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

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...

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.

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

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.

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.

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…

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

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.

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...

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.

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

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

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.

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.

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.

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".

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...

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.

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.

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.

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/

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.

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.

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

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

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.

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.

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.

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.

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.

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...

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...

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

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…

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.

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...

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.

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 ...

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

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 ...

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.

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.

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...

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

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.

[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.

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.

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.

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...

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

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...

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.

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...

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…

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.

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)

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 ...

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.

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.

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

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.

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

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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

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care.

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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.

A Multiscale Mapping Assessment of Lake Champlain Cyanobacterial Harmful Algal Blooms

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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.

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

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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.

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 ...

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.

A clinical data warehouse-based process for refining medication orders alerts.

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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.

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.

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.

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

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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.

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

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...

Harm reduction principles for healthcare settings

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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

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

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

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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.

Alertness management in two-person long-haul flight operations

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Rosekind, M. R.; Gander, P. H.

1992-01-01

Long-haul flight operations involve cumulative sleep loss, circadian disruption, and extended and irregular duty schedules. These factors reduce pilot alertness and performance on the flightdeck. Conceptually and operationally, alertness management in flight operations can be divided into preventive strategies and operational countermeasures. Preventive strategies are utilized prior to a duty period to mitigate or reduce the effects of sleep loss, circadian disruption and fatigue during subsequent flight operations. Operational countermeasures are used during operations as acute techniques for maintaining performance and alertness. Results from previous NASA Ames field studies document the sleep loss and circadian disruption in three-person long-haul flying and illustrate the application of preventive strategies and operational countermeasures. One strategy that can be used in both a preventive and operational manner is strategic napping. The application and effectiveness of strategic napping in long-haul operations will be discussed. Finally, long-haul flying in two-person highly automated aircraft capable of extended range operations will create new challenges to maintaining pilot alertness and performance. Alertness management issues in this flight environment will be explored.

Assessing harmful effects in systematic Reviews

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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.

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).

[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.

The agile alert system for gamma-ray transients

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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.

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.

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.

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 ...

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.

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.

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 ...

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.

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.

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.…

Alerts Analysis and Visualization in Network-based Intrusion Detection Systems

Energy Technology Data Exchange (ETDEWEB)

Yang, Dr. Li [University of Tennessee

2010-08-01

The alerts produced by network-based intrusion detection systems, e.g. Snort, can be difficult for network administrators to efficiently review and respond to due to the enormous number of alerts generated in a short time frame. This work describes how the visualization of raw IDS alert data assists network administrators in understanding the current state of a network and quickens the process of reviewing and responding to intrusion attempts. The project presented in this work consists of three primary components. The first component provides a visual mapping of the network topology that allows the end-user to easily browse clustered alerts. The second component is based on the flocking behavior of birds such that birds tend to follow other birds with similar behaviors. This component allows the end-user to see the clustering process and provides an efficient means for reviewing alert data. The third component discovers and visualizes patterns of multistage attacks by profiling the attacker s behaviors.

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

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.

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.

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.

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...

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.

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.).

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...

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.

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...

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.

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.

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

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.

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

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.

[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.

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.

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...

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

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...

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.

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...

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...

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.

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.

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

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.

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).

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.

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.

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...

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,...

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.

Improving Radiology Workflow with Automated Examination Tracking and Alerts.

Science.gov (United States)

Pianykh, Oleg S; Jaworsky, Christina; Shore, M T; Rosenthal, Daniel I

2017-07-01

The modern radiology workflow is a production line where imaging examinations pass in sequence through many steps. In busy clinical environments, even a minor delay in any step can propagate through the system and significantly lengthen the examination process. This is particularly true for the tasks delegated to the human operators, who may be distracted or stressed. We have developed an application to track examinations through a critical part of the workflow, from the image-acquisition scanners to the PACS archive. Our application identifies outliers and actively alerts radiology managers about the need to resolve these problems as soon as they happen. In this study, we investigate how this real-time tracking and alerting affected the speed of examination delivery to the radiologist. We demonstrate that active alerting produced a 3-fold reduction of examination-to-PACS delays. Additionally, we discover an overall improvement in examination-to-PACS delivery, evidence that the tracking and alerts instill a culture where timely processing is essential. By providing supervisors with information about exactly where delays emerge in their workflow and alerting the correct staff to take action, applications like ours create more robust radiology workflow with predictable, timely outcomes. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

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

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

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.

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...

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

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.

[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.

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.

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

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 ...

Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.

Science.gov (United States)

Cutrona, Sarah L; Fouayzi, Hassan; Burns, Laura; Sadasivam, Rajani S; Mazor, Kathleen M; Gurwitz, Jerry H; Garber, Lawrence; Sundaresan, Devi; Houston, Thomas K; Field, Terry S

2017-11-01

Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3 days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24 h. At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7 days. Of the 799 alerts, 47.1% were opened within 24 h. Patients with longer hospital stays (>4 days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24 h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24 h (OR 0.18 [CI 0.08-0.39]). The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.

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.

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

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...

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…

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

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

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.

Feature-based alert correlation in security systems using self organizing maps

Science.gov (United States)

Kumar, Munesh; Siddique, Shoaib; Noor, Humera

2009-04-01

The security of the networks has been an important concern for any organization. This is especially important for the defense sector as to get unauthorized access to the sensitive information of an organization has been the prime desire for cyber criminals. Many network security techniques like Firewall, VPN Concentrator etc. are deployed at the perimeter of network to deal with attack(s) that occur(s) from exterior of network. But any vulnerability that causes to penetrate the network's perimeter of defense, can exploit the entire network. To deal with such vulnerabilities a system has been evolved with the purpose of generating an alert for any malicious activity triggered against the network and its resources, termed as Intrusion Detection System (IDS). The traditional IDS have still some deficiencies like generating large number of alerts, containing both true and false one etc. By automatically classifying (correlating) various alerts, the high-level analysis of the security status of network can be identified and the job of network security administrator becomes much easier. In this paper we propose to utilize Self Organizing Maps (SOM); an Artificial Neural Network for correlating large amount of logged intrusion alerts based on generic features such as Source/Destination IP Addresses, Port No, Signature ID etc. The different ways in which alerts can be correlated by Artificial Intelligence techniques are also discussed. . We've shown that the strategy described in the paper improves the efficiency of IDS by better correlating the alerts, leading to reduced false positives and increased competence of network administrator.

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.

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

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

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)

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.

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.

Behavioral and Brain Measures of Phasic Alerting Effects on Visual Attention.

Science.gov (United States)

Wiegand, Iris; Petersen, Anders; Finke, Kathrin; Bundesen, Claus; Lansner, Jon; Habekost, Thomas

2017-01-01

In the present study, we investigated effects of phasic alerting on visual attention in a partial report task, in which half of the displays were preceded by an auditory warning cue. Based on the computational Theory of Visual Attention (TVA), we estimated parameters of spatial and non-spatial aspects of visual attention and measured event-related lateralizations (ERLs) over visual processing areas. We found that the TVA parameter sensory effectiveness a , which is thought to reflect visual processing capacity, significantly increased with phasic alerting. By contrast, the distribution of visual processing resources according to task relevance and spatial position, as quantified in parameters top-down control α and spatial bias w index , was not modulated by phasic alerting. On the electrophysiological level, the latencies of ERLs in response to the task displays were reduced following the warning cue. These results suggest that phasic alerting facilitates visual processing in a general, unselective manner and that this effect originates in early stages of visual information processing.

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.

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

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.

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....

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.

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.

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.

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.

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.

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.

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

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.

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.

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...

Development of case-based medication alerting and recommender system: a new approach to prevention for medication error.

Science.gov (United States)

Miyo, Kengo; Nittami, Yuki S; Kitagawa, Yoichiro; Ohe, Kazuhiko

2007-01-01

The purpose of this study was to develop a new alerting and recommender system for preventing medication errors. In recent years, alerting systems have been widely implemented, but because these systems apply a same static threshold for all patients in all cases, they produce excessive alerts and subject physicians to "alert fatigue". We believe that the most commonly-written prescription for a patient's status is the safest one. From this standpoint, we developed a real-time case-based medication alerting and recommender system linked to a database of past prescriptions. When a physician issues his or her prescription, our system dynamically compares it with past ones for similar patients in the database. An analysis of the 10 most frequently-used drugs in the University of Tokyo Hospital revealed that our system reduced the number of false alerts compared to the traditional static alert method. Our system contributes to the creation of alerts that are appropriate for patients' clinical conditions and based on physicians' empirical discretion.

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.

Behavioral and Brain Measures of Phasic Alerting Effects on Visual Attention

DEFF Research Database (Denmark)

Wiegand, Iris Michaela; Petersen, Anders; Finke, Kathrin

2017-01-01

In the present study, we investigated effects of phasic alerting on visual attention in a partial report task, in which half of the displays were preceded by an auditory warning cue. Based on the computational Theory of Visual Attention (TVA), we estimated parameters of spatial and non......-spatial aspects of visual attention and measured event-related lateralizations (ERLs) over visual processing areas. We found that the TVA parameter sensory effectiveness a, which is thought to reflect visual processing capacity, significantly increased with phasic alerting. By contrast, the distribution of visual....... These results suggest that phasic alerting facilitates visual processing in a general, unselective manner and that this effect originates in early stages of visual information processing....

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?  

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.

Automated health alerts from Kinect-based in-home gait measurements.

Science.gov (United States)

Stone, Erik E; Skubic, Marjorie; Back, Jessica

2014-01-01

A method for automatically generating alerts to clinicians in response to changes in in-home gait parameters is investigated. Kinect-based gait measurement systems were installed in apartments in a senior living facility. The systems continuously monitored the walking speed, stride time, and stride length of apartment residents. A framework for modeling uncertainty in the residents' gait parameter estimates, which is critical for robust change detection, is developed; along with an algorithm for detecting changes that may be clinically relevant. Three retrospective case studies, of individuals who had their gait monitored for periods ranging from 12 to 29 months, are presented to illustrate use of the alert method. Evidence suggests that clinicians could be alerted to health changes at an early stage, while they are still small and interventions may be most successful. Additional potential uses are also discussed.

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.

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.

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

Completed suicides and self-harm in Malaysia: a systematic review.

Science.gov (United States)

Armitage, Christopher J; Panagioti, Maria; Abdul Rahim, Wirda; Rowe, Richard; O'Connor, Rory C

2015-01-01

Most of the research into suicide and self-harm has been conducted in the United States and Europe, yet the volume of research does not reflect the distribution of suicide globally, with Asia accounting for up to 60% of all suicides. The present study systematically reviews the literature to assess the prevalence and correlates of suicidal acts in Malaysia in Southeast Asia. Five relevant databases were searched from inception up to February 2014, and a narrative synthesis of the results from the included studies was performed. Studies were eligible for inclusion if they were correlational survey research and archival/observational research describing self-harm and suicide. Outcomes included completed suicides and self-harm including suicide attempts and self-poisoning, suicide plans and suicidal ideation. In total, 39 studies met the inclusion criteria. The principal findings were that the prevalence of suicide in Malaysia is approximately 6-8 per 100,000 population per year and that there is an excess of suicide among men, people younger than 40 years and the Indian minority group. The past-month prevalence rates of suicidal ideation, plans and attempts are 1.7, 0.9% and 0.5%, respectively, whereas the past-year prevalence rates of suicidal ideation range between 6% and 8%. The present research marks a first step towards understanding the prevalence and correlates of suicide and self-harm in Malaysia. However, the heterogeneity of the included studies was high. Further research into the antecedents, consequences and interventions for suicide and self-harm in the Malaysian context is required. Copyright © 2015 Elsevier Inc. All rights reserved.

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

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.

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.

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

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.

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...

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.

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\\

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.

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.

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...

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.

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

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...

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.

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.

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.

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…

Alert: An Adaptive Low-Latency Event-Driven MAC Protocol for Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Vinod Namboodiri

2011-01-01

Full Text Available Collection of rare but delay-critical messages from a group of sensor nodes is a key process in many wireless sensor network applications. This is particularly important for security-related applications like intrusion detection and fire alarm systems. An event sensed by multiple sensor nodes in the network can trigger many messages to be sent simultaneously. We present Alert, a MAC protocol for collecting event-triggered urgent messages from a group of sensor nodes with minimum latency and without requiring any cooperation or prescheduling among the senders or between senders and receiver during protocol execution. Alert is designed to handle multiple simultaneous messages from different nodes efficiently and reliably, minimizing the overall delay to collect all messages along with the delay to get the first message. Moreover, the ability of the network to handle a large number of simultaneous messages does not come at the cost of excessive delays when only a few messages need to be handled. We analyze Alert and evaluate its feasibility and performance with an implementation on commodity hardware. We further compare Alert with existing approaches through simulations and show the performance improvement possible through Alert.

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.

Alerting, Orienting or Executive Attention Networks: Differential Patters of Pupil Dilations

Directory of Open Access Journals (Sweden)

Ronny eGeva

2013-10-01

Full Text Available Attention capacities, alerting responses, orienting to sensory stimulation, and executive monitoring of performance are considered independent yet interrelated systems. These operations play integral roles in regulating the behavior of diverse species along the evolutionary ladder. Each of the primary attention constructs—alerting, orienting, and executive monitoring— involves salient autonomic correlates as evidenced by changes in reactive pupil dilation (PD, heart rate, and skin conductance. Recent technological advances that use remote high-resolution recording may allow the discernment of temporo-spatial attributes of autonomic responses that characterize the alerting, orienting, and executive monitoring networks during free viewing, irrespective of voluntary performance. This may deepen the understanding of the roles of autonomic regulation in these mental operations and may deepen our understanding of behavioral changes in verbal as well as in non-verbal species.The aim of this study was to explore differences between psychosensory pupil dilation responses in alerting, orienting, and executive conflict monitoring tasks to generate estimates of concurrent locus coeruleus (LC noradrenergic input trajectories in healthy human adults using the attention networks test (ANT. The analysis revealed a construct-specific pattern of pupil responses: alerting is characterized by an early component (Pa, its acceleration enables covert orienting, and executive control is evidenced by a prominent late component (Pe. Pupil dilation characteristics seem to be task-sensitive, allowing exploration of mental operations irrespective of conscious voluntary responses. These data may facilitate development of studies designed to assess mental operations in diverse species using autonomic responses.

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.

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…

The effect of automated alerts on provider ordering behavior in an outpatient setting.

Directory of Open Access Journals (Sweden)

2005-09-01

Full Text Available BACKGROUND: Computerized order entry systems have the potential to prevent medication errors and decrease adverse drug events with the use of clinical-decision support systems presenting alerts to providers. Despite the large volume of medications prescribed in the outpatient setting, few studies have assessed the impact of automated alerts on medication errors related to drug-laboratory interactions in an outpatient primary-care setting. METHODS AND FINDINGS: A primary-care clinic in an integrated safety net institution was the setting for the study. In collaboration with commercial information technology vendors, rules were developed to address a set of drug-laboratory interactions. All patients seen in the clinic during the study period were eligible for the intervention. As providers ordered medications on a computer, an alert was displayed if a relevant drug-laboratory interaction existed. Comparisons were made between baseline and postintervention time periods. Provider ordering behavior was monitored focusing on the number of medication orders not completed and the number of rule-associated laboratory test orders initiated after alert display. Adverse drug events were assessed by doing a random sample of chart reviews using the Naranjo scoring scale. The rule processed 16,291 times during the study period on all possible medication orders: 7,017 during the pre-intervention period and 9,274 during the postintervention period. During the postintervention period, an alert was displayed for 11.8% (1,093 out of 9,274 of the times the rule processed, with 5.6% for only "missing laboratory values," 6.0% for only "abnormal laboratory values," and 0.2% for both types of alerts. Focusing on 18 high-volume and high-risk medications revealed a significant increase in the percentage of time the provider stopped the ordering process and did not complete the medication order when an alert for an abnormal rule-associated laboratory result was displayed

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 ...

The preliminary development and testing of a global trigger tool to detect error and patient harm in primary-care records.

Science.gov (United States)

de Wet, C; Bowie, P

2009-04-01

A multi-method strategy has been proposed to understand and improve the safety of primary care. The trigger tool is a relatively new method that has shown promise in American and secondary healthcare settings. It involves the focused review of a random sample of patient records using a series of "triggers" that alert reviewers to potential errors and previously undetected adverse events. To develop and test a global trigger tool to detect errors and adverse events in primary-care records. Trigger tool development was informed by previous research and content validated by expert opinion. The tool was applied by trained reviewers who worked in pairs to conduct focused audits of 100 randomly selected electronic patient records in each of five urban general practices in central Scotland. Review of 500 records revealed 2251 consultations and 730 triggers. An adverse event was found in 47 records (9.4%), indicating that harm occurred at a rate of one event per 48 consultations. Of these, 27 were judged to be preventable (42%). A further 17 records (3.4%) contained evidence of a potential adverse event. Harm severity was low to moderate for most patients (82.9%). Error and harm rates were higher in those aged > or =60 years, and most were medication-related (59%). The trigger tool was successful in identifying undetected patient harm in primary-care records and may be the most reliable method for achieving this. However, the feasibility of its routine application is open to question. The tool may have greater utility as a research rather than an audit technique. Further testing in larger, representative study samples is required.

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.

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,

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.

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

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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

Impact of Entrepreneurship Training on Entrepreneurial Efficacy and Alertness among Adolescent Youth

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Moon-Ho Ringo Ho

2018-03-01

Full Text Available Our study focuses on the impact of systematic entrepreneurship training comprising both active and passive learning activities on entrepreneurial alertness and efficacy among adolescent youth. Reports from a two-wave online survey among 328 students from five secondary schools (aged 13–16 years; 34.8% male and 65.2% female reveal that those who went through entrepreneurship training (treatment group, N = 142 had significantly higher entrepreneurial alertness and efficacy levels compared to those who did not go through training (control group, N = 186. We also find that even with gender effects accounted for, the higher entrepreneurial alertness and efficacy levels in the treatment group are due in part to both passive and active/hands-on elements of the program. Our study offers direct evidence that conducting entrepreneurship training programs among secondary school students could be an effective means to enhance entrepreneurial competencies among the youth. Specifically, our findings highlight the value of entrepreneurial training in improving age-appropriate competencies of entrepreneurial alertness and efficacy.

Application of Short-Range LIDAR in Early Alerting for Low-Level Windshear and Turbulence at Hong Kong International Airport

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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.

Earthquake early Warning ShakeAlert system: West coast wide production prototype

Science.gov (United States)

Kohler, Monica D.; Cochran, Elizabeth S.; Given, Douglas; Guiwits, Stephen; Neuhauser, Doug; Hensen, Ivan; Hartog, Renate; Bodin, Paul; Kress, Victor; Thompson, Stephen; Felizardo, Claude; Brody, Jeff; Bhadha, Rayo; Schwarz, Stan

2017-01-01

Earthquake early warning (EEW) is an application of seismological science that can give people, as well as mechanical and electrical systems, up to tens of seconds to take protective actions before peak earthquake shaking arrives at a location. Since 2006, the U.S. Geological Survey has been working in collaboration with several partners to develop EEW for the United States. The goal is to create and operate an EEW system, called ShakeAlert, for the highest risk areas of the United States, starting with the West Coast states of California, Oregon, and Washington. In early 2016, the Production Prototype v.1.0 was established for California; then, in early 2017, v.1.2 was established for the West Coast, with earthquake notifications being distributed to a group of beta users in California, Oregon, and Washington. The new ShakeAlert Production Prototype was an outgrowth from an earlier demonstration EEW system that began sending test notifications to selected users in California in January 2012. ShakeAlert leverages the considerable physical, technical, and organizational earthquake monitoring infrastructure of the Advanced National Seismic System, a nationwide federation of cooperating seismic networks. When fully implemented, the ShakeAlert system may reduce damage and injury caused by large earthquakes, improve the nation’s resilience, and speed recovery.

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...

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

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).

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.

Do family physicians retrieve synopses of clinical research previously read as email alerts?

Science.gov (United States)

Grad, Roland; Pluye, Pierre; Johnson-Lafleur, Janique; Granikov, Vera; Shulha, Michael; Bartlett, Gillian; Marlow, Bernard

2011-11-30

A synopsis of new clinical research highlights important aspects of one study in a brief structured format. When delivered as email alerts, synopses enable clinicians to become aware of new developments relevant for practice. Once read, a synopsis can become a known item of clinical information. In time-pressured situations, remembering a known item may facilitate information retrieval by the clinician. However, exactly how synopses first delivered as email alerts influence retrieval at some later time is not known. We examined searches for clinical information in which a synopsis previously read as an email alert was retrieved (defined as a dyad). Our study objectives were to (1) examine whether family physicians retrieved synopses they previously read as email alerts and then to (2) explore whether family physicians purposefully retrieved these synopses. We conducted a mixed-methods study in which a qualitative multiple case study explored the retrieval of email alerts within a prospective longitudinal cohort of practicing family physicians. Reading of research-based synopses was tracked in two contexts: (1) push, meaning to read on email and (2) pull, meaning to read after retrieval from one electronic knowledge resource. Dyads, defined as synopses first read as email alerts and subsequently retrieved in a search of a knowledge resource, were prospectively identified. Participants were interviewed about all of their dyads. Outcomes were the total number of dyads and their type. Over a period of 341 days, 194 unique synopses delivered to 41 participants resulted in 4937 synopsis readings. In all, 1205 synopses were retrieved over an average of 320 days. Of the 1205 retrieved synopses, 21 (1.7%) were dyads made by 17 family physicians. Of the 1205 retrieved synopses, 6 (0.5%) were known item type dyads. However, dyads also occurred serendipitously. In the single knowledge resource we studied, email alerts containing research-based synopses were rarely retrieved

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...

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

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....

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…

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

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

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.

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.

Comparison of Overridden Medication-related Clinical Decision Support in the Intensive Care Unit between a Commercial System and a Legacy System.

Science.gov (United States)

Wong, Adrian; Wright, Adam; Seger, Diane L; Amato, Mary G; Fiskio, Julie M; Bates, David

2017-08-23

Electronic health records (EHRs) with clinical decision support (CDS) have shown to be effective at improving patient safety. Despite this, alerts delivered as part of CDS are overridden frequently, which is of concern in the critical care population as this group may have an increased risk of harm. Our organization recently transitioned from an internally-developed EHR to a commercial system. Data comparing various EHR systems, especially after transitions between EHRs, are needed to identify areas for improvement. To compare the two systems and identify areas for potential improvement with the new commercial system at a single institution. Overridden medication-related CDS alerts were included from October to December of the systems' respective years (legacy, 2011; commercial, 2015), restricted to three intensive care units. The two systems were compared with regards to CDS presentation and override rates for four types of CDS: drug-allergy, drug-drug interaction (DDI), geriatric and renal alerts. A post hoc analysis to evaluate for adverse drug events (ADEs) potentially resulting from overridden alerts was performed for 'contraindicated' DDIs via chart review. There was a significant increase in provider exposure to alerts and alert overrides in the commercial system (commercial: n=5,535; legacy: n=1,030). Rates of overrides were higher for the allergy and DDI alerts (pcommercial system. Geriatric and renal alerts were significantly different in incidence and presentation between the two systems. No ADEs were identified in an analysis of 43 overridden contraindicated DDI alerts. The vendor system had much higher rates of both alerts and overrides, although we did not find evidence of harm in a review of DDIs which were overridden. We propose recommendations for improving our current system which may be helpful to other similar institutions; improving both alert presentation and the underlying knowledge base appear important.

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.

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.

Real time alert system: a disease management system leveraging health information exchange.

Science.gov (United States)

Anand, Vibha; Sheley, Meena E; Xu, Shawn; Downs, Stephen M

2012-01-01

Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA's performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Our results show that RTA was successfully able to deliver "just in time" patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient's asthma related emergency room admission so further follow up can happen in near real time.

Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

Science.gov (United States)

O'Connor, Stacy D; Dalal, Anuj K; Sahni, V Anik; Lacson, Ronilda; Khorasani, Ramin

2016-03-01

To assess whether integrating critical result management software--Alert Notification of Critical Results (ANCR)--with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts ("alerts") within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Optimization of drug-drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard.

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Simpao, Allan F; Ahumada, Luis M; Desai, Bimal R; Bonafide, Christopher P; Gálvez, Jorge A; Rehman, Mohamed A; Jawad, Abbas F; Palma, Krisha L; Shelov, Eric D

2015-03-01

To develop and evaluate an electronic dashboard of hospital-wide electronic health record medication alerts for an alert fatigue reduction quality improvement project. We used visual analytics software to develop the dashboard. We collaborated with the hospital-wide Clinical Decision Support committee to perform three interventions successively deactivating clinically irrelevant drug-drug interaction (DDI) alert rules. We analyzed the impact of the interventions on care providers' and pharmacists' alert and override rates using an interrupted time series framework with piecewise regression. We evaluated 2 391 880 medication alerts between January 31, 2011 and January 26, 2014. For pharmacists, the median alert rate prior to the first DDI deactivation was 58.74 alerts/100 orders (IQR 54.98-60.48) and 25.11 alerts/100 orders (IQR 23.45-26.57) following the three interventions (pdashboard facilitated safe rapid-cycle reductions in alert burden that were temporally associated with lower pharmacist override rates in a subgroup of DDIs not directly affected by the interventions; meanwhile, the pharmacists' frequency of selecting the 'cancel' option increased. We hypothesize that reducing the alert burden enabled pharmacists to devote more attention to clinically relevant alerts. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

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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.

A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems.

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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.

Suicide and Self-Harm Related Internet Use.

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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.

Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

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Pfeiffer, Yvonne; Schwappach, David

2016-01-01

National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts. Copyright © 2016. Published by Elsevier GmbH.

[Summarizing of medicinal alerts in Ivory Coast from 2001 till 2010].

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N'Guessan-Irié, Amenan Geneviève; Yavo, Jean-Claude; Guillaume Amari, Antoine Serge; Yapi, Ange Désiré

2012-01-01

STUDY'S AIM: This study aims a more efficient follow-up of the safety of medicines with human usage on the Ivory Coast territory. The structure responsible for pharmacovigilance in Ivory Coast i.e. DPM listed the medicinal alerts from 2001 till 2010. It emerges 237 medicinal alerts among which 145 stops of marketing, 55 withdrawals of lots, 33 information notes and 4 levying of suspension of medicines. These alerts result mainly from pharmaceutical companies (49%) and the French Drug Agency or ANSM (ex-Afssaps) (43%). They mainly concern drugs of infectious target (22%) and pneumology (18%) and their motivations are so much industrial with mainly commercial reasons (27%) as of pharmacovigilance dominated by unfavorable profit/risk connections. These results constitute an important database for the survey of the medicines market in Ivory Coast and an additional motivation to accelerate the implementation of a real national center of pharmacovigilance. © 2012 Société Française de Pharmacologie et de Thérapeutique.

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.

Harmed patients gaining voice: challenging dominant perspectives in the construction of medical harm and patient safety reforms.

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Ocloo, Josephine Enyonam

2010-08-01

Patient safety is a central issue in healthcare. In the United Kingdom, where there is more accurate information on National Health Service (NHS) hospitals than on primary care or the private sector, the evidence on adverse incidents shows that avoidable medical harm is a major concern. This paper looks at the occurrence of medical harm and argues that in the construction of patient safety reforms, it is important to be aware of alternative narratives about issues of power and accountability from harmed patients and self-help groups, that challenge dominant perspectives on the issues. The paper draws upon evidence from two sources. First, the paper draws on experiences of self-help groups set up as a result of medical harm and part of a campaigning network, where evidence was gathered from 14 groups over more than 2 years. In addition, data were obtained from 21 individuals affected by harm that attended a residential workshop called the Break Through Programme; 18 questionnaires were completed from participants and a written narrative account of their experiences and observational data were gathered from a range of workshop sessions. Looking at the issues from harmed patients' perspectives, the research illustrates that a model of medical harm focussing predominantly upon the clinical markers and individual agency associated with a medical model operates to obscure a range of social processes. These social processes, connected to the power and dominance of the medical profession and the activities of a wider state, are seen to be a major part of the construction of harm that impacts upon patients, which is further compounded by its concealment. Understanding the experiences of harmed patients is therefore seen as an important way of generating knowledge about the medical and social processes involved in harm, that can lead to a broader framework for addressing patient safety. Copyright 2010 Elsevier Ltd. All rights reserved.

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.

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

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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.

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...

Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.

Science.gov (United States)

Colpaert, Kirsten; Hoste, Eric A; Steurbaut, Kristof; Benoit, Dominique; Van Hoecke, Sofie; De Turck, Filip; Decruyenaere, Johan

2012-04-01

To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. Prospective intervention study. Surgical and medical intensive care unit in a tertiary care hospital. A total of 951 patients having in total 1,079 admission episodes were admitted during the study period (prealert control group: 227, alert group: 616, and postalert control group: 236). Three study phases were compared: A 1.5-month prealert control phase in which physicians were blinded for the acute kidney injury sniffer and a 3-month intervention phase with real-time alerting of worsening RIFLE class through the Digital Enhanced Cordless Technology telephone system followed by a second 1.5-month postalert control phase. A total of 2593 acute kidney injury alerts were recorded with a balanced distribution over all study phases. Most acute kidney injury alerts were RIFLE class risk (59.8%) followed by RIFLE class injury (34.1%) and failure (6.1%). A higher percentage of patients in the alert group received therapeutic intervention within 60 mins after the acute kidney injury alert (28.7% in alert group vs. 7.9% and 10.4% in the pre- and postalert control groups, respectively, p μ .001). In the alert group, more patients received fluid therapy (23.0% vs. 4.9% and 9.2%, p μ .01), diuretics (4.2% vs. 2.6% and 0.8%, p μ .001), or vasopressors (3.9% vs. 1.1% and 0.8%, p μ .001). Furthermore, these patients had a shorter time to intervention (p μ .001). A higher proportion of patients in the alert group showed return to a baseline kidney function within 8 hrs after an acute kidney injury alert "from normal to risk" compared with patients in the control group (p = .048). The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions

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.

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

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

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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.

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

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

Neural correlates of conventional and harm/welfare-based moral decision-making.

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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.

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.

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.

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

Optical flow and driver's kinematics analysis for state of alert sensing.

Science.gov (United States)

Jiménez-Pinto, Javier; Torres-Torriti, Miguel

2013-03-28

Road accident statistics from different countries show that a significant number of accidents occur due to driver's fatigue and lack of awareness to traffic conditions. In particular, about 60% of the accidents in which long haul truck and bus drivers are involved are attributed to drowsiness and fatigue. It is thus fundamental to improve non-invasive systems for sensing a driver's state of alert. One of the main challenges to correctly resolve the state of alert is measuring the percentage of eyelid closure over time (PERCLOS), despite the driver's head and body movements. In this paper, we propose a technique that involves optical flow and driver's kinematics analysis to improve the robustness of the driver's alert state measurement under pose changes using a single camera with near-infrared illumination. The proposed approach infers and keeps track of the driver's pose in 3D space in order to ensure that eyes can be located correctly, even after periods of partial occlusion, for example, when the driver stares away from the camera. Our experiments show the effectiveness of the approach with a correct eyes detection rate of 99.41%, on average. The results obtained with the proposed approach in an experiment involving fifteen persons under different levels of sleep deprivation also confirm the discriminability of the fatigue levels. In addition to the measurement of fatigue and drowsiness, the pose tracking capability of the proposed approach has potential applications in distraction assessment and alerting of machine operators.

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…

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....

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.

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

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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.

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

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.

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

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.

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.

A Non-Intrusive Alert System for Maritime Anomalies: Literature Review and the Development and Assessment of Interface Design Concepts (Systeme d’Alerte non Intrusive en cas d’Anomalies Maritimes: Examen de la Documentation et Elaboration/Evaluation de Concepts d’Interface)

Science.gov (United States)

2009-03-01

visualisation , en l’occurrence un système d’alerte, qui aiderait les opérateurs du TSM à mieux connaître et comprendre les anomalies maritimes indiquées...and would much rather have an audio alert. Assessment While this paper recognises the need for the operator to configure appropriate alert...displayed on the screen). The intrusiveness filter would also allow leaders to turn off audio alerts, which could be especially important if there is a

Finite-Fault and Other New Capabilities of CISN ShakeAlert

Science.gov (United States)

Boese, M.; Felizardo, C.; Heaton, T. H.; Hudnut, K. W.; Hauksson, E.

2013-12-01

Over the past 6 years, scientists at Caltech, UC Berkeley, the Univ. of Southern California, the Univ. of Washington, the US Geological Survey, and ETH Zurich (Switzerland) have developed the 'ShakeAlert' earthquake early warning demonstration system for California and the Pacific Northwest. We have now started to transform this system into a stable end-to-end production system that will be integrated into the daily routine operations of the CISN and PNSN networks. To quickly determine the earthquake magnitude and location, ShakeAlert currently processes and interprets real-time data-streams from several hundred seismic stations within the California Integrated Seismic Network (CISN) and the Pacific Northwest Seismic Network (PNSN). Based on these parameters, the 'UserDisplay' software predicts and displays the arrival and intensity of shaking at a given user site. Real-time ShakeAlert feeds are currently being shared with around 160 individuals, companies, and emergency response organizations to gather feedback about the system performance, to educate potential users about EEW, and to identify needs and applications of EEW in a future operational warning system. To improve the performance during large earthquakes (M>6.5), we have started to develop, implement, and test a number of new algorithms for the ShakeAlert system: the 'FinDer' (Finite Fault Rupture Detector) algorithm provides real-time estimates of locations and extents of finite-fault ruptures from high-frequency seismic data. The 'GPSlip' algorithm estimates the fault slip along these ruptures using high-rate real-time GPS data. And, third, a new type of ground-motion prediction models derived from over 415,000 rupture simulations along active faults in southern California improves MMI intensity predictions for large earthquakes with consideration of finite-fault, rupture directivity, and basin response effects. FinDer and GPSlip are currently being real-time and offline tested in a separate internal

A Logic Architecture for 360 ADAS-Alerts for Hazards Detection Based in Driver Actions

Directory of Open Access Journals (Sweden)

Izquierdo-Reyes Javier

2017-01-01

Full Text Available In this work is presented a novel approach for passive safety in vehicles by Advanced Driver Assistance Systems (ADAS alert emission in 360° around driver to notify about hazards nearby the vehicle depending on the actions taken by driver per the context. This proposal would create a more robust system compared to current passive ADAS systems since the feedback to driver is in the same direction that hazard is detected (Punctual Sound Source Alert, compared with most assistance systems that emits sounds from the monitor or from the dashboard provoking distractions when emits alerts unnecessarily. The increase of security by this method will allow the driver to be aware of their surroundings even in a very quiet cabin or in a noisy environment. Also, it would detect the steering wheel angle, speed of movement and the activation of turning lights among other alerts, which would allow us to define a critical action during driving; apart from using sensors and cameras aimed at the driver to detect patterns of movement during these critical actions and have a prediction of a possible turn or manoeuvre when driving, refer to Figure 1. It will be necessary a reconfiguration of the alert in frequency, time of action depending upon the level of risk to prevent an accident or to reduce the consequences in an imminent accident.

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.

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.

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

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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.

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

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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.

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.

Verbal collision avoidance messages during simulated driving: perceived urgency, alerting effectiveness and annoyance.

Science.gov (United States)

Baldwin, Carryl L

2011-04-01

Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Two experiments describe the impact of acoustic and semantic parameters on ratings of perceived urgency, annoyance and alerting effectiveness and on alarm response speed. Within a simulated driving context, participants rated and responded to collision avoidance system (CAS) messages spoken by a female or male voice (experiments 1 and 2, respectively). Results indicated greater perceived urgency and faster alarm response times as intensity increased from -2 dB signal to noise (S/N) ratio to +10 dB S/N, although annoyance ratings increased as well. CAS semantic content interacted with alarm intensity, indicating that at lower intensity levels participants paid more attention to the semantic content. Results indicate that both acoustic and semantic parameters independently and interactively impact CAS alert perceptions in divided attention conditions and this work can inform auditory alarm design for effective hazard matching. Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Here, both acoustic and semantic parameters independently and interactively impacted CAS alert perceptions in divided attention conditions. This work can inform auditory alarm design for effective hazard matching. STATEMENT OF RELEVANCE: Results indicate that both acoustic parameters and semantic content can be used to design collision warnings with a range of urgency levels. Further, these results indicate that verbal warnings tailored to a specific hazard situation may improve hazard-matching capabilities without substantial trade-offs in perceived annoyance.

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.

The effect of an electronic "hard-stop" alert on HIV testing rates in the emergency department.

Science.gov (United States)

Schnall, Rebecca; Sperling, Jeremy D; Liu, Nan; Green, Robert A; Clark, Sunday; Vawdrey, David K

2013-01-01

Use of electronic alerts in clinical practice has had mixed effects on providers' prescribing practices. Little research has explored the use of electronic alerts for improving screening practices. New York City has one of the highest rates of HIV in the United States. Recent New York State legislation requires healthcare providers to offer an HIV test to patients aged 13-64 years during a clinical encounter. Adhering to this requirement is particularly challenging in emergency department (ED) settings, which are frequently overcrowded and under-resourced. The purpose of this study was to evaluate the effect of an electronic "hard-stop" alert on HIV testing rates in the ED. Approximately four months of data were reviewed before and after the implementation of the alert. We found that use of the electronic alert significantly increased documentation of offering an HIV test (O.R. = 267.27, p<0.001) and resulted in a significant increase in HIV testing. Findings from this study add to the current knowledge about the use of electronic alertsfor improving disease screening.

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...

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

Non-visual biological effects of light on human cognition, alertness, and mood

Science.gov (United States)

Li, Huaye; Wang, Huihui; Shen, Junfei; Sun, Peng; Xie, Ting; Zhang, Siman; Zheng, Zhenrong

2017-09-01

Light exerts non-visual effects on a wide range of biological functions and behavior apart from the visual effect. Light can regulate human circadian rhythms, like the secretion of melatonin and cortisol. Light also has influence on body's physiological parameters, such as blood pressure, heart rate and body temperature. However, human cognitive performance, alertness and mood under different lighting conditions have not been considered thoroughly especially for the complicated visual task like surgical operating procedure. In this paper, an experiment was conducted to investigate the cognition, alertness and mood of healthy participants in a simulated operating room (OR) in the hospital. A LED surgical lamp was used as the light source, which is mixed by three color LEDs (amber, green and blue). The surgical lamp is flexible on both spectrum and intensity. Exposed to different light settings, which are varied from color temperature and luminance, participants were asked to take psychomotor vigilance task (PVT) for alertness measurement, alphabet test for cognitive performance measurement, positive and negative affect schedule (PANAS) for mood measurement. The result showed the participants' cognitive performance, alertness and mood are related to the color temperature and luminance of the LED light. This research will have a guidance for the surgical lighting environment, which can not only enhance doctors' efficiency during the operations, but also create a positive and peaceful surgical lighting environment.

Psychological characteristics, stressful life events and deliberate self-harm: findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

Science.gov (United States)

Madge, Nicola; Hawton, Keith; McMahon, Elaine M; Corcoran, Paul; De Leo, Diego; de Wilde, Erik Jan; Fekete, Sandor; van Heeringen, Kees; Ystgaard, Mette; Arensman, Ella

2011-10-01

There is evidence to suggest that both psychological characteristics and stressful life events are contributory factors in deliberate self-harm among young people. These links, and the possibility of a dose-response relationship between self-harm and both psychological health and life events, were investigated in the context of a seven-country school-based study. Over 30,000, mainly 15 and 16 year olds, completed anonymous questionnaires at secondary schools in Belgium, England, Hungary, Ireland, the Netherlands, Norway and Australia. Pupils were asked to report on thoughts and episodes of self-harm, complete scales on depression and anxiety symptoms, impulsivity and self-esteem and indicate stressful events in their lives. Level and frequency of self-harm was judged according to whether they had thought about harming themselves or reported single or multiple self-harm episodes. Multinomial logistic regression assessed the extent to which psychological characteristics and stressful life events distinguished between adolescents with different self-harm histories. Increased severity of self-harm history was associated with greater depression, anxiety and impulsivity and lower self-esteem and an increased prevalence of all ten life event categories. Female gender, higher impulsivity and experiencing the suicide or self-harm of others, physical or sexual abuse and worries about sexual orientation independently differentiated single-episode self-harmers from adolescents with self-harm thoughts only. Female gender, higher depression, lower self-esteem, experiencing the suicide or self-harm of others, and trouble with the police independently distinguished multiple- from single-episode self-harmers. The findings reinforce the importance of psychological characteristics and stressful life events in adolescent self-harm but nonetheless suggest that some factors are more likely than others to be implicated.

The Diagnostic Utility of Bact/ALERT and Nested PCR in the Diagnosis of Tuberculous Meningitis.

Science.gov (United States)

Sastry, Apurba Sankar; Bhat K, Sandhya; Kumudavathi

2013-01-01

The early laboratory diagnosis of Tuberculous Meningitis (TBM) is crucial, to start the antitubercular chemotherapy and to prevent its complications. However, the conventional methods are either less sensitive or time consuming. Hence, the diagnostic potentials of BacT/ALERT and Polymerase Chain Reaction (PCR) was evaluated in this study. The study group comprised of 62 cases and 33 controls. The cases were divided according to Ahuja's criteria into the confirmed (two cases), highly probable (19 cases), probable (26 cases) and the possible (15 cases) subgroups. Ziehl Neelsen's (ZN) and Auramine Phenol (AP) staining, Lowenstein Jensen (LJ) medium culture, BacT/ALERT and nested Polymerase Chain Reaction (PCR) which targeted IS6110 were carried out on all the patients. The sensitivity of the LJ culture was 3.22%. BacT/ALERT showed a sensitivity and a specificity of 25.80% and 100% and those of nested PCR were found to be 40.32% and 96.97% respectively. The mean detection time of growth of the LJ culture was 31.28 days, whereas that of BacT/ALERT was 20.68 days. The contamination rate in the LJ culture and BacT/ALERT were 7.2% and 5.8% respectively. Nested PCR was found to be more sensitive, followed by BacT/ALERT as compared to the LJ culture and smear microscopy. As both false negative and false positive results have been reported for nested PCR, so it should not be used alone as a criterion for initiating or terminating the therapy, but it should be supported by clinical, radiological, cytological and other microbiological findings.

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.

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

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 ...

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.

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.

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.

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.

Bioalerts: a python library for the derivation of structural alerts from bioactivity and toxicity data sets.

Science.gov (United States)

Cortes-Ciriano, Isidro

2016-01-01

Assessing compound toxicity at early stages of the drug discovery process is a crucial task to dismiss drug candidates likely to fail in clinical trials. Screening drug candidates against structural alerts, i.e. chemical fragments associated to a toxicological response prior or after being metabolized (bioactivation), has proved a valuable approach for this task. During the last decades, diverse algorithms have been proposed for the automatic derivation of structural alerts from categorical toxicity data sets. Here, the python library bioalerts is presented, which comprises functionalities for the automatic derivation of structural alerts from categorical (dichotomous), e.g. toxic/non-toxic, and continuous bioactivity data sets, e.g. [Formula: see text] or [Formula: see text] values. The library bioalerts relies on the RDKit implementation of the circular Morgan fingerprint algorithm to compute chemical substructures, which are derived by considering radial atom neighbourhoods of increasing bond radius. In addition to the derivation of structural alerts, bioalerts provides functionalities for the calculation of unhashed (keyed) Morgan fingerprints, which can be used in predictive bioactivity modelling with the advantage of allowing for a chemically meaningful deconvolution of the chemical space. Finally, bioalerts provides functionalities for the easy visualization of the derived structural alerts.

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.

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.

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.

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).

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 ...

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

OpenAIRE

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

2017-01-01

Background: 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. Methods: 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 rando...

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.

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

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

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

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...

CERN alerter-RSS based system for information broadcast to all CERN offices

International Nuclear Information System (INIS)

Otto, R

2008-01-01

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 q uotMESSAGE command, Zephyr [2] 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 Simple Syndication) [9] for the transport protocol and uses Microsoft SharePoint as the backend for database and posting interface. The windows-based client relies on Internet Explorer 7.0 with custom code to trigger the window pop-ups and the notifications for new events. Linux and Mac OS X clients could also rely on any RSS readers to subscribe to targeted notifications. The paper covers the architecture and implementation aspects of the new system

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…

Radar-based alert system to operate a sewerage network: relevance and operational effectiveness after several years of use.

Science.gov (United States)

Faure, D; Payrastre, O; Auchet, P

2005-01-01

Since January 2000, the sewerage network of a very urbanised catchment area in the Greater Nancy Urban Community has been operated according to the alarms generated in real time by a storm alert system using weather radar data. This alert system is based on an automatic identification of intense rain cells in the radar images. This paper presents the characteristics of this alert system and synthesises the main results of two complementary studies realised in 2002 in order to estimate the relevance and the operational effectiveness of the alert system. The first study consisted in an off-line analysis of almost 50,000 intense rain cells detected in four years of historical radar data. The second study was an analysis of the experience feedback after two years of operational use of this alert system. The results of these studies are discussed in function of the initial operational objectives.

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.

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.

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.

Detection and Alert of muscle fatigue considering a Surface Electromyography Chaotic Model

International Nuclear Information System (INIS)

Herrera, V; Romero, J F; Amestegui, M

2011-01-01

This work propose a detection and alert algorithm for muscle fatigue in paraplegic patients undergoing electro-therapy sessions. The procedure is based on a mathematical chaotic model emulating physiological signals and Continuous Wavelet Transform (CWT). The chaotic model developed is based on a logistic map that provides suitable data accomplishing some physiological signal class patterns. The CWT was applied to signals generated by the model and the resulting vector was obtained through Total Wavelet Entropy (TWE). In this sense, the presented work propose a viable and practical alert and detection algorithm for muscle fatigue.

Detection and Alert of muscle fatigue considering a Surface Electromyography Chaotic Model

Energy Technology Data Exchange (ETDEWEB)

Herrera, V; Romero, J F [Engineering, Modeling and Applied Social Sciences Center, ABC Federal University, Santo Andr - SP (Brazil); Amestegui, M, E-mail: victoria.herrera@ufabc.edu.br [Engineering Faculty, Electronics Engineering, Universidad Mayor de San Andres, La Paz (Bolivia, Plurinational State of)

2011-03-01

This work propose a detection and alert algorithm for muscle fatigue in paraplegic patients undergoing electro-therapy sessions. The procedure is based on a mathematical chaotic model emulating physiological signals and Continuous Wavelet Transform (CWT). The chaotic model developed is based on a logistic map that provides suitable data accomplishing some physiological signal class patterns. The CWT was applied to signals generated by the model and the resulting vector was obtained through Total Wavelet Entropy (TWE). In this sense, the presented work propose a viable and practical alert and detection algorithm for muscle fatigue.

Comparison of warfarin therapy clinical outcomes following implementation of an automated mobile phone-based critical laboratory value text alert system.

Science.gov (United States)

Lin, Shu-Wen; Kang, Wen-Yi; Lin, Dong-Tsamn; Lee, James; Wu, Fe-Lin; Chen, Chuen-Liang; Tseng, Yufeng J

2014-01-01

Computerized alert and reminder systems have been widely accepted and applied to various patient care settings, with increasing numbers of clinical laboratories communicating critical laboratory test values to professionals via either manual notification or automated alerting systems/computerized reminders. Warfarin, an oral anticoagulant, exhibits narrow therapeutic range between treatment response and adverse events. It requires close monitoring of prothrombin time (PT)/international normalized ratio (INR) to ensure patient safety. This study was aimed to evaluate clinical outcomes of patients on warfarin therapy following implementation of a Personal Handy-phone System-based (PHS) alert system capable of generating and delivering text messages to communicate critical PT/INR laboratory results to practitioners' mobile phones in a large tertiary teaching hospital. A retrospective analysis was performed comparing patient clinical outcomes and physician prescribing behavior following conversion from a manual laboratory result alert system to an automated system. Clinical outcomes and practitioner responses to both alert systems were compared. Complications to warfarin therapy, warfarin utilization, and PT/INR results were evaluated for both systems, as well as clinician time to read alert messages, time to warfarin therapy modification, and monitoring frequency. No significant differences were detected in major hemorrhage and thromboembolism, warfarin prescribing patterns, PT/INR results, warfarin therapy modification, or monitoring frequency following implementation of the PHS text alert system. In both study periods, approximately 80% of critical results led to warfarin discontinuation or dose reduction. Senior physicians' follow-up response time to critical results was significantly decreased in the PHS alert study period (46.3% responded within 1 day) compared to the manual notification study period (24.7%; P = 0.015). No difference in follow-up response time

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.

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...

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...

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.

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.

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.

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.

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.

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

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....

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

First Episode of Self-Harm in Older Age : A Report From the 10-Year Prospective Manchester Self-Harm Project

NARCIS (Netherlands)

Voshaar, Richard C. Oude; Cooper, Jayne; Murphy, Elizabeth; Steeg, Sarah; Kapur, Nay; Purandare, Nitin B.

Objective: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm

First episode of self-harm in older age: a report from the 10-year prospective Manchester Self-Harm project

NARCIS (Netherlands)

Oude Voshaar, R.C.; Cooper, J.; Murphy, E.; Steeg, S.; Kapur, N.; Purandare, N.B.

2011-01-01

OBJECTIVE: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm

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.

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.

A Service-Oriented Healthcare Message Alerting Architecture in an Asia Medical Center: A Case Study

Directory of Open Access Journals (Sweden)

Jin-Shin Lai

2009-06-01

Full Text Available This paper illustrates how our development team has used some information technologies to let physicians obtain an instant abnormal laboratory result report for critical patient care services. We have implementeda healthcare message alerting system (HMAS on a healthcare short message service (HSMS engine and the distributed healthcare-oriented service environment (DiHOSE in the National Taiwan University Hospital (NTUH. The HSMS engine has a general interface for all applications which could easily send any kind of alerting messages. Fundamentally, the DiHOSE uses HL7 standard formats to process the information exchange behaviors and can be flexibly extended for reasonable user requirements. The disease surveillance subsystem is an integral part of NTUH new hospital information system which is based on DiHOSE and the disease surveillance subsystem would send alerting messages through the HSMS engine. The latest cell phone message alerting subsystem, a case study, in NTUH proved that the DiHOSE could integrate the user required functions without much work. We concluded that both HSMS and DiHOSE can generalize and extend application demands efficiently.

Machine-learning-based Brokers for Real-time Classification of the LSST Alert Stream

Science.gov (United States)

Narayan, Gautham; Zaidi, Tayeb; Soraisam, Monika D.; Wang, Zhe; Lochner, Michelle; Matheson, Thomas; Saha, Abhijit; Yang, Shuo; Zhao, Zhenge; Kececioglu, John; Scheidegger, Carlos; Snodgrass, Richard T.; Axelrod, Tim; Jenness, Tim; Maier, Robert S.; Ridgway, Stephen T.; Seaman, Robert L.; Evans, Eric Michael; Singh, Navdeep; Taylor, Clark; Toeniskoetter, Jackson; Welch, Eric; Zhu, Songzhe; The ANTARES Collaboration

2018-05-01

The unprecedented volume and rate of transient events that will be discovered by the Large Synoptic Survey Telescope (LSST) demand that the astronomical community update its follow-up paradigm. Alert-brokers—automated software system to sift through, characterize, annotate, and prioritize events for follow-up—will be critical tools for managing alert streams in the LSST era. The Arizona-NOAO Temporal Analysis and Response to Events System (ANTARES) is one such broker. In this work, we develop a machine learning pipeline to characterize and classify variable and transient sources only using the available multiband optical photometry. We describe three illustrative stages of the pipeline, serving the three goals of early, intermediate, and retrospective classification of alerts. The first takes the form of variable versus transient categorization, the second a multiclass typing of the combined variable and transient data set, and the third a purity-driven subtyping of a transient class. Although several similar algorithms have proven themselves in simulations, we validate their performance on real observations for the first time. We quantitatively evaluate our pipeline on sparse, unevenly sampled, heteroskedastic data from various existing observational campaigns, and demonstrate very competitive classification performance. We describe our progress toward adapting the pipeline developed in this work into a real-time broker working on live alert streams from time-domain surveys.

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

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.

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

Optical Flow and Driver’s Kinematics Analysis for State of Alert Sensing

Directory of Open Access Journals (Sweden)

Miguel Torres-Torriti

2013-03-01

Full Text Available Road accident statistics from different countries show that a significant number of accidents occur due to driver’s fatigue and lack of awareness to traffic conditions. In particular, about 60% of the accidents in which long haul truck and bus drivers are involved are attributed to drowsiness and fatigue. It is thus fundamental to improve non-invasive systems for sensing a driver’s state of alert. One of the main challenges to correctly resolve the state of alert is measuring the percentage of eyelid closure over time (PERCLOS, despite the driver’s head and body movements. In this paper, we propose a technique that involves optical flow and driver’s kinematics analysis to improve the robustness of the driver’s alert state measurement under pose changes using a single camera with near-infrared illumination. The proposed approach infers and keeps track of the driver’s pose in 3D space in order to ensure that eyes can be located correctly, even after periods of partial occlusion, for example, when the driver stares away from the camera. Our experiments show the effectiveness of the approach with a correct eyes detection rate of 99.41%, on average. The results obtained with the proposed approach in an experiment involving fifteen persons under different levels of sleep deprivation also confirm the discriminability of the fatigue levels. In addition to the measurement of fatigue and drowsiness, the pose tracking capability of the proposed approach has potential applications in distraction assessment and alerting of machine operators.

Optical and X-Ray Early Follow-Up of ANTARES Neutrino Alerts

Science.gov (United States)

Adrian-Martinez, S.; Ageron, M.; Albert, A.; Samarai, I. Al; Andre, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Baret, B.; Barrios-Marti, J.;

Optical and X-ray early follow-up of ANTARES neutrino alerts

International Nuclear Information System (INIS)

Adrián-Martínez, S.; Ardid, M.; Ageron, M.; Al Samarai, I.; Aubert, J.-J.; Albert, A.; André, M.; Anton, G.; Baret, B.; Barrios-Martí, J.

2016-01-01

High-energy neutrinos could be produced in the interaction of charged cosmic rays with matter or radiation surrounding astrophysical sources. Even with the recent detection of extraterrestrial high-energy neutrinos by the IceCube experiment, no astrophysical neutrino source has yet been discovered. Transient sources, such as gamma-ray bursts, core-collapse supernovae, or active galactic nuclei are promising candidates. Multi-messenger programs offer a unique opportunity to detect these transient sources. By combining the information provided by the ANTARES neutrino telescope with information coming from other observatories, the probability of detecting a source is enhanced, allowing the possibility of identifying a neutrino progenitor from a single detected event. A method based on optical and X-ray follow-ups of high-energy neutrino alerts has been developed within the ANTARES collaboration. This method does not require any assumptions on the relation between neutrino and photon spectra other than time-correlation. This program, denoted as TAToO, triggers a network of robotic optical telescopes (TAROT and ROTSE) and the Swift-XRT with a delay of only a few seconds after a neutrino detection, and is therefore well-suited to search for fast transient sources. To identify an optical or X-ray counterpart to a neutrino signal, the images provided by the follow-up observations are analysed with dedicated pipelines. A total of 42 alerts with optical and 7 alerts with X-ray images taken with a maximum delay of 24 hours after the neutrino trigger have been analysed. No optical or X-ray counterparts associated to the neutrino triggers have been found, and upper limits on transient source magnitudes have been derived. The probability to reject the gamma-ray burst origin hypothesis has been computed for each alert

Optical and X-ray early follow-up of ANTARES neutrino alerts

Science.gov (United States)

Adrián-Martínez, S.; Ageron, M.; Albert, A.; Samarai, I. Al; André, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bogazzi, C.; Bormuth, R.; Bou-Cabo, M.; Bouwhuis, M. C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Chiarusi, T.; Circella, M.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Dekeyser, I.; Deschamps, A.; De Bonis, G.; Distefano, C.; Donzaud, C.; Dornic, D.; Drouhin, D.; Dumas, A.; Eberl, T.; Elsässer, D.; Enzenhöfer, A.; Fehn, K.; Felis, I.; Fermani, P.; Folger, F.; Fusco, L. A.; Galatà, S.; Gay, P.; Geißelsöder, S.; Geyer, K.; Giordano, V.; Gleixner, A.; Gracia-Ruiz, R.; Graf, K.; van Haren, H.; Heijboer, A. J.; Hello, Y.; Hernández-Rey, J. J.; Herrero, A.; Hößl, J.; Hofestädt, J.; Hugon, C.; James, C. W.; de Jong, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kooijman, P.; Kouchner, A.; Kreykenbohm, I.; Kulikovskiy, V.; Lahmann, R.; Lambard, G.; Lattuada, D.; Lefèvre, D.; Leonora, E.; Loucatos, S.; Mangano, S.; Marcelin, M.; Margiotta, A.; Martínez-Mora, J. A.; Martini, S.; Mathieu, A.; Michael, T.; Migliozzi, P.; Moussa, A.; Mueller, C.; Neff, M.; Nezri, E.; Păvălaš, G. E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Racca, C.; Riccobene, G.; Richter, R.; Roensch, K.; Rostovtsev, A.; Saldaña, M.; Samtleben, D. F. E.; Sanguineti, M.; Sapienza, P.; Schmid, J.; Schnabel, J.; Schulte, S.; Schüssler, F.; Seitz, T.; Sieger, C.; Spurio, M.; Steijger, J. J. M.; Stolarczyk, Th.; Sánchez-Losa, A.; Taiuti, M.; Tamburini, C.; Trovato, A.; Tselengidou, M.; Tönnis, C.; Turpin, D.; Vallage, B.; Vallée, C.; Van Elewyck, V.; Vecchi, M.; Visser, E.; Vivolo, D.; Wagner, S.; Wilms, J.; Zornoza, J. D.; Zúñiga, J.; Klotz, A.; Boer, M.; Le Van Suu, A.; Akerlof, C.; Zheng, W.; Evans, P.; Gehrels, N.; Kennea, J.; Osborne, J. P.; Coward, D. M.

2016-02-01

High-energy neutrinos could be produced in the interaction of charged cosmic rays with matter or radiation surrounding astrophysical sources. Even with the recent detection of extraterrestrial high-energy neutrinos by the IceCube experiment, no astrophysical neutrino source has yet been discovered. Transient sources, such as gamma-ray bursts, core-collapse supernovae, or active galactic nuclei are promising candidates. Multi-messenger programs offer a unique opportunity to detect these transient sources. By combining the information provided by the ANTARES neutrino telescope with information coming from other observatories, the probability of detecting a source is enhanced, allowing the possibility of identifying a neutrino progenitor from a single detected event. A method based on optical and X-ray follow-ups of high-energy neutrino alerts has been developed within the ANTARES collaboration. This method does not require any assumptions on the relation between neutrino and photon spectra other than time-correlation. This program, denoted as TAToO, triggers a network of robotic optical telescopes (TAROT and ROTSE) and the Swift-XRT with a delay of only a few seconds after a neutrino detection, and is therefore well-suited to search for fast transient sources. To identify an optical or X-ray counterpart to a neutrino signal, the images provided by the follow-up observations are analysed with dedicated pipelines. A total of 42 alerts with optical and 7 alerts with X-ray images taken with a maximum delay of 24 hours after the neutrino trigger have been analysed. No optical or X-ray counterparts associated to the neutrino triggers have been found, and upper limits on transient source magnitudes have been derived. The probability to reject the gamma-ray burst origin hypothesis has been computed for each alert.

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.…

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

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 ...

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

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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.

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.

Microcontroller based driver alertness detection systems to detect drowsiness

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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.

Caring for self-harming patients in general practice.

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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.

The Nature and Variability of Automated Practice Alerts Derived from Electronic Health Records in a U.S. Nationwide Critical Care Research Network.

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Benthin, Cody; Pannu, Sonal; Khan, Akram; Gong, Michelle

2016-10-01

The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsis-related syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. A majority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of one common electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.

Self-harm in patients with schizophrenia spectrum disorders.

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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.

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.

Effectiveness of lockouts in reducing alcohol-related harm: Systematic review.

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Nepal, Smriti; Kypri, Kypros; Pursey, Kirrilly; Attia, John; Chikritzhs, Tanya; Miller, Peter

2018-05-01

Australian jurisdictions have introduced lockouts to prevent alcohol-related violence. Lockouts prohibit patrons from entering licensed premises after a designated time while allowing sale and consumption of alcohol to continue. Their purposes include managing the movement of intoxicated patrons, and preventing violence and disorder by dispersing times that patrons leave premises. We sought to evaluate the effectiveness of lockouts in preventing alcohol-related harm. We systematically searched electronic databases and reference lists and asked authors to identify relevant studies published to 1 June 2017. We deemed studies eligible if they evaluated lockouts, and if outcome measures included: assault, emergency department attendances, alcohol-related disorders or drink-driving offences. Two reviewers independently extracted data. After screening 244 records, we identified five studies from electronic databases, two from reference lists search and one from a Google search (N = 8). Two studies showed a decline in assaults; a third study showed reductions occurred only inside licensed premises; two studies showed an increase in assaults; and three studies showed no association. The studies had significant design and other limitations. Lockouts have been implemented across Australian jurisdictions as a strategy to prevent alcohol-related harm, despite limited evidence. In this systematic review, we synthesised findings from studies that evaluated lockouts as stand-alone interventions, to help clarify debate on their utility as a harm prevention strategy. There is not good evidence that lockouts prevent alcohol-related harm, in contrast to what is known about stopping the sale of alcohol earlier, for which there is evidence of effectiveness. © 2018 Australasian Professional Society on Alcohol and other Drugs.

Estimation of alertness levels with changes in decibel scale wavelength of EEG during dual-task simulation of auditory sonar target detection.

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

2010-01-01

Changes in alertness levels can have dire consequences for people operating and controlling motorized equipment. Past research studies have shown the relationship of Electroencephalogram (EEG) with alertness of the person. This research reports the fractal analysis of EEG and estimation of the alertness levels of the individual based on the changes in the maximum fractal length (MFL) of EEG. The results indicate that MFL of only 2 channels of EEG can be used to identify the loss of alertness of the individual with mean (inverse) correlation coefficient = 0.82. This study has also reported that using the changes in MFL of EEG, the changes in alertness level of a person was estimated with a mean correlation coefficient = 0.69.

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...

What's the Harm? The Coverage of Ethics and Harm Avoidance in Research Methods Textbooks

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Dixon, Shane; Quirke, Linda

2018-01-01

Methods textbooks play a role in socializing a new generation of researchers about ethical research. How do undergraduate social research methods textbooks portray harm, its prevalence, and ways to mitigate harm to participants? We conducted a content analysis of ethics chapters in the 18 highest-selling undergraduate textbooks used in sociology…

Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review.

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Carter, Emily; Bryce, Jennifer; Perin, Jamie; Newby, Holly

2015-08-18

Harmful practices in the management of childhood diarrhea are associated with negative health outcomes, and conflict with WHO treatment guidelines. These practices include restriction of fluids, breast milk and/or food intake during diarrhea episodes, and incorrect use of modern medicines. We conducted a systematic review of English-language literature published since 1990 to assess the documented prevalence of these four harmful practices, and beliefs, motivations, and contextual factors associated with harmful practices in low- and middle-income countries. We electronically searched PubMed, Embase, Ovid Global Health, and the WHO Global Health Library. Publications reporting the prevalence or substantive findings on beliefs, motivations, or context related to at least one of the four harmful practices were included, regardless of study design or representativeness of the sample population. Of the 114 articles included in the review, 79 reported the prevalence of at least one harmful practice and 35 studies reported on beliefs, motivations, or context for harmful practices. Most studies relied on sub-national population samples and many were limited to small sample sizes. Study design, study population, and definition of harmful practices varied across studies. Reported prevalence of harmful practices varied greatly across study populations, and we were unable to identify clearly defined patterns across regions, countries, or time periods. Caregivers reported that diarrhea management practices were based on the advice of others (health workers, relatives, community members), as well as their own observations or understanding of the efficacy of certain treatments for diarrhea. Others reported following traditionally held beliefs on the causes and cures for specific diarrheal diseases. Available evidence suggests that harmful practices in diarrhea treatment are common in some countries with a high burden of diarrhea-related mortality. These practices can reduce

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...

The effects of Project ALERT one year past curriculum completion.

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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.

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.

The Acute Effects of Intermittent Light Exposure in the Evening on Alertness and Subsequent Sleep Architecture.

Science.gov (United States)

Yang, Minqi; Ma, Ning; Zhu, Yingying; Su, Ying-Chu; Chen, Qingwei; Hsiao, Fan-Chi; Ji, Yanran; Yang, Chien-Ming; Zhou, Guofu

2018-03-15

Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent bright light (30-min pulse of blue-enriched bright light (~1000 lux, ~6000 K) alternating with 30-min dim normal light (~5 lux, ~3600 K) three times); continuous bright light; and continuous dim light on subjective and objective alertness and subsequent sleep structure. Each light exposure was conducted during the three hours before bedtime. Fifteen healthy volunteers (20 ± 3.4 years; seven males) were scheduled to stay in the sleep laboratory for four separated nights (one for adaptation and the others for the light exposures) with a period of at least one week between nights. The results showed that when compared with dim light, both intermittent light and continuous bright light significantly increased subjective alertness and decreased sleep efficiency (SE) and total sleep time (TST). Intermittent light significantly increased objective alertness than dim light did during the second half of the light-exposure period. Our results suggested that intermittent light was as effective as continuous bright light in their acute effects in enhancing subjective and objective alertness and in negatively impacting subsequent sleep.

The Acute Effects of Intermittent Light Exposure in the Evening on Alertness and Subsequent Sleep Architecture

Directory of Open Access Journals (Sweden)

Minqi Yang

2018-03-01

Full Text Available Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent bright light (30-min pulse of blue-enriched bright light (~1000 lux, ~6000 K alternating with 30-min dim normal light (~5 lux, ~3600 K three times; continuous bright light; and continuous dim light on subjective and objective alertness and subsequent sleep structure. Each light exposure was conducted during the three hours before bedtime. Fifteen healthy volunteers (20 ± 3.4 years; seven males were scheduled to stay in the sleep laboratory for four separated nights (one for adaptation and the others for the light exposures with a period of at least one week between nights. The results showed that when compared with dim light, both intermittent light and continuous bright light significantly increased subjective alertness and decreased sleep efficiency (SE and total sleep time (TST. Intermittent light significantly increased objective alertness than dim light did during the second half of the light-exposure period. Our results suggested that intermittent light was as effective as continuous bright light in their acute effects in enhancing subjective and objective alertness and in negatively impacting subsequent sleep.

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

Science.gov (United States)

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

2014-12-01

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 basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies.

[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.

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.

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.

Appreciating Complexity in Adolescent Self-Harm Risk Factors: Psychological Profiling in a Longitudinal Community Sample.

Science.gov (United States)

Stanford, Sarah; Jones, Michael P; Hudson, Jennifer L

2018-05-01

Past research identifies a number of risk factors for adolescent self-harm, but often fails to account for overlap between these factors. This study investigated the underlying, broader concepts by identifying different psychological profiles among adolescents. We then compared new self-harm rates over a six-month period across different psychological profiles. Australian high school students (n = 326, 68.1% female) completed a questionnaire including a broad range of psychological and socioenvironmental risk and protective factors. Non-hierarchical cluster analysis produced six groups with different psychological profiles at baseline and rate of new self-harm at follow-up. The lowest rate was 1.4% in a group that appeared psychologically healthy; the highest rate was 37.5% in a group that displayed numerous psychological difficulties. Four groups with average self-harm had varied psychological profiles including low impulsivity, anxiety, impulsivity, and poor use of positive coping strategies. Identifying multiple profiles with distinct psychological characteristics can improve detection, guide prevention, and tailor treatment.

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...

Impact-based earthquake alerts with the U.S. Geological Survey's PAGER system: what's next?

Science.gov (United States)

Wald, D.J.; Jaiswal, K.S.; Marano, K.D.; Garcia, D.; So, E.; Hearne, M.

2012-01-01

In September 2010, the USGS began publicly releasing earthquake alerts for significant earthquakes around the globe based on estimates of potential casualties and economic losses with its Prompt Assessment of Global Earthquakes for Response (PAGER) system. These estimates significantly enhanced the utility of the USGS PAGER system which had been, since 2006, providing estimated population exposures to specific shaking intensities. Quantifying earthquake impacts and communicating estimated losses (and their uncertainties) to the public, the media, humanitarian, and response communities required a new protocol—necessitating the development of an Earthquake Impact Scale—described herein and now deployed with the PAGER system. After two years of PAGER-based impact alerting, we now review operations, hazard calculations, loss models, alerting protocols, and our success rate for recent (2010-2011) events. This review prompts analyses of the strengths, limitations, opportunities, and pressures, allowing clearer definition of future research and development priorities for the PAGER system.

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.

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):.

The national web-based outbreak rapid alert system in Norway: eight years of experience, 2006-2013.

Science.gov (United States)

Guzman-Herrador, B; Vold, L; Berg, T; Berglund, T M; Heier, B; Kapperud, G; Lange, H; Nygård, K

2016-01-01

In 2005, the Norwegian Institute of Public Health established a web-based outbreak rapid alert system called Vesuv. The system is used for mandatory outbreak alerts from municipal medical officers, healthcare institutions, and food safety authorities. As of 2013, 1426 outbreaks have been reported, involving 32913 cases. More than half of the outbreaks occurred in healthcare institutions (759 outbreaks, 53·2%). A total of 474 (33·2%) outbreaks were associated with food or drinking water. The web-based rapid alert system has proved to be a helpful tool by enhancing reporting and enabling rapid and efficient information sharing between different authorities at both the local and national levels. It is also an important tool for event-based reporting, as required by the International Health Regulations (IHR) 2005. Collecting information from all the outbreak alerts and reports in a national database is also useful for analysing trends, such as occurrence of certain microorganisms, places or sources of infection, or route of transmission. This can facilitate the identification of specific areas where more general preventive measures are needed.

Psychosocial therapy and causes of death after deliberate self-harm

DEFF Research Database (Denmark)

Birkbak, J; Stuart, E A; Lind, B D

2016-01-01

BACKGROUND: Psychosocial therapy after deliberate self-harm might be associated with reduced risk of specific causes of death. METHOD: In this matched cohort study, we included patients, who after an episode of deliberate self-harm received psychosocial therapy at a Suicide Prevention Clinic...... in Denmark between 1992 and 2010. We used propensity score matching in a 1:3 ratio to select a comparison group from 59 046 individuals who received standard care. National Danish registers supplied data on specific causes of death over a 20-year follow-up period. RESULTS: At the end of follow-up, 391 (6.......5-448.4) for mental or behavioural disorders as a cause of death, 111.1 (95% CI 79.2-210.5) for alcohol-related causes and 96.8 (95% CI 69.1-161.8) for other diseases and medical conditions. CONCLUSIONS: Our findings indicate that psychosocial therapy after deliberate self-harm might reduce long-term risk of death...

Getting out of (self-) harm's way: A study of factors associated with self-harm among asylum seekers in Australian immigration detention.

Science.gov (United States)

Hedrick, Kyli

2017-07-01

The monitoring of self-harm among asylum seekers in Australian immigration detention has not occurred routinely or transparently. Thus whilst concerns regarding rates of self-harm among asylum seekers have been frequently raised, a paucity of systematic information regarding key factors associated with self-harm among asylum seekers exists. The present study was designed therefore to fill a number of gaps in government monitoring by examining the government's own archived self-harm data. Via a descriptive analysis of self-harm incident reports from all operational Australian immigration detention facilities over a 20-month period to May 2011, obtained under Freedom of Information, the present study identified that 959 incidents of self-harm occurred during this period. A gender bias towards men was also found. In addition to this, 10 different methods of self-harm were identified, the four most common being: cutting (47%), attempted hanging (19%), head hitting (12%) and self-poisoning by medication (6%). Seven different precipitating factors for self-harm were also identified, the four most common were: detention conditions (39%), processing arrangements (27%), negative decisions (24%) and family separation (3%). These findings point strongly to the health benefits of considering alternatives to held immigration detention, such as community based processing. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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.

Effect of air quality alerts on human health: a regression discontinuity analysis in Toronto, Canada.

Science.gov (United States)

Chen, Hong; Li, Qiongsi; Kaufman, Jay S; Wang, Jun; Copes, Ray; Su, Yushan; Benmarhnia, Tarik

2018-01-01

Ambient air pollution is a major health risk globally. To reduce adverse health effects on days when air pollution is high, government agencies worldwide have implemented air quality alert programmes. Despite their widespread use, little is known about whether these programmes produce any observable public-health benefits. We assessed the effectiveness of such programmes using a quasi-experimental approach. We assembled a population-based cohort comprising all individuals who resided in the city of Toronto (Ontario, Canada) from 2003 to 2012 (about 2·6 million people). We ascertained seven health outcomes known to be affected by short-term elevation of air pollution, using provincial health administrative databases. These health outcomes were cardiovascular-related mortality, respiratory-related mortality, and hospital admissions or emergency-department visits for acute myocardial infarction, heart failure, stroke, asthma, and chronic obstructive pulmonary disease (COPD). We applied a regression discontinuity design to assess the effectiveness of an intervention (ie, the air quality alert programme). To quantify the effect of the air quality alert programme, we estimated for each outcome both the absolute rate difference and the rate ratio attributable to programme eligibility (by intention-to-treat analysis) and the alerts themselves (by two-stage regression approach), respectively. Between Jan 1, 2003, and Dec 31, 2012, on average between three and 27 daily cardiovascular or respiratory events were reported in Toronto (depending on the outcome). Alert announcements reduced asthma-related emergency-department visits by 4·73 cases per 1 000 000 people per day (95% CI 0·55-9·38), or in relative terms by 25% (95% CI 1-47). Programme eligibility also led to 2·05 (95% CI 0·07-4·00) fewer daily emergency-department visits for asthma. We did not detect a significant reduction in any other health outcome as a result of alert announcements or programme

A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems

OpenAIRE

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 decisio...

[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.

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…

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.

Visual perception affected by motivation and alertness controlled by a noninvasive brain-computer interface.

Science.gov (United States)

Maksimenko, Vladimir A; Runnova, Anastasia E; Zhuravlev, Maksim O; Makarov, Vladimir V; Nedayvozov, Vladimir; Grubov, Vadim V; Pchelintceva, Svetlana V; Hramov, Alexander E; Pisarchik, Alexander N

2017-01-01

The influence of motivation and alertness on brain activity associated with visual perception was studied experimentally using the Necker cube, which ambiguity was controlled by the contrast of its ribs. The wavelet analysis of recorded multichannel electroencephalograms (EEG) allowed us to distinguish two different scenarios while the brain processed the ambiguous stimulus. The first scenario is characterized by a particular destruction of alpha rhythm (8-12 Hz) with a simultaneous increase in beta-wave activity (20-30 Hz), whereas in the second scenario, the beta rhythm is not well pronounced while the alpha-wave energy remains unchanged. The experiments were carried out with a group of financially motivated subjects and another group of unpaid volunteers. It was found that the first scenario occurred mainly in the motivated group. This can be explained by the increased alertness of the motivated subjects. The prevalence of the first scenario was also observed in a group of subjects to whom images with higher ambiguity were presented. We believe that the revealed scenarios can occur not only during the perception of bistable images, but also in other perceptual tasks requiring decision making. The obtained results may have important applications for monitoring and controlling human alertness in situations which need substantial attention. On the base of the obtained results we built a brain-computer interface to estimate and control the degree of alertness in real time.

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.

Harmful alcohol habits did not explain the social gradient of sickness absence in Swedish women and men

Directory of Open Access Journals (Sweden)

Ann-Charlotte M Mardby

2013-10-01

Full Text Available Background: the aim of this study was to examine the prevalence and socioeconomic distribution of harmful alcohol habits in sick-listed women and men, and whether the social gradient in sickness absence could be explained by the socioeconomic distribution of harmful alcohol habits.Methods: this cross-sectional questionnaire study included newly sick-listed individuals (n=2 798, 19-64 years, 66% women from Sweden. The outcome variable, self-reported harmful alcohol habits, was measured with the Alcohol Use Disorder Identification Test. Registered socioeconomic variables (education, income, occupational class were explanatory variables with age as confounder and selfreported health, symptoms, mental wellbeing, and self-efficacy as mediators. Chi2-tests and logistic regression models were applied.Results: 9% of sick-listed women and 22% of men had harmful alcohol habits. Women with a low annual income (≤149 000 SEK had higher odds ratios (OR=2.47; 95% CI=1.43-4.27 of harmful alcohol habits than those with ≥300 000 SEK/year. The significance of low income remained when mediators were introduced into the logistic regression model (OR=2.03, 95% CI=1.13-3.65. In the model including age, income was no longer significant. Men with low income were more likely to have harmful alcohol habits than men with high income (OR=2.59; 95% CI=1.45-4.62. When mediators were included low income remained significant (OR=2.88; 95% CI=1.56-5.31. Income was no longer significant when age was introduced. Education and occupational status were not significant.Conclusions: harmful alcohol habits were common among sick-listed women and men. The socioeconomic differences in harmful alcohol habits did not explain the social gradient in sickness absence.

Alertness Management In Flight Operations: A NASA Education and Training Module

Science.gov (United States)

Rosekind, Mark R.; Lebacqz, Victor J.; Gander, Philippa H.; Co, Elizabeth L.; Weldon, Keri J.; Smith, Roy M.; Miller, Donna L.; Gregory, Kevin B.; Statler, Irving C. (Technical Monitor)

1994-01-01

Since 1980, the NASA Ames Fatigue Countermeasures Program has been conducting research on sleep, circadian rhythms, and fatigue in a variety of flight operations 1. An original goal of the program was to return the scientific and operational knowledge to the aviation industry. To meet this goal, the NASA Ames Fatigue Countermeasures Program has created an Education and Training Module entitled, "Strategies for Alertness Management in Flight Operations." The Module was designed to meet three objectives: 1) explain the current state of knowledge about the physiological mechanisms underlying fatigue, 2) demonstrate how this knowledge can be applied to improve flight crew sleep, performance, and alertness, and 3) offer countermeasure recommendations. The Module is composed of two components: 1) a 60-minute live presentation provided by a knowledgeable individual and 2) a NASA/FAA Technical Memorandum (TM) that contains the presentation materials and appendices with complementary information. The TM is provided to all individuals attending the live presentation. The Module content is divided into three parts: 1) basic information on sleep, sleepiness, circadian rhythms, fatigue, and how flight operations affect these physiological factors, 2) common misconceptions about sleep, sleepiness, and fatigue, and 3) alertness management strategies. The Module is intended for pilots, management personnel, schedulers, flight attendants, and the many other individuals involved in the aviation system.

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.

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...

Do e-mail alerts of new research increase knowledge translation? A "Nephrology Now" randomized control trial.

Science.gov (United States)

Tanna, Gemini V; Sood, Manish M; Schiff, Jeffrey; Schwartz, Daniel; Naimark, David M

2011-01-01

As the volume of medical literature increases exponentially, maintaining current clinical practice is becoming more difficult. Multiple, Internet-based journal clubs and alert services have recently emerged. The purpose of this study is to determine whether the use of the e-mail alert service, Nephrology Now, increases knowledge translation regarding current nephrology literature. Nephrology Now is a nonprofit, monthly e-mail alert service that highlights clinically relevant articles in nephrology. In 2007-2008, the authors randomized 1,683 subscribers into two different groups receiving select intervention articles, and then they used an online survey to assess both groups on their familiarity with the articles and their acquisition of knowledge. Of the randomized subscribers, 803 (47.7%) completed surveys, and the two groups had a similar number of responses (401 and 402, respectively). The authors noted no differences in baseline characteristics between the two groups. Familiarity increased as a result of the Nephrology Now alerts (0.23 ± 0.087 units on a familiarity scale; 95% confidence interval [CI]: 0.06-0.41; P = .007) especially in physicians (multivariate odds ratio 1.83; P = .0002). No detectable improvement in knowledge occurred (0.03 ± 0.083 units on a knowledge scale; 95% CI: -0.13 to 0.20; P = .687). An e-mail alert service of new literature improved a component of knowledge translation--familiarity--but not knowledge acquisition in a large, randomized, international population.

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.

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.

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

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...

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.

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 ...

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,…

When endogenous spatial attention improves conscious perception: effects of alerting and bottom-up activation.

Science.gov (United States)

Botta, Fabiano; Lupiáñez, Juan; Chica, Ana B

2014-01-01

Recent studies have consistently demonstrated that conscious perception interacts with exogenous attentional orienting, but it can be dissociated from endogenous attentional orienting (Chica Lasaponara, et al., 2011; Wyart & Tallon-Baudry, 2008). It has been hypothesized that enhanced conscious processing at exogenously attended locations results from a synergistic action of spatial orienting, bottom-up activation, and phasic alerting induced by the abrupt onset of the exogenous cue (Chica, Lasaponara, et al., 2011). Instead, as endogenous cues need more time to be interpreted, the phasic alerting they produce may have dissipated when the target appears. Furthermore, endogenous cues presumably elicit a weak bottom-up activation at the cued location. Consistent with these hypotheses, we observed that endogenous attention modulated conscious perception, but only when phasic alerting or bottom-up activation was increased. Results are discussed in the context of recent theoretical models of consciousness (Dehaene, Changeux, Naccache, Sackur, & Sergent, 2006). Copyright © 2013 Elsevier Inc. All rights reserved.

Exploring the heavy air pollution in Beijing in the fourth quarter of 2015: assessment of environmental benefits for red alerts

Science.gov (United States)

Nie, Teng; Nie, Lei; Zhou, Zhen; Wang, Zhanshan; Xue, Yifeng; Gao, Jiajia; Wu, Xiaoqing; Fan, Shoubin; Cheng, Linglong

2018-06-01

In recent years, Beijing has experienced severe air pollution which has caused widespread public concern. Compared to the same period in 2014, the first three quarters of 2015 exhibited significantly improved air quality. However, the air quality sharply declined in the fourth quarter of 2015, especially in November and December. During that time, Beijing issued the first red alert for severe air pollution in history. In total, 2 red alerts, 3 orange alerts, 3 yellow alerts, and 3 blue alerts were issued based on the adoption of relatively temporary emergency control measures to mitigate air pollution. This study explored the reasons for these variations in air quality and assessed the effectiveness of emergency alerts in addressing severe air pollution. A synthetic analysis of emission variations and meteorological conditions was performed to better understand these extreme air pollution episodes in the fourth quarter of 2015. The results showed that compared to those in the same period in 2014, the daily average emissions of air pollutants decreased in the fourth quarter of 2015. However, the emission levels of primary pollutants were still relatively high, which was the main intrinsic cause of haze episodes, and unfavorable meteorological conditions represented important external factors. Emergency control measures for heavy air pollution were implemented during this red alert period, decreasing the emissions of primary air pollutants by approximately 36% and the PM2.5 concentration by 11%‒21%.

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

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...

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

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

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.

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.

Bioremediation of petroleum contaminated soil at CFS Alert - Laboratory scale respirometry experiment

International Nuclear Information System (INIS)

Haidar, S.; Bennett, J.; Jarrett, P.; Biggar, K.

1998-01-01

The feasibility of 'biopiling' was tested at Canadian Forces Station 'Alert', located in the high Arctic where the feasibility of bioremediation is yet to be proven. Laboratory respirometer experiments were conducted at 11 degrees C that examined the behaviour of indigenous microorganisms. Experiments were also carried out at one contaminated site. Various soil properties were analyzed, as well as total petroleum hydrocarbons. Results showed that the respirometer system functioned properly in monitoring the behaviour of microorganisms, that indigenous microorganisms were active at 11 degrees C, and that they functioned at a constant rate of oxygen consumption. These results suggest that biopiling may be feasible under the conditions existing at CFS 'Alert'. 12 refs., 5 tabs., 8 figs

"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....

RED Alert – Early warning or detection of global re-emerging infectious disease (RED)

Energy Technology Data Exchange (ETDEWEB)

Deshpande, Alina [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-07-13

This is the PDF of a presentation for a webinar given by Los Alamos National Laboratory (LANL) on the early warning or detection of global re-emerging infectious disease (RED). First, there is an overview of LANL biosurveillance tools. Then, information is given about RED Alert. Next, a demonstration is given of a component prototype. RED Alert is an analysis tool that can provide early warning or detection of the re-emergence of an infectious disease at the global level, but through a local lens.

Trends in self-harm in Kuala Lumpur, 2005–2011

OpenAIRE

Armitage, Christopher J.; Abdul Rahim, Wirda; Rowe, Richard; O'Connor, Rory C.

2016-01-01

Acts of self-harm are not routinely tracked in Malaysia. The present study investigates the prevalence of self-harm in Kuala Lumpur, Malaysia, over a 7-year period. The aims were to: (a) assess the prevalence of self-harm; (b) examine any changes over a period of 7 years, and (c) identify correlates of methods of self-harm. Data were extracted from the hospital records of Kuala Lumpur Hospital to review trends in self-harm between 2005 and 2011. There were 918 episodes of self-harm across the...

Sexual Health Research With Young Black Men Who Have Sex With Men: Experiences of Benefits and Harms.

Science.gov (United States)

Arrington-Sanders, Renata; Morgan, Anthony; Oidtman, Jessica; Dao, Ann; Moon, Margaret; Fortenberry, J Dennis; Ott, Mary A

2017-05-01

Young Black men who have sex with men (YBMSM) are often underrepresented in sexual health research because of concerns about safety, privacy, and the potential for research harms. Empirical data are needed to understand YBMSM experience of participating in research, benefits and harms (discomfort), to inform policy and regulatory decisions. Using qualitative methods, this article examines 50 YBMSM, aged 15-19 years, experiences of benefits/harms, challenges of participating in sexual health research, and contextual factors impacting research experiences. Participants were asked about benefits and harms experienced in answering questions about sexual orientation, first same-sex attraction, and same-sex sexual experiences after completing an in-depth interview. Interviews were transcribed and coded. Inductive open coding was used to identify themes within and between interviews. Participants were able to describe perceived direct benefits resulting from research interview participation, including awareness of risky sexual behaviors, a safe space to share early coming out stories and same-sex sexual experiences, and a sense of empowerment and comfort with one's sexual orientation. Indirect benefits described by participants included perceptions of helping others and the larger gay community. Few participants described harms (discomfort recalling experiences). Our data suggest that participating in qualitative sexual health research focused on sexual orientation, sexual attraction, and early same-sex sexual experiences may result in minimal harms for YBMSM and multiple benefits, including feeling more comfortable than in a general medical visit.

Comparison of 'time to detection' values between BacT/ALERT VIRTUO and BacT/ALERT 3D instruments for clinical blood culture samples.

Science.gov (United States)

Congestrì, Francesco; Pedna, Maria Federica; Fantini, Michela; Samuelli, Michela; Schiavone, Pasqua; Torri, Arianna; Bertini, Stefania; Sambri, Vittorio

2017-09-01

The early detection of bacteraemia and fungemia is of paramount importance to guide antimicrobial therapy in septic patients. In this study the 'time to detection' (TTD) value for the new blood culture system BacT/ALERT VIRTUO (VIRTUO) was evaluated in 1462 positive clinical bottles and compared with the TTD for 1601 positive clinical bottles incubated in the BacT/ALERT 3D system (BTA-3D). The most representative microorganisms isolated from bottles incubated in both blood culture systems were divided into eight categories (in order of frequency): coagulase-negative staphylococci (CoNS), Escherichia coli, Enterobacteriaceae (other than E. coli), Staphylococcus aureus, Enterococcus spp, viridans group streptococci, Pseudomonas aeruginosa, and Candida spp. The comparison of TTD values for the two blood culture systems strongly indicated that growth of the first five groups listed above was detected earlier with VIRTUO than with BTA-3D (p culture system can reduce the TTD for more than 75% of isolated microorganisms. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

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 ...

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...

Visual perception affected by motivation and alertness controlled by a noninvasive brain-computer interface.

Directory of Open Access Journals (Sweden)

Vladimir A Maksimenko

Full Text Available The influence of motivation and alertness on brain activity associated with visual perception was studied experimentally using the Necker cube, which ambiguity was controlled by the contrast of its ribs. The wavelet analysis of recorded multichannel electroencephalograms (EEG allowed us to distinguish two different scenarios while the brain processed the ambiguous stimulus. The first scenario is characterized by a particular destruction of alpha rhythm (8-12 Hz with a simultaneous increase in beta-wave activity (20-30 Hz, whereas in the second scenario, the beta rhythm is not well pronounced while the alpha-wave energy remains unchanged. The experiments were carried out with a group of financially motivated subjects and another group of unpaid volunteers. It was found that the first scenario occurred mainly in the motivated group. This can be explained by the increased alertness of the motivated subjects. The prevalence of the first scenario was also observed in a group of subjects to whom images with higher ambiguity were presented. We believe that the revealed scenarios can occur not only during the perception of bistable images, but also in other perceptual tasks requiring decision making. The obtained results may have important applications for monitoring and controlling human alertness in situations which need substantial attention. On the base of the obtained results we built a brain-computer interface to estimate and control the degree of alertness in real time.

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.

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.

Catch the wave! Time-window sequential analysis of alertness stimulation in individuals with profound intellectual and multiple disabilities

NARCIS (Netherlands)

Munde, V. S.; Vlaskamp, C.; Maes, B.; Ruijssenaars, A. J. J. M.

BackgroundWhile optimally activities are provided at those moments when the individual with profound intellectual and multiple disabilities (PIMD) is focused on the environment' or alert', detailed information about the impact that the design and timing of the activity has on alertness is lacking.

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.

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.

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.

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

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.

Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

Directory of Open Access Journals (Sweden)

Bruni Vanida

2010-01-01

Full Text Available Abstract Background Drug prescribing errors are frequent in the hospital setting and pharmacists play an important role in detection of these errors. The objectives of this study are (1 to describe the drug prescribing errors rate during the patient's stay, (2 to find which characteristics for a prescribing error are the most predictive of their reproduction the next day despite pharmacist's alert (i.e. override the alert. Methods We prospectively collected all medication order lines and prescribing errors during 18 days in 7 medical wards' using computerized physician order entry. We described and modelled the errors rate according to the chronology of hospital stay. We performed a classification and regression tree analysis to find which characteristics of alerts were predictive of their overriding (i.e. prescribing error repeated. Results 12 533 order lines were reviewed, 117 errors (errors rate 0.9% were observed and 51% of these errors occurred on the first day of the hospital stay. The risk of a prescribing error decreased over time. 52% of the alerts were overridden (i.e error uncorrected by prescribers on the following day. Drug omissions were the most frequently taken into account by prescribers. The classification and regression tree analysis showed that overriding pharmacist's alerts is first related to the ward of the prescriber and then to either Anatomical Therapeutic Chemical class of the drug or the type of error. Conclusions Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts.

Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review

Science.gov (United States)

Glendenning, Alexander Charles; Marchant, Amanda; Montgomery, Paul; Stewart, Anne; Wood, Sophie; Lloyd, Keith; Hawton, Keith

2018-01-01

Background Given the concerns about bullying via electronic communication in children and young people and its possible contribution to self-harm, we have reviewed the evidence for associations between cyberbullying involvement and self-harm or suicidal behaviors (such as suicidal ideation, suicide plans, and suicide attempts) in children and young people. Objective The aim of this study was to systematically review the current evidence examining the association between cyberbullying involvement as victim or perpetrator and self-harm and suicidal behaviors in children and young people (younger than 25 years), and where possible, to meta-analyze data on the associations. Methods An electronic literature search was conducted for all studies published between January 1, 1996, and February 3, 2017, across sources, including MEDLINE, Cochrane, and PsycINFO. Articles were included if the study examined any association between cyberbullying involvement and self-harm or suicidal behaviors and reported empirical data in a sample aged under 25 years. Quality of included papers was assessed and data were extracted. Meta-analyses of data were conducted. Results A total of 33 eligible articles from 26 independent studies were included, covering a population of 156,384 children and young people. A total of 25 articles (20 independent studies, n=115,056) identified associations (negative influences) between cybervictimization and self-harm or suicidal behaviors or between perpetrating cyberbullying and suicidal behaviors. Three additional studies, in which the cyberbullying, self-harm, or suicidal behaviors measures had been combined with other measures (such as traditional bullying and mental health problems), also showed negative influences (n=44,526). A total of 5 studies showed no significant associations (n=5646). Meta-analyses, producing odds ratios (ORs) as a summary measure of effect size (eg, ratio of the odds of cyber victims who have experienced SH vs nonvictims who

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...

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

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.

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).

The Associations Between Children's and Adolescents' Suicidal and Self-Harming Behaviors, and Related Behaviors Within Their Social Networks: A Systematic Review.

Science.gov (United States)

Quigley, Jody; Rasmussen, Susan; McAlaney, John

2017-01-01

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, with those reporting knowing people who had engaged in suicidal or self-harming behaviors more likely to report engaging in similar behaviors themselves. Findings are discussed in relation to a number of methodological and measurement issues-including the role of normative perceptions-and implications for the prevention of suicidal and self-harming behavior are considered.

Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis.

Science.gov (United States)

Ferner, R E; Aronson, J K

2013-12-12

To review the beneficial and harmful effects of laughter. Narrative synthesis. We searched Medline (1946 to June 2013) and Embase (1974 to June 2013) for reports of benefits or harms from laughter in humans, and counted the number of papers in each category. Benefits of laughter include reduced anger, anxiety, depression, and stress; reduced tension (psychological and cardiovascular); increased pain threshold; reduced risk of myocardial infarction (presumably requiring hearty laughter); improved lung function; increased energy expenditure; and reduced blood glucose concentration. However, laughter is no joke-dangers include syncope, cardiac and oesophageal rupture, and protrusion of abdominal hernias (from side splitting laughter or laughing fit to burst), asthma attacks, interlobular emphysema, cataplexy, headaches, jaw dislocation, and stress incontinence (from laughing like a drain). Infectious laughter can disseminate real infection, which is potentially preventable by laughing up your sleeve. As a side effect of our search for side effects, we also list pathological causes of laughter, among them epilepsy (gelastic seizures), cerebral tumours, Angelman's syndrome, strokes, multiple sclerosis, and amyotrophic lateral sclerosis or motor neuron disease. Laughter is not purely beneficial. The harms it can cause are immediate and dose related, the risks being highest for Homeric (uncontrollable) laughter. The benefit-harm balance is probably favourable. It remains to be seen whether sick jokes make you ill or jokes in bad taste cause dysgeusia, and whether our views on comedians stand up to further scrutiny.

Phasic alerting increases visual attention capacity in younger but not in older individuals

DEFF Research Database (Denmark)

Wiegand, Iris Michaela; Petersen, Anders; Bundesen, Claus

2017-01-01

In the present study, we investigated effects of phasic alerting on visual attention in younger and older adults. We modelled parameters of visual attention based on the computational Theory of Visual Attention (TVA) and measured event-related lateralizations (ERLs) in a partial report task, in w...... and attention, which governs the responsiveness to external cues and is critical for general cognitive functioning in aging.......In the present study, we investigated effects of phasic alerting on visual attention in younger and older adults. We modelled parameters of visual attention based on the computational Theory of Visual Attention (TVA) and measured event-related lateralizations (ERLs) in a partial report task...

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.

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

[Harm reduction policies in Brazil: contributions of a North American program].

Science.gov (United States)

Inglez-Dias, Aline; Ribeiro, José Mendes; Bastos, Francisco I; Page, Kimberly

2014-01-01

Given the rapid spread of the HIV epidemic and the need to control its transmission among intravenous drug users (IDU), harm reduction strategies have been incorporated in many countries, including Brazil. Considering these aspects and taking into account the emergence of drugs as a core concern on the government's agenda, especially crack cocaine, this article presents some of the contributions acquired from observing and recording the practices of an American model of research and care for IDUs, namely the UFO (You Find Out) Study. Issues such as participants' access and adherence, financing difficulties, sustainability and outcome evaluation were considered. The study involved documental research, systematic observation and interviews with key informants. Some of the UFO features that could contribute to the formulation of harm reduction policies in Brazil are highlighted. The UFO appears to be a successful example of harm reduction initiatives that successfully contact and guarantee the commitment of that risk group, ensuring its access to health services and reducing risks associated with drug use.

47 CFR 76.1203 - Incidence of harm.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Incidence of harm. 76.1203 Section 76.1203 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Availability of Navigation Devices § 76.1203 Incidence of harm. A...

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.

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

Public attitudes towards gambling product harm and harm reduction strategies: an online study of 16-88 year olds in Victoria, Australia.

Science.gov (United States)

Thomas, Samantha L; Randle, Melanie; Bestman, Amy; Pitt, Hannah; Bowe, Steven J; Cowlishaw, Sean; Daube, Mike

2017-07-25

Gambling has quickly emerged as an important global public health issue. With new technologies used to develop high intensity gambling products and promotions aimed at driving consumption, public health organisations and researchers, community groups, and politicians have argued for a range of regulatory and education measures aimed at reducing gambling harm. However, there has been limited research seeking to understand community perceptions of the harms associated with gambling products and environments, and the level of community support for strategies designed to prevent and reduce gambling harm. An online study of 500 adolescents and adults (aged 16 and over) was conducted with a representative sample (by age and gender) of individuals who were current residents in the state of Victoria, Australia. Participants were asked a range of questions about their own gambling behaviours, with the Problem Gambling Severity Index (PGSI) used as a measure of problem gambling. Participants were asked about their perceptions of harms associated with electronic gambling machines (EGMs), sports betting, horse betting, and casino gambling. They were also asked about the extent to which they agreed or disagreed with gambling harm reduction strategies related to marketing and promotions, restrictions on gambling products and venues, and public education campaigns. Quantitative data were analysed using descriptive statistics and paired t tests, with thematic analysis used to interpret qualitative responses to open-ended questionnaire items. More than one third (n = 201, 40.2%) of participants were at risk of experiencing some level of harm from gambling (PGSI ≥ 1), with 83 participants (16.6%) recording scores that indicated problem gambling (PGSI ≥ 8). One in five participants gambled on EGMs at least monthly (n = 100, 20.0%). Those who gambled on sports did so frequently, with nearly 1 in 5 gambling on sport at least once a month (n = 87, 17.4%). Over

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

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

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

Physical harm due to chronic substance use