WorldWideScience

Sample records for mainz emergency evaluation

  1. MAINZ: MAMI microtron

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    Officially inaugurated at the end of January was the new Mainz Microtron - MAMI - which became fully operational last summer after a final three-year construction phase at Johannes Gutenberg University

  2. Research with Neutrons at the TRIGA Mainz

    International Nuclear Information System (INIS)

    Hampel, Gabriele

    2008-01-01

    The TRIGA Mark II reactor at the Institut fuer Kernchemie of the Johannes Gutenberg-Universitaet in Mainz became first critical on August 3, 1965 and is still intensively used for basic research, applied science and educational purposes. Considering the past and future operation schedule and the low burn-up of the fuel elements (∼4 g 235 U/a), the reactor can be operated for at least the next decade taking into account the fresh fuel elements on stock and without changing spent fuels. The operation of the TRIGA Mainz has been extended very recently until the year 2020. The TRIGA Mainz can be operated in the steady state mode with a maximum power of 100 kWth and in the pulse mode with a peak power of 250 MWth. Until now, more than 16600 pulses have been carried out without any fuel failure. For irradiations the TRIGA Mainz has a central experimental tube, three pneumatic transfer systems and a rotary specimen rack with 40 positions which allows the irradiation of 80 samples at the same time. In addition, the TRIGA Mainz includes four horizontal beam ports penetrating the concrete shielding and extending inside the pool towards the reflector. A graphite thermal column provides a source of well-thermalized neutrons suitable for physical research or biological and medical irradiations. Important projects for the future of the TRIGA Mainz are the production of ultracold neutrons (UCN) and experiments with UCN, high precision mass measurements and laser spectroscopy of short-lived fission products (TRIGA-TRAP), the production of radionuclides for fast chemical separations, medical and radiopharmaceutical applications, and the use of the neutron activation analysis for the application in archeometry, solar energy technique, criminalistics and vine analysis. Furthermore, studies are performed to judge if the Boron Neutron Capture Therapy (BNCT) can be applied at the TRIGA Mainz for cancer treatment of liver metastases. Also, the reactor facility is used for the training

  3. Research activities at the TRIGA Mainz

    International Nuclear Information System (INIS)

    Eberhardt, K.; Trautmann, N.

    2002-01-01

    The TRIGA Mark II reactor of the Mainz University became first critical on August 3, 1965. It can be operated in the steady state mode with a maximum power of 100 kW and in the pulse mode with a peak power of 250 MW. The TRIGA Mainz is mainly used for neutron activation analysis, isotope production, basic research in nuclear chemistry and nuclear physics as well as for education and training

  4. Colon pouch (Mainz III) for continent urinary diversion.

    Science.gov (United States)

    Stolzenburg, Jens-Uwe; Schwalenberg, Thilo; Liatsikos, Evangelos N; Sakelaropoulos, George; Rödder, Kilian; Hohenfellner, Rudolph; Fisch, Margit

    2007-06-01

    To evaluate the use of a continent cutaneous pouch made exclusively of colon (Mainz pouch III), as excellent results with the Mainz pouch III in irradiated patients suggested that the indication for this type of urinary diversion could be extended. The outcome of 24 patients with continent cutaneous urinary diversions using colon segments (Mainz pouch III) was investigated retrospectively. Overall, 22 of the patients had a malignant disease and two a benign disease; 16 had a hysterectomy and pelvic exenteration for gynaecological tumours; two men with a rhabdomyosarcoma of the prostate had a radical cystoprostatectomy; one woman had pelvic exenteration for bladder cancer; one man had a simultaneous rectum resection due to infiltrating rectal cancer, and another a left nephrectomy with cystectomy for concomitant kidney and bladder tumour. Benign indications were hyper-reflexive bladder after polytrauma and two cases of neurogenic bladder dysfunction. Eighteen patients had radiotherapy (32-48 Gy) before the urinary diversion. The mean (range) follow-up was 35 (12-65) months. The mean pouch capacity was 293.8 mL. Three patients died during the follow-up (two from disease progression and one suicide); 20 patients were fully continent, four with reduced pouch capacity (<300 mL) had slight incontinence and are wearing a protective pad (band-aid at the umbilicus). All patients use intermittent self-catheterization (mean catheterization frequency 6.8/day, range 6-12). Complications related to the pouch were one outlet stenosis that required revision. Postoperative pouchograms showed asymptomatic reflux in four patients. None of the patients developed metabolic acidosis or diarrhoea. The Mainz pouch III is an alternative to other types of continent urinary diversion.

  5. Status of the TRIGA user facility in Mainz

    Energy Technology Data Exchange (ETDEWEB)

    Kories, Fabian; Heil, Werner; Karch, Jan Peter; Sobolev, Yury [Institut fuer Physik, Johannes Gutenberg Universitaet Mainz (Germany); Eberhardt, Klaus; Hampel, Gabriele; Reich, Tobias; Trautmann, Norbert [Institut fuer Kernchemie, Johannes Gutenberg Universitaet Mainz (Germany)

    2014-07-01

    Ultra-cold neutrons (UCN) offer unique opportunities for investigating the properties of the free neutron with exceptionally high precision such as the measurement of its lifetime. At the pulsed TRIGA reactor in Mainz, a superthermal UCN source using solid deuterium as converter is operational and delivers up to 10 UCN/cm{sup 3} in typical storage volumes of 10 l. Within PRISMA Cluster of excellence, this source will be upgraded to a targeted strength of 100 UCN/cm{sup 3} in order to transform TRIGA Mainz into a world-leading user facility for UCN research. Besides the installation of a He liquefier to sustain long-term experiments, the existing neutron guides have to be replaced by high-quality guides with low surface roughness which are internally coated with Ni-58 to increase the phase space for UCN transport. The poster gives a status report on the activities at the UCN source at TRIGA Mainz.

  6. Five years of operating the TRIGA Mainz reactor

    International Nuclear Information System (INIS)

    Benedict, Georg

    1970-01-01

    Considerable obstacles had to be surmounted before TRIGA MAINZ, first TRIGA reactor built in Germany, reached initial criticality in 1965. Subsequent five years' operation did not raise any major problems. The facility has proven quite reliable and particularly well suited for the purposes of the nuclear chemistry research program pursued at Mainz University. Extensive use is made of the pulse mode of operation. As a result, fuel elements are obviously somewhat overstressed, even though most pulses performed are of the 1.50 dollar size. Maximum licensed steady state power of 100 kW till now has met the requirements of most experiments. However, efforts are in progress to improve irradiation conditions by increasing the reactor power to 300 kW. (author)

  7. The research reactor TRIGA Mainz

    International Nuclear Information System (INIS)

    Hampel, G.; Eberhardt, K.; Trautmann, N.

    2006-01-01

    The TRIGA Mark II reactor at the Institut fuer Kernchemie became first critical on August 3 rd , 1965. It can be operated in the steady state mode with a maximum power of 100 kWth and in the pulse mode with a peak power of 250 MWth. A survey of the research programmes performed at the TRIGA Mainz is given covering applications in basic research as well as applied science in nuclear chemistry and nuclear physics. Furthermore, the reactor is used for neutron activation analysis and for education and training of scientists, teachers, students and technical personal. Important projects for the future of the TRIGA Mainz are the UCN (ultra cold neutrons) experiment, fast chemical separation, medical applications and the use of the NAA as well as the use of the reactor facility for the training of students in the fields of nuclear chemistry, nuclear physics and radiation protection. Taking into account the past and future operation schedule and the typically low burn-up of TRIGA fuel elements (∝4 g U-235/a), the reactor can be operated for at least the next decade taking into account the fresh fuel elements on stock and without changing spent fuels. (orig.)

  8. The Boron Neutron Capture Therapy (BNCT) Project at the TRIGA Reactor in Mainz, Germany

    DEFF Research Database (Denmark)

    Hampel, G.; Grunewald, C.; Schütz, C.

    2011-01-01

    The thermal column of the TRIGA reactor in Mainz is being used very effectively for medical and biological applications. The BNCT (boron neutron capture therapy) project at the University of Mainz is focussed on the treatment of liver tumours, similar to the work performed at Pavia (Italy) a few ...

  9. Piscina cubierta en Taubertsberg Mainz, Alemania

    Directory of Open Access Journals (Sweden)

    Apel, O.

    1967-02-01

    Full Text Available The enclosed swimming pool built at Mainz involves two separate levels. The ground level contains the entrance hall, a bar, a gymnasium as well as heating, water renewal, purifying and sterilising installations. On the second level, in addition to the pool, which is 25 x 15 m in area, and a learner's pool, there are changing rooms for men and women, and shower and washing rooms. The building is of compound structure, and the enclosing walls are highly diaphanous, giving the interior much luminosity and a somewhat ethereal quality which characterises it in a very marked manner.El edificio destinado a piscina cubierta, construido en Mainz, consta de dos plantas: La planta baja aloja la zona de ingreso, el bar, un gimnasio, etc., y las instalaciones para: la calefacción, renovación, depuración y esterilización del agua, etc. La planta primera, además de los vestuarios —de señoras y de caballeros—, bloques de duchas y aseos, etc., alberga una piscina de 15 m x 25 m y otra de aprendizaje. El edificio es de estructura mixta y gran diafanidad de cerramientos, lo que proporciona una gran luminosidad y cierto aspecto etéreo que le caracteriza y distingue.

  10. The Boron Neutron Capture Therapy (BNCT) Project at the TRIGA Reactor in Mainz, Germany

    Energy Technology Data Exchange (ETDEWEB)

    Hampel, G.; Grunewald, C.; Schutz, C.; Schmitz, T.; Kratz, J.V. [Nuclear Chemistry, University of Mainz, D-55099 Mainz (Germany); Brochhausen, C.; Kirkpatrick, J. [Department of Pathology, University of Mainz, D-55099 Mainz (Germany); Bortulussi, S.; Altieri, S. [Department of Nuclear and Theoretical Physics University of Pavia, Pavia (Italy); National Institute of Nuclear Physics (INFN) Pavia Section, Pavia (Italy); Kudejova, P. [Forschungs-Neutronenquelle Heinz Maier-Leibnitz (FRM II), Technische Universitaet Muenchen, D-85748 Garching (Germany); Appelman, K.; Moss, R. [Joint Research Centre (JRC) of the European Commission, NL-1755 ZG Petten (Netherlands); Bassler, N. [University of Aarhus, Norde Ringade, DK-8000, Aarhus C (Denmark); Blaickner, M.; Ziegner, M. [Molecular Medicine, Health and Environment Department, AIT Austrian Institute of Technology GmbH (Austria); Sharpe, P.; Palmans, H. [National Physical Laboratory, Teddington TW11 0LW, Middlesex (United Kingdom); Otto, G. [Department of Hepatobiliary, Pancreatic and Transplantation Surgery, University of Mainz, D-55099 Mainz (Germany)

    2011-07-01

    The thermal column of the TRIGA reactor in Mainz is being used very effectively for medical and biological applications. The BNCT (boron neutron capture therapy) project at the University of Mainz is focussed on the treatment of liver tumours, similar to the work performed in Pavia (Italy) a few years ago, where patients with liver metastases were treated by combining BNCT with auto-transplantation of the organ. Here, in Mainz, a preclinical trial has been started on patients suffering from liver metastases of colorectal carcinoma. In vitro experiments and the first animal tests have also been initiated to investigate radiobiological effects of radiation generated during BNCT. For both experiments and the treatment, a reliable dosimetry system is necessary. From work elsewhere, the use of alanine detectors appears to be an appropriate dosimetry technique. (author)

  11. Institut fuer Kernchemie, Univ. Mainz. Annual report 1983

    International Nuclear Information System (INIS)

    Weber, M.

    1984-01-01

    This annual report contains extended abstracts about the work performed at the named institute together with a list of publications and speeches. The work concern fast chemical separations, the detection of short-lived nuclides, mass separations, nuclear spectroscopy, nuclear fission, heavy ion research, superheavy elements, radionuclide ecology, and the operation of the TRIGA Mainz reactor. (HSI) [de

  12. Outcome of Mainz II pouch urinary diversion after radical cystectomy ...

    African Journals Online (AJOL)

    Outcome of Mainz II pouch urinary diversion after radical cystectomy in patients with muscle-invasive bladder cancer: our experience. ... Nine (82%) had a histological diagnosis of transitional cell carcinoma, and two (18%) were squamous cell carcinoma (SCC). Ten (91%) patients had high‑grade disease, whereas only 1 ...

  13. Production facility for ATLAS new small wheel drift panels at JGU Mainz

    Energy Technology Data Exchange (ETDEWEB)

    Duedder, Andreas; Lin, Tai-Hua; Schott, Matthias [Johannes Gutenberg-Universitaet Mainz (Germany)

    2016-07-01

    The ATLAS Phase-I Upgrade in 2018 includes the replacement of the ATLAS Muon Small Wheel by the so-called New Small Wheel (NSW). Large-scale Micromegas detectors will serve as tracking detectors in the NSW. Parts of these detectors will be constructed at the Johannes Gutenberg University Mainz (JGU). In order to fulfill the requirements of the envisioned detector performance, a high precision detector construction is crucial. Especially the surface planarity of the produced detector panels has to better than 30 μm over an area of 2 m{sup 2}. Methods for the quality control of the raw material and the constructed parts have been developed and implemented. This talk gives an overview of the production facility at JGU Mainz which is used during the mass production of NSW components in coming years.

  14. Status and perspectives of the Mainz neutrino mass experiment

    International Nuclear Information System (INIS)

    Backe, H.; Barth, H.; Bleile, A.

    1997-01-01

    New data from the decay of molecular tritium studied with the Mainz solenoid retarding spectrometer are presented. From a region close to the end-point we deduce an upper limit for the mass of the electron antineutrino of m ν c 2 ν 2 c 4 = - 22 ± 17 stat ± 14 sys eV 2 . Possible improvements and the perspectives of the experiment are discussed. (orig.)

  15. Searches for dark photons at the Mainz Microtron

    Energy Technology Data Exchange (ETDEWEB)

    Merkel, H.; Achenbach, P.; Gayoso, C. Ayerbe; Beranek, T.; Bernauer, J. C.; Böhm, R.; Correa, L.; Denig, A.; Distler, M. O.; Esser, A.; Gómez, M.; Kegel, S.; Kohl, Y.; Mihovilovič, M.; Middleton, D. G.; Müller, U.; Nungesser, L.; Pochodzalla, J.; Rohrbeck, M.; Majos, S. Sánchez [Institut für Kernphysik, Johannes Gutenberg-Universität, D-55099 Mainz (Germany); and others

    2013-11-07

    The A1 Collaboration at the Mainz Microtron (MAMI) operates high resolution spectrometers at very high luminosities for fixed target electron scattering experiments. The setup is well suited for the search for dark photons in the mass range between 50 MeV and 300 MeV. In these experiments, a possible dark photon would appear as a sharp peak in the mass spectrum of di-lepton electro-production. In this presentation the potential of the setup is presented and the possibilities for future experiments for dark photon searches at MAMI are discussed.

  16. Research activities at the TRIGA Mainz

    International Nuclear Information System (INIS)

    Eberhardt, K.

    1994-01-01

    The experimental programme at the TRIGA Mainz covers a wide range of applications in different fields. Two of the four beam tubes are used for the development of fast and mainly continuous chemical separation procedures. These procedures are applied for the investigation of short-lived nuclides and for studies of the chemical behaviour of the heaviest elements. At the third beam tube an on-line mass-separator facility with a microwave-induced plasma as an ion source is installed. Very recently the fourth beam tube has been modified for the production of polarized neutrons by interaction with optically pumped 3 He atoms. The other irradiation facilities are used for Neutron Activation Analysis (NAA) of different samples, among them geological and environmental ones, tracer production for chemical investigations, neutron irradiations of rat brain tissue to explore the utility of 157 Gd for cancer therapy and γ-ray irradiations for biological purposes. (author)

  17. Operation and maintenance experience at the TRIGA Mainz reactor

    International Nuclear Information System (INIS)

    Menke, Helmut

    1976-01-01

    Oscillations observed in the linear power channel especially at low steady state power with the pulse-rod in down position were found to be due to wear of connections of the pulse-rod. The downstream water from the cooling system caused a swing of the rod, which in turn induced the power oscillations. The wear can be regarded as normal, as more than 10,000 pulses have been performed so far. The repairs of the rod assembly are described. No major problems in operation and maintenance of the TRIGA Mainz were met since 1974. Results of routine inspections as fuel element measurements, power calibrations, etc., are described and discussed. (author)

  18. Medical and radiobiological applications at the research reactor TRIGA Mainz

    International Nuclear Information System (INIS)

    Hampel, G.; Grunewald, C.; Kratz, J.-V.; Schmitz, T.; Schutz, C.; Werner, S.; Appelman, K.; Moss, R.; Blaickner, M.; Nawroth, T.; Otto, G.; Schmidberger, H.

    2010-01-01

    At the University of Mainz, Germany, a boron neutron capture therapy (BNCT) project has been started with the aim to expand and advance the research on the basis of the TAOrMINA protocol for the BNCT treatment of liver metastases of colorectal cancer. Irradiations take place at the TRIGA Mark II reactor. Biological and clinical research and surgery take place at the University and its hospital of Mainz. Both are situated in close vicinity to each other, which is an ideal situation for BNCT treatment, as similarly performed in Pavia, in 2001 and 2003. The application of BNCT to auto-transplanted organs requires development in the methodology, as well as regard to the irradiation facility and is part of the complex, interdisciplinary treatment process. The additional high surgical risk of auto-transplantation is only justified when a therapeutic benefit can be achieved. A BNCT protocol including explantation and conservation of the organ, neutron irradiation and re-implantation is logistically a very challenging task. Within the last years, research on all scientific, clinical and logistical aspects for the therapy has been performed. This includes work on computational modelling for the irradiation facility, tissue and blood analysis, radiation biology, dosimetry and surgery. Most recently, a clinical study on boron uptake in both healthy and tumour tissue of the liver and issues regarding dosimetry has been started, as well as a series of cell-biology experiments to obtain concrete results on the relative biological effectiveness (RBE) of ionizing radiation in liver tissue. (author)

  19. The identity of new settlements. A new experimental town: Layenhof near Mainz

    Directory of Open Access Journals (Sweden)

    Marco Venturi

    1998-01-01

    Full Text Available Even though at present the attention of European planning agencies is focused on issues of re-use and green areas, a number of events are again raising the need to define proper answers to problems of new urbanization. Following a discussion on the changing definition of the urban phenomenon, the tender for a new settlement in Layenhof near Mainz in Germany and the architectural, urban design solution are presented.

  20. Newest results from the Mainz neutrino-mass experiment

    International Nuclear Information System (INIS)

    Bonn, J.; Bornschein, B.; Bornschein, L.; Fickinger, L.; Kraus, Ch.; Otten, E.W.; Ulrich, H.; Weinheimer, Ch.; Kazachenko, O.; Kovalik, A.

    2000-01-01

    The Mainz neutrino-mass experiment investigates the endpoint region of the tritium β-decay spectrum with a MAC-E spectrometer to determine the mass of the electron antineutrino. By the recent upgrade, the former problem of dewetting T 2 films has been solved, and the signal-to-background ratio was improved by a factor of 10. The latest measurement leads to m ν 2 -3.7 ± 5.3(stat.) ± 2.1(syst.) eV 2 /c 4 , from which an upper limit of m ν 2 (95% C.L.) is derived. Some indication for the anomaly, reported by the Troitsk group, was found, but its postulated half-year period is contradicted by our data. To push the sensitivity on the neutrino mass below 1 eV/c 2 , a new larger MAC-E spectrometer is proposed. Besides its integrating mode, it could run in a new nonintegration operation MAC-E-TOF mode

  1. Research work at the TRIGA Mainz reactor

    International Nuclear Information System (INIS)

    Trautmann, Norbert

    1976-01-01

    In the last two years the research activities at the TRIGA Mark II reactor in Mainz have mainly been concentrated on the investigation of short- lived nuclides of medium mass number produced by thermal-neutron induced fission of 235 U and other fissile materials. For the identification of these nuclides and for detailed studies of their properties rapid chemical separation procedures in combination with high-resolution gamma-ray and neutron spectroscopy as well as mass-separated samples have been used. Fast, discontinuous separation techniques are illustrated by a procedure for technetium. Continuous separation methods from aqueous solutions and in the gas phase, accomplished by combining a gas jet recoil transport system with an on-line operating solvent extraction technique and a thermo- chromatographic method, are presented. The application of such procedures to decay scheme and delayed neutron studies is demonstrated by a few examples. The experimental set-up and the method for nuclear spin - and magnetic moment measurements on alkali isotopes far from the region of beta-stability applying the nuclear radiation detected optical pumping technique to mass- separated samples of neutron-rich alkali nuclides are briefly described. (author)

  2. The Dating and Authorship of the Poem Vita Mahumeti, Attributed to Embrico of Mainz

    Directory of Open Access Journals (Sweden)

    Fernando González Muñoz

    2017-12-01

    Full Text Available The aim of this paper is to review the problems with the date of writing and the authorship of one of the first legendary accounts of the Prophet Muhammad written in Central Europe: the Vita Mahumeti, attributed to Embrico of Mainz. After presenting the available evidence and the conjectures of different scholars, a new hypothesis about the identity of the author is put forward, which at the same time enables us to clarify the dating of the work, its possible sources and meaning.

  3. Technology and techniques for parity experiments at Mainz: Past, Present and Future

    Science.gov (United States)

    Diefenbach, Juergen

    2016-03-01

    For almost 20 years the Mainz accelerator facility MAMI delivered polarized electron beam to the parity violation experiment A4 that measured the contributions of strange sea quarks to the proton electromagnetic factors. Parity violation asymmetries were of the order of A ~5 ppm. Currently the A1 collaboration carries out single spin asymmetry measurements at MAMI (A ~20 ppm) to prepare for a measurement of neutron skin depth on lead (A ~1 ppm). For such high precision experiments active stabilization and precise determination of beam parameters like current, energy, position, and angle are essential requirements in addition to precision electron beam polarimetry. For the future P2 experiment at the planned superconducting accelerator MESA in Mainz the requirements for beam quality will be even higher. P2 will measure the weak mixing angle with 0.15 percent total uncertainty and, in addition, the neutron skin depth of lead as well as parity violation in electron scattering off 12C. A tiny asymmetry of only -0.03 ppm creates the needs to combine digital feedback with feedforward stabilizations along with new polarimetry developments like a hydro-Moller and a double-Mott polarimeter to meet the goals for systematic uncertainty. This talk gives an overview of our experience with polarimetry, analog feedbacks and compensation techniques for apparative asymmetries at the A4 experiment. It finally leads to the requirements and new techniques for the pioneering P2 experiment at MESA. First results from beam tests currently carried out at the existing MAMI accelerator, employing high speed analog/digital conversion and FPGAs for control of beam parameters, will be presented. Supported by the cluster of excellence PRISMA and the Deutsche Forschungsgemeinschaft in the framework of the SFB1044.

  4. Comparison of EPR response of alanine and Gd₂O₃-alanine dosimeters exposed to TRIGA Mainz reactor.

    Science.gov (United States)

    Marrale, M; Schmitz, T; Gallo, S; Hampel, G; Longo, A; Panzeca, S; Tranchina, L

    2015-12-01

    In this work we report some preliminary results regarding the analysis of electron paramagnetic resonance (EPR) response of alanine pellets and alanine pellets added with gadolinium used for dosimetry at the TRIGA research reactor in Mainz, Germany. Two set-ups were evaluated: irradiation inside PMMA phantom and irradiation inside boric acid phantom. We observed that the presence of Gd2O3 inside alanine pellets increases the EPR signal by a factor of 3.45 and 1.24 in case of PMMA and boric acid phantoms, respectively. We can conclude that in the case of neutron beam with a predominant thermal neutron component the addition of gadolinium oxide can significantly improve neutron sensitivity of alanine pellets. Monte Carlo (MC) simulations of both response of alanine and Gd-added alanine pellets with FLUKA code were performed and a good agreement was achieved for pure alanine dosimeters. For Gd2O3-alanine deviations between MC simulations and experimental data were observed and discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Irradiation facility at the TRIGA Mainz for treatment of liver metastases

    Energy Technology Data Exchange (ETDEWEB)

    Hampel, G. [Institut fuer Kernchemie, Johannes Gutenberg-Universitaet Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz (Germany)], E-mail: gabriele.hample@uni-mainz.de; Wortmann, B. [Evonik Energy Services GmbH Essen, Ruettenscheider Str. 1-3, D-45128 Essen (Germany); Blaickner, M. [Austrian Research Centers, 2444 Seibersdorf (Austria); Knorr, J. [TU Dresden, Institut fuer Energietechnik, D-01062 Dresden (Germany); Kratz, J.V. [Institut fuer Kernchemie, Johannes Gutenberg-Universitaet Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz (Germany); Lizon Aguilar, A. [Evonik Energy Services GmbH Essen, Ruettenscheider Str. 1-3, D-45128 Essen (Germany); Minouchehr, S. [Transplantationschirurgie, Universitaetsklinikum Mainz, D-55131 Mainz (Germany); Nagels, S. [Forschungszentrum Karlsruhe GmbH, Institut fuer Strahlenforschung (ISF), Postfach 3640, D-76021 Karlsruhe (Germany); Otto, G. [Transplantationschirurgie, Universitaetsklinikum Mainz, D-55131 Mainz (Germany); Schmidberger, H. [Klinik und Poliklinik fuer Radioonkologie und Strahlentherapie, Universitaetsklinikum Mainz, D-55131 Mainz (Germany); Schuetz, C.; Vogtlaender, L. [Institut fuer Kernchemie, Johannes Gutenberg-Universitaet Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz (Germany)

    2009-07-15

    The TRIGA Mark II reactor at University of Mainz provides ideal conditions for duplicating BNCT treatment as performed in Pavia, Italy, in 2001 and 2003 [Pinelli, T., Zonta, A., Altieri, S., Barni, S., Braghieri, A., Pedroni, P., Bruschi, P., Chiari, P., Ferrari, C., Fossati, F., Nano, R., Ngnitejeu Tata, S., Prati, U., Ricevuti, G., Roveda, L., Zonta, C., 2002. TAOrMINA: from the first idea to the application to the human liver. In: Sauerwein et al. (Eds.), Research and Development in Neutron Capture Therapy. Proceedings of the 10th International Congress on Neutron Capture Therapy, Monduzzi editore, Bologna, pp. 1065-1072]. In order to determine the optimal parameters for the planned therapy and therefore for the design of the thermal column, calculations were conducted using the MCNP-code and the transport code ATTILA. The results of the parameter study as well as a possible configuration for the irradiation of the liver are presented.

  6. High-statistics measurement of the η →3 π0 decay at the Mainz Microtron

    Science.gov (United States)

    Prakhov, S.; Abt, S.; Achenbach, P.; Adlarson, P.; Afzal, F.; Aguar-Bartolomé, P.; Ahmed, Z.; Ahrens, J.; Annand, J. R. M.; Arends, H. J.; Bantawa, K.; Bashkanov, M.; Beck, R.; Biroth, M.; Borisov, N. S.; Braghieri, A.; Briscoe, W. J.; Cherepnya, S.; Cividini, F.; Collicott, C.; Costanza, S.; Denig, A.; Dieterle, M.; Downie, E. J.; Drexler, P.; Ferretti Bondy, M. I.; Fil'kov, L. V.; Fix, A.; Gardner, S.; Garni, S.; Glazier, D. I.; Gorodnov, I.; Gradl, W.; Gurevich, G. M.; Hamill, C. B.; Heijkenskjöld, L.; Hornidge, D.; Huber, G. M.; Käser, A.; Kashevarov, V. L.; Kay, S.; Keshelashvili, I.; Kondratiev, R.; Korolija, M.; Krusche, B.; Lazarev, A.; Lisin, V.; Livingston, K.; Lutterer, S.; MacGregor, I. J. D.; Manley, D. M.; Martel, P. P.; McGeorge, J. C.; Middleton, D. G.; Miskimen, R.; Mornacchi, E.; Mushkarenkov, A.; Neganov, A.; Neiser, A.; Oberle, M.; Ostrick, M.; Otte, P. B.; Paudyal, D.; Pedroni, P.; Polonski, A.; Ron, G.; Rostomyan, T.; Sarty, A.; Sfienti, C.; Sokhoyan, V.; Spieker, K.; Steffen, O.; Strakovsky, I. I.; Strandberg, B.; Strub, Th.; Supek, I.; Thiel, A.; Thiel, M.; Thomas, A.; Unverzagt, M.; Usov, Yu. A.; Wagner, S.; Walford, N. K.; Watts, D. P.; Werthmüller, D.; Wettig, J.; Witthauer, L.; Wolfes, M.; Zana, L. A.; A2 Collaboration at MAMI

    2018-06-01

    The largest, at the moment, statistics of 7 ×106η →3 π0 decays, based on 6.2 ×107η mesons produced in the γ p →η p reaction, has been accumulated by the A2 Collaboration at the Mainz Microtron, MAMI. It allowed a detailed study of the η →3 π0 dynamics beyond its conventional parametrization with just the quadratic slope parameter α and enabled, for the first time, a measurement of the second-order term and a better understanding of the cusp structure in the neutral decay. The present data are also compared to recent theoretical calculations that predict a nonlinear dependence along the quadratic distance from the Dalitz-plot center.

  7. Upgrade of the ultracold neutron source at the pulsed reactor TRIGA Mainz

    Energy Technology Data Exchange (ETDEWEB)

    Kahlenberg, J.; Ross, K.U.; Beck, M.; Heil, W.; Karch, J.; Kories, F.; Kretschmer, M. [Johannes Gutenberg University, Institute of Physics, Mainz (Germany); Ries, D. [Johannes Gutenberg University, Institute of Nuclear Chemistry, Mainz (Germany); Paul Scherrer Institute (PSI), Laboratory for Particle Physics, Villigen (Switzerland); ETH Zuerich, Institute for Particle Physics, Zuerich (Switzerland); Siemensen, C.; Geppert, C.; Karpuk, S.; Reich, T.; Sobolev, Y.; Trautmann, N. [Johannes Gutenberg University, Institute of Nuclear Chemistry, Mainz (Germany); Hild, N. [Paul Scherrer Institute (PSI), Laboratory for Particle Physics, Villigen (Switzerland); ETH Zuerich, Institute for Particle Physics, Zuerich (Switzerland); Lauss, B. [Paul Scherrer Institute (PSI), Laboratory for Particle Physics, Villigen (Switzerland)

    2017-11-15

    The performance of the upgraded solid deuterium ultracold neutron source at the pulsed reactor TRIGA Mainz is described. The current configuration stage comprises the installation of a He liquefier to run UCN experiments over long-term periods, the use of stainless steel neutron guides with improved transmission as well as sputter-coated non-magnetic {sup 58}NiMo alloy at the inside walls of the thermal bridge and the converter cup. The UCN yield was measured in a ''standard'' UCN storage bottle (stainless steel) with a volume of 32 litres outside the biological shield at the experimental area yielding UCN densities of 8.5/cm{sup 3}; an increase by a factor of 3.5 compared to the former setup. The measured UCN storage curve is in good agreement with the predictions from a Monte Carlo simulation developed to model the source. The growth and formation of the solid deuterium converter during freeze-out are affected by the ortho/para ratio of the H{sub 2} premoderator. (orig.)

  8. The research reactor TRIGA Mainz. A neutron source for versatile applications in research and education

    International Nuclear Information System (INIS)

    Eberhardt, K.; Kronenberg, A.

    2000-01-01

    Currently, four research reactors with a thermal power ranging from 0.1 to 23 MW th are in operation in Germany and one new reactor (20 MW th ) is under construction. The TRIGA Mark II reactor at the Institut fuer Kernchemie became first critical on August 3, 1965. It can be operated in the steady state mode with a maximum power of 100 kW th and in the pulse mode with a peak power of 250 MW th . A survey of the research programmes carried out at the TRIGA Mainz is given covering a wide range of applications in basic and applied science in nuclear chemistry, nuclear- and particle physics. Furthermore, the reactor is used for neutron activation analysis and for education and training of students and technical personal. (orig.) [de

  9. New results from the Mainz neutrino mass experiment and perspective of a new large tritium-β-spectrometer

    International Nuclear Information System (INIS)

    Bonn, J.; Bornschein, B.; Bornschein, L.; Fickinger, L.; Kraus, Ch.; Otten, E.W.; Ulrich, H.; Weinheimer, Ch.; Kazachenko, O.; Kovalik, A.

    2001-01-01

    The Mainz neutrino mass experiment investigates the endpoint region of the tritium β decay spectrum to determine the mass of the electron antineutrino. By the recent upgrade the former problem of de-wetting T 2 films has been solved and the signal-to-background-ratio was improved by a factor of 10. The latest measurement leads to m ν 2 = -1.1 ± 2.6 stat ± 1.8 sys eV 2 /c 4 (preliminary), which corresponds to an upper limit of m ν 2 (95 % C.L.) (preliminary). Some indication for the anomaly, reported by the Troitsk group, was found, but its postulated half year period is contradicted by our data. The perspectives of a new Large Tritium-β-Spectrometer to reach sub eV sensitivity will be presented. (authors)

  10. alles – einfach – sofort: Service in Medizinbibliotheken: Jahrestagung der Arbeitsgemeinschaft für Medizinisches Bibliothekswesen (AGMB e.V. vom 27. bis 29.9.2010 in Mainz / all – simply – immediately: service in medical libraries: Annual Meeting 2010 of “Arbeitsgemeinschaft für Medizinisches Bibliothekswesen” (AGMB e.V. 27th to 29th September in Mainz

    Directory of Open Access Journals (Sweden)

    Hentschel, Eike

    2010-12-01

    Full Text Available The annual meeting 2010 of “Arbeitsgemeinschaft für Medizinisches Bibliothekswesen” (AGMB e.V. took place 27th–29th September at Mainz university.During the main event for Advanced training of medical librarianship in Germany, Austria and Switzerland the following topics were presented and discussed:Increasing digitalization of scientific communication and the consequences, innovative services in hybrid libraries (virtual textbook collections and E-Books On-Demand, education (Master degree programm “Informations- und Wissensmanagement” in Hannover, concept and building of the medical library at Düsseldorf university (O.A.S.E., quality management according to ISO 9001, subito (new services based on § 52a+b UrhG, future of the programm “Nationallizenzen” and “Allianz-Initiative der deutschen Wissenschaftsorganisationen”, information literacy (particularly blended-learning, public relation and new strategies for communication and services, future concepts for medical libraries, library services in a UK research institute, reference management, Web 2.0 and other emerging technologies, BibNet.org, Cochrane library, MedPilot, PubMed.All relevant publishers and providers for medical libraries presented new products and services in an accompanying exhibition.

  11. Evaluating emergency risk communications: a dialogue with the experts.

    Science.gov (United States)

    Thomas, Craig W; Vanderford, Marsha L; Crouse Quinn, Sandra

    2008-10-01

    Evaluating emergency risk communications is fraught with challenges since communication can be approached from both a systemic and programmatic level. Therefore, one must consider stakeholders' perspectives, effectiveness issues, standards of evidence and utility, and channels of influence (e.g., mass media and law enforcement). Evaluation issues related to timing, evaluation questions, methods, measures, and accountability are raised in this dialogue with emergency risk communication specialists. Besides the usual evaluation competencies, evaluators in this area need to understand and work collaboratively with stakeholders and be attuned to the dynamic contextual nature of emergency risk communications. Sample resources and measures are provided here to aid in this emerging and exciting field of evaluation.

  12. Evaluation of Knowledge of Emergency Healthcare Workers Regarding Approach to Emergency Patients

    Directory of Open Access Journals (Sweden)

    Özgür Tanr›verdi

    2010-09-01

    Full Text Available Aim: Emergency units constitute the most important part of all hospitals. The aim of this study was to evaluate practitioners’ and healthcare providers’ knowledge and experience regarding emergency first aid in a hospital with insufficient facilities. Methods: 17 physicians and 25 assistant staff working at our hospital were evaluated in terms of their knowledge about and experience in “emergency medicine and trauma” by a questionnaire and by observations. Results: The results of observations and questionnaire indicated that knowledge and experience among physicians were inadequate in terms of basic life support and advanced cardiac life support. This lack of knowledge was not associated with age, time of employment, faculty graduated and training on “emergency medicine” in the group of physicians (r=0.301 p>0.05, r=0.317 p>0.06, r=0.228 p>0.05, r=0.284 p>0.05, respectively and in the group of assistant staff (r=0.341 p>0.05, r=0.287 p>0.06, r=0.234 p>0.05, r=0.227 p>0.05, respectively. Conclusion: Considering that the most of the physicians are gathered in certain regions of our country and that there is a lack of emergency medicine specialists in underdeveloped regions, it has been concluded that physicians specialized in other areas and practitioners must attend emergency medicine trainings under the concept of “emergency medicine rotation”. (The Medical Bulletin of Haseki 2010; 48:103-5

  13. Detector studies for a high precision determination of the weak mixing angle at the future P2-experiment in Mainz

    Energy Technology Data Exchange (ETDEWEB)

    Gerz, Kathrin; Baunack, Sebastian; Becker, Dominik; Diefenbach, Juergen; Glaeser, Boris; Imai, Yoshio; Jennewein, Thomas [Institut fuer Kernphysik, Johannes-Gutenberg-Universitaet Mainz (Germany); Maas, Frank [Institut fuer Kernphysik, Johannes-Gutenberg-Universitaet Mainz (Germany); Helmholz-Institut Mainz (Germany); PRISMA Cluster of Excellence, Johannes Gutenberg-Universitaet, 55099 Mainz (Germany); Rodriguez, David [Helmholz-Institut Mainz (Germany); Collaboration: A4-Collaboration

    2015-07-01

    The P2 experiment at the upcoming MESA accelerator in Mainz aims for a high precision determination of the electroweak mixing angle: The 2% measurement of the parity violating asymmetry in elastic electron-proton scattering will allow for a determination of sin{sup 2}(θ{sub W}) of 0.15%. The experimental setup is currently being designed and will employ the use of an integrating, large solid angle magnetic solenoid spectrometer with quartz bars for the detection of elastically scattered electrons. The low-energy and high-statistics experiment places high demands on detector performance and radiation hardness of all materials used in the setup. We are going to present the current status of the development of the experiment, feasibility calculations and simulations. We put an emphasis on technology and design of a Cherenkov detector.

  14. Usability Evaluation in a Digitally Emerging Country

    DEFF Research Database (Denmark)

    Lizano, Fulvio; Sandoval, Maria Marta; Bruun, Anders

    2013-01-01

    Several emerging countries experience increasing software development activities. With the purpose of provide useful feedback on possible courses of action for increasing application of usability evaluation in such countries, this paper explores the status of usability evaluation in a digitally...... emerging country. Our aim is to identifying common characteristics or behavioral patterns that could be compared with digitally advanced countries. We used an online survey answered by 26 software development organizations, which gave a snapshot of the application of usability evaluation...... in these organizations. We found many similarities with advanced countries, several completely new obstacles more connected with software development matters and a relatively positive improvement in the lack of “usability culture”. These findings suggest good conditions to improve conduction of usability evaluations...

  15. Immersion and contact freezing experiments in the Mainz wind tunnel laboratory

    Science.gov (United States)

    Eppers, Oliver; Mayer, Amelie; Diehl, Karoline; Mitra, Subir; Borrmann, Stephan; Szakáll, Miklós

    2016-04-01

    Immersion and contact freezing are of outmost important ice nucleation processes in mixed phase clouds. Experimental studies are carried out in the Mainz vertical wind tunnel laboratory in order to characterize these nucleation processes for different ice nucleating particles (INP), such as for mineral dust or biological particles. Immersion freezing is investigated in our laboratory with two different experimental techniques, both attaining contact-free levitation of liquid droplets and cooling of the surrounding air down to about -25 °C. In an acoustic levitator placed in the cold room of our laboratory, drops with diameters of 2 mm are investigated. In the vertical air stream of the wind tunnel droplets with diameter of 700 micron are freely floated at their terminal velocities, simulating the flow conditions of the free atmosphere. Furthermore, the wind tunnel offers a unique platform for contact freezing experiments. Supercooled water droplets are floated in the vertical air stream at their terminal velocities and INP are injected into the tunnel air stream upstream of them. As soon as INP collides with the supercooled droplet the contact freezing is initiated. The first results of immersion and contact freezing experiments with cellulose particles both in the acoustic levitator and in the wind tunnel will be presented. Cellulose is considered as typical INP of biological origin and a macrotracer for plant debris. Nucleating properties of cellulose will be provided, mainly focusing on the temperature, INP concentration, and specific surface area dependences of the freezing processes. Direct comparison between the different experimental techniques (acoustic levitator and wind tunnel), as well as between nucleation modes (immersion and contact freezing) will be presented. The work is carried out within the framework of the German research unit INUIT.

  16. Dose calculation in biological samples in a mixed neutron-gamma field at the TRIGA reactor of the University of Mainz

    DEFF Research Database (Denmark)

    Schmitz, T.; Blaickner, M.; Schütz, C.

    2010-01-01

    and pin-diodes. Material and methods. When L-α-alanine is irradiated with ionizing radiation, it forms a stable radical which can be detected by electron spin resonance (ESR) spectroscopy. The value of the ESR signal correlates to the amount of absorbed dose. The dose for each pellet is calculated using......To establish Boron Neutron Capture Therapy (BNCT) for non-resectable liver metastases and for in vitro experiments at the TRIGA Mark II reactor at the University of Mainz, Germany, it is necessary to have a reliable dose monitoring system. The in vitro experiments are used to determine the relative......-calculations for mixed radiation fields and the Hansen & Olsen alanine detector response model. With the acquired data about the background dose and charged particle spectrum, and with the acquired information of the neutron flux, we are capable of calculating the dose to the tissue. Conclusion. Monte Carlo simulation...

  17. Evaluating the future of HCI: challenges for the evaluation of emerging applications

    NARCIS (Netherlands)

    Poppe, Ronald Walter; Rienks, R.J.

    2007-01-01

    Current evaluation methods are inappropriate for emerging HCI applications. In this paper, we give three examples of these applications and show that traditional evaluation methods fail. We identify trends in HCI development and discuss the issues that arise with evaluation. We aim at achieving

  18. Evaluating the Future of HCI : Challenges for the Evaluation of Emerging Applications

    NARCIS (Netherlands)

    Poppe, Ronald Walter; Rienks, R.J.; van Dijk, Elisabeth M.A.G.; Huang, T.S; Nijholt, Antinus; Pantic, Maja; Pentland, A.

    2007-01-01

    Current evaluation methods are inappropriate for emerging HCI applications. In this paper, we give three examples of these applications and show that traditional evaluation methods fail. We identify trends in HCI development and discuss the issues that arise with evaluation. We aim at achieving

  19. Institute for Nuclear Chemistry of the University of Mainz. Annual report 1986

    International Nuclear Information System (INIS)

    Weber, M.

    1987-01-01

    The report summarizes the points of main efforts of the Institute for Nuclear Chemistry during 1986: A. Rapid separations (thermochromatography of platinum elements; ICP source for the HELIOS mass separator; oxidation states of Lr; ionic radii of Lr 3+ and Md 3+ ; heats of hydration). B. Exotic nuclei and nuclear structure (lifetime of the 167 keV level of 97 Sr; description of the K=3/2 + side band in 99 Y with the IBF/PTQ model; pairing-free K π =1 + -rotational bands in deformed odd/odd A ≅ 100 nuclei; proton particle states in 103,105 Rh; β-decay of the 110,112 Rh isomers; β-decay half-life of 130 48 Cd and its importance for astrophysical r-process scenarios; alpha burning of 14 O; β-decay half-lives of nuclei far from stability for astrophysical application; beta delayed neutron energy spectra for application in reactor physics). C. Nuclear fission (charge distribution in the reaction 232 Th(n R ,f); isomeric ratios and decay properties of 96m,g Y, 97m,g Y and 134m,g I). D. Heavy ion reactions (quasi fission in the reaction 40 Ar + 208 Pb near the Coulomb barrier; unusual excitation-energy distribution in quasi-fission reactions; competition of direct reactions with fusion; nucleon transfer in the reaction 40 Ar + 235 U; nuclear reactions and nuclear contact in U+U collisions below the barrier; deflection function and fragmentation in the system 197 Au → 197 Au; search for exotic heavy nuclei using Rutherford backscattering). E. Ecology of radionuclides (preparation of plutonium samples for laser spectroscopy; laser resonance-ionization mass spectrometry on uranium and plutonium; capture of externally produced ions in a high frequency quadrupole trap; Chernobyl fallout in the Mainz area). (orig./RB) [de

  20. A new measurement of the rare decay eta -> pi^0 gamma gamma with the Crystal Ball/TAPS detectors at the Mainz Microtron

    Energy Technology Data Exchange (ETDEWEB)

    Nefkens, B M; Prakhov, S; Aguar-Bartolom��, P; Annand, J R; Arends, H J; Bantawa, K; Beck, R; Bekrenev, V; Bergh��user, H; Braghieri, A; Briscoe, W J; Brudvik, J; Cherepnya, S; Codling, R F; Collicott, C; Costanza, S; Danilkin, I V; Denig, A; Demissie, B; Dieterle, M; Downie, E J; Drexler, P; Fil' kov, L V; Fix, A; Garni, S; Glazier, D I; Gregor, R; Hamilton, D; Heid, E; Hornidge, D; Howdle, D; Jahn, O; Jude, T C; Kashevarov, V L; K��ser, A; Keshelashvili, I; Kondratiev, R; Korolija, M; Kotulla, M; Koulbardis, A; Kruglov, S; Krusche, B; Lisin, V; Livingston, K; MacGregor, I J; Maghrbi, Y; Mancel, J; Manley, D M; McNicoll, E F; Mekterovic, D; Metag, V; Mushkarenkov, A; Nikolaev, A; Novotny, R; Oberle, M; Ortega, H; Ostrick, M; Ott, P; Otte, P B; Oussena, B; Pedroni, P; Polonski, A; Robinson, J; Rosner, G; Rostomyan, T; Schumann, S; Sikora, M H; Starostin, A; Strakovsky, I I; Strub, T; Suarez, I M; Supek, I; Tarbert, C M; Thiel, M; Thomas, A; Unverzagt, M; Watts, D P; Werthmueller, D; Witthauer, L

    2014-08-01

    A new measurement of the rare, doubly radiative decay eta->pi^0 gamma gamma was conducted with the Crystal Ball and TAPS multiphoton spectrometers together with the photon tagging facility at the Mainz Microtron MAMI. New data on the dependence of the partial decay width, Gamma(eta->pi^0 gamma gamma), on the two-photon invariant mass squared, m^2(gamma gamma), as well as a new, more precise value for the decay width, Gamma(eta->pi^0 gamma gamma) = (0.33+/-0.03_tot) eV, are based on analysis of 1.2 x 10^3 eta->pi^0 gamma gamma decays from a total of 6 x 10^7 eta mesons produced in the gamma p -> eta p reaction. The present results for dGamma(eta->pi^0 gamma gamma)/dm^2(gamma gamma) are in good agreement with previous measurements and recent theoretical calculations for this dependence.

  1. Evaluation of Performance Indexes of Emergency Department

    Directory of Open Access Journals (Sweden)

    Alireza Baratloo

    2015-02-01

    Full Text Available Introduction: The importance of evaluating performance indicators in the emergency department, as one of the most important departments of hospital, is obvious to everyone. Therefore, in this study we aimed to appraise the five performance indicators, approved by the ministry of health, in Shohadaye Tajrish hospital, Tehran, Iran. Methods: In a descriptive cross-sectional study based on the profiles of all the patients admitted to the emergency department, performance indicators in the emergency department were evaluated. The study was divided into 2 parts about the establishment of emergency medicine system and training the medical staff: the first 6 months of 1392 and the second. Then these 2 periods were compared using Mann-Whitney U test while P< 0.05 was considered as the level of significance. Results: Of the studied indicators, mean triage time was 6.04 minutes in the first 6 months which was reduced to 1.5 minutes in the second 6 months (p=0.016. In addition, the percentage of patients who moved out of the department in 12 hours was lowered from 97.3% in the first period to 90.4% in the second (p=0.004. While, the percentage of patients who were decided upon in 6 hours (p=0.2, unsuccessful CPR percentage (p=0.34 and patients discharged against medical advice (p=0.42 showed no significant difference. Conclusion: The results of this study showed that the establishment of the emergency medicine system in the emergency department could lead to more efficient triage. Due to the differences made after their establishment including: different pattern of the patients admitted, increased stay of the patients in the department due to their need for prolonged intensive care, a raise in patient referral to the hospital by pre-hospital services and a higher percentage of occupied hospital beds, other indicators have not shown a significant improvement.

  2. Channeling experiments at planar diamond and silicon single crystals with electrons from the Mainz Microtron MAMI

    Science.gov (United States)

    Backe, H.; Lauth, W.; Tran Thi, T. N.

    2018-04-01

    Line structures were observed for (110) planar channeling of electrons in a diamond single crystal even at a beam energy of 180 MeV . This observation motivated us to initiate dechanneling length measurements as function of the beam energy since the occupation of quantum states in the channeling potential is expected to enhance the dechanneling length. High energy loss signals, generated as a result of emission of a bremsstrahlung photon with about half the beam energy at channeling of 450 and 855 MeV electrons, were measured as function of the crystal thickness. The analysis required additional assumptions which were extracted from the numerical solution of the Fokker-Planck equation. Preliminary results for diamond are presented. In addition, we reanalyzed dechanneling length measurements at silicon single crystals performed previously at the Mainz Microtron MAMI at beam energies between 195 and 855 MeV from which we conclude that the quality of our experimental data set is not sufficient to derive definite conclusions on the dechanneling length. Our experimental results are below the predictions of the Fokker-Planck equation and somewhat above the results of simulation calculations of A. V. Korol and A. V. Solov'yov et al. on the basis of the MBN Explorer simulation package. We somehow conservatively conclude that the prediction of the asymptotic dechanneling length on the basis of the Fokker-Planck equation represents an upper limit.

  3. System model for evaluation of an emergency response plan for a nuclear power plant based on an assessment of nuclear emergency exercises

    International Nuclear Information System (INIS)

    Silva, Marcos Vinicius C.; Medeiros, Jose A.C.C.

    2011-01-01

    Nuclear power plants are designed and built with systems dedicated to provide a high degree of protection to its workers, the population living in their neighborhoods and the environment. Among the requirements for ensuring safety there are the existence of the nuclear emergency plan. Due to the relationship between the actions contemplated in the emergency plan and the nuclear emergency exercise, it becomes possible to assess the quality of the nuclear emergency plan, by means of emergency exercise evaluation, The techniques used in this work aim at improving the evaluation method of a nuclear emergency exercise through the use of performance indicators in the evaluation of the structures, actions and procedures involved. The proposed model enables comparisons between different moments of an emergency plan directed to a nuclear power plant as well as comparisons between plans dedicated to different facilities. (author)

  4. System model for evaluation of an emergency response plan for a nuclear power plant based on an assessment of nuclear emergency exercises

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Marcos Vinicius C.; Medeiros, Jose A.C.C. [Universidade Federal do Rio de Janeiro (PEN/COPPE/UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-Graduacao de Engenharia. Programa de Engenharia Nuclear

    2011-07-01

    Nuclear power plants are designed and built with systems dedicated to provide a high degree of protection to its workers, the population living in their neighborhoods and the environment. Among the requirements for ensuring safety there are the existence of the nuclear emergency plan. Due to the relationship between the actions contemplated in the emergency plan and the nuclear emergency exercise, it becomes possible to assess the quality of the nuclear emergency plan, by means of emergency exercise evaluation, The techniques used in this work aim at improving the evaluation method of a nuclear emergency exercise through the use of performance indicators in the evaluation of the structures, actions and procedures involved. The proposed model enables comparisons between different moments of an emergency plan directed to a nuclear power plant as well as comparisons between plans dedicated to different facilities. (author)

  5. A Comprehensive Approach for the Ergonomic Evaluation of 13 Emergency and Transport Ventilators.

    Science.gov (United States)

    Marjanovic, Nicolas; L'Her, Erwan

    2016-05-01

    Mechanical ventilation is an important part of emergency medicine and is frequently used for transportation. Human errors during ventilator settings are frequent and may be associated with high morbidity/mortality. The aim of the study was to provide a complete ergonomic evaluation of emergency and transport ventilators, taking into account objective and subjective human-machine interface assessments and individual mental work load. We performed a prospective bench ergonomic evaluation of 13 emergency and transport ventilators, using standardized conditions and a global methodological approach. The study was performed in an evaluation laboratory dedicated to respiratory care, and 12 emergency physicians unfamiliar with the tested devices were included in the evaluation. The ventilators were classified into 3 categories (simple, sophisticated, and ICU-like). Objective chronometric evaluations were conducted considering 9 tasks, and subjective evaluations were performed (ease of use, willingness to use, and user-friendliness of monitoring) using Likert scales. Mental work load evaluation was performed using the NASA Task Load Index scale. Overall task failure rate represented 4% of all attempts. Setting modifications, ventilation mode changes, and powering down durations were different between simple and other emergency and transport ventilator categories (P < .005). There was no difference between ventilator categories for the ease of use and user-friendliness of the monitoring. In contrast, the willingness to use was lower for simple devices, compared with sophisticated and ICU-like emergency and transport ventilators (2.9 ± 1.4 vs 3.9 ± 1.2, P = .002 and 4.3 ± 1, P < .001). No differences were observed between devices regarding the mental work load, except for several specific devices in the sophisticated category. A comprehensive ergonomic evaluation provides valuable information while investigating operational friendliness in emergency and transport

  6. 75 FR 22817 - Emerging Infectious Diseases: Evaluation to Implementation for Transfusion and Transplantation...

    Science.gov (United States)

    2010-04-30

    ...] Emerging Infectious Diseases: Evaluation to Implementation for Transfusion and Transplantation Safety and... public workshops entitled ``Emerging Infectious Diseases: Evaluation to Implementation for Transfusion... Office of Science and Public Health, Centers for Disease Control and Prevention, National Institutes of...

  7. Recommended criteria for the evaluation of on-site nuclear power plant emergency exercises

    International Nuclear Information System (INIS)

    Lafortune, J.F.

    1997-01-01

    A review of existing Canadian and International emergency exercise evaluation criteria and approaches has been conducted. Based on the results of the review, criteria are proposed for the evaluation of on-site emergency exercises for Canadian nuclear power stations. The proposed criteria are performance-based. They are comprehensive, yet remain adaptable to all stations and accident scenarios. They are primarily aimed at radiological emergency exercises, but are entirely applicable to fire or other conventional exercises. This report also addresses evaluation preparation and methodology. (author). 21 refs., 6 tabs

  8. Evaluation criteria for emergency response plans in radiological transportation

    International Nuclear Information System (INIS)

    Lindell, M.K.; Perry, R.W.

    1980-01-01

    This paper identifies a set of general criteria which can be used as guides for evaluating emergency response plans prepared in connection with the transportation of radiological materials. The development of criteria takes the form of examining the meaning and role of emergency plans in general, reviewing the process as it is used in connection with natural disasters and other nonnuclear disasters, and explicitly considering unique aspects of the radiological transportation setting. Eight areas of critical importance for such response plans are isolated: notification procedures; accident assessment; public information; protection of the public at risk; other protective responses; radiological exposure control; responsibility for planning and operations; and emergency response training and exercises. (Auth.)

  9. The Profile of Neurology Patients Evaluated in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Ufuk Emre

    2009-09-01

    Full Text Available OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood count, serum glucose level, urea, creatine, erythrocyte sedimentation rate, and D-dimer levels and imaging findings were retrospectively evaluated based on patient charts. RESULTS: Impaired consciousness was the most frequent reason for neurological consultation (19.7%. Among these patients, ischemic stroke was diagnosed in 27.9%, hypoxic encephalopathy in 18.2%, cerebral hemorrhage in 9.1%, and 11% had no neurological diagnosis. Other common reasons for neurological consultation were vertigo, headache, seizure, and stroke. Clinical findings were related to other systemic causes in 43.7% of the study group. Focal neurological findings were present, especially in patients that presented with ischemic and hemorrhagic stroke, epilepsy, and hypoxic encephalopathy. CONCLUSION: In emergency departments, metabolic causes should be ruled out in patients with impaired consciousness and the absence of focal neurological signs. Intracranial structural disorders must be evaluated when focal neurological signs are present. Cautiously prepared algorithms and neurological examination training will help improve the accuracy of emergency department diagnoses

  10. Emergency preparedness exercises for nuclear facilities: Preparation, conduct and evaluation

    International Nuclear Information System (INIS)

    1985-01-01

    This publication offers guidance for operating organizations and public authorities on planning, organizing and conducting exercises, preparing scenarios and evaluating the results of exercises in order to make full use of the experience gained in improving the response planning and preparedness for radiation emergencies. The training aspects associated with achieving an adequate level of emergency preparedness are explored and examples of accident scenarios are presented

  11. X-ray phase contrast imaging at the Mainz Microtron MAMI

    International Nuclear Information System (INIS)

    Ghazaly, M. el

    2005-10-01

    Experiments have been performed to explore the potential of the low emittance 855 MeV electron beam of the Mainz Microtron MAMI for imaging with coherent X-rays. Transition radiation from a micro-focused electron beam traversing a foil stack served as X-ray source with good transverse coherence. In a first series of experiments a polychromatic transition radiation X-ray source with typical photon energies in the range of 8-30 keV and a spot size of standard deviation σ h =(8.6±0.1) μm in horizontal and σ v =(7.5±0.1) μm in vertical direction was used to record refraction contrast radiographs of low absorbing materials, in particular polymer strings with diameters between 30 and 450 μm. As detectors X-ray films were used. The source-to-detector distance amounted to 13 m. The edge enhancement contrast C ref = (I max -I min )/(I max +I min ) was investigated as a function of the distance between the object and the X-ray film which was varied between 0.5 and 5.5 m. In a second series of experiments holograms of strings were taken with a beam spot size σ v =(0.50±0.05) μm and a monochromatic X-ray beam of 6 keV energy. The good longitudinal coherence has been obtained by the (111) reflection of a flat silicon single crystal in Bragg geometry. It has been demonstrated that a direct exposure CCD chip with a pixel size of 13 x 13 μm 2 provides a highly efficient on-line detector. The on-line capability allows a minimization of the beam spot size by observing the smallest visible interference fringe spacings or the number of visible fringes. In a third series of experiments it was demonstrated that X-ray films are very useful detectors for the micro-focused and monochromized transition radiation X-ray source at MAMI. The main advantage in comparison with the direct exposure CCD chip is the resolution. For the X-ray film Structurix D3 (Agfa) the standard deviation of the resolution was measured to be σ f =(1.1±0.4) μm, which is about a factor of 6 better as for

  12. A Conceptual Framework for the Evaluation of Emergency Risk Communications

    Science.gov (United States)

    Lin, Leesa; Gamhewage, Gaya M.

    2017-01-01

    Objectives. To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). Methods. The framework proposed is based on a systematic review of the scientific literature (2001–2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. Results. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees’ data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Conclusions. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies. PMID:28892436

  13. A Conceptual Framework for the Evaluation of Emergency Risk Communications.

    Science.gov (United States)

    Savoia, Elena; Lin, Leesa; Gamhewage, Gaya M

    2017-09-01

    To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). The framework proposed is based on a systematic review of the scientific literature (2001-2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees' data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies.

  14. A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service.

    Science.gov (United States)

    Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard

    2014-09-01

    To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Pragmatic randomized controlled trial at one site with 260 participants. This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce. Trial registration details: Australian and New Zealand Clinical Trials Registry dated 18th August 2013, ACTRN12613000933752. © 2014 John Wiley & Sons Ltd.

  15. Emergency building temperature restrictions. Final evaluation

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-11-01

    On July 5, 1979, DOE promulgated final regulations of the Emergency Building Temperature Restrictions program, placing emergency restrictions on thermostat settings for space heating, space cooling, and hot water in commercial, industrial, and nonresidential public buildings. The final regulations restricted space heating to a maximum of 65/sup 0/F, hot water temperature to a maximum of 105/sup 0/F, and cooling temperature to a minimum of 78/sup 0/F. A comprehensive evaluation of the entire EBTF program for a nine-month period from July 16, 1979 is presented. In Chapter 1, an estimate of the population of buildings covered by EBTR is presented. In Chapter 2, EBTR compliance by building type and region is reported. Exemptions are also discussed. In Chapter 3, the simulations of building energy use are explained and the relative impact of various building characteristics and effectiveness of different control strategies are estimated. Finally, in Chapter 4, the methodology for scaling the individual building energy savings to the national level is described, and estimated national energy savings are presented.

  16. Experimental Simulation-Based Performance Evaluation of an SMS-Based Emergency Geolocation Notification System

    Directory of Open Access Journals (Sweden)

    Isibor Osebor

    2017-01-01

    Full Text Available In an emergency, a prompt response can save the lives of victims. This statement generates an imperative issue in emergency medical services (EMS. Designing a system that brings simplicity in locating emergency scenes is a step towards improving response time. This paper therefore implemented and evaluated the performance of an SMS-based emergency geolocation notification system with emphasis on its SMS delivery time and the system’s geolocation and dispatch time. Using the RAS metrics recommended by IEEE for evaluation, the designed system was found to be efficient and effective as its reliability stood within 62.7% to 70.0% while its availability stood at 99% with a downtime of 3.65 days/year.

  17. Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival-An evaluation of 548 emergency calls.

    Science.gov (United States)

    Viereck, Søren; Palsgaard Møller, Thea; Kjær Ersbøll, Annette; Folke, Fredrik; Lippert, Freddy

    2017-02-01

    This study aimed at evaluating if time for initiation of bystander cardiopulmonary resuscitation (CPR) - prior to the emergency call (CPR prior ) versus during the emergency call following dispatcher-assisted CPR (CPR during ) - was associated with return of spontaneous circulation (ROSC) and 30-day survival. The secondary aim was to identify predictors of CPR prior . This observational study evaluated out-of-hospital cardiac arrests (OHCA) occurring in the Capital Region of Denmark from 01.01.2013 to 31.12.2013. OHCAs were linked to emergency medical dispatch centre records and corresponding emergency calls were evaluated. Multivariable logistic regression analyses were applied to evaluate the association between time for initiation of bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of CPR prior . The study included 548 emergency calls for OHCA patients receiving bystander CPR, 34.9% (n=191) in the CPR prior group and 65.1% (n=357) in the CPR during group. Multivariable analyses showed no difference in ROSC (OR=0.88, 95% CI: 0.56-1.38) or 30-day survival (OR=1.14, 95% CI: 0.68-1.92) between CPR prior and CPR during . Predictors positively associated with CPR prior included witnessed OHCA and healthcare professional bystanders. Predictors negatively associated with CPR prior included residential location, solitary bystanders, and bystanders related to the patient. The majority of bystander CPR (65%) was initiated during the emergency call, following dispatcher-assisted CPR instructions. Whether bystander CPR was initiated prior to emergency call versus during the emergency call following dispatcher-assisted CPR was not associated with ROSC or 30-day survival. Dispatcher-assisted CPR was especially beneficial for the initiation of bystander CPR in residential areas. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  18. dAPE: a web server to detect homorepeats and follow their evolution.

    Science.gov (United States)

    Mier, Pablo; Andrade-Navarro, Miguel A

    2017-04-15

    Homorepeats are low complexity regions consisting of repetitions of a single amino acid residue. There is no current consensus on the minimum number of residues needed to define a functional homorepeat, nor even if mismatches are allowed. Here we present dAPE, a web server that helps following the evolution of homorepeats based on orthology information, using a sensitive but tunable cutoff to help in the identification of emerging homorepeats. dAPE can be accessed from http://cbdm-01.zdv.uni-mainz.de/∼munoz/polyx . munoz@uni-mainz.de. Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

  19. A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale.

    Science.gov (United States)

    Ringblom, Jenny; Wåhlin, Ingrid; Proczkowska, Marie

    2018-04-01

    Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures. The reliability of the Pediatric Anesthesia Emergence Delirium scale was also tested. One hundred and twenty-two children younger than seven years were observed at postoperative care units during recovery from anesthesia. Two or 3 observers independently assessed the children using the Pediatric Anesthesia Emergence Delirium scale. The factor analysis clearly revealed a one-factor solution, which accounted for 82% of the variation in the data. Internal consistency, calculated with Cronbach's alpha, was good (0.96). The Intraclass Correlation Coefficient, which was used to assess interrater reliability for the Pediatric Anesthesia Emergence Delirium scale sum score, was 0.97 (P Pediatric Anesthesia Emergence Delirium scale for assessing emergence delirium in children recovering from anesthesia after surgery or diagnostic procedures. The kappa statistics for the Pediatric Anesthesia Emergence Delirium scale items essentially indicated good agreement between independent raters, supporting interrater reliability. © 2018 John Wiley & Sons Ltd.

  20. Evaluation of care for traffic accidents victims made by on duty emergency physicians and surgeons in the emergency room

    Directory of Open Access Journals (Sweden)

    VLAUDIMIR DIAS MARQUES

    Full Text Available ABSTRACT Objective: to evaluate the care for victims of traffic accidents by on call emergency physicians and/or surgeons in the emergency room. Methods: we conducted a retrospective, descriptive and exploratory study on the care for traffic accidents victims in the urban area of Maringá-PR, between July 2013 and July 2014 in reference hospitals. We assessed demographics and vocational training through a questionnaire sent to the attending physicians. Results: of the 688 records evaluated, 99% of patients had a prehospital Revised Trauma Score of 12. Statistical analysis showed that in the cases conducted by the emergency physicians (n=187, the recording of the Glasgow Coma Scale and the performance of surgical procedures were less common, whereas the recording of blood pressure values was performed in greater numbers when compared with cases led by surgeons (n=501. There was a statistically significant relationship (p<0.01 between the length of hospital stay and surgical specialty, with a greater chance (crude OR=28 in the period from one to six hours for the group treated by emergency doctors. Most physicians participating in the study were young, with emergency room time of up to one to two years, and with ATLS training. Among those who had attended the ATLS course, 60% did so in the last four years. Surgeons performed 73% of hospital treatments. Conclusion: in the care of traffic victims with minor injuries, the Glasgow Coma Scale, the blood pressure levels, the type of treatment in the emergency room and hospital stay had different approaches between emergency physicians and surgeons.

  1. Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

    Science.gov (United States)

    Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

    2014-12-01

    Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

  2. X-ray phase contrast imaging at the Mainz Microtron MAMI

    Energy Technology Data Exchange (ETDEWEB)

    Ghazaly, M. el

    2005-10-15

    Experiments have been performed to explore the potential of the low emittance 855 MeV electron beam of the Mainz Microtron MAMI for imaging with coherent X-rays. Transition radiation from a micro-focused electron beam traversing a foil stack served as X-ray source with good transverse coherence. In a first series of experiments a polychromatic transition radiation X-ray source with typical photon energies in the range of 8-30 keV and a spot size of standard deviation {sigma}{sub h}=(8.6{+-}0.1) {mu}m in horizontal and {sigma}{sub v}=(7.5{+-}0.1) {mu}m in vertical direction was used to record refraction contrast radiographs of low absorbing materials, in particular polymer strings with diameters between 30 and 450 {mu}m. As detectors X-ray films were used. The source-to-detector distance amounted to 13 m. The edge enhancement contrast C{sub ref} = (I{sub max}-I{sub min})/(I{sub max}+I{sub min}) was investigated as a function of the distance between the object and the X-ray film which was varied between 0.5 and 5.5 m. In a second series of experiments holograms of strings were taken with a beam spot size {sigma}{sub v}=(0.50{+-}0.05) {mu}m and a monochromatic X-ray beam of 6 keV energy. The good longitudinal coherence has been obtained by the (111) reflection of a flat silicon single crystal in Bragg geometry. It has been demonstrated that a direct exposure CCD chip with a pixel size of 13 x 13 {mu}m{sup 2} provides a highly efficient on-line detector. The on-line capability allows a minimization of the beam spot size by observing the smallest visible interference fringe spacings or the number of visible fringes. In a third series of experiments it was demonstrated that X-ray films are very useful detectors for the micro-focused and monochromized transition radiation X-ray source at MAMI. The main advantage in comparison with the direct exposure CCD chip is the resolution. For the X-ray film Structurix D3 (Agfa) the standard deviation of the resolution was measured

  3. Psychiatric evaluation of the agitated patient: consensus statement of the american association for emergency psychiatry project Beta psychiatric evaluation workgroup.

    Science.gov (United States)

    Stowell, Keith R; Florence, Peter; Harman, Herbert J; Glick, Rachel L

    2012-02-01

    It is difficult to fully assess an agitated patient, and the complete psychiatric evaluation usually cannot be completed until the patient is calm enough to participate in a psychiatric interview. Nonetheless, emergency clinicians must perform an initial mental status screening to begin this process as soon as the agitated patient presents to an emergency setting. For this reason, the psychiatric evaluation of the agitated patient can be thought of as a 2-step process. First, a brief evaluation must be aimed at determining the most likely cause of agitation, so as to guide preliminary interventions to calm the patient. Once the patient is calmed, more extensive psychiatric assessment can be completed. The goal of the emergency assessment of the psychiatric patient is not necessarily to obtain a definitive diagnosis. Rather, ascertaining a differential diagnosis, determining safety, and developing an appropriate treatment and disposition plan are the goals of the assessment. This article will summarize what components of the psychiatric assessment can and should be done at the time the agitated patient presents to the emergency setting. The complete psychiatric evaluation of the patient whose agitation has been treated successfully is beyond the scope of this article and Project BETA (Best practices in Evaluation and Treatment of Agitation), but will be outlined briefly to give the reader an understanding of what a full psychiatric assessment would entail. Other issues related to the assessment of the agitated patient in the emergency setting will also be discussed.

  4. Evaluating emergency ultrasound training in India

    Directory of Open Access Journals (Sweden)

    Gupta Amit

    2010-01-01

    Full Text Available Background : In countries with fully developed emergency medicine systems, emergency ultrasound (EUS plays an important role in the assessment and treatment of critically ill patients. Methods : The authors sought to introduce EUS to a group of doctors working in the emergency departments (EDs in India through an intensive 4-day adult and pediatric ultrasound course held at the Apex Trauma Center and EM division of the All India Institute of Medical Sciences in New Delhi. The workshop was evaluated with a survey questionnaire and a hands-on practical test. The questionnaire was designed to assess the current state of EUS in India′s EDs, and to identify potential barriers to the incorporation of EUS into current EM practice. The EUS course consisted of a general introductory didactic session followed by pediatric, abdominal and trauma, cardiothoracic, obstetrical and gynecologic, and vascular modules. Each module had a didactic session followed by hands-on applications with live models and/or simulators. A post-course survey questionnaire was given to the participants, and there was a practical test on the final day of the course. The ultrasound images taken by the participants were digitally recorded, and were subsequently graded for their accuracy by independent observers, residency, and/or fellowship trained in EUS. Results : There were a total of 42 participants who completed the workshop and took the practical examination; 32 participants filled in the course evaluation survey. Twenty-four (75% participants had no prior experience with EUS, 5 (16% had some experience, and 3 (9% had significant experience. During the practical examination, 38 of 42 participants (90% were able to identify Morison′s pouch on the focused abdominal sonography for trauma (FAST examination, and 32 (76% were able to obtain a parasternal long axis cardiac view and identify the left ventricle. The inferior vena cava was identified as it crosses the diaphragm into

  5. Psychiatric Evaluation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Psychiatric Evaluation Workgroup

    Directory of Open Access Journals (Sweden)

    Keith R. Stowell

    2012-04-01

    Full Text Available It is difficult to fully assess an agitated patient, and the complete psychiatric evaluation usually cannot be completed until the patient is calm enough to participate in a psychiatric interview. Nonetheless, emergency clinicians must perform an initial mental status screening to begin this process as soon as the agitated patient presents to an emergency service. For this reason, the psychiatric evaluation of the agitated patient can be thought of as a two-step process. First a brief evaluation must be aimed at determining the most likely cause of agitation, so as to guide preliminary interventions to calm the patient. Once the patient is calmed, more extensive psychiatric assessment can be completed. The goal of the emergency assessment of the psychiatric patient is not necessarily to obtain a definitive diagnosis. Rather, ascertaining a differential diagnosis, determining safety, and developing an appropriate treatment and disposition plan are the goals of the assessment. This article will summarize what components of the psychiatric assessment can and should be done at the time the agitated patient presents. The complete psychiatric evaluation of the patient whose agitation has been treated successfully is beyond the scope of this paper and Project BETA, but will be outlined briefly to give the reader an understanding of what a full psychiatric assessment would entail. Other issues related to the assessment of the agitated patient in the emergency setting will also be discussed. [West J Emerg Med. 2012;13(1:11–16.

  6. Telemental health evaluations enhance access and efficiency in a critical access hospital emergency department.

    Science.gov (United States)

    Southard, Erik P; Neufeld, Jonathan D; Laws, Stephanie

    2014-07-01

    Mentally ill patients in crisis presenting to critical access hospital emergency rooms often face exorbitant wait times to be evaluated by a trained mental health provider. Patients may be discharged from the hospital before receiving an evaluation or boarded in a hospital bed for observation, reducing quality and increasing costs. This study examined the effectiveness of an emergency telemental health evaluation service implemented in a rural hospital emergency room. Retrospective data collection was implemented to consider patients presenting to the emergency room for 212 days prior to telemedicine interventions and for 184 days after. The study compared measures of time to treatment, length of stay (regardless of inpatient or outpatient status), and door-to-consult time. There were 24 patients seen before telemedicine was implemented and 38 seen using telemedicine. All patients had a mental health evaluation ordered by a physician and completed by a mental health specialist. Significant reductions in all three time measures were observed. Mean and median times to consult were reduced from 16.2 h (standard deviation=13.2 h) and 14.2 h, respectively, to 5.4 h (standard deviation =6.4 h) and 2.6 h. Similar reductions in length of stay and door-to-consult times were observed. By t tests, use of telemedicine was associated with a statistically significant reduction in all three outcome measures. Telemedicine appears to be an effective intervention for mentally ill patients by providing more timely access to mental health evaluations in rural hospital emergency departments.

  7. Handbook for the planning, co-ordination and evaluation of emergency exercises in nuclear power plants

    International Nuclear Information System (INIS)

    Schmidtborn, I.; Bath, N.

    1999-01-01

    The efficiency of the on-site emergency organization in German nuclear power plants is tested regularly through emergency exercises. To achieve federal harmonization on a high level of quality a handbook for the planning, co-ordination and evaluation of such exercises has been developed in the frame of the regulatory investigation programme. In this handbook requirements are set out for emergency training. Key elements are a modular structure, rules to be observed and guidance for post-exercise evaluation. (orig.) [de

  8. [Evaluation of the vital emergency action plan at the Navarre Hospital (Spain)].

    Science.gov (United States)

    Tirapu, Belén; Rodrigo, Isabel; Gost, Javier; Aranguren, María Isabel; Ezcurra, Paz

    2010-07-01

    Healthcare organizations are placing great emphasis on the care of patients with cardiopulmonary arrest (CPA) since interventions based on the scientific evidence can decrease both the mortality rate and sequelae. Nevertheless, there are limited comprehensive assessments covering all the resources and interventions required when a vital emergency arises. To evaluate the effectiveness of the vital emergency action plan at the Navarre Hospital by analyzing a panel of 70 indicators. Structure and process indicators were assessed in 25 clinical units at the Navarre Hospital from April to June 2008. The structure and review process of CPR carts were analyzed, defibrillators were tested and 40 simulations involving 144 professionals were evaluated. Nonconformities were found in 86% of the indicators evaluated. The percentages of compliance in the indicators of structure ranged from 39.6% to 100%. In the evaluation of process, conformity ranged from 2.5% to 100%. The percentages of simulations meeting time standards varied between 17.5% and 45%. In 37.5% of the simulations, at least 50% of trained staff were present in the unit. In 32.3% of the simulations, the standard for the number of people in the unit who participated in the simulations was achieved. This study identified problems in the structure and process of a vital emergency action plan without, at this stage, evaluating patient outcomes. Copyright © 2010 Elsevier España S.L. All rights reserved.

  9. Evaluation report of the Nordic emergency exercise Odin - November 26, 1993

    International Nuclear Information System (INIS)

    1994-01-01

    An evaluation of the second phase, ODIN, of an emergency exercise which is related to the late phase of a hypothetical nuclear accident outside, but close to the Nordic countries. This phase, in contrast to the first one (NORA) during the course of which it was found that strong national ways of thinking unfluenced decision-making, was carried out on the same day in all five Nordic countries in order to enable contact between them. The main argument in favour of a coordinated approach in the intervention policy in this area is that it is likely that the public in each of these countries would be unable to understand or accept very different levels of ambition with regard to their protection. The main objective of ODIN was to add to the knowledge and increase the capability of those responsible in the Nordic countries for handling a situation of deposition following a nuclear accident to improve provisions for Nordic coordination of the overall decision-making and to reach a joint Nordic view of emergency response. The organization of the evaluation, the methodology of the exercise and the evaluation itself covering, amongst other aspects, responses by emergency organizations to the check lists on actions, the decision-making process, international communication, public information and technical facilities are dealt with. (AB)

  10. Evaluation and management of acute abdominal pain in the emergency department

    Directory of Open Access Journals (Sweden)

    Macaluso CR

    2012-09-01

    Full Text Available Christopher R Macaluso, Robert M McNamaraDepartment of Emergency Medicine, Temple University School of Medicine, Philadelphia, PA, USAAbstract: Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain.Keywords: acute abdomen, emergency medicine, peritonitis

  11. Psychiatric Evaluation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Psychiatric Evaluation Workgroup

    OpenAIRE

    Stowell, Keith R; Florence, Peter; Harman, Herbert J; Glick, Rachel L

    2012-01-01

    It is difficult to fully assess an agitated patient, and the complete psychiatric evaluation usually cannot be completed until the patient is calm enough to participate in a psychiatric interview. Nonetheless, emergency clinicians must perform an initial mental status screening to begin this process as soon as the agitated patient presents to an emergency setting. For this reason, the psychiatric evaluation of the agitated patient can be thought of as a 2-step process. First, a brief evaluati...

  12. Assessment and Evaluation of National Human Resource Development System Competitiveness in Emerging Countries

    Science.gov (United States)

    Oh, HunSeok; Seo, DongIn; Kim, JuSeuk; Yoo, SangOk; Seong, HeeChang

    2015-01-01

    This study assessed and evaluated the competitiveness of national human resource development (NHRD) systems in emerging countries with potential for growth. The literature on emerging countries and NHRD systems was reviewed. The study developed a model mechanism with forty-one indices and nine sub-components for the NHRD system assessment in…

  13. Preparation, Conduct and Evaluation of Exercises to Test Preparedness for a Nuclear or Radiological Emergency - Training Materials

    International Nuclear Information System (INIS)

    2010-01-01

    Emergency response exercises are a key component of a good program of preparation in emergencies. They can provide a unique insight on the State of preparation of emergency response organizations. They can also be the basis for continuous improvement programs of the infrastructure of response in emergencies. However, to be more useful, the exercises in emergency response need to be well organized, professionally conducted and its assessment should focus on the potential for constructive improvement. The course of the IAEA on preparedness, conduction and evaluation exercises to test the preparation before a nuclear emergency or radiation designed for people and organizations that want to increase their ability to carry out effective and significant emergency exercises. The objectives of this course are: To familiarize participants with concepts, terminology, process of preparation, conduction and evaluation of the exercise to test the preparation before a nuclear emergency or radiation; Provide participants with knowledge practical and the ability to organize, lead and evaluate an exercise to test the preparation for a nuclear emergency or radiation in their own countries; Submit an exercise response model in emergency prepared by the IAEA; and give participants the skill to adapt the proposal of model exercise and organize and lead this exercise model right in your own country. [es

  14. An approach for evaluating expert performance in emergency situations

    International Nuclear Information System (INIS)

    Ujita, Hiroshi; Kawano, Ryutaro; Yoshimura, Sandanori

    1995-01-01

    To understand expert behavior and define what constitutes good performance in emergency situations in huge and complex plants, human performance evaluation should be made from viewpoints of not only error, but also various cognitive, psychological, and behavioral characteristics. Quantitative and qualitative measures of human performance are proposed for both individual operators and crews, based on the operator performance analysis experiment, among which cognitive and behavioral aspects are the most important. Operator performance should be further analyzed experimentally from the cognitive and behavioral viewpoints, using an evaluation based on various gross indexes considering operator's tasks which should be done in response to plant situations

  15. [The evaluation of academic emergency department design].

    Science.gov (United States)

    Deniz, Turgut; Aydinuraz, Kuzey; Oktay, Cem; Saygun, Meral; Ağalar, Fatih

    2007-01-01

    In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed. Two Emergency Medicine Departments that were not operating at that time were not included in the study. The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academic efforts in this field is emerging in challenging physical conditions. The results of our study revealed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.

  16. Introducing PCTRAN as an evaluation tool for nuclear power plant emergency responses

    International Nuclear Information System (INIS)

    Cheng, Yi-Hsiang; Shih, Chunkuan; Chiang, Show-Chyuan; Weng, Tung-Li

    2012-01-01

    Highlights: ► PCTRAN is integrated with an atmospheric dispersion algorithm. ► The improved PCTRAN acts as an accident/incident simulator and a data exchange system. ► The software helps the responsible organizations decide the rescue and protective actions. ► The evaluation results show the nuclear power plant accident and its off-site dose consequences. ► The software can be used for nuclear power plant emergency responses. - Abstract: Protecting the public from radiation exposure is important if a nuclear power plant (NPP) accident occurs. Deciding appropriate protective actions in a timely and effective manner can be fulfilled by using an effective accident evaluation tool. In our earlier work, we have integrated PCTRAN (Personal Computer Transient Analyzer) with the off-site dose calculation model. In this study, we introduce PCTRAN as an evaluation tool for nuclear power plant emergency responses. If abnormal conditions in the plant are monitored or observed, the plant staffs can distinguish accident/incident initiation events. Thus, the responsible personnel can immediately operate PCTRAN and set up those accident/incident initiation events to simulate the nuclear power plant transient or accident in conjunction with off-site dose distributions. The evaluation results consequently help the responsible organizations decide the rescue and protective actions. In this study, we explain and demonstrate the capabilities of PCTRAN for nuclear emergency responses, through applying it to simulate the postulated nuclear power plant accident scenarios.

  17. Evaluating outcomes of the emergency nurse practitioner role in a major urban emergency department, Melbourne, Australia.

    Science.gov (United States)

    Jennings, Natasha; O'Reilly, Gerard; Lee, Geraldine; Cameron, Peter; Free, Belinda; Bailey, Michael

    2008-04-01

    The aim of this study was to evaluate the impact of the introduction of Emergency Nurse Practitioner Candidates (ENPC) on waiting times and length of stay of patients presenting to a major urban Emergency Department (ED) in Melbourne, Australia. As part of a Victorian state funded initiative to improve patient outcomes, the role of the Emergency Nurse Practitioner has been developed. The integration and implementation of this role, is not only new to the Alfred Emergency and Trauma Centre but to EDs in Melbourne, Australia, with aims of providing holistic and comprehensive care for patients. A retrospective case series of all patients with common ED diagnostic subgroups were included. The ENPC group (n = 572) included all patients managed by the ENPC and the Traditional Model (TM) group (n = 2584) included all patients managed by the traditional medical ED model of care. Outcome measures included waiting times and length of stay. Statistically significant differences were evident between the two groups in waiting times and length of stay in the ED. The overall median waiting time for emergency patients to be seen by the ENPC was less than for the TM group [median (IQR): ENPC 12 (5.5-28) minutes; TM 31 (11.5-76) minutes (Wilcoxon p times for ENPC shifts vs. non-ENPC shifts revealed significant differences [median (IQR): ENPC rostered 24 (9-52) minutes; ENPC not rostered 33 (13-80.5) minutes (Wilcoxon p Melbourne, Australia were associated with significantly reduced waiting times and length of stay for emergency patients. Emergency Nurse Practitioners should be considered as a potential long term strategy to manage increased service demands on EDs. Relevance to clinical practice. This study is the first in Australia with a significant sample size to vigorously compare ENPC waiting times and length of stay outcomes with the TM model of care in the ED. The study suggests that ENPCs can have a favourable impact on patient outcomes with regard to waiting times and length

  18. Consumer evaluation of imported organic food products in emerging economies in Asia

    OpenAIRE

    Pedersen, Susanne; Aschemann-Witzel, Jessica; Thøgersen, John

    2017-01-01

    Consumer evaluation of imported organic food products in emerging economies in Asia Introduction Consumers in emerging economies such as Thailand and China have started to demand organic food products – mainly due to food safety reasons (Ortega, Wang, Wu, & Hong, 2015; Roitner-Schobesberger, Darnhofer, Somsook, & Vogl, 2008; C. L. Wang, Li, Barnes, & Ahn, 2012; O. Wang, De Steur, Gellynck, & Verbeke, 2015). However, since the domestic organic markets are still not well-establi...

  19. Signal Quality Evaluation of Emerging EEG Devices

    Directory of Open Access Journals (Sweden)

    Thea Radüntz

    2018-02-01

    Full Text Available Electroencephalogram (EEG registration as a direct measure of brain activity has unique potentials. It is one of the most reliable and predicative indicators when studying human cognition, evaluating a subject's health condition, or monitoring their mental state. Unfortunately, standard signal acquisition procedures limit the usability of EEG devices and narrow their application outside the lab. Emerging sensor technology allows gel-free EEG registration and wireless signal transmission. Thus, it enables quick and easy application of EEG devices by users themselves. Although a main requirement for the interpretation of an EEG is good signal quality, there is a lack of research on this topic in relation to new devices. In our work, we compared the signal quality of six very different EEG devices. On six consecutive days, 24 subjects wore each device for 60 min and completed tasks and games on the computer. The registered signals were evaluated in the time and frequency domains. In the time domain, we examined the percentage of artifact-contaminated EEG segments and the signal-to-noise ratios. In the frequency domain, we focused on the band power variation in relation to task demands. The results indicated that the signal quality of a mobile, gel-based EEG system could not be surpassed by that of a gel-free system. However, some of the mobile dry-electrode devices offered signals that were almost comparable and were very promising. This study provided a differentiated view of the signal quality of emerging mobile and gel-free EEG recording technology and allowed an assessment of the functionality of the new devices. Hence, it provided a crucial prerequisite for their general application, while simultaneously supporting their further development.

  20. Evaluation of the Emergency Response Command Center. Development of a method for evaluating the performance of the ERCC during exercises

    International Nuclear Information System (INIS)

    Groth, M.

    1997-02-01

    The report describes the development of a structured method for evaluation and analysis of staff performance in the Emergency Response Command Centre (ERCC) during exercises. A comprehensive literature search including current research and theoretical bases in the area of group dynamics has been carried out. To supplement this, ERCC activities during an emergency exercise were observed and responsible staff individuals and others involved were interviewed. From this material, two evaluation instruments were constructed: An Evaluation form for the function of ERCC, which addresses: Activation, information handling, teamwork and overall critique of the exercise; and an Evaluation form for responsible personnel in ERCC, which addresses: Activation, procedures-checklists etc, information handling, teamwork, personnel qualifications, and overall critique of the exercise. The method has been tested in two actual exercises at Ringhals NPP and has been found to effectively fulfill its purpose. 7 refs

  1. Preface: Proceedings of the Colloidal Dispersions in External Fields II Conference (Bonn-Bad Godesberg, 31 March 2 April 2008)

    Science.gov (United States)

    Löwen, H.

    2008-10-01

    This special issue reflects the scientific programme of the International Colloidal Dispersions in External Fields Conference (CODEF II) that took place in Bonn-Bad Godesberg from 31 March-2 April 2008. This is the second conference in a series that started in 2004 when the first CODEF meeting was held. The proceedings of the first CODEF meeting were summarized in a previous special issue (Journal of Physics: Condensed Matter 16 (issue 38)). The present issue represents recent progress in this rapidly developing field. The CODEF meeting series is held in conjunction with the German-Dutch Transregional Collaborative Research Centre SFB TR6 with the title Physics of Colloidal Dispersions in External Fields. Scientists working within this network as well as international invited guest speakers contributed to these meetings. The contributions in this issue are organized according to the type of different fields applied namely: bulk (no external field) shear flow electric field magnetic and laser-optical field confinement We would like to thank the CODEF II sponsors (Deutsche Forschungsgemeinschaft and MWFZ Mainz) for their financial support. Furthermore, we thank IOP Publishing for their willingness to publish the proceedings of this conference as a special issue. Participants O Alarcón-Waess (Puebla), M Allen (Coventry), J L Arauz-Lara (San Luis Potosi), L Assoud (Düsseldorf), G K Auernhammer (Mainz), R Backofen (Dresden), M Balbás-Gambra (Munich), J Bammert (Bayreuth), M Baptista (Mainz), J-L Barrat (Lyon), M Bier (Utrecht), K Binder (Mainz), R Blaak (Düsseldorf), V Blickle (Stuttgart), D Block (Kiel), S Böhm (Düsseldorf), V Botan (Mainz), J P Bouchaud (Paris), J Brader (Konstanz), G Brambilla (Montpellier), W J Briels (Enschede), M Brinkmann (Göttingen), C Brunet (Paris), H-J Butt (Mainz), M A Camargo Chaparro (Düsseldorf), R Castañeda Priego (Guanajuato), J J Cerdà Pino (Frankfurt), A Chatterji (Jülich), M Chavez Paez (San Luis Potosi), A Chremos

  2. Evaluating the Financial Stability of Banking System, Considering the Emergence Property

    Directory of Open Access Journals (Sweden)

    Lesik Vitaliy O.

    2017-03-01

    Full Text Available The article is concerned with analyzing the existing approaches to evaluation of the financial stability of banking system, substantiating the expedience of accounting, and generalizing the characteristics of the emergence property to determine its level. The article considers the interrelation of concepts of «financial stability» and «financial sustainability», the necessity of their correlation, taking account of the time factor, has been substantiated. A critical analysis of the approaches to evaluating the financial stability of banking system has been carried out, their eligibility according to the criteria of accounting of the identification attributes of systemacity and the analytical data aggregation has been examined. To determine the status of banking system as a system phenomenon, the necessity of carrying out an evaluation of its financial stability on the basis of the emergence approach has been substantiated, including the following directions: intensity of credit and financial interaction in the interbank market; functional load of the banking system as to ensuring the macroeconomic development; structural changes and financial disparities in the banking system; scale effects that arise as a consequence of change in the main financial parameters of the system banks.

  3. Evaluation of Intensive Construction Land Use in the Emerging City Based on PSR-Entropy model

    Science.gov (United States)

    Jia, Yuanyuan; Lei, Guangyu

    2018-01-01

    A comprehensive understanding of emerging city land utilization and the evaluation of intensive land use in the Emerging City will provide the comprehensive and reliable technical basis for the planning and management. It is an important node. According to the Han cheng from 2008 to 2016 years of land use, based on PSR-Entropy model of land use evaluation system, using entropy method to determine the index weight, the introduction of comprehensive index method to evaluate the degree of land use. The results show that the intensive land use comprehensive evaluation index of Han cheng increased from 2008 to 2015, but the land intensive use can not achieve the standards. The potential of further enhancing space is relatively large.

  4. Evaluating the success of an emergency response medical information system.

    Science.gov (United States)

    Petter, Stacie; Fruhling, Ann

    2011-07-01

    STATPack™ is an information system used to aid in the diagnosis of pathogens in hospitals and state public health laboratories. STATPack™ is used as a communication and telemedicine diagnosis tool during emergencies. This paper explores the success of this emergency response medical information system (ERMIS) using a well-known framework of information systems success developed by DeLone and McLean. Using an online survey, the entire population of STATPack™ users evaluated the success of the information system by considering system quality, information quality, system use, intention to use, user satisfaction, individual impact, and organizational impact. The results indicate that the overall quality of this ERMIS (i.e., system quality, information quality, and service quality) has a positive impact on both user satisfaction and intention to use the system. However, given the nature of ERMIS, overall quality does not necessarily predict use of the system. Moreover, the user's satisfaction with the information system positively affected the intention to use the system. User satisfaction, intention to use, and system use had a positive influence on the system's impact on the individual. Finally, the organizational impacts of the system were positively influenced by use of the system and the system's individual impact on the user. The results of the study demonstrate how to evaluate the success of an ERMIS as well as introduce potential changes in how one applies the DeLone and McLean success model in an emergency response medical information system context. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Clinic and Emergency Room Evaluation and Testing of Headache.

    Science.gov (United States)

    Nye, Barbara L; Ward, Thomas N

    2015-10-01

    Evaluation of the headache patient in the outpatient clinic and emergency department (ED) has different focuses and goals. The focus of this paper is to review the evaluation of patients in both settings with mention of evaluation in the pediatric and pregnant patient population.  The patient's history should drive the practitioner's decision and evaluation choices. We review recommendations made by the American Board of Internal Medicine and American Headache Society through the Choosing Wisely Campaign, which has an emphasis on choosing the right imaging modality for the clinical situation and elimination/prevention of medication overuse headache, as well as the US Headache Consortium guidelines for migraine headache. We will also review focusing on ED evaluation of the pediatric patient and pregnant patient presenting with headache. At the end of the review we hope to have provided you with a framework to think about the headache patient and what is the appropriate test in the given clinical setting in order to ensure that the patient gets the right diagnosis and is set on a path to the appropriate management plan. © 2015 American Headache Society.

  6. Re-evaluation of emergency planning zone for 3 NPPS in Taiwan

    International Nuclear Information System (INIS)

    Chiou, S.-T.; Yin, H.-L.; Chen, C.-S.; Shih, C.-L.

    2004-01-01

    The emergency planning zone for the 3 nuclear power plants in Taiwan are re-evaluated. The analysis is performed by the CRAC2 code and the basic approach follows the NUREG-0396 evaluation procedure. Meteorological data are provided by Taiwan Power Company and reviewed by Taiwan University and Central Weather Bureau. Accident source terms are also provided by Institute of Nuclear Energy Research (INER) by probabilistic risk assessment method with consideration of actual plant system improvement and/or modification. The dose rate distribution, acute and latent cancer fatality are evaluated and compared with proposed EPZ decision criteria including protective action guide dose levels, individual and societal risk safety goal. (author)

  7. Preparation, conduct and evaluation of exercises to test preparedness for a nuclear or radiological emergency. Emergency preparedness and response

    International Nuclear Information System (INIS)

    2005-04-01

    The aim of this publication is to serve as a practical tool for the preparation, conduct and evaluation of exercises to test preparedness for response to a nuclear or radiological emergency. It fulfils in part the functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning the methodologies, techniques and available results of research on such emergencies. To ensure effective response to radiation emergencies when needed, provisions should be made for regular training of emergency response personnel. As stated in Preparedness and Response for a Nuclear or Radiological Emergency (Safety Requirements, Safety Standard Series No. GS-R-2), 'The operator and the response organizations shall make arrangements for the selection of personnel and training to ensure that the personnel have the requisite knowledge, skills, abilities, equipment, procedures and other arrangements to perform their assigned response functions'. A further requirement is that 'Exercise programmes shall be conducted to ensure that all specified functions required to be performed for emergency response and all organizational interfaces for facilities in threat category I, II or III and the national level programmes for threat category IV or V are tested at suitable intervals'. In 2004 the IAEA General Conference, in resolution GC(48)/RES/10 encouraged Member States to 'implement the Safety Requirements for Preparedness and Response to a Nuclear or Radiological Emergency'. This document is published as part of the IAEA Emergency Preparedness and Response Series to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. It was developed based on a number of assumptions about national and local capabilities. Therefore, the exercise structure, terms and scenarios must be

  8. Evaluation of preparedness for medical emergencies among dental practitioners in Khammam town: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    L Surya Chandra Varma

    2015-01-01

    Full Text Available Introduction: Medical emergencies can occur frequently in the dental setting. Effective management of an emergency situation in the dental office is ultimately the dentist responsibility. The assessment of preparedness of dental practitioners would help to bring about required changes in the teaching aspects of dental institutions, which would ultimately help dental graduates to improve knowledge regarding management of medical emergencies. This would also make dental offices available with required emergency drugs. Aim: To evaluate the preparedness for medical emergencies among the dental practitioners in Khammam town. Materials and Methods: A cross-sectional questionnaire-based study with a sample of 301 was conducted among dental clinicians at Khammam to evaluate their knowledge regarding medical emergencies. The questionnaire consisted of nineteen questions. First nine questions are objective questions, requiring a simple yes or no reply. Next ten questions are multiple choice questions regarding Emergency Medical Services and basic life support. Chi-square test was used to analyze the data. A P < 0.05 is considered significant. Results: The results of this study showed that almost all the participants (94.02% enquired about medical and drug history, but only 67.11% of them obtained a complete health history proforma of the patient. About 83.06% record vital signs, 74.09% of members report about attending workshops on emergency training and management, and 50.5% of members were either not sure or not in a position to handle the emergency condition. Conclusion: The results of this study reflect an alarming situation of the capability of dentists to deal with medical emergencies at dental offices and make available all the emergency drugs at their offices.

  9. An evaluation of herbicides for post-emergence use in short rotation coppice

    Energy Technology Data Exchange (ETDEWEB)

    Turnbull, D.J.

    2000-07-01

    The objective of the project was to evaluate the safety and efficacy of a range of herbicides and mixtures of herbicides, with both contact and residual activity, for the post-emergence control of weeds in newly planted willow short rotation coppice (SRC). This report provides growers and advisers of short rotation coppice with important (but still limited) information on how to achieve improved weed control of problem weeds increasingly prevalent in SRC fields. This may provide guidance towards often-essential emergency treatments when the crop establishment is under considerable pressure and the potential safety, or otherwise, of certain weed-specific herbicides. (author)

  10. An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station

    Science.gov (United States)

    Marshburn, Thomas; Whitmore, Mihriban; Ortiz, Rosie; Segal, Michele; Smart, Kieran; Hughes, Catherine

    2003-01-01

    Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS

  11. Ultrasound assisted evaluation of chest pain in the emergency department.

    Science.gov (United States)

    Colony, M Deborah; Edwards, Frank; Kellogg, Dylan

    2018-04-01

    Chest pain is a commonly encountered emergency department complaint, with a broad differential including several life-threatening possible conditions. Ultrasound-assisted evaluation can potentially be used to rapidly and accurately arrive at the correct diagnosis. We propose an organized, ultrasound assisted evaluation of the patient with chest pain using a combination of ultrasound, echocardiography and clinical parameters. Basic echo techniques which can be mastered by residents in a short time are used plus standardized clinical questions and examination. Information is kept on a checklist. We hypothesize that this will result in a quicker, more accurate evaluation of chest pain in the ED leading to timely treatment and disposition of the patient, less provider anxiety, a reduction in the number of diagnostic errors, and the removal of false assumptions from the diagnostic process. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The Emergence of Contesting Motives for Student Feedback-Based Evaluation in Australian Higher Education

    Science.gov (United States)

    Darwin, Stephen

    2016-01-01

    Student feedback-based evaluation performs a significant social role in framing perceptions of the quality of teaching in contemporary Australian higher education. Yet its emergence is a relatively recent phenomenon, having only been in widespread application since the mid-1980s. The early manifestations of student feedback-based evaluation came…

  13. A further evaluation of herbicides for post-emergence use in short rotation coppice

    Energy Technology Data Exchange (ETDEWEB)

    Turnbull, D.J.

    2002-07-01

    This report summarises the findings of a project evaluating the safety and efficiency of eleven herbicides for controlling weeds in newly plated willow short rotation coppices, and provides growers with information on post-emergence herbicide options, control of problem weeds, and emergency treatments. Weed germination, crop safety, and the encouraging results obtained using Reflex T and Impuls are discussed. It is suggested that a Technical Register of herbicide applications with contributions by growers and advisers should be considered by the British Biogen trade industry body.

  14. Nuclear power plant emergency preparedness: results from an evaluation of Michigan's potassium iodide distribution program.

    Science.gov (United States)

    Zwolinski, Laura R; Stanbury, Martha; Manente, Susan

    2012-10-01

    In 2009, the Michigan Department of Community Health (MDCH) made potassium iodide (KI), a nonprescription radio-protective drug, available by mailing vouchers redeemable at local pharmacies for KI tablets, at no cost to residents living within 10 miles of Michigan's 3 nuclear power plants (NPPs). MDCH conducted an evaluation of this program to determine Michigan's KI coverage and to assess general emergency preparedness among residents living near the NPPs. KI coverage was estimated based on redeemed voucher counts and the 2010 Census. Telephone surveys were administered to a random sample (N = 153) of residents living near Michigan's NPPs to evaluate general emergency preparedness, reasons for voucher use or nonuse, and KI knowledge. Only 5.3% of eligible residences redeemed KI vouchers. Most surveyed residents (76.5%) were aware of living near an NPP, yet 42.5% reported doing "nothing" to plan for an emergency. Almost half of surveyed voucher users did not know when to take KI or which body part KI protects. Among voucher nonusers, 48.0% were either unaware of the program or did not remember receiving a voucher. Additional efforts are needed to ensure that all residents are aware of the availability of KI and that recipients of the drug understand when and why it should be taken. Minimal emergency planning among residents living near Michigan's NPPs emphasizes the need for increased emergency preparedness and awareness. Findings are particularly salient given the March 2011 Fukushima Daiichi Nuclear Power Plant emergency in Japan.

  15. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Patel NH

    2012-11-01

    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  16. Consensus Guidelines on Evaluation and Management of the Febrile Child Presenting to the Emergency Department in India.

    Science.gov (United States)

    Mahajan, Prashant; Batra, Prerna; Thakur, Neha; Patel, Reena; Rai, Narendra; Trivedi, Nitin; Fassl, Bernhard; Shah, Binita; Lozon, Marie; Oteng, Rockerfeller A; Saha, Abhijeet; Shah, Dheeraj; Galwankar, Sagar

    2017-08-15

    India, home to almost 1.5 billion people, is in need of a country-specific, evidence-based, consensus approach for the emergency department (ED) evaluation and management of the febrile child. We held two consensus meetings, performed an exhaustive literature review, and held ongoing web-based discussions to arrive at a formal consensus on the proposed evaluation and management algorithm. The first meeting was held in Delhi in October 2015, under the auspices of Pediatric Emergency Medicine (PEM) Section of Academic College of Emergency Experts in India (ACEE-INDIA); and the second meeting was conducted at Pune during Emergency Medical Pediatrics and Recent Trends (EMPART 2016) in March 2016. The second meeting was followed with futher e-mail-based discussions to arrive at a formal consensus on the proposed algorithm. To develop an algorithmic approach for the evaluation and management of the febrile child that can be easily applied in the context of emergency care and modified based on local epidemiology and practice standards. We created an algorithm that can assist the clinician in the evaluation and management of the febrile child presenting to the ED, contextualized to health care in India. This guideline includes the following key components: triage and the timely assessment; evaluation; and patient disposition from the ED. We urge the development and creation of a robust data repository of minimal standard data elements. This would provide a systematic measurement of the care processes and patient outcomes, and a better understanding of various etiologies of febrile illnesses in India; both of which can be used to further modify the proposed approach and algorithm.

  17. Exercises for radiological and nuclear emergency response. Planing - performance - evaluation

    International Nuclear Information System (INIS)

    Bayer, A.; Faleschini, J.; Goelling, K.; Stapel, R.; Strobl, C.

    2010-01-01

    The report of the study group emergency response seminar covers the following topics: (A) purpose of exercises and exercise culture: fundamentals and appliances for planning, performance and evaluation; (B) exercises in nuclear facilities; (C) exercises of national authorities and aid organizations on nuclear scenarios; exercises of national authorities and aid organizations on other radiological scenarios; (D) exercises in industrial plants, universities, medical facilities and medical services, and research institutes; (E) transnational exercises, international exercises; (F): exercises on public information.

  18. Timing of Emergency Medicine Student Evaluation Does Not Affect Scoring.

    Science.gov (United States)

    Hiller, Katherine M; Waterbrook, Anna; Waters, Kristina

    2016-02-01

    Evaluation of medical students rotating through the emergency department (ED) is an important formative and summative assessment method. Intuitively, delaying evaluation should affect the reliability of this assessment method, however, the effect of evaluation timing on scoring is unknown. A quality-improvement project evaluating the timing of end-of-shift ED evaluations at the University of Arizona was performed to determine whether delay in evaluation affected the score. End-of-shift ED evaluations completed on behalf of fourth-year medical students from July 2012 to March 2013 were reviewed. Forty-seven students were evaluated 547 times by 46 residents and attendings. Evaluation scores were means of anchored Likert scales (1-5) for the domains of energy/interest, fund of knowledge, judgment/problem-solving ability, clinical skills, personal effectiveness, and systems-based practice. Date of shift, date of evaluation, and score were collected. Linear regression was performed to determine whether timing of the evaluation had an effect on evaluation score. Data were complete for 477 of 547 evaluations (87.2%). Mean evaluation score was 4.1 (range 2.3-5, standard deviation 0.62). Evaluations took a mean of 8.5 days (median 4 days, range 0-59 days, standard deviation 9.77 days) to complete. Delay in evaluation had no significant effect on score (p = 0.983). The evaluation score was not affected by timing of the evaluation. Variance in scores was similar for both immediate and delayed evaluations. Considerable amounts of time and energy are expended tracking down delayed evaluations. This activity does not impact a student's final grade. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Development and evaluation of a leadership training program for public health emergency response: results from a Chinese study

    Directory of Open Access Journals (Sweden)

    Xu Yihua

    2008-10-01

    Full Text Available Abstract Background Since the 9/11 attack and severe acute respiratory syndrome (SARS, the development of qualified and able public health leaders has become a new urgency in building the infrastructure needed to address public health emergencies. Although previous studies have reported that the training of individual leaders is an important approach, the systemic and scientific training model need further improvement and development. The purpose of this study was to develop, deliver, and evaluate a participatory leadership training program for emergency response. Methods Forty-one public health leaders (N = 41 from five provinces completed the entire emergency preparedness training program in China. The program was evaluated by anonymous questionnaires and semi-structured interviews held prior to training, immediately post-training and 12-month after training (Follow-up. Results The emergency preparedness training resulted in positive shifts in knowledge, self-assessment of skills for public health leaders. More than ninety-five percent of participants reported that the training model was scientific and feasible. Moreover, the response of participants in the program to the avian influenza outbreak, as well as the planned evaluations for this leadership training program, further demonstrated both the successful approaches and methods and the positive impact of this integrated leadership training initiative. Conclusion The emergency preparedness training program met its aims and objectives satisfactorily, and improved the emergency capability of public health leaders. This suggests that the leadership training model was effective and feasible in improving the emergency preparedness capability.

  20. Causes of poisoning in patients evaluated in a hospital emergency department in Konya, Turkey

    International Nuclear Information System (INIS)

    Kara, H.; Bayir, A.; Degirmenci, S.; Akinci, M.; Ak, A.; Azap, M.

    2014-01-01

    Objectives: To evaluate demographic and clinical characteristics of patients with poisoning at a community hospital. Methods: The retrospective study comprised records of patients who were admitted to the emergency department of Konya Numune Hospital, Turkey, because of poisoning between January 1, 2009, and December 31, 2011. Data was evaluated for age, gender, educational status, occupation, arrival time, mechanism of intoxication , body temperature, pulse, respiratory rate, Glasgow Coma Scale score, treatment applied, duration of hospital stay, duration of follow-up, test results, final diagnosis, clinical disposition, and outcome. Agents causing the poisoning were also determined. Results: Records of 1036 patients were evaluated. Of them, 764(74%) were female and 272(26%) were male. The predominant age range was 15-24 years in 617(60%) patients. The median time from substance exposure to admission to the emergency department was 2 hours. The most common cause of poisoning was attempted suicide in 955 (92%) patients and drug intoxication was the agent involved in 932 (90%). In the 15-24 year age range, there were 469(76%) female patients. Of the total female population in the study, 716(94%) attempted suicide. The median hospital stay was 24 hours. There were 908(88%) patients who were advised to seek further evaluation at the psychiatry clinic, and 9 (0.9%) patients were admitted to the psychiatry inpatient units after medical treatment. In patients who were hospitalized and followed up, 1 (0.1%) died because of multiple drug poisoning. Conclusion: Most admissions to the emergency department for poisoning related to young women had used drugs during a suicide attempt. (author)

  1. A systematic review and overview of health economic evaluations of emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Sohail Bampoe

    2017-11-01

    Full Text Available Abstract Background Little is known about the economic impact of emergency laparotomy (EL surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. Methods MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC checklist. Results Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. Discussion EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Conclusions Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to

  2. A systematic review and overview of health economic evaluations of emergency laparotomy.

    Science.gov (United States)

    Bampoe, Sohail; Odor, Peter M; Ramani Moonesinghe, S; Dickinson, Matthew

    2017-01-01

    Little is known about the economic impact of emergency laparotomy (EL) surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC) checklist. Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to this type of surgery is to be pursued as a global health target. PROSPERO

  3. A Virtual Emergency Telemedicine Serious Game in Medical Training: A Quantitative, Professional Feedback-Informed Evaluation Study.

    Science.gov (United States)

    Nicolaidou, Iolie; Antoniades, Athos; Constantinou, Riana; Marangos, Charis; Kyriacou, Efthyvoulos; Bamidis, Panagiotis; Dafli, Eleni; Pattichis, Constantinos S

    2015-06-17

    Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students' preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in medical education and training. The VETM game makes use of data from an electrocardiogram to train practicing doctors, nurses, or medical students for problem-solving in real-life clinical scenarios through a telemedicine system and virtual patients. The study responds to two gaps: the limited number of games in emergency cardiology and the lack of evaluations by professionals. The objective of this study is a quantitative, professional feedback-informed evaluation of one scenario of VETM, involving cardiovascular complications. The study has the following research question: "What are professionals' perceptions of the potential of the Virtual Emergency Telemedicine game for training people involved in the assessment and management of emergency cases?" The evaluation of the VETM game was conducted with 90 professional ambulance crew nursing personnel specializing in the assessment and management of emergency cases. After collaboratively trying out one VETM scenario, participants individually completed an evaluation of the game (36 questions on a 5-point Likert scale) and provided written and verbal comments. The instrument assessed six dimensions of the game: (1) user interface, (2) difficulty level, (3) feedback, (4) educational value, (5) user engagement, and (6) terminology. Data sources of the study were 90 questionnaires, including written comments from 51 participants, 24 interviews with 55 participants, and 379 log files of their interaction with the game. Overall, the results were

  4. Early economic evaluation of emerging health technologies: protocol of a systematic review

    Science.gov (United States)

    2014-01-01

    Background The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to

  5. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  6. Technical support and emergency centre

    International Nuclear Information System (INIS)

    Bohun, L.; Kapisovsk y, M.

    1997-01-01

    This paper presents technical support and emergency management center which will be on two places: Mochovce NPP Emergency Centre (Technical support center and Support working center) and Reserve Emergency Centre in Levice (Reserve emergency center and Environmental Evaluation Center). The main aims of the emergency management centers are: the management and coordination of all persons and organisations; provision of the all information needed to evaluation of the accident and its mitigation; continuous evaluation of the potential or real radiological consequences; taking measure for an early notification of the governmental bodies and the organizations, warning and protection of the public; and other aims. In the next part the data for technical support and emergency centre are discussed

  7. Inadequate emergence after anesthesia: emergence delirium and hypoactive emergence in the Postanesthesia Care Unit.

    Science.gov (United States)

    Xará, Daniela; Silva, Acácio; Mendonça, Júlia; Abelha, Fernando

    2013-09-01

    To evaluate the frequency, determinants, and outcome of inadequate emergence after elective surgery in the Postanesthesia Care Unit (PACU). Prospective observational study. 12-bed PACU of a tertiary-care hospital in a major metropolitan area. 266 adult patients admitted to the PACU. To evaluate inadequate emergence, the Richmond Agitation and Sedation Scale (RASS) was administered to patients 10 minutes after their admission to the PACU. Demographic data, perioperative variables, and postoperative length of stay (LOS) in the PACU and the hospital were recorded. 40 (15%) patients showed symptoms of inadequate emergence: 17 patients (6.4%) screened positive for emergence delirium and 23 patients (8.6%) showed hypoactive emergence. Determinants of emergence delirium were longer duration of preoperative fasting (P = 0.001), higher visual analog scale (VAS) scores for pain (P = 0.002), and major surgical risk (P = 0.001); these patients had a higher frequency of postoperative delirium (P = 0.017) and had higher nausea VAS score 6 hours after surgery (P = 0.001). Determinants of hypoactive emergence were duration of surgery (P = 0.003), amount of crystalloids administered during surgery (P = 0.002), residual neuromuscular block (P < 0.001), high-risk surgery (P = 0.002), and lower core temperature on PACU admission (P = 0.028); these patients also had more frequent residual neuromuscular block (P < 0.001) postoperative delirium (P < 0.001), and more frequent adverse respiratory events (P = 0.02). Patients with hypoactive emergence had longer PACU and hospital LOS. Preventable determinants for emergence delirium were higher postoperative pain scores and longer fasting times. Hypoactive emergence was associated with longer postoperative PACU and hospital LOSs. © 2013 Elsevier Inc. All rights reserved.

  8. Evaluation of food emergency response laboratories' capability for 210Po analysis using proficiency test material with verifiable traceability

    International Nuclear Information System (INIS)

    Zhongyu Wu; Zhichao Lin; Mackill, P.; Cong Wei; Noonan, J.; Cherniack, J.; Gillis-Landrum, D.

    2009-01-01

    Measurement capability and data comparability are essential for emergency response when analytical data from cooperative laboratories are used for risk assessment and post incident decision making. In this study, the current capability of food emergency response laboratories for the analysis of 210 Po in water was evaluated using a proficiency test scheme in compliance with ISO-43 and ILAC G13 guidelines, which comprises a test sample preparation and verification protocol and an insightful statistical data evaluation. The results of performance evaluations on relative bias, value trueness, precision, false positive detection, minimum detection limit, and limit of quantification, are presented. (author)

  9. Trauma in elderly patients evaluated in a hospital emergency department in Konya, Turkey: a retrospective study

    Directory of Open Access Journals (Sweden)

    Kara H

    2013-12-01

    Full Text Available Hasan Kara,1 Aysegul Bayir,1 Ahmet Ak,1 Murat Akinci,1 Necmettin Tufekci,1 Selim Degirmenci,1 Melih Azap21Department of Emergency Medicine, Selçuk University, Konya, Turkey; 2Department of Emergency Medicine, Konya Numune Hospital, Konya, TurkeyPurpose: Trauma is a common cause of admission to the hospital emergency department. The purpose of this study was to evaluate the cause of admission, clinical characteristics, and outcomes of patients aged ≥65 years admitted to an emergency department in Turkey because of blunt trauma.Materials and methods: Medical records were retrospectively reviewed for 568 patients (314 women and 254 men aged ≥65 years who were admitted to an emergency department of a tertiary care hospital.Results: Trauma was caused by low-energy fall in 379 patients (67%, traffic accident in 79 patients (14%, high-energy fall in 69 patients (12%, and other causes in 41 patients (7%. The most frequent sites of injury were the lower extremity, thorax, upper extremity, and head. The femur was the most frequent fracture site. After evaluation in the emergency department, 377 patients (66% were hospitalized. There were 31 patients (5% who died. Risk of hospitalization after trauma was significantly associated with trauma to the lower extremity, thorax, and spine; fractures of the femur and rib; and intracranial injury.Conclusion: Emergency department admission after trauma in patients aged $65 years is common after low-energy falls, and most injuries occur to the extremities. It is important to focus on prevention of falls to decrease the frequency of trauma in the elderly.Keywords: fall, femur, fracture, injury

  10. Evaluation of diffusion-perfusion mismatch for determining indication for emergency endovascular revascularization

    International Nuclear Information System (INIS)

    Masuda, Atsushi; Miki, Takanori; Matsumoto, Hiroaki

    2010-01-01

    We evaluated the usefulness of assessing by diffusion-perfusion mismatch (D/P mismatch) whether there is adaptation of neuroendovascular revascularization for acute ischemic stroke out of intravenous tissue plasminogen activator (IV t-PA). We retrospectively analyzed 24 patients who underwent D/P mismatch and endovascular treatment between October 2005 and September 2008. This investigation included stroke patients with a National Institutes of Health Stroke Scale (NIHSS) score less than 4. Sixteen acute ischemic stroke patients had an NIHSS score greater than 5. Eight patients (50%) had a favorable neurological outcome (modified Rankin Scale 0 to 2). Eight acute ischemic stroke patients had an NIHSS score equal to or less than 4. Four patients who underwent emergency endovascular treatment on admission had a favorable neurological outcome, but 3 patients treated for progressive stroke after admission all had a poor prognosis. Evaluating D/P mismatch was useful for determining the adaptation of emergency neuroendovascular revascularization for acute ischemic stroke out of IV t-PA. Acute ischemic stroke patients with an NIHSS score equal to or less than 4 and diffusion/perfusion mismatch need careful observation to enable endovascular treatment immediately after progressive stroke. (author)

  11. Evaluation of the polytrauma victim by the nursing staff in an emergency service of Santa Catarina

    Directory of Open Access Journals (Sweden)

    Leandro Sanceverino Mattos

    2012-06-01

    Full Text Available Objective: To investigate the actions developed by the nursing staff of a private hospital emergency service in the southern Santa Catarina (SC, related to primary and secondary evaluation of polytrauma victims. Methods: Research of a qualitative approach, the type of case study, performed with twelve nurses. Sample has been characterized as non-probabilistic intentional. Data collection has been performed using the techniques of semi-structured interview and participant observation. Data analysis has been developed using the technique of content analysis. Results: Analysis of nurses’ testimonies and the results of observation have showed that most participants comprehend the importance of adopting the ABCDE rule in primary evaluation - A (Air Way - airway permeability with safe administration of cervical collar; B (Breathing; C (Circulation - search for bleeding and control; D (Disability - neurological evaluation; e E (Exposure - patient’s body exposition seeking missed injuries - and the need of meticulous secondary evaluation of polytrauma victim. However, due to demand of urgency and agility in emergencies of this nature, the rule is not followed in a systematic way. Conclusion: It has been demonstrated the nursing staff’s concern over the following aspects: agility of service; immediate performance of examinations; communication between emergency service professionals; adequate perception of the general condition of the victim; and the reception to victim and family.

  12. Multiple performance measures are needed to evaluate triage systems in the emergency department.

    Science.gov (United States)

    Zachariasse, Joany M; Nieboer, Daan; Oostenbrink, Rianne; Moll, Henriëtte A; Steyerberg, Ewout W

    2018-02-01

    Emergency department triage systems can be considered prediction rules with an ordinal outcome, where different directions of misclassification have different clinical consequences. We evaluated strategies to compare the performance of triage systems and aimed to propose a set of performance measures that should be used in future studies. We identified performance measures based on literature review and expert knowledge. Their properties are illustrated in a case study evaluating two triage modifications in a cohort of 14,485 pediatric emergency department visits. Strengths and weaknesses of the performance measures were systematically appraised. Commonly reported performance measures are measures of statistical association (34/60 studies) and diagnostic accuracy (17/60 studies). The case study illustrates that none of the performance measures fulfills all criteria for triage evaluation. Decision curves are the performance measures with the most attractive features but require dichotomization. In addition, paired diagnostic accuracy measures can be recommended for dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 for ordinal analyses. Other performance measures provide limited additional information. When comparing modifications of triage systems, decision curves and diagnostic accuracy measures should be used in a dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 in an ordinal approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Investigation of a superthermal ultracold neutron source based on a solid deuterium converter for the TRIGA Mainz reactor

    International Nuclear Information System (INIS)

    Lauer, Thorsten

    2010-01-01

    Research in fundamental physics with the free neutron is one of the key tools for testing the Standard Model at low energies. Most prominent goals in this field are the search for a neutron electric dipole moment (EDM) and the measurement of the neutron lifetime. Significant improvements of the experimental performance using ultracold neutrons (UCN) require reduction of both systematic and statistical errors.The development and construction of new UCN sources based on the superthermal concept is therefore an important step for the success of future fundamental physics with ultracold neutrons. Significant enhancement of today available UCN densities strongly correlates with an efficient use of an UCN converter material. The UCN converter here is to be understood as a medium which reduces the velocity of cold neutrons (CN, velocity of about 600 m/s) to the velocity of UCN (velocity of about 6 m/s).Several big research centers around the world are presently planning or constructing new superthermal UCN sources, which are mainly based on the use of either solid deuterium or superfluid helium as UCN converter.Thanks to the idea of Yu.Pokotilovsky, there exists the opportunity to build competitive UCN sources also at small research reactors of the TRIGA type. Of course these smaller facilities don't promise high UCN densities of several 1000 UCN/cm 3 , but they are able to provide densities around 100 UCN/cm 3 for experiments.In the context of this thesis, it was possible to demonstrate succesfully the feasibility of a superthermal UCN source at the tangential beamport C of the research reactor TRIGA Mainz. Based on a prototype for the future UCN source at the Forschungs-Neutronenquelle Heinz Maier-Leibnitz (FRMII) in Munich, which was planned and built in collaboration with the Technical University of Munich, further investigations and improvements were done and are presented in this thesis. In parallel, a second UCN source for the radial beamport D was designed and

  14. Investigation of a superthermal ultracold neutron source based on a solid deuterium converter for the TRIGA Mainz reactor

    Energy Technology Data Exchange (ETDEWEB)

    Lauer, Thorsten

    2010-12-22

    Research in fundamental physics with the free neutron is one of the key tools for testing the Standard Model at low energies. Most prominent goals in this field are the search for a neutron electric dipole moment (EDM) and the measurement of the neutron lifetime. Significant improvements of the experimental performance using ultracold neutrons (UCN) require reduction of both systematic and statistical errors.The development and construction of new UCN sources based on the superthermal concept is therefore an important step for the success of future fundamental physics with ultracold neutrons. Significant enhancement of today available UCN densities strongly correlates with an efficient use of an UCN converter material. The UCN converter here is to be understood as a medium which reduces the velocity of cold neutrons (CN, velocity of about 600 m/s) to the velocity of UCN (velocity of about 6 m/s).Several big research centers around the world are presently planning or constructing new superthermal UCN sources, which are mainly based on the use of either solid deuterium or superfluid helium as UCN converter.Thanks to the idea of Yu.Pokotilovsky, there exists the opportunity to build competitive UCN sources also at small research reactors of the TRIGA type. Of course these smaller facilities don't promise high UCN densities of several 1000 UCN/cm{sup 3}, but they are able to provide densities around 100 UCN/cm{sup 3} for experiments.In the context of this thesis, it was possible to demonstrate succesfully the feasibility of a superthermal UCN source at the tangential beamport C of the research reactor TRIGA Mainz. Based on a prototype for the future UCN source at the Forschungs-Neutronenquelle Heinz Maier-Leibnitz (FRMII) in Munich, which was planned and built in collaboration with the Technical University of Munich, further investigations and improvements were done and are presented in this thesis. In parallel, a second UCN source for the radial beamport D was

  15. Example of emergency response model evaluation of studies using the Mathew/Adpic models

    International Nuclear Information System (INIS)

    Dickerson, M.H.; Lange, R.

    1986-04-01

    This report summarizes model evaluation studies conducted for the MATHEW/ADPIC transport and diffusion models during the past ten years. These models support the US Department of Energy Atmospheric Release Advisory Capability, an emergency response service for atmospheric releases of nuclear material. Field studies involving tracer releases used in these studies cover a broad range of meteorology, terrain and tracer release heights, the three most important aspects of estimating air concentration values resulting from airborne releases of toxic material. Results of these studies show that these models can estimate air concentration values within a factor of 2 20% to 50% of the time and a factor of 5 40% to 80% of the time. As the meterology and terrain become more complex and the release height of the tracer is increased, the accuracy of the model calculations degrades. This band of uncertainty appears to correctly represent the capability of these models at this time. A method for estimating angular uncertainty in the model calculations is described and used to suggest alternative methods for evaluating emergency response models

  16. Evaluation of 6 and 10 Year-Old Child Human Body Models in Emergency Events.

    Science.gov (United States)

    Gras, Laure-Lise; Stockman, Isabelle; Brolin, Karin

    2017-01-01

    Emergency events can influence a child's kinematics prior to a car-crash, and thus its interaction with the restraint system. Numerical Human Body Models (HBMs) can help understand the behaviour of children in emergency events. The kinematic responses of two child HBMs-MADYMO 6 and 10 year-old models-were evaluated and compared with child volunteers' data during emergency events-braking and steering-with a focus on the forehead and sternum displacements. The response of the 6 year-old HBM was similar to the response of the 10 year-old HBM, however both models had a different response compared with the volunteers. The forward and lateral displacements were within the range of volunteer data up to approximately 0.3 s; but then, the HBMs head and sternum moved significantly downwards, while the volunteers experienced smaller displacement and tended to come back to their initial posture. Therefore, these HBMs, originally intended for crash simulations, are not too stiff and could be able to reproduce properly emergency events thanks, for instance, to postural control.

  17. Human reliability analysis as an evaluation tool of the emergency evacuation process on industrial installation

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Isaac J.A.L. dos; Grecco, Claudio H.S.; Mol, Antonio C.A.; Carvalho, Paulo V.R.; Oliveira, Mauro V.; Botelho, Felipe Mury [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil)]. E-mail: luquetti@ien.gov.br; grecco@ien.gov.br; mol@ien.gov.br; paulov@ien.gov.br; mvitor@ien.gov.br; felipemury@superig.com.br

    2007-07-01

    Human reliability is the probability that a person correctly performs some required activity by the system in a required time period and performs no extraneous activity that can degrade the system. Human reliability analysis (HRA) is the analysis, prediction and evaluation of work-oriented human performance using some indices as human error likelihood and probability of task accomplishment. The human error concept must not have connotation of guilt and punishment, having to be treated as a natural consequence, that emerges due to the not continuity between the human capacity and the system demand. The majority of the human error is a consequence of the work situation and not of the responsibility lack of the worker. The anticipation and the control of potentially adverse impacts of human action or interactions between the humans and the system are integral parts of the process safety, where the factors that influence the human performance must be recognized and managed. The aim of this paper is to propose a methodology to evaluate the emergency evacuation process on industrial installations including SLIM-MAUD, a HRA first-generation method, and using virtual reality and simulation software to build and to simulate the chosen emergency scenes. (author)

  18. Human reliability analysis as an evaluation tool of the emergency evacuation process on industrial installation

    International Nuclear Information System (INIS)

    Santos, Isaac J.A.L. dos; Grecco, Claudio H.S.; Mol, Antonio C.A.; Carvalho, Paulo V.R.; Oliveira, Mauro V.; Botelho, Felipe Mury

    2007-01-01

    Human reliability is the probability that a person correctly performs some required activity by the system in a required time period and performs no extraneous activity that can degrade the system. Human reliability analysis (HRA) is the analysis, prediction and evaluation of work-oriented human performance using some indices as human error likelihood and probability of task accomplishment. The human error concept must not have connotation of guilt and punishment, having to be treated as a natural consequence, that emerges due to the not continuity between the human capacity and the system demand. The majority of the human error is a consequence of the work situation and not of the responsibility lack of the worker. The anticipation and the control of potentially adverse impacts of human action or interactions between the humans and the system are integral parts of the process safety, where the factors that influence the human performance must be recognized and managed. The aim of this paper is to propose a methodology to evaluate the emergency evacuation process on industrial installations including SLIM-MAUD, a HRA first-generation method, and using virtual reality and simulation software to build and to simulate the chosen emergency scenes. (author)

  19. Nurses’ Evaluation of a New Formalized Triage System in the Emergency Department

    DEFF Research Database (Denmark)

    Brehm Johansen, Mette; Forberg, Jakob Lundager

    2011-01-01

    Introduction: Formalized triage in the emergency department (ED) is not widely used in Denmark; this study explores the effects of introducing a five-level process triage system in a Danish ED. Material and methods: Semi-structured qualitative interviews were conducted with 15 emergency nurses....... The interviews were preceded by observations of the work of the ED nurses in which focus was on the triage process. Results: Formalized triage was experienced to improve the overview of patients and resources at the ED, and the nurses described that they felt more assured when prioritizing between patients....... Communication and coordination were also improved by the triage system. But more time spent on documentation and re-evaluation may cause the nurses to feel professionally inadequate if adequate resources are not provided. Furthermore, the triage system has reduced the focus on the humanistic and psychosocial...

  20. Evaluation of New-Onset Diabetes in Patients Presenting Emergency Service with a Diabetic Ketoacidosis Attack

    Directory of Open Access Journals (Sweden)

    Yavuz Yiğit

    2013-12-01

    Full Text Available Aim: The aim of this study was to investigate the rate of new-onset diabetes mellitus (DM in patients presenting to our emergency department with diabetic ketoacidosis. Methods: We retrospectively evaluated hospital records of patients who presented to the Emergency Department at Istanbul Goztepe Research and Training Hospital between 01 April 2009 and 01 April 2011 and were diagnosed with diabetic ketoacidosis. 57 patients having complete clinical data were included in the study. Results: 45.6%of patients had type 1 DM, 33.3%- type 2 DM, and 21%of them were with new-onset DM. No statistically significant difference was found between type 1 DM, type 2 DM and new-onset DM patients with respect to arterial blood pH and HCO3 levels and serum sodium, potassium and plasma glucose levels at presentation as well as time of presentation (p>0.05, while HbA1c levels showed statistically significant difference in new-onset DM patients. Conclusion: No statistically significant difference was found between types of DM in patients diagnosed with diabetic ketoacidosis except for precipitating factors, age and HbA1c. Detecting high blood glucose levels in patients presenting to emergency room for reasons other than DM is not a rare condition. Cautious evaluation and recognition of these patients in emergency room for the possibility of undiagnosed DM is important for prevention of future diabetic ketoacidosis episodes. (The Medical Bulletin of Haseki 2013; 51: 168-72

  1. [Evaluation of hospital admissions: admission guidelines implementation in a pediatric emergency department].

    Science.gov (United States)

    Katz, Manuel; Warshawsky, Sheila S; Rosen, Shirley; Barak, Nurit; Press, Joseph

    2004-10-01

    To develop and implement locally tailored pediatric admission guidelines for use in a pediatric emergency department and evaluate the appropriateness of admissions based on these guidelines. Our Study was based on the development of admission guidelines by senior physicians, using the Delphi Consensus Process, for use in the Pediatric Emergency Department (PED) at Soroka University Medical Center (Soroka). We evaluated the appropriateness of admissions to the pediatric departments of Soroka on 33 randomly selected days in 1999 and 2000 prior to guideline implementation and 30 randomly selected days in 2001, after guideline implementation. A total of 1037 files were evaluated. A rate of 12.4% inappropriate admissions to the pediatric departments was found based on locally tailored admission guidelines. There was no change in the rate of inappropriate admissions after implementation of admission guidelines in PED. Inappropriate admissions were associated with age above 3 years, hospital stay of two days or less and the season. The main reasons for evaluating an admission as inappropriate were that the admission did not comply with the guidelines and that the case could be managed in an ambulatory setting. There were distinctive differences in the characteristics of the Bedouin and Jewish populations admitted to the pediatric departments, although no difference was found in the rate of inappropriate admissions between these populations. Patient management in Soroka PED is tailored to the conditions of this medical center and to the characteristics of the population it serves. The admission guidelines developed reflect these special conditions. Lack of change in the rate of inappropriate admissions following implementation of the guidelines indicates that the guidelines reflect the physicians' approach to patient management that existed in Soroka PED prior to guideline implementation. Hospital admission guidelines have a role in the health management system; however

  2. Evaluation Framework for Non-Emergency Medical Transportation Services for Patients with End-Stage Renal Disease

    Science.gov (United States)

    2014-12-01

    The objective of this project is to design a framework that could be used to evaluate the effectiveness and efficiency of non-emergency transportation services (NEMT) for better livability. In addition to the development of the framework, this projec...

  3. Development and use of consolidated criteria for evaluation of emergency preparedness plans for DOE facilities

    International Nuclear Information System (INIS)

    Lerner, K.; Kier, P.H.; Baldwin, T.E.

    1995-01-01

    Emergency preparedness at US Department of Energy (DOE) facilities is promoted by development and quality control of response plans. To promote quality control efforts, DOE has developed a review document that consolidates requirements and guidance pertaining to emergency response planning from various DOE and regulatory sources. The Criteria for Evaluation of Operational Emergency Plans (herein referred to as the Criteria document) has been constructed and arranged to maximize ease of use in reviewing DOE response plans. Although developed as a review instrument, the document also serves as a de facto guide for plan development, and could potentially be useful outside the scope of its original intended DOE clientele. As regulatory and DOE requirements are revised and added in the future, the document will be updated to stay current

  4. Reliability evaluation of emergency AC power systems based on operating experience at U.S. nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Baranowsky, P. W. [U.S. Nuclear Regulatory Commission, Washington, DC (United States)

    1986-02-15

    The reliability of emergency AC power Systems has been under study at the U.S. Nuclear Regulatory Commission and by its contractors for several years. This paper provides the results of work recently performed to evaluate past U.S. nuclear power plant emergency AC power System reliability performance using system level data. Operating experience involving multiple diesel generator failures, unavailabilities, and simultaneous occurrences of failures and out of service diesel generators were used to evaluate reliability performance at individual nuclear power plants covering a 9 year period from 1976 through 1984. The number and nature of failures and distributions of reliability evaluation results are provided. The results show that plant specific performance varied considerably during the period with a large number achieving high reliability performance and a smaller number accounting for lower levels of reliability performance. (author)

  5. [Evaluations by hospital-ward physicians of patient care management quality for patients hospitalized after an emergency department admission].

    Science.gov (United States)

    Bartiaux, M; Mols, P

    2017-01-01

    patient management in the acute and sub-acute setting of an Emergency Department is challenging. An assessment of the quality of provided care enables an evaluation of failings. It contributes to the identification of areas for improvement. to obtain an analysis, by hospital-ward physicians, of adult patient care management quality, as well as of the correctness of diagnosis made during emergency admissions. To evaluate the consequences of inadequate patient care management on morbidity, mortality and cost and duration of hospitalization. prospective data analysis obtained between the 1/12/2009 and the 21/12/2009 from physicians using a questionnaire on adult-patient emergency admissions and subsequent hospitalization. questionnaires were completed for 332 patients. Inadequate management of patient care were reported for 73/332 (22 %) cases. Incorrect diagnoses were reported for 20/332 (6 %) cases. 35 cases of inadequate care management (10.5 % overall) were associated with morbidity (34 cases) or mortality (1 case), including 4 cases (1.2 % ) that required emergency intensive-care or surgical interventions. this quality study analyzed the percentage of patient management cases and incorrect diagnoses in the emergency department. The data for serious outcome and wrong diagnosis are comparable with current literature. To improve performance, we consider the process for establishing a diagnosis and therapeutic care.

  6. Neurology Concepts: Young Women and Ischemic Stroke-Evaluation and Management in the Emergency Department.

    Science.gov (United States)

    Chang, Bernard P; Wira, Charles; Miller, Joseph; Akhter, Murtaza; Barth, Bradley E; Willey, Joshua; Nentwich, Lauren; Madsen, Tracy

    2018-01-01

    Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g., premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting. A panel of six board-certified emergency physicians, one with fellowship training in stroke and one with training in sex- and sex-based medicine, along with one vascular neurologist were coauthors involved in the paper. Each author used various search strategies (e.g., PubMed, PsycINFO, and Google Scholar) for primary research and reviewed articles related to their section. The references were reviewed and evaluated for relevancy and included based on review by the lead authors. Estimates on the incidence of ischemic stroke in premenopausal women range from 3.65 to 8.9 per 100,000 in the United States. Several risk factors for ischemic stroke exist for young women including oral contraceptive (OCP) use and migraine with aura. Pregnancy and the postpartum period (up to 12 weeks) is also an important transient state during which risks for both ischemic stroke and cerebral hemorrhage are elevated, accounting for 18% of strokes in women under 35. Current evidence regarding the management of acute ischemic stroke in young women is also summarized including use of thrombolytic agents (e.g., tissue plasminogen activator) in both pregnant and nonpregnant individuals. Unique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment

  7. Nuclear and radiation emergency evaluation and decision-making support system for ministry of environmental protection

    International Nuclear Information System (INIS)

    Yue Huiguo; Lin Quanyi; Zhang Jiangang

    2010-01-01

    This article introduces the design features and main functions of The Nuclear and Radiation Emergency Evaluation and Decision Support System. The Ministry of Environmental Protection will construct a complete set of evaluation and decision-making system at the Nuclear Safety Center of Ministry of Environmental Protection to cope with the sudden event. The system will provide a comprehensive technical support for the consequence evaluation and decision-making of anti-terrorism event according to the responsibility of MEP in the sudden event, with the data provided by the MEP's anti-terrorism information platform. (authors)

  8. Evaluation of the Emergency Education Response for Syrian Refugee Children and Host Communities in Jordan

    NARCIS (Netherlands)

    Culbertson, S.; Ling, T.; Henham, M.L.; Corbett, J.; Karam, R.; Pankowska, P.K.P.; Saunders, C.L.; Bellasio, J.; Baruch, B.

    2016-01-01

    The Emergency Education Response Programme (EER), launched by UNICEF, the Government of Jordan and partners in 2012, aims to provide free public formal education, as well as safe and appropriate supportive educational services, for Syrian refugee children living in Jordan. RAND's evaluation

  9. Development of scenarios for emergency exercises and the systematic evaluation of the results

    Energy Technology Data Exchange (ETDEWEB)

    Schmidtborn, I.; Playfair, A. [Colenco Power Consulting AG, Baden (Switzerland)

    2001-07-01

    This paper describes a systematic method for preparing emergency exercises for the training of power station personnel in the establishment of internal and external communications and the initiation of emergency measures in the case of beyond design basis accidents. The exercises are planned over a period of time in such a way that a wide range of scenarios are covered, keeping repetition to a minimum and the work for preparing the individual exercises is reduced as far as possible. To give an idea of the variety of exercises that can be developed using this method, a selection of the exercise titles that have been used by Colenco over the past 10 years is given. A great deal of importance has to be attached to the evaluation of the exercises.

  10. Development of scenarios for emergency exercises and the systematic evaluation of the results

    International Nuclear Information System (INIS)

    Schmidtborn, I.; Playfair, A.

    2001-01-01

    This paper describes a systematic method for preparing emergency exercises for the training of power station personnel in the establishment of internal and external communications and the initiation of emergency measures in the case of beyond design basis accidents. The exercises are planned over a period of time in such a way that a wide range of scenarios are covered, keeping repetition to a minimum and the work for preparing the individual exercises is reduced as far as possible. To give an idea of the variety of exercises that can be developed using this method, a selection of the exercise titles that have been used by Colenco over the past 10 years is given. A great deal of importance has to be attached to the evaluation of the exercises

  11. The Student Volunteer Army: a 'repeat emergent' emergency response organisation.

    Science.gov (United States)

    Carlton, Sally; Mills, Colleen E

    2017-10-01

    This paper seeks to contribute to understanding of the factors associated with an effective emergent emergency response organisation and to provide new insights into this understudied area. It examines, through an analysis of a range of textual resources, the emergence and re-emergence of the Student Volunteer Army (SVA) during the devastating earthquakes in Canterbury, New Zealand, in 2010-11. This evaluation is conducted in relation to the four key features of an effective emergency response organisation: adaptability; direction; leadership; and communication. In addition, the paper aims to further understanding of 'emergency entrepreneurship' and thus of the values and strategies that underpin social entrepreneur organisations in times of normalcy. The paper concludes that the unique position of the SVA as a 'repeat emergent' emergency response organisation enabled it to innovate continually and to improve repeatedly its systems, relationships, and image, such that it exhibited features common to emergent and established emergency response organisations. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  12. Evaluation of management of communication in the actions of preparedness and response to nuclear and radiological emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Mello Filho, Mauro Otto de Cavalcanti; Beserra, Marcela Tatiana Fernandes, E-mail: maurootto@cefet-rj.br, E-mail: maurootto@gmail.com, E-mail: mbeserra@cefet-rj.br [Centro Federal de Educacao Celso Sucknow da Fonseca (CEFET-RJ), Rio de Janeiro, RJ (Brazil); Wasserman, Maria Angelica Vergara, E-mail: mwasserman@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Wasserman, Julio Cesar de Faria Alvim, E-mail: geowass@vm.uff.br [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2013-07-01

    The use of practices involving the use of ionizing radiation in diverse areas of knowledge increases every day. This growth warning about the increased probability of accidents, radiological and nuclear emergencies, with possible consequences for the public, workers and the environment. Within this scenario, it is clear that studies and reassessments of the emergency response actions, receive proposals for continuous improvement. The achievement of the objectives of the response must be sustained by tactical, operation and logistics optimized processes. The articulation through communication between the teams involved in the response must be adaptable to each accident or emergency, respecting its size. The objectives of this study is to perform an assessment on the management of communication in the actions of Preparedness and Response to Nuclear and Radiological Emergencies. This assessment is supported by best practices of the Incident Command System (ICS) and the Institute of Project Management (Project Management Institute-PMI). For this purpose, based on models referred were established performance indicators supported by the BSC (Balanced Scorecard). These indicators allowed to evaluate more objectively the performance of the communication processes associated with each phase of the response. The study resulted in the proposed model documents aiming to assist planning of communications exercises in preparation and response actions, supported and adapted the best practices of PMI. These methodologies were evaluated by real cases selected from radiological and nuclear emergencies published by the International Atomic Energy Agency (IAEA). (author)

  13. Evaluation of management of communication in the actions of preparedness and response to nuclear and radiological emergencies

    International Nuclear Information System (INIS)

    Mello Filho, Mauro Otto de Cavalcanti; Beserra, Marcela Tatiana Fernandes; Wasserman, Maria Angelica Vergara; Wasserman, Julio Cesar de Faria Alvim

    2013-01-01

    The use of practices involving the use of ionizing radiation in diverse areas of knowledge increases every day. This growth warning about the increased probability of accidents, radiological and nuclear emergencies, with possible consequences for the public, workers and the environment. Within this scenario, it is clear that studies and reassessments of the emergency response actions, receive proposals for continuous improvement. The achievement of the objectives of the response must be sustained by tactical, operation and logistics optimized processes. The articulation through communication between the teams involved in the response must be adaptable to each accident or emergency, respecting its size. The objectives of this study is to perform an assessment on the management of communication in the actions of Preparedness and Response to Nuclear and Radiological Emergencies. This assessment is supported by best practices of the Incident Command System (ICS) and the Institute of Project Management (Project Management Institute-PMI). For this purpose, based on models referred were established performance indicators supported by the BSC (Balanced Scorecard). These indicators allowed to evaluate more objectively the performance of the communication processes associated with each phase of the response. The study resulted in the proposed model documents aiming to assist planning of communications exercises in preparation and response actions, supported and adapted the best practices of PMI. These methodologies were evaluated by real cases selected from radiological and nuclear emergencies published by the International Atomic Energy Agency (IAEA). (author)

  14. Design evaluation of emergency core cooling systems using Axiomatic Design

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Gyunyoung [Massachusetts Institute of Technology, Department of Mechanical Engineering, 77 Massachusetts Avenue, Cambridge, MA 02139 (United States)]. E-mail: gheo@mit.edu; Lee, Song Kyu [Korea Advanced Institute of Science and Technology, Department of Nuclear and Quantum Engineering, 373-1 Guseong-dong, Yuseong-gu, Daejeon (Korea, Republic of)

    2007-01-15

    In designing nuclear power plants (NPPs), the evaluation of safety is one of the important issues. As a measure for evaluating safety, this paper proposes a methodology to examine the design process of emergency core cooling systems (ECCSs) in NPPs using Axiomatic Design (AD). This is particularly important for identifying vulnerabilities and creating solutions. Korean Advanced Power Reactor 1400 MWe (APR1400) adopted the ECCS, which was improved to meet the stronger safety regulations than that of the current Optimized Power Reactor 1000 MWe (OPR1000). To improve the performance and safety of the ECCS, the various design strategies such as independency or redundancy were implemented, and their effectiveness was confirmed by calculating core damage frequency. We suggest an alternative viewpoint of evaluating the deployment of design strategies in terms of AD methodology. AD suggests two design principles and the visualization tools for organizing design process. The important benefit of AD is that it is capable of providing suitable priorities for deploying design strategies. The reverse engineering driven by AD has been able to show that the design process of the ECCS of APR1400 was improved in comparison to that of OPR1000 from the viewpoint of the coordination of design strategies.

  15. Evaluation of a model for predicting Avena fatua and Descurainia sophia seed emergence in winter rapeseed

    Energy Technology Data Exchange (ETDEWEB)

    Aboutalebian, M.A.; Nazari, S.; Gonzalez-Andujar, J.L.

    2017-07-01

    Avena fatua and Descurainia sophia are two important annual weeds throughout winter rapeseed (Brassica napus L.) production systems in the semiarid region of Iran. Timely and more accurate control of both species may be developed if there is a better understanding of its emergence patterns. Non-linear regression techniques are usually unable to accurately predict field emergence under such environmental conditions. The objectives of this research were to evaluate the emergence patterns of A. fatua and D. sophia and determine if emergence could be predicted using cumulative soil thermal time in degree days (CTT). In the present work, cumulative seedling emergence from a winter rapeseed field during 3 years data set was fitted to cumulative soil CTT using Weibull and Gompertz functions. The Weibull model provided a better fit, based on coefficient of determination (R2sqr), root mean square of error (RMSE) and Akaike index (AICd), compared to the Gompertz model between 2013 and 2016 seasons for both species. Maximum emergence of A. fatua occured 70-119 days after sowing or after equals 329-426 °Cd, while in D. sophia it occurred 119-134 days after sowing rapeseed equals 373-470 °Cd. Both models can aid in the future study of A. fatua and D. sophia emergence and assist growers and agricultural professionals with planning timely and more accurate A. fatua and D. sophia control.

  16. Evaluation of air cleaning system concepts for emergency use in LMFBR plants

    International Nuclear Information System (INIS)

    Hilliard, R.K.; McCormack, J.D.; Postma, A.K.

    1976-12-01

    Nineteen different air cleaning concepts are arranged into twenty-four systems and evaluated for use as accident mitigating systems in LMFBR plants. Both single, low-leakage containment plants and once-through operation applicable to containment/confinement plants are considered. Plant characteristics affecting air cleaning requirements are defined for 1000 MW(e) plants and a sodium and radiological release term is postulated. The accident conditions under which the emergency air cleaning system (EACS) must function is established by use of SOFIRE-II and HAA-3B computer codes. Criteria are developed for evaluating the various systems and for assigning comparative ratings. The numerical ratings are combined with information on cost and development potential to arrive at recommendations for the most promising systems. The conclusion is made that reliable and effective systems are feasible for use as engineered safety features for LMFBR plants, but that development effort is required for all the air cleaning concepts evaluated

  17. Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department.

    Science.gov (United States)

    Ngo, Stephanie; Shahsahebi, Mohammad; Schreiber, Sean; Johnson, Fred; Silberberg, Mina

    2017-11-09

    This study evaluated the correlation of an emergency department embedded care coordinator with access to community and medical records in decreasing hospital and emergency department use in patients with behavioral health issues. This retrospective cohort study presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking at all-cause healthcare utilization, care coordination was associated with a significant median decrease of one emergency department visit per patient (p management of behavioral health patients.

  18. Summary of the Fourth International Nuclear Emergency Exercise (INEX-4). Exercise Conduct and Evaluation Questionnaires

    International Nuclear Information System (INIS)

    Auclair, Jean Patrice; Duchesne, David; Caamano, Delphine; Cessac, Bruno; Mehl-auget, Isabelle; Gering, Florian; Macsuga, Geza; Fukumoto, Masahiro; Holo, Eldri Naadland; Ugletveit, Finn; Griffiths, Mike; Breitinger, Mark; Heinrich, Ann; Mcclelland, Vincent; Ahier, Brian; Lazo, Ted; Mcinturff, Sandi; Kawabata, Masanori; Lazo, Ted; Okyar, Halil Burcin

    2013-01-01

    The INEX-4 consequence management exercise, part of the OECD Nuclear Energy Agency's ongoing series of International Nuclear Emergency Exercises (INEX), was developed under the auspices of the NEA/CRPPH Working Party on Nuclear Emergency Matters (WPNEM) in response to members desire to better prepare for the longer-term response to a nuclear or radiological emergency. The INEX-4 exercise was designed to allow participants to investigate the national and, in some cases, international arrangements for responding to widespread radiological contamination of the urban environment from a radiological dispersal devise (or dirty bomb) and the consequence management issues likely to be raised in the medium to longer term after such an event. The experiences of participating countries were gathered through an evaluation questionnaire and are summarised in this report. The INEX-4 series was developed in 2008, and conducted throughout 2010 and 2011 with 17 participating countries using the INEX-4 scenario for an event involving a radiological dispersal device. An INEX-4 evaluation questionnaire was developed to document the process and results of the exercise, which was designed mainly to test emergency responses/actions related to consequence management and transition to recovery. The conclusions drawn from the INEX-4 experiences varied greatly, but this was to be expected given the nature of the scenario and the involvement of organisations outside of the nuclear community. The evaluation questionnaires completed by each participating country provided detailed information on the national approaches taken with respect to each of the exercise objectives and on issues relating to the international interfaces between countries. In collaboration with the NEA Secretariat, staff from the United States Department of Energy (DOE) reviewed each completed questionnaire to identify and summarise the essential information derived from the exercise for consideration by WPNEM members

  19. Quality Evaluation Scores are no more Reliable than Gestalt in Evaluating the Quality of Emergency Medicine Blogs: A METRIQ Study.

    Science.gov (United States)

    Thoma, Brent; Sebok-Syer, Stefanie S; Colmers-Gray, Isabelle; Sherbino, Jonathan; Ankel, Felix; Trueger, N Seth; Grock, Andrew; Siemens, Marshall; Paddock, Michael; Purdy, Eve; Kenneth Milne, William; Chan, Teresa M

    2018-01-30

    Construct: We investigated the quality of emergency medicine (EM) blogs as educational resources. Online medical education resources such as blogs are increasingly used by EM trainees and clinicians. However, quality evaluations of these resources using gestalt are unreliable. We investigated the reliability of two previously derived quality evaluation instruments for blogs. Sixty English-language EM websites that published clinically oriented blog posts between January 1 and February 24, 2016, were identified. A random number generator selected 10 websites, and the 2 most recent clinically oriented blog posts from each site were evaluated using gestalt, the Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) score, and the Medical Education Translational Resources: Impact and Quality (METRIQ-8) score, by a sample of medical students, EM residents, and EM attendings. Each rater evaluated all 20 blog posts with gestalt and 15 of the 20 blog posts with the ALiEM AIR and METRIQ-8 scores. Pearson's correlations were calculated between the average scores for each metric. Single-measure intraclass correlation coefficients (ICCs) evaluated the reliability of each instrument. Our study included 121 medical students, 88 EM residents, and 100 EM attendings who completed ratings. The average gestalt rating of each blog post correlated strongly with the average scores for ALiEM AIR (r = .94) and METRIQ-8 (r = .91). Single-measure ICCs were fair for gestalt (0.37, IQR 0.25-0.56), ALiEM AIR (0.41, IQR 0.29-0.60) and METRIQ-8 (0.40, IQR 0.28-0.59). The average scores of each blog post correlated strongly with gestalt ratings. However, neither ALiEM AIR nor METRIQ-8 showed higher reliability than gestalt. Improved reliability may be possible through rater training and instrument refinement.

  20. Emergency response guide-B ECCS guideline evaluation analyses for N reactor

    International Nuclear Information System (INIS)

    Chapman, J.C.; Callow, R.A.

    1989-07-01

    INEL conducted two ECCS analyses for Westinghouse Hanford. Both analyses will assist in the evaluation of proposed changes to the N Reactor Emergency Response Guide-B (ERG-B) Emergency Core System (ECCS) guideline. The analyses were a sensitivity study for reduced-ECCS flow rates and a mechanistically determined confinement steam source for a delayed-ECCS LOCA sequence. The reduced-ECCS sensitivity study established the maximum allowable reduction in ECCS flow as a function of time after core refill for a large break loss-of-coolant accident (LOCA) sequence in the N Reactor. The maximum allowable ECCS flow reduction is defined as the maximum flow reduction for which ECCS continues to provide adequate core cooling. The delayed-ECCS analysis established the liquid and steam break flows and enthalpies during the reflood of a hot core following a delayed ECCS injection LOCA sequence. A simulation of a large, hot leg manifold break with a seven-minute ECCS injection delay was used as a representative LOCA sequence. Both analyses were perform using the RELAP5/MOD2.5 transient computer code. 13 refs., 17 figs., 3 tabs

  1. Human errors evaluation for muster in emergency situations applying human error probability index (HEPI, in the oil company warehouse in Hamadan City

    Directory of Open Access Journals (Sweden)

    2012-12-01

    Full Text Available Introduction: Emergency situation is one of the influencing factors on human error. The aim of this research was purpose to evaluate human error in emergency situation of fire and explosion at the oil company warehouse in Hamadan city applying human error probability index (HEPI. . Material and Method: First, the scenario of emergency situation of those situation of fire and explosion at the oil company warehouse was designed and then maneuver against, was performed. The scaled questionnaire of muster for the maneuver was completed in the next stage. Collected data were analyzed to calculate the probability success for the 18 actions required in an emergency situation from starting point of the muster until the latest action to temporary sheltersafe. .Result: The result showed that the highest probability of error occurrence was related to make safe workplace (evaluation phase with 32.4 % and lowest probability of occurrence error in detection alarm (awareness phase with 1.8 %, probability. The highest severity of error was in the evaluation phase and the lowest severity of error was in the awareness and recovery phase. Maximum risk level was related to the evaluating exit routes and selecting one route and choosy another exit route and minimum risk level was related to the four evaluation phases. . Conclusion: To reduce the risk of reaction in the exit phases of an emergency situation, the following actions are recommended, based on the finding in this study: A periodic evaluation of the exit phase and modifying them if necessary, conducting more maneuvers and analyzing this results along with a sufficient feedback to the employees.

  2. Evaluation of substrates on the emergence of "araticum-de-terra-fria" (Annona emarginata (Schltdl. H. Rainer Seedlings

    Directory of Open Access Journals (Sweden)

    Daniel Baron

    2011-06-01

    Full Text Available Choosing a substrate is the determinant factor for the seedling producer; thus, the aim of this study was to evaluate the effect of different types of substrates on the emergence of "araticum-de-terra-fria" (Annona emarginata (Schltdl. H. Rainer seedlings. The experiment was carried out in a greenhouse and the experimental design was in randomized blocks, with three treatments and five replicates of 72 seeds per plot. The treatments consisted of the following substrates: coconut fiber, vermiculite and Plantmax® Citrus. The number of emerged seedlings was weekly counted for 105 days. Data regarding seedling height were obtained, and the emergence velocity index and mean time, besides total emergence percentage and that over time were calculated. Results from total mean emergence percentage, seedling height, emergence velocity index (EVI, and mean emergence time (MET were subjected to analysis of variance and means were compared by the Tukey's test at 5% significance. The curves concerning the emergence percentage over time were fit by the logistic growth equation for each treatment and the means of each parameter (A, B, C were compared by the Duncan's test at 5% significance. The substrates vermiculite led to the highest values of emergence percentage differing from the PlantMax® Citrus, but not of the coconut fiber, however the vermiculite promoted seedling height in a shorter time; therefore, this substrate is recommended for the initial development of "araticum-de-terra-fria" (Annona emarginata (Schltdl. H. Rainer seedlings.

  3. Contemporary imaging in abdominal emergencies

    International Nuclear Information System (INIS)

    Sivit, Carlos J.

    2008-01-01

    Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)

  4. Evolution of gas turbine SGT5-4000F. Experiences at combined cycle plant Mainz-Wiesbaden; Die Evolution der Gasturbine SGT5-4000F. Erfahrungen im GuD-Kraftwerk Mainz-Wiesbaden

    Energy Technology Data Exchange (ETDEWEB)

    Taud, R.; Kreyenberg, O. [Siemens Power Generation, Nuernberg (Germany); Thun, O. [Kraftwerke Mainz-Wiesbaden AG, Mainz (Germany)

    2007-07-01

    Large combined-cycle plants using natural gas emerged as the outstanding trend in electricity production in the 1990s. Pacemaker for this development has been modern gas turbine technology. High efficiency and reliability, low emissions, high operating and fuel flexibility at low investment, together with short construction times, provide extremely attractive features to the customer. (orig.)

  5. Preparation, Conduct and Evaluation of Exercises to Test Preparedness for a Nuclear or Radiological Emergency

    International Nuclear Information System (INIS)

    2010-01-01

    The aim of this publication is to serve as a practical tool for the preparation, conduct and evaluation of exercises to test preparedness for response to a nuclear or radiological emergency. It fulfils in part the functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning the methodologies, techniques and available results of research on such emergencies. To ensure effective response to radiation emergencies when needed, provisions should be made for regular training of emergency response personnel. As stated in Preparedness and Response for a Nuclear or Radiological Emergency (Safety Requirements, Safety Standard Series No. GS-R-2), 'The operator and the response organizations shall make arrangements for the selection of personnel and training to ensure that the personnel have the requisite knowledge, skills, abilities, equipment, procedures and other arrangements to perform their assigned response functions'. A further requirement is that 'Exercise programmes shall be conducted to ensure that all specified functions required to be performed for emergency response and all organizational interfaces for facilities in threat category I, II or III and the national level programmes for threat category IV or V are tested at suitable intervals'. In 2004 the IAEA General Conference, in resolution GC(48)/RES/10 encouraged Member States to 'implement the Safety Requirements for Preparedness and Response to a Nuclear or Radiological Emergency'. This document is published as part of the IAEA Emergency Preparedness and Response Series to assist in meeting these requirements and to fulfil Article 5 of the Assistance Convention. It was developed based on a number of assumptions about national and local capabilities. Therefore, the exercise structure, terms and scenarios must be

  6. Emergency evacuation/transportation plan update: Traffic model development and evaluation of early closure procedures. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-10-28

    Prolonged delays in traffic experienced by Laboratory personnel during a recent early dismissal in inclement weather, coupled with reconstruction efforts along NM 502 east of the White Rock Wye for the next 1 to 2 years, has prompted Los Alamos National Laboratory (LANL) to re-evaluate and improve the present transportation plan and its integration with contingency plans maintained in other organizations. Facilities planners and emergency operations staff need to evaluate the transportation system`s capability to inefficiently and safely evacuate LANL under different low-level emergency conditions. A variety of potential procedures governing the release of employees from the different technical areas (TAs) requires evaluation, perhaps with regard to multiple emergency-condition scenarios, with one or more optimal procedures ultimately presented for adoption by Lab Management. The work undertaken in this project will hopefully lay a foundation for an on-going, progressive transportation system analysis capability. It utilizes microscale simulation techniques to affirm, reassess and validate the Laboratory`s Early Dismissal/Closure/Delayed Opening Plan. The Laboratory is required by Federal guidelines, and compelled by prudent practice and conscientious regard for the welfare of employees and nearby residents, to maintain plans and operating procedures for evacuation if the need arises. The tools developed during this process can be used outside of contingency planning. It is anticipated that the traffic models developed will allow site planners to evaluate changes to the traffic network which could better serve the normal traffic levels. Changes in roadway configuration, control strategies (signalization and signing), response strategies to traffic accidents, and patterns of demand can be modelled using the analysis tools developed during this project. Such scenarios typically are important considerations in master planning and facilities programming.

  7. Making sense of the emerging conversation in evaluation about systems thinking and complexity science.

    Science.gov (United States)

    Gates, Emily F

    2016-12-01

    In the last twenty years, a conversation has emerged in the evaluation field about the potential of systems thinking and complexity science (STCS) to transform the practice of evaluating social interventions. Documenting and interpreting this conversation are necessary to advance our understanding of the significance of using STCS in planning, implementing, and evaluating social interventions. Guided by a generic framework for evaluation practice, this paper reports on an inter-disciplinary literature review and argues that STCS raises some new ways of thinking about and carrying out the following six activities: 1) supporting social problem solving; 2) framing interventions and contexts; 3) selecting and using methods; 4) engaging in valuing; 5) producing and justifying knowledge; and 6) facilitating use. Following a discussion of these issues, future directions for research and practice are suggested. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. High-fidelity hybrid simulation of allergic emergencies demonstrates improved preparedness for office emergencies in pediatric allergy clinics.

    Science.gov (United States)

    Kennedy, Joshua L; Jones, Stacie M; Porter, Nicholas; White, Marjorie L; Gephardt, Grace; Hill, Travis; Cantrell, Mary; Nick, Todd G; Melguizo, Maria; Smith, Chris; Boateng, Beatrice A; Perry, Tamara T; Scurlock, Amy M; Thompson, Tonya M

    2013-01-01

    Simulation models that used high-fidelity mannequins have shown promise in medical education, particularly for cases in which the event is uncommon. Allergy physicians encounter emergencies in their offices, and these can be the source of much trepidation. To determine if case-based simulations with high-fidelity mannequins are effective in teaching and retention of emergency management team skills. Allergy clinics were invited to Arkansas Children's Hospital Pediatric Understanding and Learning through Simulation Education center for a 1-day workshop to evaluate skills concerning the management of allergic emergencies. A Clinical Emergency Preparedness Team Performance Evaluation was developed to evaluate the competence of teams in several areas: leadership and/or role clarity, closed-loop communication, team support, situational awareness, and scenario-specific skills. Four cases, which focus on common allergic emergencies, were simulated by using high-fidelity mannequins and standardized patients. Teams were evaluated by multiple reviewers by using video recording and standardized scoring. Ten to 12 months after initial training, an unannounced in situ case was performed to determine retention of the skills training. Clinics showed significant improvements for role clarity, teamwork, situational awareness, and scenario-specific skills during the 1-day workshop (all P clinics (all P ≤ .004). Clinical Emergency Preparedness Team Performance Evaluation scores demonstrated improved team management skills with simulation training in office emergencies. Significant recall of team emergency management skills was demonstrated months after the initial training. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. Self-reported consumption of wine and other alcoholic beverages in a German wine area

    Directory of Open Access Journals (Sweden)

    Fronk P

    2013-06-01

    Full Text Available Petra Fronk,1 Maria Blettner,2 Heinz Decker1 1Institute for Molecular Biophysics, Johannes Gutenberg University of Mainz, Mainz, Germany; 2Institute for Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg University of Mainz, Mainz, Germany Purpose: To describe the consumption of alcoholic beverages in a German wine area, with special attention to the number of people drinking more than the tolerable upper alcohol intake level (TUAL. Methods: A cross-sectional study was conducted using a mailed questionnaire, to investigate the weekly consumption of wine, beer, and spirits during the preceding 12 months in Mainz, the state capital of Rhineland-Palatinate, Germany. The analysis included 948 responders aged 20–69 years. Results: A total of 948 respondents, with a mean age of 43.7 years, were included in the analysis. About 85% of the respondents consumed alcoholic beverages, with an average of about 13.5 g alcohol/day. Men drank about twice as much as women. In total, 30% of women and 24% of men reported drinking more than the TUAL, and 9.2% of women and 7.2% of men reported drinking more than twice as much as the TUAL. The highest proportion of persons drinking more than the TUAL was found among elderly people. The preferred beverage was wine, which contributed 74% (for women and 54% (for men to the total alcohol intake. On average, the respondents drank 2.8 glasses of wine per week, 1.4 bottles beer, and negligible amounts of spirits. Conclusion: Wine was the preferred alcoholic beverage in Mainz, which was expected for people living in a wine area. A rather large number of people, especially among the elderly, consumed alcohol in an amount higher than the TUAL which may be harmful to health. Keywords: beer, spirits, TUAL, Mainz

  10. Use of standardized multidimensional evaluation tools and the emergence of the case manager's professional identity in France.

    Science.gov (United States)

    Nugue, Mathilde; De Stampa, Matthieu; Couturier, Yves; Somme, Dominique

    2012-01-01

    In France, the national public health plan proposes a group of innovations including the initiation of case management for older adults in complex situations, particularly those with cognitive disorders. In this context, public authorities asked case managers to use a standardized multidimensional evaluation tool. The results of a qualitative study on the pertinence of such a tool relative to the emergence of this new professional field are described. Early use of an evaluation tool seems to be linked to the emergence of a new professional identity for recently recruited case managers. Factors determining the strength of this link are training tool standardization, computerization, and local structure's involvement. Our results contribute to identifying one of the ways by which professional identity can be changed to become a case manager.

  11. Evaluation of pre and post-emergence herbicides for weed management in lentil (lens culinaris medik.)

    International Nuclear Information System (INIS)

    Ali, A.; Malik, S.R.; Munawwar, H.; Tahir, M.

    2014-01-01

    The weeds in lentil are one of the major constraints in obtaining maximum yield. The manual weed control is simply not feasible because it is time consuming and costly. The chemical weed control is the effective method of weed management.A field study was conducted to evaluate pre and post-emergence herbicides for weed control in lentil. The experiment comprised eight treatments including three herbicides, manual weeding and check (no weeding). The yield was higher in manual weeding but in herbicide treatments Isoproturon as pre-emergence at the rate 2kg/sup -1/ha produced statistically at par grain yield to that of manual weeding followed by Isoproturon after one month of planting at the rate 2kg ha. Both the treatments showed 193.9% and 109.2% yield increase, respectively, over the check. It indicates that Isoproturon at the rate 2 kg ha can be used pre or post-emergence in lentil fields to control the weeds without causing injury to lentil plants. (author)

  12. Extensive Evaluation of a Diffusion Denuder Technique for the Quantification of Atmospheric Stable and Radioactive Molecular Iodine

    DEFF Research Database (Denmark)

    Huang, Ru-Jin; Hou, Xiaolin; Hoffmann, Thorsten

    2010-01-01

    In this paper we present the evaluation and optimization of a new approach for the quantification of gaseous molecular iodine (I2) for laboratory- and field-based studies and its novel application for the measurement of radioactive molecular iodine. α-Cyclodextrin (α-CD) in combination with 129I......, and condition of release and derivatization of iodine, is extensively evaluated and optimized. The collection efficiency is larger than 98% and the limit of detection (LOD) obtained is 0.17 parts-per-trillion-by-volume (pptv) for a sampling duration of 30 min at 500 mL min−1. Furthermore, the potential use...... of this protocol for the determination of radioactive I2 at ultra trace level is also demonstrated when 129I− used in the coating is replaced by 127I− and a multiple denuder system is used. Using the present method we observed 25.7−108.6 pptv 127I2 at Mweenish Bay, Ireland and 108 molecule m−3 129I2 at Mainz...

  13. Evaluation of Patients Visiting the Dermatology Emergency Unit of a University Dermatology Hospital in Tehran, Iran.

    Science.gov (United States)

    Abedini, Robabeh; Matinfar, Amin; Sasani, Pardis; Salehi, Anahita; Daneshpazhooh, Maryam

    2017-11-01

    Published studies on dermatological emergencies are limited in the literature. To our knowledge, no study has previously explored this subject in Iran. Our aim was to ascertain the characteristics of patients visiting the dermatologic emergency (DE) unit of a university skin hospital in Tehran, Iran. We studied the files of all the patients seen in the DE unit over a 3-month period, collecting data on age, sex, referral mode, duration of consultation, status (true emergency or non-emergency), and diagnosis. A total of 2539 patients were evaluated; 53% of them were female. Infection and infestation (41.9%), urticaria (16.7%), and dermatitis (13.2%) were the most prevalent entities. Almost 1% of the patients were referred by another physician and psoriasis was their most frequent diagnosis. Almost 2.6% of the patients were hospitalized; psoriasis was once again the most frequent cause. The hospitalization rate was significantly higher in referred patients (Pdermatologic disorders. This data could also help in tailoring the educational curriculum for medical students more appropriately in order to increase their knowledge of the most prevalent skin disorders.

  14. Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

    Science.gov (United States)

    Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

    2016-01-01

    To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

  15. The early emergence of sociomoral evaluation: infants prefer prosocial others.

    Science.gov (United States)

    Van de Vondervoort, Julia W; Hamlin, J Kiley

    2018-04-01

    Humans readily evaluate third-parties' prosocial and antisocial acts. Recent evidence reveals that this tendency emerges early in development-even preverbal infants selectively approach prosocial others and avoid antisocial ones. Rather than reflecting attraction toward or away from low-level characteristics of the displays or simple behavioral rules, infants are sensitive to characteristics of both the agents and recipients of prosocial and antisocial acts. Specifically, infants' preferences require that the recipients of positive and negative acts be social agents with clear unfulfilled goals, who have not previously harmed others. In addition, prosocial and antisocial agents must act intentionally, in the service of positive and negative goals. It is an open question whether these prosocial preferences reflect self-interested and/or moral concerns. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Evaluating oversight systems for emerging technologies: a case study of genetically engineered organisms.

    Science.gov (United States)

    Kuzma, Jennifer; Najmaie, Pouya; Larson, Joel

    2009-01-01

    The U.S. oversight system for genetically engineered organisms (GEOs) was evaluated to develop hypotheses and derive lessons for oversight of other emerging technologies, such as nanotechnology. Evaluation was based upon quantitative expert elicitation, semi-standardized interviews, and historical literature analysis. Through an interdisciplinary policy analysis approach, blending legal, ethical, risk analysis, and policy sciences viewpoints, criteria were used to identify strengths and weaknesses of GEOs oversight and explore correlations among its attributes and outcomes. From the three sources of data, hypotheses and broader conclusions for oversight were developed. Our analysis suggests several lessons for oversight of emerging technologies: the importance of reducing complexity and uncertainty in oversight for minimizing financial burdens on small product developers; consolidating multi-agency jurisdictions to avoid gaps and redundancies in safety reviews; consumer benefits for advancing acceptance of GEO products; rigorous and independent pre- and post-market assessment for environmental safety; early public input and transparency for ensuring public confidence; and the positive role of public input in system development, informed consent, capacity, compliance, incentives, and data requirements and stringency in promoting health and environmental safety outcomes, as well as the equitable distribution of health impacts. Our integrated approach is instructive for more comprehensive analyses of oversight systems, developing hypotheses for how features of oversight systems affect outcomes, and formulating policy options for oversight of future technological products, especially nanotechnology products.

  17. Thermal-hydraulic evaluation study of the effectiveness of emergency core cooling system for light water reactors

    International Nuclear Information System (INIS)

    Sobajima, Makoto

    1985-08-01

    In order to evaluate the core cooling capability of the emergeny core cooling system, which is a safety guard system of light water reactors for a loss-of-coolant accident, a variety of large scale test were performed. Through the results, many phenomena were investigated and the predictabity of analytical codes were examined. The tests conducted were a single-vessel blowdown test, emergency core cooling test in a PWR simulation facility, spray cooling test for a BWR, large scale reflood test and a separate effect test on countercurrent flow. These test results were examined to clarify thermal-hydraulic phenomena and the effect of various test parameters and were utilized to improve predictability of the analytical codes. Some models for flow behavior in the upper core were also developed. By evaluating the effectiveness of various emergency core cooling system configurations, more effective cooling system than the current one was proposed and demonstrated. (author)

  18. Implementation and evaluation of health passport communication tools in emergency departments.

    Science.gov (United States)

    Heifetz, Marina; Lunsky, Yona

    2018-01-01

    People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario. Health passport communication tools were locally tailored and implemented in each of the three regions. A total of 28 questionnaires and 18 interviews with stakeholders (e.g., hospital staff, community agency representatives, families) were completed across the regions to obtain feedback on the implementation of health passports with people with IDD. Participants felt that the health passport tools provided helpful information, improved communication between patients with IDD and hospital staff, and were user friendly. Continued efforts are needed to work with communities on maintenance of this tool, ensuring all hospital staff are utilizing the information. These findings emphasize the merits of health passport tools being implemented in the health system to support communication between patients with IDD and health care practitioners and the importance of tailoring tools to local settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. UAV Deployment Exercise for Mapping Purposes: Evaluation of Emergency Response Applications

    Directory of Open Access Journals (Sweden)

    Piero Boccardo

    2015-07-01

    Full Text Available Exploiting the decrease of costs related to UAV technology, the humanitarian community started piloting the use of similar systems in humanitarian crises several years ago in different application fields, i.e., disaster mapping and information gathering, community capacity building, logistics and even transportation of goods. Part of the author’s group, composed of researchers in the field of applied geomatics, has been piloting the use of UAVs since 2006, with a specific focus on disaster management application. In the framework of such activities, a UAV deployment exercise was jointly organized with the Regional Civil Protection authority, mainly aimed at assessing the operational procedures to deploy UAVs for mapping purposes and the usability of the acquired data in an emergency response context. In the paper the technical features of the UAV platforms will be described, comparing the main advantages/disadvantages of fixed-wing versus rotor platforms. The main phases of the adopted operational procedure will be discussed and assessed especially in terms of time required to carry out each step, highlighting potential bottlenecks and in view of the national regulation framework, which is rapidly evolving. Different methodologies for the processing of the acquired data will be described and discussed, evaluating the fitness for emergency response applications.

  20. UAV Deployment Exercise for Mapping Purposes: Evaluation of Emergency Response Applications.

    Science.gov (United States)

    Boccardo, Piero; Chiabrando, Filiberto; Dutto, Furio; Tonolo, Fabio Giulio; Lingua, Andrea

    2015-07-02

    Exploiting the decrease of costs related to UAV technology, the humanitarian community started piloting the use of similar systems in humanitarian crises several years ago in different application fields, i.e., disaster mapping and information gathering, community capacity building, logistics and even transportation of goods. Part of the author's group, composed of researchers in the field of applied geomatics, has been piloting the use of UAVs since 2006, with a specific focus on disaster management application. In the framework of such activities, a UAV deployment exercise was jointly organized with the Regional Civil Protection authority, mainly aimed at assessing the operational procedures to deploy UAVs for mapping purposes and the usability of the acquired data in an emergency response context. In the paper the technical features of the UAV platforms will be described, comparing the main advantages/disadvantages of fixed-wing versus rotor platforms. The main phases of the adopted operational procedure will be discussed and assessed especially in terms of time required to carry out each step, highlighting potential bottlenecks and in view of the national regulation framework, which is rapidly evolving. Different methodologies for the processing of the acquired data will be described and discussed, evaluating the fitness for emergency response applications.

  1. Feasibility study for a computerized emergency preparedness simulation facility

    International Nuclear Information System (INIS)

    Gerhardstein, L.H.; Schroeder, J.O.; Sandusky, W.F.

    1979-11-01

    This report details the feasibility of a computerized Emergency Preparedness Simulation Facility (EPSF) for use by the Nuclear Regulatory Commission (NRC). The proposed facility would be designed to provide the NRC and other federal, state, and local government agencies with a capability to formulate, test, and evaluate the Emergency Preparedness Plans (EPP) which local and state agencies have/will establish for use during nuclear emergencies. In cases of any state emergency (including a nuclear emergency), high level state government officials will direct emergency procedures and insure that state and local emergency teams carry out tasks which have been established in their EPP. When an emergency exists, rapid mobilization of emergency teams, efficient communication, and effective coordination of individual team efforts is essential to safety, preservation of property, and overall public welfare. Current EPP evaluation procedures are qualitative in nature and while they do compare emergency drill performance with the EPP, the nature of the drills often does not provide enough realism to actual emergency conditions. Automated simulation of real emergency conditions using modern computer equipment and programming techniques will provide the NRC emergency evaluation teams a simulated environment which closely approximates conditions which would actually exist during a real emergency. In addition, the computer can be used to collect and log performance and event data which will aid the evaluation team in making assessments of the state or local area's EPP and their Emergency Preparedness Teams performance during emergency drills. Overall, a computerized EPSF can improve drill testing and evaluation efficiency, provide approximate emergency condition realism, and improve public awareness of local emergency procedures

  2. The Profile of Neurology Patients Evaluated in the Emergency Department

    OpenAIRE

    Ufuk Emre; Ayşe Semra Demir; Esra Acıman; Nejla Çabuk; Sibel Kıran; Aysun Ünal

    2009-01-01

    OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood...

  3. Evaluation of Head Trauma Cases in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Alim Cokuk

    2013-02-01

    Full Text Available Aim: In this study, we aimed to determine the epidemiological characteristics, morbidity and mortality rates of patients admitted to the emergency department with head trauma. Material and Methods: In this study, ambulatory and hospitalized patients over the age of 18 brought to the Emergency Department because of head trauma between 01.12.2009 - 31.12.2010 were analyzed retrospectively. Patient data were recorded to standard data entry form. SPSS 17.0 package program was used for statistical analysis of data. The statistical significance level of all tests was p <0.05. Results: 5200 patients were included in this study. The average age of the patients was 39.97 ± 16.66 years. 4682'si patients (90 % were discharged from the emergency department. The most common reason for admission to the emergency department was falls (41.81 % in the discharged patients. 518 (10 % patients were hospitalized. Gender of these patients was 110 female (21:24% and 408 male (78.76%. 256 patients (48.35% were injured as a result of a traffic accident. 201(38.8% of the cerebral CT were reported as normal and 89 (17.2% of the cerebral CT were reported as traumatic subarachnoid hemorrhage (SAH in hospitalized patients. The fracture of lumbar spine (12 % was detected as an additional pathological disease in patients. 75 patients hospitalized because of head trauma (14.5% had died (1.44 % of all patients. Cervical spine fracture was the most common (14 patients, 18.68 % additional pathology in patients who died. Thoracic trauma was detected as the second most common (13 patients, 17.33 % additional pathology. Conclusion: Most of the patients admitted to the emergency department with head injury had a minor trauma. Patients can be discharged from the emergency department after a thorough physical examination and simple medical intervention. Most of the head injury patients admitted to hospital were male. The most common reason of the patients with head injury admitted to

  4. Economic evaluation of emergency obstetric care training: a systematic review.

    Science.gov (United States)

    Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

    2017-12-04

    Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a

  5. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice?

    Science.gov (United States)

    Heng, Kenneth Wj

    2014-01-01

    Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM residents. With the advancement in understanding of what multitasking is, deliberate attempts should be made to teach residents pitfalls and coping strategies. This can be taught through a formal curriculum, role modeling by faculty, and simulation training. The best way to evaluate multitasking ability in residents is by direct observation. The EM Milestone Project provides a framework by which multitasking can be evaluated. EM residents should be deployed in work environments commiserate with their multitasking ability and their progress should be graduated after identified deficiencies are remediated.

  6. Novel effects-based monitoring approaches to evaluate chemicals of emerging concern in the St. Louis River estuary

    Science.gov (United States)

    As part of an on-going program of research in support of the Great Lakes Restoration Initiative, the US EPA MED laboratory has been developing effects-based biomonitoring tools to evaluate the occurrence and potential hazards associated with Chemicals of Emerging Concern (CECs). ...

  7. Novel effects-based monitoring approaches to evaluate chemicals of emerging concern in Great Lakes areas of concern

    Science.gov (United States)

    As part of an on-going program of research in support of the Great Lakes Restoration Initiative, we have been developing effects-based biomonitoring tools to evaluate the occurrence and potential hazards associated with Chemicals of Emerging Concern (CECs). Over three field seaso...

  8. Evaluation of three physiologically based pharmacokinetic (PBPK) modeling tools for emergency risk assessment after acute dichloromethane exposure

    NARCIS (Netherlands)

    Boerleider, R. Z.; Olie, J. D N; van Eijkeren, J. C H; Bos, P. M J; Hof, B. G H; de Vries, I.; Bessems, J. G M; Meulenbelt, J.; Hunault, C. C.

    2015-01-01

    Introduction: Physiologically based pharmacokinetic (PBPK) models may be useful in emergency risk assessment, after acute exposure to chemicals, such as dichloromethane (DCM). We evaluated the applicability of three PBPK models for human risk assessment following a single exposure to DCM: one model

  9. Radiology in emergency medicine

    International Nuclear Information System (INIS)

    Levy, R.; Barsan, W.G.

    1986-01-01

    This book gives a discussion of radiologic modalities currently being used in emergency situations. Radiographs, echocardiographs, radionuclide scans and CT scans are systematically analyzed and evaluated to provide a step-by-step diagnostic process for emergency physicians to follow when a radiologist is not present

  10. Evaluating the performance of the ORTECR DetectiveTM for emergency urine bioassay

    International Nuclear Information System (INIS)

    Li, C.; Ko, R.; Moodie, G.; Kramer, G. H.

    2011-01-01

    The performance of the ORTEC R Detective TM as a field deployable tool for emergency urine bioassay of 137 Cs, 60 Co, 192 Ir, 169 Yb and 75 Se was evaluated against ANSI N13.30. The tested activity levels represent 10 % RL (reference level) and 1 % RL defined by [Li C., Vlahovich S., Dai X., Richardson R. B., Daka J. N. and Kramer G. H. Requirements for radiation emergency urine bioassay techniques for the public and first responders. Health Phys (in press, 99(5), 702-707 (2010)]. The tests were conducted for both single radionuclide and mixed radionuclides at two geometries, one conventional geometry (CG) and one improved geometry (IG) which improved the MDAs (minimum detectable amounts) by a factor of 1.6-2.7. The most challenging radionuclide was 169 Yb. The measurement of the mixture radionuclides for 169 Yb at the CG did not satisfy the ANSI N13.30 requirements even at 10 % RL. At 1 % RL, 169 Yb and 192 Ir were not detectable at either geometry, while the measurement of 60 Co in the mixed radionuclides satisfied the ANSI N13.30 requirements only at the IG. (authors)

  11. Evaluating the effectiveness of burned area emergency response (BAER) efforts after the 2003 wildfires, southern California

    Science.gov (United States)

    Peter M. Wohlgemuth; Ken R. Hubbert; Jan L. Beyers; David R. Weise

    2007-01-01

    Wildfires burned approximately 300,000 hectares (750,000 acres) across southern California in the fall of 2003. Over 10 million dollars were spent on Burned Area Emergency Response (BAER) treatments following these fires. To support the BAER efforts, we designed a comprehensive strategy with standardized protocols to evaluate the effectiveness of various erosion...

  12. Bedside Ultrasound in the Emergency Department to Detect Hydronephrosis for the Evaluation of Suspected Ureteric Colic.

    Science.gov (United States)

    Shrestha, R; Shakya, R M; Khan A, A

    2016-01-01

    Background Renal colic is a common emergency department presentation. Hydronephrosis is indirect sign of urinary obstruction which may be due to obstructing ureteric calculus and can be detected easily by bedside ultrasound with minimal training. Objective To compare the accuracy of detection of hydronephrosis performed by the emergency physician with that of radiologist's in suspected renal colic cases. Method This was a prospective observational study performed over a period of 6 months. Patients >8 years with provisional diagnosis of renal colic with both the bedside ultrasound and the formal ultrasound performed were included. Presence of hydronephrosis in both ultrasounds and size and location of ureteric stone if present in formal ultrasound was recorded. The accuracy of the emergency physician detection of hydronephrosis was determined using the scan reported by the radiologists as the "gold standard" as computed tomography was unavailable. Statistical analysis was executed using SPSS 17.0. Result Among the 111 included patients, 56.7% had ureteric stone detected in formal ultrasound. The overall sensitivity, specificity, positive predictive value and negative predictive value of bedside ultrasound performed by emergency physician for detection of hydronephrosis with that of formal ultrasound performed by radiologist was 90.8%., 78.3%, 85.5% and 85.7% respectively. Bedside ultrasound and formal ultrasound both detected hydronephrosis more often in patients with larger stones and the difference was statistically significant (p=.000). Conclusion Bedside ultrasound can be potentially used as an important tool in detecting clinically significant hydronephrosis in emergency to evaluate suspected ureteric colic. Focused training in ultrasound could greatly improve the emergency management of these patients.

  13. Step Test: a method for evaluating maximum oxygen consumption to determine the ability kind of work among students of medical emergencies.

    Science.gov (United States)

    Heydari, Payam; Varmazyar, Sakineh; Nikpey, Ahmad; Variani, Ali Safari; Jafarvand, Mojtaba

    2017-03-01

    Maximum oxygen consumption shows the maximum oxygen rate of muscle oxygenation that is acceptable in many cases, to measure the fitness between person and the desired job. Given that medical emergencies are important, and difficult jobs in emergency situations require people with high physical ability and readiness for the job, the aim of this study was to evaluate the maximum oxygen consumption, to determine the ability of work type among students of medical emergencies in Qazvin in 2016. This study was a descriptive - analytical, and in cross-sectional type conducted among 36 volunteer students of medical emergencies in Qazvin in 2016. After necessary coordination for the implementation of the study, participants completed health questionnaires and demographic characteristics and then the participants were evaluated with step tests of American College of Sport Medicine (ACSM). Data analysis was done by SPSS version 18 and U-Mann-Whitney tests, Kruskal-Wallis and Pearson correlation coefficient. Average of maximum oxygen consumption of the participants was estimated 3.15±0.50 liters per minute. 91.7% of medical emergencies students were selected as appropriate in terms of maximum oxygen consumption and thus had the ability to do heavy and too heavy work. Average of maximum oxygen consumption evaluated by the U-Mann-Whitney test and Kruskal-Wallis, had significant relationship with age (p<0.05) and weight groups (p<0.001). There was a significant positive correlation between maximum oxygen consumption with weight and body mass index (p<0.001). The results of this study showed that demographic variables of weight and body mass index are the factors influencing the determination of maximum oxygen consumption, as most of the students had the ability to do heavy, and too heavy work. Therefore, people with ability to do average work are not suitable for medical emergency tasks.

  14. [Triage evaluation making in a pediatric emergency department of a tertiary hospital].

    Science.gov (United States)

    Pascual-Fernández, Ma Cristina; Ignacio-Cerro, Ma Carmen; Jiménez-Carrascosa, Ma Amalia

    2014-03-01

    Evaluation triage level assignments depending level of the professionals' education and experience in the unit. This was a retrospective and observational study to triages making from January to March 2012 in Pediatric Emergency Department of tertiary hospital in Madrid. The collection data included variables from Pediatric Canadian Triage with five levels, triage tool using in the unit. 6443 triages were evaluated. The most common mistakes was: not to register pain level, 1445 (22.4%); not to register hydration level, 377 (5.9%); principal symptoms inappropriate, 232 (3.6%). Didn't indicate pain level 140 (5.6%) nurses with 12 hour formal training on triage; 492 (14.5%) with training in the unit, and 92 (16.3%) without training in the last year (p hydration level 296 (7.7%). The triage education favors better adaptation in the triage assignment. The most common errors are: not to register level pain and hydration when it's needed for the principal symptoms.

  15. Prospect Evaluation as an Emerging Pre-Evaluation Technique in the Case of Great Plains Wheat Producers’ Use of Web 2.0

    Directory of Open Access Journals (Sweden)

    Nicholas R. Brown

    2016-06-01

    Full Text Available We introduce a pre-evaluation technique, prospect evaluation, in the case of Great Plains wheat producers’ practices with Web 2.0. We emerged prospect evaluation as a pre-evaluation technique, expanding the role of evaluative logic and reasoning into the ideation phase of project and product development to close the risk gap between project idea and implementation. Prospect evaluation serves as a prequel to the well-established developmental, formative, and summative evaluation models. We implemented the prospect evaluation technique in the context of iWheat, a USDA-funded Web 2.0 project (currently known as myFields, http://myfields.info/dashboard. Wheat producers were comfortable using computers; however, they conceptualized the Internet with a Web 1.0 mindset that depends on a centralized model of development and delivery of content. Wheat producers were not comfortable actively co-creating useful information for the betterment of community, a fundamental underpinning of Web 2.0 advancement. Extension specialists and educators should focus on the rewards of contributing to Web 2.0 sites and proceed in diffusing Web 2.0 tools to the wheat producers. Prospect evaluation was sufficient for helping project leaders bridge the risk gap and move forward with the project.

  16. Evaluation of Pediatric Forensic Cases in Emergency Department: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Tanzer Korkmaz

    2014-12-01

    Full Text Available Aim: Our aim was to evaluate the properties of pediatric forensic cases and to discuss the precautions in order to prevent the occurrence of these forensic events. Methods: The patient files and forensic reports of pediatric (age 0-18 years forensic cases, who were referred to the emergency department in our hospital between January 01, 2009 and December 31, 2011 were retrospectively investigated. Results: A total of 421 forensic pediatric cases with a median age of 9.9±5.5 years were included in the study. Off the cases, 61% (n=257 were male and 47.3% were in 5-14 age group. The type of the events were traffic accident (50.4%, fall (18.3%, stab injuries (10.9%, intoxication (5.9%, pounding (5.0% and other incidents (9.5%. There were nine cases of suicide attempt (all of them were above 14 years of age and four cases of physical abuse (three of them were under 15 years of age. After the observation period, 79.8% of the cases were discharged from the emergency department, whilst 20.2% of cases were hospitalized in one of the clinics. Conclusion: Because most of the cases were traffic accident, this situation show us that these injuries are preventable. Prevention and intervention strategies should be developed for providing a safe environment for children.

  17. Short communication: Evaluation of a model for predicting Avena fatua and Descurainia sophia seed emergence in winter rapeseed

    Directory of Open Access Journals (Sweden)

    Mohammad A. Aboutalebian

    2017-07-01

    Full Text Available Avena fatua and Descurainia sophia are two important annual weeds throughout winter rapeseed (Brassica napus L. production systems in the semiarid region of Iran. Timely and more accurate control of both species may be developed if there is a better understanding of its emergence patterns. Non-linear regression techniques are usually unable to accurately predict field emergence under such environmental conditions. The objectives of this research were to evaluate the emergence patterns of A. fatua and D. sophia and determine if emergence could be predicted using cumulative soil thermal time in degree days (CTT. In the present work, cumulative seedling emergence from a winter rapeseed field during 3 years data set was fitted to cumulative soil CTT using Weibull and Gompertz functions. The Weibull model provided a better fit, based on coefficient of determination (R2sqr, root mean square of error (RMSE and Akaike index (AICd, compared to the Gompertz model between 2013 and 2016 seasons for both species. Maximum emergence of A. fatua occured 70-119 days after sowing or after equals 329-426 °Cd, while in D. sophia it occurred 119-134 days after sowing rapeseed equals 373-470 °Cd. Both models can aid in the future study of A. fatua and D. sophia emergence and assist growers and agricultural professionals with planning timely and more accurate A. fatua and D. sophia control.

  18. Performance Evaluation of Terrestrial Emergency Communication System in NPPs

    International Nuclear Information System (INIS)

    Son, Gwang Sub; Kim, Chang Hwoi; Kang, Hyun Gook

    2014-01-01

    The Fukushima accident induced by the great earthquake and tsunami reveals the vulnerability of I and C System. In the severe environment, the normal I and C system did not work properly and results in false information about the internal situation in NPP. Eventually the accident was not properly handled at the early stage. Therefore advanced emergency response system using a wireless channel is necessary to cope with the severe accident. In this paper, we introduce the ERS consisting of the HMS and MCS the ECS linking the HMS with MCS and the performance requirement of the ECS is analyzed. The ECS satisfying the requirement is designed conceptually and the performance of the ECS is evaluated through analysis and simulator. The terrestrial communication system is designed based on the IEEE 802.11. Analyzed performance results prove that the performance requirement can be sufficiently achieved. But if the scalability of data capacity is considered later, use of the advanced 802.11 standard such as 802.11n and multiple signal paths between the HMS and MCS are necessary

  19. Performance Evaluation of Terrestrial Emergency Communication System in NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Son, Gwang Sub; Kim, Chang Hwoi; Kang, Hyun Gook [KAERI, Daejeon (Korea, Republic of)

    2014-08-15

    The Fukushima accident induced by the great earthquake and tsunami reveals the vulnerability of I and C System. In the severe environment, the normal I and C system did not work properly and results in false information about the internal situation in NPP. Eventually the accident was not properly handled at the early stage. Therefore advanced emergency response system using a wireless channel is necessary to cope with the severe accident. In this paper, we introduce the ERS consisting of the HMS and MCS the ECS linking the HMS with MCS and the performance requirement of the ECS is analyzed. The ECS satisfying the requirement is designed conceptually and the performance of the ECS is evaluated through analysis and simulator. The terrestrial communication system is designed based on the IEEE 802.11. Analyzed performance results prove that the performance requirement can be sufficiently achieved. But if the scalability of data capacity is considered later, use of the advanced 802.11 standard such as 802.11n and multiple signal paths between the HMS and MCS are necessary.

  20. Pramana – Journal of Physics | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    2015-07-26

    Jul 26, 2015 ... Dipartimento di Fisica, Università di Napoli “Federico II” and INFN, Complesso Universitario Monte Sant'Angelo, Via Cintia, Edificio 6, 80126, Napoli, Italy; Johannes Gutenberg-Universität Mainz, 55099 Mainz, Germany; Omsk State University, Mira prospekt 55-A, Omsk 644077, Russia; Laboratori ...

  1. Evaluation of a Tabletop Emergency Preparedness Exercise for Pharmacy Students

    OpenAIRE

    Pate, Adam; Bratberg, Jeffrey P.; Robertson, Courtney; Smith, Gregory

    2016-01-01

    Objective. To describe the implementation and effect of an emergency preparedness laboratory activity on student knowledge, willingness to participate in emergency preparedness training, current level of preparedness, and the importance of a pharmacist’s role in disaster response.

  2. Emergency contraception: why can't you give it away? Qualitative findings from an evaluation of advance provision of emergency contraception.

    Science.gov (United States)

    Fairhurst, Karen; Ziebland, Sue; Wyke, Sally; Seaman, Peter; Glasier, Anna

    2004-07-01

    The Lothian Emergency Contraception Project (LECP)--a primary care-based intervention to offer advance supplies of emergency contraception (EC) to women aged 16-29 was not associated with a reduction in abortion rates. We undertook case studies, utilizing qualitative and quantitative methods, to evaluate the intervention. In this article we present findings from qualitative interviews with 44 primary care professionals working at case study sites and 22 women who had received advance supplies to explain this failure. Professionals reported that women rarely asked for advance supplies of EC and they were reluctant to offer supplies to women because of concerns about contradictory sexual health messages implied by the offer, a perceived association of EC use with chaotic behavior by women, views about the sort of women suitable for advance supplies and practical difficulties making the offer. Women were reluctant to ask for advance supplies because of misgivings about the appropriateness of offering advance supplies to everybody and concerns about being judged by health professionals as morally inadequate. If advance provision of EC is to be successful in reducing abortion rates, professionals must address their concerns about EC and develop imaginative ways of encouraging women most at risk of unwanted pregnancy to take supplies home.

  3. [Out-of-hospital pediatric emergencies. Perception and assessment by emergency physicians].

    Science.gov (United States)

    Eich, C; Roessler, M; Timmermann, A; Heuer, J F; Gentkow, U; Albrecht, B; Russo, S G

    2009-09-01

    Out-of-hospital (OOH) pediatric emergencies have a relatively low prevalence. In Germany the vast majority of cases are attended by non-specialized emergency physicians (EPs) for whom these are not routine procedures. This may lead to insecurity and fear. However, it is unknown how EPs perceive and assess pediatric emergencies and how they could be better prepared for them. All active EPs (n=50) of the Department of Anaesthesiology, Emergency and Intensive Care Medicine at the University Medical Centre of Göttingen were presented with a structured questionnaire in order to evaluate their perception and assessment of OOH pediatric emergencies. The 43 participating EPs made highly detailed statements on the expected characteristics of OOH pediatric emergencies. Their confidence level grew with the children's age (pemergencies. They felt the greatest deficits were in the care of infrequent but life-threatening emergencies. Three educational groups can be differentiated: knowledge and skills to be gained with children in hospital, clinical experience from adult care also applicable in children and rare diagnoses and interventions to be trained with manikins or simulators.

  4. Evaluation of semi-generic PBTK modeling for emergency risk assessment after acute inhalation exposure to volatile hazardous chemicals

    NARCIS (Netherlands)

    Olie, J Daniël N; Bessems, Jos G; Clewell, Harvey J; Meulenbelt, Jan; Hunault, Claudine C

    BACKGROUND: Physiologically Based Toxicokinetic Models (PBTK) may facilitate emergency risk assessment after chemical incidents with inhalation exposure, but they are rarely used due to their relative complexity and skill requirements. We aimed to tackle this problem by evaluating a semi-generic

  5. Evaluation of semi-generic PBTK modeling for emergency risk assessment after acute inhalation exposure to volatile hazardous chemicals

    NARCIS (Netherlands)

    Olie, J. Daniël N; Bessems, Jos G.; Clewell, Harvey J.; Meulenbelt, Jan; Hunault, Claudine C.

    2015-01-01

    BACKGROUND: Physiologically Based Toxicokinetic Models (PBTK) may facilitate emergency risk assessment after chemical incidents with inhalation exposure, but they are rarely used due to their relative complexity and skill requirements. We aimed to tackle this problem by evaluating a semi-generic

  6. Evaluating cash benefits as real options for a commodity producer in an emerging market

    Directory of Open Access Journals (Sweden)

    Fernando Antonio Lucena Aiube

    2009-07-01

    Full Text Available The amount of cash a firm should maintain is an old problem tackled by finance literature. The recent advances in finance, mainly in the derivatives area, has opened the opportunity to revisit this subject. Cossin and Hricko (2004 studied the benefits of cash holdings using the Real Options approach. We follow their ideas extending the problem to a specific commodity producer firm in an emerging economy. We evaluate the benefits considering that raising capital takes time (timing benefit and also the benefit of avoiding the issue of securities at unfavorable moments (underpricing benefit. We use numerical procedures to solve the problem. Despite the fact that the results are not totally intuitive, we verify that the timing benefit is much more relevant than that of avoiding the underpricing benefit and that firms in emerging economies have greater advantage holding cash than those in developed economies. There is empirical evidence of this last result in the literature.

  7. Evaluation of emergency department nursing services and patient satisfaction of services.

    Science.gov (United States)

    Mollaoğlu, Mukadder; Çelik, Pelin

    2016-10-01

    To identify nursing services and assess patient satisfaction in patients who present to the emergency department. Emergency nursing care is a significant determinant of patient satisfaction. Patient satisfaction is often regarded as a reliable indicator of the quality of services provided in the emergency department. This is a descriptive study. Eighty-four patients who presented to the university emergency department were included in the study. The study data were collected by the Patient Information Form and the Satisfaction Level Form. Emergency nursing services, including history taking, assessing vital signs, preparing the patient for an emergency intervention, oxygen therapy, drug delivery and blood-serum infusion were shown to be more commonly provided compared with other services such as counselling the patients and the relatives about their care or delivering educational and psychosocial services. However, 78·6% of the patients were satisfied with their nursing services. The highest satisfaction rates were observed in the following sub-dimensions of the Satisfaction Level Form: availability of the nurse (82·1%), behaviour of the nurse towards the patient (78·6%) and the frequency of nursing rounds (77·4%). The most common practices performed by nurses in the emergency department were physical nursing services. Patient satisfaction was mostly associated with the availability of nurses when they were needed. Our results suggest that in addition to the physical care, patients should also receive education and psychosocial care in the emergency department. We believe that this study will contribute to the awareness and understanding of principles and concepts of emergency nursing, extend the limits of nursing knowledge and abilities, and improve and maintain the quality of clinical nursing education and practice to train specialist nurses with high levels of understanding in ethical, intellectual, administrative, investigative and professional issues.

  8. Evaluating nuclear power plant crew performance during emergency response drills

    International Nuclear Information System (INIS)

    Rabin, D.

    1999-01-01

    The Atomic Energy Control Board (AECB) is responsible for the regulation of the health, safety and environmental consequences of nuclear activities in Canada. Recently, the Human Factors Specialists of the AECB have become involved in the assessment of emergency preparedness and emergency response at nuclear facilities. One key contribution to existing AECB methodology is the introduction of Behaviourally Anchored Rating Scales (BARS) to measure crew interaction skills during emergency response drills. This report presents results of an on-going pilot study to determine if the BARS provide a reliable and valid means of rating the key dimensions of communications, openness, task coordination and adaptability under simulated emergency circumstances. To date, the objectivity of the BARS is supported by good inter-rater reliability while the validity of the BARS is supported by the agreement between ratings of crew interaction and qualitative and quantitative observations of crew performance. (author)

  9. Skin displacement analysis (SDA: a tool for the quantitative evaluation of skin movements elicited by underlying muscles in the face and neck area

    Directory of Open Access Journals (Sweden)

    Proebstle TM

    2011-04-01

    Full Text Available Thomas M ProebstleDepartment of Dermatology, University Clinic of Mainz, Mainz, GermanyBackground: Quantitative numerical analysis of skin displacement triggered by muscles inserting the overlaying skin would be useful for monitoring the inhibition of mimetic muscles.Methods: By using removable grid markings and digital photographs, skin displacement analysis (SDA was performed on 13 patients pre-treatment and on Days 1, 2, 3, and 7 after injection of 18 units of botulinum toxin type A (BoNT/A in the fronto-glabellar area.Results: At baseline, amplitudes of horizontal skin displacement with fronto-glabellar contraction showed a linear increase along the eyebrow laterally from the midline; mean values (±standard deviation [SD] 15 and 30 mm lateral to the midline were 3.2 ± 1.0 mm (range, 1.9–4.9 mm and 6.5 ± 1.4 mm (range 4.0–8.5 mm, respectively. After injection of BoNT/A, maximum horizontal skin displacement 30 mm lateral to the midline showed a mean reduction (±SD to 62% ± 23% at Day 2 and to 17% ± 16% at Day 7; corresponding values 15 mm lateral to the midline were 62% ± 29% and 15% ± 20%, respectively. In all cases, the reduction in horizontal skin displacement compared with pre-injection levels was statistically significant (P < 0.001.Conclusion: SDA is a feasible method for the quantitative evaluation of skin movements elicited by muscles inserting the overlaying skin in the face and neck area.Keywords: botulinum toxin type A, fronto-glabellar contraction, skin displacement analysis, glabellar lines

  10. Flight Simulator Evaluation of Enhanced Propulsion Control Modes for Emergency Operation

    Science.gov (United States)

    Litt, Jonathan, S; Sowers, T.; Owen, A., Karl; Fulton, Christopher, E.; Chicatelli, Amy, K.

    2012-01-01

    This paper describes piloted evaluation of enhanced propulsion control modes for emergency operation of aircraft. Fast Response and Overthrust modes were implemented to assess their ability to help avoid or mitigate potentially catastrophic situations, both on the ground and in flight. Tests were conducted to determine the reduction in takeoff distance achievable using the Overthrust mode. Also, improvements in Dutch roll damping, enabled by using yaw rate feedback to the engines to replace the function of a stuck rudder, were investigated. Finally, pilot workload and ability to handle the impaired aircraft on approach and landing were studied. The results showed that improvement in all aspects is possible with these enhanced propulsion control modes, but the way in which they are initiated and incorporated is important for pilot comfort and perceived benefit.

  11. Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation.

    Science.gov (United States)

    Harries, Bruce; Filiatrault, Lyne; Abu-Laban, Riyad B

    2018-05-30

    Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care. We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology. The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study. Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had this approach been used in the original study, insights regarding the benefits of nurse-initiated radiography using the OAR would have been achieved earlier, and thus potentially at a lower cost. In situations where the overarching aim is to accelerate implementation of practice improvement to benefit future patients, we believe that increased consideration should be given to the use of QI analytic methodology.

  12. Planning and preparedness for radiological emergencies at nuclear power stations

    International Nuclear Information System (INIS)

    Thomson, R.; Muzzarelli, J.

    1996-01-01

    The Radiological Emergency Preparedness (REP) Program was created after the March 1979 accident at the Three Mile Island nuclear power station. The Federal Emergency Management Agency (FEMA) assists state and local governments in reviewing and evaluating state and local REP plans and preparedness for accidents at nuclear power plants, in partnership with the US Nuclear Regulatory Commission (NRC), which evaluates safety and emergency preparedness at the power stations themselves. Argonne National Laboratory provides support and technical assistance to FEMA in evaluating nuclear power plant emergency response exercises, radiological emergency plans, and preparedness

  13. Universitaet Mainz, Institut fuer Kernchemie. Annual report 1998

    International Nuclear Information System (INIS)

    Denschlag, H.O.

    1999-03-01

    The annual report concentrates on three research activities of major interest: (1) Nuclear chemistry in the sense of approaches to fundamental problems which also relate to nuclear physics (nuclear fission, chemistry of the heaviest elements, excitation of giant dipole resonance, Halo nuclei, radiochemical astrophysics (structure of neutron-rich nuclei, prediction of half-lives and P n -values, elemental abundances), metal clusters in vacuum). (2) Radiopharmaceutical chemistry and applications in nuclear medicine (synthesis of radiopharmaceuticals using 3 H and 18 F, in vitro and in vivo evaluation of radiopharmaceuticals, diagnostics using PET, solid-state target systems, development and test of radiopharmaceuticals using isotopes of As, Y, Nb, Nd, and Re). (3) Environmental analysis (humic acid complexes of actinides and lanthanides, disintegration products of cellulose, ultratrace analysis using RIMS, determination of Th and U in the environment and in urine, AOX determination in waste waters, anthropogenic γ emitters in ground level air). (orig./CB) [de

  14. Recommended criteria for the evaluation of on-site nuclear power plant emergency plans, volume II: criteria

    International Nuclear Information System (INIS)

    1997-01-01

    A critical review of existing Canadian and international nuclear power plant (NPP) emergency plans, evaluation criteria, and approaches has been conducted to provide AECB staff with information which can be used to assess the adequacy of NPP on-site emergency response plans. The results of this work are published in two volumes. Volume I, Basis Document, provides the reasons why certain requirements are in place. It also gives comprehensive references to various standards.Volume II, Criteria, contains the criteria which relate to on-site actions and their integration with control room activities and the roles of off-site responsible organizations. The recommended criteria provide information on what is required, and not on how to accomplish the requirements. The licensees are given the latitude to decide on the methods and processes needed to meet the requirements. The documents do not address NPP off-site plans and response capability, or the control room emergency operating procedures and response capability. This report contains only Volume II: Criteria. 55 refs., 2 tabs., 1 fig

  15. Clinical Aspects and Emergent Management of Snake Bites Presented to Emergency Department

    Directory of Open Access Journals (Sweden)

    Bedriye Sonmez

    2014-03-01

    Full Text Available Aim: Evaluating the epidemiologic characteristics and management of snake bites presenting to emergency departments. Material and Method: In this retrospective study 74 cases of snakebites admitted to Emergency Department of Diyarbakir Training and Research Hospital between 2008 and 2009 were retrospectively evaluated. Results: Fourty-six (62.2% of patients were male and 28 (37.8% were female. Mean age of the study population was 34.85±19.17 (min 7- max 80 years. Most of the snakebites occurred between 18.00 to 06.00 hours and at home (73%. 79.7% of snake bites occurred to upper extremities. %93 of cases had intravenous administration of antivenin (one dose. Neither none of the patients needed recurrent administration. Discussion: Snake bites are still a major public health problem especially in rural areas. Particularly emergency care physicians should be adequately capable and sophisticated in multidisciplinary management of snake bites.

  16. Operative characteristics of rest myocardial perfusion in emergency thoracic pain evaluation

    International Nuclear Information System (INIS)

    Merlano G, Sonia; Murgueitio C, Ramon; Rodriguez F, Edgard; Carvajal C, Andres; Suarez R, Martin

    2000-01-01

    Study objective: Conventional emergency department testing strategies for patients with chest pain often provide equivocal diagnosis of coronary artery disease. This study was conducted to determine the sensibility, specificity , positive predictive value (PPV), negative predictive value (NPV) and Likelihood ratio LR(-) of the myocardial perfusion imaging with single photon emission computed tomography (SPECT) imaging at rest. Methods: We design a diagnostic imaging protocol to evaluate clinical usefulness of SPECT Technetium sestamibi imaging at rest in patients with typical and atypical chest pain and normal or non diagnostic electrocardiogram. Coronary angiogram was the gold standard for positive studies and six month follow up after completing the exercise test for negatives. Nuclear Medicine physicians were unaware of the angiograms results. The inter observers variability was measure with a Kappa coefficient. Results: We enrolled 107 patients 78 males (72.8%) and 29 females (27.2%). We found sensitivity 95.45% (IC 95% 95.41-95.48), specificity 92.94%(IC 95% 92.9- 92.98) Negative predictive value 98.75% LR(-) 0.092 . The study adequately classified 93% of the patients. Kappa coefficient for concordance between observer was 0.95 Conclusion: Myocardial perfusion imaging with SPECT at rest, has a high negative predictive value and a very good ability to classify normal patients as such and therefore may be use for the assessment of patients with chest pain and normal or non diagnostic electrocardiograms at the emergency room (Au)

  17. Non-traumatic limping in Paediatric Emergencies: Epidemiology, evaluation and results.

    Science.gov (United States)

    Lázaro Carreño, M I; Fraile Currius, R; García Clemente, A

    Non-traumatic limping is a common reason for consultation in paediatric emergencies. Although transient synovitis of the hip (TS) is the most frequent diagnosis, there are cases of limping secondary to serious pathologies. The aim of this review is to describe the variables related to non-traumatic limp that come to the paediatric emergency department to establish the best management protocol, making the most of resources and speeding up emergency care. A prospective study was conducted, selecting all children less than 15 years old who consulted aspaediatric emergencies for non-traumatic limping during the 2014. Clinical variables, complementary examinations and diagnoses were collected in the emergency room consultation and 6 months after the consultation RESULTS: During 2014, 146 patients (0.69% of the emergencies) were included in the non-traumatic limping study. Four cases of severe limping were diagnosed: 2 leukaemias, 1 septic arthritis and 1 acetabular bone tumour. The most frequent diagnosis was TS (53.16%). At 6 months, 135 children (92.4%) had resolved lameness. The diagnosis was changed in 9 children (6.1%). Children with TS had fewer days of evolution, and 77% were between 3 and 10 years old. Children with a final diagnosis of severe pathology had a limp for longer, fever and did not weight bear on ambulation. In limping of probable hip origin, at the ages of between 3 and 10, without fever or systemic symptoms and of less than one week's onset, it is possible to make a clinical diagnosis of TS limiting the use of complementary examinations. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Emergence delirium

    DEFF Research Database (Denmark)

    Munk, Louise; Andersen, Lars Peter Holst; Gögenur, Ismail

    2013-01-01

    Emergence delirium (ED) is a well-known phenomenon in the postoperative period. However, the literature concerning this clinical problem is limited. This review evaluates the literature with respect to epidemiology and risk factors. Treatment strategies are discussed. The review concludes...

  19. Inspection of Emergency Arrangements

    International Nuclear Information System (INIS)

    2013-01-01

    The Working Group on Inspection Practices (WGIP) was tasked by the NEA CNRA to examine and evaluate the extent to which emergency arrangements are inspected and to identify areas of importance for the development of good inspection practices. WGIP members shared their approaches to the inspection of emergency arrangements by the use of questionnaires, which were developed from the requirements set out in IAEA Safety Standards. Detailed responses to the questionnaires from WGIP member countries have been compiled and are presented in the appendix to this report. The following commendable practices have been drawn from the completed questionnaires and views provided by WGIP members: - RBs and their Inspectors have sufficient knowledge and information regarding operator's arrangements for the preparedness and response to nuclear emergencies, to enable authoritative advice to be given to the national coordinating authority, where necessary. - Inspectors check that the operator's response to a nuclear emergency is adequately integrated with relevant response organisations. - Inspectors pay attention to consider the integration of the operator's response to safety and security threats. - The efficiency of international relations is checked in depth during some exercises (e.g. early warning, assistance and technical information), especially for near-border facilities that could lead to an emergency response abroad. - RB inspection programmes consider the adequacy of arrangements for emergency preparedness and response to multi-unit accidents. - RBs assess the adequacy of arrangements to respond to accidents in other countries. - The RB's role is adequately documented and communicated to all agencies taking part in the response to a nuclear or radiological emergency. - Inspectors check that threat assessments for NPPs have been undertaken in accordance with national requirements and that up-to-date assessments have been used as the basis for developing emergency plans for

  20. Ultrasonography in abdominal emergencies

    International Nuclear Information System (INIS)

    Risi, D.; Alessi, G.; Meli, C.; Marzano, M.; Fiori, E.; Caterino, S.

    1989-01-01

    From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 post-operative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the affidability of ultrasonography in abdominal emergencies, as shown in literature

  1. Three-year emergency medicine training program in The Netherlands: first evaluation from the residents' perspective.

    Science.gov (United States)

    Koning, Salomon Willem; Gaakeer, Menno Iskander; Veugelers, Rebekka

    2013-07-26

    The Netherlands' 3-year training in Emergency Medicine (EM) was formally approved and introduced in November 2008. To identify areas for improvement, we conducted the first evaluation of this curriculum from the residents' perspective. A questionnaire was composed on ten aspects of the curriculum. It contained multiple-choice, open and opinion questions; answers to the latter were classified using the Likert scale. The questionnaires were mailed to all enrolled residents. We mailed questionnaires to all 189 enrolled residents, and 105 responded (55.6%). Although they were satisfied with their training overall, 96.2% thought it was currently too short: 18.3% desired extension to 4 years, 76.0% to 5 and 1.9% to 6 years. Nevertheless, residents expected that they would function effectively as emergency physicians (EPs) after finishing their 3-year training program. Bedside teaching was assessed positively by 35.2%. All rotations were assessed positively, with the general practice rotation seen as contributing the least to the program. According to 43.7%, supervising EPs were available for consultation; 40.7% thought that, in a clinical capacity, the EP was sufficiently present during residents' shifts. When EPs were present, 82.5% found them to be easily accessible, and 66.6% viewed them as role models. In the Emergency Medicine Departments (EDs) with a higher number of EPs employed, residents tended to perceive better supervision and were more likely to see their EPs as role models. While residents were stimulated to do research, actual support and assistance needed to be improved. Although overall, the current training program was evaluated positively, the residents identified four areas for improvement: (1) in training hospitals, trained EPs should be present more continuously for clinical supervision; (2) bedside teaching should be improved, (3) scientific research should be facilitated more and (4) the training program should be extended.

  2. A Sample of Crisis Management in the Emergency Department and Evaluation of Patients; Reyhanli-Hatay-Turkey Experience

    Directory of Open Access Journals (Sweden)

    Ali Karakus

    2014-04-01

    Full Text Available Aim: Natural disasters, terrorist bombings, transportation and industrial accidents can lead to many deaths and injuries. The number of deaths and injuries in these situations are closely related to cooperation among police, fire fighters, ambulances and hospital staff. Practice and organized positioning can improve such cooperation and experiences. In this study, we aimed to investigate the medical situation of the patients admitted to our hospital emergency service after the terrorist bombing attack occurred on Saturday May 11th, 2013 at about 14:00 pm in the Reyhanli province and to evaluate our hospital applications. Material and Method: Data including gender, age, Glascow Coma Scale score, Injury Severity Score-ISS , K-Revise Trauma Score(RTS, type of transportation and injury, duration of treatment and prognosis of the patients injured after the explosion were collected retrospectively from the hospital records. Results: The terrorist bombing attack was the bloodiest event in the history of the Republic of Turkey. After the explosion, 51 people died. 27 of the 146 injured patients were admitted to our hospital. 20 of them were male and 7 were female. The mean age of the patients was 31,85 (1-63. Glascow Coma Scale scores were 3-8 for 3 patients, 9-13 for 6 patients and 14-15 for 18 patients. The most frequent injuries were observed in the extremities and soft tissues. 15 patients were discharged after their treatment and 9 patients were hospitalized by different services related to their medical conditions. Three patients died in the emergency department. The size of the event and the number of injured patients were evaluated by the doctors in charge in emergency service and the 112 paramedics. Then, other relevant doctors, administrative officers and health care staffs were instructed and called to the hospital. Appropriately triaged, monitored and treated patients were resulted after evaluating their conditions. Discussion: The soft

  3. Users' experiences of an emergency department patient admission predictive tool: A qualitative evaluation.

    Science.gov (United States)

    Jessup, Melanie; Crilly, Julia; Boyle, Justin; Wallis, Marianne; Lind, James; Green, David; Fitzgerald, Gerard

    2016-09-01

    Emergency department overcrowding is an increasing issue impacting patients, staff and quality of care, resulting in poor patient and system outcomes. In order to facilitate better management of emergency department resources, a patient admission predictive tool was developed and implemented. Evaluation of the tool's accuracy and efficacy was complemented with a qualitative component that explicated the experiences of users and its impact upon their management strategies, and is the focus of this article. Semi-structured interviews were conducted with 15 pertinent users, including bed managers, after-hours managers, specialty department heads, nurse unit managers and hospital executives. Analysis realised dynamics of accuracy, facilitating communication and enabling group decision-making Users generally welcomed the enhanced potential to predict and plan following the incorporation of the patient admission predictive tool into their daily and weekly decision-making processes. They offered astute feedback with regard to their responses when faced with issues of capacity and communication. Participants reported an growing confidence in making informed decisions in a cultural context that is continually moving from reactive to proactive. This information will inform further patient admission predictive tool development specifically and implementation processes generally. © The Author(s) 2015.

  4. Evaluation of pharmacists' services for dispensing emergency contraceptive pills in Delhi, India: A mystery shopper study

    Directory of Open Access Journals (Sweden)

    Pikee Saxena

    2016-01-01

    Full Text Available Background: Although emergency contraceptive pills are available over the counter, the quality of consultation, including key areas of contraceptive counseling and prevention of sexually transmitted infections (STI, has not been well documented. Objective: To evaluate actual pharmacist services while dispensing emergency contraception through a mystery shopper technique. Material and Methods: This cross-sectional study was conducted in 81 pharmacies situated in Delhi by 4 trained mystery shoppers posed as customers over a period of 6 months. Results: None of the pharmacists asked about the time lapsed since last unprotected sexual intercourse or last menstrual period before deciding the eligibility of the customer. The majority were unclear about side effects associated with emergency contraception (78.57% or with anticipated changes in menstrual flow (78.57%; 85.71% did not know whether subsequent unprotected intercourse would be protected. Only 15.71% counseled shoppers regarding risk of STI on asking leading questions and 88.5% did not provide any contraceptive advice. Conclusion: There is a huge gap in the technical knowledge and mindset of the pharmacists when it comes to checking for the eligibility of the client and providing advice regarding use of regular contraception and barrier for protection from STI, which needs to be addressed in order to realize the full benefit of making emergency contraceptive pills available over the counter.

  5. Emerging technologies in healthcare: navigating risks, evaluating rewards.

    Science.gov (United States)

    McGrady, Elizabeth; Conger, Sue; Blanke, Sandra; Landry, Brett J L

    2010-01-01

    The purpose of this prescriptive research is to help decision makers become better informed about three technologies emerging in the healthcare arena by providing a basic description of the technology and describing their current applications, future healthcare deployment, potential risks, and related managerial issues. Two of the technologies, radio frequency identification (RFID) and global positioning systems (GPS), are currently available to healthcare organizations and appear capable of decreasing cost but may require significant initial investment and have disruptive potential. The third technology, nanotechnology, has limited current use but may revolutionize both the delivery of medicine and hospital infrastructure management. With cautious attention to managerial issues and meticulous attention to implementation details, healthcare organizations that can successfully navigate the coming technologically driven paradigm shifts will emerge more resilient organizations.

  6. Multidisciplinary evaluation of an emergency department nurse navigator role: A mixed methods study.

    Science.gov (United States)

    Jessup, Melanie; Fulbrook, Paul; Kinnear, Frances B

    2017-09-20

    To utilise multidisciplinary staff feedback to assess their perceptions of a novel emergency department nurse navigator role and to understand the impact of the role on the department. Prolonged emergency department stays impact patients, staff and quality of care, and are linked to increased morbidity and mortality. One innovative strategy to facilitate patient flow is the navigator: a nurse supporting staff in care delivery to enhance efficient, timely movement of patients through the department. However, there is a lack of rigorous research into this emerging role. Sequential exploratory mixed methods. A supernumerary emergency department nurse navigator was implemented week-off-week-on, seven days a week for 20 weeks. Diaries, focus groups, and an online survey (24-item Navigator Role Evaluation tool) were used to collect and synthesise data from the perspectives of multidisciplinary departmental staff. Thematic content analysis of cumulative qualitative data drawn from the navigators' diaries, focus groups and survey revealed iterative processes of the navigators growing into the role and staff incorporating the role into departmental flow, manifested as: Reception of the role and relationships with staff; Defining the role; and Assimilation of the role. Statistical analysis of survey data revealed overall staff satisfaction with the role. Physicians, nurses and others assessed it similarly. However, only 44% felt the role was an overall success, less than half (44%) considered it necessary, and just over a third (38%) thought it positively impacted inter-professional relationships. Investigation of individual items revealed several areas of uncertainty about the role. Within-group differences between nursing grades were noted, junior nurses rating the role significantly higher than more senior nurses. Staff input yielded invaluable insider feedback for ensuing modification and optimal instigation of the navigator role, rendering a sense of departmental

  7. Guardian availability in children evaluated in the emergency department for blunt head trauma.

    Science.gov (United States)

    Holmes, James F; Holubkov, Richard; Kuppermann, Nathan

    2009-01-01

    Enrolling children in research studies in the emergency department (ED) is typically dependent on the presence of a guardian to provide written informed consent. The objectives were to determine the rate of guardian availability during the initial ED evaluation of children with nontrivial blunt head trauma, to identify the reasons why a guardian is unavailable, and to compare clinical factors in patients with and without a guardian present during initial ED evaluation. This was a prospective study of children (guardian during the initial ED evaluation. For those children for whom the guardian was not available during the initial ED evaluation, the physicians completing the data forms documented the reasons for the absence. The authors enrolled 602 patients, of whom 271 (45%, 95% confidence interval [CI] = 41% to 49%) did not have a guardian available during the initial ED evaluation. In these 271 patients, 261 had reasons documented for lack of guardian availability, 43 of whom had multiple reasons. The most common of these was that the guardian did not ride in the ambulance (51%). Those patients without a guardian available were more likely to be older (mean age, 11.4 years vs. 7.6 years; p guardian presence. Nearly one-half of children with nontrivial blunt head trauma evaluated in the ED may not have a guardian available during their initial ED evaluation. Patients whose guardians are not available at the time of initial ED evaluation are older and have more severe mechanisms of injury and more serious head trauma. ED research studies of pediatric trauma patients that require written informed consent from a guardian at the time of initial ED evaluation and treatment may have difficulty enrolling targeted sample size numbers and will likely be limited by enrollment bias.

  8. Educational program emergency planning.

    Science.gov (United States)

    Curtis, Tammy

    2009-01-01

    Tragic university shootings have prompted administrators of higher education institutions to re-evaluate their emergency preparedness plans and take appropriate measures for preventing and responding to emergencies. To review the literature and identify key components needed to prevent shootings at higher education institutions in the United States, and in particular, institutions housing radiologic science programs. Twenty-eight emergency preparedness plans were retrieved electronically and reviewed from a convenience sample of accredited radiologic science programs provided by the Joint Review Committee on Education in Radiologic Technology Web site. The review of the 28 emergency preparedness plans confirmed that most colleges are prepared for basic emergencies, but lack the key components needed to successfully address mass-casualty events. Only 5 (18%) of the 28 institutions addressed policies concerning school shootings.

  9. Severe accident modeling and offsite dose consequence evaluations for nuclear power plant emergency planning

    Energy Technology Data Exchange (ETDEWEB)

    Chen, S.H.; Feng, T.S.; Huang, K.C. [National Tsing-Hua Univ., Hsinchu, Taiwan (China); Wang, J.R. [Inst. of Nuclear Energy Research, Longtan, Taiwan (China); Cheng, Y.H. [Industrial Tech. Res. Inst., Hsinchu, Taiwan (China); Shih, C., E-mail: ckshih@ess.nthu.edu.tw [National Tsing-Hua Univ., Hsinchu, Taiwan (China)

    2011-07-01

    We have investigated the roles of Firewater Addition System and Passive Flooder in ABWR severe accidents, such as LOCA and SBO. The results are apparent that Firewater System is vital in the highly unlikely situation where all AC are lost. Also in this paper, we present EPZDose, an effective and faster-than-real time code for offsite dose consequences predictions and evaluations. Illustrations with the release from our severe accident scenario show friendly and informative user's interface for supporting decision makings in nuclear emergency situations. (author)

  10. Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol.

    Science.gov (United States)

    Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

    2013-01-01

    Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. This protocol has been approved by the CSSS Alphonse-Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

  11. Regulatory aspects of emergency planning

    International Nuclear Information System (INIS)

    Jamgochian, M.T.

    1986-01-01

    The paper discusses the advances that have been made in the USA in the field of emergency planning over the past several years and considers regulatory changes that may be on the horizon. The paper examines the importance of severe accident source terms and their relationship to emergency preparedness, recent research results of work on source terms, and the experience gained from evaluation of licensee performance during annual emergency preparedness exercises. (author)

  12. Using artificial intelligence and web media data to evaluate the growth potential of companies in emerging industry sectors

    DEFF Research Database (Denmark)

    Tanev, Stoyan; Droll, Andrew; Khan, Shahzad

    2017-01-01

    In this article, we describe our efforts to adapt and validate a web search and analytics tool – the Gnowit Cognitive Insight Engine – to evaluate the growth and competitive potential of new technology startups and existing firms in the newly emerging precision medicine sector. The results are ba...

  13. The BWR [Boiling Water Reactor] Emergency Operating Procedures Tracking System (EOPTS): Evaluation by control-room operating crews

    International Nuclear Information System (INIS)

    Spurgin, A.J.; Orvis, D.D.; Spurgin, J.P.; Luna, C.J.

    1990-05-01

    This report presents the results of a project sponsored by the Electric Power Research Institute (EPRI) and Taiwan Power Company (TPC) and conducted by APG and TPC to perform evaluation of the Emergency Operating Procedures Tracking System (EOPTS). The EOPTS is an expert system employing artificial intelligence techniques developed by EPRI for Boiling Water Reactor (BWR) plants based on emergency operating procedures (EOPs). EOPTS is a computerized decision aid used to assist plant operators in efficient and reliable use of EOPs. The main objective of this project was to evaluate the EOPTS and determine how an operator aid of this type could noticeably improve the response time and the reliability of control room crews to multi-failure scenarios. A secondary objective was to collect data on how crew performance was affected. Experiments results indicate that the EOPTS measurably improves crew performance over crews using the EOP flow charts. Time-comparison measurements indicate that crews using the EOPTS perform required actions more quickly than do those using the flowcharts. The results indicate that crews using the EOPTS are not only faster and more consistent in their actions but make fewer errors. In addition, they have a higher likelihood of recovering from the errors that they do make. Use of the EOPTS in the control room should result in faster termination and mitigation of accidents and reduced risk of power plant operations. Recommendations are made towards possible applications of the EOPTS to operator training and evaluation, and for the applicability of the evaluation methodology developed for this project to the evaluation of similar operator aides. 17 refs., 14 figs., 14 tabs

  14. Radiological evaluation of surgical emergencies in neonate

    International Nuclear Information System (INIS)

    Suh, C. O.; Oh, K. K.; Park, C. Y.

    1980-01-01

    Most pathologic conditions requiring emergent operation in neonate are congenital anomalies and delayed diagnosis and associated anomaly are important factors which have contributed to the high mortality rate of congenital anomalies. To prevent this delay, early recognition of the danger signals, adequate roentagenologic examination and accurate diagnosis should be made. Furthermore radiologists should be aware of developing mechanism, clinical manifestations and roentgenographic findings of those neonatal emergencies. 135 cases of neonatal emergencies were analyzed at this point of view, which verified by surgery and pathologic examination at Yonsei University College of Medicine, Severance Hospital since 1968. Embryology and characteristic roentgenographic pictures of each disease were discussed. The conclusions are as follows; 1. Most cases (110/135) presented intestinal obstruction. Imperforate anus (29 cases) was most common disease which followed by infantile hypertrophic pyloric stenosis (25 cases), small bowel atresia and stenosis (18 cases), congenital megacolon (15 cases) and esophageal atresia (14 cases). 2. Clinical Type and time of occurrence of symptoms and signs were so characteristic that these were helpful for differential diagnosis. 3. In infantile hypertrophic pyloric stenosis, confirmative diagnosis could be made in plain abdominal film, when 'Caterpillar sign' was seen. 4. When small bowel obstruction was suspected in plain abdominal film, barium enema examination was more helpful than upper G-I study. When microcolon was found, lower small bowel obstruction was highly suggested. 5. Diagnosis of midgut malrotation was possible in larger cases (4/7). Upper G-I examination was more valuable than barium enema study, because duodenal obstruction due to Ladd's band was common problem in neonate. 6. In neonatal period, diagnosis of aganglionosis could be made with the finding of barium stasis on 24-48 hours delay film, even though no demonstration of

  15. Evaluation of the effectiveness of peer pressure to change disposition decisions and patient throughput by emergency physician.

    Science.gov (United States)

    Wu, Kuan-Han; Cheng, Fu-Jen; Li, Chao-Jui; Cheng, Hsien-Hung; Lee, Wen-Huei; Lee, Chi-Wei

    2013-03-01

    The aim of this study was to develop a strategy for imposing peer pressure on emergency physicians to discharge patients and to evaluate patient throughput before and after intervention. A before-and-after study was conducted in a medical center with more than 120 000 annual emergency department (ED) visits. All nontraumatic adult patients who presented to the ED between 7:30 and 11:30 am Wednesday to Sunday were reviewed. We created a "team norm" imposed peer-pressure effect by announcing the patient discharge rate of each emergency physician through monthly e-mail reminders. Emergency department length of stay (LOS) and 8-hour (the end of shift) and final disposition of patients before (June 1, 2011-September 30, 2011) and after (October 1, 2011-January 30, 2012) intervention were compared. Patients enrolled before and after intervention totaled 3305 and 2945. No differences existed for age, sex, or average number of patient visits per shift. The 8-hour discharge rate increased significantly for all patients (53.5% vs 48.2%, P peer pressure to enhance patient flow and throughput. More patients were discharged at the end of shifts, particularly triage level III patients. The ED LOS for patients whose final disposition was discharge decreased significantly. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Does the emergency surgery score accurately predict outcomes in emergent laparotomies?

    Science.gov (United States)

    Peponis, Thomas; Bohnen, Jordan D; Sangji, Naveen F; Nandan, Anirudh R; Han, Kelsey; Lee, Jarone; Yeh, D Dante; de Moya, Marc A; Velmahos, George C; Chang, David C; Kaafarani, Haytham M A

    2017-08-01

    The emergency surgery score is a mortality-risk calculator for emergency general operation patients. We sought to examine whether the emergency surgery score predicts 30-day morbidity and mortality in a high-risk group of patients undergoing emergent laparotomy. Using the 2011-2012 American College of Surgeons National Surgical Quality Improvement Program database, we identified all patients who underwent emergent laparotomy using (1) the American College of Surgeons National Surgical Quality Improvement Program definition of "emergent," and (2) all Current Procedural Terminology codes denoting a laparotomy, excluding aortic aneurysm rupture. Multivariable logistic regression analyses were performed to measure the correlation (c-statistic) between the emergency surgery score and (1) 30-day mortality, and (2) 30-day morbidity after emergent laparotomy. As sensitivity analyses, the correlation between the emergency surgery score and 30-day mortality was also evaluated in prespecified subgroups based on Current Procedural Terminology codes. A total of 26,410 emergent laparotomy patients were included. Thirty-day mortality and morbidity were 10.2% and 43.8%, respectively. The emergency surgery score correlated well with mortality (c-statistic = 0.84); scores of 1, 11, and 22 correlated with mortalities of 0.4%, 39%, and 100%, respectively. Similarly, the emergency surgery score correlated well with morbidity (c-statistic = 0.74); scores of 0, 7, and 11 correlated with complication rates of 13%, 58%, and 79%, respectively. The morbidity rates plateaued for scores higher than 11. Sensitivity analyses demonstrated that the emergency surgery score effectively predicts mortality in patients undergoing emergent (1) splenic, (2) gastroduodenal, (3) intestinal, (4) hepatobiliary, or (5) incarcerated ventral hernia operation. The emergency surgery score accurately predicts outcomes in all types of emergent laparotomy patients and may prove valuable as a bedside decision

  17. Emergency department discharge prescription interventions by emergency medicine pharmacists.

    Science.gov (United States)

    Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

    2013-02-01

    We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

  18. The Effect of Emergency Department Overcrowding on Efficiency of Emergency Medicine Residents’ Education

    Directory of Open Access Journals (Sweden)

    Anita Sabzghabaei

    2014-09-01

    Full Text Available Introduction: Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding (EDO on the training of emergency medicine residents (EMR is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR’s education. Methods: In this cross-sectional study, the effects of overcrowding on EMR’s education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs.  The crowding level was calculated based on the national emergency department overcrowding scale (NEDOCS. The relationship between the two studied variables was evaluated using independent sample t-test and SPSS 21 statistical software. Results: 130 questionnaires were filled out during 61 shifts. 47 (77.05% shifts were overcrowded. The attend’s ability to teach was not affected by overcrowding in the resuscitation room (p=0.008. The similar results were seen regarding the attend’s training ability in the acute care unit. Conclusion: It seems that the emergency department overcrowding has no effect on the quality of education to the EMRs.

  19. Accident and emergency management

    International Nuclear Information System (INIS)

    Andersen, V.; Moellenbach, K.; Heinonen, R.; Jakobsson, S.; Kukko, T.; Berg, Oe.; Larsen, J.S.; Westgaard, T.; Magnusson, B.; Andersson, H.; Holmstroem, C.; Brehmer, B.; Allard, R.

    1988-06-01

    There is an increasing potential for severe accidents as the industrial development tends towards large, centralised production units. In several industries this has led to the formation of large organisations which are prepared for accidents fighting and for emergency management. The functioning of these organisations critically depends upon efficient decision making and exchange of information. This project is aimed at securing and possibly improving the functionality and efficiency of the accident and emergency management by verifying, demonstrating, and validating the possible use of advanced information technology in the organisations mentioned above. With the nuclear industry in focus the project consists of five main activities: 1) The study and detailed analysis of accident and emergency scenarios based on records from incidents and rills in nuclear installations. 2) Development of a conceptual understanding of accident and emergency management with emphasis on distributed decision making, information flow, and control structure sthat are involved. 3) Development of a general experimental methodology for evaluating the effects of different kinds of decision aids and forms of organisation for emergency management systems with distributed decision making. 4) Development and test of a prototype system for a limited part of an accident and emergency organisation to demonstrate the potential use of computer and communication systems, data-base and knowledge base technology, and applications of expert systems and methods used in artificial intelligence. 5) Production of guidelines for the introduction of advanced information technology in the organisations based on evaluation and validation of the prototype system. (author)

  20. First-trimester emergencies: a radiologist's perspective.

    Science.gov (United States)

    Phillips, Catherine H; Wortman, Jeremy R; Ginsburg, Elizabeth S; Sodickson, Aaron D; Doubilet, Peter M; Khurana, Bharti

    2018-02-01

    The purpose of this article is to help the practitioner ensure early diagnosis and response to emergencies in the first trimester by reviewing anatomy of the developing embryo, highlighting the sonographic appearance of common first-trimester emergencies, and discussing key management pathways for treating emergent cases. First-trimester fetal development is a stepwise process that can be challenging to evaluate in the emergency department (ED) setting. This is due, in part, to the complex anatomy of early pregnancy, subtlety of the sonographic findings, and the fact that fewer than half of patients with ectopic pregnancy present with the classic clinical findings of a positive pregnancy test, vaginal bleeding, pelvic pain, and tender adnexa. Ultrasound (US) has been the primary approach to diagnostic imaging of first-trimester emergencies, with magnetic resonance imaging (MRI) and computed tomography (CT) playing a supportive role in a small minority of cases. Familiarity with the sonographic findings diagnostic of and suspicious for early pregnancy failure, ectopic pregnancy, retained products of conception, gestational trophoblastic disease, failed intrauterine devices, and complications associated with assisted reproductive technology (ART) is critical for any emergency radiologist. Evaluation of first-trimester emergencies is challenging, and knowledge of key imaging findings and familiarity with management pathways are needed to ensure early diagnosis and response.

  1. Evaluation of staff cultural awareness before and after attending cultural awareness training in an Australian emergency department.

    Science.gov (United States)

    Chapman, Rose; Martin, Catherine; Smith, Tammy

    2014-10-01

    Cultural awareness of emergency department staff is important to ensure delivery of appropriate health care to people from all ethnic groups. Cultural awareness training has been found to increase knowledge about other cultures and is widely used as a means of educating staff, however, debate continues as to the effectiveness of these programs. To determine if an accredited cultural awareness training program affected emergency department staff knowledge, familiarity, attitude of and perception towards Australian Aboriginal and Torres Strait Islander people. One group pre-test and post-test intervention study compared the cultural awareness of 44 emergency department staff towards Aboriginal and Torres Strait Islander people before and after training. The cultural awareness training was delivered in six hours over three sessions and was taught by an accredited cultural awareness trainer. The cultural awareness training changed perception but did not affect attitude towards Aboriginal and Torres Strait Islander people in this group. Future strategies to improve staff cultural awareness need to be investigated, developed, implemented and evaluated. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. The prehospital emergency care system in Mexico City: a system's performance evaluation.

    Science.gov (United States)

    Peralta, Luis Mauricio Pinet

    2006-01-01

    Mexico City has one of the highest mortality rates in Mexico, with non-intentional injuries as a leading cause of death among persons 1-44 years of age. Emergency medical services (EMS) in Mexico can achieve high levels of efficiency by offering high quality medical care at a low cost through adequate system design. The objective of this study was to determine whether the prehospital EMS system in Mexico City meets the criteria standards established by the American Ambulance Association Guide for Contracting Emergency Medical Services (AAA Guide) for highly efficient EMS systems. This retrospective, descriptive study, evaluated the structure of Mexico City's EMS system and analyzed EMS response times, clinical capacity, economic efficiency, and customer satisfaction. These results were compared with the AAA guide, according to the soc ial, economic, and political context in Mexico. This paper describes the healthcare system structure in Mexico, followed by a description of the basic structure of EMS in Mexico City, and of each tenet described in the AAA guide. The p aper includesdata obtained from official documents and databases of government agencies, and operative and administrative data from public and private EMS providers. The quality of the data for response times (RT) were insufficient and widely varied among providers, with a minimum RT of 6.79 minutes (min) and a maximum RT of 61 min. Providers did not define RT clearly, and measured it with averages, which can hide potentially poor performance practices. Training institutions are not required to follow a standardized curriculum. Certifications are the responsibility of the individual training centers and have no government regulation. There was no evidence of active medical control involvement in direct patient care, and providers did not report that quality assurance programs were in place. There also are limited career advancement opportunities for EMS personnel. Small economies of scale may not allow

  3. Neurologic emergencies in sports.

    Science.gov (United States)

    Williams, Vernon B

    2014-12-01

    Sports neurology is an emerging area of subspecialty. Neurologists and non-neurologists evaluating and managing individuals participating in sports will encounter emergencies that directly or indirectly involve the nervous system. Since the primary specialty of sports medicine physicians and other practitioners involved in the delivery of medical care to athletes in emergency situations varies significantly, experience in recognition and management of neurologic emergencies in sports will vary as well. This article provides a review of information and elements essential to neurologic emergencies in sports for the practicing neurologist, although content may be of benefit to readers of varying background and expertise. Both common neurologic emergencies and less common but noteworthy neurologic emergencies are reviewed in this article. Issues that are fairly unique to sports participation are highlighted in this review. General concepts and principles related to treatment of neurologic emergencies that are often encountered unrelated to sports (eg, recognition and treatment of status epilepticus, increased intracranial pressure) are discussed but are not the focus of this article. Neurologic emergencies can involve any region of the nervous system (eg, brain, spine/spinal cord, peripheral nerves, muscles). In addition to neurologic emergencies that represent direct sports-related neurologic complications, indirect (systemic and generalized) sports-related emergencies with significant neurologic consequences can occur and are also discussed in this article. Neurologists and others involved in the care of athletes should consider neurologic emergencies in sports when planning and providing medical care.

  4. Priorities for emergency department syncope research

    NARCIS (Netherlands)

    Sun, Benjamin C.; Costantino, Giorgio; Barbic, Franca; Bossi, Ilaria; Casazza, Giovanni; Dipaola, Franca; McDermott, Daniel; Quinn, James; Reed, Matthew; Sheldon, Robert S.; Solbiati, Monica; Thiruganasambandamoorthy, Venkatesh; Krahn, Andrew D.; Beach, Daniel; Bodemer, Nicolai; Brignole, Michele; Casagranda, Ivo; Duca, Piergiorgio; Falavigna, Greta; Ippoliti, Roberto; Montano, Nicola; Olshansky, Brian; Raj, Satish R.; Ruwald, Martin H.; Shen, Win-Kuang; Stiell, Ian; Ungar, Andrea; van Dijk, J. Gert; van Dijk, Nynke; Wieling, Wouter; Furlan, Raffaello

    2014-01-01

    There is limited evidence to guide the emergency department (ED) evaluation and management of syncope. The First International Workshop on Syncope Risk Stratification in the Emergency Department identified key research questions and methodological standards essential to advancing the science of

  5. A Probabilistic Risk Assessment For Emergency Preparedness

    International Nuclear Information System (INIS)

    Lee, Joomyung; Jae, Moosung; Ahn, Kwangil

    2013-01-01

    The importance of nuclear power plant PSA has grown up all over the world due to this incident. The main concern of this study is to develop a methodology to carry on an emergency preparedness evaluation and to set an exclusive area, or the emergency response area boundary in order to apply it to domestic reference plants. This study also focuses on evaluating the risk parameter of major nuclides through a sensitivity analysis and a safety assessment by calculating the population dose, early fatality, and cancer fatality rates. A methodology for an emergency preparedness, which can be applied to evaluate the damage of the radioactive release as well as to assess the safety of the accident scenario of a nuclear power plant, has been developed and applied for the reference plants in Korea. By applying a source term analysis, an exclusive zone based on the radioactive dose is obtained. And the results of the health effect assessment based on the release fraction of specific nuclides to public with an effective emergency response activity have been simulated. A methodology utilizing the Level 3 PSA with the actual emergency response activities has been developed and applied to typical nuclear accident situations. The plausible standard for performing an emergency plan is suggested and the valuable information regarding emergency preparedness has been produced in this study. For further works, the sensitivity study on important parameters will be performed to simulate the actual severe accident situations such as sheltering, evacuation, and emergency response activities

  6. Simulator Evaluation of Simplified Propulsion-Only Emergency Flight Control Systems on Transport Aircraft

    Science.gov (United States)

    Burcham, Frank W., Jr.; Kaneshige, John; Bull, John; Maine, Trindel A.

    1999-01-01

    With the advent of digital engine control systems, considering the use of engine thrust for emergency flight control has become feasible. Many incidents have occurred in which engine thrust supplemented or replaced normal aircraft flight controls. In most of these cases, a crash has resulted, and more than 1100 lives have been lost. The NASA Dryden Flight Research Center has developed a propulsion-controlled aircraft (PCA) system in which computer-controlled engine thrust provides emergency flight control capability. Using this PCA system, an F-15 and an MD-11 airplane have been landed without using any flight controls. In simulations, C-17, B-757, and B-747 PCA systems have also been evaluated successfully. These tests used full-authority digital electronic control systems on the engines. Developing simpler PCA systems that can operate without full-authority engine control, thus allowing PCA technology to be installed on less capable airplanes or at lower cost, is also a desire. Studies have examined simplified ?PCA Ultralite? concepts in which thrust control is provided using an autothrottle system supplemented by manual differential throttle control. Some of these concepts have worked well. The PCA Ultralite study results are presented for simulation tests of MD-11, B-757, C-17, and B-747 aircraft.

  7. American National Standard: for radiological emergency-preparedness exercises for nuclear power plants

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    The development of emergency plans and procedures should provide for testing and evaluating the emergency response organization and decision making processes. To test and evaluate emergency plans and procedures, realistic scenarios should be used for drills or exercises. Emergency exercises are training activities that require a substantial effort to plan and coordinate effectively. The exercise trains personnel who would be expected to participate in the emergency response. Emergency exercises should be conducted as realistically as possible. Insofar as possible, the participants should not be notified in advance except where necessary to assure that the exercise will not cause injuries or property damage. A real emergency will naturally impart stress on emergency response personnel and their organizations. Exercises should be designed to duplicate this sense of stress insofar as practical. An important element of testing the emergency response is to ensure that provisions have been made for observation, evaluation, and critiquing each exercise. These evaluations and critiques should be used to improve and revise emergency plans and procedures where required

  8. Basic data of emergency response centre

    International Nuclear Information System (INIS)

    Jenieek, O.

    1995-01-01

    Emergency Response Centre (ERC) of Czech Republic is a highly specialized institution belonging to Nuclear Safety State Administration (SONS), which assures its activities both organizationally and technically. Main function of the ERC in the case of nuclear emergency is to fulfil the needs of SONS, Governmental Committee for Nuclear Emergencies in ER (GCNE ER) and the regional organs of State Authorities concerning the emergency planning and preparedness, evaluation of nuclear emergency consequences, including the emergency management and response. In the case of major failure or accident on NPP, the ERC carries out the performance analysis and review of a given NPP. It also monitors the dosimetric situation and transfers the recommendation to GCNE ER, Regional Emergency Management Committees and to NPP

  9. Evaluating acute medical admissions through emergency departments in Hong Kong: can one adjust for case-mix variation?

    Science.gov (United States)

    Rainer, T H; Sollich, P; Piotrowski, T; Coolen, A C C; Cheng, B; Graham, C A

    2012-12-01

    Healthcare systems are under pressure to efficiently and safely reduce acute care admissions to hospital. There is a need to develop a standardised system for assessing emergency department performance which takes into account case-mix variation. The objective of this study was to derive and validate a standardised tool for assessing variations in medical admissions through emergency departments in Hong Kong. Retrospective study of patients attending emergency departments of 14 acute hospitals in Hong Kong. Data were retrieved from a centralised administrative database. Of 2,531,225 patients who attended emergency departments between 1 January 2001 and 31 December 2003, 780,444 (30.8%) were admitted to medical wards. A model derived from 2001 data shows well-calibrated admission probabilities, with an area under the receiver operating characteristic curve for probability of admission of 90.3 (95% CI ±0.11). The areas under the receiver operating characteristic curves for 2002 and 2003 validation sets were 89.9 (95% CI ±0.11) and 89.0 (95% CI ±0.12), respectively. With an averaged benchmark, reductions in medical admissions of up to 19% could be achieved, while under the most optimistic assumption, reductions of up 36% could be achieved. A tool for benchmarking hospital medical admissions and minimising case-mix variation has been derived and validated in Hong Kong, but it requires further validation in other healthcare systems given the wide variations in admission thresholds internationally. This may be used as one potential method to evaluate the performance of emergency departments against a common standard.

  10. Evaluation of a continuous indicator for syndromic surveillance through simulation. application to vector borne disease emergence detection in cattle using milk yield.

    Directory of Open Access Journals (Sweden)

    Aurélien Madouasse

    Full Text Available Two vector borne diseases, caused by the Bluetongue and Schmallenberg viruses respectively, have emerged in the European ruminant populations since 2006. Several diseases are transmitted by the same vectors and could emerge in the future. Syndromic surveillance, which consists in the routine monitoring of indicators for the detection of adverse health events, may allow an early detection. Milk yield is routinely measured in a large proportion of dairy herds and could be incorporated as an indicator in a surveillance system. However, few studies have evaluated continuous indicators for syndromic surveillance. The aim of this study was to develop a framework for the quantification of both disease characteristics and model predictive abilities that are important for a continuous indicator to be sensitive, timely and specific for the detection of a vector-borne disease emergence. Emergences with a range of spread characteristics and effects on milk production were simulated. Milk yields collected monthly in 48 713 French dairy herds were used to simulate 576 disease emergence scenarios. First, the effect of disease characteristics on the sensitivity and timeliness of detection were assessed: Spatio-temporal clusters of low milk production were detected with a scan statistic using the difference between observed and simulated milk yields as input. In a second step, the system specificity was evaluated by running the scan statistic on the difference between observed and predicted milk yields, in the absence of simulated emergence. The timeliness of detection depended mostly on how easily the disease spread between and within herds. The time and location of the emergence or adding random noise to the simulated effects had a limited impact on the timeliness of detection. The main limitation of the system was the low specificity i.e. the high number of clusters detected from the difference between observed and predicted productions, in the absence of

  11. Emergency management information system (EMINS)

    International Nuclear Information System (INIS)

    Desonier, L.M.

    1987-01-01

    In a time of crisis or in an emergency, a manager is required to make many decisions to facilitate the proper solution and conclusion to the emergency or crisis. In order to make these decisions, it is necessary for the manager to have correct up-to-date information on the situation, which calls for an automated information display and entry process. The information handling needs are identified in terms of data, video, and voice. Studies of existing Emergency Operations Centers and evaluations of hardware and software have been completed. The result of these studies and investigations is the design and implementation of an automated Emergency Management Information System. Not only is the system useful for Emergency Management but for any information management requirement

  12. [Evaluation of the activity of a urological emergency unit in university hospital].

    Science.gov (United States)

    Martin, L; Pillot, P; Bardonnaud, N; Lillaz, J; Chabannes, E; Bernardini, S; Guichard, G; Bittard, H; Kleinclauss, F

    2014-01-01

    To determine the epidemiology of urological emergencies in a university hospital and the interest of a dedicated urological emergency unit. In 2008, a dedicated urological emergency unit was individualized in our department of urology. We conducted a retrospective study including all patients consulting in this unit in 2009 with epidemiological, clinical and therapeutic data. During 2009, 1257 patients consulted in this unit. Main diagnoses were acute urinary retention (303, 24.11%), renal colic (219, 17.42%), urinary infections (278, 22.11%), postoperative complications (141, 11.22%), symptomatic benign prostate hyperplasia (65, 5.17%), genitourinary cancers (61, 4.85%), trauma of urinary apparel (41, 3.26%), and spermatic cords torsion (10, 0.8%). In 99 cases (7.88%) diagnosis did not involved the urinary system. The treatment was surgical in 213 (17.7%) cases, technical procedure under local anesthesia in 368 (29.3%) and a medical treatment in 675 (53.7%) cases. Six hundred and sixty (52.5%) patients were managed ambulatory whereas 596 (47.5%) needed hospitalization. The opening of a dedicated urological emergency unit lead to 1257 emergency consultations. Frequent etiologies were acute urinary retention, renal colic and urinary infection. The creation of this unit allowed to register and to valorize this emergency activity through the ATU emergency amount. Copyright © 2013. Published by Elsevier Masson SAS.

  13. Retrospective evaluation of patients with elevated digoxin levels at an emergency department

    Directory of Open Access Journals (Sweden)

    Gulsum Limon

    2016-03-01

    Full Text Available Objectives: We investigated the demographic characteristics, clinical and laboratory findings, treatment strategies and clinical outcomes of patients presenting at emergency department (ED with digoxin levels at or above 1.2 ng/ml. Materials and methods: The demographic and clinical characteristics of patients with serum digoxin levels at or above 1.2 ng/ml admitted to an ED between January 2010 and July 2011 were investigated in this cross-sectional descriptive study. Patients with ECG and clinical findings consistent with digoxin toxicity and no additional explanation of their symptoms were evaluated for digoxin toxicity. Results: In this study 137 patients were included, and 68.6% of patients were women with mean age 76.1 ± 12.2. There was no significant difference between gender and digoxin intoxication. The mean age of intoxicated group was significantly higher than the non-intoxicated group (P = 0.03. The most common comorbidities were congestive heart failure (n = 91 and atrial fibrillation (n = 74. The most common symptoms were nausea, vomiting and abdominal pain. The levels of hospitalization and mortality in this group were significantly higher. Conclusion: Digoxin intoxication must be suspected in patients present in the ED, particularly those with complaints that include nausea and vomiting, as well as new ECG changes; serum digoxin levels must be determined. Keywords: Digoxin, Digoxin level, Intoxication, Emergency department

  14. Population-based evaluation of the effectiveness of two regimens for emergency contraception.

    Science.gov (United States)

    Leung, Vivian W Y; Soon, Judith A; Lynd, Larry D; Marra, Carlo A; Levine, Marc

    2016-06-01

    To estimate and compare the effectiveness of the levonorgestrel and Yuzpe regimens for hormonal emergency contraception in routine clinical practice. A retrospective population-based study included women who accessed emergency contraceptives for immediate use prescribed by community pharmacists in British Columbia, Canada, between December 2000 and December 2002. Linked administrative healthcare data were used to discern the timings of menses, unprotected intercourse, and any pregnancy-related health services. A panel of experts evaluated the compatibility of observed pregnancies with the timing of events. The two regimens were compared with statistical adjustments for potential confounding. Among 7493 women in the cohort, 4470 (59.7%) received levonorgestrel and 3023 (40.3%) the Yuzpe regimen. There were 99 (2.2%) compatible pregnancies in the levonorgestrel group and 94 (3.1%) in the Yuzpe group (P=0.017). The estimated odds ratio for levonorgestrel compared with the Yuzpe regimen after adjusting for potential confounders was 0.64 (95% confidence interval 0.47-0.87). Against an expected pregnancy rate of approximately 5%, the relative and absolute risk reductions were 56.0% and 2.8%, respectively, for levonorgestrel and 36.7% and 1.8% for the Yuzpe regimen. The levonorgestrel regimen is more effective than the Yuzpe regimen in routine use. The data suggest that both regimens are less effective than has been observed in randomized trials. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. The Evaluation and Management of Rocky Mountain Spotted Fever in the Emergency Department: a Review of the Literature.

    Science.gov (United States)

    Gottlieb, Michael; Long, Brit; Koyfman, Alex

    2018-07-01

    Rocky Mountain spotted fever (RMSF) is potentially deadly and can present subtly with signs and symptoms overlapping with other clinical conditions. Delayed diagnosis can be fatal. This review provides an evidence-based summary of the current data for the evaluation and management of RMSF in the emergency department. RMSF occurs through transmission of Rickettsia rickettsii by an infected tick. Exposure in the United States occurs most commonly from April to September, and high-risk locations include wooded, shrubby, or grassy areas. Approximately half of patients with infection do not recall tick exposure. Symptoms can include fever, headache, photophobia, malaise, myalgias, and a petechial rash that begins on the wrists and ankles and spreads to the trunk. Rash may not occur in ≤15% of patients, and the classic triad of fever, headache, and rash is also not definitive. Laboratory evaluation may demonstrate hyponatremia, anemia, thrombocytopenia, abnormal liver enzymes, and elevated coagulation tests. Antibody testing can be helpful, but these results are not typically available to the emergency clinician. Doxycycline is the treatment of choice in adults, children, and pregnant patients. Patients should be advised about prevention strategies and effective techniques for removing ticks. RMSF is a potentially deadly disease that requires prompt recognition and management. Focused history, physical examination, and testing are important in the diagnosis of this disease. Understanding the clinical features, diagnostic tools, and proper treatment can assist emergency clinicians in the management of RMSF. Published by Elsevier Inc.

  16. Evaluation of the effectiveness of digital radiography in emergency situations

    International Nuclear Information System (INIS)

    Pathi, R.; Langlois, S.

    2002-01-01

    The time differences between digital and conventional radiography for emergency patients were investigated, and clinician satisfaction with the two modalities was compared. Time-motion data was collected daily over 5 weeks for a digital group and a conventional X-ray group. For standardization purposes, only emergency patients requiring chest X-rays were selected for the study. Data were collected from 30 patients in each of the two groups in the time-motion study, and 31 out of 50 Emergency and Intensive Care clinicians responded to the questionnaire. Results were analysed by percentage, and χ 2 analysis was used where appropriate. The time for availability of images to requesting clinicians was 70% less for digital images compared to conventional radiography. The overall satisfaction between digital and conventional radiography was very similar, but most clinicians expressed an opinion that digital radiography offered significant image modification advantages. Copyright (2002) Blackwell Science Pty Ltd

  17. Application of GRA method, dynamic analysis and fuzzy set theory in evaluation and selection of emergency treatment technology for large scale phenol spill incidents

    Science.gov (United States)

    Zhao, Jingjing; Yu, Lean; Li, Lian

    2017-05-01

    Select an appropriate technology in an emergency response is a very important issue with various kinds of chemical contingency spills frequently taking place. Due to the complexity, fuzziness and uncertainties of the chemical contingency spills, the theory of GRA method, dynamic analysis combined with fuzzy set theory will be appropriately applied to selection and evaluation of emergency treatment technology. Finally, a emergency phenol spill accidence occurred in highway is provided to illustrate the applicability and feasibility of the proposed methods.

  18. Development of nuclear emergency exercise programme (NEEP) in Korea

    International Nuclear Information System (INIS)

    Shin, H. K.; Kim, J. Y.; Kim, M. K.; Kim, S. H.

    2011-01-01

    The nuclear emergency exercise programme (NEEP) is a PC-based application intended for design and planning emergency preparedness and response (EP and R) exercises for a potential nuclear emergency in Korea. The application programme allows EP and R staff to create and edit exercise scenarios based on information customised for a specific nuclear power plant's emergency plans. NEEP includes the following features: (1) step-by-step guide to developing new exercise scenario according to emergency alarm level and potential accident type, (2) database of specific plant's field exercise scenarios that can be easily modified by users, (3) generating master scenario events list and messages of exercise participants and (4) allowing the quantitative evaluation of exercise participants from the view of exercise objectives and evaluator guides. NEEP also features tools for queries, reports and visualisation that can be used to create documentation during the scenario planning and exercise evaluation processes. (authors)

  19. Child maltreatment, parents & the emergency department

    NARCIS (Netherlands)

    Hoytema van Konijnenburg, E.M.M.

    2015-01-01

    The research described in this thesis focuses on the evaluation of several methods of screening for child maltreatment at the emergency department, with an emphasis on screening based on parental risk factors (‘child check’). The use of a screening checklist (mandatory in all Dutch emergency

  20. Evaluation of Savannah River Plant emergency response models using standard and nonstandard meteorological data

    International Nuclear Information System (INIS)

    Hoel, D.D.

    1984-01-01

    Two computer codes have been developed for operational use in performing real time evaluations of atmospheric releases from the Savannah River Plant (SRP) in South Carolina. These codes, based on mathematical models, are part of the SRP WIND (Weather Information and Display) automated emergency response system. Accuracy of ground level concentrations from a Gaussian puff-plume model and a two-dimensional sequential puff model are being evaluated with data from a series of short range diffusion experiments using sulfur hexafluoride as a tracer. The models use meteorological data collected from 7 towers on SRP and at the 300 m WJBF-TV tower about 15 km northwest of SRP. The winds and the stability, which is based on turbulence measurements, are measured at the 60 m stack heights. These results are compared to downwind concentrations using only standard meteorological data, i.e., adjusted 10 m winds and stability determined by the Pasquill-Turner stability classification method. Scattergrams and simple statistics were used for model evaluations. Results indicate predictions within accepted limits for the puff-plume code and a bias in the sequential puff model predictions using the meteorologist-adjusted nonstandard data. 5 references, 4 figures, 2 tables

  1. Study on IAEA international emergency response exercise convEx-3

    International Nuclear Information System (INIS)

    Yamamoto, Kazuya

    2007-05-01

    The International Atomic Energy Agency (IAEA) carried out a large-scale international emergency response exercise in 2005 under the designated name of ConvEx-3(2005), at Romania. This review report summarizes a study about ConvEx-3(2005) based on several related open literature. The ConvEx-3 was conducted in accordance with Agency's safety standard series and requirements in the field of Emergency Preparedness and Response. The study on the preparation, conduct and evaluation of ConvEx-3(2005) exercise is expected to provide very useful knowledge for development of drills and educational programs conducted by Nuclear Emergency Assistance and Training Center (NEAT). Especially, study on the exercise evaluations is instrumental in improving evaluations of drills planned by the national government and local governments. As international cooperation among Asian countries in the field of nuclear emergency preparedness and response is going to realize, it is very useful to survey and consider scheme and methodology about international emergency preparedness, response and exercise referring the knowledge of this ConvEx-3 study. The lessons learned from this study of ConvEx-3(2005) are summarized in four chapters; methodology of exercises and educational programs, exercise evaluation process, amendments/verification of the emergency response plan of NEAT, and technical issues of systems for emergency response and assistance of NEAT relevant to interface for international emergency communication. (author)

  2. Evaluation of response capacity to patient attention demand in an Emergency Department

    OpenAIRE

    Bruballa Vilas, Eva

    2017-01-01

    The progressive growth of aging, increased life expectancy and a greater number of chronic diseases contribute significantly to the growing demand of emergency medical care, and thus, on saturation of Emergency Departments. This is one of the most important current problems in healthcare systems worldwide. This work proposes an analytical model to calculate the theoretical throughput of a particular sanitary staff configuration in a Hospital Emergency Department, which is, the number of patie...

  3. [Adverse drug reaction reporting in emergency medicine].

    Science.gov (United States)

    Milojevic, Kolia; Chassagnol, Isabelle; Brion, Nathalie; Cléro, Joël; Degrèze, Nathalie; Lambert, Yves

    2004-01-01

    A regional survey was performed between June and September 2002, to evaluate knowledge and attitudes of emergency physicians regarding adverse drug reaction (ADR) reporting in a French district. 100 questionnaires completed by physicians working in emergency departments and/or mobile intensive care units were analysed. The frequency of ADRs encountered by emergency practitioners was estimated at > or = 0.73 per year and per physician. The ADR notification rate in emergency medicine was estimated at advertising ADR reporting procedures could help to improve the notification rate in emergency medicine.

  4. Using the /phi/resund experimental data to evaluate the ARAC emergency response models

    International Nuclear Information System (INIS)

    Gudiksen, P.H.; Gryning, S.E.

    1988-07-01

    A series of meteorological and tracer experiments, was conducted during May and June 1984 over the 20-km wide /O/resund strait between Denmark and Sweden for the purpose of studying atmospheric dispersion processes over cold water and warm land surfaces and providing the data needed to evaluate meso-scale models in a coastal environment. In concert with these objectives the data from these experiments have been used as part of a continuing effort to evaluate the capability of the three-dimensional MATHEW/ADPIC (M/A) atmospheric dispersion models to simulate pollutant transport and diffusion characteristics of the atmospheric during a wide variety of meteorological conditions. Since previous studies have focused primarily on M/A model evaluations over rolling and complex terrain at inland sites, the /O/resund experiments provide a unique opportunity to evaluate the models in a coastal environment. The M/A models are used by the Atmospheric Release Advisory Capability (ARAC), developed by the Lawrence Livermore National Laboratory, for performing real-time assessments of the environmental consequences of potential or actual releases of radioactivity into the atmosphere. These assessments include estimation of radiation doses to nearby population centers and of the extent of surface contamination. Model evaluations, using field experimental data such as those generated by the /O/resund experiments, serve as a basis for providing emergency response managers with estimated of the uncertainties associated with accident consequence assessments. This report provides a brief description of the /O/resund experiments, the current understanding of the meteorological processes governing pollutant dispersion over the /O/resund strait, and the results of the M/A model simulations of these experiments. 11 refs., 7 figs., 1 tab

  5. Evaluation of the preparedness of the children's emergency rooms ...

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: The Children Emergency Room (CHER) is the first point of call for many sick children. ... limitation abounds with regards to personnel, high technology infrastructure, personnel ...

  6. Technological considerations in emergency instrumentation preparedness. Phase II-D. Evaluation testing and calibration methodology for emergency radiological instrumentation

    International Nuclear Information System (INIS)

    Bramson, P.E.; Andersen, B.V.; Fleming, D.M.; Kathren, R.L.; Mulhern, O.R.; Newton, C.E.; Oscarson, E.E.; Selby, J.M.

    1976-09-01

    In response to recommendations from the Advisory Committee on Reactor Safeguards, the Division of Operational Safety, U.S. ERDA has contracted with Battelle, Pacific Northwest Laboratories to survey the adequacy of existing instrumentation at nuclear fuel cycle facilities to meet emergency requirements and to develop technical criteria for instrumentation systems to be used in assessment of environmental conditions following plant emergencies. This report, the fifth in a series, provides: (1) calibration methods to assure the quality of radiological measurements and (2) testing procedures for determining whether an emergency radiological instrument meets the performance specifications. Three previous reports in this series identified the emergency instrumentation needs for power reactors, mixed oxide fuel plants, and fuel reprocessing facilities. Each of these three reports contains a Section VI, which sets forth applicable radiological instrument performance criteria and calibration requirements. Testing and calibration procedures in this report have been formatted in two parts: IV and V, each divided into three subsections: (1) Power Reactors, (2) Mixed Oxide Fuel Plants, and (3) Fuel Reprocessing Facilities. The three performance criteria subsections directly coincide with the performance criteria sections of the previous reports. These performance criteria sections have been reproduced in this report as Part III with references of ''required action'' added

  7. Evaluating an australian emergency nurse practitioner candidate training program.

    Science.gov (United States)

    Plath, Sharyn J; Wright, Mary; Hocking, Julia

    2017-11-01

    Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate. The training team defined milestones for Semesters one and two, and developed a case review form to assess application of the candidate's knowledge in new clinical situations, as well as check for gaps in understanding. A clinical skills guide was developed for the candidate to work toward, and a comprehensive assessment was carried out at two time points in the training program. Feedback was obtained from the mentors and the candidate at the end point of the training program, and has been used to refine the program for 2017. This in-house training program provided specialised, evidence-based training for the emergency department environment, resulting in development of the nurse practitioner candidate as a high functioning team member. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

  8. Final evaluation of the 2005 to 2007 National Pediatric Emergency Medicine Fellows' Conferences.

    Science.gov (United States)

    Jaffe, David M; Knapp, Jane F; Jeffe, Donna B

    2009-05-01

    Evaluate the effectiveness of the 2005 to 2007 National Pediatric Emergency Medicine (PEM) Fellows Conference series in achieving predefined objectives in the domains of scholarship, leadership, and partnership. Conference attendees included fellows in the existing PEM fellowship programs. Self-administered preconference and postconference questionnaires measured knowledge, research-related confidence, beliefs about institutional support for Emergency Medical Services for Children (EMSC) research, and intentions to engage in 7 specific behaviors relating to scholarship, leadership, and partnership. Pearson product-moment correlations measured relationships among continuous variables. Repeated-measures analysis of variance measured change between preconference and postconference measures. Hierarchical multiple linear regression models identified predictors of postconference intentions to engage in each of the 7 specific behaviors, controlling for preconference intention. Approximately one third of all PEM fellows attended the conference each year. Preconference and postconference questionnaires were completed by at least 70% of attendees each year. Because several fellows attended more than one conference, data were analyzed from the first conference that a fellow attended. In each year, we observed significant increases in attendees' conference-specific knowledge, confidence, and intentions to continue in EMSC research, join national collaborative research networks, and establish national mentoring relationships. The National PEM Fellows' Conference is an effective means to increasing fellows' knowledge about scholarship, leadership, and partnership in EMSC and increasing their confidence and intentions to conduct research in EMSC.

  9. Technical evaluation of the proposed changes in the technical specifications for emergency power sources for the Big Rock Point nuclear power plant

    International Nuclear Information System (INIS)

    Latorre, V.R.

    1979-12-01

    The technical evaluation is presented for the proposed changes to the Technical Specifications for emergency power sources for the Big Rock Point nuclear power plant. The criteria used to evaluate the acceptability of the changes include those delineated in IEEE Std-308-1974, and IEEE Std-450-1975 as endorsed by US NRC Regulatory Guide 1.129

  10. Too much ‘Dreaming’: Evaluations of the Northern Territory National Emergency Response Intervention 2007–2012

    Directory of Open Access Journals (Sweden)

    Jon Altman

    2012-12-01

    Full Text Available The Northern Territory National Emergency Response Intervention (the Intervention of 2007 was a bold experiment by the Howard Government. The Intervention was developed quickly without comprehensive policy development based on evidence or consultation. During its five-year statutory life (ending August 2012, the absence of coherent policy logic has seen the Intervention fundamentally reframed by the Rudd and Gillard Governments. The unprecedented and controversial nature of the Intervention has seen extraordinary levels of monitoring, review and evaluation, but the absence of an overarching evaluation strategy has resulted in a fragmented and confused approach. In this article, we do not seek to critique the Intervention itself or to assess whether these multiple monitoring and evaluation exercises have been successes or failures. Indeed, our review illustrates that in highly contested policy areas, notions of success, failure and the evaluations themselves become politically charged. Instead we make a series of critical observations regarding this contradictory messiness of evaluations, using political science and anthropological frameworks to draw wider conclusions about the nature and logic of evaluation fetishism. We conclude that evaluations of the Intervention have not led to greater transparency, accountability and monitoring of outcomes and outputs. The Intervention evaluations instead are consistent with the view that they are both obfuscating mechanisms and techniques of governance designed to allay public concern and normalise the governance of marginalised Indigenous Australian spaces.

  11. Emergency warning via automated distribution system

    International Nuclear Information System (INIS)

    Glasser, J.C.

    1981-01-01

    Due to the Three Mile Island Nuclear Power Plant accident of March 28, 1979, the Nuclear Regulatory Commission and the Federal Emergency Management Agency require a general upgrading of existing Emergency Preparedness Plans. NUREG-0654/FEMA REP-1, Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants, dated October 1980, describes the Emergency Plans required and includes the Plant Operator's Onsite Plan, as well as the State, County, and Local Offsite Plans. As part of these Emergency Preparedness Plans, an Emergency Notification System is required to alert the general population within the Emergency Planning Zone surrounding a Nuclear Power Plant that a general emergency has occurred and that they should tune to an Emergency Broadcast Station for further information and instructions. The emergency notification system for Beaver Valley Power Station is described. The system is the capability of alerting 100% of the population with 5 mi of Beaver Valley Power Station within 15 min, and the capability of alerting 100% of the population within 10 mi of Beaver Valley Power Station within 45 min

  12. Systematic preparation, execution and evaluation of emergency exercises at the Beznau nuclear power plant

    International Nuclear Information System (INIS)

    Tenschert, J.

    2011-01-01

    Based on federal acts and a specific guideline of the nuclear authority ENSI, strict requirements are imposed on emergency exercises at Swiss NPPs. The Beznau NPP has conducted emergency exercises for more than 30 years. Systematic exercise planning assures that all emergency cases defined in the plant-specific emergency plan are considered in the exercise scenarios. Technically oriented scenarios cover all groups of initiating events and all safety levels of the defense in depth principle. The exercise results are an important input for optimization measures in the areas of emergency organization, documentation and infrastructure. Due to the goal-oriented enforcement of laws and guidelines by the nuclear authority ENSI, emergency exercises serve as a motor of further optimization of emergency preparedness. (orig.)

  13. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education.

    Science.gov (United States)

    Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

    2015-01-01

    There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

  14. Quality Indicators for Evaluating Prehospital Emergency Care: A Scoping Review.

    Science.gov (United States)

    Howard, Ian; Cameron, Peter; Wallis, Lee; Castren, Maaret; Lindstrom, Veronica

    2018-02-01

    all, 42.8% were categorized as primarily Clinical, with Out-of-Hospital Cardiac Arrest contributing the highest number within this domain (30.4%). Of the QIs categorized as Non-Clinical (57.2%), Time-Based Intervals contributed the greatest number (28.8%). Population on Whom the Data Collection was Constructed made up the most commonly reported QI component (79.8%), followed by a Descriptive Statement (63.6%). Least reported were Timing of Data Collection (12.1%) and Timing of Reporting (12.1%). Pilot testing of the QIs was reported on 34.7% of QIs identified in the review. Overall, there is considerable interest in the understanding and development of PEC quality measurement. However, closer attention to the details and reporting of QIs is required for research of this type to be more easily extrapolated and generalized. Howard I , Cameron P , Wallis L , Castren M , Lindstrom V . Quality indicators for evaluating prehospital emergency care: a scoping review. Prehosp Disaster Med. 2018;33(1):43-52.

  15. Identification and evaluation of competencies of health professionals in the hospital emergency management of the radiation accident victim

    International Nuclear Information System (INIS)

    Berger, M.E.

    1982-01-01

    A preliminary list of ten competency and forty-six sub-competency statements derived from literature and consultation with experts and based on the general areas of clinical performance defined by the National Board of Medical Examiners were the concern of Phase I of this study. Forty-eight experts in nuclear medicine, radiology, radiotherapy, health physics, medical physics, radiation biology, public and occupational health, surgery, and emergency medicine and nursing considered this preliminary list of competencies and sub-competencies to determine which were essential for health professionals who may be caring for radiation accident victims in hospital emergency departments. Eight competencies and thirty-three sub-competencies were rated as Essential competencies. Competencies dealing with establishing priorities in patient care and initiating treatment, assessment, contamination control, and decontamination were highly rated. In the second part of this study, the Essential competencies were utilized in the development of an original evaluation instrument designed to identify deficiencies and continuing education needs during radiation accident drills or exercises. The instrument was designed for use in sixteen possible patient care situations in which the radiation accident victims have varying medical and radiological conditions. Development of the evaluation instrument was described

  16. A survey on evaluation function for contaminations and doses in the primary and the secondary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Yamada, Yuji; Akashi, Makoto; Shiraishi, Kunio; Suzuki, Toshikazu; Ishigure, Nobuhito; Endo, Akira; Sanada, Tetsuya; Nakayama, Kazushige; Shizuma, Kiyoshi; Takada, Chie; Momose, Takumaro; Hoshi, Masaharu; Yamaguchi, Takenori

    2009-01-01

    The questionnaire on evaluation function for contaminations and doses was sent to the primary and the secondary radiation emergency hospitals in Japan by the network council for physical dosimetry in National Institute of Radiological Sciences (NIRS) designated as the tertiary hospital. The recovery percentage from the 88 hospitals was 70%. It turned out that six primary hospitals in 37 hospitals did not have even the basic instruments on radiation measurement such as GM counter and personal dosimeter. 64% of the secondary hospitals have the whole body counter, but its operation frequency including exercise was considerably low. It is thought that the main cause originates in a chronic manpower shortage and the budget shortfall seen by all the primary and the secondary hospitals. And also peculiar difficulty of correspondence to the radiation emergency medical treatment and the few experience might promote the problem. Thus the anxiety of the site staff had been appeared to the result of the questionnaire survey in shape like the opinion and the demand, etc. It will be necessary to advance the enhancement of training and to make the manual for the contaminations and the doses evaluation in the hospitals. (author)

  17. Evaluating the cascading impacts of sea level rise and coastal flooding on emergency response spatial accessibility in Lower Manhattan, New York City

    Science.gov (United States)

    Yin, Jie; Yu, Dapeng; Lin, Ning; Wilby, Robert L.

    2017-12-01

    This paper describes a scenario-based approach for evaluating the cascading impacts of sea level rise (SLR) and coastal flooding on emergency responses. The analysis is applied to Lower Manhattan, New York City, considering FEMA's 100- and 500-year flood scenarios and New York City Panel on Climate Change (NPCC2)'s high-end SLR projections for the 2050s and 2080s, using the current situation as the baseline scenario. Service areas for different response timeframes (3-, 5- and 8-min) and various traffic conditions are simulated for three major emergency responders (i.e. New York Police Department (NYPD), Fire Department, New York (FDNY) and Emergency Medical Service (EMS)) under normal and flood scenarios. The modelling suggests that coastal flooding together with SLR could result in proportionate but non-linear impacts on emergency services at the city scale, and the performance of operational responses is largely determined by the positioning of emergency facilities and the functioning of traffic networks. Overall, emergency service accessibility to the city is primarily determined by traffic flow speed. However, the situation is expected to be further aggravated during coastal flooding, with is set to increase in frequency and magnitude due to SLR.

  18. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

    Directory of Open Access Journals (Sweden)

    Sricharoen P

    2015-02-01

    Full Text Available Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010 at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74% were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001. The top three highest average satisfaction scores in the new EM curriculum group were trauma

  19. Application and evaluation of training for response to emergency situations

    Energy Technology Data Exchange (ETDEWEB)

    Kidwell, M.D.

    1979-01-01

    At Washington Gas Light Co., a magnetic situation-simulation board has become an effective tool for training field personnel in emergency procedures and decisionmaking. Class participants use magnetic disks - symbolizing physical features and components of the distribution system and service equipment - to visually describe the step-by-step procedures applied to specific emergency scenarios. A manually operated clock keeps a running account of the time estimated for each step, emphasizing the need for quick response. Situation-board programs of typical problems, complete with script and drawings, are available to all training foremen to ensure uniform training throughout the department.

  20. Evaluating psychiatric nursing competencies applied to emergency settings: A pilot role delineation study.

    Science.gov (United States)

    Mello, Joanna J; Bell, Janice F; Siegel, Elena O; Ward, Deborah H

    2016-03-01

    Despite increasing emergency department (ED) use for psychiatric emergencies, limited evidence exists to clearly identify the competencies necessary of emergency nurses to care for this population. 1. To define the specialized skill and knowledge of emergency nurses by examining the frequency with which recommended psychiatric nursing competencies are performed in the ED setting. 2. To assess emergency nurses' rankings of importance and self-efficacy related to recommended psychiatric nursing competencies in order to explore their relevance to emergency nursing. Emergency nurses (n = 75) completed a survey ranking the frequency, importance and self-efficacy of 15 psychiatric nursing competencies. Data analysis revealed competency relevance and regression analysis demonstrated factors that may contribute to self-efficacy. Nurses reported performing psychiatric competencies frequently (mean scores of 0.64 to 3.04). Importance rankings were highest (mean scores of 1.81 to 3.67). Self-efficacy mean scores ranged from 0.89 to 3.47. Frequency and importance of activities predicted higher self-efficacy scores. Younger age and competencies often, and existing competencies appear applicable. As frequency and importance of competencies influence self-efficacy, practice and interventions to underscore the importance of competencies may improve self-efficacy. Younger and less experienced nurses might require more support. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Decision support for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1989-05-01

    A short introduction will be given to the Nordic project ''NKA/INF: Information Technology for Accident and Emergency Management'', which is now in its final phase. To perform evaluation of the project, special scenarious have been developed, and experiments based on these will be fulfilled and compared with experiments without use of the decision support system. Furthermore, the succeeding European project, ''IT Support for Emergency Management - ISEM'', with the purpose of developing a decision support system for complex and distributed decision making in emergency management in full scale, will be described and the preliminary conceptual model for the system will be presented. (author)

  2. Transient global amnesia: emergency department evaluation and management [digest].

    Science.gov (United States)

    Faust, Jeremy Samuel; Nemes, Andreea; Zaurova, Milana

    2016-08-22

    Transient global amnesia is a clinically distinct syndrome characterized by the acute inability to form new memories. It can last up to 24 hours. The diagnosis is dependent on eliminating other more serious etiologies including toxic ingestions, acute strokes, complex partial seizures, and central nervous system infections. Transient global amnesia confers no known long-term risks; however, when abnormal signs or symptoms are present, they take precedence and guide the formulation of a differential diagnosis and investigation. In witnessed transient global amnesia with classic features, a minimalist approach is reasonable, avoiding overtesting, inappropriate medication, and medical interventions in favor of observation, ensuring patient safety, and reassuring patients and their families. This review provides a detailed framework for distinguishing transient global amnesia from its dangerous mimics and managing its course in the emergency department. [Points & Pearls is a digest of Emergency Medicine Practice].

  3. Tactical training of emergency management - the MUSTER concept

    International Nuclear Information System (INIS)

    Andersen, Verner.

    1996-08-01

    The efficiency with which complex, large-scale organisations respon d to emergencies and critical situations depends crucially on the co-ordination of actions and communication among decision makers. However, decision makers have typically few opportunities to train distributed crisis management under artificial, yet realistic conditions; and at the same time, real emergencies occur fortunately so relatively infrequently that few decision makers have a chance of establishing a useful real-life experience of crisis management. There is therefore a need for having available realistic and flexible multi-user training environments in which co-ordinated response to crises or emergencies may be trained. The objective of the MUSTER project (Multi-User System for Training and Evaluating Environmental Emergency Response) is to produce specifications for a training system supporting collaborative training and evaluation directed to the special needs of environmental emergency management. The MUSTER project was partially funced by CEC

  4. Thallium myocardial scanning in the emergency department evaluation of chest pain

    International Nuclear Information System (INIS)

    Mace, S.E.

    1989-01-01

    Chest pain is a common complaint of patients seen in the emergency department. The causes are legion, and range from the non-life threatening to the potentially catastrophic. Thallium heart scanning was done prospectively in 20 patients with a ''classic'' history for myocardial infarction (eight patients) or atypical chest pain and/or associated symptoms plus an abnormal ECG (12 patients) to discern a subset of patients from whom thallium scintography may be indicated in the emergency department. Although further investigation is needed, our preliminary study suggests that myocardial scanning with thallium can be a safe, fairly rapid, and useful objective parameter in the emergency department detection of suspected myocardial infarction, and in differential diagnosis of chest pain when other data such as the history, physical examination, ECG, or enzymes are inconclusive

  5. Critical evaluation of emergency stockpile ventilators in an in vitro model of pediatric lung injury.

    Science.gov (United States)

    Custer, Jason W; Watson, Christopher M; Dwyer, Joe; Kaczka, David W; Simon, Brett A; Easley, R Blaine

    2011-11-01

    Modern health care systems may be inadequately prepared for mass casualty respiratory failure requiring mechanical ventilation. Current health policy has focused on the "stockpiling" of emergency ventilators, though little is known about the performance of these ventilators under conditions of respiratory failure in adults and children. In this study, we seek to compare emergency ventilator performance characteristics using a test lung simulating pediatric lung injury. Evaluation of ventilator performance using a test lung. Laboratory. None. Six transport/emergency ventilators capable of adult/child application were chosen on the basis of manufacturer specifications, Autovent 3000, Eagle Univent 754, EPV 100, LP-10, LTV 1200, and Parapac 200D. Manufacturer specifications for each ventilator were reviewed and compared with known standards for alarms and functionality for surge capacity ventilators. The delivered tidal volume, gas flow characteristics, and airway pressure waveforms were evaluated in vitro using a mechanical test lung to model pediatric lung injury and integrated software. Test lung and flow meter recordings were analyzed over a range of ventilator settings. Of the six ventilators assessed, only two had the minimum recommended alarm capability. Four of the six ventilators tested were capable of being set to deliver a tidal volume of less than 200 mL. The delivered tidal volume for all ventilators was within 8% of the nominal setting at a positive end expiratory pressure of zero but was reduced significantly with the addition of positive end expiratory pressure (range, ±10% to 30%; p ventilators tested performed comparably at higher set tidal volumes; however, only three of the ventilators tested delivered a tidal volume across the range of ventilator settings that was comparable to that of a standard intensive care unit ventilator. Multiple ventilators are available for the provision of ventilation to children with respiratory failure in a mass

  6. Comparison of visual analogue and Likert scales in evaluation of an emergency department bedside teaching programme.

    Science.gov (United States)

    Celenza, Antonio; Rogers, Ian R

    2011-02-01

    The present study compares visual analogue scale (VAS) to Likert-type scale (LTS) instruments in evaluating perceptions of an ED bedside clinical teaching programme. A prospective study was conducted in the ED of an urban, adult tertiary hospital. Prospective pairing occurred of a teaching consultant and registrar who were relatively quarantined from normal clinical duties. Registrars received 3 months of the teaching intervention, and 3 months without the intervention in a cross-over fashion. Evaluation questionnaires were completed using both the LTS and 100 mm horizontal VAS for each question. Correlation between VAS and LTS gave a measure of validity, and test-retest stability and internal consistency gave measures of reliability. Registrar perceptions of the teaching programme were positive, but no differences were found between the pre- and post-intervention groups. The test-retest reliabilities (intraclass correlation coefficient) for the questionnaires were 0.51 and 0.54 for the VAS, and 0.58 and 0.58 for the LTS. Cronbach's alpha varied between 0.79 and 0.91 for the VAS, and 0.79 and 0.81 for the LTS. Correlations between the two methods varied from 0.35 to 0.94 for each question. A linear regression equation describing the relationship approximated VAS = 19.5 × LTS-9 with overall r= 0.89. An ED bedside teaching programme is perceived to be a beneficial educational intervention. The VAS is a reliable and valid alternative to the LTS for educational evaluation and might provide advantages in educational measurement. Further research into the significance of extreme values and educationally important changes in scores is required. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  7. Information technology for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1990-01-01

    Improved performance in emergency management by the use of modern information technology has been investigated. Limited parts of a preparedness system have been chosen based on analysis of drills with respect to emergency situations and real accidents. Specific functions relevant for the situation have been selected and implemented in prototype test systems. Finally, the usefulness of the prototype systems has been evaluated by experiments following specific scenarios. (author) 24 refs

  8. Emergency department knowledge management in the age of Web 2.0: evaluation of a new concept.

    Science.gov (United States)

    Dinh, Michael; Tan, Timothy; Bein, Kendall; Hayman, Jon; Wong, Yuk Kuen; Dinh, David

    2011-02-01

    The objective of the present study was to describe the implementation of an organizational learning model and evaluate the effectiveness and usability of an application used to facilitate it in an ED setting. This was an implementation case study and technology evaluation. The organizational learning model was implemented using an online Web 2.0 collaborative learning application developed by the investigating team. Online use was tracked over a 9-month period. At the end of the study period, a usability assessment was conducted as well as a semistructured interview of participants to assess perceptions of usefulness and effect on learning capacity in the ED. Over a period of 9 months, a total of 54 individual sites from 74 eligible staff members were created within a specific web domain. There were 251 registered users including users outside the ED, who accessed learning materials within these sites 7494 times. The majority of staff members interviewed agreed or strongly agreed that the collaborative learning application had improved learning capacity within this ED (88%, 95% CI 74-94%). We demonstrate the implementation of an organizational learning model based on independent online sites networking together within an organization. This appears to be both usable and acceptable to staff members working in a large ED as a means of knowledge management. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  9. Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

    Science.gov (United States)

    Yang, Nikki H; Dharmar, Madan; Yoo, Byung-Kwang; Leigh, J Paul; Kuppermann, Nathan; Romano, Patrick S; Nesbitt, Thomas S; Marcin, James P

    2015-08-01

    Comprehensive economic evaluations have not been conducted on telemedicine consultations to children in rural emergency departments (EDs). We conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. We built a decision model with parameters from primary programmatic data, national data, and the literature. We performed a base-case cost-effectiveness analysis (CEA), a probabilistic CEA with Monte Carlo simulation, and ROI estimation when CEA suggested cost-saving. The CEA was based on program effectiveness, derived from transfer decisions following telemedicine and telephone consultations. The average cost for a telemedicine consultation was $3641 per child/ED/year in 2013 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared with telephone consultations and a cost reduction of $4662 per child/ED/year. Our probabilistic CEA demonstrated telemedicine consultations were less costly than telephone consultations in 57% of simulation iterations. The ROI was calculated to be 1.28 ($4662/$3641) from the base-case analysis and estimated to be 1.96 from the probabilistic analysis, suggesting a $1.96 return for each dollar invested in telemedicine. Treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. Telephone and telemedicine consultations were not randomly assigned, potentially resulting in biased results. From a health care payer perspective, telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving (base-case and more than half of Monte Carlo simulation iterations) or cost-effective compared with telephone consultations. © The Author(s) 2015.

  10. Cultural Competence Training for Law Enforcement Responding to Domestic Violence Emergencies With the Deaf and Hard of Hearing: A Mixed-Methods Evaluation.

    Science.gov (United States)

    Engelman, Alina; Deardorff, Julianna

    2016-03-01

    To evaluate a training workshop for law enforcement as first responders for the purpose of increasing officers' cultural competency in working with Deaf and hard-of-hearing people (Deaf/HH) during domestic violence (DV) emergencies. This evaluation assesses the efficacy of a 2-hour training workshop for law enforcement. Thirty-four participants completed questionnaires at pre- and postintervention to assess participants' (1) satisfaction with training; (2) skills in responding to Deaf/HH individual(s) in a DV emergency; (3) attitudes toward the Deaf/HH, including bias recognition, self-assessment of cultural competency, and perceived self-efficacy; and (4) knowledge of communication. Focus groups (FGs) were also conducted (n = 6 for FG1, n = 13 for FG2). SPSS software was used to analyze survey data; principal components analysis was conducted on the survey instruments. There were significant differences between pre- and posttests for several targeted outcomes, including knowledge and perceived self-efficacy. Both survey and FG results demonstrated that participants gained cultural competency skills as indicated by changes in attitudes toward the Deaf/HH, both in DV emergencies and in large-scale emergencies. Significant differences were evident between pre and posttest results in terms of knowledge and perceived self-efficacy. Nonetheless, survey participants demonstrated a lack of knowledge about policy and the law. Survey findings also suggest that while a onetime training can improve the perceived self-efficacy of participants, shifting attitudes about the capabilities of the Deaf/HH may require different training strategies. FG participants demonstrated a greater awareness of the complexity of working with this population in a DV emergency. © 2015 Society for Public Health Education.

  11. Evaluation of emergency medical text processor, a system for cleaning chief complaint text data.

    Science.gov (United States)

    Travers, Debbie A; Haas, Stephanie W

    2004-11-01

    Emergency Medical Text Processor (EMT-P) version 1, a natural language processing system that cleans emergency department text (e.g., chst pn, chest pai), was developed to maximize extraction of standard terms (e.g., chest pain). The authors compared the number of standard terms extracted from raw chief complaint (CC) data with that for CC data cleaned with EMT-P and evaluated the accuracy of EMT-P. This cross-sectional observation study included CC text entries for all emergency department visits to three tertiary care centers in 2001. Terms were extracted from CC entries before and after cleaning with EMT-P. Descriptive statistics included number and percentage of all entries (tokens) and all unique entries (types) that matched a standard term from the Unified Medical Language System (UMLS). An expert panel rated the accuracy of the CC-UMLS term matches; inter-rater reliability was measured with kappa. The authors collected 203,509 CC entry tokens, of which 63,946 were unique entry types. For the raw data, 89,337 tokens (44%) and 5,081 types (8%) matched a standard term. After EMT-P cleaning, 168,050 tokens (83%) and 44,430 types (69%) matched a standard term. The expert panel reached consensus on 201 of the 222 CC-UMLS term matches reviewed (kappa=0.69-0.72). Ninety-six percent of the 201 matches were rated equivalent or related. Thirty-eight percent of the nonmatches were found to match UMLS concepts. EMT-P version 1 is relatively accurate, and cleaning with EMT-P improved the CC-UMLS term match rate over raw data. The authors identified areas for improvement in future EMT-P versions and issues to be resolved in developing a standard CC terminology.

  12. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Walsh, Steven Thomas; Groen, Arend J.; van der Sijde, Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies

  13. How and when do expert emergency physicians generate and evaluate diagnostic hypotheses? A qualitative study using head-mounted video cued-recall interviews.

    Science.gov (United States)

    Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Ammirati, Christine; Bertrand, Catherine; Dory, Valérie; Charlin, Bernard

    2014-12-01

    The ability to make a diagnosis is a crucial skill in emergency medicine. Little is known about the way emergency physicians reach a diagnosis. This study aims to identify how and when, during the initial patient examination, emergency physicians generate and evaluate diagnostic hypotheses. We carried out a qualitative research project based on semistructured interviews with emergency physicians. The interviews concerned management of an emergency situation during routine medical practice. They were associated with viewing the video recording of emergency situations filmed in an "own-point-of-view" perspective. The emergency physicians generated an average of 5 diagnostic hypotheses. Most of these hypotheses were generated before meeting the patient or within the first 5 minutes of the meeting. The hypotheses were then rank ordered within the context of a verification procedure based on identifying key information. These tasks were usually accomplished without conscious effort. No hypothesis was completely confirmed or refuted until the results of investigations were available. The generation and rank ordering of diagnostic hypotheses is based on the activation of cognitive processes, enabling expert emergency physicians to process environmental information and link it to past experiences. The physicians seemed to strive to avoid the risk of error by remaining aware of the possibility of alternative hypotheses as long as they did not have the results of investigations. Understanding the diagnostic process used by emergency physicians provides interesting ideas for training residents in a specialty in which the prevalence of reasoning errors leading to incorrect diagnoses is high. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  14. Challenges of measuring quality in emergency management

    DEFF Research Database (Denmark)

    Lynette, Jennifer Elyse

    2016-01-01

    This paper describes the challenges and importance of measuring quality within the field of emergency response. Using quality as a standard of measurement to evaluate response efforts of trained personnel in emergency situations is necessary to increase effectiveness in the response phase...... of an emergency event. The intended outcome of utilizing quality as a tool of measurement is to save additional lives, property, and resources. The adoption of a system to measure quality can be utilized by multiple professions under the broader field of emergency response services. Quality is discussed in terms...

  15. [Security material for venous peripheral..catheterization evaluation in an emergency ward].

    Science.gov (United States)

    Romero Ruiz, Adolfo; Jiménez Ruiz, Manuel; Rodríguez Navarro, Luis Miguel; Muñoz Pascual, José Carlos; Ramos Rueda, M del Carmen; Torres Pérez, Luis

    2007-06-01

    Venous canalization can be one of the most frequent causes of accidents due to an accidental puncture. To carry out activities which serve to lessen these misfortunes, bearing high biological risk, should become a priority for sanitary institutions and for their professionals. Inside a global strategy which deals with this aspect and with the objective of evaluating the convenience these instruments have in our center the authors made a practical evaluation on a series of them to discover their technical viability and their subjective consideration by professionals who employ them. For motives related to the practices of the ward in which this research took place, an emergency ward, the authors intentionally chose two passive instruments, available on the market, and three nurses who received 120 sample security catheters, 60 each for products A and B, to carry out habitual clinical practices, alongside a pad of paper on which to record any incidents. Regarding instrument A, 30 incidents, 52.6%, were detected while 37 sample procedures occurred. Regarding instrument B, 4 incidents, 7.01%, were detected while 47 sample procedures occurred. In absolute terms, neither of the two instruments demonstrated problems of an insecure manner; which is to say neither produced a situation related to the appearance of mis fortunate incidents associated to accidental punctures. The lower number of incidents with instrument B appears to be related to the habitual use of a conventional cathetec not a security one, produced by the same manufacturer in our center This research project was subsidized by the Sanitary Research Fund, PI 051265.

  16. The Mainz Neutrino Mass Experiment

    Czech Academy of Sciences Publication Activity Database

    Kraus, C.; Bornschein, L.; Bonn, J.; Bornschein, B.; Flatt, B.; Kovalík, Alojz; Müller, B.; Otten, EW; Schall, JP.; Thummler, T.; Weinheimer, C.

    2005-01-01

    Roč. 143, - (2005), s. 143 ISSN 0920-5632. [International Conference on Neutrino Physics and Astrophysics /21./. Paříž, 14.06.2004-19.06.2004] R&D Projects: GA MŠk 1P04LA213 Institutional research plan: CEZ:AV0Z10480505 Keywords : neutrino mass * tritium beta decay Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders Impact factor: 0.875, year: 2005

  17. Individual feature identification method for nuclear accident emergency decision-making

    International Nuclear Information System (INIS)

    Chen Yingfeng; Wang Jianlong; Lin Xiaoling; Yang Yongxin; Lu Xincheng

    2014-01-01

    According to the individual feature identification method and combining with the characteristics of nuclear accident emergency decision-making, the evaluation index system of the nuclear accident emergency decision-making was determined on the basis of investigation and analysis. The effectiveness of the nuclear accident emergency decision-making was evaluated based on the individual standards by solving the individual features of the individual standard identification decisions. The case study shows that the optimization result is reasonable, objective and reliable, and it can provide an effective analysis method and decision-making support for optimization of nuclear accident emergency protective measures. (authors)

  18. Asset Pricing in Emerging Markets

    OpenAIRE

    Ajrapetova, Tamara

    2017-01-01

    General content: Current methods of estimation of cost of capital in the emerging markets are often neglecting various contradictions with the essentials of the model structure and assumptions. As the result of such imprecisions, the cost of equity is often understated (overstated). This thesis will attempt to assess current level of emerging market integration, liquidity and concentration. This will be followed by evaluation of traditional and alternative models for estimation of cost of equ...

  19. Environmental monitoring in emergency situations

    International Nuclear Information System (INIS)

    1966-01-01

    This manual gives technical guidance on emergency monitoring procedures to those who would have to assess the situation after an accident leading to the uncontrolled release of radioactive substances to the environment. Its aim is to draw attention to the important factors that should be considered in formulating emergency plans. The seven annexes contain inventories of fission products and possible releases; dispersion, deposition and dose-exposure relationships for airborne releases; α-, β- and γ-radiation surveys; information on sample collection and field evaluation; and brief descriptions of the environmental monitoring procedures adopted in previous emergencies (Windscale 1957, AERE Harwell 1961 and NRTS Idaho 1961).

  20. Development on the radiological emergency management guide

    Energy Technology Data Exchange (ETDEWEB)

    Khang, Byung Oui; Lee, Jong Tai; Lee, Goan Yup; Lee, Moon

    2000-01-01

    The comprehensive emergency management system in KAERI describes the requirements for emergency plan, preparedness, evaluations and readiness assurance, response and recovery activities to timely and effectively countermeasure according to the type and size of an event. The guidance of facility emergency plan and detailed response procedures for initial action, building/site evacuation, personnel accountability, search and fire fighting in the radioactive, fissionable, toxic and inflammable hazardous substances handling facilities are also developed. (author)

  1. [Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

    Science.gov (United States)

    Dick, W

    1994-01-01

    Emergency medicine is subjected worldwide to financial stringencies and organizational evaluations of cost-effectiveness. The various links in the chain of survival are affected differently. Bystander assistance or bystander CPR is available in only 30% of the emergencies, response intervals--if at all required by legislation--are observed to only a limited degree or are too extended for survival in cardiac arrest. A single emergency telephone number is lacking. Too many different phone numbers for emergency reporting result in confusion and delays. Organizational realities are not fully overcome and impair efficiency. The position of the emergency physician in the EMS System is inadequately defined, the qualification of too many emergency physicians are unsatisfactory. In spite of this, emergency physicians are frequently forced to answer out-of-hospital emergency calls. Conflicts between emergency physicians and EMTs may be overcome by providing both groups with comparable qualifications as well as by providing an explicit definition of emergency competence. A further source of conflict occurs at the juncture of prehospital and inhospital emergency care in the emergency department. Deficiencies on either side play a decisive role. At least in principle there are solutions to the deficiencies in the EMSS and in intensive care medicine. They are among others: Adequate financial compensation of emergency personnel, availability of sufficient numbers of highly qualified personnel, availability of a central receiving area with an adjacent emergency ward, constant information flow to the dispatch center on the number of available emergency beds, maintaining 5% of all beds as emergency beds, establishing intermediate care facilities. Efficiency of emergency physician activities can be demonstrated in polytraumatized patients or in patients with ventricular fibrillation or acute myocardial infarction, in patients with acute myocardial insufficiency and other emergency

  2. Construction of a technique plan repository and evaluation system based on AHP group decision-making for emergency treatment and disposal in chemical pollution accidents

    International Nuclear Information System (INIS)

    Shi, Shenggang; Cao, Jingcan; Feng, Li; Liang, Wenyan; Zhang, Liqiu

    2014-01-01

    Highlights: • Different chemical pollution accidents were simplified using the event tree analysis. • Emergency disposal technique plan repository of chemicals accidents was constructed. • The technique evaluation index system of chemicals accidents disposal was developed. • A combination of group decision and analytical hierarchy process (AHP) was employed. • Group decision introducing similarity and diversity factor was used for data analysis. - Abstract: The environmental pollution resulting from chemical accidents has caused increasingly serious concerns. Therefore, it is very important to be able to determine in advance the appropriate emergency treatment and disposal technology for different types of chemical accidents. However, the formulation of an emergency plan for chemical pollution accidents is considerably difficult due to the substantial uncertainty and complexity of such accidents. This paper explains how the event tree method was used to create 54 different scenarios for chemical pollution accidents, based on the polluted medium, dangerous characteristics and properties of chemicals involved. For each type of chemical accident, feasible emergency treatment and disposal technology schemes were established, considering the areas of pollution source control, pollutant non-proliferation, contaminant elimination and waste disposal. Meanwhile, in order to obtain the optimum emergency disposal technology schemes as soon as the chemical pollution accident occurs from the plan repository, the technique evaluation index system was developed based on group decision-improved analytical hierarchy process (AHP), and has been tested by using a sudden aniline pollution accident that occurred in a river in December 2012

  3. Construction of a technique plan repository and evaluation system based on AHP group decision-making for emergency treatment and disposal in chemical pollution accidents

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Shenggang [College of Environmental Science and Engineering, Beijing Forestry University, Beijing 100083 (China); College of Chemistry, Baotou Teachers’ College, Baotou 014030 (China); Cao, Jingcan; Feng, Li; Liang, Wenyan [College of Environmental Science and Engineering, Beijing Forestry University, Beijing 100083 (China); Zhang, Liqiu, E-mail: zhangliqiu@163.com [College of Environmental Science and Engineering, Beijing Forestry University, Beijing 100083 (China)

    2014-07-15

    Highlights: • Different chemical pollution accidents were simplified using the event tree analysis. • Emergency disposal technique plan repository of chemicals accidents was constructed. • The technique evaluation index system of chemicals accidents disposal was developed. • A combination of group decision and analytical hierarchy process (AHP) was employed. • Group decision introducing similarity and diversity factor was used for data analysis. - Abstract: The environmental pollution resulting from chemical accidents has caused increasingly serious concerns. Therefore, it is very important to be able to determine in advance the appropriate emergency treatment and disposal technology for different types of chemical accidents. However, the formulation of an emergency plan for chemical pollution accidents is considerably difficult due to the substantial uncertainty and complexity of such accidents. This paper explains how the event tree method was used to create 54 different scenarios for chemical pollution accidents, based on the polluted medium, dangerous characteristics and properties of chemicals involved. For each type of chemical accident, feasible emergency treatment and disposal technology schemes were established, considering the areas of pollution source control, pollutant non-proliferation, contaminant elimination and waste disposal. Meanwhile, in order to obtain the optimum emergency disposal technology schemes as soon as the chemical pollution accident occurs from the plan repository, the technique evaluation index system was developed based on group decision-improved analytical hierarchy process (AHP), and has been tested by using a sudden aniline pollution accident that occurred in a river in December 2012.

  4. Identification of training and emergency-planning needs through job-safety analysis

    Energy Technology Data Exchange (ETDEWEB)

    Veltrie, J.

    1987-01-01

    Training and emergency-planning needs within the photovoltaic industry may be more accurately determined through the performance of detailed job-safety analysis. This paper outlines the four major components of such an analysis, namely operational review, hazards evaluation, personnel review and resources evaluation. It then shows how these may be developed into coherent training and planning recommendations, for both emergency and non-emergency situations.

  5. Energy emergency planning guide: Winter 1977-78

    Energy Technology Data Exchange (ETDEWEB)

    1977-11-01

    This Energy Emergency Planning Guide for Winter, 1977-78 has been prepared in order to: identify and evaluate actions available to deal with energy emergencies this winter; provide an advance indication to the public of those actions considered most likely to be taken by the government, and provide industry, state, and local governments with suggestions about actions which they can take to deal with energy emergencies. The Guide contains specifications for over 50 standby programs and procedures, recommended implementation guidelines for using these programs keyed to a pre-emergency phase and three phases of shortfalls, and a design for an Energy Emergency Center. Flexible implementation guidelines are proposed for natural gas, petroleum, electricity/coal, and propane shortages. (MCW)

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

    International Nuclear Information System (INIS)

    2007-01-01

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

  7. Improved TOPSIS decision model for NPP emergencies

    International Nuclear Information System (INIS)

    Zhang Jin; Liu Feng; Huang Lian

    2011-01-01

    In this paper,an improved decision model is developed for its use as a tool to respond to emergencies at nuclear power plants. Given the complexity of multi-attribute emergency decision-making on nuclear accident, the improved TOPSIS method is used to build a decision-making model that integrates subjective weight and objective weight of each evaluation index. A comparison between the results of this new model and two traditional methods of fuzzy hierarchy analysis method and weighted analysis method demonstrates that the improved TOPSIS model has a better evaluation effect. (authors)

  8. An economic evaluation of forest improvement opportunities and impacts from the emergence of a biomass fuel market in southwestern Nova Scotia

    International Nuclear Information System (INIS)

    Manley, A.L.; Savage, G.D.

    1993-01-01

    In 1991, Nova Scotia's public power utility initiated a process to purchase privately produced electrical power. A proposal was received to produce 20--25 megawatts from the burning of 350 to 400,000 tonnes annually of wood residue and forest biomass in a co-generation facility in southwestern Nova Scotia, Canada. This proposal has been proceeding and is nearing the construction phase. As a result of this potential market, there is an opportunity for increasing the scope and extent of forest improvement operations. Options for a closer integration of planning, harvesting, and silviculture activities will emerge. Optimum end use allocation could occur and enhance overall economic efficiency. The objective of this project is to assess the effect that this emerging market for forest biomass could have on forest management in the supply area. This project has two phases. Phase 1, presented here, develops the framework and methodology. Phase 2 will apply a linear programming-based analytical model for evaluation. Phase 1 accumulated the required data and information for both the current management and marketing situation and that including the emerging biomass market. Growth and yield of the natural stand types were calculated for a mixture of conventional roundwood products and chip equivalents. Management regimes, based on current forest type, site class, and appropriate silviculture treatments, were established. Expected multiproduct yields, by regime were estimated. Silviculture and harvest costs along with product revenues were used to calculate standing timber and soil expectation values. In Phase 2, a stand-based optimization model will be developed to explore and evaluate the long term opportunities and differences between the present and emerging management and market situations

  9. Outcomes of allergy/immunology follow-up after an emergency department evaluation for anaphylaxis.

    Science.gov (United States)

    Campbell, Ronna L; Park, Miguel A; Kueber, Michael A; Lee, Sangil; Hagan, John B

    2015-01-01

    Anaphylaxis guidelines currently recommend referring patients with anaphylaxis seen in the emergency department (ED) to an allergist for follow up. The objective of our study was to evaluate outcomes of allergy/immunology follow-up after an ED visit for anaphylaxis. A retrospective health records review was conducted from April 2008 to August 2012. Charts were reviewed independently by 2 allergists to determine outcomes. Descriptive statistics with corresponding 95% CIs were calculated. Among 573 patients seen in the ED who met anaphylaxis diagnostic criteria, 217 (38%) had a documented allergy/immunology follow-up. After allergy/immunology evaluation, 16 patients (7% [95% CI, 5%-12%]) had anaphylaxis ruled out. Among those with an unknown ED trigger (n = 74), 24 (32% [95% CI, 23%-44%]) had a trigger identified; and, among those who had a specific suspected ED trigger (n = 143), 9 (6% [95% CI, 3%-12%]) had a trigger identified in a category other than the one suspected in the ED, and 28 (20% [95% CI, 14%-27%]) had an unknown trigger. Thus, there were a total of 77 patients (35% [95% CI, 29%-42%]) who had an alteration in the diagnosis of anaphylaxis or trigger after allergy/immunology evaluation. Four patients (2% [95% CI, 0.7%-4.6%]) were diagnosed with a mast cell activation disorder, and 13 patients (6% [95% CI, 4%-10%]) underwent immunotherapy or desensitization. Overall, 35% of the patients with suspected anaphylaxis in the ED had an alteration in the diagnosis or suspected trigger after allergy/immunology evaluation. These results underscore the importance of allergy/immunology follow-up after an ED visit for anaphylaxis. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Evaluation of seed coating formulations of Trichoderma harzianum on cucumber seeds against pre- and post-emergence damping-off caused by Pythium ultimum

    Science.gov (United States)

    Seed coating formulations of Trichoderma harzianum were evaluated on cucumber seeds to control pre- and post-emergence damping-off caused by Pythium ultimum in greenhouse studies. Results showed that coating formulation H reduced the disease incidence significantly, and had the potential for commer...

  11. Comparisons between Full-time and Part-time Pediatric Emergency Physicians in Pediatric Emergency Department.

    Science.gov (United States)

    Huang, I-Anne; Tuan, Pao-Lan; Jaing, Tang-Her; Wu, Chang-Teng; Chao, Minston; Wang, Hui-Hsuan; Hsia, Shao-Hsuan; Hsiao, Hsiang-Ju; Chang, Yu-Ching

    2016-10-01

    Pediatric emergency medicine is a young field that has established itself in recent decades. Many unanswered questions remain regarding how to deliver better pediatric emergency care. The implementation of full-time pediatric emergency physicians is a quality improvement strategy for child care in Taiwan. The aim of this study is to evaluate the quality of care under different physician coverage models in the pediatric emergency department (ED). The medical records of 132,398 patients visiting the pediatric ED of a tertiary care university hospital during January 2004 to December 2006 were retrospectively reviewed. Full-time pediatric emergency physicians are the group specializing in the pediatric emergency medicine, and they only work in the pediatric ED. Part-time pediatricians specializing in other subspecialties also can work an extra shift in the pediatric ED, with the majority working in their inpatient and outpatient services. We compared quality performance indicators, including: mortality rate, the 72-hour return visit rate, length of stay, admission rate, and the rate of being kept for observation between full-time and part-time pediatric emergency physicians. An average of 3678 ± 125 [mean ± standard error (SE)] visits per month (with a range of 2487-6646) were observed. The trends in quality of care, observed monthly, indicated that the 72-hour return rate was 2-6% and length of stay in the ED decreased from 11.5 hours to 3.2 hours over the study period. The annual mortality rate within 48 hours of admission to the ED increased from 0.04% to 0.05% and then decreased to 0.02%, and the overall mortality rate dropped from 0.13% to 0.07%. Multivariate analyses indicated that there was no change in the 72-hour return visit rate for full-time pediatric emergency physicians; they were more likely to admit and keep patients for observation [odds ratio = 1.43 and odds ratio = 1.71, respectively], and these results were similar to those of senior

  12. Occupational stress among Thai emergency department nurses : Development and validation of an instrument for measuring stressors in emergency departments

    OpenAIRE

    Yuwanich, Nuttapol

    2017-01-01

    Working at an emergency department has some characteristics, which may generate stress. In this thesis, the stressors for emergency nurses were evaluated and an instrument was developed for measuring their impact. In order to gain a deeper understanding regarding the occupational stress among emergency nurses, a descriptive qualitative design with semi-structured interviews were used in two studies (I, II), one at a private and the other at a public hospital in Thailand. Three main categories...

  13. Imaging Total Stations - Modular and Integrated Concepts

    Science.gov (United States)

    Hauth, Stefan; Schlüter, Martin

    2010-05-01

    Keywords: 3D-Metrology, Engineering Geodesy, Digital Image Processing Initialized in 2009, the Institute for Spatial Information and Surveying Technology i3mainz, Mainz University of Applied Sciences, forces research towards modular concepts for imaging total stations. On the one hand, this research is driven by the successful setup of high precision imaging motor theodolites in the near past, on the other hand it is pushed by the actual introduction of integrated imaging total stations to the positioning market by the manufacturers Topcon and Trimble. Modular concepts for imaging total stations are manufacturer independent to a large extent and consist of a particular combination of accessory hardware, software and algorithmic procedures. The hardware part consists mainly of an interchangeable eyepiece adapter offering opportunities for digital imaging and motorized focus control. An easy assembly and disassembly in the field is possible allowing the user to switch between the classical and the imaging use of a robotic total station. The software part primarily has to ensure hardware control, but several level of algorithmic support might be added and have to be distinguished. Algorithmic procedures allow to reach several levels of calibration concerning the geometry of the external digital camera and the total station. We deliver insight in our recent developments and quality characteristics. Both the modular and the integrated approach seem to have its individual strengths and weaknesses. Therefore we expect that both approaches might point at different target applications. Our aim is a better understanding of appropriate applications for robotic imaging total stations. First results are presented. Stefan Hauth, Martin Schlüter i3mainz - Institut für Raumbezogene Informations- und Messtechnik FH Mainz University of Applied Sciences Lucy-Hillebrand-Straße 2, 55128 Mainz, Germany

  14. Classification,Hazards and Countermeasures of Agricultural Environmental Pollution Emergencies

    Institute of Scientific and Technical Information of China (English)

    Xiaoming; CHUAI; Haixia; ZHOU; Jianping; ZHAO; Shubo; CHENG; Jiang; YU

    2013-01-01

    Agricultural environmental pollution emergencies have become a hot research topic because of the high incidence and influence depth.This paper introduces classification and features of agricultural environmental pollution emergencies:by pollutant type,it falls into organic pollution emergencies and inorganic pollution emergencies;by the approach of entering agricultural environment,it falls into water resource agricultural environmental pollution emergencies and non-water resource agricultural environmental pollution emergencies.Hazards of agricultural environmental pollution emergencies are analyzed from 4 perspectives:personal security,indirect loss,ecological environment and social stability.In view of the hazards,countermeasures are given to deal with the pollution emergencies as(i)establishing a risk evaluation mechanism for agricultural environment;(ii)enhancing the capacity of handling agricultural environmental pollution emergencies;(iii)introducing new management concepts for environmental emergencies,and cultivating keen emergency management consciousness.

  15. Can emergency physicians accurately and reliably assess acute vertigo in the emergency department?

    Science.gov (United States)

    Vanni, Simone; Nazerian, Peiman; Casati, Carlotta; Moroni, Federico; Risso, Michele; Ottaviani, Maddalena; Pecci, Rudi; Pepe, Giuseppe; Vannucchi, Paolo; Grifoni, Stefano

    2015-04-01

    To validate a clinical diagnostic tool, used by emergency physicians (EPs), to diagnose the central cause of patients presenting with vertigo, and to determine interrater reliability of this tool. A convenience sample of adult patients presenting to a single academic ED with isolated vertigo (i.e. vertigo without other neurological deficits) was prospectively evaluated with STANDING (SponTAneousNystagmus, Direction, head Impulse test, standiNG) by five trained EPs. The first step focused on the presence of spontaneous nystagmus, the second on the direction of nystagmus, the third on head impulse test and the fourth on gait. The local standard practice, senior audiologist evaluation corroborated by neuroimaging when deemed appropriate, was considered the reference standard. Sensitivity and specificity of STANDING were calculated. On the first 30 patients, inter-observer agreement among EPs was also assessed. Five EPs with limited experience in nystagmus assessment volunteered to participate in the present study enrolling 98 patients. Their average evaluation time was 9.9 ± 2.8 min (range 6-17). Central acute vertigo was suspected in 16 (16.3%) patients. There were 13 true positives, three false positives, 81 true negatives and one false negative, with a high sensitivity (92.9%, 95% CI 70-100%) and specificity (96.4%, 95% CI 93-38%) for central acute vertigo according to senior audiologist evaluation. The Cohen's kappas of the first, second, third and fourth steps of the STANDING were 0.86, 0.93, 0.73 and 0.78, respectively. The whole test showed a good inter-observer agreement (k = 0.76, 95% CI 0.45-1). In the hands of EPs, STANDING showed a good inter-observer agreement and accuracy validated against the local standard of care. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  16. Evaluation of the preparedness of the children's emergency rooms ...

    African Journals Online (AJOL)

    2017-02-09

    Feb 9, 2017 ... beds per nurse ranges from 3-15, giving a nurse: patient ratio of 1:3-15. (Table 1) .... Emergency Rooms (CHER) in the tertiary health institu- .... vices offered in our tertiary centres must go beyond the mundane ... medical tourism abroad as most often any care beyond the basic ... of general practitioner care.

  17. Evaluating and Measuring the Return on Investment of an Emergency Center Health Care Professional Picture Archiving and Communication Systems Training Program

    Science.gov (United States)

    Roelandt, James P.

    2012-01-01

    Picture archiving and communication system (PACS) workflow directly affects the quality of emergency patient care through radiology exam turn-around times and the speed of delivery of diagnostic radiology results. This study was a mixed methods training and performance improvement study that evaluated the effectiveness and value of a hospital…

  18. Criteria for preparation and evaluation of radiological emergency response plans and preparedness in support of nuclear power plants: Criteria for utility offsite planning and preparedness: Final report

    International Nuclear Information System (INIS)

    Podolak, E.M. Jr.; Sanders, M.E.; Wingert, V.L.; Donovan, R.W.

    1988-09-01

    The Nuclear Regulatory Commission (NRC) and the Federal Emergency Management Agency (FEMA) have added a supplement to NUREG-0654/FEMA-REP-1, Rev. 1 that provides guidance for the development, review, and evaluation of utility offsite radiological emergency response planning and preparedness for those situations in which state and/or local governments decline to participate in emergency planning. While this guidance primarily applies to plants that do not have full-power operating licenses, it does have relevance to operating nuclear power plants

  19. Methodology for Assessing Radiation Detectors Used by Emergency Responders

    International Nuclear Information System (INIS)

    Piotr Wasiolek; April Simpson

    2008-01-01

    The threat of weapons of mass destruction terrorism resulted in the U.S. Department of Homeland Security deploying large quantities of radiation detectors throughout the emergency responder community. However, emergency responders specific needs were not always met by standard health physics instrumentation used in radiation facilities. Several American National Standards Institute standards were developed and approved to evaluate the technical capabilities of detection equipment. Establishing technical capability is a critical step, but it is equally important to emergency responders that the instruments are easy to operate and can withstand the rugged situations they encounter. The System Assessment and Validation for Emergency Responders (SAVER) Program (managed by the U.S. Department of Homeland Security, Office of Grants and Training, Systems Support Division) focuses predominantly on the usability, ergonomics, readability, and other features of the detectors, rather than performance controlled by industry standards and the manufacturers. National Security Technologies, LLC, as a SAVER Technical Agent, conducts equipment evaluations using active emergency responders who are familiar with the detection equipment and knowledgeable of situations encountered in the field, which provides more relevant data to emergency responders

  20. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation

    Directory of Open Access Journals (Sweden)

    Tan-Hsu Tan

    2017-01-01

    Full Text Available This study presents a new ubiquitous emergency medical service system (UEMS that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients’ biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient’s biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios.

  1. Evaluation of the Medical Care of Patients with Hypertension in an Emergency Department and in Ambulatory Hypertension Unit

    Directory of Open Access Journals (Sweden)

    Fernando Nobre

    2002-02-01

    Full Text Available OBJECTIVE: To evaluate the characteristics of the patients receiving medical care in the Ambulatory of Hypertension of the Emergency Department, Division of Cardiology, and in the Emergency Unit of the Clinical Hospital of the Ribeirão Preto Medical School. METHODS: Using a protocol, we compared the care of the same hypertensive patients in on different occasions in the 2 different places. The characteristics of 62 patients, 29 men with a mean age of 57 years, were analyzed between January 1996 and December 1997. RESULTS: The care of these patients resulted in different medical treatment regardless of their clinical features and blood pressure levels. Thus, in the Emergency Unit, 97% presented with symptoms, and 64.5% received medication to rapidly reduce blood pressure. In 50% of the cases, nifedipine SL was the elected medication. Patients who applied to the Ambulatory of Hypertension presenting with similar features, or, in some cases, presenting with similar clinically higher levels of blood pressure, were not prescribed medication for a rapid reduction of blood pressure at any of the appointments. CONCLUSION: The therapeutic approach to patients with high blood pressure levels, symptomatic or asymptomatic, was dependent on the place of treatment. In the Emergency Unit, the conduct was, in the majority of cases, to decrease blood pressure immediately, whereas in the Ambulatory of Hypertension, the same levels of blood pressure, in the same individuals, resulted in therapeutic adjustment with nonpharmacological management. These results show the need to reconsider the concept of hypertensive crises and their therapeutical implications.

  2. Evaluating the effect of emergency residency training on productivity in the emergency department.

    Science.gov (United States)

    Henning, Daniel J; McGillicuddy, Daniel C; Sanchez, Leon D

    2013-09-01

    Resident productivity, defined as patients seen per unit time, is one measure that is used to assess the performance and educational progress of residents in the emergency department (ED). One published study suggested that emergency residency training (EM) does not improve productivity compared with that in other specialties, including internal medicine (IM). This study assesses how EM and IM trainees perform in the ED and illustrates how resident productivity changes through the academic year. A retrospective review of attending physicians and residents working 8-h shifts in the higher acuity zone of a large-volume, tertiary, academic health care center was performed for July 2009, October 2009, January 2010, and April 2010. The total number of patients seen primarily and admitted during each shift was recorded. ED volume was approximated by the number of patients seen by the attending physician, and acuity was approximated by admission rate. A mixed model regression assessed the impact of year and type of residency training (e.g., EM1, EM2, IM1, and IM2), ED volume, and acuity on resident productivity (number of patients per shift). The study was granted waiver of informed consent by our institutional review board. We reviewed 936 shifts. After adjusting for acuity and ED volume, the EM1 group had a significant increase in patients per shift over the year, from 6.11 in July to 10.3 in April (p increased productivity significantly. The first EM training year leads to a significant change in productivity that separates EM from IM residents. This contradicts the previous assertion that non-EM residents have the same productivity as EM residents in the ED. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Retrospective Evaluation of Patients Admitted to the Pediatric Emergency Department with Intoxication

    Directory of Open Access Journals (Sweden)

    Alaaddin Yorulmaz

    2017-12-01

    Full Text Available Introduction: In this study, we aimed to retrospectively analyze the demographic and epidemiologic features, clinical course, laboratory results and prognoses of the patients admitted to the department of pediatric emergency due to poisoning. Methods: This trial enrolled a total of 430 patients aged 1 month to 18 years. The medical data of the patients were reviewed retrospectively according to patient's medical record. Demographic data such as age, sex, time of occurrence, time of patient presentation to the emergency department, time to first medical intervention after taking the drug, cause of poisoning, received active substances, ways of taking, number of active substances received, and symptoms at admission to the hospital were analyzed. Results: The study population consisted of 0.74% of all patients who were admitted to the department of pediatric emergency. 243 (56.5% patients were female and 187 (43.5% were male. The age of the patients ranged from 4 months to 220 months (72.89±66.38. One hundred-thirteen (26.3% of our patients were referred to our hospital in the summer, 111 (25.8% in the spring, 110 (25.6% in the autumn and 96 (22.3% in the winter. Eighteen patients were admitted to our emergency department with poisoning in 2014, 193 in 2015, 178 in 2016 and 41 in 2017. 12.3% of our patients were referred to our emergency department between hours 00:00 and 08:00, 35.1% between 08:00 and 16:00 and 52.6% between 16:00 and 24:00. Ninety-six of the patients were admitted to our emergency department due to suicidal poisoning and 334 due to accidental poisoning. Nausea was present at the time of presentation in 142 (33.02% of our patients, vomiting in 122 (28.37% and dizziness in 102 (23.72%. Conclusion: We believe that determination of the epidemiological features of the poisonings in our country by large scale studies and public consciousness will contribute significantly to the prevention of childhood poisoning.

  4. Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency departments.

    Science.gov (United States)

    Zeller, Scott; Calma, Nicole; Stone, Ashley

    2014-02-01

    Mental health patients boarding for long hours, even days, in United States emergency departments (EDs) awaiting transfer for psychiatric services has become a considerable and widespread problem. Past studies have shown average boarding times ranging from 6.8 hours to 34 hours. Most proposed solutions to this issue have focused solely on increasing available inpatient psychiatric hospital beds, rather than considering alternative emergency care designs that could provide prompt access to treatment and might reduce the need for many hospitalizations. One suggested option has been the "regional dedicated emergency psychiatric facility," which serves to evaluate and treat all mental health patients for a given area, and can accept direct transfers from other EDs. This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the "Alameda Model" on boarding times and hospitalization rates for psychiatric patients in area EDs. Over a 30-day period beginning in January 2013, 5 community hospitals in Alameda County, California, tracked all ED patients on involuntary mental health holds to determine boarding time, defined as the difference between when they were deemed stable for psychiatric disposition and the time they were discharged from the ED for transfer to the regional psychiatric emergency service. Patients were also followed to determine the percentage admitted to inpatient psychiatric units after evaluation and treatment in the psychiatric emergency service. In a total sample of 144 patients, the average boarding time was approximately 1 hour and 48 minutes. Only 24.8% were admitted for inpatient psychiatric hospitalization from the psychiatric emergency service. The results of this study indicate that the Alameda Model of transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus

  5. Emergency and backup power supplies at Department of Energy facilities: Augmented Evaluation Team -- Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    This report documents the results of the Defense Programs (DP) Augmented Evaluation Team (AET) review of emergency and backup power supplies (i.e., generator, uninterruptible power supply, and battery systems) at DP facilities. The review was conducted in response to concerns expressed by former Secretary of Energy James D. Watkins over the number of incidents where backup power sources failed to provide electrical power during tests or actual demands. The AET conducted a series of on-site reviews for the purpose of understanding the design, operation, maintenance, and safety significance of emergency and backup power (E&BP) supplies. The AET found that the quality of programs related to maintenance of backup power systems varies greatly among the sites visited, and often among facilities at the same site. No major safety issues were identified. However, there are areas where the AET believes the reliability of emergency and backup power systems can and should be improved. Recommendations for improving the performance of E&BP systems are provided in this report. The report also discusses progress made by Management and Operating (M&O) contractors to improve the reliability of backup sources used in safety significant applications. One area that requires further attention is the analysis and understanding of the safety implications of backup power equipment. This understanding is needed for proper graded-approach implementation of Department of Energy (DOE) Orders, and to help ensure that equipment important to the safety of DOE workers, the public, and the environment is identified, classified, recognized, and treated as such by designers, users, and maintainers. Another area considered important for improving E&BP system performance is the assignment of overall ownership responsibility and authority for ensuring that E&BP equipment performs adequately and that reliability and availability are maintained at acceptable levels.

  6. Accident assessment under emergency situation in Daya Bay nuclear power station

    International Nuclear Information System (INIS)

    Yang Ling; Chen Degan; Lin Shumou; Fu Guohui

    2004-01-01

    The accident assessment under emergency situation includes the accident status evaluation and its consequence estimation. This paper introduces evaluation methods for accident status and its assistant computer system (SESAME-GNP) utilized during the emergency situation in Guangdong Daya Bay Nuclear Power Station (GNPS) in detail. At the same time, an improved accident consequence estimation system in GNPS (RACAS-GNP) is briefly described. With the improvement of the accident assessment systems, the capability of emergency response in GNPS is strengthened

  7. Standard review plan for the review and evaluation of emergency plans for research and test reactors

    International Nuclear Information System (INIS)

    1983-10-01

    This document provides a Standard Review Plan to assure that complete and uniform reviews are made of research and test reactor radiological emergency plans. The report is organized under ten planning standards which correspond to the guidance criteria in American National Standard ANSI/ANS 15.16 - 1982 as endorsed by Revision 1 to Regulatory Guide 2.6. The applicability of the items under each planning standard is indicated by subdivisions of the steady-state thermal power levels at which the reactors are licensed to operate. Standard emergency classes and example action levels for research and test reactors which should initiate these classes are given in an Appendix. The content of the emergency plan is as follows: the emergency plan addresses the necessary provisions for coping with radiological emergencies. Activation of the emergency plan is in response to the emergency action levels. In addition to addressing those severe emergencies that will fall within one of the standard emergency classes, the plan also discusses the necessary provisions to deal with radiological emergencies of lesser severity that can occur within the operations boundary. The emergency plan allows for emergency personnel to deviate from actions described in the plan for unusual or unanticipated conditions

  8. Knowledge and use of emergency contraception among educated ...

    African Journals Online (AJOL)

    Background: One of the effective ways to reduce unwanted pregnancy and its consequences is the knowledge and effective use of emergency contraception among the population. Aim: To evaluate the knowledge of emergency contraception among educated men and women and how often they use it. Methodology: ...

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

    Directory of Open Access Journals (Sweden)

    Weili Duan

    2015-07-01

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

  10. The Role of Radio Frequency Detection System Embedded Surgical Sponges in Preventing Retained Surgical Sponges: A Prospective Evaluation in Patients Undergoing Emergency Surgery.

    Science.gov (United States)

    Inaba, Kenji; Okoye, Obi; Aksoy, Hande; Skiada, Dimitra; Ault, Glenn; Sener, Stephen; Lam, Lydia; Benjamin, Elizabeth; Demetriades, Demetrios

    2016-10-01

    To prospectively evaluate the ability of radio frequency detection (RFD) system-embedded sponges to mitigate the incidence of retained surgical sponges (RSS) after emergency surgery. Emergency surgery patients are at high risk for retained foreign bodies. All emergent trauma and nontrauma cavitary operations over a 5-year period (January 2010-December 2014) were prospectively enrolled. For damage-control procedures, only the definitive closure was included. RFD sponges were used exclusively throughout the study period. Before closure, the sponge and instrument count was followed by RFD scanning and x-ray evaluation for retained sponges. RSS and near-misses averted using the RFD system were analyzed. In all, 2051 patients [median (range)], aged 41 (1-101) years, 72.2% male, 46.8% trauma patients, underwent 2148 operations (1824 laparotomy, 100 thoracotomy, 30 sternotomy, and 97 combined). RFD detected retained sponges in 11 (0.5%) patients (81.8%laparotomy, 18.2% sternotomy) before cavitary closure. All postclosure x-rays were negative. No retained sponges were missed by the RFD system. Body mass index was 29 (23-43), estimated blood loss 1.0 L (0-23), and operating room time 160 minutes (71-869). Procedures started after 18:00 to 06:00 hours in 45.5% of the patients. The sponge count was incorrect in 36.4%, not performed due to time constraints in 45.5%, and correct in 18.2%. The additional cost of using RFD-embedded disposables was $0.17 for a 4X18 laparotomy sponge and $0.46 for a 10 pack of 12ply, 4X8. Emergent surgical procedures are high-risk for retained sponges, even when sponge counts are performed and found to be correct. Implementation of a RFD system was effective in preventing this complication and should be considered for emergent operations in an effort to improve patient safety.

  11. Examining professional emergency managers in Korea

    International Nuclear Information System (INIS)

    Ha, Kyoo-Man

    2017-01-01

    Although the number of emergency managers has risen in South Korea (hereafter referred to as Korea) over the years, their role is not yet as defined and noteworthy compared to other professions because of its unidisciplinary approach. This article investigates how Korea has to improve emergency managers' disciplinary approach to ultimately contribute to the goal of effective transnational disaster management. This study uses qualitative content analysis of government policies, college curricula, nongovernmental organizations' (NGOs') emergency-manager certification, and mass media coverage to compare emergency managers' unidisciplinary and multidisciplinary approaches. The key tenet is that Korea must change its emergency managers' unidisciplinary approach into a multidisciplinary approach because the former is less effective when dealing with complicated disaster management systems. To achieve this change, the stakeholders must carry out their assigned responsibilities under risk-oriented management. As for the study's international implications, developing nations may consider the enhancement of related educational curricula, collaborative learning, continuous evaluation, disaster awareness, and disaster prevention for the emergency managers' multidisciplinary approach.

  12. Examining professional emergency managers in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Kyoo-Man, E-mail: ha1999@hotmail.com

    2017-01-15

    Although the number of emergency managers has risen in South Korea (hereafter referred to as Korea) over the years, their role is not yet as defined and noteworthy compared to other professions because of its unidisciplinary approach. This article investigates how Korea has to improve emergency managers' disciplinary approach to ultimately contribute to the goal of effective transnational disaster management. This study uses qualitative content analysis of government policies, college curricula, nongovernmental organizations' (NGOs') emergency-manager certification, and mass media coverage to compare emergency managers' unidisciplinary and multidisciplinary approaches. The key tenet is that Korea must change its emergency managers' unidisciplinary approach into a multidisciplinary approach because the former is less effective when dealing with complicated disaster management systems. To achieve this change, the stakeholders must carry out their assigned responsibilities under risk-oriented management. As for the study's international implications, developing nations may consider the enhancement of related educational curricula, collaborative learning, continuous evaluation, disaster awareness, and disaster prevention for the emergency managers' multidisciplinary approach.

  13. Seedling vigor and genetic variability for rice seed, seedling emergence and seedling traits

    International Nuclear Information System (INIS)

    Ali, S.S.; Jafri, S.J.H.; Jamil, M.; Ijaz, M.

    1994-01-01

    Eleven local rice cultivars including Basmati 370 were evaluated for seedling vigor. Three groups of traits were evaluated viz; seed traits (Seed density, seed volume see weight, paddy length and grain length), seed emergence traits (emergence %, emergence index and emergence rate index), and seedling traits (fresh root length, dry root weight, emergence percentage, root length, dry root weight, seed weight and relative root weight were observed significant, respectively. Seed density, relative root weight, emergence rate index and root to shoot ratio were relatively more amenable to improvement. Relative expected genetic advance was the function of heritability and coefficient of phenotypic variability, latter being more important. (author)

  14. Can public health registry data improve Emergency Medical Dispatch?

    DEFF Research Database (Denmark)

    Andersen, M S; Christensen, E F; Jepsen, S B

    2016-01-01

    BACKGROUND: Emergency Medical Dispatchers make decisions based on limited information. We aimed to investigate if adding demographic and hospitalization history information to the dispatch process improved precision. METHODS: This 30-day follow-up study evaluated time-critical emergencies...

  15. Evaluation report of the Nordic emergency exercise Nora - January 14, 1993

    International Nuclear Information System (INIS)

    Salo, A.; Singer, K.; Aakesson, T.; Valfells, A.; Backe, S.; Kallhagen, B.

    1993-01-01

    Nordic countries are signatories to the Convention on Early Notification of a Nuclear Accident and to the Convention on Assistance in Case of a Nuclear Accident or Radiological Emergency. In addition to these international conventions the states, except Iceland, have bilateral agreements on early notification and exchange of information with each other and with neighbouring countries. The bilateral agreements also require notification if levels of radionuclide contamination are observed which prompt information to the public or activation of the emergency organization or part of it. The main objective of the exercise NORA was to test and harmonize the overall decision making in the responsible Nordic approach to the emergency response, to improve co-operation in assessing rumour-, threat- and accident-situations, to improve co-operation in making decisions on intervention levels and on interventions in a Nordic perspective, to enhance harmony in information policy concerning information to the public in order to avoid ''double messages'', to improve information exchange between the Nordic countries and internationally. The objectives of the exercise were considered to have been met satisfactorily and the exercise made a valuable contribution to further develop the Nordic co-operation. (EG)

  16. Emergency thoracic surgery in elderly patients

    OpenAIRE

    Limmer, Stefan; Unger, Lena; Czymek, Ralf; Kujath, Peter; Hoffmann, Martin

    2011-01-01

    Objectives Emergency thoracic surgery in the elderly represents an extreme situation for both the surgeon and patient. The lack of an adequate patient history as well as the inability to optimize any co-morbidities, which are the result of the emergent situation, are the cause of increased morbidity and mortality. We evaluated the outcome and prognostic factors for this selected group of patients. Design Retrospective chart review. Setting Academic tertiary care referral center. Participants ...

  17. A reactor core/containment status evaluation flowchart for determining protective actions in emergencies

    International Nuclear Information System (INIS)

    Glissman, M.A.

    1988-01-01

    In the event of an emergency at a power reactor station, there might not be adequate time or sufficient data to fully assess radiological implications and make protective action recommendations based on projected population exposures. Thus, decision-making guidance is needed that is based on readily available plant indicators, not just on time-consuming dose calculations. In the United States, this guidance must be compatible with the recommended by the Nuclear Regulatory Commission and the Environmental Protection Agency, and it must include predetermined, measurable, site-specific parameters for assessing conditions in the reactor core and containment. The preparation of this real time guidance calls for the selection of suitable parameters and the determination of the values for these parameters that will correspond to different levels of protective action. This process is illustrated in this paper by selecting parameters and determining appropriate values for constructing a Core/Containment Status Evaluation Flowchart for an example power plant

  18. Post-Chernobyl emergency planning

    International Nuclear Information System (INIS)

    1986-01-01

    This report is the result of a study ordered by the Swedish Nuclear Power Inspectorate and the National Swedish Institute of Radiation Protection to evaluate the measurements taken in Sweden in response to the Chernobyl accident. The enquiry was also given the task of suggesting improvements of the nuclear accidents emergency planning and other activities relevant to nuclear accidents. Detailed accounts are given of the course of events in Sweden at the Chernobyl accident and the steps taken by central or local authorities are discussed. Several alterations of the emergency planning are proposed and a better coordination of the affected organizations is suggested. (L.E.)

  19. Role of presepsin for the evaluation of sepsis in the emergency department.

    Science.gov (United States)

    Pizzolato, Elisa; Ulla, Marco; Galluzzo, Claudia; Lucchiari, Manuela; Manetta, Tilde; Lupia, Enrico; Mengozzi, Giulio; Battista, Stefania

    2014-10-01

    Sepsis, severe sepsis and septic shock are among the most common conditions handled in the emergency department (ED). According to new Sepsis Guidelines, early diagnosis and treatment are the keys to improve survival. Plasma C-reactive protein (CRP) and procalcitonin (PCT) levels, when associated with documented or suspected infection, are now part of the definitions of sepsis. Blood culture is the gold standard method for detecting microorganisms but it requires too much time for results to be known. Sensitive biomarkers are required for early diagnosis and as indexes of prognosis sepsis. CRP is one of the acute phase proteins synthesized by the liver: it has a great sensitivity but a very poor specificity for bacterial infections. Moreover, the evolution of sepsis does not correlate with CRP plasma changes. In recent years PCT has been widely used for sepsis differential diagnosis, because of its close correlation with infections, but it still retains some limitations and false positivity (such as in multiple trauma and burns). Soluble CD14 subtype (sCD14-ST), also known as presepsin, is a novel and promising biomarker that has been shown to increase significantly in patients with sepsis, in comparison to the healthy population. Studies pointed out the capability of this biomarker for diagnosing sepsis, assessing the severity of the disease and providing a prognostic evaluation of patient outcome. In this mini review we mainly focused on presepsin: we evaluate its diagnostic and prognostic roles in patients presenting to the ED with systemic inflammatory response syndrome (SIRS), suspected sepsis or septic shock.

  20. An evaluation of emerging vaccines for childhood meningococcal disease

    Directory of Open Access Journals (Sweden)

    Nelson Christopher B

    2011-04-01

    Full Text Available Abstract Background Meningococcal meningitis is a major cause of disease worldwide, with frequent epidemics particularly affecting an area of sub-Saharan Africa known as the “meningitis belt”. Neisseria meningitidis group A (MenA is responsible for major epidemics in Africa. Recently W-135 has emerged as an important pathogen. Currently, the strategy for control of such outbreaks is emergency use of meningococcal (MC polysaccharide vaccines, but these have a limited ability to induce herd immunity and elicit an adequate immune response in infant and young children. In recent times initiatives have been taken to introduce meningococcal conjugate vaccine in these African countries. Currently there are two different types of MC conjugate vaccines at late stages of development covering serogroup A and W-135: a multivalent MC conjugate vaccine against serogroup A,C,Y and W-135; and a monovalent conjugate vaccine against serogroup A. We aimed to perform a structured assessment of these emerging meningococcal vaccines as a means of reducing global meningococal disease burden among children under 5 years of age. Methods We used a modified CHNRI methodology for setting priorities in health research investments. This was done in two stages. In the first stage we systematically reviewed the literature related to emerging MC vaccines relevant to 12 criteria of interest. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies. They answered questions from CHNRI framework and their “collective optimism” towards each criterion was documented on a scale from 0 to 100%. Results For MenA conjugate vaccine the experts showed very high level of optimism (~ 90% or more for 7 out of the 12 criteria. The experts felt that the likelihood of efficacy on meningitis was very high (~ 90%. Deliverability

  1. Evaluating the effectiveness of warning systems for nuclear power plant emergencies: criteria and application

    International Nuclear Information System (INIS)

    Sorensen, J.H.

    1984-01-01

    The accident at Three Mile Island Nuclear Power Plant in 1979 was an emergency management disaster. Chief among the problems was ineffective public warning and communications. While it is difficult to assign blame for that condition to any given party or determine if it was due to unique situational factors, the failure led to fairly significant regulatory changes in the arena of public warning and notification. These changes are intended to avoid the problems that arose during the TMI accident. This chapter reviews these regulations and suggests an alternative set of criteria for evaluating warning systems. The criteria are used to assess the effectiveness of the warning system at the Ft. St. Vrain nuclear power plant in Colorado. The paper concludes with some discussion of the lessons learned from the TMI experience as they apply to warning systems for all nuclear generating stations

  2. Emergency Department Management of Delirium in the Elderly

    Directory of Open Access Journals (Sweden)

    Lynn E.J. Gower, DO

    2012-05-01

    Full Text Available An increasing number of elderly patients are presenting to the emergency department. Numerousstudies have observed that emergency physicians often fail to identify and diagnose delirium in theelderly. These studies also suggest that even when emergency physicians recognized delirium, theystill may not have fully appreciated the import of the diagnosis. Delirium is not a normal manifestation ofaging and, often, is the only sign of a serious underlying medical condition. This article will review thesignificance, definition, and principal features of delirium so that emergency physicians may betterappreciate, recognize, evaluate, and manage delirium in the elderly.

  3. Nuclear emergency preparedness in the Netherlands

    International Nuclear Information System (INIS)

    Dal, A.H.; Molhoek, W.; Leest, A.M.M.; Moen, J.E.T.; Sonderen, J.F. van; Aldenkamp, F.J.

    1997-01-01

    The Dutch organisation for nuclear emergency management has been described in previous papers. Briefly, the Ministry of Housing, Spatial Planning and Environment (VROM) and the Ministry of the Interior (BIZA) coordinate the input of all other Ministries and agencies at the government level, and provide the general strategy for dealing with the situation at hand. Any indication of a possible nuclear incident may alert the organization. Signals indicating, such incidents are continuously collected by the Emergency Management Department a VROM in the Hague. An expert group is permanently available for the evaluation of serious warnings, either via bilateral or other international contacts (IAEA, EC, neighbouring countries) or through the Dutch early warning monitoring network via the National Institute of Public Health and the Environment (RIVM). The chairman of this evaluation group has the authority to decide whether to start up the National Organization for Nuclear Emergency Management. Its start means the installation of a Policy Team of Cabinet Ministers or their representatives, and the involvement of many authorities and organizations at the national, provincial and local levels

  4. Electrical conductivity of the seed soaking solution and soybean seedling emergence

    Directory of Open Access Journals (Sweden)

    Vieira Roberval Daiton

    2004-01-01

    Full Text Available Vigor of soybean [Glycine max (L. Merrill] seeds can be evaluated by measuring the electrical conductivity (EC of the seed soaking solution, which has shown a satisfactory relationship with field seedling emergence, but has not had aproper definition of range yet. This work studies the relationship between EC and soybean seedling emergence both in the field and laboratory conditions, using twenty two seed lots. Seed water content, standard germination and vigor (EC, accelerated aging and cold tests were evaluated under laboratory conditions using -0.03; -0.20; -0.40 and -0.60 MPa matric potentials, and field seedling emergence was also observed. There was direct relationship between EC and field seedling emergence (FE. Under laboratory conditions, a decreasing relationship was found between EC and FE as water content in the substrate decreased. Relationships between these two parameters were also found when -0.03; -0.20 and -0.40 MPa matric potentials were used. EC tests can be used successfully to evaluate soybean seed vigor and identify lots with higher or lower field emergence potential.

  5. Sowing on the emergence and early development of seedlings o baru

    Directory of Open Access Journals (Sweden)

    Alan Mario Zuffo

    2014-09-01

    Full Text Available The objective of this work to evaluate the influence of the position of baru seeds, the emergence and early seedling development. The test was conducted in a greenhouse experiment in randomized blocks, with five treatments (seeding position, with four replications, positions were: A - Hilo up, B - hilo down C - hilum and raphe aside, D - horizontal raphe up, E - horizontal raphe down. It was observed that the seeds deposited at the position B (heel down provided better emergence and seedling development. We evaluated the emergence, speed of emergence index, plant height, stem diameter, root length, dry mass of air, root dry weight, relative AP/DC, FSPA/FSR and Dickson quality index. The emergence and early seedling development baru were influenced by sowing position. The seeds deposited with the hilum down provided better results.

  6. Course evaluation questionnaire

    International Nuclear Information System (INIS)

    2011-01-01

    This report evaluates the issues related to a radiological emergency and that the participants consider relevant such as: principles and response, emergency management, procedures for fist responders, radiation protection of workers, medical emergency, security, exercises and simulation

  7. The role of perceived threat during emergency department cardiac evaluation and the age-posttraumatic stress disorder link.

    Science.gov (United States)

    Meli, Laura; Kautz, Marin; Julian, Jacob; Edmondson, Donald; Sumner, Jennifer A

    2018-06-01

    Evaluation for acute coronary syndrome (ACS) can trigger posttraumatic stress symptoms (PSS). Research suggests that younger, versus older, individuals may be at elevated risk for PSS after ACS evaluation. It has been proposed that younger individuals may be at greater risk because they perceive the suspected ACS event as more threatening than their older counterparts; however, this has yet to be tested. We examined whether perceived threat during ACS evaluation mediated the association between age and PSS after ACS evaluation in an observational cohort study of patients presenting to the emergency department (ED) with suspected ACS. Demographics and perceived threat were assessed in the ED. PSS were measured upon inpatient transfer or by phone 3 days later. The analytic sample comprised 871 adult participants. Multiple linear regression was used to examine (1) associations of age and perceived threat with PSS and (2) whether perceived threat mediated the association. Bootstrapping with percentile-based confidence intervals (CIs) was used to test the indirect effect. Each year of age was associated with lower PSS (b = - 0.12, p age was associated with lower perceived threat during ACS evaluation (b = - 0.05, p age differences in PSS development risk and the potential impact of age on threat perceptions may help inform ED treatment.

  8. Evaluating the Emergence of Reverse Intraverbals in Children with Autism

    Science.gov (United States)

    Allan, Alicia C.; Vladescu, Jason C.; Kisamore, April N.; Reeve, Sharon A.; Sidener, Tina M.

    2015-01-01

    Verbal behavior plays a fundamental role in the development of complex social and communication skills. Many children diagnosed with autism spectrum disorder exhibit profound deficiencies in intraverbal repertoires and the development of social relationships. Recent studies that investigated the effects of intraverbal training on the emergence of…

  9. MBRRACE in simulation: an evaluation of a multi-disciplinary simulation training for medical emergencies in obstetrics (MEmO).

    Science.gov (United States)

    Lavelle, Mary; Abthorpe, Jennifer; Simpson, Thomas; Reedy, Gabriel; Little, Fiona; Banerjee, Anita

    2018-03-21

    The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49). The training improved participants' clinical management of medical deterioration in pregnancy (p=.003) alongside improving their human factors skills (p=.004). Furthermore, participants reported the translation of these skills to their routine clinical practice. This flexible training is responsive to the changing national needs and contextualises the MBRRACE findings for healthcare staff. It is a promising avenue for reducing the rates of in-direct death in pregnancy. Impact statement What is already known on this subject? The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions. The management of medical conditions in pregnancy relies on a multi-professional approach. However, serious gaps in clinicians' human factors skills, highlighted by the MBRRACE report, may contribute to maternal death. What do the results of this study add? This study evaluated the first multi-disciplinary, simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Training significantly improved participants' management of medical deterioration in pregnancy and human factors skills, particularly in the areas of leadership, communication and teamwork. Moreover, the participants learning translated into their clinical practice. What are the implications of

  10. Evaluation of emergency transcatheter arterial embolization in intractable postpartum hemorrhage

    International Nuclear Information System (INIS)

    Qi Weihong; Wang Song; Zhan Ying

    2008-01-01

    Objective: To assess the efficacy and safety of emergency transcatheter arterial embolization in the management of intractable postpartum hemorrhage. Methods: Twenty-five patients with intractable postpartum hemorrhage were undertaken superselective catheterization into the bilateral internal iliac arteries or uterial arteries to find the causes and sites of bleeding through DSA and then followed by arterial embolization with gelfoam particles. Result: All of the 25 patients with obstetrical bleeding were successfully controlled by TAE, the procedure lasted for 25-60 min, (mean 42.5 ± 4.6 min); with both catheterization and bleeding halt successful rates of 100%. Comparison of hemoglobin and heartbeat before and after the procedure showed significance (t=29.49, P<0.01; t=16.51, P<0.01). The uterus showed reintegration on time and menstruation resumed in all patients. Conclusions: Emergency arterial embolization is a safe and effective means for control of intractable postpartum hemorrhage, providing less trauma and no severe complications, especially as an unique management for fetal postpartum hemorrhage. (authors)

  11. Interaction Modes for Emergency Mobile Apps

    Directory of Open Access Journals (Sweden)

    Claudia Nass

    2018-01-01

    Full Text Available While seemingly irrational behaviors such as panicking or displaying antisocial behavior are the responses to emergency situations the media and movies lead us to believe, several studies show that people rather react based on decision-making such as acting altruistically and protectively. However, what can we really expect from people in a crowd in terms of participation in an emergency response system? In this paper, we present a mobile application called the RESCUER App, which allows civilians to participate in the emergency response process by providing information about the emergency to a command center and to receive instructions from this command center. We developed a human reaction model for emergencies to better understand the human–computer interaction capabilities of people in an emergency situation. Based on this model, we defined three different interaction modes: one-click interaction, guided interaction, and chat interaction. These interaction modes were implemented in an interactive prototype and evaluated in an experiment in which high cognitive load was induced to simulate a stress situation, similar to the stress experienced in an emergency. The experiment results showed that the three predefined interaction modes enabled people to interact with the RESCUER App even though they were in a stress situation.

  12. Relationships of hospital-based emergency department culture to work satisfaction and intent to leave of emergency physicians and nurses.

    Science.gov (United States)

    Lin, Blossom Yen-Ju; Wan, Thomas T H; Hsu, Chung-Ping Cliff; Hung, Feng-Ru; Juan, Chi-Wen; Lin, Cheng-Chieh

    2012-05-01

    Given the limited studies on emergency care management, this study aimed to explore the relationships of emergency department (ED) culture values to certain dimensions of ED physicians' and nurses' work satisfaction and intent to leave. Four hundred and forty-two emergency medical professionals completed the employee satisfaction questionnaire across 119 hospital-based EDs, which had culture value evaluations filed, were used as unit of analysis in this study. Adjusting the personal and employment backgrounds, and the surrounded EDs' unit characteristics and environmental factors, multiple regression analyses revealed that clan and market cultures were related to emergency physicians' work satisfaction and intent to leave. On the other hand, adhocracy, market and hierarchical cultures were related to emergency nurses' work satisfaction. There do exist different patterns among various culture types on various work satisfaction dimensions and intent to leave of emergency physicians and nurses. The findings could offer hospital and ED leaders insights for changes or for building a better atmosphere to enhance the work life of emergency physicians and nurses.

  13. American Association for Emergency Psychiatry Task Force on Medical Clearance of Adults

    Directory of Open Access Journals (Sweden)

    Eric L. Anderson

    2017-02-01

    Full Text Available Introduction: In the United States, the number of patients presenting to the emergency department (ED for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs. Methods: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED (Part I and then combined this with expert consensus (Part II. Results: In Part I, we discuss terminological issues and existing evidence on medical exams and laboratory studies of psychiatric patients in the ED. Conclusion: Emergency physicians should work cooperatively with psychiatric receiving facilities to decrease unnecessary testing while increasing the quality of medical screening exams for psychiatric patients who present to EDs. [West J Emerg Med. 2017;18(2235-242.

  14. Evaluating the efficacy of pre- and post-emergence herbicides for controlling Amaranthus retroflexus L. and Chenopodium album L. in potato

    DEFF Research Database (Denmark)

    Alebrahim, M. T.; Majd, R.; Rashed Mohassel, M. H.

    2012-01-01

    Field studies were conducted from 2008 to 2010 to evaluate the control of Amaranthus retroflexus and Chenopodium album and tolerance of potato (Solanum tuberosum cv. Agria) to ethalfluralin, trifluralin, pendimethalin, rimsulfuron, EPTC and oxadiargyl applied pre-emergence (PRE) and post-emergenc...

  15. 1992 update of US EPA's Superfund Innovative Technology Evaluation (SITE) Emerging Technology Program

    International Nuclear Information System (INIS)

    Lewis, N.M.; Barkley, N.P.; Williams, T.

    1992-01-01

    The Superfund Innovative Technology Evaluation (SITE) Emerging Technology Program (ETP) has financially supported further development of bench- and pilot-scale testing and evaluation of innovative technologies for use at hazardous waste sites for five years. The ETP was established under the Superfund Amendments and Reauthorization Act (SARA) of 1986. The ETP complies with the goal of the SITE Program to promote, accelerate and make commercially available the development of alternative/innovative treatment technologies for use at Superfund sites. Technologies are submitted to the ETP through yearly solicitations for Preproposals. Applicants are asked to submit a detailed project proposal and a cooperative agreement application that requires Developer/EPA cost sharing. EPA co-funds selected Developers for one to two years. Second-year funding requires documentation of significant progress during the first year. Facilities, equipment, data collection, performance and development are monitored throughout the project. The US Department of Energy (DOE) and the US Air Force (USAF) are participants in the ETP. DOE has co-funded ETP projects since 1990 and the USAF since 1991. A goal of the ETP is to move developed technologies to the field-demonstration stage. A developer may be considered for participation in the SITE Demonstration Program if performance in the ETP indicates the technology is field-ready for evaluation. Six technology categories: biological, chemical, materials handling, physical, solidification/stabilization and thermal, are presently in the ETP. Technologies of primary interest to EPA are those that can treat complex mixtures of hazardous organic and inorganic contaminants and provide improved solids handling and/or pretreatment. An account of the background and progress of the ETP's first five years is presented in this paper. Technologies currently in the ETP are noted, and developers and EPA Project Managers, are listed. 4 refs., 11 figs., 6 tabs

  16. A Conceptual Framework to Measure Systems’ Performance during Emergency Preparedness Exercises

    Directory of Open Access Journals (Sweden)

    Elena Savoia

    2014-09-01

    Full Text Available Large-scale public health emergencies require a sophisticated, coordinated response involving multiple entities to protect health and minimize suffering. However, the rarity of such emergencies presents a barrier to gathering observational data about the effectiveness of the public health response before such events occur. For this reason, public health practitioners increasingly have relied on simulated emergencies, known as “exercises” as proxies to test their emergency capabilities. However, the formal evaluation of performance in these exercises, historically has been inconsistent, and there is little research to describe how data acquired from simulated emergencies actually support conclusions about the quality of the public health emergency response system. Over the past six years, we have designed and evaluated more than seventy public health emergency exercises, collaborating with public health agencies, hospitals and others to test a wide variety of systems and their capabilities. Using the data and experience that we gathered, we have developed a conceptual framework that describes the essential elements necessary to consider when applying performance measurement science to public health emergency exercises. We suggest that this framework may assist practitioners and researchers who wish to better measure performance in exercises and to improve public health emergency preparedness.

  17. The consumer quality index (CQ-index in an accident and emergency department: development and first evaluation

    Directory of Open Access Journals (Sweden)

    Bos Nanne

    2012-08-01

    Full Text Available Abstract Background Assessment of patients’ views are essential to provide a patient-centred health service and to evaluating quality of care. As no standardized and validated system for measuring patients’ experiences in accident and emergency departments existed, we have developed the Consumer Quality index for the accident and emergency department (CQI A&E. Methods Qualitative research has been undertaken to determine the content validity of the CQI A&E. In order to assess psychometric characteristics an 84-item questionnaire was sent to 653 patients who had attended a large A&E in the Netherlands. Also, fifty importance questions were added to determine relevance of the questions and for future calculations of improvement scores. Exploratory factor analysis was applied to detect the domains of the questionnaire. Results Survey data of 304 (47% patients were used for the analysis. The first exploratory factor analysis resulted in three domains based on 13 items: ‘Attitude of the healthcare professionals’, ‘Environment and impression of the A&E’ and ‘Respect for and explanation to the patient’. The first two had an acceptable internal consistency. The second analysis, included 24 items grouped into 5 domains: ‘Attitude of the healthcare professionals’, ‘Information and explanation’, ‘Environment of the A&E’,’Leaving the A&E’ and ‘General information and rapidity of care’. All factors were internal consistent. According to the patients, the three most important aspects in healthcare performance in the A&E were: trust in the competence of the healthcare professionals, hygiene in the A&E and patients’ health care expectations. In general, the highest improvement scores concerned patient information. Conclusions The Consumer Quality index for the accident and emergency department measures patients’ experiences of A&E healthcare performance. Preliminary psychometric characteristics are sufficient to justify

  18. Emergency supply of prescription-only medicines to patients by community pharmacists: a mixed methods evaluation incorporating patient, pharmacist and GP perspectives.

    Science.gov (United States)

    Morecroft, Charles W; Mackridge, Adam J; Stokes, Elizabeth C; Gray, Nicola J; Wilson, Sarah E; Ashcroft, Darren M; Mensah, Noah; Pickup, Graham B

    2015-07-10

    To evaluate and inform emergency supply of prescription-only medicines by community pharmacists (CPs), including how the service could form an integral component of established healthcare provision to maximise adherence. Mixed methods. 4 phases: prospective audit of emergency supply requests for prescribed medicines (October-November 2012 and April 2013); interviews with CPs (February-April 2013); follow-up interviews with patients (April-May 2013); interactive feedback sessions with general practice teams (October-November 2013). 22 community pharmacies and 6 general practices in Northwest England. 27 CPs with experience of dealing with requests for emergency supplies; 25 patients who received an emergency supply of a prescribed medicine; 58 staff at 6 general practices. Clinical audit in 22 pharmacies over two 4-week periods reported that 526 medicines were requested by 450 patients. Requests peaked over a bank holiday and around weekends. A significant number of supplies were made during practice opening hours. Most requests were for older patients and for medicines used in long-term conditions. Difficulty in renewing repeat medication (forgetting to order, or prescription delays) was the major reason for requests. The majority of medicines were 'loaned' in advance of a National Health Service (NHS) prescription. Interviews with CPs and patients indicated that continuous supply had a positive impact on medicines adherence, removing the need to access urgent care. General practice staff were surprised and concerned by the extent of emergency supply episodes. CPs regularly provide emergency supplies to patients who run out of their repeat medication, including during practice opening hours. This may aid adherence. There is currently no feedback loop, however, to general practice. Patient care and interprofessional communication may be better served by the introduction of a formally structured and funded NHS emergency supply service from community pharmacies, with

  19. Evaluation of the crash mitigation effect of low-speed automated emergency braking systems based on insurance claims data.

    Science.gov (United States)

    Isaksson-Hellman, Irene; Lindman, Magdalena

    2016-09-01

    The aim of the present study was to evaluate the crash mitigation performance of low-speed automated emergency braking collision avoidance technologies by examining crash rates, car damage, and personal injuries. Insurance claims data were used to identify rear-end frontal collisions, the specific situations where the low-speed automated emergency braking system intervenes. We compared cars of the same model (Volvo V70) with and without the low-speed automated emergency braking system (AEB and no AEB, respectively). Distributions of spare parts required for car repair were analyzed to identify car damage, and crash severity was estimated by comparing the results with laboratory crash tests. Repair costs and occupant injuries were investigated for both the striking and the struck vehicle. Rear-end frontal collisions were reduced by 27% for cars with low-speed AEB compared to cars without the system. Those of low severity were reduced by 37%, though more severe crashes were not reduced. Accordingly, the number of injured occupants in vehicles struck by low-speed AEB cars was reduced in low-severity crashes. In offset crash configurations, the system was found to be less effective. This study adds important information about the safety performance of collision avoidance technologies, beyond the number of crashes avoided. By combining insurance claims data and information from spare parts used, the study demonstrates a mitigating effect of low-speed AEB in real-world traffic.

  20. [Wells clinical prediction criteria in patients suspected of having deep vein thrombosis: evaluation of components and use in the emergency department].

    Science.gov (United States)

    García-Castrillo Riesgo, Luis; Jiménez Hernández, Sònia; Piñera Salmerón, Pascual

    2015-01-01

    To determine the applicability of the Wells clinical prediction criteria for deep vein thrombosis (DVT) in patients in hospital emergency departments and to evaluate the relevance of the score's components. Prospective multicenter cohort study in consecutive hospital emergency department patients suspected of having DVT. Full-leg Doppler compression ultrasound imaging was performed on all patients. We recorded information on variables related to risk for DVT and the components of clinical prediction scales. Wells and Oudega clinical prediction scores were calculated. We studied 362 patients in 23 hospital emergency departments; the mean (SD) age was 65 (18) years and 52.8% were women. DVT was diagnosed in 254 patients (70.16%); 171 (47.2%) had proximal DVT. The clinical probability of DVT according to the Wells scale and the prevalence of proximal DVT were as follows: low probability, 57 patients (14 with DVT, 24.6%); intermediate probability, 124 (43 with DVT, 34.7%), and high probability, 181 (114 with DVT, 63%). Only 5 of the components of the Wells scale were associated with the presence of proximal DVT. The prevalence of DVT is very high in the 3 categories of clinical probability indicated by the Wells score. The prevalences do not correspond to those of the cohort used to validate the scale. It appears to be necessary to develop scales adjusted for use in hospital emergency departments when DVT is suspected.

  1. Correlação entre testes para avaliação da qualidade de sementes de girassol e emergência das plântulas em campo Correlation between sunflower seeds quality evaluation tests and seedling emergence in field

    Directory of Open Access Journals (Sweden)

    Madelon Rodrigues Sá Braz

    2009-10-01

    Full Text Available A capacidade do teste de germinação para estimar o potencial de emergência de plântulas no campo diminui à medida que as condições do ambiente são desfavoráveis. No entanto, diferentes testes de vigor têm sido utilizados para identificar os lotes de sementes que apresentam melhor desempenho nessas situações. O objetivo do trabalho foi correlacionar os resultados dos testes conduzidos no laboratório com a emergência das plântulas de girassol em campo. Para isso, cinco lotes de sementes de girassol da cultivar 'Embrapa 122 V2000' foram submetidos aos testes de germinação e vigor (primeira contagem, classificação de plântulas, teste de frio, condutividade elétrica, emergência de plântulas em areia e em campo, índice de velocidade de emergência, envelhecimento acelerado e deterioração controlada. Em condições adversas, a emergência das plântulas de girassol em campo apresentou maior correlação com o vigor, avaliado pelos testes de envelhecimento acelerado, de deterioração controlada e de condutividade elétrica.The germination capacity test to estimate the potential of seedlings emergence in the field decreases when the environmental conditions are unfavorable. However, different vigour tests have been used to identify the seed lots that have better perform in these situations. The objective of this research was to correlate the results of tests conducted in the laboratory with the emergence of sunflower seedlings in the field. For this, five lots of seeds sunflower cultivar 'Embrapa 122 V2000' were submitted to the germination and vigour tests (first count, classification of seedlings, cold test, electrical conductivity, seedling emergence in sand and in the field, emergence speed index, accelerated aging and controlled deterioration. Under adverse conditions, the seed vigour evaluated by accelerated aging, controlled deterioration and electrical conductivity presented higher correlation with sunflower plant

  2. Future enhanced clinical role of pharmacists in emergency departments in England:multi-site observational evaluation

    OpenAIRE

    Hughes, Elizabeth; Terry, David; Huynh, Chi; Petridis, Konstantinos; Aiello, Matthew; Mazard, Louis; Ubhi, Hirminder; Terry, Alex; Wilson, Keith; Sinclair, Anthony

    2017-01-01

    Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at thei...

  3. How emergency nurse practitioners view their role within the emergency department: A qualitative study.

    Science.gov (United States)

    Lloyd-Rees, Johanna

    2016-01-01

    The Emergency Nurse Practitioner (ENP) role has become established over the last two decades within emergency care. This role has developed to meet the rising demands of healthcare, combat the continuing medical workforce shortfall and address targets around healthcare delivery within emergency care. The ENP role has been widely evaluated in terms of patient satisfaction, safety and outcome. To date there is no published literature exploring what drives senior nurses to undertake this role which involves additional clinical responsibility and educational preparation for no increase in pay. This research seeks to explore how Emergency Nurse Practitioners view their role within the Emergency Department and Emergency Care Team. A qualitative approach was utilised in order to gain greater in-depth understanding of ENPs' perspectives. A purposive sample of eight ENPs was chosen and semi-structured interviews were digitally recorded. The transcribed interviews were subjected to thematic analysis to look for any recurrent themes. Following analysis of the data, four main themes emerged with a total of eight sub themes. The findings suggested that whilst the role had been accepted amongst doctors within the ED, there was still a lack of understanding of the role outside the ED and conflict still existed amongst junior nurses. ENPs were motivated to undertake the role in order to gain greater job satisfaction. The findings also highlighted the concerns regarding financial remuneration for the role, lack of standardisation of the role and educational preparation. The study concludes that education has a key role in the development and acceptance of the role and that ENPs are disappointed with the lack of financial remuneration for the role. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Best practices in managing child and adolescent behavioral health emergencies.

    Science.gov (United States)

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M

    2018-01-01

    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies.

  5. High-Fidelity Simulation: Preparing Dental Hygiene Students for Managing Medical Emergencies.

    Science.gov (United States)

    Bilich, Lisa A; Jackson, Sarah C; Bray, Brenda S; Willson, Megan N

    2015-09-01

    Medical emergencies can occur at any time in the dental office, so being prepared to properly manage the situation can be the difference between life and death. The entire dental team must be properly trained regarding all aspects of emergency management in the dental clinic. The aim of this study was to evaluate a new educational approach using a high-fidelity simulator to prepare dental hygiene students for medical emergencies. This study utilized high-fidelity simulation (HFS) to evaluate the abilities of junior dental hygiene students at Eastern Washington University to handle a medical emergency in the dental hygiene clinic. Students were given a medical emergency scenario requiring them to assess the emergency and implement life-saving protocols in a simulated "real-life" situation using a high-fidelity manikin. Retrospective data were collected for four years from the classes of 2010 through 2013 (N=114). The results indicated that learning with simulation was effective in helping the students identify the medical emergency in a timely manner, implement emergency procedures correctly, locate and correctly utilize contents of the emergency kit, administer appropriate intervention/treatment for a specific patient, and provide the patient with appropriate follow-up instructions. For dental hygiene programs seeking to enhance their curricula in the area of medical emergencies, this study suggests that HFS is an effective tool to prepare students to appropriately handle medical emergencies. Faculty calibration is essential to standardize simulation.

  6. Emergency surgery for Crohn's disease.

    Science.gov (United States)

    Smida, Malek; Miloudi, Nizar; Hefaiedh, Rania; Zaibi, Rabaa

    2016-03-01

    Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis. Indicate the incidence of indications in emergent surgery for Crohn's disease. Specify the types of procedures performed in these cases and assess the Results of emergency surgery for Crohn's disease postoperatively,  in short , medium and long term. Retrospective analysis of collected data of 38 patients, who underwent surgical resection for Crohn's disease during a period of 19 years from 1992 to 2011 at the department of surgery in MONGI SLIM Hospital, and among them 17 patients underwent emergency surgery for Crohn's disease. In addition to socio-demographic characteristics and clinical presentations of our study population, we evaluated the indications, the type of intervention, duration of evolution preoperative and postoperative complications and overall prognosis of the disease. Of the 38 patients with Crohn's disease requiring surgical intervention, 17/38 patients underwent emergency surgery. Crohn's disease was inaugurated by the complications requiring emergency surgery in 11 patients. The mean duration of symptoms prior to surgery was 1.5 year. The most common indication for emergency surgery was acute intestinal obstruction (n=6) followed by perforation and peritonitis (n=5). A misdiagnosis of appendicitis was found in 4 patients and a complicated severe acute colitis for undiagnosed Crohn's disease was found in 2 cases. The open conventional surgery was performed for 15 patients. Ileocolic resection was the most used intervention. There was one perioperative mortality and 5 postoperative morbidities. The mean of postoperative hospital stay was 14 days (range 4-60 days). Six patients required a second operation during the follow-up period. The incidence of emergency surgery for Crohn's disease in our experience was high (17/38 patients), and is not as rare as the published estimates

  7. The role of radionuclide studies in emergency cases

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Hayashida, Kohei; Uehara, Toshiisa

    1982-01-01

    Radionuclide studies have been performed popularly because of its noninvasive and simple method recently. In this study, we applied this technique for the evaluation of emergency cases in cardiovascular diseases. There were 93 cases (1.5%) out of 6163 cases, done during 1981. The subjects were 34 cases of cardiac studies (9 cases of sup(99m)Tc-PYP myocardial imaging, 12 cases of thallium myocardial imaging, 13 cases of cardioangiography), 23 cases of peripheral diseases (12 cases of peripheral angiography, 11 cases of venography), 16 cases of pulmonary imaging, 10 cases of renal studies (6 cases of renal angiography, 9 cases of renal imaging) and 5 cases of brain angiography. These studies were proven to be useful clinically for the evaluation of emergency cases and follow-up studies. In the near future, ''emergency radionuclide studies'' would be benefit for the high-risk patients noninvasively. (author)

  8. Attitudes towards emergency plans, information and tasks

    International Nuclear Information System (INIS)

    Hultaaker, Oe.

    1986-11-01

    The staff composed of policemen, firemen, home-guards and coast-guards having emergency service at the Ringhals nuclear power plant have been interviewed as to their viewpoints. They have a similar attitude to nuclear power as the general public which is varying. They accept, however, the actual risk evaluation to a large extent. There are also opponents of nuclear power who are difficult to motivate about the training for emergency service. (G.B.)

  9. Osteopathic Emergency Medicine Programs Infrequently Publish in High-Impact Emergency Medicine Journals

    OpenAIRE

    Baskin, Sean M; Lin, Christina; Carlson, Jestin N

    2014-01-01

    Introduction: Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. Methods: We performed a retrospective literature re...

  10. Characteristics of Emergency Gastrointestinal Stromal Tumor (GIST).

    Science.gov (United States)

    Uçar, Ahmet Deniz; Oymaci, Erkan; Carti, Erdem Bariş; Yakan, Savaş; Vardar, Enver; Erkan, Nazif; Mehmet, Yildirim

    2015-05-01

    Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract (GIT). Importance of GISTs is increasing while surgeons are facing with more frequent either in emergency setting of elective cases. Delineating the presentation and management of emergency GIST is important. From 2005 to 2014, emergency cases with final diagnosis of GIST were examined retrospectively. Total of 13 operated cases were evaluated by patients characteristics, clinical presentation, operational findings and postoperative prognosis. There were 9 male and 4 female with the mean age of 48.15 years. The most frequent presentations are ileus and GIT hemorrhage both covering the 84% of patients. Small bowel was the dominating site with ileus. Stomach was the second frequent site of the disease with the finding of hemorrhage. Emergency patients are more likely to come with small bowel GIST and obstruction symptoms. Hemorrhage is the most frequent symptom for emergency GIST of stomach and duodenum.

  11. Emergency Kausch-Whipple procedure: indications and experiences.

    Science.gov (United States)

    Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

    2010-03-01

    Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

  12. Radiologic procedures, policies and protocols for pediatric emergency medicine

    International Nuclear Information System (INIS)

    Woodward, George A.

    2008-01-01

    Protocol development between radiology and pediatric emergency medicine requires a multidisciplinary approach to manage straightforward as well as complex and time-sensitive needs for emergency department patients. Imaging evaluation requires coordination of radiologic technologists, radiologists, transporters, nurses and coordinators, among others, and might require accelerated routines or occur at sub-optimal times. Standardized protocol development enables providers to design a best practice in all of these situations and should be predicated on evidence, mission, and service expectations. As in any new process, constructive feedback channels are imperative for evaluation and modification. (orig.)

  13. Avaliação de herbicidas de pós-emergência na cultura da batata Evaluation of herbicides on post emergent weed control in potato crops

    Directory of Open Access Journals (Sweden)

    Jeferson Zagonel

    1999-03-01

    Full Text Available O experimento foi instalado na Fazenda Escola da UEPG, Ponta Grossa-PR, em solo Latossolo Vermelho Escuro de textura média argilosa, tendo como objetivo avaliar a eficiência e a seletividade do herbicida propaquizafop no controle pós-emergente de plantas daninhas na cultura da batata. O delineamento experimental foi de blocos ao acaso com seis tratamentos: propaquizafop (100, 125 e 150 g i.a./ha; fluazifop-p-butil (188 g i.a./ha; testemunha capinada e testemunha sem capina, em quatro repetições. O plantio foi realizado em 26 de outubro com a cultivar Elvira, usando-se o espaçamento de 0,70 x 0,35 m. As plantas daninhas presentes foram: Brachiaria plantaginea (capim-papuã, Digitaria horizontalis (capim-milhã e Eleusine indica (capim pé-de-galinha. As avaliações foram efetuadas aos 15, 30 e 45 dias após a aplicação dos tratamento. Observou-se que a aplicação de herbicidas pós-emergentes após a amontoa, permite controle adequado de plantas daninhas desde a emergência até a colheita; o herbicida propaquizafop mostrou-se eficiente no controle sobre capim-papuã e capim pé-de-galinha nas doses de 100, 125 e 150 g i.a./ha e sobre capim-milhã nas doses de 125 e 150 g i.a./ha. As perdas na produção causadas pela competição com plantas daninha foram da ordem de 57,4 %. Não foram observados efeitos fitotóxicos nas plantas de batata que pudessem ser atribuídos aos tratamentos aplicados.The presented field experiment was conducted at the Universidade Estadual de Ponta Grossa, Paraná State, Brazil, on Dark Red Latossoil, to evaluate the efficiency and selectivity of herbicides on post emergence weed control in potato crops. The experiment was laid out in a randomized block design with six treatments and four replications: propaquizafop (100, 125 and 150 g a.i/ha; fluazifop-p-butil (188 g a.i/ha, weed free and weedy. Planting was conducted on October 26, using the cultivar Elvira. Potato plants were spaced 0.70 x 0.35 m. The

  14. Mental health triage in emergency medicine.

    Science.gov (United States)

    Smart, D; Pollard, C; Walpole, B

    1999-02-01

    The aim of this study was to: (i) develop a triage scale consistent with the National Triage Scale (NTS) for patients with mental health problems attending emergency departments; and (ii) to reduce emergency waiting times, transit times and improve skills assessing mental health problems. We developed a Mental Health Triage Scale (MHTS) consistent with the NTS. The MHTS was then implemented using a structured education package, and evaluated from March to August 1994. Further evaluation occurred after 2 years. A four-tiered MHTS was produced: category 2, violent, aggressive or suicidal, danger to self or others or with police escort; category 3, very distressed or psychotic, likely to deteriorate, situational crisis, danger to self or others; category 4, long-standing semi-urgent mental health disorder, supporting agency present; and category 5, long-standing non-acute mental health disorder, no support agency present. Patients with illness, injury or self-harm were triaged using combined mental health and medical information. Mean emergency waiting times and transit times were reduced. More consistent triaging for mental health patients occurred, and more consistent admission rates by urgency. Reduced mental health 'did not waits' showed improved customer satisfaction. Mental Health Triage Scale was considered appropriate by liaison psychiatry and its use has continued at 2 years follow-up. A systematic approach to mental health triaging produced a workable scale, reduced waiting times, transit times, and provided effective and consistent integration of mental health patients into a general emergency department.

  15. The TransPetro emergency response system

    Energy Technology Data Exchange (ETDEWEB)

    Filho, A.T.F.; Cardoso, V.F.; Carbone, R.; Berardinelli, R.P. [Petrobras-TransPetro, Rio de Janeiro (Brazil); Carvalho, M.T.M.; Casanova, M.A. [Pontificia Univ. Catolica, Rio de Janeiro (Brazil). Dept. de Informatica, TeCGraf

    2004-07-01

    Petrobras-TransPetro developed the TransPetro Emergency Response System in response to emergency situations at large oil pipelines or at terminal facilities located in sea or river harbour areas. The standard of excellence includes full compliance with environmental regulations set by the federal government. A distributed workflow management software called InfoPAE forms the basis of the system in which actions are defined, along with geographic and conventional data. The first prototype of InfoPAE was installed in 1999. Currently it is operational in nearly 80 installations. The basic concepts and functionality of the TransPetro Emergency Response System were outlined in this paper with reference to the mitigative actions that are based on an evaluation of the organization of the emergency teams; the communication procedures; characterization of the installations; definition of accidental scenarios; environmental sensitivity maps; simulation of oil spill trajectories and dispersion behaviour; geographical data of the area surrounding the installations; and, other conventional data related to the installations, including available equipment. The emergency response team can take action as soon as an accident is detected. The action plan involves characterizing several scenarios and delegating mitigative actions to specific sub-teams, each with access to geographic data on the region where the emergency occurred. 13 refs., 3 figs.

  16. Differences between orthopaedic evaluation and radiological reports of conventional radiographs in patients with minor trauma admitted to the emergency department.

    Science.gov (United States)

    Catapano, Michele; Albano, Domenico; Pozzi, Grazia; Accetta, Riccardo; Memoria, Sergio; Pregliasco, Fabrizio; Messina, Carmelo; Sconfienza, Luca Maria

    2017-11-01

    During night and on weekends, in our emergency department there is no radiologist on duty or on call: thus, X-ray examinations (XR) are evaluated by the orthopaedic surgeon on duty and reported the following morning/monday by radiologists. The aim of our study was to examine the discrepancy rate between orthopaedists and radiologists in the interpretation of imaging examinations performed on patients in our tertiary level orthopaedic institution and the consequences of delayed diagnosis in terms of patient management and therapeutic strategy. We retrospectively reviewed all cases of discrepancy between orthopaedists and radiologists, which were categorized according to anatomical location of injury, initial diagnosis and treatment, change in diagnosis and treatment. We used the Chi square test to compare the frequencies of discrepancies between patients ≤14 and >14years of age. From January to December 2016, 19,512 patients admitted to our emergency department performed at least an imaging examination; among these patients, 13,561 underwent XR in absence of an attending radiologist. A discrepant diagnosis was found in 337/13,561 (2.5%; 184 males; mean age: 36.7±23.7, range 2-95); 151/337 (45%) discrepancies were encountered in the lower limbs, with ankle being the most common site of misdiagnosis (64/151), and 103/337 (30%) in the upper limbs, with the elbow being the most frequent site in this district (35/103). We found 293/337 false negatives (87%) and 44/337 false positives (13%), with 134 and 13 patients needing treatment change, respectively. We found 85/337 discrepancies (25%) in patients ≤14 years of age, and 252/337 (75%) in those >14years. The distribution of discrepancies per anatomic district was significantly different (P<0.001) in these two groups of patients. A low rate of discrepancy between orthopaedists and radiologists in evaluating images of patients admitted to our emergency department was found, although treatment change occurred in about

  17. Emergency Preparedness and Response: A Safety Net

    Energy Technology Data Exchange (ETDEWEB)

    Aaltonen, H., E-mail: hannele.aaltonen@stuk.fi [Radiation and Nuclear Safety Authority (STUK), Helsinki (Finland)

    2014-10-15

    Full text: The objective of nuclear regulatory work is to prevent accidents. Nevertheless, possibility of a severe accident cannot be totally excluded, which makes a safety net, efficient emergency preparedness and response, necessary. Should the possibility of accidents be rejected, the result would be in the worst case inadequate protection of population, functions of society, and environment from harmful effects of radiation. Adequate resources for maintenance and development of emergency arrangement are crucial. However, they need to be balanced taking into account risks assessments, justified expectations of society, and international requirements. To successfully respond to an emergency, effective emergency preparedness, such as up-to-date plans and procedures, robust arrangements and knowledgeable and regularly trained staff are required. These, however, are not enough without willingness and proactive attitude to • communicate in a timely manner; • co-operate and coordinate actions; • provide and receive assistance; and • evaluate and improve emergency arrangements. In the establishment and development of emergency arrangements, redundant and diverse means or tools used are needed in, for example, communication and assessment of hazard. Any severe nuclear emergency would affect all countries either directly or indirectly. Thus, national emergency arrangements have to be compatible to the extent practicable with international emergency arrangements. It is important to all countries that the safety nets of emergency arrangements are reliable - and operate efficiently in a coordinated manner when needed - on national, regional and international level. (author)

  18. Supporting Sustainable Markets Through Life Cycle Assessment: Evaluating emerging technologies, incorporating uncertainty and the consumer perspective

    Science.gov (United States)

    Merugula, Laura

    As civilization's collective knowledge grows, we are met with the realization that human-induced physical and biological transformations influenced by exogenous psychosocial and economic factors affect virtually every ecosystem on the planet. Despite improvements in energy generation and efficiencies, demand of material goods and energy services increases with no sign of a slowing pace. Sustainable development requires a multi-prong approach that involves reshaping demand, consumer education, sustainability-oriented policy, and supply chain management that does not serve the expansionist mentality. Thus, decision support tools are needed that inform developers, consumers, and policy-makers for short-term and long-term planning. These tools should incorporate uncertainty through quantitative methods as well as qualitatively informing the nature of the model as imperfect but necessary and adequate. A case study is presented of the manufacture and deployment of utility-scale wind turbines evaluated for a proposed change in blade manufacturing. It provides the first life cycle assessment (LCA) evaluating impact of carbon nanofibers, an emerging material, proposed for integration to wind power generation systems as blade reinforcement. Few LCAs of nanoproducts are available in scientific literature due to research and development (R&D) for applications that continues to outpace R&D for environmental, health, and safety (EHS) and life cycle impacts. LCAs of emerging technologies are crucial for informing developers of potential impacts, especially where market growth is swift and dissipative. A second case study is presented that evaluates consumer choice between disposable and reusable beverage cups. While there are a few studies that attempt to make the comparison using LCA, none adequately address uncertainty, nor are they representative for the typical American consumer. By disaggregating U.S. power generation into 26 subregional grid production mixes and evaluating

  19. Nuclear medicine in emergency

    International Nuclear Information System (INIS)

    Mansi, L.; Rambaldi, P.F.; Cuccurullo, V.; Varetto, T.

    2005-01-01

    The role of a procedure depends not only on its own capabilities but also on a cost/effective comparison with alternative technique giving similar information. Starting from the definition of emergency as a sudden unexpected occurrence demanding immediate action, the role of nuclear medicine (NM) is difficult to identify if it is not possible to respond 24h a day, 365 days a year, to clinical demands. To justify a 24 h NM service it is necessary to reaffirm the role in diagnosis of pulmonary embolism in the spiral CT era, to spread knowledge of the capabilities of nuclear cardiology in reliability diagnosis myocardial infraction (better defining admission and discharge to/from the emergency department), to increase the number of indications. Radionuclide technique could be used as first line, alternative, complementary procedures in a diagnostic tree taking into account not only the diagnosis but also the connections with prognosis and therapy in evaluating cerebral pathologies, acute inflammation/infection, transplants, bleeding, trauma, skeletal, hepatobiliary, renal and endocrine emergencies, acute scrotal pain

  20. A novel two-stage evaluation system based on a Group-G1 approach to identify appropriate emergency treatment technology schemes in sudden water source pollution accidents.

    Science.gov (United States)

    Qu, Jianhua; Meng, Xianlin; Hu, Qi; You, Hong

    2016-02-01

    Sudden water source pollution resulting from hazardous materials has gradually become a major threat to the safety of the urban water supply. Over the past years, various treatment techniques have been proposed for the removal of the pollutants to minimize the threat of such pollutions. Given the diversity of techniques available, the current challenge is how to scientifically select the most desirable alternative for different threat degrees. Therefore, a novel two-stage evaluation system was developed based on a circulation-correction improved Group-G1 method to determine the optimal emergency treatment technology scheme, considering the areas of contaminant elimination in both drinking water sources and water treatment plants. In stage 1, the threat degree caused by the pollution was predicted using a threat evaluation index system and was subdivided into four levels. Then, a technique evaluation index system containing four sets of criteria weights was constructed in stage 2 to obtain the optimum treatment schemes corresponding to the different threat levels. The applicability of the established evaluation system was tested by a practical cadmium-contaminated accident that occurred in 2012. The results show this system capable of facilitating scientific analysis in the evaluation and selection of emergency treatment technologies for drinking water source security.

  1. An Evaluation of Complications in Ultrasound-Guided Central Venous Catheter Insertion in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Engin OZAKIN

    2014-06-01

    Full Text Available SUMMARY: Objectives: In emergency departments, emergency physicians frequently have to perform central venous access. In cases where peripheral venous access is not possible, central venous access is required for dialysis, fulfillment of urgent fluid need, or central venous pressure measurement. This study was carried out to evaluate the emergence of complications in the process of and in the 15 days following the insertion of central venous catheter under ultrasound guidance in the emergency department. Methods: For this study, patients who presented to the emergency department over a period of eight months with an urgent need for central catheter were examined prospectively. Age, gender, and accompanying diseases of patients as well as the type, time, duration, and indication of the venous access were recorded. Furthermore, the amount of experience of the physician was taken into consideration. Results: In the emergency department, physicians performed ultrasound-guided central venous catheter insertion for 74 patients (40 men and 34 women. For access, internal jugular vein was used in 65 (87.8% patients, and femoral vein was used in 9 (12.2% patients. The reason for access was urgent dialysis need in 55 (74.3%, CVP measurement in 3 (4.1%, fluid support due to severe hypovolemia in 6 (8.1%, and difficulty of peripheral venous access in 10 (13.5% patients. None of the patients developed complications in the process of or after the insertion. Patients did not have infections related to the catheter in 15 days following the insertion. Conclusions: Central venous access is frequently required in emergency departments. The risk of complication is little if any in ultrasonographyguided access carried out under appropriate conditions. ÖZET: Amaç: Acil servislerde acil tıp hekimlerince santral damar yolu işlemi sık uygulanır. Periferik damar yolu açılamadığı hallerde, diyaliz, acil sıvı ihtiyacı veya santral venöz basınç

  2. Evaluation of the certificate in emerging infectious disease research and the certificate in one health training programs, University of Florida

    Directory of Open Access Journals (Sweden)

    Marissa A. Valentine

    2015-03-01

    Full Text Available In developing countries, public health professionals and scientists need targeted training and practical skills to respond to global emerging infectious disease threats. The Certificate in Emerging Infectious Disease Research was developed in 2008 to aid such professionals to respond to complex emerging disease problems. The short-course was modified slightly in 2013 and renamed the Certificate in One Health. To evaluate the immediate impact of the short-course, an online survey of 176 past participants from both the courses was conducted. The survey tool assessed the program’s process, impact, and outcome measures respectively via assessing the courses’ perceived strengths and weaknesses, perceived skills gained, and the participants’ current position, publication status, funding status, and educational attainment; 85 (48.3% participants completed the survey. Reported program strengths included the curriculum, expertise of lecturers, and diversity of the training cohort. The principal reported weakness was the compressed academic schedule. The most frequently reported benefits included: epidemiological and biostatistical skills, followed by One-Health knowledge, and research skills. Twenty-eight percent of the survey respondents reported publishing one or more manuscripts since completing the course and 21% reported receiving research funding. The course appears to have had a positive, immediate impact on the students’ self-perceived knowledge and capabilities.

  3. The 2010 amendments to the environmental emergency regulations

    International Nuclear Information System (INIS)

    Dowdall, E.; Ketcheson, K.; Shrives, J.; Hradecky, K.

    2009-01-01

    This presentation gave notice of amendments to the Environmental Emergency Regulations, pursuant to section 200 of the 1999 Canadian Environmental Protection Act. At the time of publication, the Regulations required the development and implementation of environmental emergency plans for 174 substances with associated thresholds that, if released to the environment, could harm human health or environmental quality. Substances of concern, including CEPA toxic substances are reviewed regularly by the Environmental Emergencies Division of Environment Canada to determine whether they should be added to the Regulations. An evaluation of substances has been completed and, as a result, 33 new substances have been proposed to be added to the Regulations. Thirty are known CEPA toxics and the other 3 are substances of concern, notably acetic acid, ammonium nitrate and styrene. These substances of concern are considered to pose an unacceptable level of risk from their release and would require environmental emergency planning. This paper also identified the substances from the Chemicals Management Plan that have been evaluated using environmental criteria and have been found to be candidates for possible future addition to the Regulations. The process used to determine regulated threshold quantities was also described. 5 refs., 5 tabs.

  4. A multicentre observational study to evaluate a new tool to assess emergency physicians' non-technical skills.

    Science.gov (United States)

    Flowerdew, Lynsey; Gaunt, Arran; Spedding, Jessica; Bhargava, Ajay; Brown, Ruth; Vincent, Charles; Woloshynowych, Maria

    2013-06-01

    To evaluate a new tool to assess emergency physicians' non-technical skills. This was a multicentre observational study using data collected at four emergency departments in England. A proportion of observations used paired observers to obtain data for inter-rater reliability. Data were also collected for test-retest reliability, observability of skills, mean ratings and dispersion of ratings for each skill, as well as a comparison of skill level between hospitals. Qualitative data described the range of non-technical skills exhibited by trainees and identified sources of rater error. 96 assessments of 43 senior trainees were completed. At a scale level, intra-class coefficients were 0.575, 0.532 and 0.419 and using mean scores were 0.824, 0.702 and 0.519. Spearman's ρ for calculating test-retest reliability was 0.70 using mean scores. All skills were observed more than 60% of the time. The skill Maintenance of Standards received the lowest mean rating (4.8 on a nine-point scale) and the highest mean was calculated for Team Building (6.0). Two skills, Supervision & Feedback and Situational Awareness-Gathering Information, had significantly different distributions of ratings across the four hospitals (ptechnical skills, especially in relation to leadership. The framework of skills may be used to identify areas for development in individual trainees, as well as guide other patient safety interventions.

  5. Mainz/PSI φ-factory design considerations

    International Nuclear Information System (INIS)

    Streun, A.

    1991-01-01

    Design considerations for a φ-factory with a Luminosity of the order of 10 33 cm -2 s -1 lead to the concept of a multi-bunch round beam double storage ring with superconducting solenoids for micro-beta focusing and beam rotation. Simulations of the beam-beam-interaction indicate, that significantly higher beam-beam-parameters may become possible with round beams. A rough draft design of a round beam φ-factory is presented. (orig.)

  6. Emergency procedures

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following subjects are discussed - Emergency Procedures: emergency equipment, emergency procedures; emergency procedure involving X-Ray equipment; emergency procedure involving radioactive sources

  7. Sector emergency procedures for Pakistan Research Reactor-1 (PARR-1) PINSTECH

    International Nuclear Information System (INIS)

    Aziz, A.; Aslam, M.; Faruq, M.U.; Ahmad, B.; Hasan, S.; Lodhi, N.P.K.

    1992-12-01

    A plan for handling of the radiation emergency situation prevailing outside PINSTECH has been incorporated in this report. This report outlines the detailed procedures and collective responsibilities and actions to be undertaken for meeting the emergency situation. These procedures include announcement/notification of emergency, evaluation of emergency, control of access and aggress, personnel monitoring and internal dosimetry, medical care of injured etc. A summary of the role and responsibilities of PINSTECH and the public organisations during a sector emergency at PINSTECH has been included as an appendix. (Orig./A.B.)

  8. Best practices in managing child and adolescent behavioral health emergencies [digest].

    Science.gov (United States)

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M; Wormley, Molly

    2018-01-22

    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  9. Emergency department management of priapism [digest].

    Science.gov (United States)

    Podolej, Gregory S; Babcock, Christine; Kim, Jeremy

    2017-01-22

    Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. The diagnosis of ischemic priapism relies heavily on the history and physical examination and may be facilitated by penile blood gas analysis and penile ultrasound. This issue reviews current evidence regarding emergency department treatment of ischemic priapism using a stepwise approach that begins with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents. Evidence-based management and appropriate urologic follow-up of nonischemic and recurrent ischemic priapism maximizes patient outcomes and resource utilization. [Points & Pearls is a digest of Emergency Medicine Practice].

  10. National emergency medical assistance program for commercial nuclear power plants

    International Nuclear Information System (INIS)

    Linnemann, R.E.; Berger, M.E.

    1987-01-01

    Radiation Management Consultant's Emergency Medical Assistance Program (EMAP) for nuclear facilities provides a twenty-four hour emergency medical and health physics response capability, training of site and off-site personnel, and three levels of care for radiation accident victims: first air and rescue at an accident site, hospital emergency assessment and treatment, and definitive evaluation and treatment at a specialized medical center. These aspects of emergency preparedness and fifteen years of experience in dealing with medical personnel and patients with real or suspected radiation injury will be reviewed

  11. Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations.

    Science.gov (United States)

    Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R

    2017-11-01

    Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  12. Emergency preparedness

    International Nuclear Information System (INIS)

    1998-01-01

    According the conception of the Emergency Response Centre (ERC) of the Nuclear Regulatory Authority of the Slovak Republic (NRA), and the obtained experience from exercises, and as well as on the basis of recommendations of international missions, the NRA SR started, in 1997 the ERC extension. The new room enable the work for radiation protection group, reactor safety and logistic group separately. At the same time special room was build for work of the NECRA Technical Support Group of the Emergency Commission for Radiation Accidents of the SR.This group co-operates closely with ERC while evaluation the situation, and by using the information system of the NRA and database of ERC to generate the conditions of nuclear facilities in once of emergency. Extension of the mentioned rooms was carried out. The financing by the European Union helped to build the project RAMG. In this way the NRA gained a working site which, with its equipment and parameters belongs to the top working sites of regulatory bodies of developed European countries. The NRA preparation of exercise and special staff education was carried out in 1997, for employees of the NRA and members of Emergency Headquarters (EH) for work in ERC in case of nuclear installation accident. The task of education of member of EH was their preparation for carrying out three exercises. These exercises are described. In the area of emergency preparedness, in accordance with inspection plan of the Office, 7 team inspections were carried out in individual localities; in NPP Bohunice, two in NPP Mochovce and one in Bohunice Conditioning Centre for radioactive wastes. Solution of the task of development of science and technology in the area of 'Development of technical and programme means for analyses of accidents and solutions of crisis situations'continued in 1997. Another regulations were elaborated for activity of members of EH of the NRA. The following was was carried out: selection of data for transfer and the

  13. Biopharmaceutical industry-sponsored global clinical trials in emerging countries.

    Science.gov (United States)

    Alvarenga, Lenio Souza; Martins, Elisabeth Nogueira

    2010-01-01

    To evaluate biopharmaceutical industry-sponsored clinical trials placed in countries previously described as emerging regions for clinical research, and potential differences for those placed in Brazil. Data regarding recruitment of subjects for clinical trials were retrieved from www.clinicaltrials.gov on February 2nd 2009. Proportions of sites in each country were compared among emerging countries. Multiple logistic regressions were performed to evaluate whether trial placement in Brazil could be predicted by trial location in other countries and/or by trial features. A total of 8,501 trials were then active and 1,170 (13.8%) included sites in emerging countries (i.e., Argentina, Brazil, China, Czech Republic, Hungary, India, Mexico, Poland, Russia, South Korea, and South Africa). South Korea and China presented a significantly higher proportion of sites when compared to other countries (pattractiveness for biopharmaceutical industry-sponsored clinical trials.

  14. Ocular emergencies presenting to Menelik II Hospital.

    Science.gov (United States)

    Negussie, Dereje; Bejiga, Abebe

    2011-01-01

    Ocular conditions such as trauma, painful red eye of any cause, painless sudden visual loss and others are commonly seen as ocular emergencies, and can lead to ocular morbidity and visual loss. To determine types and causes of ocular emergencies seen at Menelik II hospital. A cross-sectional study was conducted from April to October, 2007. Consecutive patients who presented with ocular emergencies at any time of the day were prospectively evaluated and registered on a formatted questionnaire. Evaluation of the patients included history of presenting illness, visual acuity testing intraocular pressure measurement on non-perforated and non-infected eyes, and complete eye examination in order to arrive at the diagnosis. A total of 26,400 patients attended Menelik II hospital during the study period. Of these, 758 (3%) were persons with an ocular emergency. The majority of patients (n=551; 72.7%) were male, with a male to female ratio of 2.7:1. The age group of 16 to 30 years was the most affected (47.9%), followed by those aged 15 years or younger (27.3%). Ocular trauma and ocular infections accounted for 75.6% and 13.1% of cases, respectively. Of the total ocular emergencies, open globe injuries constituted 171 (22.6%), corneal foreign bodies and abrasion 125 (16.5%), and open adnexal injuries 119 (15.7%). Metal and wood were the commonest work-related causes of ocular injuries in adults, with both together accounting for 60% of all ocular injuries. Children, on the other hand, sustained ocular injury while playing with others in 128 (22.3%) of cases. This study was able to provide a more complete picture to improve understanding of the nature and circumstances of ocular emergencies in Ethiopia. Ocular emergencies were dominated by ocular trauma, particularly affecting males and working-age adults. Public education and use of protective safety measures are recommended to alleviate the problem.

  15. Improving emergency management through shared information processing - considerations in Emergency Operations Center design

    International Nuclear Information System (INIS)

    DeBusk, R.E.; Walker, J.A.

    1987-01-01

    An Emergency Operations Center (EOC) is a shared information processing facility. Although seemingly obvious, many EOCs are designed and operated based on other criteria. The results, measured in terms of response effectiveness, are difficult to determine. A review of some recent disasters reveals a pattern of poor performance for the EOCs involved. These conclusions are tentative because so little research has been done on the design, operation, or evaluation of emergency operations centers. The EOC is not an onsite response command post but a facility removed from the response where tactical and strategic decisions are made based on information from the response site and elsewhere. The EOC is therefore the central focus of emergency information processing and higher-level decision making. Examining existing EOCs, several common functions emerge. These functions can be described in terms of shared information processing. However, many factors impact the design and operation of EOCs. Politics, budgets, and personal ambition are only a few such factors. Examining EOC design and operation in terms of shared information processing operationalized in the seven principal functions within the EOC provides a framework for establishing principles of EOC design and operation. In the response to emergencies such as Bhopal or Chernobyl the stakes are high. Applying new techniques and technologies of management systems can improve the probability of success. This research is a beginning step - to understand how EOCs function, to define the system. Predictive or prescriptive analysis must wait until sufficient empirical data is available to complete a descriptive model for EOC operations

  16. New Emergency control center of Slovenske Elektrarne Bohunice NPP

    International Nuclear Information System (INIS)

    Pecko, E.

    2012-01-01

    Emergency preparedness of nuclear power plant and operation assurance in case of a possible emergency calls to have devices for emergency response with equipment for rapid detection and continuous evaluation of anticipated events. Chief executive body designated to manage a nuclear power plant during major events is the emergency committee (EC). Emergency Committee is a part of the Emergency Response Organization (ERO). The following centers are on alert to ensure the activities of the ERO - Emergency Response office: - control room (CR) and emergency control room (ECR); - emergency management center (EMC); - Monitoring Centre (MC); - emergency backup control center (EBCC); - congregations of civil protection (CP) and CP shelters; - communications with warning and notification system (VARVYR). From a historical and practical point of view in the vicinity of Jaslovske Bohunice has been set up a joint emergency control center. The center was located on the territory of the former already inoperative V1 NPP. V1 NPP is currently integrated into the organizational structure of JAVYS. Operating Bohunice V2 NPP plant is a designated part of the Slovenske Elektrarne, a. s., whose majority owner is an Italian operator ENEL. In terms of various relevant factors, it was decided to build a new emergency management center on the territory of operating V2 NPP, meet the current standards.

  17. Impact of international humanitarian service-learning on emerging adult social competence: A mixed-methods evaluation

    Directory of Open Access Journals (Sweden)

    Paul Schvaneveldt

    2016-09-01

    Full Text Available This article presents the results from a study into international humanitarian service-learning experiences on young adult volunteers. Specifically, the service-learning experiences of emerging adults who had served in orphanages in Latin America were assessed, in a pre- and post-test design, for their development in areas of social competency such as identity, self-efficacy, self-esteem and ethnocentric attitudes. A mixed-methods design using both qualitative and quantitative measures was used. Both qualitative and quantitative results identified significant and important impacts on the development of the social competencies of these emerging adults. In addition, several qualitative themes illustrated that longer term international service-learning experiences have a profound impact on the social competence of emerging adults. Keywords: International humanitarian service, service-learning, emerging adult competency

  18. Reliability of emergency diesel-generators used in french NPP evaluation of the failure rate and its trend failures and dysfunctions review

    International Nuclear Information System (INIS)

    Colas, A.F.

    1990-01-01

    Emergency Diesel-Generators (EDG) reliability evaluation is based on examination of tests and operation abnormalities collected in national computerised data bank. We gather all available data in order to establish failures rate annual values and to follow their trend. Technical analysis aims at identifying failures modes in order to find palliative or curative solutions. The present paper tries to show our main findings and the way of technical approach we follow in this matters

  19. Reliability of emergency diesel-generators used in french NPP evaluation of the failure rate and its trend failures and dysfunctions review

    International Nuclear Information System (INIS)

    Colas, A.F.

    1989-04-01

    Emergency Diesel-Generators (EDG) reliability evaluation is based on examination of tests and operation abnormalities collected in national computerised data bank. We gather all available data in order to establish failures rate annual values and to follow their trend. Technical analysis aims at identifying failures modes in order to find palliative or curative solutions. The present paper tries to show our main findings and the way of technical approach we follow in this matters

  20. Sensory evaluation of a highly nutritive bread, formulated for populations suffering food emergencies, preserved with ionizing radiation

    International Nuclear Information System (INIS)

    Gonzalez, G.S.; Gómez, B.; Cova, M.C.; Narvaiz, Patricia

    2011-01-01

    The aim of this work was to evaluate with sensorial analysis, the feasibility of extending the shelf life at room temperature of highly nutritive bread, specially formulated for people suffering alimentary emergencies such as floods, earthquakes, geographical isolation or malnourishment, by means of ionizing radiation. The shelf life of any bread is limited by microbial growth, so the food industry uses chemicals and /or refrigeration to control it. Twenty one breads were formulated and manufactured employing wheat and soybean flours, dehydrated whey, skim milk and egg, vegetal oil, water, and some commercial food additives as emulsifiers and water retention substances. A final formulation was chosen by means of a preliminary sensory evaluation. Bibliographic estimations were made on its nutritional quality as compared to that of a regular wheat bread; improvements were found on vitamins, minerals, proteins, lipids and fibre. Forty 450 g breads were manufactured, oven cooked at 220°C for 20 minutes, packaged with polyethylene film, 100 microns thickness, and irradiated at the semi industrial cobalt-60 facility of the Ezeiza Atomic Centre, about 600,000 Ci of activity, with doses of 0, 6 and 10 kilo Grays, dose rate: 10 kGy/h, dose uniformity: 1.1. Control and irradiated samples were stored at room temperature and relative humidity for 43 days. Sensory analysis was performed with a panel of about 50 consumers on days 3, 29 and 43, evaluating aroma, aspect, colour, flavour, texture and general acceptability with hedonic scores ranging from 1 to 9. No significant differences between control and irradiated samples were found, being the latter afforded scores close to 7 even at the end of the storage period. Control samples had to be discarded on day 6 due to visible mould growth. So this bread formulation, suitable to fulfill most of the nutritional requirements of a population under alimentary emergency, attained at least a 7 fold shelf life increase when treated

  1. A transputer based high resolution TDC system for A1 experiment

    International Nuclear Information System (INIS)

    Geiges, R.; Merle, K.

    1996-01-01

    A multichannel TDC subsystem was designed and built at the Institute for Nuclear Physics at Mainz University. The subsystem is used for the readout of the vertical drift chambers (VDC) of the A1 experiment at the MAMI accelerator in Mainz. The system is based on a TDC ASIC chip called TDC 2001 and consists of several TDC modules housed in a VME-type crate. The TDC modules are controlled and read out by a transputer. The transputer can deliver the data through the transputer links to VME-systems, workstations, or PCs as data acquisition master

  2. Construction of a technique plan repository and evaluation system based on AHP group decision-making for emergency treatment and disposal in chemical pollution accidents.

    Science.gov (United States)

    Shi, Shenggang; Cao, Jingcan; Feng, Li; Liang, Wenyan; Zhang, Liqiu

    2014-07-15

    The environmental pollution resulting from chemical accidents has caused increasingly serious concerns. Therefore, it is very important to be able to determine in advance the appropriate emergency treatment and disposal technology for different types of chemical accidents. However, the formulation of an emergency plan for chemical pollution accidents is considerably difficult due to the substantial uncertainty and complexity of such accidents. This paper explains how the event tree method was used to create 54 different scenarios for chemical pollution accidents, based on the polluted medium, dangerous characteristics and properties of chemicals involved. For each type of chemical accident, feasible emergency treatment and disposal technology schemes were established, considering the areas of pollution source control, pollutant non-proliferation, contaminant elimination and waste disposal. Meanwhile, in order to obtain the optimum emergency disposal technology schemes as soon as the chemical pollution accident occurs from the plan repository, the technique evaluation index system was developed based on group decision-improved analytical hierarchy process (AHP), and has been tested by using a sudden aniline pollution accident that occurred in a river in December 2012. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. 44 CFR 16.110 - Self-evaluation.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Self-evaluation. 16.110... ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.110 Self-evaluation. (a) The agency... handicaps or organizations representing individuals with handicaps, to participate in the self-evaluation...

  4. Evaluation of semi-generic PBTK modeling for emergency risk assessment after acute inhalation exposure to volatile hazardous chemicals.

    Science.gov (United States)

    Olie, J Daniël N; Bessems, Jos G; Clewell, Harvey J; Meulenbelt, Jan; Hunault, Claudine C

    2015-08-01

    Physiologically Based Toxicokinetic Models (PBTK) may facilitate emergency risk assessment after chemical incidents with inhalation exposure, but they are rarely used due to their relative complexity and skill requirements. We aimed to tackle this problem by evaluating a semi-generic PBTK model built in MS Excel for nine chemicals that are widely-used and often released in a chemical incident. The semi-generic PBTK model was used to predict blood concentration-time curves using inhalation exposure scenarios from human volunteer studies, case reports and hypothetical exposures at Emergency Response Planning Guideline, Level 3 (ERPG-3) levels.(2) Predictions using this model were compared with measured blood concentrations from volunteer studies or case reports, as well as blood concentrations predicted by chemical-specific models. The performances of the semi-generic model were evaluated on biological rationale, accuracy, and ease of use and range of application. Our results indicate that the semi-generic model can be easily used to predict blood levels for eight out of nine parent chemicals (dichloromethane, benzene, xylene, styrene, toluene, isopropanol trichloroethylene and tetrachloroethylene). However, for methanol, 2-propanol and dichloromethane the semi-generic model could not cope with the endogenous production of methanol and of acetone (being a metabolite of 2-propanol) nor could it simulate the formation of HbCO, which is one of the toxic end-points of dichloromethane. The model is easy and intuitive to use by people who are not so familiar with toxicokinetic models. A semi-generic PBTK modeling approach can be used as a 'quick-and-dirty' method to get a crude estimate of the exposure dose. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Diabetic Emergencies

    Science.gov (United States)

    ... Campaigns Share this! EmergencyCareForYou » Emergency 101 » Diabetic Emergencies Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  6. Predicting pneumococcal community-acquired pneumonia in the emergency department: evaluation of clinical parameters.

    Science.gov (United States)

    Huijts, S M; Boersma, W G; Grobbee, D E; Gruber, W C; Jansen, K U; Kluytmans, J A J W; Kuipers, B A F; Palmen, F; Pride, M W; Webber, C; Bonten, M J M

    2014-12-01

    The aim of this study was to quantify the value of clinical predictors available in the emergency department (ED) in predicting Streptococcus pneumoniae as the cause of community-acquired pneumonia (CAP). A prospective, observational, cohort study of patients with CAP presenting in the ED was performed. Pneumococcal aetiology of CAP was based on either bacteraemia, or S. pneumoniae being cultured from sputum, or urinary immunochromatographic assay positivity, or positivity of a novel serotype-specific urinary antigen detection test. Multivariate logistic regression was used to identify independent predictors and various cut-off values of probability scores were used to evaluate the usefulness of the model. Three hundred and twenty-eight (31.0%) of 1057 patients with CAP had pneumococcal CAP. Nine independent predictors for pneumococcal pneumonia were identified, but the clinical utility of this prediction model was disappointing, because of low positive predictive values or a small yield. Clinical criteria have insufficient diagnostic capacity to predict pneumococcal CAP. Rapid antigen detection tests are needed to diagnose S. pneumoniae at the time of hospital admission. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

  7. Neuroimaging of Patients with Headache in the Emergency Room: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    ibrahim Burak Atci

    2015-03-01

    Conclusion: In the emergency department during evaluation of headache, that should be done first is the exclusion of headaches which is caused by non beningn intracranial patologies. Therefore, from the entrance of the patients evaluated in the emergency room, it is important that they must be directed to rapid diagnosis and treatment with considering the red alert findings. [Cukurova Med J 2015; 40(1.000: 86-90

  8. Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.

    Science.gov (United States)

    Franc, Jeffrey Michael; Nichols, Darren; Dong, Sandy L

    2012-02-01

    Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training. A simulation-based curriculum was developed. The curriculum included four group exercises in which the participants developed a disaster plan for a simulated hospital. This was followed by a disaster simulation using the Disastermed.Ca Emergency Disaster Simulator computer software Version 3.5.2 (Disastermed.Ca, Edmonton, Alberta, Canada) and the disaster plan developed by the participants. Progress was assessed by a pre- and post-test, resident evaluations, faculty evaluation of Command and Control, and markers obtained from the Disastermed.Ca software. Twenty-five residents agreed to partake in the training curriculum. Seventeen completed the simulation. There was no statistically significant difference in pre- and post-test scores. Residents indicated that they felt the curriculum had been useful, and judged it to be preferable to a didactic curriculum. In addition, the residents' confidence in their ability to manage a disaster increased on both a personal and and a departmental level. A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.

  9. Interpretation manual of emergency cranial tomography

    International Nuclear Information System (INIS)

    Mejias Soto, Carolina

    2012-01-01

    A manual has been prepared for the correct evaluation of tomographic studies in emergencies. The literature review was developed selecting printed books, journal articles, electronic of cases in etiopathogenesis, and neuroimaging findings frequently made emergencies. The information has been consulted in major bibliographic databases such as MD-Consult and Med-Line, radiology journals such as: Radiology, Radiographics, Clinics of North America, American Journal of Roetnology and newly available texts on neuroimaging. The manual has been a guide for radiology resident physicians, of the topics of greatest interest to collaborate in the diagnosis, monitoring of patients and therapeutic decisions [es

  10. Post-anaesthetic emergence delirium in adults

    DEFF Research Database (Denmark)

    Munk, L; Andersen, G; Møller, A M

    2016-01-01

    BACKGROUND: Emergence delirium (ED) after general anaesthesia (GA) is a well-known phenomenon, yet the risk factors are still unclear. The aims of this study were to determine the incidence and independent predictors of ED and secondly to determine to which degree ED has any relevant, clinical...... consequences to medical staff as well as to patients. METHOD: This prospective, observational cohort study assessed adult patients emerging from GA in the operating room, using the Richmond Agitation-Sedation Scale (RASS). Signs of ED, defined as RASS≥1 along with possible clinical consequences were noted....... Patients with ED were re-evaluated in the post-anaesthesia care unit (PACU) and concomitant patient and anaesthesia related factors were noted. RESULTS: Among the 1970 patients enrolled, 73 (3.7%) showed signs of ED when emerging from anaesthesia. When reassessed in PACU, the number had declined to 25...

  11. A study on the evaluation of pneumothorax by imaging methods in patients presenting to the emergency department for blunt thoracic trauma.

    Science.gov (United States)

    Kaya, Şeyhmus; Çevik, Arif Alper; Acar, Nurdan; Döner, Egemen; Sivrikoz, Cumhur; Özkan, Ragıp

    2015-09-01

    Pneumothorax (PNX) is the collection of air between parietal and visceral pleura, and collapsed lung develops as a complication of the trapped air. PNX is likely to develop spontaneously in people with risk factors. However, it is mostly seen with blunt or penetrating trauma. Diagnosis is generally confirmed by chest radiography [posteroanterior chest radiography (PACR)]. Chest ultrasound (US) is also a promising technique for the detection of PNX in trauma patients. There is not much literature on the evaluation of blunt thoracic trauma (BTT) and pneumothorax (PNX) in the emergency department (ED). The aim of this study was to investigate the effectiveness of chest US for the diagnosis of PNX in patients presenting to ED with BTT. This study was carried out for a period of nine months in the ED of a university hospital. The chest US of patients was performed by emergency physicians trained in the field. The results were compared with anteroposterior chest radiography and/or CT scan of the chest. The APCR and chest CT results were evaluated by a radiology specialist blind to US findings. The evaluation of the radiology specialist was taken as the gold standard for diagnosis by imaging methods. Clinical follow-up was taken into consideration for the diagnosis of PNX in patients on whom CT scan was not performed. Chest US was performed on all two hundred and twelve patients (144 female and 68 male patients; mean age 45.8) who participated in this study. The supine APCR was performed on two hundred and ten (99%) patients and chest CT was performed on one hundred and twenty (56.6%). Out of the twenty-five (11.8%) diagnosed cases of PNX, 22 (88%) were diagnosed by chest US and 8 were diagnosed by APCR. For the detection of PNX, compared to clinical follow-up and chest CT, the sensitivity of chest US was 88%, specificity 99.5%, positive predictive value 95.7% and negative predictive value 98.4%. Chest US has not superseded supine and standing chest radiography for PNX

  12. Medical intervention in radiological emergencies, formation and training

    International Nuclear Information System (INIS)

    Cardenas H, J.

    2006-01-01

    The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

  13. Emergências hipertensivas Hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Gilson Soares Feitosa-Filho

    2008-09-01

    Full Text Available As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É caracterizada por pressão arterial marcadamente elevada e sinais de lesões de órgãos-alvo (encefalopatia, infarto agudo do miocárdio, angina instável, edema agudo de pulmão, eclâmpsia, acidente vascular encefálico. O objetivo deste estudo foi apresentar os principais pontos sobre o seu apropriado diagnóstico e tratamento. Foi realizada busca por artigos originais com os unitermos "crise hipertensiva" e "emergência hipertensiva" nas bases de dados Pubmed e MedLine nos últimos dez anos. As referências disponíveis destes artigos foram verificadas. Os artigos foram identificados e revisados e o presente estudo condensa os principais resultados descritos. Para esta revisão foram considerados ensaios clínicos em língua inglesa, estudos retrospectivos e artigos de revisão. A crise hipertensiva é a entidade clínica com aumento súbito da PA (> 180 x 120 mmHg, acompanhada por sintomas, que podem ser leves (cefaléia, tontura, zumbido ou graves (dispnéia, dor precordial, coma e até morte, com ou sem lesão aguda de órgãos-alvo. Se os sintomas forem leves e sem lesão aguda de órgãos alvos, define-se a urgência hipertensiva. Se o quadro clínico apresentar risco de vida e refletir lesão aguda de órgãos-alvo têm-se, então, a emergência hipertensiva. Muitos pacientes também apresentam uma PA elevada demais, por não usarem suas medicações, tratando-se apenas de hipertensão arterial sistêmica crônica n

  14. Role of computed tomography in emergency evaluation of the nervous system

    International Nuclear Information System (INIS)

    Pelletier, J.; Martini, P.

    1994-01-01

    Computed tomography is the essential examination in patients with severe manifestations of neurological disorders. We discuss emergency situations involving the central nervous system due to vascular and infections lesions. Trauma and acute complications of brain tumours, usually seen within a neurosurgical context, are not discussed here. (authors). 11 refs., 19 figs

  15. Review of IAEA documentation on Nuclear and radiological emergency

    International Nuclear Information System (INIS)

    Mukhono, P. M.

    2014-10-01

    The project focuses on the review of IAEA documentation on nuclear or radiological emergencies with main focus on methodology for developing and arrangement for nuclear and radiological emergencies. The main objective of this work is to identify limitations in IAEA documentation on emergency preparedness and response (EPR) and provide recommendation on the main actions needed to fill the gaps identified thus aiding in improvement of emergency preparedness and response to nuclear and radiological accidents. The review of IAEA documentation on nuclear and radiological emergency has been carried out by evaluating various emergency response elements. Several elements for EPR were highlighted covering the safety fundamentals, general safety requirements and EPR methods for development of an effective emergence response capability for nuclear or radiological emergencies. From these issues, the limitations of IAEA documentation on EPR were drawn and recommendations suggested as a means of improving EPR methods. Among them was the need for IAEA consider establishment of follow up and inspection programmes to facilitate implementation of EPR requirements in most developing countries, establishment of programmes that provide platforms for the countries to be motivated to update their system in line with the current status of emergency preparedness, review of the international information exchange aspects of nuclear emergencies in order to improve capabilities to communicate reliable data, information and decisions quickly and effectively among national authorities and their emergency and emergency response centres. (au)

  16. Radiological emergency response - a functional approach

    International Nuclear Information System (INIS)

    Chowdhury, P.

    1998-01-01

    The state of Louisiana's radiological emergency response programme is based on the federal guidance 'Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants' (NUREG-0654, FEMA-REP-1 Rev. 1). Over the past 14 years, the planning and implementation of response capabilities became more organized and efficient; the training programme has strengthened considerably; co-ordination with all participating agencies has assumed a more co-operative role, and as a result, a fairly well integrated response planning has evolved. Recently, a more 'functional' approach is being adopted to maximize the programme's efficiency not only for nuclear power plant emergency response, but radiological emergency response as a whole. First, several broad-based 'components' are identified; clusters of 'nodes' are generated for each component; these 'nodes' may be divided into 'sub-nodes' which will contain some 'attributes'; 'relational bonds' among the 'attributes' will exist. When executed, the process begins and continues with the 'nodes' assuming a functional and dynamic role based on the nature and characteristics of the 'attributes'. The typical response based on stand-alone elements is thus eliminated, the overlapping of functions is avoided, and a well structured and efficient organization is produced, that is essential for today's complex nature of emergency response. (author)

  17. Automatic Emergence Detection in Complex Systems

    Directory of Open Access Journals (Sweden)

    Eugene Santos

    2017-01-01

    Full Text Available Complex systems consist of multiple interacting subsystems, whose nonlinear interactions can result in unanticipated (emergent system events. Extant systems analysis approaches fail to detect such emergent properties, since they analyze each subsystem separately and arrive at decisions typically through linear aggregations of individual analysis results. In this paper, we propose a quantitative definition of emergence for complex systems. We also propose a framework to detect emergent properties given observations of its subsystems. This framework, based on a probabilistic graphical model called Bayesian Knowledge Bases (BKBs, learns individual subsystem dynamics from data, probabilistically and structurally fuses said dynamics into a single complex system dynamics, and detects emergent properties. Fusion is the central element of our approach to account for situations when a common variable may have different probabilistic distributions in different subsystems. We evaluate our detection performance against a baseline approach (Bayesian Network ensemble on synthetic testbeds from UCI datasets. To do so, we also introduce a method to simulate and a metric to measure discrepancies that occur with shared/common variables. Experiments demonstrate that our framework outperforms the baseline. In addition, we demonstrate that this framework has uniform polynomial time complexity across all three learning, fusion, and reasoning procedures.

  18. Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

    Science.gov (United States)

    Safdar, Basmah; Greenberg, Marna R

    2014-12-01

    With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the

  19. Increasing Completion Rate of an M4 Emergency Medicine Student End-of-Shift Evaluation Using a Mobile Electronic Platform and Real-Time Completion

    Directory of Open Access Journals (Sweden)

    Matthew C. Tews

    2016-06-01

    Full Text Available Introduction: Medical students on an emergency medicine rotation are traditionally evaluated at the end of each shift with paper-based forms, and data are often missing due to forms not being turned in or completed. Because students’ grades depend on these evaluations, change was needed to increase form rate of return. We analyzed a new electronic evaluation form and modified completion process to determine if it would increase the completion rate without altering how faculty scored student performance. Methods: During fall 2013, 29 faculty completed paper N=339 evaluations consisting of seven competencies for 33 students. In fall 2014, an electronic evaluation form with the same competencies was designed using an electronic platform and completed N=319 times by 27 faculty using 25 students’ electronic devices. Feedback checkboxes were added to facilitate collection of common comments. Data was analyzed with IBM® SPSS® 21.0 using multi-factor analysis of variance with the students’ global rating (GR as an outcome. Inter-item reliability was determined with Cronbach alpha. Results: There was a significantly higher completion rate (p=0.001 of 98% electronic vs. 69% paper forms, lower (p=0.001 missed GR rate (1% electronic. vs 12% paper, and higher mean scores (p=0.001 for the GR with the electronic (7.0±1.1 vs. paper (6.8±1.2 form. Feedback checkboxes were completed on every form. The inter-item reliability for electronic and paper forms was each alpha=0.95. Conclusion: The use of a new electronic form and modified completion process for evaluating students at the end of shift demonstrated a higher faculty completion rate, a lower missed data rate, a higher global rating and consistent collection of common feedback. The use of the electronic form and the process for obtaining the information made our end-of-shift evaluation process for students more reliable and provided more accurate, up-to-date information for student feedback and when

  20. Evaluación del aprendizaje emergente: una experiencia con estudiantes universitarias de Educación Preescolar / Evaluating emergent learning: an experience with university preschool education students

    Directory of Open Access Journals (Sweden)

    Badilla Saxe, Eleonora

    2008-12-01

    Full Text Available Resumen: Se aborda en este ensayo la necesidad de comprender y evaluar el aprendizaje como un fenómeno emergente, más allá del aprendizaje previsto en los planes de estudio y diseño curricular. Se ejemplifica con la reflexión del propio aprendizaje emergente de la autora en su proceso de dirección de un proyecto de investigación-acción en la Universidad de Costa Rica. En dicha investigación-acción participaron once estudiantes de licenciatura en educación preescolar y veinticinco niños y niñas de 5 y 6 años que contaron con materiales digitales en su ambiente y proceso de aprendizaje.Abstract:This essay discusses the need to understand and evaluate learning as an emergent phenomenon that transcends what has been foreseen in the curriculum. It includes reflections of the author as Director of a Reflective-Research Project at the University of Costa Rica UCR about her own emergent learning about evaluating emergent learning. The Research project was developed by eleven university students at the School of Education at UCR and twenty five preschool children using digital technologies in their learning process and environment.

  1. Emergence Unites Ecology and Society

    Directory of Open Access Journals (Sweden)

    Ronald L. Trosper

    2005-06-01

    Full Text Available The effort to combine analysis of ecosystems and social systems requires a firm theoretical basis. When humans are present in an ecosystem, their actions affect emergent structures; this paper examines forms of emergence that account for the presence of humans. Humans monitor and regulate ecosystems based on their cultural systems. Cultural systems consist of concepts linked in complicated ways that can form consistent world views, can contain inconsistencies, and may or may not accurately model the properties of a social-ecological system. Consequently, human monitoring and regulating processes will differ, depending on cultural systems. Humans, as agents, change or maintain pre-existing material and cultural emergent structures. The presentation is illustrated with a case study of fire-prone forests. The paper shows that explicit attention to emergence serves very well in unifying the following requirements for social-ecological analysis: coherent and observable definitions of sustainability; ways to link ecological and social phenomena; ways to understand cultural reasons for stability and instability in dynamic social-ecological systems; and ways to include human self-evaluation and culture within dynamic models of social-ecological systems. Analysis of cultural emergent structures clarifies many differences in assumptions among the fields of economics, sociology, political science, ecology, and ecological economics. Because it can be readily applied to empirical questions, the framework provides a good way to organize policy analysis that is not dominated by one or another discipline.

  2. Errors in fracture diagnoses in the emergency department--characteristics of patients and diurnal variation

    DEFF Research Database (Denmark)

    Hallas, Peter; Ellingsen, Trond

    2006-01-01

    Evaluation of the circumstances related to errors in diagnosis of fractures at an Emergency Department may suggest ways to reduce the incidence of such errors.......Evaluation of the circumstances related to errors in diagnosis of fractures at an Emergency Department may suggest ways to reduce the incidence of such errors....

  3. Clinical characteristics of dental emergencies and prevalence of dental trauma at a university hospital emergency center in Korea.

    Science.gov (United States)

    Bae, Ji-Hyun; Kim, Young-Kyun; Choi, Yong-Hoon

    2011-10-01

    The aim of this study was to examine the clinical characteristics of dental emergency patients who visited a university hospital emergency center and to evaluate the incidence of dental trauma. A retrospective chart review of patients with dental complaints and who visited the Seoul National University Bundang Hospital (SNUBH) emergency center in Gyeonggi-do, Korea, from January 2009 to December 2009 was conducted. Information regarding age, gender, the time, day, and month of presentation, diagnosis, treatment, and follow up was collected and analyzed. One thousand four hundred twenty-five patients with dental problems visited the SNUBH emergency center. Dental patients accounted for 1.47% of the total 96,708 patients at the emergency center. The male-to-female ratio was 1.68:1, with a considerably larger number of male patients (62.7%). The age distribution peak was at 0-9 years (27.5%), followed by patients in their forties (14.1%). The number of patients visiting the dental emergency center peaked in May (14.2%), on Sundays (22.4%), and between 2100 and 2400 h (20.8%). The patients' chief complaints were as follows: dental trauma, dental infection, oral bleeding, and temporomandibular joint disorder (TMD). The prevalence of dental trauma was 66%. The reasons for dental emergency visits included the following: dental trauma, dental infection, oral bleeding, and TMD, with 66% of the patients requiring management of dental trauma. It is important that dentists make a prompt, accurate diagnosis and initiate effective treatment in case of dental emergencies, especially dental trauma. © 2011 John Wiley & Sons A/S.

  4. Transient virulence of emerging pathogens.

    Science.gov (United States)

    Bolker, Benjamin M; Nanda, Arjun; Shah, Dharmini

    2010-05-06

    Should emerging pathogens be unusually virulent? If so, why? Existing theories of virulence evolution based on a tradeoff between high transmission rates and long infectious periods imply that epidemic growth conditions will select for higher virulence, possibly leading to a transient peak in virulence near the beginning of an epidemic. This transient selection could lead to high virulence in emerging pathogens. Using a simple model of the epidemiological and evolutionary dynamics of emerging pathogens, along with rough estimates of parameters for pathogens such as severe acute respiratory syndrome, West Nile virus and myxomatosis, we estimated the potential magnitude and timing of such transient virulence peaks. Pathogens that are moderately evolvable, highly transmissible, and highly virulent at equilibrium could briefly double their virulence during an epidemic; thus, epidemic-phase selection could contribute significantly to the virulence of emerging pathogens. In order to further assess the potential significance of this mechanism, we bring together data from the literature for the shapes of tradeoff curves for several pathogens (myxomatosis, HIV, and a parasite of Daphnia) and the level of genetic variation for virulence for one (myxomatosis). We discuss the need for better data on tradeoff curves and genetic variance in order to evaluate the plausibility of various scenarios of virulence evolution.

  5. Human Trafficking: A Guide to Identification and Approach for the Emergency Physician.

    Science.gov (United States)

    Shandro, Jamie; Chisolm-Straker, Makini; Duber, Herbert C; Findlay, Shannon Lynn; Munoz, Jessica; Schmitz, Gillian; Stanzer, Melanie; Stoklosa, Hanni; Wiener, Dan E; Wingkun, Neil

    2016-10-01

    Human trafficking is a significant human rights problem that is often associated with psychological and physical violence. There is no demographic that is spared from human trafficking. Traffickers maintain control of victims through physical, sexual, and emotional violence and manipulation. Because victims of trafficking seek medical attention for the medical and psychological consequences of assault and neglected health conditions, emergency clinicians are in a unique position to recognize victims and intervene. Evaluation of possible trafficking victims is challenging because patients who have been exploited rarely self-identify. This article outlines the clinical approach to the identification and treatment of a potential victim of human trafficking in the emergency department. Emergency practitioners should maintain a high index of suspicion when evaluating patients who appear to be at risk for abuse and violence, and assess for specific indicators of trafficking. Potential victims should be evaluated with a multidisciplinary and patient-centered technique. Furthermore, emergency practitioners should be aware of national and local resources to guide the approach to helping identified victims. Having established protocols for victim identification, care, and referrals can greatly facilitate health care providers' assisting this population. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  6. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... IUD placed inside the uterus CHOICES FOR EMERGENCY CONTRACEPTION Two emergency contraceptive pills may be bought without a prescription. ...

  7. Osteopathic emergency medicine programs infrequently publish in high-impact emergency medicine journals.

    Science.gov (United States)

    Baskin, Sean M; Lin, Christina; Carlson, Jestin N

    2014-11-01

    Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. We performed a retrospective literature review using the Journal Citation Report database and identified the top five journals in the category of 'Emergency Medicine' by their 2011 Impact Factor. We examined all publications from each journal for 2011. For each article we recorded article type, authors' names, position of authorship (first, senior or other), the author's degree and affiliated institution. We present the data in raw numbers and percentages. The 2011 EM journals with the highest impact factor were the following: Annals of Emergency Medicine, Resuscitation, Journal of Trauma, Injury, and Academic Emergency Medicine. Of the 9,298 authors published in these journals in 2011; 1,309 (15%) claimed affiliation with U.S.-based EM programs, of which 16 (1%) listed their affiliations with eight different osteopathic EM programs. The 16 authors claimed affiliation with 8 of 46 osteopathic EM programs (17%), while 1,301 authors claimed affiliation with 104 of 148 (70%) U.S.-based allopathic programs. Authors from osteopathic EM programs are under-represented in the top EM journals. With the pending ACGME/AOA merger, there is a significant opportunity for improvement in the rate of publication of osteopathic EM programs in top tier EM journals.

  8. Emergence of Industrial Ecosystems in Post-Authoritarian Contexts

    Directory of Open Access Journals (Sweden)

    Kristina Grumadaite

    2016-09-01

    -authoritarian contexts and thus evaluate the aspects of emergence emphasised in the theoretical part of the article.

  9. Emergency in the clinic: a simulation curriculum to improve outpatient safety.

    Science.gov (United States)

    Espey, Eve; Baty, Gillian; Rask, John; Chungtuyco, Michelle; Pereda, Brenda; Leeman, Lawrence

    2017-12-01

    Emergency response skills are essential when events such as seizure, anaphylaxis, or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy. This pre- and postcurriculum study enrolled residents and fellows in Obstetrics and Gynecology and Family Medicine in a simulation-based, outpatient emergency management curriculum. Learners completed self-efficacy questionnaires and were videotaped managing 3 medical emergency scenarios (seizure, over-sedation/cardiopulmonary arrest, and hemorrhage) in the simulation laboratory both before and after completion of the curriculum. Evaluators who were blinded to training level scored the simulation performance videotapes using a graded rubric with critical action checklists. Scenario scores were assigned in 5 domains and globally. Paired t-tests were used to determine differences pre- and postcurriculum. Thirty residents completed the curriculum and pre- and postcurriculum testing. Subjects' objective performance scores improved in all 5 domains (Pimprovement. When scores were stratified by previous outpatient simulation experience, subjects with previous experience improved in all but management of excess sedation. Pre- and postcurriculum self-efficacy evaluations demonstrated improvement in all 7 measured areas: confidence, use of appropriate resources, communication skills, complex airway management, bag mask ventilation, resuscitation, and hemorrhage management. Self-efficacy assessment showed improvement in confidence managing outpatient emergencies (P=.001) and ability to communicate well in emergency situations (Pimproved both self-efficacy and objectively rated performance scores in management of outpatient medical

  10. Childhood Emergencies

    Science.gov (United States)

    ... SUBSCRIBE Emergency 101 Share this! Home » Emergency 101 Childhood Emergencies Keeping children healthy and safe is every ... and tools to prevent, recognize and address a childhood emergency is the first step in keeping your ...

  11. Eye Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

  12. Evaluation of Social Media Use by Emergency Medicine Residents and Faculty.

    Science.gov (United States)

    Pearson, David; Bond, Michael C; Kegg, Jason; Pillow, Tyson; Hopson, Laura; Cooney, Robert; Garg, Manish; Khadpe, Jay; Runyon, Michael; Patterson, Leigh

    2015-09-01

    Clinicians and residency programs are increasing their use of social media (SM) websites for educational and promotional uses, yet little is known about the use of these sites by residents and faculty. The objective of the study is to assess patterns of SM use for personal and professional purposes among emergency medicine (EM) residents and faculty. In this multi-site study, an 18-question survey was sent by e-mail to the residents and faculty in 14 EM programs and to the Council of Emergency Medicine Residency Directors (CORD) listserv via the online tool SurveyMonkey™. We compiled descriptive statistics, including assessment with the chi-square test or Fisher's exact test. StatsDirect software (v 2.8.0, StatsDirect, Cheshire, UK) was used for all analyses. We received 1,314 responses: 63% of respondents were male, 40% were respondents completed residency more than 10 years ago. Residents used SM markedly more than faculty for social interactions with family and friends (83% vs 65% [psocial media. Awareness of these utilization patterns could benefit future educational endeavors.

  13. Is a mobile emergency severity index (ESI) triage better than the paper ESI?

    Science.gov (United States)

    Savatmongkorngul, Sorravit; Yuksen, Chaiyaporn; Suwattanasilp, Chanakarn; Sawanyawisuth, Kittisak; Sittichanbuncha, Yuwares

    2017-12-01

    This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI. The ESI results for each patient were compared with the standard ESI. Concordance and kappa statistics were calculated for pairs of the evaluators. There were 486 patients enrolled in the study; 235 patients (48.4%) were assessed using the mobile ESI, and 251 patients (51.6%) were in the original ESI group. The baseline characteristics of patients in both groups were mostly comparable except for the ED visit time. The percentages of concordance and kappa statistics in the original ESI group were lower than in the mobile group in all three comparisons (medical students vs gold standard, emergency physicians vs gold standard, and medical students vs emergency physicians). The highest kappa in the original ESI group is 0.69, comparing emergency physicians vs gold standard, while the lowest kappa in the application group is 0.84 comparing the medical students vs gold standard. Both medical students and emergency physicians are more confident with the mobile ESI application triage. In conclusion, the mobile ESI has better inter-rater reliability, and is more user-friendly than the original paper form.

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

    Directory of Open Access Journals (Sweden)

    Hansen Elisabeth

    2009-07-01

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

  15. The risk stratification and prognostic evaluation of soluble programmed death-1 on patients with sepsis in emergency department.

    Science.gov (United States)

    Zhao, Yongzhen; Jia, Yumei; Li, Chunsheng; Fang, Yingying; Shao, Rui

    2018-01-01

    To evaluate the efficacy of soluble programmed death-1 (sPD-1) for risk stratification and prediction of 28-day mortality in patients with sepsis, we compared serum sPD-1 with procalcitonin (PCT), C-reactive protein (CRP), and the Mortality in Emergency Department Sepsis (MEDS) score. A total of 60 healthy volunteers and 595 emergency department (ED) patients were recruited for this prospective cohort study. According to the severity of their condition on ED arrival, the patients were allocated to the systemic inflammatory response syndrome group (130 cases), sepsis group (276 cases), severe sepsis group (121 cases), and septic shock group (68 cases). In addition, all patients with sepsis were also divided into the survivor group (349 cases) and nonsurvivor group (116 cases) according to the 28-day outcomes. When the severity of sepsis increased, the levels of sPD-1 gradually increased. The levels of sPD-1, PCT, CRP and the MEDS score were also higher in the nonsurvivor group compared to the survivor group. Logistic regression suggested that sPD-1, PCT, and the MEDS score were independent risk factors for 28-day mortality of patients with sepsis. Area under the curve (AUC) of sPD-1, PCT and the MEDS score for 28-day mortality was 0.725, 0.693, and 0.767, respectively, and the AUC was improved when all 3 factors were combined (0.843). Serum sPD-1 is positively correlated with the severity of sepsis, and it is valuable for risk stratification of patients and prediction of 28-day mortality. Combining sPD-1 with PCT and the MEDS score improves the prognostic evaluation. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Mitigating action strategies in radiological emergencies

    International Nuclear Information System (INIS)

    Carrillo, D.

    1984-08-01

    On the basis of an assumed reactor accident, the report deals with the evaluation of the emergency response effectiveness obtained under several response strategies. The selected strategies consider sheltering, evacuation and short-term relocation (24 h) separately and in combination. The selected strategies give rise to different biological radiation effects. These effects are used as comparative parameters in the evaluation of the response effectiveness. The biological radiation effects have been calculated by means of the consequence assessment program CRAC 2

  17. Evaluation of the Effect of a Preoperative Single Dose of Gabapentin on Emergence Agitation in Patients Undergoing Breast Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Simin Azemati

    2013-10-01

    Full Text Available Background: Emergence agitation is a transient confusional state that usuallyoccurs within 10 to 30 minutes of recovery from general anesthesia. It may lead to seriousconsequences and increasing hospital costs. This study evaluates the effect of gabapentinon emergence agitation in patients undergoing breast cancer surgery.Methods: This randomized, double blind controlled trial enrolled 100 femalepatients with American Society of Anesthesiologists' classifications I and II who werecandidates for breast cancer surgery. Patients were randomly assigned into two groups(n=50 that received either oral gabapentin 600 mg or placebo. Induction andmaintenance of anesthesia were similar in both groups. At the end of surgery, patient'sagitation score, pain score, and presence of nausea or vomiting were reported. In theward, the presence of headache or dizziness was checked during the first 8 h. Mann-Whitney test was used for comparison of agitation and pain scores between two groups.Chi-square test was used for comparing occurrence of nausea, vomiting and qualitative.The qualitative demographic variable and t-test compared quantitative demographicvariables.Results: There was a significantly lower incidence of emergence agitation in thegabapentin group before (P<0.001 and after (P=0.029 extubation. There weresignificantly lower mean agitation scores before (P<001 and after (P=0.006 extubationand in the pain score (P=0.005 in the gabapentin group. The need for remifentanilinfusion (P<0.05 during surgery was significantly lower in the gabapentin groupcompared with the placebo group. Occurrence of nausea and vomiting and gabapentinside effects that included headache or dizziness did not significantly differ between twogroups (P=0.126, P=1, P=0.629 respectively.Conclusion: Gabapentin not only decreased postoperative pain but also effectivelyreduced emergence agitation without any significant side effects in patients undergoingbreast cancer surgery.

  18. Evaluation of Ventricle Size Measurements in Infants by Pediatric Emergency Medicine Physicians.

    Science.gov (United States)

    Halm, Brunhild M; Leone, Tina A; Chaudoin, Lindsey T; McKinley, Kenneth W; Ruzal-Shapiro, Carrie; Franke, Adrian A; Tsze, Daniel S

    2018-06-05

    The identification of hydrocephalus in infants by pediatric emergency medicine (PEM) physicians using cranial point-of-care ultrasound (POCUS) has not been evaluated. We aimed to conduct a pilot/proof-of-concept study to evaluate whether PEM physicians can identify hydrocephalus (anterior horn width >5 mm) in 15 infants (mean 69 ± 42 days old) from the neonatal intensive care unit using POCUS. Our exploratory aims were to determine the test characteristics of cranial POCUS performed by PEM physicians for diagnosing hydrocephalus and the interrater reliability between measurements made by the PEM physicians and the radiologist. Depending on the availability, 1 or 2 PEM physicians performed a cranial POCUS through the open anterior fontanel for each infant after a 30-minute didactic lecture to determine the size of the left and right ventricles by measuring the anterior horn width at the foramen of Monroe in coronal view. Within 1 week, an ultrasound (US) technologist performed a cranial US and a radiologist determined the ventricle sizes from the US images; these measurements were the criterion standard. A radiologist determined 12 of the 30 ventricles as hydrocephalic. The sensitivity and specificity of the PEM physicians performed cranial POCUS was 66.7% (95% confidence interval [CI], 34.9%-90.1%) and 94.4% (95% CI, 72.7%-99.9%), whereas the positive and negative predictive values were 88.9% (95% CI, 53.3%-98.2%) and 81.0% (95% CI, 65.5%-90.5%), respectively. The interrater reliability between the PEM physician's and radiologist's measurements was r = 0.91. The entire POCUS examinations performed by the PEM physicians took an average of 1.5 minutes. The time between the cranial POCUS and the radiology US was, on average, 4 days. While the PEM physicians in our study were able to determine the absence of hydrocephalus in infants with high specificity using cranial POCUS, there was insufficient evidence to support the use of this modality for identifying

  19. Rural emergency medical technician pre-hospital electrocardiogram transmission.

    Science.gov (United States)

    Powell, A M; Halon, J M; Nelson, J

    2014-01-01

    Emergent care of the acute heart attack patient continues to be at the forefront of quality and cost reduction strategies throughout the healthcare industry. Although the average cardiac door-to-balloon (D2B) times have decreased substantially over the past few years, there are still vast disparities found in D2B times in populations that reside in rural areas. Such disparities are mostly related to prolonged travel time and subsequent delays in cardiac catherization lab team activation. Urban ambulance companies that are routinely staffed with paramedic level providers have been successful in the implementation of pre-hospital 12-lead electrocardiogram (ECG) protocols as a strategy to reduce D2B times. The authors sought to evaluate the evidence related to the risk and benefits associated with the replication of an ECG transmission protocol in a small rural emergency medical service. The latter is staffed with emergency medical technician-basics (EMT-B), emergency medical technician-advanced (EMT-A), and emergency medical technician-intermediate (EMT-I) level. The evidence reviewed was limited to studies with relevant data regarding the challenges and complexities of the ECG transmission process, the difficulties associated with ECG transmission in rural settings, and ECG transmission outcomes by provider level. The evidence supports additional research to further evaluate the feasibility of ECG transmission at the non-paramedic level. Multiple variables must be investigated including equipment cost, utilization, and rural transmission capabilities. Clearly, pre-hospital ECG transmission and early activation of the cardiac catheterization laboratory are critical components to successfully decreasing D2B times.

  20. Management of gynecologic oncology emergencies

    International Nuclear Information System (INIS)

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-01-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references

  1. An Online Tool for Nurse Triage to Evaluate Risk for Acute Coronary Syndrome at Emergency Department

    Directory of Open Access Journals (Sweden)

    Yuwares Sittichanbuncha

    2015-01-01

    Full Text Available Background. To differentiate acute coronary syndrome (ACS from other causes in patients presenting with chest pain at the emergency department (ED is crucial and can be performed by the nurse triage. We evaluated the effectiveness of the ED nurse triage for ACS of the tertiary care hospital. Methods. We retrospectively enrolled consecutive patients who were identified as ACS at risk patients by the ED nurse triage. Patients were categorized as ACS and non-ACS group by the final diagnosis. Multivariate logistic analysis was used to predict factors associated with ACS. An online model predictive of ACS for the ED nurse triage was constructed. Results. There were 175 patients who met the study criteria. Of those, 28 patients (16.0% were diagnosed with ACS. Patients with diabetes, patients with previous history of CAD, and those who had at least one character of ACS chest pain were independently associated with having ACS by multivariate logistic regression. The adjusted odds ratios (95% confidence interval were 4.220 (1.445, 12.327, 3.333 (1.040, 10.684, and 12.539 (3.876, 40.567, respectively. Conclusions. The effectiveness of the ED nurse triage for ACS was 16%. The online tool is available for the ED triage nurse to evaluate risk of ACS in individuals.

  2. Military Emergency Medical Service System Assessment: Application of the National Park Service Needs Assessment and Program Audit to Objectively Evaluate the Military EMS System of Okinawa, Japan.

    Science.gov (United States)

    Ross, Elliot M; Harper, Stephen A; Cunningham, Cord; Walrath, Benjamin D; DeMers, Gerard; Kharod, Chetan U

    2017-03-01

    As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment. After all the data had been collected, a joint committee of Military EMS physicians reviewed the findings and made formal recommendations. From 2011 to 2014, U.S. military EMS on Okinawa averaged 1,345 ± 137 patient transports annually. An advanced life support (ALS) provider would have been dispatched on 558 EMS runs (38%) based on chief complaint in 2014 had they been available. Over 36,000 man-hours were expended during this period to provide National Registry Emergency Medical Technician (EMT)-accredited instruction to certify 141 Navy Corpsman as EMT Basics. The NPS EMS Program Audit Worksheet was used and the program scored a total of 31, suggesting the program is well planned and operating within standards. This evaluation of the Military EMS system on Okinawa using the NPS program assessment and audit worksheet demonstrates the NPS evaluation instruments may offer a useful assessment tool for the evaluation of Military EMS systems. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  3. Ectopic Pregnancy After Plan B Emergency Contraceptive Use.

    Science.gov (United States)

    Steele, Brianne Jo; Layman, Kerri

    2016-04-01

    Pregnancy outcomes after emergency contraceptive use has been debated over time, but review of the literature includes mechanisms by which these medications may increase the chance of an ectopic pregnancy. Such cases are infrequently reported, and many emergency providers may not readily consider this possibility when treating patients. This is a case presentation of ectopic pregnancy in a patient who had recently used Plan B (levonorgestrel) emergency contraceptive. She presented with abdominal pain and vaginal spotting, and was evaluated by serum testing and pelvic ultrasound. She was discovered to have a right adnexal pregnancy. She was treated initially with methotrexate, though she ultimately required surgery for definitive treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report aims to bring a unique clinical case to the attention of emergency providers. The goal is to review research on the topic of levonorgestrel use and the incidence of ectopic pregnancies. The mechanism of action of this emergency contraceptive is addressed, and though no definite causal relationship is known between levonorgestrel and ectopic pregnancies, there is a pharmacologic explanation for how this event may occur after use of this medication. Ultimately, the emergency provider will be reminded of the importance of educating the patient on the possible outcomes after its use, including failure of an emergency contraceptive and the potential of ectopic pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Blog and Podcast Watch: Cutaneous Emergencies

    Directory of Open Access Journals (Sweden)

    Andrew Grock

    2017-02-01

    Full Text Available The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM based on the ongoing Academic Life in Emergency Medicine (ALiEM Approved Instructional Resources (AIR and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of cutaneous emergencies from the AIR series.    The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors (CORD annual testing schedule. For each module, relevant content is collected from the top 50 most accessed sites per the Social Media Index published within the previous 12 months and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an “honorable mention” label, if the editorial board agrees that the post is accurate and educationally valuable. A total of 35 blog posts and podcasts were evaluated. None scored ≥30 points necessary for the AIR label, although four honorable mention posts were identified. Key educational pearls from these honorable mention posts are summarized. This Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expertbased, post-publication curation of educational social media content for EM clinicians with this installment focusing on cutaneous emergencies. [West J Emerg Med. 2017;18(2288-292.

  5. Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) Training Evaluation: Potential Implications for Disaster Health Care Volunteers.

    Science.gov (United States)

    Schmitz, Susan; Radcliff, Tiffany A; Chu, Karen; Smith, Robert E; Dobalian, Aram

    2018-02-20

    The US Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) is a team of employee disaster response volunteers who provide clinical and non-clinical staffing assistance when local systems are overwhelmed. This study evaluated attitudes and recommendations of the DEMPS program to understand the impact of multi-modal training on volunteer perceptions. DEMPS volunteers completed an electronic survey in 2012 (n=2120). Three training modes were evaluated: online, field exercise, and face-to-face. Measures included: "Training Satisfaction," "Attitudes about Training," "Continued Engagement in DEMPS." Data were analyzed using χ2 and logistic regression. Open-ended questions were evaluated in a manner consistent with grounded theory methodology. Most respondents participated in DEMPS training (80%). Volunteers with multi-modal training who completed all 3 modes (14%) were significantly more likely to have positive attitudes about training, plan to continue as volunteers, and would recommend DEMPS to others (P-valuevolunteer engagement. A blended learning environment using multi-modal training methods, could enhance satisfaction and attitudes and possibly encourage continued engagement in DEMPS or similar programs. DEMPS training program modifications in 2015 expanded this blended learning approach through new interactive online learning opportunities. (Disaster Med Public Health Preparedness. 2018; page 1 of 8).

  6. Psychiatric patient disposition agreement between the emergency physician and the psychiatry consultant.

    Science.gov (United States)

    Chakravarthy, Bharath; Menchine, Michael; Thompson, Daniel E; Rajeev, Sindhya; Santos, Barbara-Jean

    2013-01-01

    Mental illness is prevalent, disabling, and costly. Emergency department (ED) visits for mental health-related reasons are on the increase. Determine the level of agreement between emergency physicians and psychiatrists regarding psychiatric patient disposition. We conducted a prospective, observational study at a private university hospital ED from October 2008-April 2009 using a convenience sample of patients of all ages with psychiatric complaints who received formal psychiatric consultation during their ED visit. The emergency physician completed a data sheet prior to psychiatric consultation, assessing the likelihood of admission for psychiatric evaluation. We evaluated the positive predictive value (PPV) and negative predictive value (NPV) of the emergency physician admission decision for all patients before psychiatric consultation, compared with the patients' actual disposition as determined by the consulting psychiatrist. The study captured 230 subjects, 53% of whom were suicidal patients. 74% of patients were eventually admitted. The emergency physician decision to admit for inpatient psychiatric evaluation had a PPV of 87.3% (CI 81.4-91.9%) and an NPV of 66.7% (CI 52.9-78.6%) compared to the psychiatrist decision for the total sample, and a PPV of 90% (CI 82.4-95.1%) and an NPV of 69.6% (CI 47.1-86.8%) for suicidal patients. Additionally, the κ score, a measure of agreement between emergency physician disposition decision and psychiatrist disposition decision, was 0.530 (Cl 0.404-0.656). 95% of patients with an ED assessment of "definitely admit" were eventually admitted by the psychiatrist. Emergency physician disposition has a high PPV (87.3%) and a moderate NPV (66.7%) compared to psychiatrist disposition.

  7. Laser Compton polarimetry at JLab and MAMI. A status report

    International Nuclear Information System (INIS)

    Diefenbach, J.; Imai, Y.; Han Lee, J.; Maas, F.; Taylor, S.

    2007-01-01

    For modern parity violation experiments it is crucial to measure and monitor the electron beam polarization continuously. In the recent years different high-luminosity concepts, for precision Compton backscattering polarimetry, have been developed, to be used at modern CW electron beam accelerator facilities. As Compton backscattering polarimetry is free of intrinsic systematic uncertainties, it can be a superior alternative to other polarimetry techniques such as Moeller and Mott scattering. State-of-the-art high-luminosity Compton backscattering designs currently in use and under development at JLab and Mainz are compared to each other. The latest results from the Mainz A4 Compton polarimeter are presented. (orig.)

  8. Wheat seedling emergence estimated from seed analysis Emergência de plântulas de trigo estimadas a partir da análise de sementes

    Directory of Open Access Journals (Sweden)

    Alexandra Augusti Boligon

    2011-06-01

    Full Text Available There are various vigor tests for the evaluation of seeds physiological quality, however, few studies correlate this tests with plants emergency. This study aimed at identifying wheat (Triticum aestivum L. seed analysis variables that best predict seedling emergence. Wheat seeds (CEP 30 cultivar were divided into two batches, one initially subjected to the accelerated ageing process and forming the low-quality batch, and the other, without application of the accelerated ageing process, to compose a high-quality batch. The following seed test variables were evaluated: (i percentage of normal seedlings in the germination tests, (ii initial germination counting, (iii accelerated ageing, (iv cold test without soil, (v germination speed index, and (vi emergence of seedlings in sand after seven and 15 days. The following seedling characteristics were evaluated: root and shoot lengths, total length, and dry mass of the root and shoot. The characteristics evaluated for the seedlings were subjected to path analysis and the seed tests variables to stepwise multiple regression analysis, taking seedling emergence at seven days as the response variable. Factor analysis was also carried out on all variables. Dry mass of the shoot and root length presented the best correlation with seedling emergence for the high-quality batch, but this behavior was not observed for any variable in the low-quality batch. Accelerated ageing was the best seedling emergence estimator for both batches of the used cultivar.Existem inúmeros testes de vigor que podem ser utilizados na avaliação da qualidade fisiológica das sementes, porém, são poucos os estudos que relacionam estes testes com a emergência de plântulas das culturas. Identificaram-se variáveis da análise de sementes de trigo (Triticum aestivum L. que mais bem predizem a emergência de plântulas dessa cultura. Um lote de sementes de trigo do cultivar CEP 30 foi dividido em dois sublotes, sendo um submetido

  9. Established and emerging methods for assessment of small and large intestinal motility

    DEFF Research Database (Denmark)

    Grønlund, D; Poulsen, J L; Sandberg, T H

    2017-01-01

    and validation of objective methods to evaluate motility of the whole gut is important. Such techniques may be applied in clinical settings as diagnostic tools, in research to elucidate underlying mechanisms of diseases, and to evaluate how the gut responds to various drugs. A wide array of such methods exists...... emerged, with the advantages that they are less invasive, use no radiation, and provide much more detailed information. PURPOSE: This review outlines well-established and emerging methods to evaluate small bowel and colonic motility in clinical settings and in research. The latter include the 3D...

  10. Smartphone application for emergency signal detection.

    Science.gov (United States)

    Figueiredo, Isabel N; Leal, Carlos; Pinto, Luís; Bolito, Jason; Lemos, André

    2016-09-01

    Currently, a number of studies focus on the study and design of new healthcare technologies to improve elderly health and quality of life. Taking advantage of the popularity, portability, and inherent technology of smartphones, we present an emergency application for smartphones, designated as knock-to-panic (KTP). This innovative and novel system enables users to simply hit their devices in order to send an alarm signal to an emergency service. This application is a complete and autonomous emergency system, and can provide an economic, reliable, and unobtrusive method for elderly monitoring or safety protection. Moreover, the simple and fast activation of KTP makes it a viable and potentially superior alternative to traditional ambient assisted living emergency calls. Furthermore, KTP can be further extended to the general population as well and not just be limited for elderly persons. The proposed method is a threshold-based algorithm and is designed to require a low battery power consumption. The evaluation of the performance of the algorithm in collected data indicates that both sensitivity and specificity are above 90%. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  11. Emergency Medicine Evaluation of Community-Acquired Pneumonia: History, Examination, Imaging and Laboratory Assessment, and Risk Scores.

    Science.gov (United States)

    Long, Brit; Long, Drew; Koyfman, Alex

    2017-11-01

    Pneumonia is a common infection, accounting for approximately one million hospitalizations in the United States annually. This potentially life-threatening disease is commonly diagnosed based on history, physical examination, and chest radiograph. To investigate emergency medicine evaluation of community-acquired pneumonia including history, physical examination, imaging, and the use of risk scores in patient assessment. Pneumonia is the number one cause of death from infectious disease. The condition is broken into several categories, the most common being community-acquired pneumonia. Diagnosis centers on history, physical examination, and chest radiograph. However, all are unreliable when used alone, and misdiagnosis occurs in up to one-third of patients. Chest radiograph has a sensitivity of 46-77%, and biomarkers including white blood cell count, procalcitonin, and C-reactive protein provide little benefit in diagnosis. Biomarkers may assist admitting teams, but require further study for use in the emergency department. Ultrasound has shown utility in correctly identifying pneumonia. Clinical gestalt demonstrates greater ability to diagnose pneumonia. Clinical scores including Pneumonia Severity Index (PSI); Confusion, blood Urea nitrogen, Respiratory rate, Blood pressure, age 65 score (CURB-65); and several others may be helpful for disposition, but should supplement, not replace, clinical judgment. Patient socioeconomic status must be considered in disposition decisions. The diagnosis of pneumonia requires clinical gestalt using a combination of history and physical examination. Chest radiograph may be negative, particularly in patients presenting early in disease course and elderly patients. Clinical scores can supplement clinical gestalt and assist in disposition when used appropriately. Published by Elsevier Inc.

  12. Development of supporting system for emergency response to maritime transport accidents involving radioactive material

    International Nuclear Information System (INIS)

    Odano, N.; Matsuoka, T.; Suzuki, H.

    2004-01-01

    National Maritime Research Institute has developed a supporting system for emergency response of competent authority to maritime transport accidents involving radioactive material. The supporting system for emergency response has functions of radiation shielding calculation, marine diffusion simulation, air diffusion simulation and radiological impact evaluation to grasp potential hazard of radiation. Loss of shielding performance accident and loss of sealing ability accident were postulated and impact of the accidents was evaluated based on the postulated accident scenario. Procedures for responding to emergency were examined by the present simulation results

  13. Availability of emergency drugs and equipment in general and specialist dental settings in Babol, Iran.

    Science.gov (United States)

    Mehdizadeh, Mohammad; Nosrati, Kamran; Hamzeh, Mahtab

    2014-11-01

    Medical emergencies can frequently happen in dental settings and it is critical to outfit the clinic by emergency drugs and equipment. The aim of this study was to evaluate the emergency drugs and equipment in general and specialist dental settings in Babol, Iran. A questionnaire containing closed ended questions about the available emergency drugs and equipment was used in this descriptive-analytical study. Data were subjected to descriptive analysis using SPSS 18.0 to identify the most frequent drugs and equipment. Chi-square and t-test were used to evaluate the correlation between the variables. p < 0.05 was considered statistically significant. One hundred and twelve dentists answered the questionnaire. The most available drug and equipment were epinephrine (67%) and single use syringe (81.3%) respectively. Significant correlation was found between degree of education and availability of first group of emergency drugs and between sex and possession of second group of emergency equipment (p < 0.05). Degree of availability of emergency drugs and equipment was moderate to low and training about emergencies should be included in the didactic topics of universities and workshops. Information about emergency drug and equipment would help to manage the unwanted emergency situations.

  14. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 2. Equipment, Safe Driving Practices, Legal Aspects, Controlling the Situation, Action Evaluation Conference. Revised.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    This student manual, the second in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains five sections that cover the following course content: ambulance equipment, safe driving practices for emergency vehicle drivers, legal aspects of the EMT's job, how to maintain control at an accident scene…

  15. The Quebec emergency department guide: A cross-sectional study to evaluate its use, perceived usefulness, and implementation in rural emergency departments.

    Science.gov (United States)

    Fleet, Richard; Hegg-Deloye, Sandrine; Maltais-Giguère, Julie; Légaré, France; Ouimet, Mathieu; Poitras, Julien; Tanguay, Alain; Archambault, Patrick; Levesque, Jean-Frédéric; Simard-Racine, Geneviève; Dupuis, Gilles

    2017-12-07

    The Quebec Emergency Department Management Guide (QEDMG) is a unique document with 78 recommendations designed to improve the organization of emergency departments (EDs) in the province of Quebec. However, no study has examined how this guide is perceived or used by rural health care management. We invited all directors of professional services (DPS), directors of nursing services (DNS), head nurses (HN), and emergency department directors (EDD) working in Quebec's rural hospitals to complete an online survey (144 questions). Simple frequency analyses (percentage [%] and 95% confidence interval) were conducted to establish general familiarity and use of the QEDMG, as well as perceived usefulness and implementation of its recommendations. Seventy-three percent (19/26) of Quebec's rural EDs participated in the study. A total of 82% (62/76) of the targeted stakeholders participated. Sixty-one percent of respondents reported being "moderately or a lot" familiar with the QEDMG, whereas 77% reported "almost never or sometimes" refer to this guide. Physician management (DPS, EDD) were more likely than nursing management (DNS and especially HN) to report "not at all" or "little" familiarity on use of the guide. Finally, 98% of the QEDMG recommendations were considered useful. Although the QEDMG is considered a useful guide for rural EDs, it is not optimally known or used in rural EDs, especially by physician management. Stakeholders should consider these findings before implementing the revised versions of the QEDMG.

  16. College Student Utilization of a Comprehensive Psychiatric Emergency Program

    Science.gov (United States)

    Mitchell, Sharon L.; Kader, Mahrin; Haggerty, Melinda Z.; Bakhai, Yogesh D.; Warren, Calvert G.

    2013-01-01

    The authors sought to identify college students at risk for experiencing a mental health crisis that warranted a psychiatric evaluation at a hospital and/or a psychiatric hospitalization. A retrospective chart review of college students evaluated at a comprehensive psychiatric emergency program during a 1-year period was conducted. Demographic…

  17. The crisis in United States hospital emergency services.

    Science.gov (United States)

    Harrison, Jeffrey P; Ferguson, Emily D

    2011-01-01

    Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

  18. Evaluating legacy contaminants and emerging chemicals in marine environments using adverse outcome pathways and biological effects-directed analysis.

    Science.gov (United States)

    Hutchinson, Thomas H; Lyons, Brett P; Thain, John E; Law, Robin J

    2013-09-30

    Natural and synthetic chemicals are essential to our daily lives, food supplies, health care, industries and safe sanitation. At the same time protecting marine ecosystems and seafood resources from the adverse effects of chemical contaminants remains an important issue. Since the 1970s, monitoring of persistent, bioaccumulative and toxic (PBT) chemicals using analytical chemistry has provided important spatial and temporal trend data in three important contexts; relating to human health protection from seafood contamination, addressing threats to marine top predators and finally providing essential evidence to better protect the biodiversity of commercial and non-commercial marine species. A number of regional conventions have led to controls on certain PBT chemicals over several years (termed 'legacy contaminants'; e.g. cadmium, lindane, polycyclic aromatic hydrocarbons [PAHs] and polychlorinated biphenyls [PCBs]). Analytical chemistry plays a key role in evaluating to what extent such regulatory steps have been effective in leading to reduced emissions of these legacy contaminants into marine environments. In parallel, the application of biomarkers (e.g. DNA adducts, CYP1A-EROD, vitellogenin) and bioassays integrated with analytical chemistry has strengthened the evidence base to support an ecosystem approach to manage marine pollution problems. In recent years, however,the increased sensitivity of analytical chemistry, toxicity alerts and wider environmental awareness has led to a focus on emerging chemical contaminants (defined as chemicals that have been detected in the environment, but which are currently not included in regulatory monitoring programmes and whose fate and biological impacts are poorly understood). It is also known that natural chemicals (e.g. algal biotoxins) may also pose a threat to marine species and seafood quality. Hence complex mixtures of legacy contaminants, emerging chemicals and natural biotoxins in marine ecosystems represent

  19. Evaluating legacy contaminants and emerging chemicals in marine environments using adverse outcome pathways and biological effects-directed analysis

    International Nuclear Information System (INIS)

    Hutchinson, Thomas H.; Lyons, Brett P.; Thain, John E.; Law, Robin J.

    2013-01-01

    Natural and synthetic chemicals are essential to our daily lives, food supplies, health care, industries and safe sanitation. At the same time protecting marine ecosystems and seafood resources from the adverse effects of chemical contaminants remains an important issue. Since the 1970s, monitoring of persistent, bioaccumulative and toxic (PBT) chemicals using analytical chemistry has provided important spatial and temporal trend data in three important contexts; relating to human health protection from seafood contamination, addressing threats to marine top predators and finally providing essential evidence to better protect the biodiversity of commercial and non-commercial marine species. A number of regional conventions have led to controls on certain PBT chemicals over several years (termed ‘legacy contaminants’; e.g. cadmium, lindane, polycyclic aromatic hydrocarbons [PAHs] and polychlorinated biphenyls [PCBs]). Analytical chemistry plays a key role in evaluating to what extent such regulatory steps have been effective in leading to reduced emissions of these legacy contaminants into marine environments. In parallel, the application of biomarkers (e.g. DNA adducts, CYP1A-EROD, vitellogenin) and bioassays integrated with analytical chemistry has strengthened the evidence base to support an ecosystem approach to manage marine pollution problems. In recent years, however, the increased sensitivity of analytical chemistry, toxicity alerts and wider environmental awareness has led to a focus on emerging chemical contaminants (defined as chemicals that have been detected in the environment, but which are currently not included in regulatory monitoring programmes and whose fate and biological impacts are poorly understood). It is also known that natural chemicals (e.g. algal biotoxins) may also pose a threat to marine species and seafood quality. Hence complex mixtures of legacy contaminants, emerging chemicals and natural biotoxins in marine ecosystems represent

  20. A primitive study on unsupervised anomaly detection with an autoencoder in emergency head CT volumes

    Science.gov (United States)

    Sato, Daisuke; Hanaoka, Shouhei; Nomura, Yukihiro; Takenaga, Tomomi; Miki, Soichiro; Yoshikawa, Takeharu; Hayashi, Naoto; Abe, Osamu

    2018-02-01

    Purpose: The target disorders of emergency head CT are wide-ranging. Therefore, people working in an emergency department desire a computer-aided detection system for general disorders. In this study, we proposed an unsupervised anomaly detection method in emergency head CT using an autoencoder and evaluated the anomaly detection performance of our method in emergency head CT. Methods: We used a 3D convolutional autoencoder (3D-CAE), which contains 11 layers in the convolution block and 6 layers in the deconvolution block. In the training phase, we trained the 3D-CAE using 10,000 3D patches extracted from 50 normal cases. In the test phase, we calculated abnormalities of each voxel in 38 emergency head CT volumes (22 abnormal cases and 16 normal cases) for evaluation and evaluated the likelihood of lesion existence. Results: Our method achieved a sensitivity of 68% and a specificity of 88%, with an area under the curve of the receiver operating characteristic curve of 0.87. It shows that this method has a moderate accuracy to distinguish normal CT cases to abnormal ones. Conclusion: Our method has potentialities for anomaly detection in emergency head CT.

  1. Ethics curriculum for emergency medicine graduate medical education.

    Science.gov (United States)

    Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P

    2011-05-01

    Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. The Information Management Platform on Nuclear Emergency Resources of China

    International Nuclear Information System (INIS)

    Dong, L.

    2016-01-01

    Full text: The Chinese government has always attached great importance to nuclear emergency work, and has invested to form lots of nuclear emergency resources. Meanwhile, there also exist some management problems such as repeated investment, fragmented inventory list, inefficient management, etc. To achieve integrated management on the nuclear emergency resources of China, the Chinese government initiated the project “The Information Management Platform on Nuclear Emergency Resources of China”. The goal of the project is to support a timely, managed, controlled, coordinated and effective response while the resources managing process remains economically efficient. The project team firstly completed the nuclear emergency resources classification and encoding. Based on these, the nuclear emergency resources information management software system was developed. The pilot operation in the system was carried out both in Guangxi and Liaoning Province at the same time. Nuclear emergency resources survey was done as the relevant information was put into the database in these regions. The evaluation result on the pilot operation showed that, the information management platform on emergency resources would apparently improve efficiency of nuclear emergency preparedness and response, and it also would increase economical efficiency on inventory list, information management and invest decision. (author

  3. Evaluating the effect of clinical decision units on patient flow in seven Canadian emergency departments.

    Science.gov (United States)

    Schull, Michael J; Vermeulen, Marian J; Stukel, Therese A; Guttmann, Astrid; Leaver, Chad A; Rowe, Brian H; Sales, Anne

    2012-07-01

    To evaluate the effect of emergency department (ED) clinical decision units (CDUs) on overall ED patient flow in a pilot project funded in 2008 by the Ontario Ministry of Health and Long-Term Care (MOHLTC). A retrospective analysis of unscheduled ED visits at seven CDU pilot and nine control sites was conducted using administrative data. The authors examined trends in CDU utilization and compared outcomes between pilot-CDU and control sites 1 year prior to implementation, with the first 18 months of CDU operation. Sites that were unsuccessful in their applications for CDU program funding served as controls. Outcomes included ED length of stay (LOS), admission rates, and ED revisit rates. At CDU sites, roughly 4% of ED patients were admitted to CDUs. The presence of a pilot-CDU was independently associated with a small reduction in ED LOS for all low-acuity patients (-0.14 hour, 95% confidence interval [CI]=-0.22 to -0.07) and nonadmitted patients (-0.11 hour, 95% CI=-0.16 to -0.07). A small independent effect on absolute hospital admission rate for all high-acuity patients (-0.8%, 95% CI=-1.5% to -0.03%) and moderate-acuity patients (-0.6%, 95% CI=-1.1% to -0.2%) was also observed. Pilot-CDUs were not associated with changes in ED revisit rates. With only 4% of ED patients admitted to CDUs, the potential for efficiency gains in these EDs was limited. Nonetheless, these findings suggest small improvements in the operation of the ED through CDU implementation. Although marginal, the observed effects of CDU operation were in the desired direction of reduced ED LOS, reduced admission rate, and no increase in ED revisit rate. © 2012 by the Society for Academic Emergency Medicine.

  4. Utilization of emergent aquatic plants for biomass-energy-systems development

    Energy Technology Data Exchange (ETDEWEB)

    Kresovich, S.; Wagner, C.K.; Scantland, D.A.; Groet, S.S.; Lawhon, W.T.

    1982-02-01

    A review was conducted of the available literature pertaining to the following aspects of emergent aquatic biomass: identification of prospective emergent plant species for management; evaluation of prospects for genetic manipulation; evaluation of biological and environmental tolerances; examination of current production technologies; determination of availability of seeds and/or other propagules, and projections for probable end-uses and products. Species identified as potential candidates for production in biomass systems include Arundo donax, Cyperus papyrus, Phragmites communis, Saccharum spontaneum, Spartina alterniflora, and Typha latifolia. If these species are to be viable candidates in biomass systems, a number of research areas must be further investigated. Points such as development of baseline yield data for managed systems, harvesting conceptualization, genetic (crop) improvement, and identification of secondary plant products require refinement. However, the potential pay-off for developing emergent aquatic systems will be significant if development is successful.

  5. Predictors of aggression in 3.322 patients with affective disorders and schizophrenia spectrum disorders evaluated in an emergency department setting.

    Science.gov (United States)

    Blanco, Emily A; Duque, Laura M; Rachamallu, Vivekananda; Yuen, Eunice; Kane, John M; Gallego, Juan A

    2018-05-01

    The aim of this study is to determine odds of aggression and associated factors in patients with schizophrenia-spectrum disorders (SSD) and affective disorders who were evaluated in an emergency department setting. A retrospective study was conducted using de-identified data from electronic medical records from 3.322 patients who were evaluated at emergency psychiatric settings. Data extracted included demographic information, variables related to aggression towards people or property in the past 6months, and other factors that could potentially impact the risk of aggression, such as comorbid diagnoses, physical abuse and sexual abuse. Bivariate analyses and multivariate regression analyses were conducted to determine the variables significantly associated with aggression. An initial multivariate regression analysis showed that SSD had 3.1 times the odds of aggression, while bipolar disorder had 2.2 times the odds of aggression compared to unipolar depression. A second regression analysis including bipolar subtypes showed, using unipolar depression as the reference group, that bipolar disorder with a recent mixed episode had an odds ratio (OR) of 4.3, schizophrenia had an OR of 2.6 and bipolar disorder with a recent manic episode had an OR of 2.2. Generalized anxiety disorder was associated with lower odds in both regression analyses. As a whole, the SSD group had higher odds of aggression than the bipolar disorder group. However, after subdividing the groups, schizophrenia had higher odds of aggression than bipolar disorder with a recent manic episode and lower odds of aggression than bipolar disorder with a recent mixed episode. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Emergency preparedness for nuclear power plants in the USA

    International Nuclear Information System (INIS)

    Schwartz, S.A.

    1986-01-01

    In the case of an operating reactor, if it is determined that there are such deficiencies that a favourable NRC finding is not warranted and if the deficiencies are not corrected within four months of that determination, the Commission will determine whether the reactor should be shut down or whether some other enforcement action is appropriate. In any case, where the Commission believes that the public health, safety, or interest so requires, the plant will be required to shut down immediately. Emergency planning considerations must be extended to emergency planning zones, and these shall consist of an area of about 10 miles in radius for exposure to the radioactive plume that might result from an accident in a nuclear power reactor and an area of about 50 miles in radius for food that might become contaminated. To evaluate the effectiveness of the licensee programme to implement their emergency plan, a 'management oversight and risk tree' (MORT) approach was developed and used by NRC appraisal teams at all operating facilities and those close to licensing. Since April 1981, over 250 emergency preparedness exercises have been observed and annual inspections conducted at US commercial nuclear power generating facilities. As a result of this experience, licensees have generally progressed from a basic ability to implement their plan to a systematic demonstration of their emergency preparedness capabilities. Almost five years have elapsed since the inception of the upgraded emergency preparedness regulatory programme, and the NRC is evaluating the resources committed to the programme to determine if modifications are appropriate. Our goal is to ensure continued adequate readiness capability to protect the public health and safety in the event of an accident

  7. An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil.

    Science.gov (United States)

    Tallo, Fernando Sabia; Campos Vieira Abib, Simone de; Baitello, André Luciano; Lopes, Renato Delascio

    2014-09-01

    To describe the profile of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil and to evaluate their quality of life. Both a semi-structured questionnaire with 57 questions and the SF-36 questionnaire were sent to research departments within SAMU in the Brazilian state capitals, the Federal District and inland towns in Brazil. Of a total of 902 physicians, including 644 (71.4%) males, 533 (59.1%) were between 30 and 45 years of age and 562 (62.4%) worked in a state capital. Regarding education level, 45.1% had graduated less than five years before and only 43% were specialists recognized by the Brazilian Medical Association. Regarding training, 95% did not report any specific training for their work at SAMU. The main weaknesses identified were psychiatric care and surgical emergencies in 57.2 and 42.9% of cases, respectively; traumatic pediatric emergencies, 48.9%; and medical emergencies, 42.9%. As for procedure-related skills, the physicians reported difficulties in pediatric advanced support (62.4%), airway surgical access (45.6%), pericardiocentesis (64.4%) and thoracentesis (29.9%). Difficulties in using an artificial ventilator (43.3%) and in transcutaneous pacing (42.2%) were also reported. Higher percentages of young physicians, aged 25-30 years (26.7 vs 19.0%; p48 h per week (12.8 vs 8.6%; p<0.001), and were non-specialists with the shortest length of service (<1 year) at SAMU (30.1 vs 18.2%; p<0.001) who were hired without having to pass public service exams (i.e., for a temporary job) (61.8 vs 46.2%; p<0.001). Regarding quality of life, the pain domain yielded the worst result among physicians at SAMU. The doctors in this sample were young and within a few years of graduation, and they had no specific training in prehospital emergencies. Deficiencies were mostly found in pediatrics and psychiatry, with specific deficiencies in the handling of essential equipment and in the skills necessary to adequately attend to prehospital

  8. Screening of the frail patient in the emergency department

    DEFF Research Database (Denmark)

    Jørgensen, Rasmus; Brabrand, Mikkel

    2017-01-01

    to detect frailty in patients. ≥. 65. years by their ability to identify the risk of adverse outcomes. Methods: An extensive medical literature search of Embase and PubMed was conducted, to identify studies using frailty screening scales in the emergency department. Data was subsequently extracted...... and evaluated from the results of the included studies. Results: Four studies met the exact inclusion criteria. Four different frailty screening scales: Clinical Frailty Scale, Deficit Accumulation Index, Identification of Seniors At Risk and The Study of Osteoporotic Fracture frailty index used...... emergency department visit. Frailty does however not predict increased risk of 30. day emergency department revisit. Further research highlighting the value of screening for frailty level in elderly emergency department patients is needed. Learning points: Although frail elders in need of further geriatric...

  9. The diagnostic value of ultrasonography in the gyneocological emergency

    International Nuclear Information System (INIS)

    Su Hui; Chen Fanghua; Peng Xiulan

    2006-01-01

    Objective: To evaluate the ultrasonography in the diagnosis and differential diagnosis of gynecologic emergency. Methods: 138 patients suffered from gynecologic emergency were examined with ultrasonography. The images were retrospectively reviewed and compared with pathologic or clinical results. Results: The total correct diagnostic rate was 89.1%. Among 138 cases of gynecologic emergency, there were 45 cases of ectopic pregnancy, 27 cases of ruptured corpus luteum, 24 cases of torsion of ovarian cyst, and 42 cases of acute pelvic inflammation. The correct diagnostic rates were 91.1%, 81.5%, 87.5%, 92.2%, respectively. Conclusion: The ultrasonography plays an important role in the diagnosis of gynecological emergency. When the US findings were not typical, the clinical history, symptoms and HCG level should be considered in order to avoid misdiagnosis. (authors)

  10. Performance diagnostic system for emergency diesel generators

    International Nuclear Information System (INIS)

    Logan, K.P.

    1991-01-01

    Diesel generators are commonly used for emergency backup power at nuclear stations. Emergency diesel generators (EDGs) are subject to both start-up and operating failures, due to infrequent and fast-start use. EDG reliability can be critical to plant safety, particularly when station blackout occurs. This paper describes an expert diagnostic system designed to consistently evaluate the operating performance of diesel generators. The prototype system is comprised of a suite of sensor monitoring, cylinder combustion analyzing, and diagnostic workstation computers. On-demand assessments of generator and auxiliary equipment performance are provided along with color trend displays comparing measured performance to reference-normal conditions

  11. Emergency Communication

    Science.gov (United States)

    : Environmental Documents, Reports LANL Home Calendar Search Contacts Resources » Emergency Communication Emergency Communication Stay informed of emergencies, weather delays, closures, other alerts. Find links to

  12. Evaluation of a web-based asynchronous pediatric emergency medicine learning tool for residents and medical students.

    Science.gov (United States)

    Burnette, Kreg; Ramundo, Maria; Stevenson, Michelle; Beeson, Michael S

    2009-12-01

    To examine the effectiveness of an asynchronous learning tool consisting of web-based lectures for trainees covering major topics pertinent to pediatric emergency medicine (PEM) and to assess resident and student evaluation of this mode of education. PEM faculty and fellows created a 21-lecture, web-based curriculum. These 20-minute online lectures used Microsoft PowerPoint with the voice-over feature. A 75-question test was created to assess the effectiveness of the web-based learning model, administered online before and after the rotation in the pediatric emergency department (PED). All fourth-year medical students and residents (across all specialties) rotating through the PED were required to complete 10 of the 21 lectures during their 1-month rotation. The main outcome variable was difference in score between pre- and post-rotation tests of participants who viewed no lectures and those who viewed at least one lecture. Evaluation of the program was assessed by anonymous survey using 5-point discrete visual analog scales. Responses of 4 or 5 were considered positive for analysis. One hundred eleven residents and fourth-year medical students participated in the program. An initial 32 completed testing before implementation of the on-line lectures (March 2007-August 2007), and another five did not complete the on-line lectures after implementation (September 2007-February 2008). Seventy-one completed testing and on-line lectures, and all but three completed at least 10 on-line lectures during their rotation. Fourteen of 111 trainees did not complete the pre- or post-test (including two who viewed the lectures). The mean change in score was a 1% improvement from pre-test to post-test for trainees who viewed no lectures and a 6.2% improvement for those who viewed the lectures (mean difference = 5.2%, 95% confidence interval = 2.5% to 7.9%). In the linear regression model, the estimate of the coefficient was 0.43 (p lecture viewed, post-test score rose by 0

  13. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-06-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  14. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-03-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  15. Influence of the sowing depth and amount of sugarcane straw on the emergence of Chloris polydactyla and Eleusine indica and their control by herbicides applied pre-emergence

    Directory of Open Access Journals (Sweden)

    Marcelo Rafael Malardo

    2017-06-01

    Full Text Available The objective of this study was to evaluate the effect of the sowing depth and amount of sugarcane straw on the soil on the emergence of Chloris polydactyla (‘capim-branco’ and Eleusine indica (Indian goosegrass and to determine the efficacy of herbicides applied pre-emergence in the control of these species under different straw amount and rainfall regime conditions. The experiments were conducted in a completely randomized design with four replications. In the first experiment, the effects of six sowing depths (0.5, 1, 2, 4, 8, and 10 cm and six sugarcane straw amounts (0, 1, 2, 4, 8 and 10 t ha -1 were assessed on the emergence of Indian goosegrass and ‘capim-branco’ in a 6 x 6 factorial arrangement. In the second experiment, the efficacy in the control of these species was evaluated for one control without herbicide and five treatments (indaziflam, metribuzin, tebuthiuron, indaziflam + metribuzin, and indaziflam + tebuthiuron applied pre-emergence over four straw amounts (0, 1, 2, and 4 t ha-1 in a 6 x 4 factorial arrangement. This experiment was evaluated under two rainfall regimes in separate experiments (simulation of 20 mm of rainfall 1 or 10 days after herbicide application. The ‘capim-branco’ showed a marked reduction in emergence beginning at 2 t ha-1 of straw and a 2 cm sowing depth. For the Indian goosegrass, the decline in emergence mainly occurred beginning at 4 t ha-1 of straw and a 4 cm sowing depth. Only some of the Indian goosegrass plants emerged at the greater sowing depths (8 and 10 cm and straw amounts (8 and 10 t ha-1, whereas no emergence of the ‘capim-branco’ was observed under these conditions. The treatments with sowing at a 1 cm depth and with 0, 1, 2, and 4 t ha-1 of straw provided the highest emergence percentage for the species. Application of the herbicide indaziflam alone was the only ineffective treatment for the control of the weeds regardless of the amount of straw and the water regime used

  16. Future enhanced clinical role of pharmacists in Emergency Departments in England: multi-site observational evaluation.

    Science.gov (United States)

    Hughes, Elizabeth; Terry, David; Huynh, Chi; Petridis, Konstantinos; Aiello, Matthew; Mazard, Louis; Ubhi, Hirminder; Terry, Alex; Wilson, Keith; Sinclair, Anthony

    2017-08-01

    Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at their Emergency Department, recorded anonymized details of 400 cases and categorized each into one of four possible options: cases which could be managed by a community pharmacist; could be managed by a hospital pharmacist independent prescriber; could be managed by a hospital pharmacist independent prescriber with additional clinical training; or medical team only (unsuitable for pharmacists to manage). Impact indices sensitive to both workload and proportion of pharmacist manageable cases were calculated for each clinical group. Main outcome measure Proportion of cases which could be managed by a pharmacist. Results 18,613 cases were observed from 49 sites. 726 (3.9%) of cases were judged suitable for clinical management by community pharmacists, 719 (3.9%) by pharmacist prescribers, 5202 (27.9%) by pharmacist prescribers with further training, and 11,966 (64.3%) for medical team only. Impact Indices of the most frequent clinical groupings were general medicine (13.18) and orthopaedics (9.69). Conclusion The proportion of Emergency Department cases that could potentially be managed by a pharmacist was 36%. Greatest potential for pharmacist management was in general medicine and orthopaedics (usually minor trauma). Findings support the case for extending the clinical role of pharmacists.

  17. Evaluation Use in Evaluation Systems

    DEFF Research Database (Denmark)

    Højlund, Steven

    2014-01-01

    This article investigates the European Union’s evaluation system and its conduciveness to evaluation use. Taking the European Commission’s LIFE programme as its case, the article makes an empirical contribution to an emerging focus in the literature on the importance of organization...... and institutions when analyzing evaluation use. By focusing on the European Union’s evaluation system the article finds that evaluation use mainly takes place in the European Commission and less so in the European Parliament and the European Council. The main explanatory factors enabling evaluation use relate...... to the system’s formalization of evaluation implementation and use; these factors ensure evaluation quality, timeliness and capacity in the Commission. At the same time, however, the system’s formalization also impedes evaluation use, reducing the direct influence of evaluations on policy-making and effectively...

  18. Emergent Writing in Preschoolers: Preliminary Evidence for a Theoretical Framework

    Science.gov (United States)

    Puranik, Cynthia S.; Lonigan, Christopher J.

    2014-01-01

    Researchers and educators use the term emergent literacy to refer to a broad set of skills and attitudes that serve as foundational skills for acquiring success in later reading and writing; however, models of emergent literacy have generally focused on reading and reading-related behaviors. Hence, the primary aim of this study was to articulate and evaluate a theoretical model of the components of emergent writing. Alternative models of the structure of individual and developmental differences of emergent writing and writing-related skills were examined in 372 preschool children who ranged in age from 3- to 5-years using confirmatory factor analysis. Results from a confirmatory factor analysis provide evidence that these emergent writing skills are best described by three correlated but distinct factors, (a) Conceptual Knowledge, (b) Procedural Knowledge, and (c) Generative Knowledge. Evidence that these three emergent writing factors show different patterns of relations to emergent literacy constructs is presented. Implications for understanding the development of writing and assessment of early writing skills are discussed. PMID:25316955

  19. Assessment of Evacuation Protective Action Strategies For Emergency Preparedness Plan

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joomyung; Jae, Moosung [Hanyang Univ., Seoul (Korea, Republic of); Ahn, Kwangil [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-10-15

    This report which studies about evacuation formation suggests some considerable factors to reduce damage of radiological accidents. Additional details would be required to study in depth and more elements should be considered for updating emergency preparedness. However, this methodology with sensitivity analysis could adapt to specific plant which has total information such as geological data, weather data and population data. In this point of view the evacuation study could be contribute to set up emergency preparedness plan and propose the direction to enhance protective action strategies. In radiological emergency, residents nearby nuclear power plant should perform protective action that is suggested by emergency preparedness plan. The objective of emergency preparedness plan is that damages, such as casualties and environmental damages, due to radioactive accident should be minimized. The recent PAR study includes a number of subjects to improve the quality of protective action strategies. For enhancing protective action strategies, researches that evaluate many factors related with emergency response scenario are essential parts to update emergency preparedness plan. Evacuation is very important response action as protective action strategy.

  20. Assessment of Evacuation Protective Action Strategies For Emergency Preparedness Plan

    International Nuclear Information System (INIS)

    Lee, Joomyung; Jae, Moosung; Ahn, Kwangil

    2013-01-01

    This report which studies about evacuation formation suggests some considerable factors to reduce damage of radiological accidents. Additional details would be required to study in depth and more elements should be considered for updating emergency preparedness. However, this methodology with sensitivity analysis could adapt to specific plant which has total information such as geological data, weather data and population data. In this point of view the evacuation study could be contribute to set up emergency preparedness plan and propose the direction to enhance protective action strategies. In radiological emergency, residents nearby nuclear power plant should perform protective action that is suggested by emergency preparedness plan. The objective of emergency preparedness plan is that damages, such as casualties and environmental damages, due to radioactive accident should be minimized. The recent PAR study includes a number of subjects to improve the quality of protective action strategies. For enhancing protective action strategies, researches that evaluate many factors related with emergency response scenario are essential parts to update emergency preparedness plan. Evacuation is very important response action as protective action strategy

  1. Air contamination analysis during emergency medical treatment

    International Nuclear Information System (INIS)

    Yamada, Y.; Fukutsu, K.; Yuuki, M.; Akashi, M.

    2009-01-01

    After radiological emergencies, patients contaminated with radioactivity are taken to radiation emergency hospitals for treatment. Numerical simulations using the computer software 'Flow Designer R were made in order to evaluate indoor air contamination caused by the breathing out of contaminated air. The National Inst. of Radiological Sciences facility was used for the numerical evaluation. Results indicate that the dispersion of contaminated air depends on the characteristics of the contaminants, and that the dispersion range was limited and localised. Only medical staff standing in a special position near the patient was exposed to almost un-diluted contaminated air. Highly contaminated air was evacuated with a local exhaust pump system. Room air quality was monitored using a continuous air sampling system, but it was found that the sampling point was not representative for the purpose of radiation protection. From the air-flow analysis, some problems that affect radiological safety were revealed and valuable information and measures for preventing secondary contamination were determined. (authors)

  2. Suspected leaking abdominal aortic aneurysm: use of sonography in the emergency room.

    Science.gov (United States)

    Shuman, W P; Hastrup, W; Kohler, T R; Nyberg, D A; Wang, K Y; Vincent, L M; Mack, L A

    1988-07-01

    To determine the value of sonography in the emergent evaluation of suspected leaking abdominal aortic aneurysms, the authors examined 60 patients in the emergency department using sonography and a protocol involving advance radio notification from the ambulance; arrival of sonographic personnel and equipment in the triage room before patient arrival; and, during other triage activities, rapid sonographic evaluation of the aorta for aneurysm and of the paraaortic region for extraluminal blood. Sonographic findings were correlated with surgical results and clinical outcome. When performed under these circumstances, sonography was accurate in demonstrating presence or absence of aneurysm (98%), but its sensitivity for extraluminal blood was poor (4%). A combination of sonographic confirmation of aneurysm, abdominal pain, and unstable hemodynamic condition resulted in the correct decision to perform emergent surgery in 21 of 22 patients (95%). An abbreviated sonographic examination done in the emergency room can provide accurate, useful information about the presence of aneurysm; this procedure does not significantly delay triage of these patients.

  3. Use of radiological accident experience in establishing appropriate perspectives in emergency planning

    International Nuclear Information System (INIS)

    Selby, J.M.; Vallario, E.J.; Moeller, D.W.; Stephan, J.G.

    1987-08-01

    Within a nuclear facility, an emergency can range from a situation that only involves the employees of that facility to a series of events that have both onsite and offsite consequences. Analyses of nuclear and non-nuclear emergencies can provide valuable information on the causes of, as well as the problems encountered during emergencies. Reports on facility emergencies indicate that up to 90% involve human error. Such events occur more frequently during the night shifts or on weekends. These occurrences may result from the absence of experienced personnel as well as the reduced alertness of onsite personnel. Therefore, this paper emphasizes the human element in a review of accidents that have occurred at nuclear facilities including Windscale, SL-1, the Recuplex criticality, the Wood River Junction criticality, the Browns Ferry fire, Three Mile Island, and Chernobyl. These accidents are described, and their consequences are evaluated. The information obtained from these evaluations may be useful for inclusion in nuclear plant operating and testing procedures. 21 refs

  4. On-the-job training and practical emergency exercises

    International Nuclear Information System (INIS)

    Reuhl, R.

    1996-01-01

    It is described in detail how OJT during initial and retraining of licensed shift personnel is performed. Furthermore it is explained how an emergency exercise, which is OJT of highest value, is prepared, conducted and evaluated. 9 figs

  5. A randomized controlled evaluation of specialist nurse education following accident and emergency department attendance for acute asthma.

    Science.gov (United States)

    Levy, M L; Robb, M; Allen, J; Doherty, C; Bland, J M; Winter, R J

    2000-09-01

    We investigated whether hospital-based specialist asthma nurses improved recognition and self-treatment of asthma episodes by patients followed up after attending accident and emergency departments (A&E) for asthma exacerbations. We carried out a randomized prospective controlled trial of adult asthma self-management, following a hospital outpatient nurse consultation in two outer-London District General Hospitals (secondary care centres). The study included 211 adults, over 18 years old (mean age 40 years) who attended for asthma in two accident and emergency departments over 13 months. One hundred and eight evaluable patients were randomized into the control group who continued with their usual medical treatment and were not offered any intervention during the study period. One hundred and three evaluable patients were randomized into the intervention group. They were offered three 6-weekly outpatient appointments with one of two specialist asthma nurses for a structured asthma consultation, after attendance at the accident and emergency department. Following assessment of their asthma treatment and control, the nurses advised patients, through the use of self-management-plans, how to recognize and manage uncontrolled asthma and when to seek medical assistance. Medication and inhaler device type were altered if necessary The primary outcome was patient reported self-management of asthma exacerbations for 6 months. Secondary outcomes were assessed at baseline, 3 months and 6 months. These included home peak flow and symptom diaries, structured telephone questionnaires and audit of general practitioner records to determine utilization of services (6 months before and after A&E). Data were analysed on an intention to treat basis by multiple and logistic regression. The intervention group increased their use of inhaled topical steroids in 31/61 (51%) vs. 15/70 (21%) attacks in controls (OR 3.91 CI 1.8-8.4, Pentry. Thirty-four percent of intervention patients vs. 42

  6. Fracture evaluation of a crack in the service water piping system to an emergency diesel generator

    International Nuclear Information System (INIS)

    Rudland, D.; Scott, P.; Rahman, S.; Wilkowski, G.

    1995-01-01

    A pipe fracture experiment was conducted on a section of 6-inch nominal diameter pipe which was degraded by microbiologically induced corrosion (MIC) at a circumferential girth weld. The pipe was a section of one of the service water piping system to one of the emergency diesel generators at the Haddam Neck (Connecticut Yankee) plant. The experimental results will help validate future ASME Section XI pipe flaw evaluation criteria for other than Class 1 piping. A critical aspect of this experiment was an assessment of the degree of conservatism embodied in the ASME definition of flaw size. The ASME flaw size definition assumes a rectangular shaped, constant depth flaw with a depth equal to its maximum depth for its entire length. Since most service flaws are very irregular in shape, this definition can be very conservative. Alternative equivalent flaw size definitions for irregular shaped flaws are explored in this paper. (author). 7 refs., 2 figs., 4 tabs

  7. Bedside Ultrasonography as an Adjunct to Routine Evaluation of Acute Appendicitis in the Emergency Department

    OpenAIRE

    Lam, Samuel H.F.; Grippo, Anthony; Kerwin, Chistopher; Konicki, P. John; Goodwine, Diana; Lambert, Michael J.

    2014-01-01

    Introduction: Appendicitis is a common condition presenting to the emergency department (ED). Increasingly emergency physicians (EP) are using bedside ultrasound (BUS) as an adjunct diagnostic tool. Our objective is to investigate the test characteristics of BUS for the diagnosis of appendicitis and identify components of routine ED workup and BUS associated with the presence of appendicitis. Methods: Patients four years of age and older presenting to the ED with suspect...

  8. Lung Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at increased risk of sudden lung ...

  9. Disease elimination and re-emergence in differential-equation models.

    Science.gov (United States)

    Greenhalgh, Scott; Galvani, Alison P; Medlock, Jan

    2015-12-21

    Traditional differential equation models of disease transmission are often used to predict disease trajectories and evaluate the effectiveness of alternative intervention strategies. However, such models cannot account explicitly for probabilistic events, such as those that dominate dynamics when disease prevalence is low during the elimination and re-emergence phases of an outbreak. To account for the dynamics at low prevalence, i.e. the elimination and risk of disease re-emergence, without the added analytical and computational complexity of a stochastic model, we develop a novel application of control theory. We apply our approach to analyze historical data of measles elimination and re-emergence in Iceland from 1923 to 1938, predicting the temporal trajectory of local measles elimination and re-emerge as a result of disease migration from Copenhagen, Denmark. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. [Oncological emergencies in the emergency department].

    Science.gov (United States)

    Cimpoeşu, Diana; Dumea, Mihaela; Durchi, Simona; Apostoae, F; Olaru, G; Ciolan, Mioara; Popa, O; Corlade-Andrei, Mihaela

    2011-01-01

    to assess the profile and the characteristic of oncological patients, establishing management in patients with neoplasia presented in the emergency department (ED), the analysis of short-term movements in patients with neoplasia whilst in the ED. we performed a retrospective study on nonrandomized consecutive cases. The lot analysis included 1315 oncological patients admitted in the Emergency Department of the Clinical Emergency Hospital "St. Spiridon" Iaşi, in the period June 1st, 2009 - May 31st, 2010. 23.12% of the patients had high suspicion of neoplasia at the first visit to the ED. 67.07% of patients were in metastatic stage disease located as follows: liver metastasis 37.59%, lung metastasis 18.36%, lymph node metastasis 13, 29%. After processing the data there were found statistically significant correlations between the age of patients and the documented/suspected diagnosis of neoplasia (p = 0.01) in the sense that a neoplasia diagnosis in emergency was more frequent in people of young age. It should be mentioned that other studies rarely mention first diagnosis of neoplasia in emergency department with presence of complications. 1315 oncological patients presented in ED, almost a quarter of which presented high suspicion of neoplasia (still without histopathological confirmation) when in ED (23.12%). Most of them were aged male patients (over 65 years old), with tumors of the digestive system. A significant proportion (almost 60%) of these patients ended up in emergency due to complications and the therapy intended life support and pain management. Some of these patients were directed to further exploring and emergency outpatient therapy while 75% of patients were hospitalized after stabilization. Although we expected that the frequency of complications to be higher in patients previously diagnosed with cancer, data analysis showed no statistically significant differences (p = NS) between the rate of complications in patients previously diagnosed with

  11. Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival

    DEFF Research Database (Denmark)

    Viereck, Søren; Palsgaard Møller, Thea; Kjær Ersbøll, Annette

    2017-01-01

    BACKGROUND: This study aimed at evaluating if time for initiation of bystander cardiopulmonary resuscitation (CPR) - prior to the emergency call (CPRprior) versus during the emergency call following dispatcher-assisted CPR (CPRduring) - was associated with return of spontaneous circulation (ROSC...... and corresponding emergency calls were evaluated. Multivariable logistic regression analyses were applied to evaluate the association between time for initiation of bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of CPRprior. RESULTS: The study...... included 548 emergency calls for OHCA patients receiving bystander CPR, 34.9% (n=191) in the CPRpriorgroup and 65.1% (n=357) in the CPRduringgroup. Multivariable analyses showed no difference in ROSC (OR=0.88, 95% CI: 0.56-1.38) or 30-day survival (OR=1.14, 95% CI: 0.68-1.92) between CPRpriorand CPRduring...

  12. Emerging Options for Emergency Contraception

    Science.gov (United States)

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-01-01

    Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

  13. Integrated emergency management in KKG

    International Nuclear Information System (INIS)

    Kluegel, J.U.; Plank, H.

    2007-01-01

    The development and introduction of emergency measures in Switzerland was mainly characterized by the evaluation of international experience and by systematic analysis of beyond-design basis accidents within the framework of plant-specific probabilistic safety analyses. As early as in the mid-eighties, the Swiss regulatory authority demanded that measures be taken against severe accidents, and periodically added more detailed requirements, most recently in 2000 when the introduction of Severe Accident Management Guidelines (SMAG) was demanded for power operation as well as operation in the non-power mode. The SMAG were introduced at the Goesgen nuclear power station within a project in the period between 2003 and 2005. For this purpose, a concept of integrated emergency management was developed which is based on updates of the proven emergency manual. One important aspect of this integrative concept is the distinction between preventive and mitigating procedures by defining appropriate criteria. The findings made in the implementation phase of the project include the realization that the introduction of procedures dealing with severe accidents also requires the ability to develop new ways of thinking and acting in accident management. This implies the awareness that procedures covering severe accidents must be applied much more flexibly and in the light of the situation than regulations covering fault conditions. Also possibilities to simulate severe accidents were created within the project both for the development of procedures and for training plant operators and members of the emergency staff. (orig.)

  14. Gamification for data gathering in emergency response exercises

    NARCIS (Netherlands)

    Meesters, Kenny; Ruhe, Aaron; Soetanto, Marvin; Munkvold, R.; Kolås, L.

    2015-01-01

    Our paper describes how gamification can be implemented in an emergency response exercise. In particular, we focus on the potential of gamification to support self-evaluation processes through the automated gathering of data about the participants' performance. Disaster-exercises are typically

  15. Cost-effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective.

    Science.gov (United States)

    April, Michael D; Murray, Brian P

    2017-06-01

    Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policymakers have any formal training in CEA methodology. This paper provides an introduction to the interpretation and use of CEA with a focus on application to emergency medicine problems and settings. It applies a previously published CEA to the hypothetical case of a patient presenting to the ED with chest pain who requires risk stratification. This paper uses a widely cited checklist to appraise the CEA. This checklist serves as a vehicle for presenting basic CEA terminology and concepts. General topics of focus include measurement of costs and outcomes, incremental analysis, and sensitivity analysis. Integrated throughout the paper are recommendations for good CEA practice with emphasis on the guidelines published by the U.S. Panel on Cost-Effectiveness in Health and Medicine. Unique challenges for emergency medicine CEAs discussed include the projection of long-term outcomes from emergent interventions, costing ED services, and applying study results to diverse patient populations across various ED settings. The discussion also includes an overview of the limitations inherent in applying CEA results to clinical practice to include the lack of incorporation of noncost considerations in CEA (e.g., ethics). After reading this article, emergency medicine leaders and researchers will have an enhanced understanding of the basics of CEA critical appraisal and application. The paper concludes with an overview of economic evaluation resources for readers interested in conducting ED-based economic evaluation

  16. Outcomes of medical emergencies on commercial airline flights.

    Science.gov (United States)

    Peterson, Drew C; Martin-Gill, Christian; Guyette, Francis X; Tobias, Adam Z; McCarthy, Catherine E; Harrington, Scott T; Delbridge, Theodore R; Yealy, Donald M

    2013-05-30

    Worldwide, 2.75 billion passengers fly on commercial airlines annually. When in-flight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events. We reviewed records of in-flight medical emergency calls from five domestic and international airlines to a physician-directed medical communications center from January 1, 2008, through October 31, 2010. We characterized the most common medical problems and the type of on-board assistance rendered. We determined the incidence of and factors associated with unscheduled aircraft diversion, transport to a hospital, and hospital admission, and we determined the incidence of death. There were 11,920 in-flight medical emergencies resulting in calls to the center (1 medical emergency per 604 flights). The most common problems were syncope or presyncope (37.4% of cases), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). Physician passengers provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. Of 10,914 patients for whom postflight follow-up data were available, 25.8% were transported to a hospital by emergency-medical-service personnel, 8.6% were admitted, and 0.3% died. The most common triggers for admission were possible stroke (odds ratio, 3.36; 95% confidence interval [CI], 1.88 to 6.03), respiratory symptoms (odds ratio, 2.13; 95% CI, 1.48 to 3.06), and cardiac symptoms (odds ratio, 1.95; 95% CI, 1.37 to 2.77). Most in-flight medical emergencies were related to syncope, respiratory symptoms, or gastrointestinal symptoms, and a physician was frequently the responding medical volunteer. Few in-flight medical emergencies resulted in diversion of aircraft or death; one fourth of passengers who had an in-flight medical emergency underwent additional evaluation in a hospital. (Funded by the National Institutes of Health.).

  17. Conversion disorder in a neurological emergency department: Restrospective series

    Directory of Open Access Journals (Sweden)

    Alejandro Cardozo

    2017-01-01

    Full Text Available Objective: To observe the conversion disorder in a neurological emergency department. Methods: It is common that the initial approach to this patients include the use of various diagnostic exams. In this series we reviewed 94 patients that arrived a neurological emergency room in a 3 year period.Results: 72 patients were females (76%, and the initial presumptive diagnosis were: neurovascular syndrome in 36 patients (38.3%, convulsive disorder in 20 patients (21.28%, and conversive disorder in 8 patients (8.51%. 82 patients had motor symptoms and 61 sensitive symptoms. 88 patients (93% required neuroimaging studies, 77 (81% patients underwent through basic biochemical panels. Other tests performed were: electroencephalogram in 12 patients (12.77%, electromyography in 11 patients (11.7%, lumbar punction in 8 patients (8.04% and regarding the medical consult in the care of these patients 11 were evaluated by 1 specialists, 35 (37.2% by 2 different specialties, 42 (44.63% patients required evaluation by 3, and 6 patients (6.38% required evaluation by 4 different specialties.Conclusions: Based on this data, we concl