results were screened by two reviewers. Data were extracted by one reviewer and verified by another. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Results Due to heterogeneity in study objectives and outcomes, results were not pooled; a narrative analysis is presented. 26 studies were included. Most were conducted in Canada or the UK (30.8% each), used qualitative designs (42.3%), and evaluated discussion forums (73.1%). Participants were most often aged 19–21 years (69.2%), female (mean 68.6%), and 19.2% had a documented history of depression. The social media platforms evaluated were commonly supportive and provided a sense of community among users. Support included suggestions for formal treatment, advice on stopping self-harming behavior, and encouragement. Harms included normalizing and accepting self-harming behavior; discussion of motivation or triggers, concealment, suicidal ideation or plans; and live depictions of self-harm acts. Conclusions Although this evidence is limited by its descriptive nature, studies identify beneficial and detrimental effects for young people using social media to discuss and view deliberate self-harm. The connections users make online may be valuable to explore for therapeutic benefit. Prospective, longitudinal investigations are needed to identify short- and long-term potential harms associated with use. PMID:27191728

  3. Can harmful tax competition be curbed at the international level?

    Energy Technology Data Exchange (ETDEWEB)

    Gjersti, Per O. [Finans- og Tolldepartementet, Oslo (Norway)

    1998-07-01

    This presentation discusses the following issues: (1) Good vs harmful tax competition?, (2) How to identify harmful competition?, (3) What is the economic and social impact of harmful tax competition?, (4) What can be done about harmful tax competition? There are three levels, the EU level, the OECD level and the global level. Existing measures to counteract harmful tax practices are insufficient because action by one country merely shifts activity to another country and puts its tax payers at a competitive disadvantage and because coordination action eases political pressure. The EU code of good conduct and the OECD guidelines for dealing with harmful preferential tax regimes are compared, with respect to general features, with respect to key factors to identify harmful measures, and with respect to general scope.

  4. Intensification of sewage treatment processes from harmful substances

    International Nuclear Information System (INIS)

    Asadov, S.M.

    2007-01-01

    Full text: Intensive development of power, chemical, oil, machine-building and other industries results in increase of industrial toxic emissions. Local pollutions as a result of emissions of the industrial enterprises in many cases surpass the maximum permissible sanitary norms. E.g. works connected to an oil recovery, have led to pollution of huge territories of the Azerbaijan Republic, including Caspian Sea. Development of scientific bases of optimization of operating practices of industrial sewage treatment will allow to liquidate the harmful impurities. It is necessary for preservation of the environment to increase the clearing and sewage quality degree. During modeling a real process of sewage treatment from polluting impurities we need to build more and more complex models. It demands in return the application of applied mathematics methods for process of clearing of liquids. General theory and technology of sewage treatment, in particular, from heavy metals, radioactive nuclides now are absent. Achievement of an object provides for solution of the following problems: a) Research of laws of influence of various technological and physical and chemical parameters on efficiency of waste treatment from heavy metals and radioactive nuclides; b) Development of the effective reagents, allowing to remove from sewage cations of toxic heavy metals and radioactive nuclides; c) Construction of statistical models of an experimental material on clearing concrete sewage; d) Modeling of searches of optimum modes of sewage treatment processes from heavy metals ions; e) Development of optimum processes of sewage treatment from toxic heavy metals ions. The mentioned above problems are scantily studied both in experimental, and in the theoretical point of view. Expected scientific novelty of the offered project can be made in the following: Technological modes of carrying out of deep clearing processes of real sewage from toxic impurities, in particular from heavy metals ions

  5. Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program

    Science.gov (United States)

    DeGroot, R. M.; Strauss, J. A.; Given, D. D.; Cochran, E. S.; Burkett, E. R.; Long, K.

    2016-12-01

    Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing an EEW system for the West Coast of the United States. To be an integral part of successful implementation, EEW engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education efforts. Our presentation outlines how the USGS and its partners will approach this effort in the context of the EEW system through the work of a multistate and multiagency committee that participates in the design, implementation, and evaluation of a portfolio of programs and products. This committee, referred to as the ShakeAlert Joint Committee for Communication, Education, and Outreach (ShakeAlert CEO), is working to identify, develop, and cultivate partnerships with EEW stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on EEW, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the EEW alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive an EEW warning. The USGS and the participating states and agencies acknowledge that the implementation of EEW is a collective effort requiring the participation of hundreds of stakeholders committed to ensuring public accessibility.

  6. No harm done? Assessing risk of harm under the federal breach notification rule.

    Science.gov (United States)

    Dimick, Chris

    2010-08-01

    Provisions within the HITECH Act require that covered entities notify individuals if their protected health information is breached. However, the current regulation allows an exemption if the risk of harm is slight. Assessing risk can be subjective, and privacy officers have been working to create methods to conduct and document their analyses.

  7. Harming High Performers : A Social Comparison Perspective on Interpersonal Harming in Work Teams

    NARCIS (Netherlands)

    Lam, Catherine K.; Van der Vegt, Gerben S.; Walter, Frank; Huang, Xu; Huang, Xin

    This study developed a multilevel model of the interpersonal harming behavior associated with social comparison processes in work teams. We tested this model using temporally lagged data from a sample of student teams (Study 1) and cross-sectional data from a sample of work teams in a

  8. Are long physician working hours harmful to patient safety?

    Science.gov (United States)

    Ehara, Akira

    2008-04-01

    Pediatricians of Japanese hospitals including not only residents but also attending physicians work long hours, and 8% work for >79 h per week. Most of them work consecutively for >or=32 h when they are on call. The aim of the present study was to evaluate the effect of long work hours on patient safety. The electronic databases MEDLINE and EMBASE to searched identify the English- and Japanese-language literature for studies on work hours, medical errors, patient safety, and malpractice for years 1966-2005. Studies that analyzed the relationship between physician work hours and outcomes directly related to patient safety were selected. Seven studies met the criteria. Four studies suggest that reduction of work hours has a favorable effect on patient safety indicators. In the other three studies no significant changes of the indicators were observed, but no report found that shorter work hours were harmful to patient safety. Decrease of physician work hours is not harmful but favorable to patient safety.

  9. Suicidal ideation and self-harm following K2 use.

    Science.gov (United States)

    Thomas, Shannon; Bliss, Sarah; Malik, Mohammed

    2012-11-01

    There is emerging evidence of adverse effects associated with K2 and similar synthetic cannabinoid compounds marketed as herbal alternatives to marijuana. Few studies were identified regarding the psychiatric effects of K2, including suicidal ideation, and to our knowledge none have been written related to self-harm following use of K2. A healthy 20-year-old single Caucasian male with no previous psychiatric diagnoses or treatment was brought by police to the ED with acute agitation, confusion, suicidal ideation, and self-inflicted trauma after smoking K2. Evaluation in the ED was notable for agitation, significant abrasions, respiratory rate of 30, negative UDS, and sinus tachycardia on EKG. Once medically stabilized, he was transferred to the inpatient psychiatric unit for continued monitoring. Upon evaluation on the psychiatric unit the following day, his symptoms had completely resolved, he continued to deny any previous psychiatric history, and was discharged home. K2 and other synthetic cannabinoids have been shown to have significant medical and psychiatric adverse effects and they are still readily available for purchase. Evidence is limited regarding the psychiatric effects; however, synthetic cannabinoid products may potentially lead to suicidal ideation and self-harm behaviors amongst many other psychiatric symptoms.The long-term risks are still unclear, but some studies suggest the possibility of inducing chronic psychotic symptoms and worsening underlying psychiatric illness. Continued research is needed regarding the effects of these substances as well as an increase in public awareness of the risks.

  10. Effect of ergonomics training on agreement between expert and nonexpert ratings of the potential for musculoskeletal harm in manufacturing tasks.

    Science.gov (United States)

    Fethke, Nathan B; Merlino, Linda; Gerr, Fred

    2013-12-01

    To evaluate the effect of ergonomics training on non-ergonomists' ability to recognize and characterize the potential for musculoskeletal harm in manufacturing tasks. Ergonomics training was delivered to members of a participatory ergonomics team in a manufacturing facility. Before and after training, participatory ergonomics team members and the research team rated the potential for musculoskeletal harm for each of 30 tasks. Measures of agreement included Pearson, concordance, and intraclass correlation coefficients. Measures of agreement generally improved after training. The greatest agreement was observed for ratings of the potential for musculoskeletal harm to the low back. The greatest improvement in agreement was observed for ratings of the potential for musculoskeletal harm to the neck/shoulder. The training seemed to improve non-experts' ability to identify the potential for musculoskeletal harm.

  11. Climate change, irrigation, and Israeli agriculture. Will warming be harmful?

    Energy Technology Data Exchange (ETDEWEB)

    Fleischer, Aliza; Lichtman, Ivgenia [Hebrew University of Jerusalem, Jerusalem (Israel); Mendelsohn, Robert [Yale University, New Haven, Connecticut (United States)

    2008-04-15

    This paper utilizes a Ricardian model to test the relationship between annual net revenues and climate across Israeli farms. The study finds that it is important to include the amount of irrigation water available to each farm in order to measure the response of farms to climate. With irrigation water omitted, the model predicts climate change is strictly beneficial. However, with water included, the model predicts that only modest climate changes are beneficial while drastic climate change in the long run will be harmful. Using the AOGCM Scenarios we show that farm net revenue is expected to increase. Although Israel has a relatively warm climate a mild increase in temperature is beneficial due to the ability to supply international markets with farm product early in the season. (author)

  12. Climate change, irrigation, and Israeli agriculture. Will warming be harmful?

    International Nuclear Information System (INIS)

    Fleischer, Aliza; Lichtman, Ivgenia; Mendelsohn, Robert

    2008-01-01

    This paper utilizes a Ricardian model to test the relationship between annual net revenues and climate across Israeli farms. The study finds that it is important to include the amount of irrigation water available to each farm in order to measure the response of farms to climate. With irrigation water omitted, the model predicts climate change is strictly beneficial. However, with water included, the model predicts that only modest climate changes are beneficial while drastic climate change in the long run will be harmful. Using the AOGCM Scenarios we show that farm net revenue is expected to increase. Although Israel has a relatively warm climate a mild increase in temperature is beneficial due to the ability to supply international markets with farm product early in the season. (author)

  13. Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated with hGH

    Science.gov (United States)

    ... Were Treated with hGH Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated with hGH ... Adrenal crisis is a serious condition that can cause death in people who lack the pituitary hormone ACTH. ...

  14. Space Environment Automated Alerts and Anomaly Analysis Assistant (SEA^5) for NASA

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to develop a comprehensive analysis and dissemination system (Space Environment Automated Alerts  & Anomaly Analysis Assistant: SEA5) that will...

  15. Enforcement Alert: EPA Enforcement Efforts Focus on Prevention of Chemical Accidents

    Science.gov (United States)

    This Alert is intended to inform the industry that companies must take responsibility to prevent accidental releases of dangerous chemicals like anhydrous ammonia through compliance with CAA’s Chemical Accident Prevention Program.

  16. Factors affecting driver alertness during the operation of haul trucks in the South African mining industry

    CSIR Research Space (South Africa)

    Schutte, PC

    2003-06-01

    Full Text Available In view of the seriousness of haul trucks accidents, SIMRAC initiated research to identify factors affecting haul truck driver alertness during mining operations. The information obtained during the risk analysis was used to identify possible...

  17. Alerting and vitalizing effects of color temperature during daytime: findings on subjective and objective indicators

    NARCIS (Netherlands)

    Smolders, K.C.H.J.; Kort, de Y.A.W.; Haans, A.; Gennip, van D. A. P.; Ham, J.; Kort, de Y. A. W.

    2011-01-01

    We investigated the effects of correlated colour temperature on alertness, vitality and performance during daytime. Results of a within-groups experiment demonstrate time dependent effects on subjective indicators; objective measures are still being analysed.

  18. A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems.

    Science.gov (United States)

    Phansalkar, Shobha; Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

    2010-01-01

    The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decision support. Last, we suggest actionable recommendations for delivering effective clinical decision support using alerts. A review of studies from the medical informatics literature suggests that many basic human factors principles are not followed, possibly contributing to the lack of acceptance of alerts in clinical information systems. We evaluate the limitations of current alerting philosophies and provide recommendations for improving acceptance of alerts by incorporating human factors principles in their design.

  19. Should people be physically active outdoors on smog alert days?

    Science.gov (United States)

    Campbell, Monica E; Li, Qian; Gingrich, Sarah E; Macfarlane, Ronald G; Cheng, Shouquan

    2005-01-01

    Given the importance of physical activity to well-being, there is a need to encourage people to be physically active year-round. At the same time, many people are vulnerable to adverse health effects from air pollution, especially on smog alert days. This study was undertaken to determine when air pollution levels tend to be lowest so that the public can modify strenuous outdoor activity accordingly. Existing hourly air pollution data for Toronto were analyzed to determine how pollutant levels varied from hour to hour throughout each 24-hour day, to identify the times when pollution levels are at their lowest on average. Pollutant levels vary throughout the day, with concentrations of some pollutants (such as ozone, particles and sulphur dioxide) being highest during mid-day, and others (such as carbon monoxide and nitrogen dioxide) being highest with morning rush hour. Overall, pollutant concentrations tend to be lowest before seven a.m. and after eight p.m. The public should be encouraged to maintain regular physical activity outdoors while monitoring any air pollution-related symptoms. The intensity of outdoor activity should be reduced, or activities replaced with indoor exercise, at those Air Quality Index (AQI) levels that trigger individual symptoms and when AQI values exceed 50. Where possible, strenuous activity should be taken when and where air pollution levels tend to be lowest, namely early in the morning and in low-traffic areas. More research is required to guide development of health protective advice on exercising when air quality is poor.

  20. Federal technology alert. Parabolic-trough solar water heating

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    Parabolic-trough solar water heating is a well-proven renewable energy technology with considerable potential for application at Federal facilities. For the US, parabolic-trough water-heating systems are most cost effective in the Southwest where direct solar radiation is high. Jails, hospitals, barracks, and other facilities that consistently use large volumes of hot water are particularly good candidates, as are facilities with central plants for district heating. As with any renewable energy or energy efficiency technology requiring significant initial capital investment, the primary condition that will make a parabolic-trough system economically viable is if it is replacing expensive conventional water heating. In combination with absorption cooling systems, parabolic-trough collectors can also be used for air-conditioning. Industrial Solar Technology (IST) of Golden, Colorado, is the sole current manufacturer of parabolic-trough solar water heating systems. IST has an Indefinite Delivery/Indefinite Quantity (IDIQ) contract with the Federal Energy Management Program (FEMP) of the US Department of Energy (DOE) to finance and install parabolic-trough solar water heating on an Energy Savings Performance Contract (ESPC) basis for any Federal facility that requests it and for which it proves viable. For an ESPC project, the facility does not pay for design, capital equipment, or installation. Instead, it pays only for guaranteed energy savings. Preparing and implementing delivery or task orders against the IDIQ is much simpler than the standard procurement process. This Federal Technology Alert (FTA) of the New Technology Demonstration Program is one of a series of guides to renewable energy and new energy-efficient technologies.

  1. Functional organization of area V2 in the alert macaque.

    Science.gov (United States)

    Peterhans, E; von der Heydt, R

    1993-05-01

    We studied the relation between anatomical structure and functional properties of cells in area V2 of the macaque. Visual function was assessed in the alert animal during fixation of gaze. Recording sites were reconstructed with respect to cortical lamination and the cytochrome oxidase pattern. We measured orientation and direction selectivity, end-stopping, sensitivity to binocular disparity and ocular dominance, and determined more complex functions like sensitivity to anomalous contours and lines defined by coherent motion. Orientation selectivity was found in all parts of area V2, with high frequencies in the pale and thick stripes of the cytochrome oxidase pattern, and with lower frequency in the thin stripes. Representations of anomalous contours were found in the pale and thick stripes with similar frequencies, but generally not in the thin stripes, which have been thought to process colour. Lines defined by coherent motion were most frequently represented in the thick stripes; they were less frequent in the pale stripes, and (as with anomalous contours) were not found in the thin stripes. Sensitivity to binocular disparity was found in all types of stripes, but more frequently in the thick stripes, where the exclusively binocular neurons were also concentrated. By contrast, no segregation was found for direction selectivity and end-stopping. All neuronal properties were distributed evenly across cortical laminae. We conclude that mechanisms for figure-ground segregation involve the pale and the thick stripes of the cytochrome oxidase pattern, perhaps with greater emphasis on 'shape from motion' and 'stereoscopic depth' in the thick stripes, while more elementary neuronal properties are distributed almost evenly across the stripe pattern.

  2. Concentrations of heavy metals in sediment and organisms during a harmful algal bloom (HAB) at Kun Kaak Bay, Sonora, Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Hernandez, Jaqueline [Centro de investigacion en Alimentacion y Desarrollo AC (CIAD) Guaymas Unit, Carretera al Varadero Nal. Km 6.6, Apdo. Postal 284, CP 85480 Guaymas, Sonora (Mexico)]. E-mail: jaqueline@cascabel.ciad.mx; Garcia-Rico, Leticia [Centro de investigacion en Alimentacion y Desarrollo AC (CIAD), Carretera a la Victoria Km 0.6, Apdo. Postal 1735, CP 83000 Hermosillo, Sonora (Mexico)]. E-mail: lgarciar@cascabel.ciad.mx; Jara-Marini, Martin E. [Centro de investigacion en Alimentacion y Desarrollo AC (CIAD), Carretera a la Victoria Km 0.6, Apdo. Postal 1735, CP 83000 Hermosillo, Sonora (Mexico)]. E-mail: mjara@cascabel.ciad.mx; Barraza-Guardado, Ramon [Departamento de Investigaciones Cientificas y Tecnologicas de la Universidad de Sonora (DICTUS), Rosales y Ninos Heroes s/n Col. Centro, CP 83000 Hermosillo, Sonora (Mexico)]. E-mail: rbarraza@rtn.uson.mx; Hudson Weaver, Amy [Comunidad y Biodiversidad AC - COBI, Terminacion Bahia de Bacochibampo s/m, Fraccionamiento Lomas de Cortes, CP 85450 Guaymas, Sonora (Mexico)]. E-mail: ahw@cobi.org.mx

    2005-07-01

    In early April 2003, fishermen from Kino Bay Sonora alerted us about a massive die-off of fish and mollusks occurring at Kun Kaak Bay. Phytoplankton samples taken on 17 May 2003 reported the presence of a harmful algal bloom composed of Chatonella marina, Chatonella cf. ovata, Gymnodinium catenatum and Gymnodinium sanguineum. On 22 of May, we collected samples of water, sediment and organisms at the affected area. Physicochemical parameters and nutrients were measured in water samples from different depths. Sediment and benthic organisms were analyzed for Cd, Cu, Zn, Pb and Hg. We found concentrations of heavy metals higher than background levels for this area. Cadmium and Lead concentrations in sediment from the HAB area were up to 6x greater than background levels and Cd in mollusks was 8x greater than regulations allow. A relationship between elevated Cd and Pb concentrations in sediment and the survival of toxic dinoflagellates is suspected.

  3. Concentrations of heavy metals in sediment and organisms during a harmful algal bloom (HAB) at Kun Kaak Bay, Sonora, Mexico

    International Nuclear Information System (INIS)

    Garcia-Hernandez, Jaqueline; Garcia-Rico, Leticia; Jara-Marini, Martin E.; Barraza-Guardado, Ramon; Hudson Weaver, Amy

    2005-01-01

    In early April 2003, fishermen from Kino Bay Sonora alerted us about a massive die-off of fish and mollusks occurring at Kun Kaak Bay. Phytoplankton samples taken on 17 May 2003 reported the presence of a harmful algal bloom composed of Chatonella marina, Chatonella cf. ovata, Gymnodinium catenatum and Gymnodinium sanguineum. On 22 of May, we collected samples of water, sediment and organisms at the affected area. Physicochemical parameters and nutrients were measured in water samples from different depths. Sediment and benthic organisms were analyzed for Cd, Cu, Zn, Pb and Hg. We found concentrations of heavy metals higher than background levels for this area. Cadmium and Lead concentrations in sediment from the HAB area were up to 6x greater than background levels and Cd in mollusks was 8x greater than regulations allow. A relationship between elevated Cd and Pb concentrations in sediment and the survival of toxic dinoflagellates is suspected

  4. Concentrations of heavy metals in sediment and organisms during a harmful algal bloom (HAB) at Kun Kaak Bay, Sonora, Mexico.

    Science.gov (United States)

    García-Hernández, Jaqueline; García-Rico, Leticia; Jara-Marini, Martin E; Barraza-Guardado, Ramón; Hudson Weaver, Amy

    2005-07-01

    In early April 2003, fishermen from Kino Bay Sonora alerted us about a massive die-off of fish and mollusks occurring at Kun Kaak Bay. Phytoplankton samples taken on 17 May 2003 reported the presence of a harmful algal bloom composed of Chatonella marina, Chatonella cf. ovata, Gymnodinium catenatum and Gymnodinium sanguineum. On 22 of May, we collected samples of water, sediment and organisms at the affected area. Physicochemical parameters and nutrients were measured in water samples from different depths. Sediment and benthic organisms were analyzed for Cd, Cu, Zn, Pb and Hg. We found concentrations of heavy metals higher than background levels for this area. Cadmium and Lead concentrations in sediment from the HAB area were up to 6x greater than background levels and Cd in mollusks was 8x greater than regulations allow. A relationship between elevated Cd and Pb concentrations in sediment and the survival of toxic dinoflagellates is suspected.

  5. Methods uncovering usability issues in medication-related alerting functions: results from a systematic review.

    Science.gov (United States)

    Marcilly, Romaric; Vasseur, Francis; Ammenwerth, Elske; Beuscart-Zephir, Marie-Catherine

    2014-01-01

    This paper aims at listing the methods used to evaluate the usability of medication-related alerting functions and at knowing what type of usability issues those methods allow to detect. A sub-analysis of data from this systematic review has been performed. Methods applied in the included papers were collected. Then, included papers were sorted in four types of evaluation: "expert evaluation", "user- testing/simulation", "on site observation" and "impact studies". The types of usability issues (usability flaws, usage problems and negative outcomes) uncovered by those evaluations were analyzed. Results show that a large set of methods are used. The largest proportion of papers uses "on site observation" evaluation. This is the only evaluation type for which every kind of usability flaws, usage problems and outcomes are detected. It is somehow surprising that, in a usability systematic review, most of the papers included use a method that is not often presented as a usability method. Results are discussed about the opportunity to provide usability information collected after the implementation of the technology during their design process, i.e. before their implementation.

  6. How gambling harms experienced by Pacific people in New Zealand amplify when they are culture-related.

    Science.gov (United States)

    Kolandai-Matchett, Komathi; Langham, Erika; Bellringer, Maria; Siitia, Pesio Ah-Honi

    2017-01-01

    Pacific people in New Zealand are a minority ethnic population identified in national prevalence studies as having the highest risk of developing gambling problems. As earlier studies identified some links between culture and gambling for this population, our study aimed to deepen understanding of these links and their role in explaining the disproportionate gambling harms experienced by Pacific people. To achieve this aim we employed intersectionality as a theoretical framework to explore the culture-gambling intersection for this population group. We analysed data from a subset of focus groups conducted for a broad study of gambling harms in New Zealand. The subset was selected based on the presence of individuals knowledgeable about Pacific people's gambling behaviours, including staff from Pacific problem gambling treatment services who provided examples from a cultural perspective. We identified themes at a latent level via an interpretive process to identify underlying cultural contexts of gambling harms. Findings indicated that whilst harms experienced by Pacific people were similar to those identified amongst the general population, the cultural contexts in which some harms manifested were complex. This paper contributes to the existing knowledge base about gambling harms for Pacific people in relation to six culture-gambling intersecting themes that emerged from the data: collectivism, gift-giving, gambling-based fundraising, patriarchy, beliefs about blessings, and sports celebrities. Findings are discussed in relation to the current knowledge of gambling and conceptualisations of gambling harm within Pacific communities. Implications for culturally appropriate harm minimisation strategies and prevention interventions for this population are suggested.

  7. Harmful Effects of Nanoparticles on Animals

    Directory of Open Access Journals (Sweden)

    Jean-Marie Exbrayat

    2015-01-01

    Full Text Available Since several years nanoparticles (NPs are produced by industries and used in several fields of activities. They are finally found in aquatic and terrestrial environments, where they are ingested by living organisms in which they accumulate, before being eliminated. In organisms, NPs represent foreign elements with their own physicochemical properties due to their small size. So NPs may interfere with the normal physiological mechanisms of the embryos, growing animals, and adults, and it is indispensable to understand their potentially direct or indirect harmful effects on living organisms. It has been already shown that NPs could be toxic to bacteria, algae, invertebrates, and vertebrates. In this review, several examples of recent studies are given. We will examine successively the effects of NPs on terrestrial and semiaquatic and aquatic vertebrate and invertebrate animals.

  8. Potentially harmful excipients in neonatal medicines

    DEFF Research Database (Denmark)

    Nellis, Georgi; Metsvaht, Tuuli; Varendi, Heili

    2015-01-01

    OBJECTIVES: We aimed to describe administration of eight potentially harmful excipients of interest (EOI)-parabens, polysorbate 80, propylene glycol, benzoates, saccharin sodium, sorbitol, ethanol and benzalkonium chloride-to hospitalised neonates in Europe and to identify risk factors for exposure....... METHODS: All medicines administered to neonates during 1 day with individual prescription and demographic data were registered in a web-based point prevalence study. Excipients were identified from the Summaries of Product Characteristics. Determinants of EOI administration (geographical region......, gestational age (GA), active pharmaceutical ingredient, unit level and hospital teaching status) were identified using multivariable logistical regression analysis. RESULTS: Overall 89 neonatal units from 21 countries participated. Altogether 2095 prescriptions for 530 products administered to 726 neonates...

  9. Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions

    DEFF Research Database (Denmark)

    Madsen, Lizell Bustamante; Eddleston, Michael; Hansen, Kristian Schultz

    2018-01-01

    Background: Death following self-harm constitutes a major global public health challenge and there is an urgent need for governments to implement cost-effective, national suicide prevention strategies. Aim: To conduct a systematic review and quality appraisal of the economic evaluations...... of interventions aimed at preventing suicidal behavior. Method: A systematic literature search was performed in several literature databases to identify relevant articles published from 2003 to 2016. Drummond's 10-item appraisal tool was used to assess the methodological quality of the included studies. Results....... The discussion of suicide and self-harm prevention should be as nuanced as possible, including health economics along with cultural, social, and political aspects....

  10. Strengthening Laboratory Capacity for Early Warning Alert and Response System (EWARS) in Indonesia

    OpenAIRE

    Kandel, Nirmal; Hapsari, Ratna Budi; Riana, Dyah Armi; Setiawaty, Vivi; Larasati, Wita; Wulandari, Endang; Purwanto, Edy

    2017-01-01

    Background: Establishment of Early Warning Alert and Response System (EWARS) in Indonesia was initiated since 2009 in few selected provinces and government was planning to roll out in other provinces. Before initiating this roll out the assessment of performance of EWARS in 2012 was conducted. The aim of the assessment is to strengthen laboratory for supporting to EWARS for alerts testing. Methods: Laboratory capacity mapping tool and laboratory algorithm for twenty two priority diseases of ...

  11. Assigning a volcano alert level: negotiating uncertainty, risk, and complexity in decision-making processes

    OpenAIRE

    Carina J Fearnley

    2013-01-01

    A volcano alert level system (VALS) is used to communicate warning information from scientists to civil authorities managing volcanic hazards. This paper provides the first evaluation of how the decision-making process behind the assignation of an alert level, using forecasts of volcanic behaviour, operates in practice . Using interviews conducted from 2007 to 2009 at five USGS-managed (US Geological Survey) volcano observatories (Alaska, Cascades, Hawaii, Long Valley, and Yellowstone), two k...

  12. [Harmful biological agents at museum workposts].

    Science.gov (United States)

    Skóra, Justyna; Zduniak, Katarzyna; Gutarowska, Beata; Rembisz, Daria

    2012-01-01

    The aim of the studies was to determine the level and kind of microbiological contamination of air and surfaces in museum premises with various collection specificities. In addition, the criteria for selecting indicators of contamination with harmful biological agents at museum workposts are proposed. The analysis of microbial contamination was carried out in 14 museum premises (storehouses, restoration workshops, exhibition hall). Microbiological air purity was measured with a MAS-100 Eco Air Sampler. Surface samples were collected using contact plates RODAC Envirocheck. Biochemical API tests were used to identify bacteria and yeasts. Fungi were diagnosed with taxonomic keys, based on macro- and microscopic mycelia assessment. The levels of microbiological contamination in museums varied and ranged from 2.1 x 10(2) to 7.0 x 10(3) cfu/m3 in the air and from 1.4 x 10(2) to 1.7 x 10(4) cfu/100 cm2 on surfaces. The dominant microorganisms were fungi, which accounted respectively for 18-98% and 23-100% of all isolates from tested sites and surfaces. It was found that the amount of fungi in the indoor air of the Museum of Archeology and Ethnography and the Museum of Independence Traditions equaled respectively 4.2 x 10(2) cfu/m3 and 1.4 x 10(4) cfu/m3, which means that they exceeded the recommended reference value of 2.0 x 10(2) cfu/m3. Having analyzed the frequency of strain isolation, the source of microorganisms and the hazard to human health, 10 fungal species were isolated, which may be regarded as indicators of contamination with harmful biological agents at museum workposts. They are: Aspergillus (A. niger, A. versicolor), Cladosporium (C. herbarum, C. macrocarpum), Penicillium (P. carneum, P. digitatum, P. italicum, P. paneum, P. polonicum), Rhizopus nigricans.

  13. Geoengineering, Climate Harm, and Business as Usual

    Science.gov (United States)

    Jankunis, F. J.; Peacock, K.

    2014-12-01

    We define geoengineering (GE) as the intentional use of technology to change the planet's climate. Many people believe GE is different in kind rather than degree from any other organized activity in human history. In fact, humans caused changes in the planet's climate long before the industrial age, and all organisms engineer their environments directly or indirectly. The relevant difference between this cumulative and generally inadvertent activity and GE is the presence of intention. Now that science has revealed the extent to which humans can change the climate, however, even the continuance of Business as Usual (BAU) is, in effect, a form of intentional GE, albeit one that will cause significant climate harm, defined as effects such as sea level rise that will impact human well-being. But as with all forms of engineering, the devil is in the details: what forms of GE should be tried first? Some methods, such as large-scale afforestation, are low risk but have long-term payoffs; others, such as aerosol injection into the stratosphere, could help buy time in a warming crisis but have unknown side-effects and little long-term future. Climate change is a world-wide, inter-generational tragedy of the commons. Rational choice theory, the spatial and temporal extension of the problem, poorly fitted moral frameworks, and political maneuvering are all factors that inhibit solutions to the climate tragedy of the commons. The longer that such factors are allowed to dominate decision-making (or the lack thereof) the more likely it is that humanity will be forced to resort to riskier and more drastic forms of GE. We argue that this fact brings an additional measure of urgency to the search for ways to engineer the climate differently so as to avoid climate harm in the most lasting and least risky way.

  14. A novel strategy for evaluating the effects of an electronic test ordering alert message: Optimizing cardiac marker use

    Directory of Open Access Journals (Sweden)

    Jason M Baron

    2012-01-01

    Full Text Available Background: Laboratory ordering functions within computerized provider order entry (CPOE systems typically support the display of electronic alert messages to improve test utilization or implement new ordering policies. However, alert strategies have been shown to vary considerably in their success and the characteristics contributing to an alert′s success are poorly understood. Improved methodologies are needed to evaluate alerts and their mechanisms of action. Materials and Methods: Clinicians order inpatient and emergency department laboratory tests using our institutional CPOE system. We analyzed user interaction data captured by our CPOE system to evaluate how clinicians responded to an alert. We evaluated an alert designed to implement an institutional policy restricting the indications for ordering creatine kinase-MB (CKMB. Results: Within 2 months of alert implementation, CKMB-associated searches declined by 79% with a corresponding decline in CKMB orders. Furthermore, while prior to alert implementation, clinicians searching for CKMB ultimately ordered this test 99% of the time, following implementation, only 60% of CKMB searches ultimately led to CKMB test orders. This difference presumably represents clinicians who reconsidered the need for CKMB in response to the alert, demonstrating the alert′s just-in-time advisory capability. In addition, as clinicians repeatedly viewed the alert, there was a "dose-dependant" decrease in the fraction of searches without orders. This presumably reflects the alerting strategy′s long-term educational component, as clinicians aware of the new policy will not search for CKMB when not indicated. Conclusions: Our analytic approach provides insight into the mechanism of a CPOE alert and demonstrates that alerts may act through a combination of just-in-time advice and longer term education. Use of this approach when implementing alerts may prove useful to improve the success of a given alerting

  15. Entrepreneurial alertness: Study of the Influence of Individual Characteristics and Entrepreneurship

    Directory of Open Access Journals (Sweden)

    Hilka Pelizza Vier Machado

    2016-01-01

    Full Text Available ABSTRACT This research tried to understand which statistical variables associated to the individual and the company influence the entrepreneurial alertness. The sample was constituted by 180 entrepreneurs. The entrepreneurial alertness was measured in agreement with the model of Tang, Kacmar and Busenitz (2012. Descriptive statistical tests and normality exam were developed; as well as checked the validity and reliability of the scale through Confirmatory Factor Analysis (CFA. In order to identify the factors that influenced the alertness we developed multiple linear regression and the ANOVA test to determine possible differences among groups (gender, education. The results showed the negative influence of the educational level and the size of enterprises on alertness level; as well as the negative relationship between age and entrepreneurial experience, furthermore, shows that alert level is not determined by gender difference. One of the main implications of this research is to present factors that can potentiate the effects of the entrepreneurial alertness, enlarging the possibilities of identification of opportunities for individuals.

  16. Impact of e-alert systems on the care of patients with acute kidney injury.

    Science.gov (United States)

    Breighner, Crystal M; Kashani, Kianoush B

    2017-09-01

    With the recent advancement in electronic health record systems and meaningful use of information technology incentive programs (i.e., the American Recovery and Reinvestment Act, the Health Information Technology for Economic and Clinical Health Act, and the Centers for Medicare & Medicaid Services), interest in clinical decision support systems has risen. These systems have been used to examine a variety of different syndromes with variable reported effects. In recent years, electronic alerts (e-alerts) have been implemented at various institutions to decrease the morbidity associated with acute kidney injury (AKI). AKI is common, accounting for 1 in 7 hospital admissions, and is associated with increased length of hospital stay and mortality. AKI is often underrecognized, causing delayed intervention. The use of e-alerts may result in earlier recognition and intervention, as well as decreased morbidity and mortality. This must be balanced with the possibility of increased resource utilization that e-alerts may cause. Before widespread implementation, the ethical and legal consequences of not following e-alert recommendations must be established, and the optimal algorithm for AKI e-alert detection must be determined. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Exploring the use and effects of deliberate self-harm websites: an Internet-based study.

    Science.gov (United States)

    Harris, Isobel Marion; Roberts, Lesley Martine

    2013-12-20

    In the United Kingdom, rates of deliberate self-harm (DSH) are rising. Alongside this, there has been an increase in the number of websites available with DSH content, and the Internet is known as a valuable resource for those who feel isolated by their condition(s). However, there is little and contradictory evidence available on the effects of using such websites. Further research is therefore required to examine the use and effects of DSH websites. Our objectives were to explore (1) the reasons people engage in the use of self-harm forums/websites, (2) the beliefs of users of self-harm forums regarding the role of such websites, (3) how the use of self-harm forums/websites modulates self-harm behaviors, and (4) other ways that self-harm forums affect the lives of individuals who use them. Data were collected by a questionnaire hosted on 20 websites with self-harm content. Participants were self-selected from users of these sites. Results were analyzed using descriptive statistics and simple thematic analysis. In total, 329 responses were received with 91.8% (302/329) from female site users. The majority of participants (65.6%, 187/285) visited these sites at least twice per week, and most participants used the sites to find information (78.2%, 223/285) or participate in the forums (68.4%, 195/285). Positive effects of website use such as gaining help and support, isolation reduction, and a reduction in self-harm behaviors were reported by a large number of participants. However, smaller but important numbers reported negative effects including worsened self-harm, being triggered to self-harm, and additional negative physical and psychological effects. This is the first multisite study to explore DSH website use in depth. There are clear and important benefits to engaging in website use for many individuals; however, these are not experienced by all website users. Negative effects were experienced by moderate numbers following website use, and clinicians should

  18. Potentially Harmful Therapy and Multicultural Counseling: Bridging Two Disciplinary Discourses

    Science.gov (United States)

    Wendt, Dennis C.; Gone, Joseph P.; Nagata, Donna K.

    2015-01-01

    In recent years psychologists have been increasingly concerned about potentially harmful therapy, yet this recent discourse has not addressed issues that have long been voiced by the multicultural counseling and psychotherapy movement. We aim to begin to bring these seemingly disparate discourses of harm into greater conversation with one another, in the service of placing the discipline on a firmer foothold in its considerations of potentially harmful therapy. After reviewing the two discourses and exploring reasons for their divergence, we argue that they operate according to differing assumptions pertaining to the sources, objects, and scope of harm. We then argue that these differences reveal the discipline’s need to better appreciate that harm is a social construct, that psychotherapy may be inherently ethnocentric, and that strategies for collecting evidence of harm should be integrated with a social justice agenda. PMID:26339075

  19. Self-harm in patients with schizophrenia spectrum disorders.

    Science.gov (United States)

    Mork, Erlend; Mehlum, Lars; Barrett, Elizabeth A; Agartz, Ingrid; Harkavy-Friedman, Jill M; Lorentzen, Steinar; Melle, Ingrid; Andreassen, Ole A; Walby, Fredrik A

    2012-01-01

    This study describes the prevalence, clinical characteristics, and gender profile of self-harm in a cross-sectional sample of 388 patients with schizophrenia spectrum disorders. All patients were interviewed and assessed with respect to lifetime self-harm and relevant clinical variables. An overall of 49% of the patients reported self-harm which was associated with female gender, having had a depressive episode, younger age at psychosis onset, alcohol abuse or dependence, current suicidality, awareness of illness, and low adherence to prescribed medication. Higher awareness of having a mental disorder was associated with self-harm in men only, while emotional dysregulation was associated with self-harm in women only. We conclude that while self-harm in patients with schizophrenia spectrum disorders is highly prevalent in both genders, risk factors in men and women differ in several important ways.

  20. Risk factors and correlates of deliberate self-harm behavior: a systematic review.

    Science.gov (United States)

    Fliege, Herbert; Lee, Jeong-Ran; Grimm, Anne; Klapp, Burghard F

    2009-06-01

    Deliberate self-harm behavior--without suicidal intent--is a serious health problem and may be studied as a clinical phenomenon in its own right. Empirical studies of sociodemographic and psychological correlates and risk factors are systematically reviewed. We searched Medline, PsycINFO, PSYNDEX (German psychological literature), and reference lists. We targeted self-induced bodily harm without conscious suicidal intent. Studies on suicidal behavior or self-poisoning were only included if they also assessed nonsuicidal self-harm. Fifty-nine original studies met the criteria. Deliberate self-harm may occur at all ages, yet adolescents and young adults are at a higher risk. Evidence on gender is complex. Only 5 studies realize a prospective design (6 months to 10 years) and test predictors. The majority use cross-sectional and retrospective methods. No longitudinal study (separately) examines new incidence. Evidence of correlates encompasses distal/proximal, person/environment, and state/trait factors. Many studies report associations between current self-harm behavior and a history of childhood sexual abuse. Adolescent and adult self-harmers experience more frequent and more negative emotions, such as anxiety, depression, and aggressiveness, than persons who do not self-harm. Two studies yield specific interactions between childhood trauma and current traits and states such as low emotional expressivity, low self-esteem, and dissociation with respect to a vulnerability to self-harm. Evidence of distal, biographical stressors is fairly strong. Proximal stressors have rarely been investigated; protective factors, hardly at all. Despite many findings of correlates, the data do not yet justify terming them risk factors. Longitudinal studies are needed.

  1. CISN ShakeAlert: Faster Warning Information Through Multiple Threshold Event Detection in the Virtual Seismologist (VS) Early Warning Algorithm

    Science.gov (United States)

    Cua, G. B.; Fischer, M.; Caprio, M.; Heaton, T. H.; Cisn Earthquake Early Warning Project Team

    2010-12-01

    The Virtual Seismologist (VS) earthquake early warning (EEW) algorithm is one of 3 EEW approaches being incorporated into the California Integrated Seismic Network (CISN) ShakeAlert system, a prototype EEW system that could potentially be implemented in California. The VS algorithm, implemented by the Swiss Seismological Service at ETH Zurich, is a Bayesian approach to EEW, wherein the most probable source estimate at any given time is a combination of contributions from a likehihood function that evolves in response to incoming data from the on-going earthquake, and selected prior information, which can include factors such as network topology, the Gutenberg-Richter relationship or previously observed seismicity. The VS codes have been running in real-time at the Southern California Seismic Network since July 2008, and at the Northern California Seismic Network since February 2009. We discuss recent enhancements to the VS EEW algorithm that are being integrated into CISN ShakeAlert. We developed and continue to test a multiple-threshold event detection scheme, which uses different association / location approaches depending on the peak amplitudes associated with an incoming P pick. With this scheme, an event with sufficiently high initial amplitudes can be declared on the basis of a single station, maximizing warning times for damaging events for which EEW is most relevant. Smaller, non-damaging events, which will have lower initial amplitudes, will require more picks to initiate an event declaration, with the goal of reducing false alarms. This transforms the VS codes from a regional EEW approach reliant on traditional location estimation (and the requirement of at least 4 picks as implemented by the Binder Earthworm phase associator) into an on-site/regional approach capable of providing a continuously evolving stream of EEW information starting from the first P-detection. Real-time and offline analysis on Swiss and California waveform datasets indicate that the

  2. Harmful Freshwater Algal Blooms, With an Emphasis on Cyanobacteria

    Directory of Open Access Journals (Sweden)

    Hans W. Paerl

    2001-01-01

    Full Text Available Suspended algae, or phytoplankton, are the prime source of organic matter supporting food webs in freshwater ecosystems. Phytoplankton productivity is reliant on adequate nutrient supplies; however, increasing rates of nutrient supply, much of it manmade, fuels accelerating primary production or eutrophication. An obvious and problematic symptom of eutrophication is rapid growth and accumulations of phytoplankton, leading to discoloration of affected waters. These events are termed blooms. Blooms are a prime agent of water quality deterioration, including foul odors and tastes, deoxygenation of bottom waters (hypoxia and anoxia, toxicity, fish kills, and food web alterations. Toxins produced by blooms can adversely affect animal (including human health in waters used for recreational and drinking purposes. Numerous freshwater genera within the diverse phyla comprising the phytoplankton are capable of forming blooms; however, the blue-green algae (or cyanobacteria are the most notorious bloom formers. This is especially true for harmful toxic, surface-dwelling, scum-forming genera (e.g., Anabaena, Aphanizomenon, Nodularia, Microcystis and some subsurface bloom-formers (Cylindrospermopsis, Oscillatoria that are adept at exploiting nutrient-enriched conditions. They thrive in highly productive waters by being able to rapidly migrate between radiance-rich surface waters and nutrient-rich bottom waters. Furthermore, many harmful species are tolerant of extreme environmental conditions, including very high light levels, high temperatures, various degrees of desiccation, and periodic nutrient deprivation. Some of the most noxious cyanobacterial bloom genera (e.g., Anabaena, Aphanizomenon, Cylindrospermopsis, Nodularia are capable of fixing atmospheric nitrogen (N2, enabling them to periodically dominate under nitrogen-limited conditions. Cyanobacteria produce a range of organic compounds, including those that are toxic to higher-ranked consumers, from

  3. ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, Philip; Constine, Louis S. [Univ. Rochester Medical Center, NY (United States). Dept. of Radiation Oncology; Marks, Lawrence B. (ed.) [Univ. North Carolina and Lineberger, Comprehensive Cancer Center, Chapel Hill, NC (United States). Dept. of Radiation Oncology

    2014-09-01

    Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

  4. ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

    International Nuclear Information System (INIS)

    Rubin, Philip; Constine, Louis S.; Marks, Lawrence B.

    2014-01-01

    Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

  5. Impulsivity and self-harm in adolescence: a systematic review.

    Science.gov (United States)

    Lockwood, Joanna; Daley, David; Townsend, Ellen; Sayal, Kapil

    2017-04-01

    Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.

  6. Intrapersonal factors of adolescents self-harming behaviour

    OpenAIRE

    Volodko, Liubov

    2014-01-01

    Researches often differentiate two groups of self-harming adolescents: those who attempters a suicide, and those who are harming themselves in a non-suicidal way, and they don‘t seek the death. However just a few community-based research, which would directly compare these groups, were done so far, and therefore information about the differences of the psychological peculiarity and self-harming behavior‘s internal factors between the groups is ambivalent. Lifestyle and Coping Skills Questionn...

  7. Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the Multicentre Study of Self-harm in England.

    Science.gov (United States)

    Hawton, Keith; Bergen, Helen; Kapur, Navneet; Cooper, Jayne; Steeg, Sarah; Ness, Jennifer; Waters, Keith

    2012-12-01

    Self-harm (intentional self-poisoning and self-injury) in children and adolescents is often repeated and is associated with increased risk of future suicide. We have investigated factors associated with these outcomes. We used data collected in the Multicentre Study of Self-harm in England on all self-harm hospital presentations by individuals aged 10-18 years between 2000 and 2007, and national death information on these individuals to the end of 2010. Cox hazard proportional models were used to identify independent and multivariable predictors of repetition of self-harm and of suicide. Repetition of self-harm occurred in 27.3% of individuals (N = 3920) who presented between 2000 and 2005 and were followed up until 2007. Multivariate analysis showed that repetition was associated with age, self-cutting, and previous self-harm and psychiatric treatment. Of 51 deaths in individuals who presented between 2000 and 2007 and were followed up to 2010 (N = 5133) half (49.0%) were suicides. The method used was usually different to that used for self-harm. Multivariate analysis showed that suicide was associated with male gender [Hazard ratio (HR) = 2.4, 95% CI 1.2-4.8], self-cutting (HR = 2.1, 95% CI 1.1-3.7) and prior psychiatric treatment at initial presentation (HR = 4.2, 95% CI 1.7-10.5). It was also associated with self-cutting and history of psychiatric treatment at the last episode before death, and history of previous self harm. Self-cutting as a method of self-harm in children and adolescents conveys greater risk of suicide (and repetition) than self-poisoning although different methods are usually used for suicide. The findings underline the need for psychosocial assessment in all cases. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

  8. Impacts of licensed premises trading hour policies on alcohol-related harms.

    Science.gov (United States)

    Atkinson, Jo-An; Prodan, Ante; Livingston, Michael; Knowles, Dylan; O'Donnell, Eloise; Room, Robin; Indig, Devon; Page, Andrew; McDonnell, Geoff; Wiggers, John

    2018-07-01

    Evaluations of alcohol policy changes demonstrate that restriction of trading hours of both 'on'- and 'off'-licence venues can be an effective means of reducing rates of alcohol-related harm. Despite this, the effects of different trading hour policy options over time, accounting for different contexts and demographic characteristics, and the common co-occurrence of other harm reduction strategies in trading hour policy initiatives, are difficult to estimate. The aim of this study was to use dynamic simulation modelling to compare estimated impacts over time of a range of trading hour policy options on various indicators of acute alcohol-related harm. An agent-based model of alcohol consumption in New South Wales, Australia was developed using existing research evidence, analysis of available data and a structured approach to incorporating expert opinion. Five policy scenarios were simulated, including restrictions to trading hours of on-licence venues and extensions to trading hours of bottle shops. The impact of the scenarios on four measures of alcohol-related harm were considered: total acute harms, alcohol-related violence, emergency department (ED) presentations and hospitalizations. Simulation of a 3 a.m. (rather than 5 a.m.) closing time resulted in an estimated 12.3 ± 2.4% reduction in total acute alcohol-related harms, a 7.9 ± 0.8% reduction in violence, an 11.9 ± 2.1% reduction in ED presentations and a 9.5 ± 1.8% reduction in hospitalizations. Further reductions were achieved simulating a 1 a.m. closing time, including a 17.5 ± 1.1% reduction in alcohol-related violence. Simulated extensions to bottle shop trading hours resulted in increases in rates of all four measures of harm, although most of the effects came from increasing operating hours from 10 p.m. to 11 p.m. An agent-based simulation model suggests that restricting trading hours of licensed venues reduces rates of alcohol-related harm and extending trading hours of bottle

  9. Predictive Factors of Suicide Attempt and Non-Suicidal Self-Harm in Emergency Department

    Directory of Open Access Journals (Sweden)

    Saad Salman

    2014-09-01

    Full Text Available Introduction: Suicide is the third cause of mortality in America, second leading cause of death in developed countries, and one of the major health problems. Self-harm is self-inflicted damage to one’s self with or without suicidal intent. In the present study, the predictive factors of suicide attempt and non-suicidal self-harm were evaluated in patients referred to emergency department (ED with these problem. Methods: The total number of 45 patients with suicide attempt or self-harm admitted to ED were included. Clinical symptoms, thoughts and behaviors of suicidal, and non-suicidal self-harm in these patients were evaluated at baseline. Suicidality, suicidal intent and ideation, non-suicidal self-injury, social withdrawal, disruptive behavior, and poor family functions were evaluated at admission time. Brief clinical visits were scheduled for the twelfth weeks. In the twelfth week, patients returned for their final visit to determine their maintenance treatment. Finally data were analyzed using chi-squared and multiple logistic regression. Results: Forty five patients were included in the study (56.1% female. The mean age of patients was 23.3±10.2 years (range: 15-75; 33.3% married. Significant association of suicide and self-injury was presented at the baseline and in the month before attempting (p=0.001. The most important predictive factors of suicide and self-harm based on univariate analysis were depression (suicidal and non-suicidal items of Hamilton depression rating scale, anxiety, hopelessness, younger age, history of non-suicidal self-harm and female gender (p<0.05. The participants’ quality of life analysis showed a significant higher quality in physical component summary (p=0.002, mental component summary (p=0.001, and general health (p=0.001 at follow up period. Conclusion: At the time of admission in ED, suicide attempt and non-suicidal self-harm are subsequent clinical markers for the patient attempting suicide again. The

  10. The harm principle as a mid-level principle?: three problems from the context of infectious disease control.

    Science.gov (United States)

    Krom, André

    2011-10-01

    Effective infectious disease control may require states to restrict the liberty of individuals. Since preventing harm to others is almost universally accepted as a legitimate (prima facie) reason for restricting the liberty of individuals, it seems plausible to employ a mid-level harm principle in infectious disease control. Moral practices like infectious disease control support - or even require - a certain level of theory-modesty. However, employing a mid-level harm principle in infectious disease control faces at least three problems. First, it is unclear what we gain by attaining convergence on a specific formulation of the harm principle. Likely candidates for convergence, a harm principle aimed at preventing harmful conduct, supplemented by considerations of effectiveness and always choosing the least intrusive means still leave ample room for normative disagreement. Second, while mid-level principles are sometimes put forward in response to the problem of normative theories attaching different weight to moral principles, employing a mid-level harm principle completely leaves open how to determine what weight to attach to it in application. Third, there appears to be a trade-off between attaining convergence and finding a formulation of the harm principle that can justify liberty-restrictions in all situations of contagion, including interventions that are commonly allowed. These are not reasons to abandon mid-level theorizing altogether. But there is no reason to be too theory-modest in applied ethics. Morally justifying e.g. if a liberty-restriction in infectious disease control is proportional to the aim of harm-prevention, promptly requires moving beyond the mid-level harm principle. © 2011 Blackwell Publishing Ltd.

  11. Self-harm and ethnicity: A systematic review.

    Science.gov (United States)

    Al-Sharifi, Ali; Krynicki, Carl R; Upthegrove, Rachel

    2015-09-01

    This review will focus on the rates, clinical characteristics, risk factors and methods of self-harm and suicide in different ethnic groups in the United Kingdom, providing an update synthesis of recent literature. Studies that met the inclusion criteria between 2003 and 2013 were reviewed using the following databases: MEDLINE, PsycINFO, EMBASE and CINAHL. The methodological quality of each study was then assessed using a structured scoring system. A total of 2,362 articles were retrieved, 10 of which matched the inclusion criteria were reviewed. Significant differences were found in the rates of self-harm between ethnic groups with Asian males being least likely to self-harm and Black females being most likely to self-harm. Also, Black and South Asian people were less likely to repeat self-harm. Factors that may help protect or predispose individuals to self-harm or attempt suicide (such as religion, mental health and coping styles) also differ between ethnic groups. There are clear ethnic differences in self-harm and suicide, which may be affected by factors such as cultural pressures and prevalence of mental illness. An awareness of these differences is vital to help prevent further attempts of self-harm and suicide. Further research into differences between ethnic and cultural groups and self-harm continues to be important. © The Author(s) 2015.

  12. Caring for self-harming patients in general practice.

    Science.gov (United States)

    Rowe, Joanne; Jaye, Chrystal

    2017-12-01

    INTRODUCTION Intentional self-harm is an international public health issue with high personal, social and financial costs to society. Poor relationship dynamics are known to have a negative influence on the psyche of people who self-harm, and this can increase anxiety and decrease self-esteem, both shown to be significant contributors to self-harm behaviours. Positive and functional social supports have been proposed as a cost-effective and constructive approach in diminishing self-harming behaviours. AIM This qualitative study investigated the aspects of professional, social, familial and romantic relationships that people who have self-harmed identified as having a positive and constructive effect on their self-harm behaviour. METHODS Twelve participants with a history of self-harming behaviours were recruited through free press advertising in primary care and interviewed. The participants ranged in age from 19 to 70 years, and represented New Zealand (NZ) European and Māori from across the Southern region of NZ. RESULTS This study shows that constructive relationships that inhibit self-harm behaviours are characterised by participants' perceptions of authenticity in their relationships, and knowing that other people genuinely care. Feeling cared for within an authentic therapeutic relationship enabled participants to overcome their perception of being damaged selves and gave them the skills and confidence to develop functional relationships within their communities. A relationship-centred care approach may be useful for general practitioners seeking to develop more effective therapeutic relationships with patients who deliberately self-harm.

  13. Pollutants in drinking water - sources, harmful effects and removal procedures

    International Nuclear Information System (INIS)

    Qadeer, R.

    2005-01-01

    The underground water resources available for human consumption are being continuously contaminated by the natural sources and anthropogenic activities. The pollutants include toxic microorganism, inorganic and organic chemicals and radionuclide etc. This is an acute problem in our country, where free style way of disposal of industrial effluents into the natural water bodies contaminates the surface and ground water. These contaminants make their way into human body through contaminated drinking water, which leads to the malfunctioning of the body organs. Details of some pollutants present in drinking water, their source and harmful effects on human beings are reviewed in this communication Merits and demerits of methods used to remove the pollutants from drinking water are also discussed. (author)

  14. Strategies for an effective tobacco harm reduction policy in Indonesia

    Directory of Open Access Journals (Sweden)

    Fariz Nurwidya

    2014-12-01

    Full Text Available Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation.

  15. Benefit and harm of pregabalin in acute pain treatment

    DEFF Research Database (Denmark)

    Fabritius, M L; Strøm, C; Koyuncu, S

    2017-01-01

    Pregabalin has demonstrated anti-hyperalgesic properties and was introduced into acute pain treatment in 2001. Our aim was to evaluate the beneficial and harmful effects of pregabalin in postoperative pain management. We included randomized clinical trials investigating perioperative pregabalin......, Peto's odds ratio was 2.9 (1.2, 6.8; TSA adjusted confidence interval: 0.1, 97.1). Based on trials with low risk of bias, pregabalin may have a minimal opioid-sparing effect, but the risk of SAEs seems increased. However, the GRADE-rated evaluations showed only moderate to very low quality of evidence....... Consequently, a routine use of pregabalin for postoperative pain treatment cannot be recommended....

  16. Acceptability of dating violence and expectations of relationship harm among adolescent girls exposed to intimate partner violence.

    Science.gov (United States)

    Lee, Michelle Seulki; Begun, Stephanie; DePrince, Anne P; Chu, Ann T

    2016-07-01

    Little is known about the factors that contribute to adolescents' perceptions of the acceptability of dating violence, particularly among girls who have witnessed intimate partner violence (IPV). Drawing on relevant theory, the current study tests a path model linking frequency of witnessing IPV in childhood, sexist beliefs, and automatic relationship-to-harm associations to acceptability of dating violence. Participants were 79 female adolescents with a mean age of 16.08 years (SD = 1.52) involved in the child welfare system. Participants self-reported frequency of witnessing IPV in childhood, ambivalent sexism, and acceptability of dating violence. A lexical-decision task assessed implicit relationship-to-harm priming, which reflects the degree to which people automatically assume that relationships include harm. Consistent with hypotheses, frequency of witnessing IPV was significantly associated with strength of implicit relationship-to-harm associations. Implicit relationship-to-harm associations and hostile sexism were significantly associated with girls' attitudes that dating violence is acceptable. There was a significant indirect effect of witnessing IPV and acceptability of dating violence through relationship-to-harm associations. The current study provides information that is relevant to dating violence intervention among adolescent girls. Interventions that target girls' schema about relationships-making explicit that healthy relationships do not involve harm-and include education about sexism in society are likely to decrease dating violence risk over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Gaia science alerts and the observing facilities of the Serbian-Bulgarian mini-network telescopes

    Directory of Open Access Journals (Sweden)

    Damljanović G.

    2014-01-01

    Full Text Available The astrometric European Space Agency (ESA Gaia mission was launched in December 19, 2013. One of the tasks of the Gaia mission is production of an astrometric catalog of over one billion stars and more than 500000 extragalactic sources. The quasars (QSOs, as extragalactic sources and radio emitters, are active galactic nuclei objects (AGNs whose coordinates are well determined via Very Long Baseline Interferometry (VLBI technique and may reach sub-milliarcsecond accuracy. The QSOs are the defining sources of the quasi-inertial International Celestial Reference Frame (ICRF because of their core radio morphology, negligible proper motions (until sub-milliarcsecond per year, and apparent point-like nature. Compact AGNs, visible in optical domain, are useful for a direct link of the future Gaia optical reference frame with the most accurate radio one. Apart from the above mentioned activities, Gaia has other goals such as follow-up of transient objects. One of the most important Gaia's requirements for photometric alerts is a fast observation and reduction response, that is, submition of observations within 24 hours. For this reason we have developed a pipeline. In line with possibilities of our new telescope (D(cm/F(cm=60/600 at the Astronomical Station Vidojevica (ASV, of the Astronomical Observatory in Belgrade, we joined the Gaia-Follow-Up Network for Transients Objects (Gaia-FUN-TO for the photometric alerts. Moreover, in view of the cooperation with Bulgarian colleagues (in the frst place, SV, one of us (GD initiated a local mini-network of Serbian { Bulgarian telescopes useful for the Gaia-FUN-TO and other astronomical purposes. During the next year we expect a new 1.4 m telescope at ASV site. The speed of data processing (from observation to calibration server could be one day. Here, we present an overview of our activities in the Gaia-FUN-TO which includes establishing Serbian { Bulgarian mini-network (of five telescopes at three sites

  18. Initial Development and Validation of the BullyHARM: The Bullying, Harassment, and Aggression Receipt Measure

    Science.gov (United States)

    Hall, William J.

    2017-01-01

    This article describes the development and preliminary validation of the Bullying, Harassment, and Aggression Receipt Measure (BullyHARM). The development of the BullyHARM involved a number of steps and methods, including a literature review, expert review, cognitive testing, readability testing, data collection from a large sample, reliability testing, and confirmatory factor analysis. A sample of 275 middle school students was used to examine the psychometric properties and factor structure of the BullyHARM, which consists of 22 items and 6 subscales: physical bullying, verbal bullying, social/relational bullying, cyber-bullying, property bullying, and sexual bullying. First-order and second-order factor models were evaluated. Results demonstrate that the first-order factor model had superior fit. Results of reliability testing indicate that the BullyHARM scale and subscales have very good internal consistency reliability. Findings indicate that the BullyHARM has good properties regarding content validation and respondent-related validation and is a promising instrument for measuring bullying victimization in school. PMID:28194041

  19. Varenicline and Risk of Self-Harm: A Nested Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Mina Tadrous

    Full Text Available Smoking remains a serious public health concern. Pharmacotherapy for smoking cessation, including bupropion and varenicline, are proven means to increase quit rates. Post-marketing reports describing suicidal behaviours have raised concerns about the safety of varenicline. However, whether varenicline imparts a higher risk of suicide relative to bupropion remains uncertain.A population-based nested case-control study in Ontario, Canada, from April 1, 2011 to March 31, 2015 was conducted. Subjects were residents of Ontario aged 18 years and older with publicly funded drug coverage receiving either bupropion or varenicline for smoking cessation. We defined cases were those with a hospitalization or emergency department visit for suicide or non-fatal self-harm within 90 days of treatment. For each case, we identified up to fifty controls from the same cohort matched on age, sex, history of self-harm, use of selected psychotropic medications, alcohol abuse and prior admission to a mental health unit. Adjusted odds ratio were used to compare the risk of suicide/self-harm of varenicline to bupropion.We identified 331 cases and 5,346 matched-controls. Following adjustment for potential confounders, we found that varenicline was not associated with an increased risk of suicide/self-harm relative to bupropion (adjusted odds ratio 1.15; 95% confidence interval 0.71 to 1.87.Treatment with varenicline does not appear to significantly increase the risk of suicide or self-harm relative to bupropion.

  20. Ethical considerations of e-cigarette use for tobacco harm reduction.

    Science.gov (United States)

    Franck, Caroline; Filion, Kristian B; Kimmelman, Jonathan; Grad, Roland; Eisenberg, Mark J

    2016-05-17

    Due to their similarity to tobacco cigarettes, electronic cigarettes (e-cigarettes) could play an important role in tobacco harm reduction. However, the public health community remains divided concerning the appropriateness of endorsing a device whose safety and efficacy for smoking cessation remain unclear. We identified the major ethical considerations surrounding the use of e-cigarettes for tobacco harm reduction, including product safety, efficacy for smoking cessation and reduction, use among non-smokers, use among youth, marketing and advertisement, use in public places, renormalization of a smoking culture, and market ownership. Overall, the safety profile of e-cigarettes is unlikely to warrant serious public health concerns, particularly given the known adverse health effects associated with tobacco cigarettes. As a result, it is unlikely that the population-level harms resulting from e-cigarette uptake among non-smokers would overshadow the public health gains obtained from tobacco harm reduction among current smokers. While the existence of a gateway effect for youth remains uncertain, e-cigarette use in this population should be discouraged. Similarly, marketing and advertisement should remain aligned with the degree of known product risk and should be targeted to current smokers. Overall, the available evidence supports the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking, while taking measures to protect vulnerable groups and individuals.

  1. Decreased functional connectivity and structural deficit in alertness network with right-sided temporal lobe epilepsy.

    Science.gov (United States)

    Gao, Yujun; Zheng, Jinou; Li, Yaping; Guo, Danni; Wang, Mingli; Cui, Xiangxiang; Ye, Wei

    2018-04-01

    Patients with temporal lobe epilepsy (TLE) often suffer from alertness alterations. However, specific regions connected with alertness remain controversial, and whether these regions have structural impairment is also elusive. This study aimed to investigate the characteristics and neural mechanisms underlying the functions and structures of alertness network in patients with right-sided temporal lobe epilepsy (rTLE) by performing the attentional network test (ANT), resting-state functional magnetic resonance imaging (R-SfMRI), and diffusion tensor imaging (DTI).A total of 47 patients with rTLE and 34 healthy controls underwent ANT, R-SfMRI, and DTI scan. The seed-based functional connectivity (FC) method and deterministic tractography were used to analyze the data.Patients with rTLE had longer reaction times in the no-cue and double-cue conditions. However, no differences were noted in the alertness effect between the 2 groups. The patient group had lower FC compared with the control group in the right inferior parietal lobe (IPL), amygdala, and insula. Structural deficits were found in the right parahippocampal gyrus, superior temporal pole, insula, and amygdala in the patient group compared with the control group. Also significantly negative correlations were observed between abnormal fractional anisotropy (between the right insula and the superior temporal pole) and illness duration in the patients with rTLE.The findings of this study suggested abnormal intrinsic and phasic alertness, decreased FC, and structural deficits within the alerting network in the rTLE. This study provided new insights into the mechanisms of alertness alterations in rTLE.

  2. EEG quantification of alertness: methods for early identification of individuals most susceptible to sleep deprivation

    Science.gov (United States)

    Berka, Chris; Levendowski, Daniel J.; Westbrook, Philip; Davis, Gene; Lumicao, Michelle N.; Olmstead, Richard E.; Popovic, Miodrag; Zivkovic, Vladimir T.; Ramsey, Caitlin K.

    2005-05-01

    Electroencephalographic (EEG) and neurocognitive measures were simultaneously acquired to quantify alertness from 24 participants during 44-hours of sleep deprivation. Performance on a three-choice vigilance task (3C-VT), paired-associate learning/memory task (PAL) and modified Maintenance of Wakefulness Test (MWT), and sleep technician-observed drowsiness (eye-closures, head-nods, EEG slowing) were quantified. The B-Alert system automatically classifies each second of EEG on an alertness/drowsiness continuum. B-Alert classifications were significantly correlated with technician-observations, visually scored EEG and performance measures. B-Alert classifications during 3C-VT, and technician observations and performance during the 3C-VT and PAL evidenced progressively increasing drowsiness as a result of sleep deprivation with a stabilizing effect observed at the batteries occurring between 0600 and 1100 suggesting a possible circadian effect similar to those reported in previous sleep deprivation studies. Participants were given an opportunity to take a 40-minute nap approximately 24-hours into the sleep deprivation portion of the study (i.e., 7 PM on Saturday). The nap was followed by a transient period of increased alertness. Approximately 8 hours after the nap, behavioral and physiological measures of drowsiness returned to levels prior to the nap. Cluster analysis was used to stratify individuals into three groups based on their level of impairment as a result of sleep deprivation. The combination of B-Alert and neuro-behavioral measures may identify individuals whose performance is most susceptible to sleep deprivation. These objective measures could be applied in an operational setting to provide a "biobehavioral assay" to determine vulnerability to sleep deprivation.

  3. Do Austerity Measures Harm International Trade?

    Directory of Open Access Journals (Sweden)

    Dorin Iulian CHIRIŢOIU

    2015-06-01

    Full Text Available This paper focuses on the trade relations between Romania and the PIIGS (Portugal, Italy, Ireland, Greece, and Spain in order to verify whether the exports of Romania have been positively or negatively affected by the austerity measures adopted by these Eurozone periphery countries, thus diminishing Romania’s export performance in such markets. Hence, our main research question is whether austerity measures harm or affect in any way the inflows and outflows of international trade in the studied countries. To assess this hypothesis, we focused on the external trade relations, and their linkages with the macroeconomic environment, rather than the competitiveness of a state explained by a detailed sectoral analysis. In this respect, we use comparative and descriptive statistics in order to observe the consequences of the internal devaluation, and implicitly austerity measures, on the PIIGS-Romanian trade relations. Our findings suggest that the effects of austerity measures are not homogenous because they depend on the scale of trade exchanges and on the way in which the austerity measures were applied.

  4. Evaluation of Harmful Algal Bloom Outreach Activities

    Directory of Open Access Journals (Sweden)

    Richard Weisman

    2007-12-01

    Full Text Available With an apparent increase of harmful algal blooms (HABs worldwide,healthcare providers, public health personnel and coastal managers are struggling toprovide scientifically-based appropriately-targeted HAB outreach and education. Since1998, the Florida Poison Information Center-Miami, with its 24 hour/365 day/year freeAquatic Toxins Hotline (1-888-232-8635 available in several languages, has received over 25,000 HAB-related calls. As part of HAB surveillance, all possible cases of HAB-relatedillness among callers are reported to the Florida Health Department. This pilot studyevaluated an automated call processing menu system that allows callers to access bilingualHAB information, and to speak directly with a trained Poison Information Specialist. Themajority (68% of callers reported satisfaction with the information, and many provided specific suggestions for improvement. This pilot study, the first known evaluation of use and satisfaction with HAB educational outreach materials, demonstrated that the automated system provided useful HAB-related information for the majority of callers, and decreased the routine informational call workload for the Poison Information Specialists, allowing them to focus on callers needing immediate assistance and their healthcare providers. These results will lead to improvement of this valuable HAB outreach, education and surveillance tool. Formal evaluation is recommended for future HAB outreach and educational materials.

  5. Calcium supplementation in osteoporosis: useful or harmful?

    Science.gov (United States)

    Chiodini, Iacopo; Bolland, Mark J

    2018-04-01

    Osteoporosis and fragility fractures are important social and economic problems worldwide and are due to both the loss of bone mineral density and sarcopenia. Indeed, fragility fractures are associated with increased disability, morbidity and mortality. It is known that a normal calcium balance together with a normal vitamin D status is important for maintaining well-balanced bone metabolism, and for many years, calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, recently, the usefulness of calcium supplementation (alone or with concomitant vitamin D) has been questioned, since some studies reported only weak efficacy of these supplementations in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of co-administered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation. This debate article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation. © 2018 European Society of Endocrinology.

  6. The Associations Between Children's and Adolescents’ Suicidal and Self-Harming Behaviors, and Related Behaviors Within Their Social Networks: A Systematic Review

    OpenAIRE

    Quigley, J.; Rasmussen, S.; McAlaney, John

    2017-01-01

    © 2017, Copyright © International Academy for Suicide Research.Social influences—including the suicidal and self-harming behaviors of others—have been highlighted as a risk factor for suicidal and self-harming behavior in young people, but synthesis of the evidence is lacking. A systematic review of 86 relevant papers was conducted. Considerable published evidence was obtained for positive associations between young people's suicidal and self-harming behavior and that of people they know, wit...

  7. Feedback mechanisms of change: How problem alerts reported by youth clients and their caregivers impact clinician-reported session content

    Science.gov (United States)

    Douglas, Susan R.; Jonghyuk, Bae; de Andrade, Ana Regina Vides; Tomlinson, M. Michele; Hargraves, Ryan Pamela; Bickman, Leonard

    2015-01-01

    Objective This study explored how clinician-reported content addressed in treatment sessions was predicted by clinician feedback group and multi-informant cumulative problem alerts that appeared in computerized feedback reports for 299 clients aged 11 to 18 years receiving home-based community mental health treatment. Method Measures included a clinician-report of content addressed in sessions and additional measures of treatment progress and process (e.g., therapeutic alliance) completed by clinicians, clients, and their caregivers. Item responses in the top 25th percentile in severity from these measures appeared as ‘problem alerts’ on corresponding computerized feedback reports. Clinicians randomized to the feedback group received feedback weekly while the control group did not. Analyses were conducted using the Cox proportional hazards regression for recurrent events. Results For all content domains, the results of the survival analyses indicated a robust effect of the feedback group on addressing specific content in sessions, with feedback associated with shorter duration to first occurrence and increased likelihood of addressing or focusing on a topic compared to the non-feedback group. Conclusion There appears to be an important relationship between feedback and cumulative problem alerts reported by multiple informants as they influence session content. PMID:26337327

  8. A Clinical Communication Strategy to Enhance Effectiveness and CAHPS Scores: The ALERT Model.

    Science.gov (United States)

    Hardee, James T; Kasper, Ilene K

    2008-01-01

    The Consumer Assessment of Healthcare Providers and Systems (CAHPS) program is a national annual report that surveys patients and rates health plans on a variety of metrics, including claims processing, customer service, office staff helpfulness, and ability to get needed care. Although physicians may feel they have no immediate control over many aspects of this questionnaire, there is an important area of the survey where they do have direct control: "how well the doctor communicates."It is well established that effective physician-patient communication has beneficial effects not only on physician and patient satisfaction but also on adherence to medical advice, diagnostic accuracy, and malpractice risk. The creators of the CAHPS survey developed and incorporated four questions seeking to ascertain the patient's impression of the physician's communication skills. These questions assess how well the physician listened carefully to the patient, how often the physician explained things understandably, how often the physician showed respect for what the patient said, and how often the physician spent enough time with the patient.Many excellent clinical communication models exist that touch on aspects of the CAHPS topics, but it behooves physicians to be mindful of the exact survey questions. The ALERT model of communication was developed to facilitate physicians' recall of these measures. By incorporating key verbal and nonverbal communication skills, clinicians can address and improve their scores on this important area of the CAHPS survey.

  9. Job strain, sleep and alertness in shift working health care professionals -- a field study.

    Science.gov (United States)

    Karhula, Kati; Härmä, Mikko; Sallinen, Mikael; Hublin, Christer; Virkkala, Jussi; Kivimäki, Mika; Vahtera, Jussi; Puttonen, Sampsa

    2013-01-01

    We explored the associations of job strain with sleep and alertness of shift working female nurses and nursing assistants. Participants (n=95) were recruited from the Finnish Public Sector Study, from hospital wards that belonged to the top or bottom quartiles on job strain. Participants' own job strain was at least as high in high-strain group or low in low-strain group as the ward's average. The study included three-week measurements with sleep diary and actigraphy. Psychomotor Vigilance Test (PVT) was performed during one pre-selected morning and night shift and a day off. Sleep efficiency before morning shifts was lower in the high-strain than low-strain group (p=0.03). Low-strain group took more often (72 vs. 45%; psleep were more common in high-strain group, especially after evening shifts (psleep duration (06:49 h) and efficiency (89%) did not differ between these groups. In conclusion, high job strain is associated with difficulties initiating sleep and reduced psychomotor vigilance in night shifts. Shift working contributed to impaired sleep in both high and low job strain group. Individual and organization-based actions are needed to promote sufficient sleep in shift working nurses, especially with high job strain.

  10. Crew Factors in Flight Operations X: Alertness Management in Flight Operations

    Science.gov (United States)

    Rosekind, Mark R.; Gander, Philippa H.; Connell, Linda J.; Co, Elizabeth L.

    2001-01-01

    In response to a 1980 congressional request, NASA Ames Research Center initiated a Fatigue/Jet Lag Program to examine fatigue, sleep loss, and circadian disruption in aviation. Research has examined fatigue in a variety of flight environments using a range of measures (from self-report to performance to physiological). In 1991, the program evolved into the Fatigue Countermeasures Program, emphasizing the development and evaluation of strategies to maintain alertness and performance in operational settings. Over the years, the Federal Aviation Administration (FAA) has become a collaborative partner in support of fatigue research and other Program activities. From the inception of the Program, a principal goal was to return the information learned from research and other Program activities to the operational community. The objectives of this Education and Training Module are to explain what has been learned about the physiological mechanisms that underlie fatigue, demonstrate the application of this information in flight operations, and offer some specific fatigue countermeasure recommendations. It is intended for all segments of the aeronautics industry, including pilots, flight attendants, managers, schedulers, safety and policy personnel, maintenance crews, and others involved in an operational environment that challenges human physiological capabilities because of fatigue, sleep loss, and circadian disruption.

  11. Perception of e-cigarette harm and its correlation with use among U.S. adolescents.

    Science.gov (United States)

    Amrock, Stephen M; Zakhar, Joseph; Zhou, Sherry; Weitzman, Michael

    2015-03-01

    U.S. adolescents increasingly use e-cigarettes. The perceived harm of e-cigarettes has not been described, nor has the correlation between harm perception and e-cigarette use been assessed. This study examines correlates of e-cigarette harm perception and use of e-cigarettes in a national survey. We used cross-sectional nationally representative data from the 2012 National Youth Tobacco Survey (n = 24,658). Cross-tabulations and multivariate ordered probit and logistic regression models were employed to assess relative harm perception and e-cigarette use. Half of U.S. adolescents had heard of e-cigarettes. Of these, 13.2% (95% confidence interval [CI] = 11.7-14.9) and 4.0% (95% CI = 3.4-4.7) reported ever or currently using e-cigarettes, respectively. Of those aware of e-cigarettes, 34.2% (95% CI = 32.8-35.6) believed e-cigarettes were less harmful than cigarettes. Among those trying e-cigarettes, 71.8% (95% CI = 69.0-74.5) believed e-cigarettes were comparatively less harmful. Females and those ≥ 17 years old were more likely to perceive e-cigarettes as more harmful relative to cigarettes, while on average Whites, users of other tobacco products, and those with family members who used tobacco were more likely to perceive e-cigarettes as comparatively safer. Among cigarette-naive e-cigarette users, use of other tobacco products and perceived harm reduction by e-cigarettes were, respectively, on average associated with 1.6 and 4.1 percentage-point increases in e-cigarette use. Perception of e-cigarettes as less harmful than conventional cigarettes was associated with increased e-cigarette use, including among cigarette-naive e-cigarette users. These findings should prompt further scientific investigation and merit attention from regulators. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Key Considerations for Using No-Harm Contracts with Clients Who Self-Injure

    Science.gov (United States)

    Hyldahl, Rebecca S.; Richardson, Brent

    2011-01-01

    One of the more controversial issues in working with people who self-injure is whether counselors should use no-harm contracts. Important therapeutic considerations include the efficacy of such contracts or agreements in preventing self-injury, the emotional and behavioral responses of clients, and the perceived protection these contracts or…

  13. Satellite monitoring of cyanobacterial harmful algal bloom frequency in recreational waters and drinking water sources

    Science.gov (United States)

    Cyanobacterial harmful algal blooms (cyanoHABs) cause extensive problems in lakes worldwide, including human and ecological health risks, anoxia and fish kills, and taste and odor problems. CyanoHABs are a particular concern because of their dense biomass and the risk of expos...

  14. Modifying effects of perceived adaptation to shift work on health, wellbeing, and alertness on the job among nuclear power plant operators.

    Science.gov (United States)

    Takahashi, Masaya; Tanigawa, Takeshi; Tachibana, Naoko; Mutou, Keiko; Kage, Yoshiko; Smith, Lawrence; Iso, Hiroyasu

    2005-01-01

    This study examined the relationship between perceived adaptation to shift work and shift-related problems. A total of 608 male operators at nuclear power plants completed a set of validated questionnaires including a modified version of the Standard Shiftwork Index, which covered adaptation to shift work, fit to job content, chronotypes, chronic fatigue, sleep, naps, shift work locus of control (SHLOC), psychological health, social/family life, daytime sleepiness, workload, alertness on the job, and lifestyle factors. Participants were divided into two groups according to their perceived level of adaptation to shift work. The good adaptation group showed better outcomes than the poor adaptation group in terms of fit to job content, chronic fatigue, daytime sleep before night shifts, social and family disruption, SHLOC, psychological health, and alertness during night shifts (pseffects of working shifts may be modified by perceptions of shift work adaptation.

  15. Hospital staff experiences of their relationships with adults who self-harm: A meta-synthesis.

    Science.gov (United States)

    O'Connor, Sophie; Glover, Lesley

    2017-09-01

    This review aimed to synthesize qualitative literature exploring inpatient hospital staff experiences of their relationships with people who self-harm. Nine studies were identified from a systematic search of five research databases. Papers included the experiences of physical health and mental health staff working in inpatient settings. The studies employed various qualitative research methods and were appraised using an adapted quality assessment tool (Tong, Sainsbury, & Craig, 2007). A meta-synthesis was conducted using traditional qualitative analysis methods including coding and categorizing data into themes. Three main themes derived from the data. 'The impact of the system' influenced the extent to which staff were 'Fearing the harm from self-harm', or were 'Working alongside the whole person'. A fear-based relationship occurred across mental health and physical health settings despite differences in training; however, 'Working alongside the whole person' primarily emerged from mental health staff experiences. Systemic factors provided either an inhibitory or facilitative influence on the relational process. Staff experiences of their relationship with people who self-harm were highlighted to have an important impact on the delivery and outcome of care. Increasing support for staff with a focus on distress tolerance, managing relational issues, and developing self-awareness within the relationship may lead to a more mutually beneficial experience of care. Equally, structure, clarity, and support within inpatient systems may empower staff to feel more confident in utilizing their existing skills. Working with people who self-harm can be emotionally challenging and how staff cope with this can significantly impact on the engagement of staff and patients. Increasing the skills of staff in managing relational issues and tolerating distress, as well as providing support and reflective practice groups may be useful in managing emotional responses to working with

  16. [Harmful alcohol consumption: prevalence, trends, health burden, reduction strategy].

    Science.gov (United States)

    Грузева, Татьяна С; Дуфинец, Василий А; Замкевич, Виктория Б

    2016-01-01

    with mental and behavioral disorders due to use of psychoactive substances wereregistered in health care facilities in 2014. Standardized mortality rate from causes related to alcohol in Ukraine (185.4 per 100 thousand.) is one of the largest in Europe, with only Kazakhstan (308.4) and Belarus (187.9) being behind. Regular work aiming at prevention of alcohol abuse is carried out by 49.4% of primary care professionals; 21.3% of physiciansinsist on reducing alcohol use on occasion. Alcohol abuse is a major factor of morbidity, epidemic of noncommunicable diseases in Ukraine, causing significant medical and social costs and economic losts.Ukraine ranks fifth in alcohol consumption per capita among WHO European Region countries. High level and unhealthy patterns of alcohol consumption in the population causes high morbidity and mortality from noncommunicable diseases, accidents, exceeding pan-European indices and indicators in the European Union. Primary health care facility staff has insufficient knowledge, skills and gaps in professional training regarding the prevention of harmful use of alcohol.There is a high need for effective strategies to reduce the prevalence of this risk factor in Ukraine. In developing the National Action Plan to reduce the harmful use of alcohol, a national context and WHO recommendationsshould be considered, including improving the efficiency of health services, high-quality prevention and effective treatment of disorders caused by alcohol, countermeasures on driving drunk, limiting the sale and availability of alcohol, prevention the spread of manufacturing and marketing of alcoholbeverages produced illegally, including falsification, the revitalization of local communities, weakening the impact of marketing of alcohol beverages.

  17. Does applying the Canadian Cervical Spine rule reduce cervical spine radiography rates in alert patients with blunt trauma to the neck? A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Yesupalan Rajam

    2008-06-01

    Full Text Available Abstract Background A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries. Methods This was a retrospective study conducted in 2 hospitals. 114 alert and stable patients who had cervical spine radiographs for suspected neck injuries were included in the study. Data on patient demographics, high risk & low risk factors as per the Canadian Cervical Spine rule and cervical spine radiography results were collected and analysed. Results 28 patients were included in the high risk category according to the Canadian Cervical Spine rule. 86 patients fell into the low risk category. If the Canadian Cervical Spine rule was applied, there would have been a significant reduction in cervical spine radiographs as 86/114 patients (75.4% would not have needed cervical spine radiograph. 2/114 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied. Conclusion Applying the Canadian Cervical Spine rule for neck injuries in alert and stable patients would have reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. This relates to reduction in radiation exposure to patients and health care costs.

  18. The role of interpersonal harm in distinguishing regret from guilt.

    Science.gov (United States)

    Zeelenberg, Marcel; Breugelmans, Seger M

    2008-10-01

    Regret and guilt are emotions that are produced by negative outcomes for which one is responsible. Both emotions have received ample attention in the psychological literature; however, it is still unclear to what extent regret and guilt represent distinct psychological processes. We examined the extent to which the distinction between interpersonal harm (negative outcomes for others) and intrapersonal harm (negative outcomes for self) is crucial in differentiating these two emotions. In a series of 3 studies we found that guilt is predominantly felt in situations of interpersonal harm, whereas regret is felt in both situations of interpersonal harm and intrapersonal harm. Moreover, the results show that in situations of interpersonal harm the phenomenology of regret shares many, but not all features with the phenomenology of guilt. We conclude that the emotion processes resulting from interpersonal and intrapersonal harm are clearly distinct, but that regret as an emotion label is applied to both types of processes whereas the emotion label guilt is primarily used to refer to experiences of interpersonal harm. Implications for emotion research are discussed. (c) 2008 APA, all rights reserved

  19. Managing Sexually Harmful Behaviour in a Residential Special School

    Science.gov (United States)

    Pritchard, Duncan; Graham, Nicola; Ikin, Annette; Penney, Heather; Kovacs, Lisa; Mercer, Dawn; Edwards, Richard; Jones, Dylan; Mace, Floyd Charles

    2012-01-01

    Children and young people with learning disabilities who present sexually harmful behaviour are marginalised and do not always participate in community activities. This case study describes a multi-component intervention that successfully reduced the sexually harmful behaviour of a 16-year-old boy with a mild learning disability. The intervention…

  20. Harmful algal blooms of the Southern Benguela current: A review ...

    African Journals Online (AJOL)

    Harmful algal blooms of the Southern Benguela current: A review and appraisal of monitoring from 1989 to 1997. ... The Benguela upwelling system is subjected to blooms of harmful and toxic algae, the incidence and consequences of which are documented here. Red tides are common and usually attributed to members of ...