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Sample records for accident management procedures

  1. Application of NUREG-1150 methods and results to accident management

    SciTech Connect

    Dingman, S.; Sype, T.; Camp, A.; Maloney, K.

    1990-01-01

    The use of NUREG-1150 and similar Probabilistic Risk Assessments in NRC and industry risk management programs is discussed. Risk management'' is more comprehensive than the commonly used term accident management.'' Accident management includes strategies to prevent vessel breach, mitigate radionuclide releases from the reactor coolant system, and mitigate radionuclide releases to the environment. Risk management also addresses prevention of accident initiators, prevention of core damage, and implementation of effective emergency response procedures. The methods and results produced in NUREG-1150 provide a framework within which current risk management strategies can be evaluated, and future risk management programs can be developed and assessed. Examples of the use of the NUREG-1150 framework for identifying and evaluating risk management options are presented. All phases of risk management are discussed, with particular attention given to the early phases of accidents. Plans and methods for evaluating accident management strategies that have been identified in the NRC accident management program are discussed. 2 refs., 3 figs.

  2. Accident Sequence Evaluation Program: Human reliability analysis procedure

    SciTech Connect

    Swain, A.D.

    1987-02-01

    This document presents a shortened version of the procedure, models, and data for human reliability analysis (HRA) which are presented in the Handbook of Human Reliability Analysis With emphasis on Nuclear Power Plant Applications (NUREG/CR-1278, August 1983). This shortened version was prepared and tried out as part of the Accident Sequence Evaluation Program (ASEP) funded by the US Nuclear Regulatory Commission and managed by Sandia National Laboratories. The intent of this new HRA procedure, called the ''ASEP HRA Procedure,'' is to enable systems analysts, with minimal support from experts in human reliability analysis, to make estimates of human error probabilities and other human performance characteristics which are sufficiently accurate for many probabilistic risk assessments. The ASEP HRA Procedure consists of a Pre-Accident Screening HRA, a Pre-Accident Nominal HRA, a Post-Accident Screening HRA, and a Post-Accident Nominal HRA. The procedure in this document includes changes made after tryout and evaluation of the procedure in four nuclear power plants by four different systems analysts and related personnel, including human reliability specialists. The changes consist of some additional explanatory material (including examples), and more detailed definitions of some of the terms. 42 refs.

  3. The Fukushima radiation accident: consequences for radiation accident medical management.

    PubMed

    Meineke, Viktor; Dörr, Harald

    2012-08-01

    The March 2011 radiation accident in Fukushima, Japan, is a textbook example of a radiation accident of global significance. In view of the global dimensions of the accident, it is important to consider the lessons learned. In this context, emphasis must be placed on consequences for planning appropriate medical management for radiation accidents including, for example, estimates of necessary human and material resources. The specific characteristics of the radiation accident in Fukushima are thematically divided into five groups: the exceptional environmental influences on the Fukushima radiation accident, particular circumstances of the accident, differences in risk perception, changed psychosocial factors in the age of the Internet and globalization, and the ignorance of the effects of ionizing radiation both among the general public and health care professionals. Conclusions like the need for reviewing international communication, interfacing, and interface definitions will be drawn from the Fukushima radiation accident.

  4. Nuclear Weapon Accident Response Procedures (NARP)

    DTIC Science & Technology

    2005-02-22

    Fast, reliable, and accurate communications are essential for nuclear weapon accident response operations. Moreover, securing adequate internal ...activities near the scene of a nuclear weapon accident to speed the flow of information to the public and the internal audience. Although it is 183...Departments and Agencies in a nuclear weapon accident. Inherent in this event are the relationships between international , national, State, and

  5. ATHLET validation using accident management experiments

    SciTech Connect

    Teschendorff, V.; Glaeser, H.; Steinhoff, F.

    1995-09-01

    The computer code ATHLET is being developed as an advanced best-estimate code for the simulation of leaks and transients in PWRs and BWRs including beyond design basis accidents. The code has features that are of special interest for applications to small leaks and transients with accident management, e.g. initialisation by a steady-state calculation, full-range drift-flux model, and dynamic mixture level tracking. The General Control Simulation Module of ATHLET is a flexible tool for the simulation of the balance-of-plant and control systems including the various operator actions in the course of accident sequences with AM measures. The systematic validation of ATHLET is based on a well balanced set of integral and separate effect tests derived from the CSNI proposal emphasising, however, the German combined ECC injection system which was investigated in the UPTF, PKL and LOBI test facilities. PKL-III test B 2.1 simulates a cool-down procedure during an emergency power case with three steam generators isolated. Natural circulation under these conditions was investigated in detail in a pressure range of 4 to 2 MPa. The transient was calculated over 22000 s with complicated boundary conditions including manual control actions. The calculations demonstrations the capability to model the following processes successfully: (1) variation of the natural circulation caused by steam generator isolation, (2) vapour formation in the U-tubes of the isolated steam generators, (3) break-down of circulation in the loop containing the isolated steam generator following controlled cool-down of the secondary side, (4) accumulation of vapour in the pressure vessel dome. One conclusion with respect to the suitability of experiments simulating AM procedures for code validation purposes is that complete documentation of control actions during the experiment must be available. Special attention should be given to the documentation of operator actions in the course of the experiment.

  6. Investigations on optimization of accident management measures following a station blackout accident in a VVER-1000 pressurized water reactor

    SciTech Connect

    Tusheva, P.; Schaefer, F.; Kliem, S.

    2012-07-01

    The reactor safety issues are of primary importance for preserving the health of the population and ensuring no release of radioactivity and fission products into the environment. A part of the nuclear research focuses on improvement of the safety of existing nuclear power plants. Studies, research and efforts are a continuing process at improving the safety and reliability of existing and newly developed nuclear power plants at prevention of a core melt accident. Station blackout (loss of AC power supply) is one of the dominant accidents taken into consideration at performing accident analysis. In case of multiple failures of safety systems it leads to a severe accident. To prevent an accident to turn into a severe one or to mitigate the consequences, accident management measures must be performed. The present paper outlines possibilities for application and optimization of accident management measures following a station blackout accident. Assessed is the behaviour of the nuclear power plant during a station blackout accident without accident management measures and with application of primary/secondary side oriented accident management measures. Discussed are the possibilities for operators ' intervention and the influence of the performed accident management measures on the course of the accident. Special attention has been paid to the effectiveness of the passive feeding and physical phenomena having an influence on the system behaviour. The performed simulations show that the effectiveness of the secondary side feeding procedure can be limited due to an early evaporation or flashing effects in the feed water system. The analyzed cases show that the effectiveness of the accident management measures strongly depends on the initiation criteria applied for depressurization of the reactor coolant system. (authors)

  7. Nuclear Weapon Accident Response Procedures (NARP) Manual

    DTIC Science & Technology

    1990-09-01

    SUMMARY OF SPECIALIZED CAPABILITIES 20-1 G eneral ............................................................................. 20-1 20-2 Purpose...and Analysis Form ............................... 5-E-17 5-E-7 Weapons Accident Environmental Radiation Alpha Probe Data Form ................. 5-E-19...Emergency Preparedness Responsibilities, 13 Nov 88. (j) JCS Publication 1-03.6, Joint Reporting Structure Event/Incident Report , Nov 80. (k) TP 20-11

  8. Post Accident Procedures for Chemicals and Propellants.

    DTIC Science & Technology

    1982-09-01

    Baltimore , Ohio 14 Pittsburgh, Pa. 20 Pryor, Okla. 14 Reidsville, N.C. 14 Santa Clara, Calif. 11 Sparrows Point, Md. 117 Toledo, Ohio 14 ".eirton, W.Va...3 Baltimore . Md. 16 Burns Harbor, Ind. 180 Canton, Ohio 11 Cape Kennedy, Fla. 23 Cleveland, Ohio 52 Coatesville, Pa. 5 Deer Park, Tax. 90 Duquesne, Pa...propellants range from $36,200 to an insignificant amount per occurrence. MMH had the lowest average accident cost of approximately $1, but since

  9. Post Accident Procedures for Chemicals and Propellants.

    DTIC Science & Technology

    1982-09-01

    hazardous materials, the following 16 materials were involved in incidents in any of the ten cities: acetone, acrylonitrile, anhydrous ammonia, chlorine...of Rank Material Accidents Sample 1 Sodium hydroxide 26 23.5 2 Methanol 15 13.5 3 Acetone 14 12.6 4 Anhydrous Ammonia 13 11.7 5 Toluene 9 8.1...1 1 14 Acrylonitrile 1 1 2 4 Anhydrous Ammonia 2 4I 1 3 3 13 Chlorine 1 1 1 1 4 Ethylene Oxide 1 1 -Hydrazine 1 1 Liquefied Hydrogen 1 1 2 Methanol 3

  10. Recommended Procedures for Handling Emergency Illnesses and Accidents at School.

    ERIC Educational Resources Information Center

    North Dakota State Dept. of Health, Bismarck.

    Recommended procedures for handling emergency illnesses and accidents are provided in this guide for school personnel prepared by the North Dakota State Department of Health. Following five general recommendations for steps to take in emergency situations, advice and techniques are given for handling: nose bleeds; abdominal pain; toothaches and…

  11. Recommended Procedures for Handling Emergency Illnesses and Accidents at School.

    ERIC Educational Resources Information Center

    North Dakota State Dept. of Health, Bismarck.

    Recommended procedures for handling emergency illnesses and accidents are provided in this guide for school personnel prepared by the North Dakota State Department of Health. Following five general recommendations for steps to take in emergency situations, advice and techniques are given for handling: nose bleeds; abdominal pain; toothaches and…

  12. Accident management for indian pressurized heavy water reactors

    SciTech Connect

    Hajela, S.; Grover, R.; Ghadge, S.G.; Bajaj, S.S.

    2006-07-01

    Indian nuclear power program as of now is mainly based on Pressurized Heavy Water Reactors (PHWRs). Operating Procedures for normal power operation and Emergency Operating Procedures for operational transients and accidents within design basis exist for all Indian PHWRs. In addition, on-site and off-site emergency response procedures are also available for these NPPs. The guidelines needed for severe accidents mitigation are now formally being documented for Indian PHWRs. Also, in line with International trend of having symptom based emergency handling, the work is in advanced stage for preparation of symptom-based emergency operating procedures. Following a plant upset condition; a number of alarms distributed in different information systems appear in the control room to aid operator to identify the nature of the event. After identifying the event, appropriate intervention in the form of event based emergency operating procedure is put into use by the operating staff. However, if the initiating event cannot be unambiguously identified or after the initial event some other failures take place, then the selected event based emergency operating procedure will not be optimal. In such a case, reactor safety is ensured by monitoring safety functions (depicted by selected plant parameters grouped together) throughout the event handling so that the barriers to radioactivity release namely, fuel and fuel cladding, primary heat transport system integrity and containment remain intact. Simultaneous monitoring of all these safety functions is proposed through status trees and this concept will be implemented through a computer-based system. For beyond design basis accidents, event sequences are identified which may lead to severe core damage. As part of this project, severe accident mitigation guidelines are being finalized for the selected event sequences. The paper brings out the details of work being carried out for Indian PHWRs for symptom based event handling and severe

  13. Simulation of Accident Sequences Including Emergency Operating Procedures

    SciTech Connect

    Queral, Cesar; Exposito, Antonio; Hortal, Javier

    2004-07-01

    Operator actions play an important role in accident sequences. However, design analysis (Safety Analysis Report, SAR) seldom includes consideration of operator actions, although they are required by compulsory Emergency Operating Procedures (EOP) to perform some checks and actions from the very beginning of the accident. The basic aim of the project is to develop a procedure validation system which consists of the combination of three elements: a plant transient simulation code TRETA (a C based modular program) developed by the CSN, a computerized procedure system COPMA-III (Java technology based program) developed by the OECD-Halden Reactor Project and adapted for simulation with the contribution of our group and a software interface that provides the communication between COPMA-III and TRETA. The new combined system is going to be applied in a pilot study in order to analyze sequences initiated by secondary side breaks in a Pressurized Water Reactors (PWR) plant. (authors)

  14. OSSA - An optimized approach to severe accident management: EPR application

    SciTech Connect

    Sauvage, E. C.; Prior, R.; Coffey, K.; Mazurkiewicz, S. M.

    2006-07-01

    There is a recognized need to provide nuclear power plant technical staff with structured guidance for response to a potential severe accident condition involving core damage and potential release of fission products to the environment. Over the past ten years, many plants worldwide have implemented such guidance for their emergency technical support center teams either by following one of the generic approaches, or by developing fully independent approaches. There are many lessons to be learned from the experience of the past decade, in developing, implementing, and validating severe accident management guidance. Also, though numerous basic approaches exist which share common principles, there are differences in the methodology and application of the guidelines. AREVA/Framatome-ANP is developing an optimized approach to severe accident management guidance in a project called OSSA ('Operating Strategies for Severe Accidents'). There are still numerous operating power plants which have yet to implement severe accident management programs. For these, the option to use an updated approach which makes full use of lessons learned and experience, is seen as a major advantage. Very few of the current approaches covers all operating plant states, including shutdown states with the primary system closed and open. Although it is not necessary to develop an entirely new approach in order to add this capability, the opportunity has been taken to develop revised full scope guidance covering all plant states in addition to the fuel in the fuel building. The EPR includes at the design phase systems and measures to minimize the risk of severe accident and to mitigate such potential scenarios. This presents a difference in comparison with existing plant, for which severe accidents where not considered in the design. Thought developed for all type of plants, OSSA will also be applied on the EPR, with adaptations designed to take into account its favourable situation in that field

  15. Managing major chemical accidents in China: towards effective risk information.

    PubMed

    He, Guizhen; Zhang, Lei; Lu, Yonglong; Mol, Arthur P J

    2011-03-15

    Chemical industries, from their very inception, have been controversial due to the high risks they impose on safety of human beings and the environment. Recent decades have witnessed increasing impacts of the accelerating expansion of chemical industries and chemical accidents have become a major contributor to environmental and health risks in China. This calls for the establishment of an effective chemical risk management system, which requires reliable, accurate and comprehensive data in the first place. However, the current chemical accident-related data system is highly fragmented and incomplete, as different responsible authorities adopt different data collection standards and procedures for different purposes. In building a more comprehensive, integrated and effective information system, this article: (i) reviews and assesses the existing data sources and data management, (ii) analyzes data on 976 recorded major hazardous chemical accidents in China over the last 40 years, and (iii) identifies the improvements required for developing integrated risk management in China. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Assessment of light water reactor accident management programs and experience

    SciTech Connect

    Hammersley, R.J.

    1992-03-01

    The objective of this report is to provide an assessment of the current light water reactor experience regarding accident management programs and associated technology developments. This assessment for light water reactor (LWR) designs is provided as a resource and reference for the development of accident management capabilities for the production reactors at the Savannah River Site. The specific objectives of this assessment are as follows: 1. Perform a review of the NRC, utility, and industry (NUMARC, EPRI) accident management programs and implementation experience. 2. Provide an assessment of the problems and opportunities in developing an accident management program in conjunction or following the Individual Plant Examination process. 3. Review current NRC, utility, and industry technological developments in the areas of computational tools, severe accident predictive tools, diagnostic aids, and severe accident training and simulation.

  17. Assessment of two BWR accident management strategies

    SciTech Connect

    Hodge, S.A.; Petek, M.

    1991-01-01

    Candidate mitigative strategies for management of in-vessel events during the late phase (after core degradation has occurred) of postulated BWR severe accidents were considered at Oak Ridge National Laboratory (ORNL) during 1990. The identification of new strategies was subject to the constraint that they should, to the maximum extent possible, make use of the existing equipment and water resources of the BWR facilities and not require major equipment modifications or additions. As a result of this effort, two of these candidate strategies were recommended for additional assessment. The first is a strategy for containment flooding to maintain the core and structural debris within the reactor vessel in the event that vessel injection cannot be restored to terminate a severe accident sequence. The second strategy pertains to the opposite case, for which vessel injection would be restored after control blade melting had begun; its purpose is to provide an injection source of borated water at the concentration necessary to preclude criticality upon recovering a damaged BWR core. Assessments of these two strategies have been performed during 1991 under the auspices of the Detailed Assessment of BWR In-Vessel Strategies Program. This paper provides a discussion of the motivation for and purpose of these strategies and the potential for their success. 33 refs., 9 figs.

  18. Safeguards management inspection procedures

    SciTech Connect

    Barth, M.J.; Dunn, D.R.

    1984-08-01

    The objective of this inspection module is to independently assess the contributions of licensee management to overall safeguards systems performance. The inspector accomplishes this objective by comparing the licensee's safeguards management to both the 10 CFR, parts 70 and 73, requirements and to generally accepted management practices. The vehicle by which this comparison is to be made consists of assessment questions and key issues which point the inspector to areas of primary concern to the NRC and which raise additional issues for the purpose of exposing management ineffectiveness. Further insight into management effectiveness is obtained through those assessment questions specifically directed toward the licensee's safeguards system performance. If the quality of the safeguards is poor, then the inspector should strongly suspect that management's role is ineffective and should attempt to determine management's influence (or lack thereof) on the underlying safeguards deficiencies. (The converse is not necessarily true, however.) The assessment questions in essence provide an opportunity for the inspector to identify, to single out, and to probe further, questionable management practices. Specific issues, circumstances, and concerns which point to questionable or inappropriate practices should be explicitly identified and referenced against the CFR and the assessment questions. The inspection report should also explain why the inspector feels certain management practices are poor, counter to the CFR, and/or point to ineffecive management. Concurrent with documenting the inspection results, the inspector should provide recommendations for alleviating observed management practices that are detrimental to effective safeguards. The recommendations could include: specific changes in the practices of the licensee, followup procedures on the part of NRC, and proposed license changes.

  19. A framework for the assessment of severe accident management strategies

    SciTech Connect

    Kastenberg, W.E.; Apostolakis, G.; Dhir, V.K.

    1993-09-01

    Severe accident management can be defined as the use of existing and/or altemative resources, systems and actors to prevent or mitigate a core-melt accident. For each accident sequence and each combination of severe accident management strategies, there may be several options available to the operator, and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrumentation behavior during an accident. A framework based on decision trees and influence diagrams has been developed which incorporates such criteria as feasibility, effectiveness, and adverse effects, for evaluating potential severe accident management strategies. The framework is also capable of propagating both data and model uncertainty. It is applied to several potential strategies including PWR cavity flooding, BWR drywell flooding, PWR depressurization and PWR feed and bleed.

  20. Summary of a workshop on severe accident management for BWRs

    SciTech Connect

    Kastenberg, W.E.; Apostolakis, G.; Jae, M.; Milici, T.; Park, H.; Xing, L.; Dhir, V.K.; Lim, H.; Okrent, D.; Swider, J.; Yu, D.

    1991-11-01

    Severe accident management can be defined as the use of existing and/or alternative resources, systems and actions to prevent or mitigate a core-melt accident. For each accident sequence and each combination of strategies there may be several options available to the operator; and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrument behavior during an accident. During the period September 26--28, 1990, a workshop was held at the University of California, Los Angeles, to address these uncertainties for Boiling Water Reactors (BWRs). This report contains a summary of the workshop proceedings.

  1. French policy for managing the post-accident phase of a nuclear accident.

    PubMed

    Gallay, F; Godet, J L; Niel, J C

    2015-06-01

    In 2005, at the request of the French Government, the Nuclear Safety Authority (ASN) established a Steering Committee for the Management of the Post-Accident Phase of a Nuclear Accident or a Radiological Emergency, with the objective of establishing a policy framework. Under the supervision of ASN, this Committee, involving several tens of experts from different backgrounds (e.g. relevant ministerial offices, expert agencies, local information commissions around nuclear installations, non-governmental organisations, elected officials, licensees, and international experts), developed a number of recommendations over a 7-year period. First published in November 2012, these recommendations cover the immediate post-emergency situation, and the transition and longer-term periods of the post-accident phase in the case of medium-scale nuclear accidents causing short-term radioactive release (less than 24 h) that might occur at French nuclear facilities. They also apply to actions to be undertaken in the event of accidents during the transportation of radioactive materials. These recommendations are an important first step in preparation for the management of a post-accident situation in France in the case of a nuclear accident. © The Chartered Institution of Building Services Engineers 2014.

  2. The role of NUREG-1150 in accident management

    SciTech Connect

    Camp, A.L.; Cramond, W.R.; Sype, T.T.

    1988-01-01

    The NUREG-1150 report is being prepared by the US Nuclear Regulatory Commission and its contractors to estimate the risk from five commercial light water reactors: Surry, Sequoyah, Peach Bottom, Grand Gulf, and Zion. Level-3 probabilistic risk assessments (PRAs) are being prepared for each of these plants. These PRAs provided a framework for evaluating accident management alternatives from a risk standpoint. This paper describes the accident management benefits that NUREG-1150 is providing.

  3. The role of NUREG-1150 in accident management

    SciTech Connect

    Camp, A.L.; Cramond, W.R.; Sype, T.T.

    1988-01-01

    NUREG-1150 is being prepared by the NRC and its contractors to estimate the risk from five commercial light water reactors: Surry, Sequoyah, Peach Bottom, Grand Gulf, and Zion. Level 3 probabilistic risk assessments (PRAs) are being prepared for each of these plants. These PRAs provide a framework for evaluating accident management alternatives from a risk standpoint. This paper describes the accident management benefits that NUREG-1150 is providing.

  4. Analysis of Convair 990 rejected-takeoff accident with emphasis on decision making, training and procedures

    NASA Technical Reports Server (NTRS)

    Batthauer, Byron E.

    1987-01-01

    This paper analyzes a NASA Convair 990 (CV-990) accident with emphasis on rejected-takeoff (RTO) decision making, training, procedures, and accident statistics. The NASA Aircraft Accident Investigation Board was somewhat perplexed that an aircraft could be destroyed as a result of blown tires during the takeoff roll. To provide a better understanding of tire failure RTO's, The Board obtained accident reports, Federal Aviation Administration (FAA) studies, and other pertinent information related to the elements of this accident. This material enhanced the analysis process and convinced the Accident Board that high-speed RTO's in transport aircraft should be given more emphasis during pilot training. Pilots should be made aware of various RTO situations and statistics with emphasis on failed-tire RTO's. This background information could enhance the split-second decision-making process that is required prior to initiating an RTO.

  5. Postmortem Ethanol Testing Procedures Available to Accident Investigators

    DTIC Science & Technology

    2007-08-01

    cruiser, traveling at an estimated speed of 61 to 72 mph, hydroplaned on the wet highway, spun around, crossed the center line, and crashed into a...Kupiec, and E. Huffine. Postmor- tem alcohol production in fatal aircraft accidents. J Forensic Sci 38:914-7 (1993). 7. A.W. Jones and P. Holmgren

  6. Network-Based Management Procedures.

    ERIC Educational Resources Information Center

    Buckner, Allen L.

    Network-based management procedures serve as valuable aids in organizational management, achievement of objectives, problem solving, and decisionmaking. Network techniques especially applicable to educational management systems are the program evaluation and review technique (PERT) and the critical path method (CPM). Other network charting…

  7. J79-15/-17 Turbojet Engine Accident Investigation Procedures

    DTIC Science & Technology

    1975-08-01

    resistant materials, cannot withstand the temperatures reached in a hydrocarbon fuel type fire; titanium and stainless steels are among the exceptions...OF GOOD INVESTIGATION Promptness The inv-. atigator should get to the scene oF an accident as sotn as possible, before the evidence is disturbed, and...material is evidenced by breaking out the surface layer of steel . Such a failure starts in a small area, spreads rapidly, and would eventually spread

  8. [Rehabilitation networking illustrated by case management after occupational accidents].

    PubMed

    Mehrhoff, F

    2000-08-01

    No net without a spider! After work accidents the victims can rely on the infrastructure created by the German accident insurance scheme (Berufsgenossenschaften). A surgeon, a so-called transit physician, is responsible after acute treatments also for all phases of rehabilitation. A Case Manager (Berufshelfer), an employee of the Berufsgenossenschaften, advises the victim in all matters, including vocational rehabilitation and personal concerns. Both factors combine to form a network that orientates on the social needs of the injured worker, on the financial tasks of the insurance agency and on incentives to the rehabilitation facilities. The goals comprise "rehabilitation before compensation" and "job retention instead of job loss".

  9. A defense in depth approach for nuclear power plant accident management

    SciTech Connect

    Chih-Yao Hsieh; Hwai-Pwu Chou

    2015-07-01

    An initiating event may lead to a severe accident if the plant safety functions have been challenged or operators do not follow the appropriate accident management procedures. Beyond design basis accidents are those corresponding to events of very low occurrence probability but such an accident may lead to significant consequences. The defense in depth approach is important to assure nuclear safety even in a severe accident. Plant Damage States (PDS) can be defined by the combination of the possible values for each of the PDS parameters which are showed on the nuclear power plant simulator. PDS is used to identify what the initiating event is, and can also give the information of safety system's status whether they are bypassed, inoperable or not. Initiating event and safety system's status are used in the construction of Containment Event Tree (CET) to determine containment failure modes by using probabilistic risk assessment (PRA) technique. Different initiating events will correspond to different CETs. With these CETs, the core melt frequency of an initiating event can be found. The use of Plant Damage States (PDS) is a symptom-oriented approach. On the other hand, the use of Containment Event Tree (CET) is an event-oriented approach. In this study, the Taiwan's fourth nuclear power plants, the Lungmen nuclear power station (LNPS), which is an advanced boiling water reactor (ABWR) with fully digitized instrumentation and control (I and C) system is chosen as the target plant. The LNPS full scope engineering simulator is used to generate the testing data for method development. The following common initiating events are considered in this study: loss of coolant accidents (LOCA), total loss of feedwater (TLOFW), loss of offsite power (LOOP), station blackout (SBO). Studies have indicated that the combination of the symptom-oriented approach and the event-oriented approach can be helpful to find mitigation strategies and is useful for the accident management

  10. Accident Precursor Analysis and Management: Reducing Technological Risk Through Diligence

    NASA Technical Reports Server (NTRS)

    Phimister, James R. (Editor); Bier, Vicki M. (Editor); Kunreuther, Howard C. (Editor)

    2004-01-01

    Almost every year there is at least one technological disaster that highlights the challenge of managing technological risk. On February 1, 2003, the space shuttle Columbia and her crew were lost during reentry into the atmosphere. In the summer of 2003, there was a blackout that left millions of people in the northeast United States without electricity. Forensic analyses, congressional hearings, investigations by scientific boards and panels, and journalistic and academic research have yielded a wealth of information about the events that led up to each disaster, and questions have arisen. Why were the events that led to the accident not recognized as harbingers? Why were risk-reducing steps not taken? This line of questioning is based on the assumption that signals before an accident can and should be recognized. To examine the validity of this assumption, the National Academy of Engineering (NAE) undertook the Accident Precursors Project in February 2003. The project was overseen by a committee of experts from the safety and risk-sciences communities. Rather than examining a single accident or incident, the committee decided to investigate how different organizations anticipate and assess the likelihood of accidents from accident precursors. The project culminated in a workshop held in Washington, D.C., in July 2003. This report includes the papers presented at the workshop, as well as findings and recommendations based on the workshop results and committee discussions. The papers describe precursor strategies in aviation, the chemical industry, health care, nuclear power and security operations. In addition to current practices, they also address some areas for future research.

  11. Major accident prevention through applying safety knowledge management approach.

    PubMed

    Kalatpour, Omid

    2016-01-01

    Many scattered resources of knowledge are available to use for chemical accident prevention purposes. The common approach to management process safety, including using databases and referring to the available knowledge has some drawbacks. The main goal of this article was to devise a new emerged knowledge base (KB) for the chemical accident prevention domain. The scattered sources of safety knowledge were identified and scanned. Then, the collected knowledge was formalized through a computerized program. The Protégé software was used to formalize and represent the stored safety knowledge. The domain knowledge retrieved as well as data and information. This optimized approach improved safety and health knowledge management (KM) process and resolved some typical problems in the KM process. Upgrading the traditional resources of safety databases into the KBs can improve the interaction between the users and knowledge repository.

  12. The Goiania accident waste management - Reconditioning operation

    SciTech Connect

    Sophia Teh Whei Miaw

    1994-12-31

    As a result of an accidental breakage of a {sup 137}Cs radiotherapy source, radioactive waste was generated in Goiania-Brazil. It was collected in different types of packaging and removed to a temporary storage site near Abadia de Goias. After four years in open air storage, corrosion was detected in some packages, especially in the 200 1drums. Measures to ensure a safe interim storage were adopted, until a final disposal plan was to be executed. The objective was to make the waste product suitable for the final disposal requests according to Brazilian standards. These measures were concerned mainly with the waste reconditioning. This paper presents the waste management strategy adopted for this operation.

  13. Root Canal Stripping: Malpractice or Common Procedural Accident-An Ethical Dilemma in Endodontics.

    PubMed

    Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena

    2016-01-01

    Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.

  14. [Tasks of case managers in statutory accident insurance].

    PubMed

    Böhnert, W

    1997-02-01

    The present article gives an outline of vocational rehabilitation in the Federal Republic of Germany from the perspective of the statutory accident insurance scheme. Termed "Berufshilfe", occupational assistance, the services and benefits provided under the scheme also encompass elements of medical and social rehabilitation of persons who have incurred an industrial injury or occupational disease. Given the scheme's comprehensive catalog of benefits and services, a multitude of possibilities result for assistance to eligible workers and their relatives, which are illustrated by examples. Central to the presentation is the work of the "Berufshelfer", the accident insurance agency's case manager for vocational rehabilitation service provision. Along with competence of the accident insurance agency for medical, vocational and social rehabilitation, this case manager is the point of contact for all those involved in rehabilitation in the individual case, hence in particular for the individual affected, his or her relatives, physicians, rehabilitation facilities, employers as well as third parties, moreover being the point of liaison among these various parties and the administration. The primary objective of these entire efforts is to achieve lasting reintegration of people with physical or emotional disablement in employment, career, and society.

  15. Simplification and transformation of ASTM F1292 measurement procedure for fall accident injury criteria.

    PubMed

    Kato, Maki; Shimodaira, Yoshie; Sato, Takeshi; Iida, Hiromi

    2014-01-01

    Protecting children from injuries caused by fall accidents from playground equipment is important. Therefore, measures toward minimizing the risk of fall accident injuries are required. The risk of injury can be evaluated using ASTM F1292. In this test, G-max and the HIC are used to estimate the risk of injury. However, the measurement procedure is too complicated for application to a large number of installed equipment. F1292 requires simplified by reducing the number of phases, even with a small risk of loss in accuracy. With this in mind, this study proposes a shortened measurement procedure and a transformation equation to estimate the risk as same as F1292. As the result of experiments, it was revealed that G-max and the HIC values for both procedures linearly increase with drop height. The differences in outcomes between the regression equations of the standardized procedure and those of the shortened procedure can be used as a correction value. They can be added to the value measured by the shortened procedure. This suggests that the combination of the shortened procedure and transformation equation would be equivalent to F1292, with the advantage of being more easily and efficiently applied to the evaluation of installed playground equipment.

  16. Simplification and Transformation of ASTM F1292 Measurement Procedure for Fall Accident Injury Criteria

    PubMed Central

    KATO, Maki; SHIMODAIRA, Yoshie; SATO, Takeshi; IIDA, Hiromi

    2014-01-01

    Abstract: Protecting children from injuries caused by fall accidents from playground equipment is important. Therefore, measures toward minimizing the risk of fall accident injuries are required. The risk of injury can be evaluated using ASTM F1292. In this test, G-max and the HIC are used to estimate the risk of injury. However, the measurement procedure is too complicated for application to a large number of installed equipment. F1292 requires simplified by reducing the number of phases, even with a small risk of loss in accuracy. With this in mind, this study proposes a shortened measurement procedure and a transformation equation to estimate the risk as same as F1292. As the result of experiments, it was revealed that G-max and the HIC values for both procedures linearly increase with drop height. The differences in outcomes between the regression equations of the standardized procedure and those of the shortened procedure can be used as a correction value. They can be added to the value measured by the shortened procedure. This suggests that the combination of the shortened procedure and transformation equation would be equivalent to F1292, with the advantage of being more easily and efficiently applied to the evaluation of installed playground equipment. PMID:25088989

  17. Using cost/risk procedures to establish recovery criteria following a nuclear reactor accident.

    PubMed

    Tawil, J J; Strenge, D L

    1987-02-01

    In the event of a major accidental release of radionuclides at a nuclear power plant, large populated areas could become seriously contaminated. Local officials would be responsible for establishing radiation recovery criteria that would permit the evacuated population to return safely to their jobs and homes. The range of acceptable criteria could imply variations in property losses in the billions of dollars. Given the likely public concern over the health consequences and the enormity of the potential property losses, a cost/risk analysis can provide important input to establishing the recovery criteria. This paper describes procedures for conducting a cost/risk analysis of a site radiologically contaminated by a nuclear power plant accident. The procedures are illustrated by analyzing a hypothetically contaminated site, using software developed for determining the property and health effects of major reactor accidents.

  18. Identification and evaluation of PWR in-vessel severe accident management strategies

    SciTech Connect

    Dukelow, J S; Harrison, D G; Morgenstern, M

    1992-03-01

    This reports documents work performed the NRC/RES Accident Management Guidance Program to evaluate possible strategies for mitigating the consequences of PWR severe accidents. The selection and evaluation of strategies was limited to the in-vessel phase of the severe accident, i.e., after the initiation of core degradation and prior to RPV failure. A parallel project at BNL has been considering strategies applicable to the ex-vessel phase of PWR severe accidents.

  19. Identification and initial assessment of candidate BWR late-phase in-vessel accident management strategies

    SciTech Connect

    Hodge, S.A.

    1991-04-15

    Work sponsored by the United States Nuclear Regulatory Commission (USNRC) to identify and perform preliminary assessments of candidate BWR (boiling water reactor) in-vessel accident management strategies was completed at Oak Ridge National Laboratory (ORNL) during fiscal year 1990. Mitigative strategies for containment events have been the subject of a companion study at Brookhaven National Laboratory. The focus of this Oak Ridge effort was the development of new strategies for mitigation of the late phase events, that is, the events that would occur in-vessel after the onset of significant core damage. The work began with an investigation of the current status of BWR in-vessel accident management procedures and proceeded through a preliminary evaluation of several candidate new strategies. The steps leading to the identification of the candidate strategies are described. The four new candidate late-phase (in-vessel) accident mitigation strategies identified by this study and discussed in the report are: (1) keep the reactor vessel depressurized; (2) restore injection in a controlled manner; (3) inject boron if control blade damage has occurred; and (4) containment flooding to maintain core and structural debris in-vessel. Additional assessments of these strategies are proposed.

  20. [Initial medical management in radiological accidents and nuclear disaster].

    PubMed

    Tanigawa, Koichi

    2012-03-01

    Major radiological emergencies include criticality in nuclear power plants or terrorist attacks using dirty bombs or nuclear device detonation. Because irradiation itself does not cause any immediate death of the victims, and there is a minimum risk of secondary irradiation to medical personnel during decontamination procedures, lifesaving treatments should be prioritized. When a major radiological accident occurs, information is scarce and/or becomes intricate. We might face with significant difficulties in determining the exact culprits of the event, i.e., radiological or chemical or others. Therefore, it is strongly recommended for the national and local governments, related organizations and hospitals to develop comprehensive systems to cope with all hazards(chemical, biological, radiation, nuclear, and explosion) under the common incident command system.

  1. Management of a sandbag accident in an MRI unit.

    PubMed

    Lee, Chee Hwee; Lin, Ming-Fang; Chan, Wing P

    2015-11-01

    Our aim is to report the cause and management of a ferromagnetic sandbag accident that occurred when an unconscious patient was sent for brain MRI. A 2-kg sandbag had been placed in the vicinity of his right groin to aid hemostasis after a femoral venous puncture for thrombocytopenia. His clothing and blanket had not been examined thoroughly before he was moved to the scanner and the sandbag went unnoticed. Its attraction to the scanner and adherence to the scanner rim resulted in a minor abrasion and bruise on the patient's face. We decided to manually remove some of the pellets from the sandbag after cutting the vinyl bag at one corner with a nonferromagnetic screwdriver. Piece-meal removal of about two-thirds of the pellets facilitated removal of the remaining pellets and the sandbag as a whole. The word "sandbag" is misleading and led to a lack of communication between the clinical team and the MRI staff and failure by the MRI staff to recognize a sandbag as a ferromagnetic object. Careful manual removal of small amounts of pellets can be used to avoid more time- and labor-intensive strategies to deal with a sandbag accident (e.g., magnet quench or ramp-down). Installation of a ferromagnetic material detector to screen patients before entering the scanner room is recommended.

  2. The link between off-site-emergency planning and plant-internal accident management

    SciTech Connect

    Braun, H.; Goertz, R.

    1995-02-01

    A variety of accident management measures has been developed and implemented in the German nuclear power plants. They constitute a fourth level of safety in the defence-in-depth concept. The containment venting system is an important example. A functioning link with well defined lines of communication between plant-internal accident management and off-site disaster emergency planning has been established.

  3. Diving accident management, with special emphasis on the situation in the Red Sea.

    PubMed

    Taher, A

    1999-01-01

    Accident management is a concept commonly misunderstood, frequently confused with accident treatment. The situation in the Sinai and the Red Sea makes a broad definition of the term "management" necessary. Management encompasses the whole spectrum: from recognition of the need for a hyperbaric facility, establishing one, education of dive center management, instructors, boat skippers and deck hands, to actual contingency plans set according to the different geographical sites. The essential elements of communication, oxygen first aid, transportation, and actual recompression therapy or other treatments and follow-up must be included. Furthermore, a link to the international organisations involved with diving accident management is an essential and desired backup.

  4. The research of highway traffic accident management and pre-alarm system

    NASA Astrophysics Data System (ADS)

    Xu, Jianping; Zhang, Tiejun; Wan, Jiaonan; Zhang, Juwen; Wang, Rui

    For the rigorous traffic safety issues resulting from rapid transportation development, as well as the more and more attention paid to the traffic accidents dynamic analysis and pre-alarm methods, combined with the practical needs of the highway safety management, this paper summarizes the experience of traffic safety pre-alarm research both in domestic and abroad, designs the frame of highway traffic accident management and pre-alarm system from the function and software engineering requirement, and refines kernel modules such as accident prone section judgement, traffic safety pre-alarm analysis and perfecting safety measures analysis, in order to guide the exploitation and application of the system.

  5. The Design of PSB-VVER Experiments Relevant to Accident Management

    NASA Astrophysics Data System (ADS)

    Nevo, Alessandro Del; D'Auria, Francesco; Mazzini, Marino; Bykov, Michael; Elkin, Ilya V.; Suslov, Alexander

    Experimental programs carried-out in integral test facilities are relevant for validating the best estimate thermal-hydraulic codes(1), which are used for accident analyses, design of accident management procedures, licensing of nuclear power plants, etc. The validation process, in fact, is based on well designed experiments. It consists in the comparison of the measured and calculated parameters and the determination whether a computer code has an adequate capability in predicting the major phenomena expected to occur in the course of transient and/or accidents. University of Pisa was responsible of the numerical design of the 12 experiments executed in PSB-VVER facility (2), operated at Electrogorsk Research and Engineering Center (Russia), in the framework of the TACIS 2.03/97 Contract 3.03.03 Part A, EC financed (3). The paper describes the methodology adopted at University of Pisa, starting form the scenarios foreseen in the final test matrix until the execution of the experiments. This process considers three key topics: a) the scaling issue and the simulation, with unavoidable distortions, of the expected performance of the reference nuclear power plants; b) the code assessment process involving the identification of phenomena challenging the code models; c) the features of the concerned integral test facility (scaling limitations, control logics, data acquisition system, instrumentation, etc.). The activities performed in this respect are discussed, and emphasis is also given to the relevance of the thermal losses to the environment. This issue affects particularly the small scaled facilities and has relevance on the scaling approach related to the power and volume of the facility.

  6. Long-term management of severe ocular surface injury due to methamphetamine production accidents.

    PubMed

    Movahedan, Asadolah; Genereux, Brad M; Darvish-Zargar, Mahshad; Shah, Kevin J; Holland, Edward J

    2015-04-01

    The aim of this study was to report the clinical features and management of patients with ocular surface damage during methamphetamine production accidents. This is a retrospective noncomparative interventional case series of 5 patients with methamphetamine production-related ocular injuries referred to the Cincinnati Eye Institute between 1999 and 2014. Four of 5 cases were white young men with severe bilateral ocular injury and extremely poor vision. All except 1 eye (9 of 10) were diagnosed with total or near-total ocular surface failure. Limbal stem cell transplantation was performed in 8 of 10 eyes. Keratolimbal allograft was followed by penetrating keratoplasty in 7 of 10 eyes. Ocular surface stability was achieved in 7 of 10 eyes after keratolimabl allograft. Postoperative visual acuity was better than 20/200 in 4 of 10 of eyes. Keratolimbal graft rejection occurred in 3 of 10 eyes; the rate of rejection of penetrating keratoplasty was also 3 out of 10 eyes. Methamphetamine-related accidents can lead to severe bilateral ocular injuries. Although stem cell transplantation procedure success is guarded in most of these patients because of severe conjunctival inflammation and accompanying ocular comorbidities, as well as personality issues, compliant patients can achieve good visual function with ocular surface transplantation and subsequent keratoplasty.

  7. [Procedure optimization in hospital management].

    PubMed

    Bauer, M; Hanss, R; Schleppers, A; Steinfath, M; Tonner, P H; Martin, J

    2004-05-01

    Starting January 1st 2004 the German diagnosis-related group (DRG) system was established for in-patient cases. Consequently, the detection and realization of cost-saving potentials are becoming more and more important. For a successful future, efficient allocation of resources is essential. Economically, anaesthesia-related time delays during perioperative work-flow should be minimized. Since numerous entities contribute to perioperative care, it is extremely complex to analyze and optimize this process flow. In this publication single steps leading to an optimized perioperative process flow will be presented: documentation of predefined time points, calculation of relevant time intervals and analysis of key numbers for complex settings. Single steps of the given process analysis will be demonstrated using data from surgical patients at the University Hospital Schleswig-Holstein, Campus Kiel. The attached data collection sheets can be used by interested hospital departments and are meant to serve as a template for further process analyses. Based on the shown analysis, an example will be given to develop an optimized work-flow as a standard operating procedure (SOP). The implementation of the SOP module in an interdisciplinary clinical pathway (CP), which defines efficient medical care from admission to discharge, is mainly responsible for decreased process costs but increased quality of care.

  8. Bibliography for nuclear criticality accident experience, alarm systems, and emergency management

    SciTech Connect

    Putman, V.L.

    1995-09-01

    The characteristics, detection, and emergency management of nuclear criticality accidents outside reactors has been an important component of criticality safety for as long as the need for this specialized safety discipline has been recognized. The general interest and importance of such topics receives special emphasis because of the potentially lethal, albeit highly localized, effects of criticality accidents and because of heightened public and regulatory concerns for any undesirable event in nuclear and radiological fields. This bibliography lists references which are potentially applicable to or interesting for criticality alarm, detection, and warning systems; criticality accident emergency management; and their associated programs. The lists are annotated to assist bibliography users in identifying applicable: industry and regulatory guidance and requirements, with historical development information and comments; criticality accident characteristics, consequences, experiences, and responses; hazard-, risk-, or safety-analysis criteria; CAS design and qualification criteria; CAS calibration, maintenance, repair, and testing criteria; experiences of CAS designers and maintainers; criticality accident emergency management (planning, preparedness, response, and recovery) requirements and guidance; criticality accident emergency management experience, plans, and techniques; methods and tools for analysis; and additional bibliographies.

  9. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  10. [Rehabilitation management system of the German Social Accident Insurance. Initial medical experiences].

    PubMed

    Lugeder, A; Berkenbrink, A; Zeichen, J

    2013-03-01

    To improve outcome quality of rehabilitation, the German Social Accident Insurance implemented a rehabilitation management system. A rehabilitation manager operates as active supervisor of the rehabilitation process of severely injured persons beginning from the time when the accident happened. The sequence is recorded on a rehabilitation schedule by the physician, rehabilitation manager and patient together. The concept has not yet been fully accepted by all insurers. Furthermore there is no uniform approach in compiling the rehabilitation schedule which can lead to delays in the process and insecurity of patients. In the following article these aspects are illustrated and improvement suggestions are highlighted.

  11. WASTE-ACC: A computer model for analysis of waste management accidents

    SciTech Connect

    Nabelssi, B.K.; Folga, S.; Kohout, E.J.; Mueller, C.J.; Roglans-Ribas, J.

    1996-12-01

    In support of the U.S. Department of Energy`s (DOE`s) Waste Management Programmatic Environmental Impact Statement, Argonne National Laboratory has developed WASTE-ACC, a computational framework and integrated PC-based database system, to assess atmospheric releases from facility accidents. WASTE-ACC facilitates the many calculations for the accident analyses necessitated by the numerous combinations of waste types, waste management process technologies, facility locations, and site consolidation strategies in the waste management alternatives across the DOE complex. WASTE-ACC is a comprehensive tool that can effectively test future DOE waste management alternatives and assumptions. The computational framework can access several relational databases to calculate atmospheric releases. The databases contain throughput volumes, waste profiles, treatment process parameters, and accident data such as frequencies of initiators, conditional probabilities of subsequent events, and source term release parameters of the various waste forms under accident stresses. This report describes the computational framework and supporting databases used to conduct accident analyses and to develop source terms to assess potential health impacts that may affect on-site workers and off-site members of the public under various DOE waste management alternatives.

  12. Development of a site-wide accident management center for the Savannah River Site

    SciTech Connect

    Heal, D.W.; Britt, T.E.

    1992-01-01

    In 1990, the Safety Analysis Group at the Savannah River Site (SRS) began development of an Accident Management program. The program was designed to provide a total system which would meet the Department of Energy (DOE) Safety Performance Criteria, in regard to severe accident management, in the most effective manner. This paper will present two significant changes in the current SRS Accident Management program which will be used to meet these expanded needs. The first and most significant change will be to expand the diversity of the groups involved in the Accident Management process. In the future, organizations such as Environmental Safety, Health Quality Assurance, Emergency Planning, Site Management, Human Factors, Risk Assessment, and many others will work as an integrated team to solve facility problems. Organizations such as Materials Technology, Equipment Engineering and many of the laboratories on site will be utilized as support groups to increase the technical capability for specific accident analyses. This phase of the program is currently being structured, and should be operational by January of 1993.

  13. Development of a site-wide accident management center for the Savannah River Site

    SciTech Connect

    Heal, D.W.; Britt, T.E.

    1992-12-31

    In 1990, the Safety Analysis Group at the Savannah River Site (SRS) began development of an Accident Management program. The program was designed to provide a total system which would meet the Department of Energy (DOE) Safety Performance Criteria, in regard to severe accident management, in the most effective manner. This paper will present two significant changes in the current SRS Accident Management program which will be used to meet these expanded needs. The first and most significant change will be to expand the diversity of the groups involved in the Accident Management process. In the future, organizations such as Environmental Safety, Health & Quality Assurance, Emergency Planning, Site Management, Human Factors, Risk Assessment, and many others will work as an integrated team to solve facility problems. Organizations such as Materials Technology, Equipment Engineering and many of the laboratories on site will be utilized as support groups to increase the technical capability for specific accident analyses. This phase of the program is currently being structured, and should be operational by January of 1993.

  14. Procedural Pain Management for Children Receiving Physiotherapy

    PubMed Central

    Tupper, Susan M.

    2010-01-01

    ABSTRACT Purpose: This article provides an overview of literature relevant to the prevention and relief of pain and distress during physiotherapy procedures, with guidance for physiotherapists treating children. Summary of key points: Physiotherapists are generally well trained in assessing and managing pain as a symptom of injury or disease, but there is a need to improve the identification and management of pain produced by physiotherapy procedures such as stretching and splinting. In contrast to physiotherapy, other health care disciplines, such as dentistry, nursing, paediatrics, emergency medicine, and paediatric psychology, produce extensive literature on painful procedures. Procedural pain in children is particularly important because it can lead to later fear and avoidance of necessary medical care. Recommendations: We emphasize the need for physiotherapists to recognize procedural pain and fear in the course of treatment using verbal, nonverbal, and contextual cues. We present many methods that physiotherapists can use to prevent or relieve procedural pain and fear in paediatric patients and provide an example of a simple, integrated plan for prevention and relief of distress induced by painful procedures. PMID:21886372

  15. Markov Model of Severe Accident Progression and Management

    SciTech Connect

    Bari, R.A.; Cheng, L.; Cuadra,A.; Ginsberg,T.; Lehner,J.; Martinez-Guridi,G.; Mubayi,V.; Pratt,W.T.; Yue, M.

    2012-06-25

    The earthquake and tsunami that hit the nuclear power plants at the Fukushima Daiichi site in March 2011 led to extensive fuel damage, including possible fuel melting, slumping, and relocation at the affected reactors. A so-called feed-and-bleed mode of reactor cooling was initially established to remove decay heat. The plan was to eventually switch over to a recirculation cooling system. Failure of feed and bleed was a possibility during the interim period. Furthermore, even if recirculation was established, there was a possibility of its subsequent failure. Decay heat has to be sufficiently removed to prevent further core degradation. To understand the possible evolution of the accident conditions and to have a tool for potential future hypothetical evaluations of accidents at other nuclear facilities, a Markov model of the state of the reactors was constructed in the immediate aftermath of the accident and was executed under different assumptions of potential future challenges. This work was performed at the request of the U.S. Department of Energy to explore 'what-if' scenarios in the immediate aftermath of the accident. The work began in mid-March and continued until mid-May 2011. The analysis had the following goals: (1) To provide an overall framework for describing possible future states of the damaged reactors; (2) To permit an impact analysis of 'what-if' scenarios that could lead to more severe outcomes; (3) To determine approximate probabilities of alternative end-states under various assumptions about failure and repair times of cooling systems; (4) To infer the reliability requirements of closed loop cooling systems needed to achieve stable core end-states and (5) To establish the importance for the results of the various cooling system and physical phenomenological parameters via sensitivity calculations.

  16. 79 FR 13006 - Process Safety Management and Prevention of Major Chemical Accidents; Extension of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2014-03-07

    ... Occupational Safety and Health Administration 29 CFR Part 1910 RIN No. 1218-AC82 Process Safety Management and... Request for Information on Process Safety Management and Prevention of Major Chemical Accidents. DATES... Federal e- Rulemaking Portal. Click on the ``COMMENT NOW!'' box next to the title ``Process...

  17. Radiation accidents and their management: emphasis on the role of nuclear medicine professionals

    PubMed Central

    Novruzov, Fuad; Vinjamuri, Sobhan

    2014-01-01

    Large-scale radiation accidents are few in number, but those that have occurred have subsequently led to strict regulation in most countries. Here, different accident scenarios involving exposure to radiation have been reviewed. A triage of injured persons has been summarized and guidance on management has been provided in accordance with the early symptoms. Types of casualty to be expected in atomic blasts have been discussed. Management at the scene of an accident has been described, with explanation of the role of the radiation protection officer, the nature of contaminants, and monitoring for surface contamination. Methods for early diagnosis of radiation injuries have been then described. The need for individualization of treatment according to the nature and grade of the combined injuries has been emphasized, and different approaches to the treatment of internal contamination have been presented. The role of nuclear medicine professionals, including physicians and physicists, has been reviewed. It has been concluded that the management of radiation accidents is a very challenging process and that nuclear medicine physicians have to be well organized in order to deliver suitable management in any type of radiation accident. PMID:25004166

  18. Coagulation management in patients undergoing neurosurgical procedures.

    PubMed

    Robba, Chiara; Bertuetti, Rita; Rasulo, Frank; Bertuccio, Alessando; Matta, Basil

    2017-10-01

    Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures. Antihemostatic and anticoagulant drugs have shown to be associated with perioperative bleeding. On the other hand, an increased risk of venous thromboembolism and hypercoagulative state after elective and emergency neurosurgery, in particular after brain tumor surgery, has been described in several patients. To balance the risk between thrombosis and bleeding, it is important to be familiar with the perioperative changes in coagulation and with the recent management guidelines for anticoagulated patients undergoing neurosurgical procedures, in particular for those taking new direct anticoagulants. We have considered the current clinical trials and literature regarding both safety and efficacy of deep venous thrombosis prophylaxis in the neurosurgical population. These were mainly trials concerning both elective surgical and intensive care patients with a poor grade intracranial bleed or multiple traumas with an associated severe traumatic brain injury (TBI). Coagulation management remains a major issue in patients undergoing neurosurgical procedures. However, in this field of research, literature quality is poor and further studies are necessary to identify the best strategies to minimize risks in this group of patients.

  19. Risk management: Role of societal factors in major industrial accidents

    SciTech Connect

    Hovden, J.; Rausand, M.; Sergeev, G.

    1995-12-31

    The paper discusses factors influencing the occurrence of major accidents in complex technological systems. Societal factors are identified as most significant in this context. Important types of societal factors are pin-pointed and discussed. The safety situation in the former Soviet Union and in today`s Russian is described. The calamities at Chernobyl, Three Mile Island, and partly also Bhopal are discussed, and the role of societal factors identified. A main point of view is that it is not surprising that these catastrophes happened in the then existing conditions. What is surprising is that they did not happen earlier!

  20. Nationwide Procedural Trends for Renal Trauma Management.

    PubMed

    Colaco, Marc; Navarrete, Roberto A; MacDonald, Susan M; Stitzel, Joel D; Terlecki, Ryan P

    2017-08-29

    To characterize national trends in procedural management of renal trauma. Management of renal trauma has evolved to favor a more conservative approach. For patients requiring intervention, there is a paucity of information to characterize the nature of procedural therapy administered. A retrospective cross-sectional analysis was performed using data contained within the National Trauma Data Bank. The National Trauma Data Bank is a voluntary data repository managed by the American College of Surgeons, containing data regarding trauma admissions at 747 level I to V trauma centers throughout the United States and Canada. Participants included any patient with renal trauma requiring intervention from 2002 to 2012. They were identified according to International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes, with codes 866.00 through 866.03 for blunt renal trauma, and codes 866.10 through 866.13 for penetrating trauma. Cases were separated into those requiring nephrectomy, renorrhaphy, or endovascular repair based on ICD-9 procedure code. The number of cases performed each year and yearly trends as measured by linear regression. A total of 4296 cases were reported during the study period. Of these cases, 2635 involved blunt trauma and 1661 involved penetrating injury. There was a significant increase in the percentage of cases managed by endovascular means for both blunt and penetrating trauma (R = 0.92, P < 0.01; and R = 0.86, P < 0.01, respectively). This was primarily at the expense of nephrectomy, with cases showing significant decline in both groups. National trends for procedural management of renal trauma are toward less invasive interventions. These trends suggest favorable change towards renal preservation and decreased morbidity, potentially facilitated, in part, by improved radiographic staging and endovascular techniques, and also increased provider awareness of the safety and value of conservative management.

  1. Radiological protection from radioactive waste management in existing exposure situations resulting from a nuclear accident.

    PubMed

    Sugiyama, Daisuke; Hattori, Takatoshi

    2013-01-01

    In environmental remediation after nuclear accidents, radioactive wastes have to be appropriately managed in existing exposure situations with contamination resulting from the emission of radionuclides by such accidents. In this paper, a framework of radiation protection from radioactive waste management in existing exposure situations for application to the practical and reasonable waste management in contaminated areas, referring to related ICRP recommendations was proposed. In the proposed concept, intermediate reference levels for waste management are adopted gradually according to the progress of the reduction in the existing ambient dose in the environment on the basis of the principles of justification and optimisation by taking into account the practicability of the management of radioactive waste and environmental remediation. It is essential to include the participation of relevant stakeholders living in existing exposure situations in the selection of reference levels for the existing ambient dose and waste management.

  2. Radiological protection from radioactive waste management in existing exposure situations resulting from a nuclear accident

    PubMed Central

    Sugiyama, Daisuke; Hattori, Takatoshi

    2013-01-01

    In environmental remediation after nuclear accidents, radioactive wastes have to be appropriately managed in existing exposure situations with contamination resulting from the emission of radionuclides by such accidents. In this paper, a framework of radiation protection from radioactive waste management in existing exposure situations for application to the practical and reasonable waste management in contaminated areas, referring to related ICRP recommendations was proposed. In the proposed concept, intermediate reference levels for waste management are adopted gradually according to the progress of the reduction in the existing ambient dose in the environment on the basis of the principles of justification and optimisation by taking into account the practicability of the management of radioactive waste and environmental remediation. It is essential to include the participation of relevant stakeholders living in existing exposure situations in the selection of reference levels for the existing ambient dose and waste management. PMID:22719047

  3. Isovolemic hemodilution-red cell exchange for prevention of cerebrovascular accident in sickle cell anemia: the standard operating procedure.

    PubMed

    Matevosyan, Karén; Anderson, Christina; Sarode, Ravi

    2012-01-01

    Red blood cell exchange is an accepted superior therapy to simple chronic transfusion, due to minimal risk of iron overload, for secondary prevention of cerebrovascular accidents in selected patients with sickle cell anemia. Recently, we described our experience of Isovolemic Hemodilution-Red Blood Cell Exchange (IHD-RBCx), a two-step modification of the conventional RBCx with several advantages, including cost reduction. We are describing our standard operating procedure for IHD-RBCx with COBE Spectra apheresis system to make it widely available to the apheresis centers interested in implementing this procedure.

  4. Managing moral hazard in motor vehicle accident insurance claims.

    PubMed

    Ebrahim, Shanil; Busse, Jason W; Guyatt, Gordon H; Birch, Stephen

    2013-05-01

    Motor vehicle accident (MVA) insurance in Canada is based primarily on two different compensation systems: (i) no-fault, in which policyholders are unable to seek recovery for losses caused by other parties (unless they have specified dollar or verbal thresholds) and (ii) tort, in which policyholders may seek general damages. As insurance companies pay for MVA-related health care costs, excess use of health care services may occur as a result of consumers' (accident victims) and/or producers' (health care providers) behavior - often referred to as the moral hazard of insurance. In the United States, moral hazard is greater for low dollar threshold no-fault insurance compared with tort systems. In Canada, high dollar threshold or pure no-fault versus tort systems are associated with faster patient recovery and reduced MVA claims. These findings suggest that high threshold no-fault or pure no-fault compensation systems may be associated with improved outcomes for patients and reduced moral hazard.

  5. 77 FR 31615 - Improving Mail Management Policies, Procedures, and Activities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... ADMINISTRATION Improving Mail Management Policies, Procedures, and Activities AGENCY: Office of Governmentwide... Services Administration (GSA) has issued Federal Management Regulation (FMR) Bulletin G-03 which provides guidance to Executive Branch agencies for improving mail management policies, procedures, and...

  6. [The new medical treatment procedure of the German Statutory Accident Insurance: From the perspective of BG hospitals].

    PubMed

    Bühren, V; Perl, M

    2016-11-01

    The Hospital Group of the Statutory Accident Insurance (BG hospitals) was affected by the new requirements for severe injury procedures (SAV) in the same manner as all other maximum care hospitals. Simultaneously, the BG clinics were merged to form a centrally organized hospital group. A substantial need for adjustment existed for specialties, such as neurosurgery and visceral surgery at some sites. Needless to say, all trauma victims benefit from the high standards required by the Statutory Accident Insurance regardless of their insurance status. The provision of medical treatment with respect to its implementation into routine practice must be further optimized and additions, e.g. for the occurrence of complications are necessary.

  7. Geographic Information System (GIS) capabilities in traffic accident information management: a qualitative approach.

    PubMed

    Ahmadi, Maryam; Valinejadi, Ali; Goodarzi, Afshin; Safari, Ameneh; Hemmat, Morteza; Majdabadi, Hesamedin Askari; Mohammadi, Ali

    2017-06-01

    Traffic accidents are one of the more important national and international issues, and their consequences are important for the political, economical, and social level in a country. Management of traffic accident information requires information systems with analytical and accessibility capabilities to spatial and descriptive data. The aim of this study was to determine the capabilities of a Geographic Information System (GIS) in management of traffic accident information. This qualitative cross-sectional study was performed in 2016. In the first step, GIS capabilities were identified via literature retrieved from the Internet and based on the included criteria. Review of the literature was performed until data saturation was reached; a form was used to extract the capabilities. In the second step, study population were hospital managers, police, emergency, statisticians, and IT experts in trauma, emergency and police centers. Sampling was purposive. Data was collected using a questionnaire based on the first step data; validity and reliability were determined by content validity and Cronbach's alpha of 75%. Data was analyzed using the decision Delphi technique. GIS capabilities were identified in ten categories and 64 sub-categories. Import and process of spatial and descriptive data and so, analysis of this data were the most important capabilities of GIS in traffic accident information management. Storing and retrieving of descriptive and spatial data, providing statistical analysis in table, chart and zoning format, management of bad structure issues, determining the cost effectiveness of the decisions and prioritizing their implementation were the most important capabilities of GIS which can be efficient in the management of traffic accident information.

  8. Geographic Information System (GIS) capabilities in traffic accident information management: a qualitative approach

    PubMed Central

    Ahmadi, Maryam; Valinejadi, Ali; Goodarzi, Afshin; Safari, Ameneh; Hemmat, Morteza; Majdabadi, Hesamedin Askari; Mohammadi, Ali

    2017-01-01

    Background Traffic accidents are one of the more important national and international issues, and their consequences are important for the political, economical, and social level in a country. Management of traffic accident information requires information systems with analytical and accessibility capabilities to spatial and descriptive data. Objective The aim of this study was to determine the capabilities of a Geographic Information System (GIS) in management of traffic accident information. Methods This qualitative cross-sectional study was performed in 2016. In the first step, GIS capabilities were identified via literature retrieved from the Internet and based on the included criteria. Review of the literature was performed until data saturation was reached; a form was used to extract the capabilities. In the second step, study population were hospital managers, police, emergency, statisticians, and IT experts in trauma, emergency and police centers. Sampling was purposive. Data was collected using a questionnaire based on the first step data; validity and reliability were determined by content validity and Cronbach’s alpha of 75%. Data was analyzed using the decision Delphi technique. Results GIS capabilities were identified in ten categories and 64 sub-categories. Import and process of spatial and descriptive data and so, analysis of this data were the most important capabilities of GIS in traffic accident information management. Conclusion Storing and retrieving of descriptive and spatial data, providing statistical analysis in table, chart and zoning format, management of bad structure issues, determining the cost effectiveness of the decisions and prioritizing their implementation were the most important capabilities of GIS which can be efficient in the management of traffic accident information. PMID:28848627

  9. Military Curricula for Vocational and Technical Education. Traffic Management and Accident Investigation, 17-8.

    ERIC Educational Resources Information Center

    Air Force, Washington, DC.

    This teaching guide and student workbook for a postsecondary level course in traffic management and accident investigation is one of a number of military-developed curriculum packages selected for adaptation to vocational instruction and curriculum development in a civilian setting. Purpose stated for the 132-hour course is to expose students to…

  10. Pleural procedural complications: prevention and management

    PubMed Central

    Psallidas, Ioannis; Wrightson, John M.; Hallifax, Robert J.; Rahman, Najib M.

    2015-01-01

    Pleural disease is common with a rising case frequency. Many of these patients will be symptomatic and require diagnostic and/or therapeutic procedures. Patients with pleural disease present to a number of different medical specialties, and an equally broad range of clinicians are therefore required to have practical knowledge of these procedures. There is often underestimation of the morbidity and mortality associated with pleural interventions, even those regarded as being relatively straightforward, with potentially significant implications for processes relating to patient safety and informed consent. The advent of thoracic ultrasound (TUS) has had a major influence on patient safety and the number of physicians with the necessary skill set to perform pleural procedures. As the variety and complexity of pleural interventions increases, there is increasing recognition that early specialist input can reduce the risk of complications and number of procedures a patient requires. This review looks at the means by which complications of pleural procedures arise, along with how they can be managed or ideally prevented. PMID:26150919

  11. Steady Heat Removal Test by BWR Drywell Cooler under Accident Management Conditions

    SciTech Connect

    Yokobori, Seiichi; Tobimatsu, Toshimi; Akinaga, Makoto; Fukasawa, Masanori; Nagasaka, Hideo

    2002-07-01

    This paper deals with the heat removal performance of the BWR drywell local cooler (DWC) applied as a Japanese phase-II accident management. Separated effect tests were conducted using a single DWC unit of a typical BWR plant under severe accident (SA) condition. It was demonstrated that noncondensable gas mixture with nitrogen and helium was constantly vented from the DWC casing and the favorable steam condensation rate was maintained even under the highest assumed gas condition. The DWC was found to be promising even under wide range of SA conditions. (authors)

  12. Motor vehicle accidents: How should cirrhotic patients be managed?

    PubMed Central

    Kawaguchi, Takumi; Taniguchi, Eitaro; Sata, Michio

    2012-01-01

    Motor vehicle accidents (MVAs) are serious social issues worldwide and driver illness is an important cause of MVAs. Minimal hepatic encephalopathy (MHE) is a complex cognitive dysfunction with attention deficit, which frequently occurs in cirrhotic patients independent of severity of liver disease. Although MHE is known as a risk factor for MVAs, the impact of diagnosis and treatment of MHE on MVA-related societal costs is largely unknown. Recently, Bajaj et al demonstrated valuable findings that the diagnosis of MHE by rapid screening using the inhibitory control test (ICT), and subsequent treatment with lactulose could substantially reduce the societal costs by preventing MVAs. Besides the ICT and lactulose, there are various diagnostic tools and therapeutic strategies for MHE. In this commentary, we discussed a current issue of diagnostic tools for MHE, including neuropsychological tests. We also discussed the advantages of the other therapeutic strategies for MHE, such as intake of a regular breakfast and coffee, and supplementation with zinc and branched chain amino acids, on the MVA-related societal costs. PMID:22690067

  13. Fukushima nuclear power plant accident and comprehensive health risk management-global radiocontamination and information disaster.

    PubMed

    Yamashita, Shunichi

    2014-06-01

    The Great East Japan Earthquake on March 11, 2011, besides further studying the appropriateness of the initial response and post-countermeasures against the severe Fukushima nuclear accident, has now increased the importance of the epidemiological study in comprehensive health risk management and radiation protection; lessons learnt from the Chernobyl accident should be also implemented. Therefore, since May 2011, Fukushima Prefecture has started the "Fukushima Health Management Survey Project" for the purpose of long-term health care administration and early diagnosis/treatment for the prefectural residents. Basic survey is under investigation on a retrospective estimation of external exposure of the first four months. As one of the four detailed surveys, the thyroid ultrasound examination has clarified the increased detection rate of childhood thyroid cancers as a screening effect in the past three years and so thyroid cancer occurrence by Fukushima nuclear power plant accident, especially due to radioactive iodine will be discussed despite of difficult challenge of accurate estimation of low dose and low-dose rate radiation exposures. Through the on-site valuable experience and a difficult challenge for recovery, we should learn the lessons from this severe and large-scale nuclear accident, especially how to countermeasure against public health emergency at the standpoint of health risk and also social risk management.

  14. 14 CFR 91.1021 - Internal safety reporting and incident/accident response.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .../accident response. 91.1021 Section 91.1021 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... incident/accident response. (a) Each program manager must establish an internal anonymous safety reporting.... (b) Each program manager must establish procedures to respond to an aviation incident/accident....

  15. 14 CFR 91.1021 - Internal safety reporting and incident/accident response.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .../accident response. 91.1021 Section 91.1021 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... incident/accident response. (a) Each program manager must establish an internal anonymous safety reporting.... (b) Each program manager must establish procedures to respond to an aviation incident/accident....

  16. 14 CFR 91.1021 - Internal safety reporting and incident/accident response.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .../accident response. 91.1021 Section 91.1021 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... incident/accident response. (a) Each program manager must establish an internal anonymous safety reporting.... (b) Each program manager must establish procedures to respond to an aviation incident/accident....

  17. 14 CFR 91.1021 - Internal safety reporting and incident/accident response.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .../accident response. 91.1021 Section 91.1021 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... incident/accident response. (a) Each program manager must establish an internal anonymous safety reporting.... (b) Each program manager must establish procedures to respond to an aviation incident/accident....

  18. 14 CFR 91.1021 - Internal safety reporting and incident/accident response.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .../accident response. 91.1021 Section 91.1021 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... incident/accident response. (a) Each program manager must establish an internal anonymous safety reporting.... (b) Each program manager must establish procedures to respond to an aviation incident/accident....

  19. Developing a Minimum Data Set for an Information Management System to Study Traffic Accidents in Iran

    PubMed Central

    Mohammadi, Ali; Ahmadi, Maryam; Gharagozlu, Alireza

    2016-01-01

    Background: Each year, around 1.2 million people die in the road traffic incidents. Reducing traffic accidents requires an exact understanding of the risk factors associated with traffic patterns and behaviors. Properly analyzing these factors calls for a comprehensive system for collecting and processing accident data. Objectives: The aim of this study was to develop a minimum data set (MDS) for an information management system to study traffic accidents in Iran. Materials and Methods: This descriptive, cross-sectional study was performed in 2014. Data were collected from the traffic police, trauma centers, medical emergency centers, and via the internet. The investigated resources for this study were forms, databases, and documents retrieved from the internet. Forms and databases were identical, and one sample of each was evaluated. The related internet-sourced data were evaluated in their entirety. Data were collected using three checklists. In order to arrive at a consensus about the data elements, the decision Delphi technique was applied using questionnaires. The content validity and reliability of the questionnaires were assessed by experts’ opinions and the test-retest method, respectively. Results: An (MDS) of a traffic accident information management system was assigned to three sections: a minimum data set for traffic police with six classes, including 118 data elements; a trauma center with five data classes, including 57 data elements; and a medical emergency center, with 11 classes, including 64 data elements. Conclusions: Planning for the prevention of traffic accidents requires standardized data. As the foundation for crash prevention efforts, existing standard data infrastructures present policymakers and government officials with a great opportunity to strengthen and integrate existing accident information systems to better track road traffic injuries and fatalities. PMID:27247791

  20. Developing a Minimum Data Set for an Information Management System to Study Traffic Accidents in Iran.

    PubMed

    Mohammadi, Ali; Ahmadi, Maryam; Gharagozlu, Alireza

    2016-03-01

    Each year, around 1.2 million people die in the road traffic incidents. Reducing traffic accidents requires an exact understanding of the risk factors associated with traffic patterns and behaviors. Properly analyzing these factors calls for a comprehensive system for collecting and processing accident data. The aim of this study was to develop a minimum data set (MDS) for an information management system to study traffic accidents in Iran. This descriptive, cross-sectional study was performed in 2014. Data were collected from the traffic police, trauma centers, medical emergency centers, and via the internet. The investigated resources for this study were forms, databases, and documents retrieved from the internet. Forms and databases were identical, and one sample of each was evaluated. The related internet-sourced data were evaluated in their entirety. Data were collected using three checklists. In order to arrive at a consensus about the data elements, the decision Delphi technique was applied using questionnaires. The content validity and reliability of the questionnaires were assessed by experts' opinions and the test-retest method, respectively. An (MDS) of a traffic accident information management system was assigned to three sections: a minimum data set for traffic police with six classes, including 118 data elements; a trauma center with five data classes, including 57 data elements; and a medical emergency center, with 11 classes, including 64 data elements. Planning for the prevention of traffic accidents requires standardized data. As the foundation for crash prevention efforts, existing standard data infrastructures present policymakers and government officials with a great opportunity to strengthen and integrate existing accident information systems to better track road traffic injuries and fatalities.

  1. Criticality accident alarm system at the Fernald Environmental Management Project

    SciTech Connect

    Marble, R.C.; Brown, T.D.; Wooldridge, J.C.

    1994-12-31

    This paper describes the staus of the Fernald Environmental Management Project (FEMP) criticality alarm system. A new radiation detection alarm system was installed in 1990. The anunciation system, calibration and maintenance, and detector placement is described.

  2. A system of safety management practices and worker engagement for reducing and preventing accidents: an empirical and theoretical investigation.

    PubMed

    Wachter, Jan K; Yorio, Patrick L

    2014-07-01

    The overall research objective was to theoretically and empirically develop the ideas around a system of safety management practices (ten practices were elaborated), to test their relationship with objective safety statistics (such as accident rates), and to explore how these practices work to achieve positive safety results (accident prevention) through worker engagement. Data were collected using safety manager, supervisor and employee surveys designed to assess and link safety management system practices, employee perceptions resulting from existing practices, and safety performance outcomes. Results indicate the following: there is a significant negative relationship between the presence of ten individual safety management practices, as well as the composite of these practices, with accident rates; there is a significant negative relationship between the level of safety-focused worker emotional and cognitive engagement with accident rates; safety management systems and worker engagement levels can be used individually to predict accident rates; safety management systems can be used to predict worker engagement levels; and worker engagement levels act as mediators between the safety management system and safety performance outcomes (such as accident rates). Even though the presence of safety management system practices is linked with incident reduction and may represent a necessary first-step in accident prevention, safety performance may also depend on mediation by safety-focused cognitive and emotional engagement by workers. Thus, when organizations invest in a safety management system approach to reducing/preventing accidents and improving safety performance, they should also be concerned about winning over the minds and hearts of their workers through human performance-based safety management systems designed to promote and enhance worker engagement. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Comprehensive Health Risk Management after the Fukushima Nuclear Power Plant Accident.

    PubMed

    Yamashita, S

    2016-04-01

    Five years have passed since the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Plant accident on 11 March 2011. Countermeasures aimed at human protection during the emergency period, including evacuation, sheltering and control of the food chain were implemented in a timely manner by the Japanese Government. However, there is an apparent need for improvement, especially in the areas of nuclear safety and protection, and also in the management of radiation health risk during and even after the accident. Continuous monitoring and characterisation of the levels of radioactivity in the environment and foods in Fukushima are now essential for obtaining informed consent to the decisions on living in the radio-contaminated areas and also on returning back to the evacuated areas once re-entry is allowed; it is also important to carry out a realistic assessment of the radiation doses on the basis of measurements. Until now, various types of radiation health risk management projects and research have been implemented in Fukushima, among which the Fukushima Health Management Survey is the largest health monitoring project. It includes the Basic Survey for the estimation of external radiation doses received during the first 4 months after the accident and four detailed surveys: thyroid ultrasound examination, comprehensive health check-up, mental health and lifestyle survey, and survey on pregnant women and nursing mothers, with the aim to prospectively take care of the health of all the residents of Fukushima Prefecture for a long time. In particular, among evacuees of the Fukushima Nuclear Power Plant accident, concern about radiation risk is associated with psychological stresses. Here, ongoing health risk management will be reviewed, focusing on the difficult challenge of post-disaster recovery and resilience in Fukushima. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  4. [The acute stage of the cerebrovascular accident; characteristics and management].

    PubMed

    Schuling, J; Greidanus, J

    1992-02-29

    Description of stroke patient characteristics, outcome in the acute phase (the first 3 weeks post-stroke) and management by the general practitioner (GP). Community based prospective study. During the research period GPs reported all stroke patients (first event as well as recurring); these patients were followed at fixed intervals post-stroke regardless of treatment. The 98 GPs reported 185 patients. Stroke patients are predominantly old to very old people with a lot of comorbidity and an impaired pre-stroke functional status. The GP treated one third of the patients himself; half of the patients were instantly referred to a hospital. Younger patients are referred for further examination, probably because of possible therapeutic consequences. The very old are referred if their impairment makes home care impossible. Mortality, especially in the hospital group is high; 10% died within 24 hours, while after 1 week this figure was 17% and after 3 weeks 23%. In 21% of the referred patients no CT scan was made; the motive for referral was to provide sufficient care for the patient. In nine referred patients (8%) the diagnosis was changed. In choosing a strategy the GP considers several factors, of which impairment and the possibilities of home care are the most important. Diagnostic uncertainty played a minor role.

  5. [Vascular interventional radiology: a fundamental procedure for the management of paediatric trauma].

    PubMed

    Bordón Cabrera, E; Laín, A; Gander, R; Pérez Lafuente, M; Díez Miranda, I; Fontecha, C G; Seidler, L; Delgado, I; Cañadas Palazón, S; Lloret, J

    2016-01-25

    The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment. The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs. Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques. In the reported study period 16 patients underwent VIR procedures. Medium age was 13 years (5-17). The most frequent lesion mechanism was traffic accident (8 out of 17) and 93,75% were blunt traumas. Findings on initial Computed Tomography were 12 contrast blushes and 2 absences of arterial flow. In 2 cases the contrast blush appeared 48 hours after the accident. Arteriography allowed us to localize the bleeding vessels in all the cases, performing selective or supraselective renal (7), pelvic (5), hepatic (3), splenic (1) and intercostal (1) embolization. One patient required an endoprothesis for renal revascularization. Two cases needed additional surgical procedures (2 nephrectomies) because of complete section of the renal artery (1) and disruption of the ureteropelvic junction (1). One case required hemofiltration in relation to rhabdomyolysis. In our experience VIR is a valuable diagnostic and therapeutic procedure for the management of paediatric trauma patients, with high effectiveness and a low complication rate.

  6. Safety culture and accident analysis--a socio-management approach based on organizational safety social capital.

    PubMed

    Rao, Suman

    2007-04-11

    One of the biggest challenges for organizations in today's competitive business environment is to create and preserve a self-sustaining safety culture. Typically, the key drivers of safety culture in many organizations are regulation, audits, safety training, various types of employee exhortations to comply with safety norms, etc. However, less evident factors like networking relationships and social trust amongst employees, as also extended networking relationships and social trust of organizations with external stakeholders like government, suppliers, regulators, etc., which constitute the safety social capital in the Organization--seem to also influence the sustenance of organizational safety culture. Can erosion in safety social capital cause deterioration in safety culture and contribute to accidents? If so, how does it contribute? As existing accident analysis models do not provide answers to these questions, CAMSoC (Curtailing Accidents by Managing Social Capital), an accident analysis model, is proposed. As an illustration, five accidents: Bhopal (India), Hyatt Regency (USA), Tenerife (Canary Islands), Westray (Canada) and Exxon Valdez (USA) have been analyzed using CAMSoC. This limited cross-industry analysis provides two key socio-management insights: the biggest source of motivation that causes deviant behavior leading to accidents is 'Faulty Value Systems'. The second biggest source is 'Enforceable Trust'. From a management control perspective, deterioration in safety culture and resultant accidents is more due to the 'action controls' rather than explicit 'cultural controls'. Future research directions to enhance the model's utility through layering are addressed briefly.

  7. Construction safety: Can management prevent all accidents or are workers responsible for their own actions?

    SciTech Connect

    Cotten, G.B.; Jenkins, S.L.

    1997-10-01

    The construction industry has struggled for many years with the answer to the question posed in the title: Can Management Prevent All Accidents or Are Workers Responsible for Their Own Actions? In the litigious society that we live, it has become more important to find someone {open_quotes}at fault{close_quotes} for an accident than it is to find out how we can prevent it from ever happening again. Most successful companies subscribe to the theme that {open_quotes}all accidents can be prevented.{close_quotes} They institute training and qualification programs, safe performance incentives, and culture-change-driven directorates such as the Voluntary Protection Program (VPP); yet we still see construction accidents that result in lost time, and occasionally death, which is extremely costly in the shortsighted measure of money and, in real terms, impact to the worker`s family. Workers need to be properly trained in safety and health protection before they are assigned to a job that may expose them to safety and health hazards. A management committed to improving worker safety and health will bring about significant results in terms of financial savings, improved employee morale, enhanced communities, and increased production. But how can this happen, you say? Reduction in injury and lost workdays are the rewards. A decline in reduction of injuries and lost workdays results in lower workers` compensation premiums and insurance rates. In 1991, United States workplace injuries and illnesses cost public and private sector employers an estimated $62 billion in workers` compensation expenditures.

  8. Procedures to Help Program Offices with Earned Value Management

    EPA Pesticide Factsheets

    EPA’s Earned Value Management (EVM) Procedures describe the Agency methods for collecting and reporting performance information on major IT investments. The EVM Procedures explain how EPA Program Offices are to receive, organize, analyze, and report cost.

  9. Management of Ultimate Risk of Nuclear Power Plants by Source Terms - Lessons Learned from the Chernobyl Accident

    SciTech Connect

    Genn Saji

    2006-07-01

    The term 'ultimate risk' is used here to describe the probabilities and radiological consequences that should be incorporated in siting, containment design and accident management of nuclear power plants for hypothetical accidents. It is closely related with the source terms specified in siting criteria which assures an adequate separation of radioactive inventories of the plants from the public, in the event of a hypothetical and severe accident situation. The author would like to point out that current source terms which are based on the information from the Windscale accident (1957) through TID-14844 are very outdated and do not incorporate lessons learned from either the Three Miles Island (TMI, 1979) nor Chernobyl accident (1986), two of the most severe accidents ever experienced. As a result of the observations of benign radionuclides released at TMI, the technical community in the US felt that a more realistic evaluation of severe reactor accident source terms was necessary. In this background, the 'source term research project' was organized in 1984 to respond to these challenges. Unfortunately, soon after the time of the final report from this project was released, the Chernobyl accident occurred. Due to the enormous consequences induced by then accident, the one time optimistic perspectives in establishing a more realistic source term were completely shattered. The Chernobyl accident, with its human death toll and dispersion of a large part of the fission fragments inventories into the environment, created a significant degradation in the public's acceptance of nuclear energy throughout the world. In spite of this, nuclear communities have been prudent in responding to the public's anxiety towards the ultimate safety of nuclear plants, since there still remained many unknown points revolving around the mechanism of the Chernobyl accident. In order to resolve some of these mysteries, the author has performed a scoping study of the dispersion and deposition

  10. Managing Operating Procedures in Distributed Collaborative Projects

    NASA Astrophysics Data System (ADS)

    Hool, A.; Beuzelin Ollivier, M.-G.; Roubert, F.

    2013-04-01

    In recent years, large distributed collaborative projects have become very prominent in scientific research, allowing exchanges between laboratories located in different institutions and countries and between various domains of competence. Particularly the work on nanotoxicity - a field which has only been under investigation for a few years and is still lacking regulatory framework - highlighted the need for well-controlled methods, as well as rules for the handling and disposal of used materials. To obtain comparable and reproducible results of experiments conducted in a distributed context, the standardisation and proper documentation of the applied methods is crucial. The European project NanoDiaRA, whose aim is to develop nanoparticles and biomarkers for the early diagnosis of inflammatory disease, faces this situation as it involves 15 European partners and brings together different scientific cultures and professional backgrounds. Protocols especially developed for Superparamagnetic Iron Oxide Nanoparticles and a management system were designed and implemented within the NanoDiaRA project to fulfil those needs. The main goals were the establishment of standardised Standard Operating Procedures assuring transparency and reproducibility and the provision of access to these protocols to every project partner, as well as their clear allocation to carry out precise measurements and production steps.

  11. Depressurization as an accident management strategy to minimize the consequences of direct containment heating

    SciTech Connect

    Hanson, D.J.; Golden, D.W.; Chambers, R.; Miller, J.D.; Hallbert, B.P.; Dobbe, C.A. )

    1990-10-01

    Probabilistic Risk Assessments (PRAs) have identified severe accidents for nuclear power plants that have the potential to cause failure of the containment through direct containment heating (DCH). Prevention of DCH or mitigation of its effects may be possible using accident management strategies that intentionally depressurize the reactor coolant system (RCS). The effectiveness of intentional depressurization during a station blackout TMLB' sequence was evaluated considering the phenomenological behavior, hardware performance, and operational performance. Phenomenological behavior was calculated using the SCDAP/RELAP5 severe accident analysis code. Two strategies to mitigate DCH by depressurization of the RCS were considered. One strategy, called early depressurization, assumed that the reactor head vent and pressurizer power-operated relief valves (PORVs) were latched open at steam generator dryout. The second strategy, called late depression, assumed that the head vent and PORVs were latched open at a core exit temperature of {approximately}922 K (1200{degree}F). Depressurization of the RCS to a low value that may mitigate DCH was predicted prior to reactor pressure vessel breach for both early and late depressurization. The strategy of late depressurization is preferred over early depressurization because there are greater opportunities to recover plant functions prior to core damage and because failure uncertainties are lessened. 22 refs., 38 figs., 6 tabs.

  12. Decision support system for emergency management of oil spill accidents in the Mediterranean Sea

    NASA Astrophysics Data System (ADS)

    Liubartseva, Svitlana; Coppini, Giovanni; Pinardi, Nadia; De Dominicis, Michela; Lecci, Rita; Turrisi, Giuseppe; Cretì, Sergio; Martinelli, Sara; Agostini, Paola; Marra, Palmalisa; Palermo, Francesco

    2016-08-01

    This paper presents an innovative web-based decision support system to facilitate emergency management in the case of oil spill accidents, called WITOIL (Where Is The Oil). The system can be applied to create a forecast of oil spill events, evaluate uncertainty of the predictions, and calculate hazards based on historical meteo-oceanographic datasets. To compute the oil transport and transformation, WITOIL uses the MEDSLIK-II oil spill model forced by operational meteo-oceanographic services. Results of the modeling are visualized through Google Maps. A special application for Android is designed to provide mobile access for competent authorities, technical and scientific institutions, and citizens.

  13. [The new treatment procedure of the German statutory accident insurance: From the perspective of a community hospital].

    PubMed

    Bonnaire, F; Goepel, M; Bula, P

    2016-11-01

    The requirements of the German statutory accident insurance (DGUV) for the new treatment procedure were presented on 1 January 2013 in a new catalogue. The implementation of the certification of hospitals for the very severe injury procedure (SAV) by the DGUV should have been completed by 2014. These requirements placed high demands on trauma-oriented hospitals because of the high structural and personnel prerequisites. The background to the new organization was the wish of the DGUV for quality improvement in patient treatment in hospitals for patients with very severe occupational and occupation-related trauma by placement in qualified centers with high case numbers. No increase in income was planned for the hospitals to cope with the necessary improvements in quality. After 2 years of experience with the SAV we can confirm for a community hospital that the structural requirements could be improved (e.g. establishment of departments of neurosurgery, plastic surgery and thoracic surgery) but the high requirements for qualification and attendance of physicians on duty are a continuous problem and are also costly. The numbers of severely injured trauma patients have greatly increased, particularly in 2015. The charges for the complex treatment are not adequately reflected in the German diagnosis-related groups system and no extra flat rate funding per case is explicitly planned in the DRG remuneration catalogue. The invoicing of a center surcharge in addition to the DRG charges has not been introduced.

  14. RADIOACTIVE WASTE MANAGEMENT IN THE CHERNOBYL EXCLUSION ZONE - 25 YEARS SINCE THE CHERNOBYL NUCLEAR POWER PLANT ACCIDENT

    SciTech Connect

    Farfan, E.; Jannik, T.

    2011-10-01

    Radioactive waste management is an important component of the Chernobyl Nuclear Power Plant accident mitigation and remediation activities of the so-called Chernobyl Exclusion Zone. This article describes the localization and characteristics of the radioactive waste present in the Chernobyl Exclusion Zone and summarizes the pathways and strategy for handling the radioactive waste related problems in Ukraine and the Chernobyl Exclusion Zone, and in particular, the pathways and strategies stipulated by the National Radioactive Waste Management Program. The brief overview of the radioactive waste issues in the ChEZ presented in this article demonstrates that management of radioactive waste resulting from a beyond-designbasis accident at a nuclear power plant becomes the most challenging and the costliest effort during the mitigation and remediation activities. The costs of these activities are so high that the provision of radioactive waste final disposal facilities compliant with existing radiation safety requirements becomes an intolerable burden for the current generation of a single country, Ukraine. The nuclear accident at the Fukushima-1 NPP strongly indicates that accidents at nuclear sites may occur in any, even in a most technologically advanced country, and the Chernobyl experience shows that the scope of the radioactive waste management activities associated with the mitigation of such accidents may exceed the capabilities of a single country. Development of a special international program for broad international cooperation in accident related radioactive waste management activities is required to handle these issues. It would also be reasonable to consider establishment of a dedicated international fund for mitigation of accidents at nuclear sites, specifically, for handling radioactive waste problems in the ChEZ. The experience of handling Chernobyl radioactive waste management issues, including large volumes of radioactive soils and complex structures

  15. Towards emergency management of natural disasters and critical accidents: the Greek experience.

    PubMed

    Nivolianitou, Zoe; Synodinou, Barbara

    2011-10-01

    This paper presents the findings of a prototype study which sought to identify factors that contribute to effective emergency management in Greece and other European states regarding both natural disasters and critical accidents. The parameters for proper action and successful intervention in operational and logistical are identified based on the document analysis and interviews with emergency responders. The interviews are conducted between state-owned and voluntary organizations. They were asked to rate in terms of their importance for effective emergency response efforts. This paper offers useful information of the organization and management of emergency response in Greece, as well as provides interesting responders' opinions data concerning important priorities in the emergency management area. Despite the fact that the data come from the Greek experience, the conclusions may be applied for a broader use in the emergency planning of disasters. The whole study has been undertaken within the European Pre-Emergencies (PreEm) project.

  16. Sixteenth water reactor safety information meeting: Proceedings: Volume 5, NUREG-1150, accident managment, recent advances in severe accident research, TMI-2, BWR Mark l shell failure

    SciTech Connect

    Weiss, A.J.

    1989-03-01

    This five-volume report contains 141 papers out of the 175 that were presented at the Sixteenth Water Reactor Safety Information Meeting held at the National Institute of Standards and Technology, Gaithersburg, Maryland, during the week of October 24--27, 1988. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included twenty different papers presented by researchers from Germany, Italy, Japan, Sweden, Switzerland, Taiwan and the United Kingdom. The titles of the papers and the names of the authors have been updated and may differ from those that appeared in the final program of the meeting. This document, Volume 5, discusses NUREG-1150, Accident Management, Recent Advances in Severe Accident Research, BWR Mark I Shell Failure, and the Three Mile Island-2 Reactor.

  17. Procedures for Electronic Management of Rulemaking and Other Docketed Records in the Federal Docket Management System

    EPA Pesticide Factsheets

    This procedure identifies the specific requirements, processes and supporting documents EPA uses to electronically manage rulemaking and other docketed records in the Federal Docket Management System (FDMS).

  18. An Examination of Commercial Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Reveley, Mary S.; Briggs, Jeffrey L.; Thomas, Megan A.; Evans, Joni K.; Jones, Sharon M.

    2011-01-01

    The Integrated Vehicle Health Management (IVHM) Project is one of the four projects within the National Aeronautics and Space Administration's (NASA) Aviation Safety Program (AvSafe). The IVHM Project conducts research to develop validated tools and technologies for automated detection, diagnosis, and prognosis that enable mitigation of adverse events during flight. Adverse events include those that arise from system, subsystem, or component failure, faults, and malfunctions due to damage, degradation, or environmental hazards that occur during flight. Determining the causal factors and adverse events related to IVHM technologies will help in the formulation of research requirements and establish a list of example adverse conditions against which IVHM technologies can be evaluated. This paper documents the results of an examination of the most recent statistical/prognostic accident and incident data that is available from the Aviation Safety Information Analysis and Sharing (ASIAS) System to determine the causal factors of system/component failures and/or malfunctions in U.S. commercial aviation accidents and incidents.

  19. Managing Errors to Reduce Accidents in High Consequence Networked Information Systems

    SciTech Connect

    Ganter, J.H.

    1999-02-01

    Computers have always helped to amplify and propagate errors made by people. The emergence of Networked Information Systems (NISs), which allow people and systems to quickly interact worldwide, has made understanding and minimizing human error more critical. This paper applies concepts from system safety to analyze how hazards (from hackers to power disruptions) penetrate NIS defenses (e.g., firewalls and operating systems) to cause accidents. Such events usually result from both active, easily identified failures and more subtle latent conditions that have resided in the system for long periods. Both active failures and latent conditions result from human errors. We classify these into several types (slips, lapses, mistakes, etc.) and provide NIS examples of how they occur. Next we examine error minimization throughout the NIS lifecycle, from design through operation to reengineering. At each stage, steps can be taken to minimize the occurrence and effects of human errors. These include defensive design philosophies, architectural patterns to guide developers, and collaborative design that incorporates operational experiences and surprises into design efforts. We conclude by looking at three aspects of NISs that will cause continuing challenges in error and accident management: immaturity of the industry, limited risk perception, and resource tradeoffs.

  20. Procedural Pain Management in Neonates, Infants and Children

    PubMed Central

    2011-01-01

    Neonates, infants and children all feel pain and require analgesia for painful procedures. Many painful procedures are associated with medical interventions, including immunisation, heel lance, venesection, IV cannulation and dressing change. Untreated pain can have short and long term effects, including sensitisation to pain episodes in later life. A range of non-pharmacological and pharmacological interventions have been shown to be effective for procedural pain management in infants and children, and are most effective when used in combination. Developmental changes in pain responses, analgesic response and drug pharmacokinetics need to be taken into account when planning procedural pain management for neonates. Comprehensive evidence based guidelines are available to guide effective procedural pain management in neonates, infants and older children. PMID:26526331

  1. Complication of improper management of sodium hypochlorite accident during root canal treatment.

    PubMed

    Faras, Fatemah; Abo-Alhassan, Fawaz; Sadeq, Abdullah; Burezq, Hisham

    2016-01-01

    Sodium Hypochlorite (NaOCl) is a common irrigation solution used in root canal treatment. It has strong antibacterial and tissue dissolving properties. Nevertheless, it has some serious complications, some of which are life-threatening. A young male presented with severe chemical burn of the right infraorbital area and partial necrosis of the hard palate resulting from extrusion of NaOCl during root canal treatment of the upper right 2(nd) molar tooth. The patient had a facial scar, and mucosal damage healed nearly completely. Several precautions must be taken during NaOCl use to prevent the spread of the solution into surrounding tissues. Early recognition of NaOCl accident and proper immediate management are important to achieve the best possible outcome.

  2. Complication of improper management of sodium hypochlorite accident during root canal treatment

    PubMed Central

    Faras, Fatemah; Abo-Alhassan, Fawaz; Sadeq, Abdullah; Burezq, Hisham

    2016-01-01

    Sodium Hypochlorite (NaOCl) is a common irrigation solution used in root canal treatment. It has strong antibacterial and tissue dissolving properties. Nevertheless, it has some serious complications, some of which are life-threatening. A young male presented with severe chemical burn of the right infraorbital area and partial necrosis of the hard palate resulting from extrusion of NaOCl during root canal treatment of the upper right 2nd molar tooth. The patient had a facial scar, and mucosal damage healed nearly completely. Several precautions must be taken during NaOCl use to prevent the spread of the solution into surrounding tissues. Early recognition of NaOCl accident and proper immediate management are important to achieve the best possible outcome. PMID:27891318

  3. System Integral Test by BWR Drywell Cooler Applied as Phase-II Accident Management

    SciTech Connect

    Nagasaka, Hideo; Tobimatsu, Toshimi; Tahara, Mika; Yokobori, Seiichi; Akinaga, Makoto

    2002-07-01

    This paper deals with the system interaction performance using the BWR drywell local cooler (DWC) in combination with containment spray as a Japanese Phase-II accident management (AM). By using almost full height simulation test facility (GIRAFFE-DWC) with scaling ratio of 1/600, the system integral tests simulating BWR low pressure vessel failure sequence were accomplished during about 14 hours. In case of DWC application, the containment pressure increase was found milder due to DWC heat removal performance. Initial spray timing was delayed about 3 hours and each spray period was reduced almost by half. It was concluded that the application of a BWR DWC to Phase-II AM measure is quite promising from the point of delaying or preventing the containment venting. (authors)

  4. School-Based Management & Accountability Procedures Manual.

    ERIC Educational Resources Information Center

    North Carolina State Board of Education, Raleigh.

    The 1996 session of the North Carolina General Assembly enacted legislation, The School-Based Management and Accountability Program (the ABCs plan), an educational reform initiative designed to improve student performance. The accountability model for the public schools in kindergarten through eighth grade is designed to provide focus on the basic…

  5. Management of complications with flap procedures and replantation.

    PubMed

    Sammer, Douglas M

    2015-05-01

    Replantation and flap procedures employ microvascular techniques to salvage or reconstruct a severely damaged limb or digit. The most devastating complications include complete or partial flap loss, or replantation failure due to vascular complications. Often, these complications can be prevented by appropriate patient selection, careful surgical planning, meticulous technique, and proper postoperative management. This article discusses complications related to replantation and flap procedures in the upper limb, focusing on preventing and managing these complications.

  6. Space Geodesy Project Information and Configuration Management Procedure

    NASA Technical Reports Server (NTRS)

    Merkowitz, Stephen M.

    2016-01-01

    This plan defines the Space Geodesy Project (SGP) policies, procedures, and requirements for Information and Configuration Management (CM). This procedure describes a process that is intended to ensure that all proposed and approved technical and programmatic baselines and changes to the SGP hardware, software, support systems, and equipment are documented.

  7. Managing diagnostic procedures in idiopathic pulmonary fibrosis.

    PubMed

    Wells, Athol U

    2013-06-01

    Idiopathic pulmonary fibrosis (IPF), the most prevalent of the idiopathic interstitial pneumonias, is associated with a poor prognosis. An accurate diagnosis of IPF is essential for its optimal management. The 2011 American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society (JRS)/Latin American Thoracic Association (ALAT) recommendations on the diagnosis and management of IPF were developed from a systematic review of the published literature. High-resolution computed tomography (HRCT) scanning has a central role in the IPF diagnostic pathway, with formal designation of criteria for an HRCT pattern of usual interstitial pneumonia. In the correct clinical context, a usual interstitial pneumonia pattern on HRCT is indicative of a definite diagnosis of IPF and negates the need for a surgical lung biopsy. However, although the 2011 ATS/ERS/JRS/ALAT statement is a major advance, the application of the guideline recommendations by clinicians has identified limitations that should be addressed in future statements. Key problems include: 1) HRCT misdiagnosis, particularly by less experienced radiologists; 2) lack of management recommendations for the highly prevalent clinical scenarios of "probable" or "possible" IPF; 3) ongoing confusion concerning the diagnostic role of bronchoalveolar lavage; and 4) the lack of integration of clinical data in the designation of the diagnostic likelihood of IPF, including the treated course of disease. These issues become evident as the recommendations are applied and highlight the need for continued guideline adjustments.

  8. Quality assurance in military medical research and medical radiation accident management.

    PubMed

    Hotz, Mark E; Meineke, Viktor

    2012-08-01

    The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within

  9. Non-Procedural Languages for Information Resource Management.

    ERIC Educational Resources Information Center

    Bearley, William L.

    The future of information resources management requires new approaches to implementing systems which will include a type of data base management that frees users to solve data processing problems logically by telling the system what they want, together with powerful non-procedural languages that will permit communication in simple, concise…

  10. Non-Procedural Languages for Information Resource Management.

    ERIC Educational Resources Information Center

    Bearley, William L.

    The future of information resources management requires new approaches to implementing systems which will include a type of data base management that frees users to solve data processing problems logically by telling the system what they want, together with powerful non-procedural languages that will permit communication in simple, concise…

  11. Radioactive waste management in the Chernobyl exclusion zone: 25 years since the Chernobyl nuclear power plant accident.

    PubMed

    Oskolkov, Boris Y; Bondarkov, Mikhail D; Zinkevich, Lubov I; Proskura, Nikolai I; Farfán, Eduardo B; Jannik, G Timothy

    2011-10-01

    Radioactive waste management is an important component of the Chernobyl Nuclear Power Plant accident mitigation and remediation activities in the so-called Chernobyl Exclusion Zone. This article describes the localization and characteristics of the radioactive waste present in the Chernobyl Exclusion Zone and summarizes the pathways and strategy for handling the radioactive waste-related problems in Ukraine and the Chernobyl Exclusion Zone and, in particular, the pathways and strategies stipulated by the National Radioactive Waste Management Program.

  12. Influence of occupational safety management on the incidence rate of occupational accidents in the Spanish industrial and ornamental stone mining.

    PubMed

    Sanmiquel, Lluís; Rossell, Josep M; Vintró, Carla; Freijo, Modesto

    2014-01-01

    Mines are hazardous and workers can suffer many types of accidents caused by fire, flood, explosion or collapse. Injury incidence rates in mining are considerably higher than those registered by other economic sectors. One of the main reasons for this high-level incidence rate is the existence of a large number of dangerous workplaces. This work analyzes the influence that occupational safety management had on the accidents that took place in Spanish mining of industrial and ornamental stone during the period 2007-2008. Primary data sources are: (a) Results from a statistical study of the occupational health and safety management practices of 71 quarries defined by a questionnaire of 41 items; and (b) Occupational accidents registered in the Spanish industrial and ornamental stone mining throughout the period 2007-2008. The obtained results indicate that workplaces with a low average score in the analysis of occupational safety management have a higher incidence rate of accidents. Studies on mining workplaces are very important to help detect occupational safety concerns. Results from this study help raise awareness and will encourage the adoption of appropriate measures to improve safety.

  13. Implications for accident management of adding water to a degrading reactor core

    SciTech Connect

    Kuan, P.; Hanson, D.J.; Pafford, D.J.; Quick, K.S.; Witt, R.J.

    1994-02-01

    This report evaluates both the positive and negative consequences of adding water to a degraded reactor core during a severe accident. The evaluation discusses the earliest possible stage at which an accident can be terminated and how plant personnel can best respond to undesired results. Specifically discussed are (a) the potential for plant personnel to add water for a range of severe accidents, (b) the time available for plant personnel to act, (c) possible plant responses to water added during the various stages of core degradation, (d) plant instrumentation available to understand the core condition and (e) the expected response of the instrumentation during the various stages of severe accidents.

  14. Spacecraft momentum management procedures. [large space telescope

    NASA Technical Reports Server (NTRS)

    Chen, L. C.; Davenport, P. B.; Sturch, C. R.

    1980-01-01

    Techniques appropriate for implementation onboard the space telescope and other spacecraft to manage the accumulation of momentum in reaction wheel control systems using magnetic torquing coils are described. Generalized analytical equations are derived for momentum control laws that command the magnetic torquers. These control laws naturally fall into two main categories according to the methods used for updating the magnetic dipole command: closed loop, in which the update is based on current measurements to achieve a desired torque instantaneously, and open-loop, in which the update is based on predicted information to achieve a desired momentum at the end of a period of time. Physical interpretations of control laws in general and of the Space Telescope cross product and minimum energy control laws in particular are presented, and their merits and drawbacks are discussed. A technique for retaining the advantages of both the open-loop and the closed-loop control laws is introduced. Simulation results are presented to compare the performance of these control laws in the Space Telescope environment.

  15. Work Incapacity and Treatment Costs After Severe Accidents: Standard Versus Intensive Case Management in a 6-Year Randomized Controlled Trial.

    PubMed

    Scholz, Stefan M; Andermatt, Peter; Tobler, Benno L; Spinnler, Dieter

    2016-09-01

    Purpose Case management is widely accepted as an effective method to support medical rehabilitation and vocational reintegration of accident victims with musculoskeletal injuries. This study investigates whether more intensive case management improves outcomes such as work incapacity and treatment costs for severely injured patients. Methods 8,050 patients were randomly allocated either to standard case management (SCM, administered by claims specialists) or intensive case management (ICM, administered by case managers). These study groups differ mainly by caseload, which was approximately 100 cases in SCM and 35 in ICM. The setting is equivalent to a prospective randomized controlled trial. A 6-year follow-up period was chosen in order to encompass both short-term insurance benefits and permanent disability costs. All data were extracted from administrative insurance databases. Results Average work incapacity over the 6-year follow-up, including contributions from daily allowances and permanent losses from disability, was slightly but insignificantly higher under ICM than under SCM (21.6 vs. 21.3 % of pre-accident work capacity). Remaining work incapacity after 6 years of follow-up showed no difference between ICM and SCM (8.9 vs. 8.8 % of pre-accident work incapacity). Treatment costs were 43,500 Swiss Francs (CHF) in ICM compared to 39,800 in SCM (+9.4 %, p = 0.01). The number of care providers involved in ICM was 10.5 compared to 10.0 in ICM (+5.0 %, p < 0.001). Conclusions Contrary to expectations, ICM did not reduce work incapacity as compared to SCM, but did increase healthcare consumption and treatment costs. It is concluded that the intensity of case management alone is not sufficient to improve rehabilitation and vocational reintegration of accident victims.

  16. Esophageal distensibility measurement: impact on clinical management and procedure length.

    PubMed

    Ahuja, N K; Agnihotri, A; Lynch, K L; Hoo-Fatt, D; Onyimba, F; McKnight, M; Okeke, F C; Garcia, P; Dhalla, S; Stein, E; Pasricha, P J; Clarke, J O

    2017-08-01

    Luminal distensibility measurement has demonstrated relevance to various disease processes, though its effects on clinical decision-making have been less well understood. This study aims to characterize the clinical impact of impedance planimetry measurement as well as the learning curve associated with its use in the esophagus. A single provider performed distensibility measurement in conjunction with upper endoscopy for a variety of clinical indications with the functional lumen imaging probe (FLIP) over a period of 21 months. Procedural data were prospectively collected and, along with medical records, retrospectively reviewed. Seventy-three procedures (70 patients) underwent esophageal distensibility measurement over the timeline of this study. The most common procedural indications were known or suspected achalasia (32.9%), dysphagia with connective tissue disease (13.7%), eosinophilic esophagitis (12.3%), and dysphagia with prior fundoplication (9.6%). FLIP results independently led to a change in management in 29 (39.7%) cases and supported a change in management in an additional 15 (20.5%) cases. The most common change in management was a new or amended therapeutic procedure (79.5%). Procedural time added by distensibility measurement was greater among earlier cases than among later cases. The median time added overall was 5 minutes and 46 seconds. Procedural time added varied significantly by procedural indication, but changes in management did not. Distensibility measurement added meaningful diagnostic information that impacted therapeutic decision-making in the majority of cases in which it was performed. Procedural time added by this modality is typically modest and decreases with experience. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Hazardous waste storage facility accident scenarios for the U.S. Department of Energy Environmental Restoration and Waste Management Programmatic Environmental Impact Statement

    SciTech Connect

    Policastro, A.; Roglans-Ribas, J.; Marmer, D.; Lazaro, M.; Mueller, C.; Freeman, W.

    1994-03-01

    This paper presents the methods for developing accident categories and accident frequencies for internally initiated accidents at hazardous waste storage facilities (HWSFs) at US Department of Energy (DOE) sites. This categorization is a necessary first step in evaluating the risk of accidents to workers and the general population at each of the sites. This risk evaluation is part of the process of comparing alternative management strategies in DOE`s Environmental Restoration and Waste Management (EM) Programmatic Environmental Impact Statement (PEIS). Such strategies involve regionalization, decentralization, and centralization of waste treatment, storage, and disposal activities. Potential accidents at the HWSFs at the DOE sites are divided into categories of spill alone, spill plus fire, and other event combinations including spill plus fire plus explosion, fire only, spill and explosion, and fire and explosion. One or more accidents are chosen to represent the types of accidents for FY 1992 for 12 DOE sites were studied to determine the most representative set of possible accidents at all DOE sites. Each accident scenario is given a probability of occurrence that is adjusted, depending on the throughput and waste composition that passes through the HWSF at the particular site. The justification for the probabilities chosen is presented.

  18. Quality initiatives: measuring and managing the procedural competency of radiologists.

    PubMed

    Mendiratta-Lala, Mishal; Eisenberg, Ronald L; Steele, Joseph R; Boiselle, Phillip M; Kruskal, Jonathan B

    2011-01-01

    Many regulatory and oversight groups require that the professional performance of radiologists be evaluated on an ongoing basis. Although the diagnostic accuracy of radiologists is routinely measured at most institutions by means of peer review processes, systems for evaluating procedural competency are not widely available. Consequently, technical skills are seldom, if ever, evaluated or managed. The key elements of a system for evaluating procedural competency include the following: (a) clear definition of all elements of a transparent evaluation process; (b) definition of standards for training and credentialing and options for maintenance of competency certification in interventional procedures; (c) collection and analysis of process and outcomes metrics; (d) multisource feedback on procedural, patient care, and safety skills; and (e) an effective, anonymous process for managing radiologists in whom deficiencies are identified. Although no ideal system for evaluating procedural competency currently exists, inclusion of these elements goes a long way toward facilitating the introduction of a simple process for providing appropriate feedback to procedural radiologists, acknowledging excellence, and identifying and managing deficiencies if they occur.

  19. Tenth Warren K. Sinclair keynote address-the Fukushima nuclear power plant accident and comprehensive health risk management.

    PubMed

    Yamashita, Shunichi

    2014-02-01

    Just two years have passed since the Tokyo Electric Power Company-Fukushima Daiichi Nuclear Power Plant (NPP) accident, a multidimensional disaster that combined to destroy the local infrastructure on which the safety system depended and gave a serious impact to the world. Countermeasures including evacuation, sheltering, and control of the food chain were implemented in a timely manner by the Japanese government. However, there is a clear need for improvement, especially in the areas of nuclear safety and protection and also in the management of the radiation health risk during and even after the accident. To date there have been no acute radiation injuries. The radiation-related physical health consequences to the general public, including evacuees, are likely to be much lower than those arising from the Chernobyl nuclear reactor accident, because the radiation fallout and the subsequent environmental contamination were much more limited. However, the social, psychological, and economic impacts of the Fukushima NPP accident are expected to be considerable. Currently, continued monitoring and characterization of the levels of radioactivity in the environment and foods in Fukushima are vital for obtaining informed consent to the decisions on living in the areas already radiocontaminated and returning back to the evacuated areas once re-entry is permitted; it is also important to perform a realistic assessment of the radiation doses on the basis of measurements. We are currently implementing the official plans of the Fukushima Health Management Survey, which includes a basic survey for the estimation of the external doses that were received during the first 4 mo after the accident and four more detailed surveys (thyroid ultrasound examination, comprehensive health check-up, mental health and life-style survey, and survey of pregnant women and nursing mothers), with the aim to take care of the health of all of the residents of the Fukushima Prefecture for a long time

  20. Analysis of Surface Water Pollution Accidents in China: Characteristics and Lessons for Risk Management.

    PubMed

    Yao, Hong; Zhang, Tongzhu; Liu, Bo; Lu, Feng; Fang, Shurong; You, Zhen

    2016-04-01

    Understanding historical accidents is important for accident prevention and risk mitigation; however, there are no public databases of pollution accidents in China, and no detailed information regarding such incidents is readily available. Thus, 653 representative cases of surface water pollution accidents in China were identified and described as a function of time, location, materials involved, origin, and causes. The severity and other features of the accidents, frequency and quantities of chemicals involved, frequency and number of people poisoned, frequency and number of people affected, frequency and time for which pollution lasted, and frequency and length of pollution zone were effectively used to value and estimate the accumulated probabilities. The probabilities of occurrences of various types based on origin and causes were also summarized based on these observations. The following conclusions can be drawn from these analyses: (1) There was a high proportion of accidents involving multi-district boundary regions and drinking water crises, indicating that more attention should be paid to environmental risk prevention and the mitigation of such incidents. (2) A high proportion of accidents originated from small-sized chemical plants, indicating that these types of enterprises should be considered during policy making. (3) The most common cause (49.8% of the total) was intentional acts (illegal discharge); accordingly, efforts to increase environmental consciousness in China should be enhanced.

  1. Analysis of Surface Water Pollution Accidents in China: Characteristics and Lessons for Risk Management

    NASA Astrophysics Data System (ADS)

    Yao, Hong; Zhang, Tongzhu; Liu, Bo; Lu, Feng; Fang, Shurong; You, Zhen

    2016-04-01

    Understanding historical accidents is important for accident prevention and risk mitigation; however, there are no public databases of pollution accidents in China, and no detailed information regarding such incidents is readily available. Thus, 653 representative cases of surface water pollution accidents in China were identified and described as a function of time, location, materials involved, origin, and causes. The severity and other features of the accidents, frequency and quantities of chemicals involved, frequency and number of people poisoned, frequency and number of people affected, frequency and time for which pollution lasted, and frequency and length of pollution zone were effectively used to value and estimate the accumulated probabilities. The probabilities of occurrences of various types based on origin and causes were also summarized based on these observations. The following conclusions can be drawn from these analyses: (1) There was a high proportion of accidents involving multi-district boundary regions and drinking water crises, indicating that more attention should be paid to environmental risk prevention and the mitigation of such incidents. (2) A high proportion of accidents originated from small-sized chemical plants, indicating that these types of enterprises should be considered during policy making. (3) The most common cause (49.8 % of the total) was intentional acts (illegal discharge); accordingly, efforts to increase environmental consciousness in China should be enhanced.

  2. Accident investigation

    NASA Technical Reports Server (NTRS)

    Brunstein, A. I.

    1979-01-01

    Aircraft accident investigations are discussed with emphasis on those accidents that involved weather as a contributing factor. The organization of the accident investigation board for air carrier accidents is described along with the hearings, and formal report preparation. Statistical summaries of the investigations of general aviation accidents are provided.

  3. Peri-procedural management of patients taking oral anticoagulants.

    PubMed

    Daniels, Paul R

    2015-07-14

    The use of oral anticoagulants is becoming increasingly common. For many years warfarin was the main oral anticoagulant available, but therapeutic options have expanded with the introduction of oral direct thrombin (dabigatran) and factor Xa inhibitors (apixaban, rivaroxaban, and edoxaban). Management of patients taking any oral anticoagulant in the peri-procedural period poses a challenge to medical and surgical providers because of the competing risks of thrombosis and hemorrhage. Bridging therapy has been used to minimize time without anticoagulation when warfarin is interrupted for invasive procedures, but validated strategies based on high quality data are lacking. Existing data suggest that the use of bridging therapy may increase the risk of bleeding for some patients without reducing the risk of thrombosis. Clinical trials are currently under way to answer these questions. Because the half lives and time to anticoagulant activity of newer oral anticoagulants are shorter than for warfarin, bridging therapy is not thought to be necessary with these agents. Peri-procedural management of patients taking these agents is complicated by the lack of demonstrated reversal agents in emergency situations, although specific antidotes are being developed and tested. Existing guidelines for peri-procedural management of patients on oral anticoagulants highlight the importance of individualized patient decision making and suggest strategies to minimize complications. From a patient's perspective, given the uncertainties surrounding optimal management, explicit discussions regarding risks and benefits of treatment options and demonstration of effective communication among medical and surgical providers are essential.

  4. Pleural procedures in the management of malignant effusions

    PubMed Central

    Ferreiro, Lucía; Suárez-Antelo, Juan; Valdés, Luis

    2017-01-01

    Malignant pleural effusion (MPE) is common in clinical practice, and despite the existence of studies to guide clinical decisions, it often poses diagnostic and therapeutic dilemmas. Once it is diagnosed, median survival does not usually exceed 6 months. The management of these patients focuses on symptom relief since no treatments have been shown to increase survival to date. Conversely, poor management can shorten survival. The approach must be multidisciplinary and allow for individualized care. Initial diagnostic procedures should be minimally invasive and, according to the results and other factors, procedures of increasing complexity will be selecting. Likewise, the treatment of MPEs should be individualized according to factors such as type of tumor, patient functional status, means available, benefits of each procedure, or life expectancy. Currently, treatment seems to tend toward less interventional approaches, in which patients can be managed on an outpatient basis, thus minimizing both the discomfort that more aggressive approaches involve and the costs of care associated with this disease. This article reviews the pleural procedures employed in the management of MPEs with special emphasis on the indication for each one, its usefulness, benefits, and complications. PMID:28197215

  5. Policy and Procedures for Managing Dual Use Research of Concern

    EPA Pesticide Factsheets

    The DURC and iDURC Policies require all federal departments and agencies that conduct life sciences research to implement their provisions. EPA Order 1000.19, Policy and Procedures for Managing Dual Use Research of Concern, implements both policies at EPA.

  6. Self-Management Procedures: A Comparison across the Autism Spectrum

    ERIC Educational Resources Information Center

    Southall, Candice M.; Gast, David L.

    2011-01-01

    Individuals with autism spectrum disorders (ASD) have difficulty generalizing learned behavior to varied environments with independence. This review of 24 empirical studies compares self-management as a systematic procedure for modifying one's own behavior, to increase target behaviors in students with either autistic disorder (AD) or…

  7. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  8. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  9. 45 CFR 1304.51 - Management systems and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Management systems and procedures. 1304.51 Section 1304.51 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES,...

  10. 45 CFR 1304.51 - Management systems and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Management systems and procedures. 1304.51 Section 1304.51 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES,...

  11. 45 CFR 1304.51 - Management systems and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Management systems and procedures. 1304.51 Section 1304.51 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES,...

  12. Self-Management Procedures: A Comparison across the Autism Spectrum

    ERIC Educational Resources Information Center

    Southall, Candice M.; Gast, David L.

    2011-01-01

    Individuals with autism spectrum disorders (ASD) have difficulty generalizing learned behavior to varied environments with independence. This review of 24 empirical studies compares self-management as a systematic procedure for modifying one's own behavior, to increase target behaviors in students with either autistic disorder (AD) or…

  13. School Building Maintenance Procedures. School Plant Management Series.

    ERIC Educational Resources Information Center

    Finchum, R.N.

    One of a series dealing with school management, the publication identifies and describes the function of, and outlines maintenance procedures for many components of school buildings. The purpose of maintenance is to safeguard the public's investment, increase the functional life of the building, and provide the best possible environment for…

  14. Cleft lift procedure for pilonidal disease: technique and perioperative management.

    PubMed

    Favuzza, J; Brand, M; Francescatti, A; Orkin, B

    2015-08-01

    Pilonidal disease is a common condition affecting young patients. It is often disruptive to their lifestyle due to recurrent abscesses or chronic wound drainage. The most common surgical treatment, "cystectomy," removes useful tissue unnecessarily and does not address the etiology of the condition. Herein, we describe the etiology of pilonidal disease and our technique for definitive management of pilonidal disease using the cleft lift procedure. In this paper, we present our method of performing the cleft lift procedure for pilonidal disease including perioperative management and surgical technique. We have used the cleft lift procedure in nearly 200 patients with pilonidal disease, in both primary and salvage procedures settings. It has been equally successful in both settings with a high rate of success. It results in a closed wound with relatively minimal discomfort and straightforward wound care. We have described our current approach to recurrent and complex pilonidal disease using the cleft lift procedure. Once learned, the cleft lift procedure is a straightforward and highly successful solution to a chronic and challenging condition.

  15. Management of oral anticoagulation in patients undergoing minor dental procedures.

    PubMed

    Alaali, Yathreb; Barnes, Geoffrey D; Froehlich, James B; Kaatz, Scott

    2012-08-01

    Approximately 4.2 million patients in the United States are taking warfarin, making it the 11th most prescribed drug. Warfarin is primarily used for treatment of venous thromboembolic disease and stroke prevention in patients with atrial fibrillation and mechanical heart valves. Dentists frequently encounter anticoagulated patients and are faced with management decisions in these patients who require dental procedures. Observational studies suggest the risk of thrombosis if anticoagulation is suspended during dental procedures is higher than the risk of bleeding if anticoagulation is not suspended. Several groups now offer guidelines that recommend most minor dental procedures should be performed while on therapeutic warfarin. The recent approval of several new oral anticoagulants has introduced greater complexity to the management of the anticoagulated patient, and this narrative review will discuss current guidelines, the scientific underpinnings of the guidelines, and offer some practical suggestions for patients that are receiving the new agents.

  16. Complications of Minimally Invasive Cosmetic Procedures: Prevention and Management

    PubMed Central

    Levy, Lauren L; Emer, Jason J

    2012-01-01

    Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care. PMID:23060707

  17. Repository preclosure accident scenarios

    SciTech Connect

    Yook, H.R.; Arbital, J.G.; Keeton, J.M.; Mosier, J.E.; Weaver, B.S.

    1984-09-01

    Waste-handling operations at a spent-fuel repository were investigated to identify operational accidents that could occur. The facility was subdivided, through systems engineering procedures, into individual operations that involve the waste and one specific component of the waste package, in one specific area of the handling facility. From this subdivision approximately 600 potential accidents involving waste package components were identified and then discussed. Supporting descriptive data included for each accident scenario are distance of drop, speed of collision, weight of package component, and weight of equipment involved. The energy of impact associated with each potential accident is calculated to provide a basis for comparison of the relative severities of all the accidents. The results and conclusions suggest approaches to accident consequence mitigation through waste package and facility design. 35 figures, 9 tables.

  18. Ex-vessel melt-coolant interactions in deep water pool: Studies and accident management for Swedish BWRs

    SciTech Connect

    Sienicki, J.J.; Chu, C.C.; Spencer, B.W.; Frid, W.; Loewenhielm, G.

    1993-01-01

    In Swedish BWRs having an annular suppression pool, the lower drywell beneath the reactor vessel is flooded with water to mitigate against the effects of melt release into the drywell during a severe accident. The THIRMAL code has been used to analyze the effectiveness of the water pool to protect lower drywell penetrations by fragmenting and quenching the melt as it relocates downward through the water. Experiments have also been performed to investigate the benefits of adding surfactants to the water to reduce the likelihood of fine-scale debris formation from steam explosions. This paper presents an overview of the accident management approach and surfactant investigations together with results from the THIRMAL analyses.

  19. Environmental risk management for radiological accidents: integrating risk assessment and decision analysis for remediation at different spatial scales.

    PubMed

    Yatsalo, Boris; Sullivan, Terrence; Didenko, Vladimir; Linkov, Igor

    2011-07-01

    The consequences of the Tohuku earthquake and subsequent tsunami in March 2011 caused a loss of power at the Fukushima Daiichi nuclear power plant, in Japan, and led to the release of radioactive materials into the environment. Although the full extent of the contamination is not currently known, the highly complex nature of the environmental contamination (radionuclides in water, soil, and agricultural produce) typical of nuclear accidents requires a detailed geospatial analysis of information with the ability to extrapolate across different scales with applications to risk assessment models and decision making support. This article briefly summarizes the approach used to inform risk-based land management and remediation decision making after the Chernobyl, Soviet Ukraine, accident in 1986. Copyright © 2011 SETAC.

  20. Process for controlling accidents in chemical laboratories

    SciTech Connect

    Delvin, W.L.

    1980-10-01

    Most laboratory safety programs include inspections to identify hazards and thereby control accidents. There are certain elements that must be a part of a successful inspection and control process. These are a systematic and consistent inspection procedure, a reliable evaluation of identified hazards, and effective follow-up actions. Laboratory management, through its responsibility for the total system, has a key role in the inspection and control process for follow-up actions and accepting risks. If any of the above requirements are missing, the process will be less than adequate. Understanding the relationship between accidents, hazards, and risks is important in establishing an effective inspection and control program. Hazards are potential sources of accidents (accidents waiting to happen). Associated with each is a risk, which has two components: probability and consequence. Probability refers to the likelihood that a hazard will turn into an accident and consequence is the result of such an accident. In assessing the seriousness of a hazard, both probability and consequence must be considered in terms of risk level and acceptability. This paper presents a process that can be used by laboratory management to establish an effective inspection and control program for the laboratory. A discussion of safety concepts and their relationships that affect the process is included.

  1. Gadolinium Use in Spine Pain Management Procedures for Patients with Contrast Allergies: Results in 527 Procedures

    SciTech Connect

    Safriel, Yair Ang, Roberto; Ali, Muhammed

    2008-03-15

    Introduction. To review the safety and efficacy of gadolinium in spine pain management procedures in patients at high risk for a contrast reaction and who are not suitable candidates for the use of standard non-ionic contrast. Methods. We reviewed records over a 61-month period of all image-guided spinal pain management procedures where patients had allergies making them unsuitable candidates for standard non-ionic contrast and where gadolinium was used to confirm needle tip placement prior to injection of medication. Results. Three hundred and four outpatients underwent 527 procedures. A spinal needle was used in all but 41 procedures. Gadolinium was visualized using portable C-arm fluoroscopy in vivo allowing for confirmation of needle tip location. The gadolinium dose ranged from 0.2 to 10 ml per level. The highest dose received by one patient was 15.83 ml intradiscally during a three-level discogram. Three hundred and one patients were discharged without complication or known delayed complications. One patient had documented intrathecal injection but without sequelae and 2 patients who underwent cervical procedures experienced seizures requiring admission to the intensive care unit. Both the latter patients were discharged without any further complications. Conclusion. Based on our experience we recommend using gadolinium judiciously for needle tip confirmation. We feel more confident using gadolinium in the lumbar spine and in cervical nerve blocks. Gadolinium should probably not be used as an injectate volume expander. The indications for gadolinium use in cervical needle-guided spine procedures are less clear and use of a blunt-tipped needle should be considered.

  2. Acceptability of Flight Deck-Based Interval Management Crew Procedures

    NASA Technical Reports Server (NTRS)

    Murdock, Jennifer L.; Wilson, Sara R.; Hubbs, Clay E.; Smail, James W.

    2013-01-01

    The Interval Management for Near-term Operations Validation of Acceptability (IM-NOVA) experiment was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC) in support of the NASA Next Generation Air Transportation System (NextGen) Airspace Systems Program's Air Traffic Management Technology Demonstration - 1 (ATD-1). ATD-1 is intended to showcase an integrated set of technologies that provide an efficient arrival solution for managing aircraft using NextGen surveillance, navigation, procedures, and automation for both airborne and ground-based systems. The goal of the IM-NOVA experiment was to assess if procedures outlined by the ATD-1 Concept of Operations, when used with a minimum set of Flight deck-based Interval Management (FIM) equipment and a prototype crew interface, were acceptable to and feasible for use by flight crews in a voice communications environment. To investigate an integrated arrival solution using ground-based air traffic control tools and aircraft automatic dependent surveillance broadcast (ADS-B) tools, the LaRC FIM system and the Traffic Management Advisor with Terminal Metering and Controller Managed Spacing tools developed at the NASA Ames Research Center (ARC) were integrated in LaRC's Air Traffic Operations Laboratory. Data were collected from 10 crews of current, qualified 757/767 pilots asked to fly a high-fidelity, fixed based simulator during scenarios conducted within an airspace environment modeled on the Dallas-Fort Worth (DFW) Terminal Radar Approach Control area. The aircraft simulator was equipped with the Airborne Spacing for Terminal Area Routes algorithm and a FIM crew interface consisting of electronic flight bags and ADS-B guidance displays. Researchers used "pseudo-pilot" stations to control 24 simulated aircraft that provided multiple air traffic flows into DFW, and recently retired DFW air traffic controllers served as confederate Center, Feeder, Final, and Tower

  3. Periosteal Fixation Procedures in the Management of Incomitant Strabismus

    PubMed Central

    Saxena, Rohit; Phuljhele, Swati; Sharma, Pradeep; Pinto, C. N.

    2015-01-01

    Managing a case of incomitant strabismus from nerve palsy or extraocular muscle loss is a major challenge. Among possible management options are globe or extraocular muscle fixation to the orbital wall coupled with weakening or strengthening of the relevant antagonist. Extraocular muscle fixation to the orbital wall can also be used in cases of abnormal synkinesis to eliminate the abnormal eye movements of a misfiring extraocular muscle, which thereby allows the use of standard paralytic strabismus surgery techniques. This review article summarizes indications and techniques of periosteal fixation procedures for incomitant strabismus. PMID:26180470

  4. The Comprehensive Arthroscopic Management Procedure for Treatment of Glenohumeral Osteoarthritis.

    PubMed

    Mook, William R; Petri, Maximilian; Greenspoon, Joshua A; Millett, Peter J

    2015-10-01

    Younger, high-demand patients who are less suitable for joint replacement procedures are often affected by advanced glenohumeral osteoarthritis. There are several alternatives to total joint arthroplasty for the treatment of these patients. However, the outcomes of these procedures are less predictable and have limited durability. The comprehensive arthroscopic management procedure, which includes a combination of arthroscopic glenohumeral debridement, chondroplasty, synovectomy, loose body removal, humeral osteoplasty with excision of the goat's beard osteophyte, capsular releases, subacromial and subcoracoid decompressions, axillary nerve decompression, and biceps tenodesis, has been shown to reduce pain, improve function, and provide a predictable short-term joint-preserving option for patients with advanced glenohumeral osteoarthritis. A unique feature of the comprehensive arthroscopic management procedure is the indirect and direct decompression of the axillary nerve, which may explain the difference in outcomes with this technique compared with other approaches. Furthermore, the technique is technically demanding and associated with several notable pitfalls that are preventable when using the meticulous surgical technique detailed in this article and accompanying video.

  5. Effect of Occupational Health and Safety Management System on Work-Related Accident Rate and Differences of Occupational Health and Safety Management System Awareness between Managers in South Korea's Construction Industry

    PubMed Central

    Yoon, Seok J.; Lin, Hsing K.; Chen, Gang; Yi, Shinjea; Choi, Jeawook; Rui, Zhenhua

    2013-01-01

    Background The study was conducted to investigate the current status of the occupational health and safety management system (OHSMS) in the construction industry and the effect of OHSMS on accident rates. Differences of awareness levels on safety issues among site general managers and occupational health and safety (OHS) managers are identified through surveys. Methods The accident rates for the OHSMS-certified construction companies from 2006 to 2011, when the construction OHSMS became widely available, were analyzed to understand the effect of OHSMS on the work-related injury rates in the construction industry. The Korea Occupational Safety and Health Agency 18001 is the certification to these companies performing OHSMS in South Korea. The questionnaire was created to analyze the differences of OHSMS awareness between site general managers and OHS managers of construction companies. Results The implementation of OHSMS among the top 100 construction companies in South Korea shows that the accident rate decreased by 67% and the fatal accident rate decreased by 10.3% during the period from 2006 to 2011. The survey in this study shows different OHSMS awareness levels between site general managers and OHS managers. The differences were motivation for developing OHSMS, external support needed for implementing OHSMS, problems and effectiveness of implementing OHSMS. Conclusion Both work-related accident and fatal accident rates were found to be significantly reduced by implementing OHSMS in this study. The differences of OHSMS awareness between site general managers and OHS managers were identified through a survey. The effect of these differences on safety and other benefits warrants further research with proper data collection. PMID:24422176

  6. Effect of Occupational Health and Safety Management System on Work-Related Accident Rate and Differences of Occupational Health and Safety Management System Awareness between Managers in South Korea's Construction Industry.

    PubMed

    Yoon, Seok J; Lin, Hsing K; Chen, Gang; Yi, Shinjea; Choi, Jeawook; Rui, Zhenhua

    2013-12-01

    The study was conducted to investigate the current status of the occupational health and safety management system (OHSMS) in the construction industry and the effect of OHSMS on accident rates. Differences of awareness levels on safety issues among site general managers and occupational health and safety (OHS) managers are identified through surveys. The accident rates for the OHSMS-certified construction companies from 2006 to 2011, when the construction OHSMS became widely available, were analyzed to understand the effect of OHSMS on the work-related injury rates in the construction industry. The Korea Occupational Safety and Health Agency 18001 is the certification to these companies performing OHSMS in South Korea. The questionnaire was created to analyze the differences of OHSMS awareness between site general managers and OHS managers of construction companies. The implementation of OHSMS among the top 100 construction companies in South Korea shows that the accident rate decreased by 67% and the fatal accident rate decreased by 10.3% during the period from 2006 to 2011. The survey in this study shows different OHSMS awareness levels between site general managers and OHS managers. The differences were motivation for developing OHSMS, external support needed for implementing OHSMS, problems and effectiveness of implementing OHSMS. Both work-related accident and fatal accident rates were found to be significantly reduced by implementing OHSMS in this study. The differences of OHSMS awareness between site general managers and OHS managers were identified through a survey. The effect of these differences on safety and other benefits warrants further research with proper data collection.

  7. [Integration of hospital social services in the rehabilitation of accident patients by the statutory accident insurance. Results of a one-year model project].

    PubMed

    Lukasczik, M; Geyer, S; Neuderth, S; Gerlich, C; Weis, I; Raiber, I; Weber-Falkensammer, H; Vogel, H

    2008-02-01

    In accident patient care, there is a substantial overlap between the scope of duties of hospital social services and tasks fulfilled by the German statutory accident insurances' visiting staff that regularly takes care of accident patients. Therefore, a project on the integration of hospital social services into the organizational structures of the German statutory accident insurance was initiated which aimed at optimising communication and realising synergy effects. A formative evaluation of the project was conducted that provided process- and outcome-related data for a comprehensive evaluation of the strengths and potentials of the project. Report forms containing patient-related information were completed by hospital social services. Forms were evaluated in terms of their utility for case management by accident insurance administrators using a checklist. Project implementation and procedures were documented and evaluated using semi-structured interviews with social services staff and accident insurance employees. Through the model, a comprehensive care for accident patients could be reached. In one third of all cases reviewed, rehabilitation management could be improved by including hospital social services. Moreover, in one third of all cases, care-related activities initiated by accident insurance funds could be reduced by involving local hospital social services. The report form used by hospital social services was evaluated as a useful tool in the context of patient care and rehabilitation management. The model was evaluated by interview participants as a highly targeted approach in accident patients' care management. Implications of the study for improving health care are discussed.

  8. Advances in pleural disease management including updated procedural coding.

    PubMed

    Haas, Andrew R; Sterman, Daniel H

    2014-08-01

    Over 1.5 million pleural effusions occur in the United States every year as a consequence of a variety of inflammatory, infectious, and malignant conditions. Although rarely fatal in isolation, pleural effusions are often a marker of a serious underlying medical condition and contribute to significant patient morbidity, quality-of-life reduction, and mortality. Pleural effusion management centers on pleural fluid drainage to relieve symptoms and to investigate pleural fluid accumulation etiology. Many recent studies have demonstrated important advances in pleural disease management approaches for a variety of pleural fluid etiologies, including malignant pleural effusion, complicated parapneumonic effusion and empyema, and chest tube size. The last decade has seen greater implementation of real-time imaging assistance for pleural effusion management and increasing use of smaller bore percutaneous chest tubes. This article will briefly review recent pleural effusion management literature and update the latest changes in common procedural terminology billing codes as reflected in the changing landscape of imaging use and percutaneous approaches to pleural disease management.

  9. Management of the sodium hypochlorite accident: a rare but significant complication of root canal treatment

    PubMed Central

    Walsh, Stephen; Wilson, Alan

    2015-01-01

    A 66-year-old female patient presented to the accident and emergency department, 3 h following a dental appointment. Significant right-sided facial swelling, bruising and pain were present. The patient had been sent by her general dental practitioner with a covering letter explaining that a hypochlorite accident had occurred during root canal treatment of the upper right first premolar tooth. An iatrogenic perforation was suspected. The patient was admitted under the care of the maxillofacial team and intravenous antibiotics, analgesia and steroids were administered. The patient was prepared for the possibility of requiring surgical intervention under a general anaesthetic. No nerve injury was encountered and the periorbital tissues were spared. A full recovery was made by the patient with no surgical intervention required but significant bruising and swelling were present up to 4 weeks following the incident. PMID:25809429

  10. Management of the sodium hypochlorite accident: a rare but significant complication of root canal treatment.

    PubMed

    Hatton, Jonathan; Walsh, Stephen; Wilson, Alan

    2015-03-25

    A 66-year-old female patient presented to the accident and emergency department, 3 h following a dental appointment. Significant right-sided facial swelling, bruising and pain were present. The patient had been sent by her general dental practitioner with a covering letter explaining that a hypochlorite accident had occurred during root canal treatment of the upper right first premolar tooth. An iatrogenic perforation was suspected. The patient was admitted under the care of the maxillofacial team and intravenous antibiotics, analgesia and steroids were administered. The patient was prepared for the possibility of requiring surgical intervention under a general anaesthetic. No nerve injury was encountered and the periorbital tissues were spared. A full recovery was made by the patient with no surgical intervention required but significant bruising and swelling were present up to 4 weeks following the incident. 2015 BMJ Publishing Group Ltd.

  11. Prevention and Management Following Complications from Endourology Procedures.

    PubMed

    Cornu, Jean Nicolas; Herrmann, Thomas; Traxer, Olivier; Matlaga, Brian

    2016-04-01

    Endourologic procedures are very common in daily urologic practice for treatment of benign prostatic obstruction, stone disease, urothelial tumors, or stenosis. To characterize the complications following endoscopic procedures, to describe their management, and to gather information about their prevention in current urologic practice. A review of the literature was conducted using PubMed/Medline database to include the most relevant articles on the topic. The search focused on endoscopic approaches for treatment of prostate, bladder, or upper urinary tract disease. Percutaneous approaches and noninvasive extracorporeal techniques were excluded. Complications of endourologic procedures were identified through level 1 evidence, systematic reviews of the literature, or original articles assessing complications as the primary end point. Data about management and prevention of each type of complication were retrieved in a second round using specific keywords. Complications of endoscopic urologic procedures are specific to each surgical approach. Main complications after prostate surgery include transurethral resection of the prostate syndrome, bleeding and transfusion, acute urinary retention, urinary tract infection, clot retention, postoperative irritative symptoms, ejaculatory dysfunction, urinary incontinence, bladder neck contracture, and urethral stricture. Major complications after transurethral bladder tumor include severe bleeding, transfusion, bladder perforation, and urinary tract infection. The most frequent complications after ureteroscopy are fever and sepsis, bleeding, steinstrasse, and ureteral injury. Overall, the literature is very poor, with no systematic reporting of complications and underuse of classification systems. No clear protocols are available for management of complications, and most are based on studies with low levels of evidence. Good clinical practice recommendations and guidelines give useful support about technical issues

  12. 44 CFR 207.7 - Procedures for requesting management cost funding.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... management cost funding. 207.7 Section 207.7 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE MANAGEMENT COSTS § 207.7 Procedures for requesting management cost funding. (a) General. This section describes the procedures to be used by...

  13. 44 CFR 207.7 - Procedures for requesting management cost funding.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... management cost funding. 207.7 Section 207.7 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE MANAGEMENT COSTS § 207.7 Procedures for requesting management cost funding. (a) General. This section describes the procedures to be used by...

  14. 44 CFR 207.7 - Procedures for requesting management cost funding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... management cost funding. 207.7 Section 207.7 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE MANAGEMENT COSTS § 207.7 Procedures for requesting management cost funding. (a) General. This section describes the procedures to be used by...

  15. 44 CFR 207.7 - Procedures for requesting management cost funding.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... management cost funding. 207.7 Section 207.7 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE MANAGEMENT COSTS § 207.7 Procedures for requesting management cost funding. (a) General. This section describes the procedures to be used by...

  16. 44 CFR 207.7 - Procedures for requesting management cost funding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... management cost funding. 207.7 Section 207.7 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE MANAGEMENT COSTS § 207.7 Procedures for requesting management cost funding. (a) General. This section describes the procedures to be used by...

  17. Use of an influence diagram and fuzzy probability for evaluating accident management in a boiling water reactor

    SciTech Connect

    Yu, D.; Kastenberg, W.E.; Okrent, D. . Mechanical, Aerospace, and Nuclear Engineering Dept.)

    1994-06-01

    A new approach is presented for evaluating the uncertainties inherent in severe accident management strategies. At first, this analysis considers accident management as a decision problem (i.e., applying a strategy compared with do nothing) and uses an influence diagram. To evaluate imprecise node probabilities in the influence diagram, the analysis introduces the concept of a fuzzy probability. When fuzzy logic is applied, fuzzy probabilities are easily propagated to obtain results. In addition, the results obtained provide not only information similar to the classical approach, which uses point-estimate values, but also additional information regarding the impact of using imprecise input data. As an illustrative example, the proposed methodology is applied to the evaluation of the drywell flooding strategy for a long-term station blackout sequence at the Peach Bottom nuclear power plant. The results show that the drywell flooding strategy is beneficial for preventing reactor vessel breach. It is also effective for reducing the probability of containment failure for both liner melt-through and late overpressurization. Even though uncertainty exists in the results, flooding is preferred to do nothing when evaluated in terms of two risk measures: early and late fatalities.

  18. Physician reimbursement perception for outpatient procedures and procedures among managed care patients with diabetes

    PubMed Central

    Kim, Catherine; Tierney, Edward F.; Herman, William H.; Mangione, Carol M.; Venkat Narayan, K.M.; Gerzoff, Robert B.; Bilik, Dori; Ettner, Susan L.

    2013-01-01

    OBJECTIVE To examine the association between physicians’ reimbursement perceptions and outpatient test performance. Previous studies have documented an association between reimbursement perceptions and electrocardiogram performance, but not for other common outpatient procedures. STUDY DESIGN Cross-sectional analysis. METHODS Participants were physicians (n = 766) and their managed care patients with diabetes mellitus (n = 2758) enrolled in 6 plans in 2003. Procedures measured included electrocardiograms, radiographs or x-rays, urine microalbumin measures, hemoglobin A1cs, and Pap smears for women. Hierarchical logistic regression models were adjusted for health plan and physician level clustering and for physician and patient covariates. To minimize confounding by unmeasured health plan variables, we adjusted for plan as a fixed effect. Thus, we estimated variation between physicians using only the variance within health plans. RESULTS Patients of physicians who reported reimbursement for electrocardiograms were more likely to receive electrocardiograms than patients of physicians who did not perceive reimbursement (unadjusted mean difference 4.9% (95% confidence interval, 1.1% to 8.9%)) and adjusted mean difference 3.9% (95% confidence interval, 0.21% to 7.8%)). For the other tests examined, no significant differences in procedure performance were found between patients of physicians who perceived reimbursement and patients of physicians who did not perceive reimbursement. CONCLUSIONS Our findings suggest that reimbursement perception was associated with electrocardiograms, but not with other commonly performed outpatient procedures. Future research should investigate how associations change with perceived amount of reimbursement and interactions with other influences upon test-ordering behavior such as perceived appropriateness. PMID:19146362

  19. Radiation accidents

    SciTech Connect

    Saenger, E.L.

    1986-09-01

    It is essential that emergency physicians understand ways to manage patients contaminated by radioactive materials and/or exposed to external radiation sources. Contamination accidents require careful surveys to identify the metabolic pathway of the radionuclides to guide prognosis and treatment. The level of treatment required will depend on careful surveys and meticulous decontamination. There is no specific therapy for the acute radiation syndrome. Prophylactic antibodies are desirable. For severely exposed patients treatment is similar to the supportive care given to patients undergoing organ transplantation. For high-dose extremity injury, no methods have been developed to reverse the fibrosing endarteritis that eventually leads to tissue death so frequently found with this type of injury. Although the Three Mile Island episode of March 1979 created tremendous public concern, there were no radiation injuries. The contamination outside the reactor building and the release of radioiodine were negligible. The accidental fuel element meltdown at Chernobyl, USSR, resulted in many cases of acute radiation syndrome. More than 100,000 people were exposed to high levels of radioactive fallout. The general principles outlined here are applicable to accidents of that degree of severity.

  20. Accident liability.

    PubMed Central

    Kuné, J B

    1985-01-01

    The idea of accident proneness, which originated in the early 1900s, has proved to be ineffectual as an operational concept. Discrete econometric methods may be useful to find out which factors are at work in the process that leads to accidents and whether there are individuals who are more liable to accidents than others. PMID:3986144

  1. 41 CFR 101-39.407 - Accident records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Accident records. 101-39...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.407 Accident records. If GSA's records of vehicle accidents indicate that a particular activity has had an unusually high accident...

  2. 41 CFR 101-39.407 - Accident records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Accident records. 101-39...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.407 Accident records. If GSA's records of vehicle accidents indicate that a particular activity has had an unusually high accident...

  3. 41 CFR 101-39.407 - Accident records.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Accident records. 101-39...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.407 Accident records. If GSA's records of vehicle accidents indicate that a particular activity has had an unusually high accident...

  4. 41 CFR 101-39.407 - Accident records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Accident records. 101-39...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.407 Accident records. If GSA's records of vehicle accidents indicate that a particular activity has had an unusually high accident...

  5. 41 CFR 101-39.407 - Accident records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Accident records. 101-39...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.407 Accident records. If GSA's records of vehicle accidents indicate that a particular activity has had an unusually high accident...

  6. Endoscopic management of erosion after banded bariatric procedures.

    PubMed

    Spann, Matthew D; Aher, Chetan V; English, Wayne J; Williams, D Brandon

    2017-07-24

    Prosthetic materials wrapped around a portion of the stomach have been used to provide gastric restriction in bariatric surgery for many years. Intraluminal erosion of adjustable and nonadjustable gastric bands typically occurs many years after placement and results in various symptoms. Endoscopic management of gastric band erosion has been described and allows for optimal patient outcomes. We will describe our methods and experience with endoscopic management of intraluminal gastric band erosions after bariatric procedures. University hospital in the United States. A retrospective review of our bariatric surgery database identified patients undergoing removal of gastric bands. A chart review was then undertaken to confirm erosion of prosthetic material into the gastrointestinal tract. Baseline characteristics, operative reports, and follow-up data were analyzed. Sixteen patients were identified with an eroded gastric band: 11 after banded gastric bypass, 3 after laparoscopic adjustable gastric band (LAGB), and 2 after vertical banded gastroplasty. All patients were successfully treated with endoscopic removal of the prosthetic materials using either endoscopic scissors or ligation of the banding material with off-label use of a mechanical lithotripter device. Complications included a postoperative gastrointestinal bleed requiring repeat endoscopy, 1 patient with asymptomatic pneumoperitoneum requiring observation, and 1 with seroma at the site of LAGB port removal. Endoscopic management of intraluminal prosthetic erosion after gastric banded bariatric procedures can be safe and effective and should be considered when treating this complication. Erosion of the prosthetic materials inside the gastric lumen allows for potential endoscopic removal without free intraabdominal perforation. Endoscopic devices designed for dividing eroded LAGBs may help standardize and increase utilization of this approach. Copyright © 2017 American Society for Bariatric Surgery

  7. A computerized maintenance management system's requirements for standard operating procedures.

    PubMed

    Barta, R A

    2001-01-01

    From this review of the 6 aspects of opportunity for inconsistency to corrupt or skew the reliability of data, it becomes apparent why members of management must provide the standards of operation and use within the CMMS for their employees. The possibility of poor data integrity due to any one of these aspects may not be severe; however, the severity is compounded and inevitable when different aspects are combined. Responding to information collected through the CMMS can be effective only if the data are reliable. With SOPs, management has provided their personnel with the necessary tools to ensure department-wide consistency. Management cannot afford to allow any one [table: see text] individual to apply personal interpretations of the importance and requirements in their approach to using the CMMS. If this is permitted, the loss of integrity due to one individual's judgment grows rapidly when data are analyzed at the departmental level. Standard operating procedures go beyond creating a "how to" for the CMMS; they provide the critical elements for collecting responsible and reliable data.

  8. Learning from Accident Analysis: The Dynamics Leading Up to a Rafting Accident.

    ERIC Educational Resources Information Center

    Hovelynck, Johan

    1998-01-01

    Analysis of a case study of a whitewater rafting accident reveals that such accidents tend to result from multiple actions. Many events leading up to such accidents include procedural and process factors, suggesting that hard-skills technical training is an insufficient approach to accident prevention. Contains 26 references. (SAS)

  9. Learning from Accident Analysis: The Dynamics Leading Up to a Rafting Accident.

    ERIC Educational Resources Information Center

    Hovelynck, Johan

    1998-01-01

    Analysis of a case study of a whitewater rafting accident reveals that such accidents tend to result from multiple actions. Many events leading up to such accidents include procedural and process factors, suggesting that hard-skills technical training is an insufficient approach to accident prevention. Contains 26 references. (SAS)

  10. Managing the identification of the mortal victims run over by a train in the Castelldefels railway accident (Barcelona).

    PubMed

    Barbería, Eneko; Martin-Fumadó, Carles; Galtés, Ignasi; Subirana-Domenech, Mercé; Puigbarraca-Sol, Lourdes; Vidal-Gutiérrez, Claudina; Valverde-Villarreal, Juan Luis; Castellà-García, Josep; Medallo-Muñiz, Jordi

    2015-09-01

    The identification of disaster victims is the formal, organized process of identifying multiple bodies after an incident with multiple victims. The appropriate management of these incidents, particularly of the bodies, is one of the most crucial aspects of disaster response and its importance has led to the evolution of the concept of Disaster Victim Management. The aim of this study is to report how the process of identifying the 12 mortal victims of a railway accident in June 2010 in Castelldefels (Barcelona) was managed. The methodology used complied with the National Protocol for medical forensic and scientific police response to mass casualty incidents. The family assistance center also served as an ante mortem (AM) office. Despite the fragmentation of the bodies, all the victims were identified satisfactorily. The main problems observed during the management of the disaster were due to the state of the bodies, which raised many doubts as to the number of fatalities. The experience prompted a proposal to establish some recommendations on limiting the number of fragments to be analyzed genetically. We would like to stress the importance of setting up a Data Integration Center which brought together all the participating institutions, and collected and supervised all the different identification reports in a single comprehensive text addressed to the competent legal authority.

  11. Agricultural land management options after the Chernobyl and Fukushima accidents: The articulation of science, technology, and society.

    PubMed

    Vandenhove, Hildegarde; Turcanu, Catrinel

    2016-10-01

    The options adopted for recovery of agricultural land after the Chernobyl and Fukushima accidents are compared by examining their technical and socio-economic aspects. The analysis highlights commonalities such as the implementation of tillage and other types of countermeasures and differences in approach, such as preferences for topsoil removal in Fukushima and the application of K fertilizers in Chernobyl. This analysis shows that the recovery approach needs to be context-specific to best suit the physical, social, and political environment. The complex nature of the decision problem calls for a formal process for engaging stakeholders and the development of adequate decision support tools. Integr Environ Assess Manag 2016;12:662-666. © 2016 SETAC.

  12. In-vessel melt retention as a severe accident management strategy for the Loviisa Nuclear Power Plant

    SciTech Connect

    Kymaelaeinen, O.; Tuomisto, H.; Theofanous, T.G.

    1997-02-01

    The concept of lower head coolability and in-vessel retention of corium has been approved as a basic element of the severe accident management strategy for IVO`s Loviisa Plant (VVER-440) in Finland. The selected approach takes advantage of the unique features of the plant such as low power density, reactor pressure vessel without penetrations at the bottom and ice-condenser containment which ensures flooded cavity in all risk significant sequences. The thermal analyses, which are supported by experimental program, demonstrate that in Loviisa the molten corium on the lower head of the reactor vessel is coolable externally with wide margins. This paper summarizes the approach and the plant modifications being implemented. During the approval process some technical concerns were raised, particularly with regard to thermal loadings caused by contact of cool cavity water and hot corium with the reactor vessel. Resolution of these concerns is also discussed.

  13. Laryngeal Fracture after Blunt Cervical Trauma in Motorcycle Accident and Its Management

    PubMed Central

    Carneiro Sousa, Pedro; Abreu Pereira, Diogo; Azevedo, Paula; Duarte, Delfim

    2017-01-01

    Laryngeal fracture is a rare traumatic injury, potentially fatal, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centers. Because of the rarity of this injury, physician may be not aware of its existence, leading to a late diagnosis of this entity. We report a case of a 59-year-old woman admitted to the emergency room after a motorcycle accident with cervical trauma. The patient presented with dysphonia, hemoptysis, cervical subcutaneous emphysema, and increasing respiratory distress that led to the intubation of the patient. CT-scan demonstrated displaced fracture of the cricoid and thyroid cartilage. The patient was submitted to tracheostomy and the fracture was surgically repaired. Tracheostomy was removed in third postoperative month. The patient presented a good recovery, reporting only hoarseness but without swallowing or breathing problems at 6-month follow-up. PMID:28261512

  14. Laryngeal Fracture after Blunt Cervical Trauma in Motorcycle Accident and Its Management.

    PubMed

    Ribeiro-Costa, Nuno; Carneiro Sousa, Pedro; Abreu Pereira, Diogo; Azevedo, Paula; Duarte, Delfim

    2017-01-01

    Laryngeal fracture is a rare traumatic injury, potentially fatal, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centers. Because of the rarity of this injury, physician may be not aware of its existence, leading to a late diagnosis of this entity. We report a case of a 59-year-old woman admitted to the emergency room after a motorcycle accident with cervical trauma. The patient presented with dysphonia, hemoptysis, cervical subcutaneous emphysema, and increasing respiratory distress that led to the intubation of the patient. CT-scan demonstrated displaced fracture of the cricoid and thyroid cartilage. The patient was submitted to tracheostomy and the fracture was surgically repaired. Tracheostomy was removed in third postoperative month. The patient presented a good recovery, reporting only hoarseness but without swallowing or breathing problems at 6-month follow-up.

  15. Analysis of accident sequences and source terms at treatment and storage facilities for waste generated by US Department of Energy waste management operations

    SciTech Connect

    Mueller, C.; Nabelssi, B.; Roglans-Ribas, J.; Folga, S.; Policastro, A.; Freeman, W.; Jackson, R.; Mishima, J.; Turner, S.

    1996-12-01

    This report documents the methodology, computational framework, and results of facility accident analyses performed for the US Department of Energy (DOE) Waste Management Programmatic Environmental Impact Statement (WM PEIS). The accident sequences potentially important to human health risk are specified, their frequencies assessed, and the resultant radiological and chemical source terms evaluated. A personal-computer-based computational framework and database have been developed that provide these results as input to the WM PEIS for the calculation of human health risk impacts. The WM PEIS addresses management of five waste streams in the DOE complex: low-level waste (LLW), hazardous waste (HW), high-level waste (HLW), low-level mixed waste (LLMW), and transuranic waste (TRUW). Currently projected waste generation rates, storage inventories, and treatment process throughputs have been calculated for each of the waste streams. This report summarizes the accident analyses and aggregates the key results for each of the waste streams. Source terms are estimated, and results are presented for each of the major DOE sites and facilities by WM PEIS alternative for each waste stream. Key assumptions in the development of the source terms are identified. The appendices identify the potential atmospheric release of each toxic chemical or radionuclide for each accident scenario studied. They also discuss specific accident analysis data and guidance used or consulted in this report.

  16. Australian and New Zealand Perfusion Survey: Management and Procedure

    PubMed Central

    Tuble, Sigrid C.; Willcox, Timothy W.; Baker, Robert A.

    2009-01-01

    Abstract: In this report, we will discuss management and procedural aspects of perfusion practice. This report allows us to compare and contrast recent trends and changes in perfusion with historic practices. A survey comprised of 233 single-answer and 12 open-ended questions was sent by e-mail to senior perfusionists or individuals in charge of perfusion in 40 hospital groups. The survey encompasses a review of the perfusion practices for the calendar year of 2003, and respondents were required to answer the survey based on the predominant practice in their institutions. Standard management of routine adult cardiopulmonary bypass (CPB) in 2003 consisted of perfusion strategies that achieved a target temperature of 32.0°C (range, 28.0–35.0°C), a flow index of 2.4 L/min/m2 (range, 1.6–3.0 L/min/m2) during normothermia and 1.8 L/min/m2 (range, 1.2–3.0 L/min/m2) during hypothermia, and a pressure during CPB between 50 (range, 30–65 mmHg) and 70 mmHg (range, 60–95 mmHg). Myocardial protection with blood cardioplegia was used in 77% of the 20,688 CPB cases, whereas in 53% cases, cardiotomy blood was never processed. Pre-operatively, 76% of perfusion groups assessed their patients (21% directly with the patient), and 85% responded that perfusionists performed or participated in a formal pre-bypass checklist. The majority of the perfusion groups used a handwritten perfusion record (62%), 12% used an electronic perfusion record, and 26% used both, whereas more than one half of the groups were involved in quality assurance (79%), incident reporting (74%), audits (62%), research (53%), participating in interdisciplinary meetings (53%), and morbidity and mortality meetings (65%). Only 26% conducted formal perfusion team meetings. This report outlines the status of clinical management and procedural performance for perfusion practices in Australia and New Zealand in 2003. Awareness of these trends will allow perfusionists to assess both individual practices and

  17. Anesthetic management of neurosurgical procedures during pregnancy: a case series.

    PubMed

    Kazemi, Pooya; Villar, Giselle; Flexman, Alana M

    2014-07-01

    Neurosurgical disorders are rare during pregnancy and challenge the anesthesiologist with conflicting anesthetic considerations and little evidence to guide decision-making. Our objective was to review the anesthetic management of pregnant patients undergoing intracranial neurosurgery at our institution and to describe the perioperative complications and outcomes. We used our institutional Discharge Abstract Database to identify patients assigned both neurological and obstetrical International Classification of Disease 10-A codes between April 1, 2001 and March 1, 2012. Pregnant patients who underwent intracranial neurosurgical procedures underwent a detailed chart review to extract demographic data and details about their anesthetic management and outcome. Nine patients underwent full chart review with a median age of 28 (range, 17 to 35) years and a gestational age of 23 (range, 7 to 30) weeks. Patients underwent a craniotomy for vascular lesions (4), neoplasms (3), and traumatic brain injuries (2). One patient was hyperventilated (PaCO2 28 mmHg), and mannitol and furosemide were used in 6 and 3 patients, respectively, without complication. Maternal neurological outcomes were good in 5 patients (Glasgow Outcome Scale of >3), poor in 3 patients (Glasgow Outcome Scale 3), and 1 patient died. Fetal outcomes were good in 5 patients and poor in 4 patients (1 therapeutic abortion, 3 intrauterine fetal demises). All cases of fetal distress or demise were either remote or occurred before the anesthetic management. Pregnant patients undergoing neurosurgery experience a high rate of morbidity and mortality. There were no adverse outcomes directly attributed to the use of osmotic diuretics and hyperventilation in our series.

  18. Analysis of accidents with organic material in health workers.

    PubMed

    Vieira, Mariana; Padilha, Maria Itayra; Pinheiro, Regina Dal Castel

    2011-01-01

    This retrospective and descriptive study with a quantitative design aimed to evaluate occupational accidents with exposure to biological material, as well as the profile of workers, based on reporting forms sent to the Regional Reference Center of Occupational Health in Florianópolis/SC. Data collection was carried out through a survey of 118 reporting forms in 2007. Data were analyzed electronically. The occurrence of accidents was predominantly among nursing technicians, women and the mean age was 34.5 years. 73% of accidents involved percutaneous exposure, 78% had blood and fluid with blood, 44.91% resulted from invasive procedures. It was concluded that strategies to prevent the occurrence of accidents with biological material should include joint activities between workers and service management and should be directed at improving work conditions and organization.

  19. Safe procedure development to manage hazardous drugs in the workplace.

    PubMed

    Gaspar Carreño, Marisa; Achau Muñoz, Rubén; Torrico Martín, Fátima; Agún Gonzalez, Juan José; Sanchez Santos, Jose Cristobal; Cercos Lletí, Ana Cristina; Ramos Orozco, Pedro

    2017-03-01

    To develop a safety working procedure for the employees in the Intermutual Hospital de Levante (HIL) in those areas of activity that deal with the handling of hazardous drugs (MP). The procedure was developed in six phases: 1) hazard definition; 2) definition and identification of processes and development of general correct work practices about hazardous drugs' selection and special handling; 3) detection, selection and set of specific recommendations to handle with hazardous drugs during the processes of preparation and administration included in the hospital GFT; 4) categorization of risk during the preparation/administration and development of an identification system; 5) information and training of professionals; 6) implementation of the identification measures and prevention guidelines. Six processes were detected handling HD. During those processes, thirty HD were identified included in the hospital GFT and a safer alternative was found for 6 of them. The HD were classified into 4 risk categories based on those measures to be taken during the preparation and administration of each of them. The development and implementation of specific safety-work processes dealing with medication handling, allows hospital managers to accomplish effectively with their legal obligations about the area of prevention and provides healthcare professional staff with the adequate techniques and safety equipment to avoid possible dangers and risks of some drugs. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Proceedings of the US Nuclear Regulatory Commission fifteenth water reactor safety information meeting: Volume 6, Decontamination and decommissioning, accident management, TMI-2

    SciTech Connect

    Weiss, A. J.

    1988-02-01

    This six-volume report contains 140 papers out of the 164 that were presented at the Fifteenth Water Reactor Safety Information Meeting held at the National Bureau of Standards, Gaithersburg, Maryland, during the week of October 26-29, 1987. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. This report, Volume 6, discusses decontamination and decommissioning, accident management, and the Three Mile Island-2 reactor accident. Thirteen reports have been cataloged separately.

  1. Human factors review for Severe Accident Sequence Analysis (SASA)

    SciTech Connect

    Krois, P.A.; Haas, P.M.; Manning, J.J.; Bovell, C.R.

    1984-01-01

    The paper will discuss work being conducted during this human factors review including: (1) support of the Severe Accident Sequence Analysis (SASA) Program based on an assessment of operator actions, and (2) development of a descriptive model of operator severe accident management. Research by SASA analysts on the Browns Ferry Unit One (BF1) anticipated transient without scram (ATWS) was supported through a concurrent assessment of operator performance to demonstrate contributions to SASA analyses from human factors data and methods. A descriptive model was developed called the Function Oriented Accident Management (FOAM) model, which serves as a structure for bridging human factors, operations, and engineering expertise and which is useful for identifying needs/deficiencies in the area of accident management. The assessment of human factors issues related to ATWS required extensive coordination with SASA analysts. The analysis was consolidated primarily to six operator actions identified in the Emergency Procedure Guidelines (EPGs) as being the most critical to the accident sequence. These actions were assessed through simulator exercises, qualitative reviews, and quantitative human reliability analyses. The FOAM descriptive model assumes as a starting point that multiple operator/system failures exceed the scope of procedures and necessitates a knowledge-based emergency response by the operators. The FOAM model provides a functionally-oriented structure for assembling human factors, operations, and engineering data and expertise into operator guidance for unconventional emergency responses to mitigate severe accident progression and avoid/minimize core degradation. Operators must also respond to potential radiological release beyond plant protective barriers. Research needs in accident management and potential uses of the FOAM model are described. 11 references, 1 figure.

  2. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Interest-rate-risk-management procedures. 563.176 Section 563.176 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures. Savings associations shall take the...

  3. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 6 2013-01-01 2012-01-01 true Interest-rate-risk-management procedures. 563.176 Section 563.176 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures. Savings associations shall take the...

  4. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 6 2014-01-01 2012-01-01 true Interest-rate-risk-management procedures. 563.176 Section 563.176 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures. Savings associations shall take the...

  5. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Interest-rate-risk-management procedures. 563.176 Section 563.176 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures. Savings associations shall take the...

  6. 12 CFR 163.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 1 2013-01-01 2013-01-01 false Interest-rate-risk-management procedures. 163.176 Section 163.176 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 163.176 Interest-rate-risk-management procedures. Federal savings associations shall take th...

  7. 12 CFR 563.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 6 2012-01-01 2012-01-01 false Interest-rate-risk-management procedures. 563.176 Section 563.176 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 563.176 Interest-rate-risk-management procedures. Savings associations shall take the...

  8. 12 CFR 163.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 1 2014-01-01 2014-01-01 false Interest-rate-risk-management procedures. 163.176 Section 163.176 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 163.176 Interest-rate-risk-management procedures. Federal savings associations shall take th...

  9. 12 CFR 163.176 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Interest-rate-risk-management procedures. 163.176 Section 163.176 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SAVINGS ASSOCIATIONS-OPERATIONS Financial Management Policies § 163.176 Interest-rate-risk-management procedures. Federal savings associations shall take th...

  10. 75 FR 50713 - Procedural Changes to the Fire Management Assistance Declaration Process

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-17

    ... SECURITY Federal Emergency Management Agency 44 CFR Part 204 RIN-1660-AA72 Procedural Changes to the Fire... rule. SUMMARY: By this final rule, the Federal Emergency Management Agency (FEMA) is updating its Fire... for fire management assistance declarations, and resulting internal procedural changes that...

  11. 75 FR 6818 - Revision to the Manual of Regulations and Procedures for Federal Radio Frequency Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-11

    ... Manual of Regulations and Procedures for Federal Radio Frequency Management AGENCY: National... Radio Frequency Management (NTIA Manual). Specifically, the NTIA updates the version of the Manual of Regulations and Procedures for Federal Radio Frequency Management with which Federal agencies must comply when...

  12. 76 FR 18652 - Revision to the Manual of Regulations and Procedures for Federal Radio Frequency Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-05

    ... Manual of Regulations and Procedures for Federal Radio Frequency Management AGENCY: National... Radio Frequency Management (NTIA Manual). Specifically, NTIA updates the version of the Manual of Regulations and Procedures for Federal Radio Frequency Management with which federal agencies must comply when...

  13. 75 FR 54790 - Revision to the Manual of Regulations and Procedures for Federal Radio Frequency Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... Manual of Regulations and Procedures for Federal Radio Frequency Management AGENCY: National... Radio Frequency Management (NTIA Manual). Specifically, NTIA updates the version of the Manual of Regulations and Procedures for Federal Radio Frequency Management with which federal agencies must comply when...

  14. 76 FR 56984 - Revision to the Manual of Regulations and Procedures for Federal Radio Frequency Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ... Manual of Regulations and Procedures for Federal Radio Frequency Management AGENCY: National... Radio Frequency Management (NTIA Manual). Specifically, NTIA updates the version of the Manual of Regulations and Procedures for Federal Radio Frequency Management with which federal agencies must comply when...

  15. A Cost Management Control Procedure for Initial Training in Surface Ship Acquisition Programs. Final Report.

    ERIC Educational Resources Information Center

    Nutter, Roger V.; And Others

    A study was conducted to develop a cost management control procedure to assist Navy managers in making decisions about initial training development and implementation in surface ship acquisition programs. Objectives were (1) develop and illustrate a cost management control procedure for centralized collection, storage, and control of cost data for…

  16. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2)....

  17. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2)....

  18. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Conferring on procedures for the exercise... Conferring on procedures for the exercise of management rights. (a) As provided by § 9701.511(c), management... this section will delay the exercise of a management right under § 9701.511(a)(1) and (2)....

  19. Tools for improving safety management in the Norwegian Fishing Fleet occupational accidents analysis period of 1998-2006.

    PubMed

    Aasjord, Halvard L

    2006-01-01

    Reporting of human accidents in the Norwegian Fishing Fleet has always been very difficult because there has been no tradition in making reports on all types of working accidents among fishermen, if the accident does not seem to be very serious or there is no economical incentive to report. Therefore reports are only written when the accidents are serious or if the fisherman is reported sick. Reports about an accident are sent to the insurance company, but another report should also be sent to the Norwegian Maritime Directorate (NMD). Comparing of data from one former insurance company and NMD shows that the real numbers of injuries or serious accidents among Norwegian fishermen could be up to two times more than the numbers reported to NMD. Special analyses of 1690 accidents from the so called PUS-database (NMD) for the period 1998-2002, show that the calculated risk was 23.6 accidents per 1000 man-years. This is quite a high risk level, and most of the accidents in the fishing fleet were rather serious. The calculated risks are highest for fishermen on board the deep sea fleet of trawlers (28.6 accidents per 1000 man-years) and also on the deep sea fleet of purse seiners (28.9 accidents per 1000 man-years). Fatal accidents over a longer period of 51.5 years from 1955 to 2006 are also roughly analysed. These data from SINTEF's own database show that the numbers of fatal accidents have been decreasing over this long period, except for the two periods 1980-84 and 1990-94 where we had some casualties with total losses of larger vessels with the loss of most of the crew, but also many others typical work accidents on smaller vessels. The total numbers of registered Norwegian fishermen and also the numbers of man-years have been drastically reduced over the 51.5 years from 1955 to 2006. The risks of fatal accidents have been very steady over time at a high level, although there has been a marked risk reduction since 1990-94. For the last 8.5-year period of January 1998

  20. A risk management procedure for the Washington state ferries.

    PubMed

    van Dorp, J R; Merrick, J R; Harrald, J R; Mazzuchi, T A; Grabowski, M

    2001-02-01

    The state of Washington operates the largest passenger vessel ferry system in the United States. In part due to the introduction of high-speed ferries, the state of Washington established an independent blue-ribbon panel to assess the adequacy of requirements for passenger and crew safety aboard the Washington state ferries. On July 9, 1998, the Blue Ribbon Panel on Washington State Ferry Safety engaged a consultant team from The George Washington University and Rensselaer Polytechnic Institute/Le Moyne College to assess the adequacy of passenger and crew safety in the Washington state ferry (WSF) system, to evaluate the level of risk present in the WSF system, and to develop recommendations for prioritized risk reduction measures, which, once implemented, can improve the level of safety in the WSF system. The probability of ferry collisions in the WSF system was assessed using a dynamic simulation methodology that extends the scope of available data with expert judgment. The potential consequences of collisions were modeled in order to determine the requirements for onboard and external emergency response procedures and equipment. The methodology was used to evaluate potential risk reduction measures and to make detailed risk management recommendations to the blue-ribbon panel and the Washington State Transportation Commission.

  1. Angiographic management of the left hepatic artery disruption following motor vehicle accident.

    PubMed

    Dullet, Navjit; Marshall, Dustyn

    2017-09-01

    Trauma is a leading cause of death in younger individuals. Blunt abdominal trauma has the potential to mask severe injuries-there can be serious organ or vascular injury underneath intact skin. Increasingly, there is a trend toward nonoperative management of blunt abdominal trauma. We report the case of a left hepatic artery transection managed in the interventional radiology suite.

  2. Savannah River Site`s procedure management steering committee: A voice in the crowd

    SciTech Connect

    Schmidt, K.; Powe, K.; Grider, L.

    1994-12-31

    When Westinghouse Electric Corporation`s subsidiary, Westinghouse Savannah River Company, assumed operation of the Savannah River site (SRS) from the DuPont Corporation in April of 1989, it made a commitment to operate facilities and equipment according to explicit procedures. To enact this philosophy, a procedure management control system was needed. Daniel Plung and his management standards department (MSD) developed and implemented such a program, entitled the Integrated Procedure Management System (IPMS). The MSD reviewed the site`s many different practices on handling procedures and examined hundreds of procedures themselves. From that knowledge, the MSD was able to identify and seek out subject matter experts from the major contributors and producers of procedures throughout the SRS. These people formed the basis of the Procedures Management Steering Committee (PMSC), the committee that would help define policy related to the IPMS.

  3. US EPA Base Study Standard Operating Procedure for Data Processing and Data Management

    EPA Pesticide Factsheets

    The purpose of the Standard Operating Procedures (SOP) for data management and data processing is to facilitate consistent documentation and completion of data processing duties and management responsibilities in order to maintain a high standard of data quality.

  4. 78 FR 73756 - Process Safety Management and Prevention of Major Chemical Accidents

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-09

    ... information: Ms. Lisa Long, Director, Office of Engineering Safety, OSHA Directorate of Standards and Guidance... generally accepted good engineering practices (RAGAGEP); 8. Clarifying the PSM Standard by Adding a... safety management principles or good engineering practice had been followed more effectively at the...

  5. Tree failures and accidents in recreation areas: a guide to data management for hazard control

    Treesearch

    Lee A. Paine; James W. Clarke

    1978-01-01

    A data management system has been developed for storage and retrieval of tree failure and hazard data, with provision for computer analyses and presentation of results in useful tables. This system emphasizes important relationships between tree characteristics, environmental factors, and the resulting hazard. The analysis programs permit easy selection of subsets of...

  6. Epidemiology and management of painful procedures in children in Canadian hospitals

    PubMed Central

    Stevens, Bonnie J.; Abbott, Laura K.; Yamada, Janet; Harrison, Denise; Stinson, Jennifer; Taddio, Anna; Barwick, Melanie; Latimer, Margot; Scott, Shannon D.; Rashotte, Judith; Campbell, Fiona; Finley, G. Allen

    2011-01-01

    Background Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. Methods We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ2) analyses. Results Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. Interpretation For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of

  7. Policy, Procedures and Standards for Enterprise Information Management

    EPA Pesticide Factsheets

    This policy establishes a standard approach for managing information produced by, funded by, or received per regulated reporting and/or federal-wide requirements and subsequently held or cataloged in information management systems by EPA.

  8. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Natural history resource management procedures. 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands (Continued... Recreation Programs § 9268.2 Natural history resource management procedures....

  9. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Natural history resource management procedures. 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands (Continued... Recreation Programs § 9268.2 Natural history resource management procedures....

  10. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Natural history resource management procedures. 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands (Continued... Recreation Programs § 9268.2 Natural history resource management procedures....

  11. 43 CFR 9268.2 - Natural history resource management procedures. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Natural history resource management procedures. 9268.2 Section 9268.2 Public Lands: Interior Regulations Relating to Public Lands (Continued... Recreation Programs § 9268.2 Natural history resource management procedures....

  12. 41 CFR 101-39.401 - Reporting of accidents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Reporting of accidents...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.401 Reporting of accidents. (a) The..., by telephone, or by facsimile machine of any accident in which the vehicle may be involved: (1)...

  13. 41 CFR 101-39.401 - Reporting of accidents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Reporting of accidents...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.401 Reporting of accidents. (a) The..., by telephone, or by facsimile machine of any accident in which the vehicle may be involved: (1)...

  14. 41 CFR 101-39.401 - Reporting of accidents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Reporting of accidents...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.401 Reporting of accidents. (a) The..., by telephone, or by facsimile machine of any accident in which the vehicle may be involved: (1)...

  15. 41 CFR 101-39.401 - Reporting of accidents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Reporting of accidents...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.401 Reporting of accidents. (a) The..., by telephone, or by facsimile machine of any accident in which the vehicle may be involved: (1)...

  16. 41 CFR 101-39.401 - Reporting of accidents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Reporting of accidents...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.401 Reporting of accidents. (a) The..., by telephone, or by facsimile machine of any accident in which the vehicle may be involved: (1)...

  17. Nuclear accidents

    SciTech Connect

    Mobley, J.A.

    1982-05-01

    A nuclear accident with radioactive contamination can happen anywhere in the world. Because expert nuclear emergency teams may take several hours to arrive at the scene, local authorities must have a plan of action for the hours immediately following an accident. The site should be left untouched except to remove casualties. Treatment of victims includes decontamination and meticulous wound debridement. Acute radiation syndrome may be an overwhelming sequela.

  18. Wilderness Medical Society Practice Guidelines for Prevention and Management of Avalanche and Nonavalanche Snow Burial Accidents.

    PubMed

    Van Tilburg, Christopher; Grissom, Colin K; Zafren, Ken; McIntosh, Scott; Radwin, Martin I; Paal, Peter; Haegeli, Pascal; Smith, William Will R; Wheeler, Albert R; Weber, David; Tremper, Bruce; Brugger, Hermann

    2017-03-01

    To provide guidance to clinicians and avalanche professionals about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention, rescue, and medical management of avalanche and nonavalanche snow burial victims. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians. Copyright © 2017. Published by Elsevier Inc.

  19. Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

    PubMed

    Rüter, Anders; Vikstrom, Tore

    2009-01-01

    Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

  20. Management of the critical airway when an EXIT procedure is not an option: A case report.

    PubMed

    Diercks, Gillian R; Hartnick, Christopher J; Bates, Sara V

    2015-12-01

    Perinatal imaging facilitates detection of congenital head and neck masses to plan fetal procedures which secure the airway. Ex utero intrapartum therapy (EXIT) procedures are preferred to protect the neonatal airway. Herein we present a case in which a neonate with a large oropharyngeal lymphovascular malformation was delivered and the airway successfully managed without an EXIT procedure using a multidisciplinary approach. Preparations for the non-EXIT delivery and critical airway management are described.

  1. Summary of the SRS Severe Accident Analysis Program, 1987--1992

    SciTech Connect

    Long, T.A.; Hyder, M.L.; Britt, T.E.; Allison, D.K.; Chow, S.; Graves, R.D.; DeWald, A.B. Jr.; Monson, P.R. Jr.; Wooten, L.A.

    1992-11-01

    The Severe Accident Analysis Program (SAAP) is a program of experimental and analytical studies aimed at characterizing severe accidents that might occur in the Savannah River Site Production Reactors. The goals of the Severe Accident Analysis Program are: To develop an understanding of severe accidents in SRS reactors that is adequate to support safety documentation for these reactors, including the Safety Analysis Report (SAR), the Probabilistic Risk Assessment (PRA), and other studies evaluating the safety of reactor operation; To provide tools and bases for the evaluation of existing or proposed safety related equipment in the SRS reactors; To provide bases for the development of accident management procedures for the SRS reactors; To develop and maintain on the site a sufficient body of knowledge, including documents, computer codes, and cognizant engineers and scientists, that can be used to authoritatively resolve questions or issues related to reactor accidents. The Severe Accident Analysis Program was instituted in 1987 and has already produced a substantial amount of information, and specialized calculational tools. Products of the Severe Accident Analysis Program (listed in Section 9 of this report) have been used in the development of the Safety Analysis Report (SAR) and the Probabilistic Risk Assessment (PRA), and in the development of technical specifications for the SRS reactors. A staff of about seven people is currently involved directly in the program and in providing input on severe accidents to other SRS activities.

  2. Medical Management of Tumor Lysis Syndrome, Postprocedural Pain, and Venous Thromboembolism Following Interventional Radiology Procedures

    PubMed Central

    Faramarzalian, Ali; Armitage, Keith B.; Kapoor, Baljendra; Kalva, Sanjeeva P.

    2015-01-01

    The rapid expansion of minimally invasive image-guided procedures has led to their extensive use in the interdisciplinary management of patients with vascular, hepatobiliary, genitourinary, and oncologic diseases. Given the increased availability and breadth of these procedures, it is important for physicians to be aware of common complications and their management. In this article, the authors describe management of select common complications from interventional radiology procedures including tumor lysis syndrome, acute on chronic postprocedural pain, and venous thromboembolism. These complications are discussed in detail and their medical management is outlined according to generally accepted practice and evidence from the literature. PMID:26038627

  3. Ultrasound-guided interventional procedures for chronic pain management

    PubMed Central

    Korbe, Samuel; Udoji, Esther N; Ness, Timothy J; Udoji, Mercy A

    2015-01-01

    Ultrasonography has multiple advantages over traditional radiologic imaging modalities when used for interventional procedures. It allows improved visualization of the anatomy while avoiding ionizing radiation and risks associated with contrast use. It has proved superiority at accuracy of delivery and procedural effectiveness over blind procedures when used in association with interventional pain procedures. Although limited in its ability to see through bony structures, ultrasound has utility in visualizing soft tissues and vascular structures in anatomic regions of interest resulting in increased use for posterior neuraxial, periaxial, peripheral nerve and joint-related structures. Current evidence for use in these settings is presented here. In some cases, optimal utility may be improved by combining ultrasonography with other imaging modalities. PMID:26402316

  4. Ultrasound-guided interventional procedures for chronic pain management.

    PubMed

    Korbe, Samuel; Udoji, Esther N; Ness, Timothy J; Udoji, Mercy A

    2015-01-01

    Ultrasonography has multiple advantages over traditional radiologic imaging modalities when used for interventional procedures. It allows improved visualization of the anatomy while avoiding ionizing radiation and risks associated with contrast use. It has proved superiority at accuracy of delivery and procedural effectiveness over blind procedures when used in association with interventional pain procedures. Although limited in its ability to see through bony structures, ultrasound has utility in visualizing soft tissues and vascular structures in anatomic regions of interest resulting in increased use for posterior neuraxial, periaxial, peripheral nerve and joint-related structures. Current evidence for use in these settings is presented here. In some cases, optimal utility may be improved by combining ultrasonography with other imaging modalities.

  5. RENEB accident simulation exercise.

    PubMed

    Brzozowska, Beata; Ainsbury, Elizabeth; Baert, Annelot; Beaton-Green, Lindsay; Barrios, Leonardo; Barquinero, Joan Francesc; Bassinet, Celine; Beinke, Christina; Benedek, Anett; Beukes, Philip; Bortolin, Emanuela; Buraczewska, Iwona; Burbidge, Christopher; De Amicis, Andrea; De Angelis, Cinzia; Della Monaca, Sara; Depuydt, Julie; De Sanctis, Stefania; Dobos, Katalin; Domene, Mercedes Moreno; Domínguez, Inmaculada; Facco, Eva; Fattibene, Paola; Frenzel, Monika; Monteiro Gil, Octávia; Gonon, Géraldine; Gregoire, Eric; Gruel, Gaëtan; Hadjidekova, Valeria; Hatzi, Vasiliki I; Hristova, Rositsa; Jaworska, Alicja; Kis, Enikő; Kowalska, Maria; Kulka, Ulrike; Lista, Florigio; Lumniczky, Katalin; Martínez-López, Wilner; Meschini, Roberta; Moertl, Simone; Moquet, Jayne; Noditi, Mihaela; Oestreicher, Ursula; Orta Vázquez, Manuel Luis; Palma, Valentina; Pantelias, Gabriel; Montoro Pastor, Alegria; Patrono, Clarice; Piqueret-Stephan, Laure; Quattrini, Maria Cristina; Regalbuto, Elisa; Ricoul, Michelle; Roch-Lefevre, Sandrine; Roy, Laurence; Sabatier, Laure; Sarchiapone, Lucia; Sebastià, Natividad; Sommer, Sylwester; Sun, Mingzhu; Suto, Yumiko; Terzoudi, Georgia; Trompier, Francois; Vral, Anne; Wilkins, Ruth; Zafiropoulos, Demetre; Wieser, Albrecht; Woda, Clemens; Wojcik, Andrzej

    2017-01-01

    The RENEB accident exercise was carried out in order to train the RENEB participants in coordinating and managing potentially large data sets that would be generated in case of a major radiological event. Each participant was offered the possibility to activate the network by sending an alerting email about a simulated radiation emergency. The same participant had to collect, compile and report capacity, triage categorization and exposure scenario results obtained from all other participants. The exercise was performed over 27 weeks and involved the network consisting of 28 institutes: 21 RENEB members, four candidates and three non-RENEB partners. The duration of a single exercise never exceeded 10 days, while the response from the assisting laboratories never came later than within half a day. During each week of the exercise, around 4500 samples were reported by all service laboratories (SL) to be examined and 54 scenarios were coherently estimated by all laboratories (the standard deviation from the mean of all SL answers for a given scenario category and a set of data was not larger than 3 patient codes). Each participant received training in both the role of a reference laboratory (activating the network) and of a service laboratory (responding to an activation request). The procedures in the case of radiological event were successfully established and tested.

  6. European consensus on the medical management of acute radiation syndrome and analysis of the radiation accidents in Belgium and Senegal.

    PubMed

    Gourmelon, Patrick; Benderitter, Marc; Bertho, Jean Marc; Huet, Christelle; Gorin, Norbert Claude; De Revel, Patrick

    2010-06-01

    A European consensus concerning the medical management of mass radiation exposure was obtained in 2005 during a conference held by the European Group for Blood and Bone Marrow Transplantation, the Institute of Radioprotection and Nuclear Safety, and the University of Ulm. At the conference, a two-step triage strategy to deal with large masses of radiation-exposed patients was designed. The first step of this strategy concerns the first 48 h and involves scoring the patients exclusively on the basis of their clinical symptoms and biological data. This allows the non-irradiated bystanders and outpatient candidates to be identified. The remaining patients are hospitalized and diagnosis is confirmed after the first 48-h period according to the METREPOL (Medical Treatment Protocols for radiation accident victims) scale. This grades the patients according to the severity of their symptoms. It was also agreed that in the case of acute radiation syndrome (ARS), emergency hematopoietic stem cell (HSC) transplantation is not necessary. Instead, cytokines that promote hematological reconstruction should be administered as early as possible for 14-21 d. Crucial tests for determining whether the patient has residual hematopoiesis are physical dose reconstructions combined with daily blood count analyses. It was agreed that HSC transplantation should only be considered if severe aplasia persists after cytokine treatment. Two recent cases of accidental radiation exposure that were managed successfully by following the European consensus with modification are reviewed here. Thus, a European standard for the evaluation and treatment of ARS victims is now available. This standard may be suitable for application around the world.

  7. Emergency preparedness and response: compensating victims of a nuclear accident.

    PubMed

    Schwartz, Julia

    2004-07-26

    The 1986 tragedy at the Chernobyl Nuclear Power Plant in Ukraine motivated the entire international nuclear community to ensure that countries would, in the future, be well prepared to manage the physical, psychological and financial consequences of a serious nuclear accident. Since that event, numerous nuclear emergency preparedness and post-emergency management programmes have been established at national and international levels to ensure that appropriate mechanisms will respond to the threat, and the aftermath, of a nuclear accident. The INEX 2000 Workshop on the Indemnification of Nuclear Damage, jointly organised by the OECD/Nuclear Energy Agency and the French Government, was the first ever international programme to address the manner in which victims of a nuclear accident with trans-boundary consequences would be compensated for damage suffered before, during and after the accident. The Workshop results revealed striking differences in the compensation principles and practices implemented in the 30 participating countries, in the co-ordination measures between different public authorities within an affected state, and in the co-operative procedures between the accident state and its neighbours. All participants agreed on the need for improvement in these areas, particularly for maintaining public confidence in governments' ability to properly manage nuclear emergencies.

  8. The Euratom-Rosatom ERCOSAM-SAMARA projects on containment thermal-hydraulics of current and future LWRs for severe accident management

    SciTech Connect

    Paladino, D.; Guentay, S.; Andreani, M.; Tkatschenko, I.; Brinster, J.; Dabbene, F.; Kelm, S.; Allelein, H. J.; Visser, D. C.; Benz, S.; Jordan, T.; Liang, Z.; Porcheron, E.; Malet, J.; Bentaib, A.; Kiselev, A.; Yudina, T.; Filippov, A.; Khizbullin, A.; Kamnev, M.; Zaytsev, A.; Loukianov, A.

    2012-07-01

    During a postulated severe accident with core degradation, hydrogen would form in the reactor pressure vessel mainly due to high temperatures zirconium-steam reaction and flow together with steam into the containment where it will mix with the containment atmosphere (steam-air). The hydrogen transport into the containment is a safety concern because it can lead to explosive mixtures through the associated phenomena of condensation, mixing and stratification. The ERCOSAM and SAMARA projects, co-financed by the European Union and the Russia, include various experiments addressing accident scenarios scaled down from existing plant calculations to different thermal-hydraulics facilities (TOSQAN, MISTRA, PANDA, SPOT). The tests sequences aim to investigate hydrogen concentration build-up and stratification during a postulated accident and the effect of the activation of Severe Accident Management systems (SAMs), e.g. sprays, coolers and Passive Auto-catalytic Recombiners (PARs). Analytical activities, performed by the project participants, are an essential component of the projects, as they aim to improve and validate various computational methods. They accompany the projects in the various phases; plant calculations, scaling to generic containment and to the different facilities, planning pre-test and post-test simulations are performed. Code benchmark activities on the basis of conceptual near full scale HYMIX facility will finally provide a further opportunity to evaluate the applicability of the various methods to the study of scaling issues. (authors)

  9. The management of ureteric stones in the Accident and Emergency department.

    PubMed

    Dawson, Kirsty; Dawson, Lindsay

    2014-01-01

    Ureteric stones is a common cause for attendance to the A&E department. Active or conservative management is delivered dependent on the relevant history, clinical condition, and investigation results. The majority of patients can be treated conservatively and do not require admission. However, some cases of ureteric stones present as a urological emergency if, for example, there is an infected obstructed system. An initial audit over a two month period of A&E admissions with radiologically proven ureteric stones demonstrated there was no easily accessible, specific criteria used to guide which patients were admitted and which patients were discharged from A&E. Therefore, an admission criteria and discharge proforma was developed and implemented in the A&E department to ensure patients were appropriately discharged if they could be managed conservatively and appropriately admitted if they potentially required further observation and intervention. A repeat audit using the same methods and criteria was carried out and demonstrated fewer unnecessary admissions and fewer inappropriate discharges.

  10. The Classroom Manager: Procedures and Practices to Improve Instruction

    ERIC Educational Resources Information Center

    Houff, Suzanne G.

    2009-01-01

    Using William Glasser's five basic needs as a foundation, "The Classroom Manager" provides a theoretical base to guide readers in the understanding and development of an effective classroom management program. The topics of survival, belonging and love, power, fun, and freedom are explored through definitions, practical recommendations and case…

  11. The Classroom Manager: Procedures and Practices to Improve Instruction

    ERIC Educational Resources Information Center

    Houff, Suzanne G.

    2009-01-01

    Using William Glasser's five basic needs as a foundation, "The Classroom Manager" provides a theoretical base to guide readers in the understanding and development of an effective classroom management program. The topics of survival, belonging and love, power, fun, and freedom are explored through definitions, practical recommendations and case…

  12. An intelligent flight-management aid for procedure execution

    NASA Technical Reports Server (NTRS)

    Hammer, J. M.

    1984-01-01

    A computer program is described that contains a model of the procedures used in the operation of a twin engine aircraft. This program, by comparing the model to the aircraft state, can determine when a procedure (or checklist) should be or is invoked and when each step (detectable by a change in the aircraft state) is completed. Thus, the program tracks the flight crew's procedure execution through changes in the aircraft state. Data were used for evaluation from an earlier experiment on a Link GAT-II simulator. The program had been able to identify practically all of the errors identified by human judges as well as locate some missed by them. It is felt that this model could significantly aid flight crews.

  13. Crown lengthening procedure in the management of amelogenesis imperfecta.

    PubMed

    Kalaivani, S; Manohar, Jenish; Shakunthala, P; Sujatha, S; Rajasekaran, S A; Karthikeyan, B; Kalaiselvan, S

    2015-08-01

    Full mouth rehabilitation includes a promising treatment planning and execution thus fulfilling esthetic, occlusal, and functional parameters maintaining the harmony of the stomatognathic system. Crown lengthening procedures have become an integral component of the esthetic armamentarium and are utilized with increasing frequency to enhance the appearance of restorations placed in the esthetic zone. Crown lengthening plays a role to create healthy relationship of the gingiva and bone levels so as to gain access to more of the tooth which can be restored, if it is badly worn, decayed or fractured, below the gum line. This paper highlights the full mouth crown lengthening procedure performed on a patient with amelogenesis imperfecta.

  14. Crown lengthening procedure in the management of amelogenesis imperfecta

    PubMed Central

    Kalaivani, S.; Manohar, Jenish; Shakunthala, P.; Sujatha, S.; Rajasekaran, S. A.; Karthikeyan, B.; Kalaiselvan, S.

    2015-01-01

    Full mouth rehabilitation includes a promising treatment planning and execution thus fulfilling esthetic, occlusal, and functional parameters maintaining the harmony of the stomatognathic system. Crown lengthening procedures have become an integral component of the esthetic armamentarium and are utilized with increasing frequency to enhance the appearance of restorations placed in the esthetic zone. Crown lengthening plays a role to create healthy relationship of the gingiva and bone levels so as to gain access to more of the tooth which can be restored, if it is badly worn, decayed or fractured, below the gum line. This paper highlights the full mouth crown lengthening procedure performed on a patient with amelogenesis imperfecta. PMID:26538965

  15. Human factors engineering in healthcare systems: the problem of human error and accident management.

    PubMed

    Cacciabue, P C; Vella, G

    2010-04-01

    This paper discusses some crucial issues associated with the exploitation of data and information about health care for the improvement of patient safety. In particular, the issues of human factors and safety management are analysed in relation to exploitation of reports about non-conformity events and field observations. A methodology for integrating field observation and theoretical approaches for safety studies is described. Two sample cases are discussed in detail: the first one makes reference to the use of data collected in the aviation domain and shows how these can be utilised to define hazard and risk; the second one concerns a typical ethnographic study in a large hospital structure for the identification of most relevant areas of intervention. The results show that, if national authorities find a way to harmonise and formalize critical aspects, such as the severity of standard events, it is possible to estimate risk and define auditing needs, well before the occurrence of serious incidents, and to indicate practical ways forward for improving safety standards. (c) 2008. Published by Elsevier Ireland Ltd. All rights reserved.

  16. PIL: A Control Procedure for Technical Services Management *

    PubMed Central

    Ausherman, Marian R.; Wittekind, William D.; Divett, Robert T.

    1967-01-01

    An acquisitions control procedure at the University of New Mexico Library of the Medical Sciences is described. Using an IBM 360/40, a program has been written to keep the acquisitions section and the administration apprised of the status of materials ordered or donated to the library. Future modifications of the program are also described. Images PMID:6066009

  17. Dialogue procedures for the management of odour related community conflicts.

    PubMed

    Sucker, K

    2009-01-01

    In the German Guideline on Odour in Ambient Air (GOAA) statements about the degree of residential odour annoyance are based on the frequency of recognisable odours and hedonic tone. The use of olfactory standards to adequately estimate the annoyance impact is limited if, for example, worry about adverse health outcomes significantly influences the annoyance response of the population. This report introduces dialogue procedures as complementary measures to consider the complainants' subjective perceptions and worries adequately. At first, it is illustrated that odour exposure and number of odour complaints are not necessarily correlated. Then the "interest analysis" and the five steps of a dialogue procedure are presented. A dialogue procedure can be initiated in "quiet times" - where the focus is on trust building and on the development of adequate communication strategies to promote realistic risk reception - as well as in order to establish a successful conflict resolution process if the issue is complex and emotionally discussed. After that, two examples of handling odour complaints are shown. Finally, considerations applying dialogue procedures as a tool to advance odour annoyance mitigation are outlined.

  18. Managing Mergers of Human Service Agencies: People, Programs, and Procedures.

    ERIC Educational Resources Information Center

    Taylor, Joseph; And Others

    1992-01-01

    Offers detailed guidelines that could be used as standard operating procedures for the merger of voluntary social service agencies. Discusses a survey of 32 agencies that merged during the years 1973 to 1986. Issues related to the roles of organization, staff, and service delivery in such mergers receive particular attention. (Author/BB)

  19. Evaluation and Interventional Management of Pain After Vertebral Augmentation Procedures

    PubMed Central

    Granville, Michelle; Jacobson, Robert E

    2017-01-01

    Introduction A small subset of patients who underwent successful vertebral compression fracture (VCF) augmentation procedures may develop subsequent pain requiring spinal injections. In a retrospective analysis, we determined whether the pain was related to the original fracture site or to another area within the lumbar or thoracic spine. The pain occurred either at the same/adjacent level and/or non-adjacent level as the VCF. Interventional treatments primarily targeted the facet joints, specifically in the form of facet joint blocks and/or radiofrequency ablation to the medial branches. The pattern of facet injections relative to the original fracture level was studied. Additionally, the elapsed time between the vertebral augmentation and the subsequent interventional blocks was also evaluated. Methods A total of 56 patients sustained VCFs. 12 of these patients underwent interventional procedures after vertebral augmentation procedures. The level(s) of same/adjacent level and non-adjacent level pain were determined via physical examination and/or imaging studies. These levels were subsequently treated with interventional procedures primarily focused on the facet joints. The time period of the injections varied from two weeks status post-vertebral augmentation to as late as 304 weeks (5.8 years) status post-vertebral augmentation. Results We performed 25 vertebral augmentation procedures on these 12 patients. 15 lumbar, eight lower thoracic, and two mid-thoracic VCFs were augmented. 9/14 cases of blocks included those performed at non-adjacent levels, whereas 5/14 cases of blocks were performed only at the same and/or adjacent levels as the VCF. For the events in which thoracic VCFs were augmented, 6/7 (or 86%) had developed non-adjacent level pain in areas of the lumbar spine.  The time from vertebral augmentation procedure to subsequent pain procedure ranged from two weeks to five plus years. The average time elapsed was 83 weeks. Only one case

  20. Supplemental analysis of accident sequences and source terms for waste treatment and storage operations and related facilities for the US Department of Energy waste management programmatic environmental impact statement

    SciTech Connect

    Folga, S.; Mueller, C.; Nabelssi, B.; Kohout, E.; Mishima, J.

    1996-12-01

    This report presents supplemental information for the document Analysis of Accident Sequences and Source Terms at Waste Treatment, Storage, and Disposal Facilities for Waste Generated by US Department of Energy Waste Management Operations. Additional technical support information is supplied concerning treatment of transuranic waste by incineration and considering the Alternative Organic Treatment option for low-level mixed waste. The latest respirable airborne release fraction values published by the US Department of Energy for use in accident analysis have been used and are included as Appendix D, where respirable airborne release fraction is defined as the fraction of material exposed to accident stresses that could become airborne as a result of the accident. A set of dominant waste treatment processes and accident scenarios was selected for a screening-process analysis. A subset of results (release source terms) from this analysis is presented.

  1. Multiservice Procedures for Joint Task Force Information Management (JTF-IM)

    DTIC Science & Technology

    1999-04-01

    information management . (4) Provides techniques on how to manage the vast amounts of information generated by different processes and systems (that is, electronic mail E-MAIL, newsgroups, home pages, the Global Command and Control System GCCS, official message traffic, and intelligence feeds). (5) Provides tactics, techniques, and procedures to manage the information flow between the joint operations center (JOC) and the joint intelligence support element (JISE). (6) Provides guidelines on managing the information pertaining to commander’s critical information

  2. Policy, Procedures and Guidance for System Life Cycle Management (SLCM)

    EPA Pesticide Factsheets

    The purpose of this policy is to establish a consistent framework across the Agency to ensure that EPA IT systems and applications are properly planned and managed, controllable, cost-effective and that they support the Agency’s mission and business goals.

  3. Food Service 255. Operational Management II: Procedures. Course Outline.

    ERIC Educational Resources Information Center

    Woodward, Nell M.

    An outline is provided of Food Service 225, a course offered at Orange Coast College dealing with the organization and management of food service departments within health care, community care, and school feeding programs. The outline first presents a course description, which covers prerequisite course work, the role of the course within the…

  4. Management Aids and Procedures for Strategic Planning. Staff Report.

    ERIC Educational Resources Information Center

    Cope, Robert G.

    Management aids required in strategic planning are divided into three categories: (1) assessing the environment, (2) providing a process for reaching decisions, and (3) presenting criteria to evaluate strategic decisions. A model for scanning the environment has four dimensions that concern economic, social, knowledge-technology, and public policy…

  5. 43 CFR 9268.3 - Recreation management-procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... established, may be operated on public lands. (iii) By posting appropriate signs or by marking a map which... tracked snowmachines with a maximum capacity of two people may have only one headlight. (B) Red taillights... Federal Land Policy and Management Act of 1976, the Land and Water Conservation Fund Act, as amended,...

  6. China's classification-based forest management: procedures, problems, and prospects.

    PubMed

    Dai, Limin; Zhao, Fuqiang; Shao, Guofan; Zhou, Li; Tang, Lina

    2009-06-01

    China's new Classification-Based Forest Management (CFM) is a two-class system, including Commodity Forest (CoF) and Ecological Welfare Forest (EWF) lands, so named according to differences in their distinct functions and services. The purposes of CFM are to improve forestry economic systems, strengthen resource management in a market economy, ease the conflicts between wood demands and public welfare, and meet the diversified needs for forest services in China. The formative process of China's CFM has involved a series of trials and revisions. China's central government accelerated the reform of CFM in the year 2000 and completed the final version in 2003. CFM was implemented at the provincial level with the aid of subsidies from the central government. About a quarter of the forestland in China was approved as National EWF lands by the State Forestry Administration in 2006 and 2007. Logging is prohibited on National EWF lands, and their landowners or managers receive subsidies of about 70 RMB (US$10) per hectare from the central government. CFM represents a new forestry strategy in China and its implementation inevitably faces challenges in promoting the understanding of forest ecological services, generalizing nationwide criteria for identifying EWF and CoF lands, setting up forest-specific compensation mechanisms for ecological benefits, enhancing the knowledge of administrators and the general public about CFM, and sustaining EWF lands under China's current forestland tenure system. CFM does, however, offer a viable pathway toward sustainable forest management in China.

  7. China's Classification-Based Forest Management: Procedures, Problems, and Prospects

    NASA Astrophysics Data System (ADS)

    Dai, Limin; Zhao, Fuqiang; Shao, Guofan; Zhou, Li; Tang, Lina

    2009-06-01

    China’s new Classification-Based Forest Management (CFM) is a two-class system, including Commodity Forest (CoF) and Ecological Welfare Forest (EWF) lands, so named according to differences in their distinct functions and services. The purposes of CFM are to improve forestry economic systems, strengthen resource management in a market economy, ease the conflicts between wood demands and public welfare, and meet the diversified needs for forest services in China. The formative process of China’s CFM has involved a series of trials and revisions. China’s central government accelerated the reform of CFM in the year 2000 and completed the final version in 2003. CFM was implemented at the provincial level with the aid of subsidies from the central government. About a quarter of the forestland in China was approved as National EWF lands by the State Forestry Administration in 2006 and 2007. Logging is prohibited on National EWF lands, and their landowners or managers receive subsidies of about 70 RMB (US10) per hectare from the central government. CFM represents a new forestry strategy in China and its implementation inevitably faces challenges in promoting the understanding of forest ecological services, generalizing nationwide criteria for identifying EWF and CoF lands, setting up forest-specific compensation mechanisms for ecological benefits, enhancing the knowledge of administrators and the general public about CFM, and sustaining EWF lands under China’s current forestland tenure system. CFM does, however, offer a viable pathway toward sustainable forest management in China.

  8. Specialist management of routine dental procedures in adults with refractory epilepsy.

    PubMed

    Ransford, N; Soryal, I; McCorry, D; Sander, J W; Duncan, F; Huggins, N

    2014-04-01

    Little published information exists about the management of dental treatment procedures for people with epilepsy who, despite their medication, continue to have seizures. This paper draws on relevant literature in neurology and anaesthetics to provide a multi-speciality consensus on methods of assessment and adjunctive treatment options in order to manage the risk of a clinically significant seizure occurring during a procedure. It aims to enhance current guidelines and practice in the provision of specialist care for this diverse group.

  9. Student Opinions about the Seven-Step Procedure in Problem-Based Hospitality Management Education

    ERIC Educational Resources Information Center

    Zwaal, Wichard; Otting, Hans

    2014-01-01

    This study investigates how hospitality management students appreciate the role and application of the seven-step procedure in problem-based learning. A survey was developed containing sections about personal characteristics, recall of the seven steps, overall report marks, and 30 statements about the seven-step procedure. The survey was…

  10. Data management procedures for Tiepoint Registration, pre and post processing, and ICD116

    NASA Technical Reports Server (NTRS)

    Nowakowski, B. S.

    1983-01-01

    The data management procedures for tiepoint registration, pre and post processing, and "ICD116' are described. With each procedure description, the pertinent execs are listed and purposes defined. An example run of each of the 32 execs is included with user inputs identified.

  11. [Diagnostic procedures and management of Fever in pediatric cancer patients].

    PubMed

    Laws, H-J; Ammann, R A; Lehrnbecher, T

    2005-11-01

    The rapid institution of empirical broad-spectrum antibiotics has become the gold standard of treatment for febrile neutropenic children undergoing therapy for cancer. With this approach, morbidity and mortality have dropped significantly but have not been eliminated altogether. In recent randomized studies evaluating different drug combinations, there is still a 3-10 % mortality reported in febrile, neutropenic cancer events. Despite improvements in invasive and non-invasive diagnostic procedures, a majority of patients will receive antibiotic therapy despite an inability to identify a specific pathogen or source (fever of unknown origin, FUO). While there are evidence-based guidelines in adult patients with fever and neutropenia, data are less clear in the pediatric population. Experts agree on the early use of empirical antibiotic therapy, which covers Pseudomonas spp. and is initiated at the first sign of fever. The success of this approach has been based upon clinical intervention before the results of the diagnostic evaluation are available. In contrast, the use of aminoglycosides or glycopeptides is still a matter of debate, as it is the duration of antibiotic therapy. Based on published data in pediatric and adult patients with cancer, the current diagnostic procedures and therapeutic strategies will are discussed. The recommendations given are a consensus of the German Society of Pediatric Oncology and Hematology (GPOH) and the German Society of Pediatric Infectious Diseases (DGPI).

  12. Procedure for assessing visual quality for landscape planning and management

    NASA Astrophysics Data System (ADS)

    Gimblett, H. Randal; Fitzgibbon, John E.; Bechard, Kevin P.; Wightman, J. A.; Itami, Robert M.

    1987-07-01

    Incorporation of aesthetic considerations in the process of landscape planning and development has frequently met with poor results due to its lack of theoretical basis, public involvement, and failure to deal with spatial implications. This problem has been especially evident when dealing with large areas, for example, the Adirondacks, Scenic Highways, and National Forests and Parks. This study made use of public participation to evaluate scenic quality in a portion of the Niagara Escarpment in Southern Ontario, Canada. The results of this study were analyzed using the visual management model proposed by Brown and Itami (1982) as a means of assessing and evaluating scenic quality. The map analysis package formulated by Tomlin (1980) was then applied to this assessment for the purpose of spatial mapping of visual impact. The results of this study illustrate that it is possible to assess visual quality for landscape/management, preservation, and protection using a theoretical basis, public participation, and a systematic spatial mapping process.

  13. Augmented reality and training for airway management procedures.

    PubMed

    Davis, Larry; Ha, Yonggang; Frolich, Seth; Martin, Glenn; Meyer, Catherine; Pettitt, Beth; Norfleet, Jack; Lin, Kuo-Chi; Rolland, Jannick P

    2002-01-01

    Augmented reality is often used for interactive, three-dimensional visualization within the medical community. To this end, we present the integration of an augmented reality system that will be used to train military medics in airway management. The system demonstrates how a head-mounted projective display can be integrated with a desktop PC to create an augmented reality visualization. Furthermore, the system, which uses a lightweight optical tracker, demonstrates the low cost and the portability of the application.

  14. Managing dentoalveolar surgical procedures in patients taking new oral anticoagulants.

    PubMed

    Sivolella, Stefano; De Biagi, Marleen; Brunello, Giulia; Berengo, Mario; Pengo, Vittorio

    2015-09-01

    The development of new orally administered anticoagulants, such as dabigatran, rivaroxaban, and apixaban, in the past few years has focused on avoiding some of the drawbacks associated with warfarin. This work aims to illustrate the main features of the most commonly used new oral anticoagulants, reviewing the current literature on the management of patients taking these drugs and needing oral and implant surgery, and discussing the currently proposed related guidelines.

  15. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...) Allow no visitors except under controlled conditions to minimize the introduction of Salmonella...

  16. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...) Allow no visitors except under controlled conditions to minimize the introduction of Salmonella...

  17. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Bridge resource management policy... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1... in charge of the navigational watch concerning the need for continuously reassessing how bridge-watch...

  18. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Bridge resource management policy... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1... in charge of the navigational watch concerning the need for continuously reassessing how bridge-watch...

  19. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Bridge resource management policy... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1... in charge of the navigational watch concerning the need for continuously reassessing how bridge-watch...

  20. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Bridge resource management policy... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1... in charge of the navigational watch concerning the need for continuously reassessing how bridge-watch...

  1. 33 CFR 157.415 - Bridge resource management policy and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Bridge resource management policy... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1... in charge of the navigational watch concerning the need for continuously reassessing how bridge-watch...

  2. Using Numerical Models in the Development of Software Tools for Risk Management of Accidents with Oil and Inert Spills

    NASA Astrophysics Data System (ADS)

    Fernandes, R.; Leitão, P. C.; Braunschweig, F.; Lourenço, F.; Galvão, P.; Neves, R.

    2012-04-01

    The increasing ship traffic and maritime transport of dangerous substances make it more difficult to significantly reduce the environmental, economic and social risks posed by potential spills, although the security rules are becoming more restrictive (ships with double hull, etc.) and the surveillance systems are becoming more developed (VTS, AIS). In fact, the problematic associated to spills is and will always be a main topic: spill events are continuously happening, most of them unknown for the general public because of their small scale impact, but with some of them (in a much smaller number) becoming authentic media phenomena in this information era, due to their large dimensions and environmental and social-economic impacts on ecosystems and local communities, and also due to some spectacular or shocking pictures generated. Hence, the adverse consequences posed by these type of accidents, increase the preoccupation of avoiding them in the future, or minimize their impacts, using not only surveillance and monitoring tools, but also increasing the capacity to predict the fate and behaviour of bodies, objects, or substances in the following hours after the accident - numerical models can have now a leading role in operational oceanography applied to safety and pollution response in the ocean because of their predictive potential. Search and rescue operation, oil, inert (ship debris, or floating containers), and HNS (hazardous and noxious substances) spills risk analysis are the main areas where models can be used. Model applications have been widely used in emergency or planning issues associated to pollution risks, and contingency and mitigation measures. Before a spill, in the planning stage, modelling simulations are used in environmental impact studies, or risk maps, using historical data, reference situations, and typical scenarios. After a spill, the use of fast and simple modelling applications allow to understand the fate and behaviour of the spilt

  3. 44 CFR 204.52 - Application and approval procedures for a subgrant under a fire management assistance grant.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... procedures for a subgrant under a fire management assistance grant. 204.52 Section 204.52 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FIRE MANAGEMENT ASSISTANCE GRANT PROGRAM Application Procedures § 204.52 Application and...

  4. Kidney transplantation procedures in rats: assessments, complications, and management.

    PubMed

    Pahlavan, Payam S; Smallegange, Corry; Adams, Michael A; Schumacher, Martin

    2006-01-01

    Kidney transplantation in rats is an experimental model often used for the development of general microsurgical or transplantation techniques, for immunologic studies, and for analyzing transplant-associated long-term arterial blood-pressure changes. The aim of the present study was to analyze different surgical techniques of kidney transplantation in rats, with emphasis on minimizing surgical complications and establishing guidelines for their prevention and management. Complications were categorized into general (e.g., core body temperature drop, ischemic time) and surgically related vascular and urinary tract complications. In conclusion, a significant reduction of the complication rate in renal transplantation in rats can be achieved by placing the animal on a heating pad at an appropriate temperature. To reduce the risk of vascular thrombosis, ice-cold saline with heparin and careful flushing of the donor kidneys are recommended. Vascular complications can be avoided by performing "end-to-end" anastomosis techniques. The use of stents and cannulas in the urinary tract is associated with a high risk of urinary tract obstruction, and therefore is not recommended.

  5. SCAP: a new methodology for safety management based on feedback from credible accident-probabilistic fault tree analysis system.

    PubMed

    Khan, F I; Iqbal, A; Ramesh, N; Abbasi, S A

    2001-10-12

    As it is conventionally done, strategies for incorporating accident--prevention measures in any hazardous chemical process industry are developed on the basis of input from risk assessment. However, the two steps-- risk assessment and hazard reduction (or safety) measures--are not linked interactively in the existing methodologies. This prevents a quantitative assessment of the impacts of safety measures on risk control. We have made an attempt to develop a methodology in which risk assessment steps are interactively linked with implementation of safety measures. The resultant system tells us the extent of reduction of risk by each successive safety measure. It also tells based on sophisticated maximum credible accident analysis (MCAA) and probabilistic fault tree analysis (PFTA) whether a given unit can ever be made 'safe'. The application of the methodology has been illustrated with a case study.

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

    SciTech Connect

    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.

  7. Accidents associated with equipment.

    PubMed

    Heath, M L

    1984-01-01

    Serious accidents in which the possibility of equipment-related hazards are raised have been reported to the Scientific and Technical Branch of the Department of Health and Social Security. The author has examined anonymous summaries of 23 such reports of events which occurred over a 5-year period. The principle cause of catastrophe in seventeen of the incidents was user error involving disconnexion or misconnexion. Faulty systems of equipment management combined in some cases with inadequate pre-anaesthetic checking of apparatus were responsible for the other instances. Appropriate systems of equipment management and checking together with meticulous basic clinical monitoring are recommended as the best safeguards in anaesthetic practice.

  8. PTSD in post-road traffic accident patients requiring hospitalization in Indian subcontinent: A review on magnitude of the problem and management guidelines

    PubMed Central

    Undavalli, Chaitanya; Das, Piyush; Dutt, Taru; Bhoi, Sanjeev; Kashyap, Rahul

    2014-01-01

    Traumatic events after a road traffic accident (RTA) can be physical and/or psychological. Posttraumatic stress disorder (PTSD) is one of the major psychological conditions which affect accident victims. Psychological issues may not be addressed in the emergency department(ED) immediately. There have been reports about a mismatch between the timely referrals from ED to occupational or primary care services for these issues. If left untreated, there may be adverse effects on quality of life (QOL) and work productivity. Hospital expenses, loss of income, and loss of work could create a never ending cycle for financial difficulties and burden in trauma victims. The aim of our review is to address the magnitude of PTSD in post-RTA hospitalized patients in Indian subcontinent population. We also attempted to emphasis on few management guidelines. A comprehensive search was conducted on major databases with Medical Subject Headings (MeSH) term ‘PTSD or post-traumatic stress’ and Emergency department and vehicle or road or highway or automobile or car or truck or trauma and India. Out of 120 studies, a total of six studies met our inclusion criteria and were included in the review. Our interpretation of the problem is that; hospital expenditure due to trauma, time away from work during hospitalization, and reduction in work performance, are three major hits that can lead RTA victims to financial crisis. Proposed management guidelines are; establish a coordinated triage, implementing a screening tool in the ED, and provide psychological counseling. PMID:25400398

  9. PTSD in post-road traffic accident patients requiring hospitalization in Indian subcontinent: A review on magnitude of the problem and management guidelines.

    PubMed

    Undavalli, Chaitanya; Das, Piyush; Dutt, Taru; Bhoi, Sanjeev; Kashyap, Rahul

    2014-10-01

    Traumatic events after a road traffic accident (RTA) can be physical and/or psychological. Posttraumatic stress disorder (PTSD) is one of the major psychological conditions which affect accident victims. Psychological issues may not be addressed in the emergency department(ED) immediately. There have been reports about a mismatch between the timely referrals from ED to occupational or primary care services for these issues. If left untreated, there may be adverse effects on quality of life (QOL) and work productivity. Hospital expenses, loss of income, and loss of work could create a never ending cycle for financial difficulties and burden in trauma victims. The aim of our review is to address the magnitude of PTSD in post-RTA hospitalized patients in Indian subcontinent population. We also attempted to emphasis on few management guidelines. A comprehensive search was conducted on major databases with Medical Subject Headings (MeSH) term 'PTSD or post-traumatic stress' and Emergency department and vehicle or road or highway or automobile or car or truck or trauma and India. Out of 120 studies, a total of six studies met our inclusion criteria and were included in the review. Our interpretation of the problem is that; hospital expenditure due to trauma, time away from work during hospitalization, and reduction in work performance, are three major hits that can lead RTA victims to financial crisis. Proposed management guidelines are; establish a coordinated triage, implementing a screening tool in the ED, and provide psychological counseling.

  10. Consumer managed care appeals: are the available procedural protections fundamentally fair?

    PubMed

    Nevers, A H

    2000-01-01

    Managed care incentives to reduce costs have also resulted in incentives to deny care. Anecdotes concerning managed care denials of care have led to a consumer outcry for protection either through the use of procedural due process or by the establishment of patient rights that would include appeal and grievance protections. This Article reviews the procedural protections of constitutional due process, the Consumer Due Process Protocol, and the Patient Bill of Rights. The Article then extensively discusses the availability of these procedural protections in various public and private forums. The discussion of public forums includes proposals contained in recent national legislative initiatives. The author then reviews relevant federal and state law, as well as Uniform Law proposals. Next, the Article analyzes the protections provided by accreditation agencies, dispute resolution organizations, professional organizations, and health insurers. Finally, the author recommends criteria to be used to determine whether a procedure is fundamentally fair.

  11. Association of early post-procedure hemodynamic management with the outcomes of subarachnoid hemorrhage patients.

    PubMed

    Kuwabara, Kazuaki; Fushimi, Kiyohide; Matsuda, Shinya; Ishikawa, Koichi B; Horiguchi, Hiromasa; Fujimori, Kenji

    2013-03-01

    Post-procedure hemodynamic management for aneurysmal subarachnoid hemorrhage is controversial because of the paucity of studied patients. Using a Japanese administrative database, we tested whether increased albumin, catecholamine, and volumes of fluid administered between the procedure and the 4th post-procedure day would be associated with outcomes of mortality, consciousness deterioration at discharge and re-intubation between the 5th and 14th post-procedure days. Across 550 hospitals, 5,400 patients were identified who received clipping, wrapping and endovascular coiling within 48 h after admission in 2010. Patient characteristics and the administration of albumin, catecholamine, and volume of fluid normalized by body weight were analyzed among the groups and categorized according to the presence of albumin and catecholamine administered between the procedure and the 4th post-procedure day. The association of early hemodynamic management with outcomes was measured using logistic regression models, through controlling for the preference of early administration of albumin and catecholamine. For the patients, 9.3 % received albumin only, 14.4 % catecholamine only, and 4.9 % both between the procedure and the 4th post-procedure day, while 16.5 % received albumin or catecholamine on other days. Variation in albumin and catecholamine administration was observed. Higher normalized fluid volume, commenced before the 4th post-procedure day, was associated with increased mortality and re-intubation (although with decreased complications), and vice versa between the 4th and 14th post-procedure days. Catecholamine administration was associated with worsened outcomes. Hypervolemic and hypertensive therapies commenced before the 4th post-procedure day require further research to determine whether their associations with outcomes in this administrative data base are causal or not.

  12. Analysis of accident sequences and source terms at waste treatment and storage facilities for waste generated by U.S. Department of Energy Waste Management Operations, Volume 3: Appendixes C-H

    SciTech Connect

    Mueller, C.; Nabelssi, B.; Roglans-Ribas, J.

    1995-04-01

    This report contains the Appendices for the Analysis of Accident Sequences and Source Terms at Waste Treatment and Storage Facilities for Waste Generated by the U.S. Department of Energy Waste Management Operations. The main report documents the methodology, computational framework, and results of facility accident analyses performed as a part of the U.S. Department of Energy (DOE) Waste Management Programmatic Environmental Impact Statement (WM PEIS). The accident sequences potentially important to human health risk are specified, their frequencies are assessed, and the resultant radiological and chemical source terms are evaluated. A personal computer-based computational framework and database have been developed that provide these results as input to the WM PEIS for calculation of human health risk impacts. This report summarizes the accident analyses and aggregates the key results for each of the waste streams. Source terms are estimated and results are presented for each of the major DOE sites and facilities by WM PEIS alternative for each waste stream. The appendices identify the potential atmospheric release of each toxic chemical or radionuclide for each accident scenario studied. They also provide discussion of specific accident analysis data and guidance used or consulted in this report.

  13. Advanced medical countermeasures for radiological accidents and nuclear disasters: prevention, prophylaxis, treatment and pre- and post-exposure management.

    NASA Astrophysics Data System (ADS)

    Popov, Dmitri; Maliev, Slava; Jones, Jeffrey

    Countermeasures against nuclear terrorism to prevent or limit the number of irradiated human population or radiation intoxications include early identification of the nuclear terrorism event and all persons which exposed by radiation, decontamination program and procedures, radiation control, and medical countermeasures which include medical diagnosis,differential diagnosis of Acute Radiation Syndromes by Immune Enzyme Assay , pre-exposure vaccination with Human Antiradiation Vaccine, post-exposure specific treatment - de-intoxication with Radiation Antidote IgG (blocking Antiradiation Antibodies). Our Advanced Medical Technology elaborated as a part of effective countermeasure include Plan of Action.Countermeasures against nuclear terrorism to prevent or limit the number of high level of lethality and severe forms of radiation illness or intoxications include A.early identification of the nuclear terrorism event and persons exposed,b. appropriate decontamination, c. radiation control, and d.medical countermeasures and medical management of ARS. Medical countermeasures, which include medical interventions such as active immuneprophylaxis with Human Antiradiation Vaccine , passive immune-prophylaxis with Antiradiation Antitoxins immune-globulins IgG , and chemoprophylaxis - post-exposure antioxidants prophylaxis and antibioticprophylaxis. Medical countermeasures with Antiradiation Vaccine should be initiated before an exposure (if individuals are identified as being at high risk for exposure)but after a confirmed exposure event Antiradiation Vaccine not effective and Antiradiation Antidot IgG must be applyed for treatment of Acute Radiation Syndromes.

  14. Severe Psychological Distress of Evacuees in Evacuation Zone Caused by the Fukushima Daiichi Nuclear Power Plant Accident: The Fukushima Health Management Survey.

    PubMed

    Kunii, Yasuto; Suzuki, Yuriko; Shiga, Tetsuya; Yabe, Hirooki; Yasumura, Seiji; Maeda, Masaharu; Niwa, Shin-Ichi; Otsuru, Akira; Mashiko, Hirobumi; Abe, Masafumi

    2016-01-01

    Following the Great East Japan Earthquake on March 11, 2011, the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant has continued to affect the mental health status of residents in the evacuation zone. To examine the mental health status of evacuee after the nuclear accident, we conducted the Mental Health and Lifestyle Survey as part of the ongoing Fukushima Health Management Survey. We measured mental health status using the Kessler 6-item psychological distress scale (K6) in a total of 73,569 (response rate: 40.7%) evacuees aged 15 and over who lived in the evacuation zone in Fukushima Prefecture. We then dichotomized responders using a 12/13 cutoff on the K6, and compared the proportion of K6 scores ≥13 and ≤12 in each risk factor including demographic information, socioeconomic variables, and disaster-related variables. We also performed bivariate analyses between mental health status and possible risk factors using the chi-square test. Furthermore, we performed multivariate regression analysis using modified Poisson regression models. The median K6 score was 5 (interquartile range: 1-10). The number of psychological distress was 8,717 (14.6%). We found that significant differences in the prevalence of psychological distress by almost all survey items, including disaster-related risk factors, most of which were also associated with increased Prevalence ratios (PRs). Additionally, we found that psychological distress in each evacuation zone was significantly positively associated with the radiation levels in their environment (r = 0.768, p = 0.002). The earthquake, tsunami and subsequent nuclear accident likely caused severe psychological distress among residents in the evacuation zone in Fukushima Prefecture. The close association between psychological distress and the radiation levels shows that the nuclear accident seriously influenced the mental health of the residents, which might be exacerbated by increased risk perception. To provide

  15. Severe Psychological Distress of Evacuees in Evacuation Zone Caused by the Fukushima Daiichi Nuclear Power Plant Accident: The Fukushima Health Management Survey

    PubMed Central

    Kunii, Yasuto; Suzuki, Yuriko; Shiga, Tetsuya; Yabe, Hirooki; Yasumura, Seiji; Maeda, Masaharu; Niwa, Shin-ichi; Otsuru, Akira; Mashiko, Hirobumi; Abe, Masafumi

    2016-01-01

    Background Following the Great East Japan Earthquake on March 11, 2011, the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant has continued to affect the mental health status of residents in the evacuation zone. To examine the mental health status of evacuee after the nuclear accident, we conducted the Mental Health and Lifestyle Survey as part of the ongoing Fukushima Health Management Survey. Methods We measured mental health status using the Kessler 6-item psychological distress scale (K6) in a total of 73,569 (response rate: 40.7%) evacuees aged 15 and over who lived in the evacuation zone in Fukushima Prefecture. We then dichotomized responders using a 12/13 cutoff on the K6, and compared the proportion of K6 scores ≥13 and ≤12 in each risk factor including demographic information, socioeconomic variables, and disaster-related variables. We also performed bivariate analyses between mental health status and possible risk factors using the chi-square test. Furthermore, we performed multivariate regression analysis using modified Poisson regression models. Results The median K6 score was 5 (interquartile range: 1–10). The number of psychological distress was 8,717 (14.6%). We found that significant differences in the prevalence of psychological distress by almost all survey items, including disaster-related risk factors, most of which were also associated with increased Prevalence ratios (PRs). Additionally, we found that psychological distress in each evacuation zone was significantly positively associated with the radiation levels in their environment (r = 0.768, p = 0.002). Conclusion The earthquake, tsunami and subsequent nuclear accident likely caused severe psychological distress among residents in the evacuation zone in Fukushima Prefecture. The close association between psychological distress and the radiation levels shows that the nuclear accident seriously influenced the mental health of the residents, which might be exacerbated by

  16. MSHA releases data on CM crushing accidents

    SciTech Connect

    2007-02-15

    The US Mine Safety and Health Administration (MHSA) recently formed a committee to identify norms and trends in remote control continuous miner crushing accidents. The final report found that these types of accidents commonly happen to experienced miners during routine mining activities, with the majority occurring while moving the miner from one face to another, place changing. Another common aspect of the accidents is that many of the victims are experienced miners who are newly employed at the mine where the accident occurred. Training all employees to stay outside the turning radius of an energized remote control continuous miner, establishing this as a safe operating procedure, and consistently enforcing this practice among miners will reduce these types of accidents. This article was excerpted from the 'Remote Control Continuous Mining Machine Crushing Accident Data Study' published in May 2006. The report may be found from the website: www.msha.gov. 4 figs., 1 tab.

  17. Supplemental national crash severity study accident reconstruction

    NASA Astrophysics Data System (ADS)

    Segal, D. J.; McGrath, M. T.; Balasubramanian, N.

    1980-09-01

    Accident data was collected that allows determination of the relationships between occupant injury and accident severity. The measure of severity most commonly used to characterize an accident is the velocity change experienced by the passenger compartment during the collision. In some 52 percent of the accidents contained in the pre-April 1978 National Crash Severity Study (NCSS) data file, these velocity changes were established with the CRASH computer program. A substantial number of the remaining cases were reconstructable with other methods. Procedures were developed to estimate velocity changes in two car accidents in which the damage to 484 additional accidents from the pre-April 1978 NCSS file were reconstructed to the point of having velocity change estimates for the vehicles involved.

  18. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  19. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  20. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  1. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  2. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  3. 14 CFR 420.59 - Launch site accident investigation plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Launch site accident investigation plan... Licensee § 420.59 Launch site accident investigation plan. (a) General. A licensee shall develop and implement a launch site accident investigation plan that contains the licensee's procedures for...

  4. 14 CFR 420.59 - Launch site accident investigation plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Launch site accident investigation plan... Licensee § 420.59 Launch site accident investigation plan. (a) General. A licensee shall develop and implement a launch site accident investigation plan that contains the licensee's procedures for...

  5. 14 CFR 420.59 - Launch site accident investigation plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Launch site accident investigation plan... Licensee § 420.59 Launch site accident investigation plan. (a) General. A licensee shall develop and implement a launch site accident investigation plan that contains the licensee's procedures for...

  6. 14 CFR 420.59 - Launch site accident investigation plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Launch site accident investigation plan... Licensee § 420.59 Launch site accident investigation plan. (a) General. A licensee shall develop and implement a launch site accident investigation plan that contains the licensee's procedures for...

  7. 14 CFR 420.59 - Launch site accident investigation plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Launch site accident investigation plan... Licensee § 420.59 Launch site accident investigation plan. (a) General. A licensee shall develop and implement a launch site accident investigation plan that contains the licensee's procedures for...

  8. Total Quality Management (TQM) as the Procedure for Management of Integrated Academics.

    ERIC Educational Resources Information Center

    Anderson, Lowell D.

    Total Quality Management (TQM) is a way of doing business that involves every employee, both labor and management, in an effort to improve quality and productivity. The quality management concept consists of common principles: (1) customer focus; (2) process focus; (3) failure prevention; (4) mobilization of work force; (5) decision making based…

  9. Don't let safety happen by accident.

    PubMed

    Blaco, C E

    1992-02-01

    Get ready to update and improve your company's safety program. On pages 24-38, you'll find a comprehensive guide to safe industry practices to enhance your operation and help you stay in compliance with OSHA regulations such as the General Duty Clause and the Right-to-Know law. Achieving a safe, healthy, productive, and profitable business doesn't happen by accident. It takes upper-management commitment to improve equipment, procedures, and employee training. Managers have a personal and a legal responsibility for employees' safety on the job. Don't delay safety improvements!

  10. Underreporting of maritime accidents to vessel accident databases.

    PubMed

    Hassel, Martin; Asbjørnslett, Bjørn Egil; Hole, Lars Petter

    2011-11-01

    Underreporting of maritime accidents is a problem not only for authorities trying to improve maritime safety through legislation, but also to risk management companies and other entities using maritime casualty statistics in risk and accident analysis. This study collected and compared casualty data from 01.01.2005 to 31.12.2009, from IHS Fairplay and the maritime authorities from a set of nations. The data was compared to find common records, and estimation of the true number of occurred accidents was performed using conditional probability given positive dependency between data sources, several variations of the capture-recapture method, calculation of best case scenario assuming perfect reporting, and scaling up a subset of casualty information from a marine insurance statistics database. The estimated upper limit reporting performance for the selected flag states ranged from 14% to 74%, while the corresponding estimated coverage of IHS Fairplay ranges from 4% to 62%. On average the study results document that the number of unreported accidents makes up roughly 50% of all occurred accidents. Even in a best case scenario, only a few flag states come close to perfect reporting (94%). The considerable scope of underreporting uncovered in the study, indicates that users of statistical vessel accident data should assume a certain degree of underreporting, and adjust their analyses accordingly. Whether to use correction factors, a safety margin, or rely on expert judgment, should be decided on a case by case basis.

  11. Regional Office Procedures. Stage I Final Report for the Study of Program Management Procedures in the Campus-Based and Basic Grant Programs. (Volume III).

    ERIC Educational Resources Information Center

    Puma, Michael J.

    Volume III of a study of program management procedures in the campus-based and Basic Educational Opportunity Grant (BEOG) programs provides a description of procedures employed within the U.S. Office of Education regional offices to administer the Basic Grant and campus-based student financial assistance programs. The objective of the report is to…

  12. Performance of Core Exit Thermocouple for PWR Accident Management Action in Vessel Top Break LOCA Simulation Experiment at OECD/NEA ROSA Project

    NASA Astrophysics Data System (ADS)

    Suzuki, Mitsuhiro; Takeda, Takeshi; Nakamura, Hideo

    Presented are experiment results of the Large Scale Test Facility (LSTF) conducted at the Japan Atomic Energy Agency (JAEA) with a focus on core exit thermocouple (CET) performance to detect core overheat during a vessel top break loss-of-coolant accident (LOCA) simulation experiment. The CET temperatures are used to start accident management (AM) action to quickly depressurize steam generator (SG) secondary side in case of core temperature excursion. Test 6-1 is the first test of the OECD/NEA ROSA Project started in 2005, simulating withdraw of a control rod drive mechanism penetration nozzle at the vessel top head. The break size is equivalent to 1.9% cold leg break. The AM action was initiated when CET temperature rose up to 623K. There was no reflux water fallback onto the CETs during the core heat-up period. The core overheat, however, was detected with a time delay of about 230s. In addition, a large temperature discrepancy was observed between the CETs and the hottest core region. This paper clarifies the reasons of time delay and temperature discrepancy between the CETs and heated core during boil-off including three-dimensional steam flows in the core and core exit. The paper discusses applicability of the LSTF CET performance to pressurized water reactor (PWR) conditions and a possibility of alternative indicators for earlier AM action than in Test 6-1 is studied by using symptom-based plant parameters such as a reactor vessel water level detection.

  13. 12 CFR 390.353 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Interest-rate-risk-management procedures. 390.353 Section 390.353 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY REGULATIONS TRANSFERRED FROM THE OFFICE OF THRIFT SUPERVISION State Savings Associations-Operations § 390.353...

  14. 12 CFR 390.353 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Interest-rate-risk-management procedures. 390.353 Section 390.353 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY REGULATIONS TRANSFERRED FROM THE OFFICE OF THRIFT SUPERVISION State Savings Associations-Operations § 390.353...

  15. 12 CFR 390.353 - Interest-rate-risk-management procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Interest-rate-risk-management procedures. 390.353 Section 390.353 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY REGULATIONS TRANSFERRED FROM THE OFFICE OF THRIFT SUPERVISION State Savings Associations-Operations § 390.353...

  16. Development of Criteria and Procedures for Management of Classified Document Collections.

    ERIC Educational Resources Information Center

    Rea, Jack C.

    The report describes work done in development of criteria and procedures for management of collections of classified documents. Material is presented on philosophy of operation, concept of user service, accession and retention. Much of the discussion is based upon the concept of conversion to a microfiche-oriented library; however, hard copy…

  17. 20 CFR 668.860 - What cash management procedures apply to INA grant funds?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What cash management procedures apply to INA grant funds? 668.860 Section 668.860 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) INDIAN AND NATIVE AMERICAN PROGRAMS UNDER TITLE I OF THE WORKFORCE...

  18. 20 CFR 668.860 - What cash management procedures apply to INA grant funds?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What cash management procedures apply to INA grant funds? 668.860 Section 668.860 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) INDIAN AND NATIVE AMERICAN PROGRAMS UNDER TITLE I OF THE WORKFORCE...

  19. 20 CFR 668.860 - What cash management procedures apply to INA grant funds?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What cash management procedures apply to INA grant funds? 668.860 Section 668.860 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) INDIAN AND NATIVE AMERICAN PROGRAMS UNDER TITLE I OF THE WORKFORCE...

  20. Directive Management Procedures, Staffing Patterns in Education for Emotionally Disturbed Students.

    ERIC Educational Resources Information Center

    DeYoung, Michael

    A systematic procedure is outlined which gives guidance to therapists and teachers in managing seriously emotionally disturbed (SED) students (9 to 18 years old) who reside at a licensed children's institution or are attending a centralized public school facility for SED students. Among findings from a review of the literature was that intensive…

  1. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Procedures for establishing isolation and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma...

  2. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Procedures for establishing isolation and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma...

  3. 9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Procedures for establishing isolation and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma...

  4. The Effect of Contingency Management Procedures on the Rate of Learning.

    ERIC Educational Resources Information Center

    McKee, John M.; And Others

    Two different groups of subjects--incarcerated adult offenders and freshman nursing students--participated in an academic experiment which employed an individually prescribed learning system. The system featured programmed instructional materials and contingency management procedures to obtain stable cumulative records of learning performance.…

  5. Development of Criteria and Procedures for Management of Classified Document Collections.

    ERIC Educational Resources Information Center

    Rea, Jack C.

    The report describes work done in development of criteria and procedures for management of collections of classified documents. Material is presented on philosophy of operation, concept of user service, accession and retention. Much of the discussion is based upon the concept of conversion to a microfiche-oriented library; however, hard copy…

  6. Spec Kits; Systems and Procedures in the Area of Library Management.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Univ. Library Management Studies.

    The Systems and Procedures Exchange Center (SPEC) of the Association of Research Libraries (ARL) compiles these SPEC Kits as a means of sharing management techniques and expertise. The materials enclosed in each kit are reproductions of working tools developed by individual libraries to meet their specific purposes within a limited area of library…

  7. School Building Maintenance Procedures. School Plant Management Series. Bulletin, 1964, No. 17. OE-21027

    ERIC Educational Resources Information Center

    Finchum, R. N.

    1964-01-01

    Adequate maintenance of school buildings representing a public investment of billions of dollars is a problem of grave concern to both taxpayers and school officials. This publication, one of a series dealing with school plant management problems, identifies, describes, shows the function of, and outlines maintenance procedures for many components…

  8. Activities identification for activity-based cost/management applications of the diagnostics outpatient procedures.

    PubMed

    Alrashdan, Abdalla; Momani, Amer; Ababneh, Tamador

    2012-01-01

    One of the most challenging problems facing healthcare providers is to determine the actual cost for their procedures, which is important for internal accounting and price justification to insurers. The objective of this paper is to find suitable categories to identify the diagnostic outpatient medical procedures and translate them from functional orientation to process orientation. A hierarchal task tree is developed based on a classification schema of procedural activities. Each procedure is seen as a process consisting of a number of activities. This makes a powerful foundation for activity-based cost/management implementation and provides enough information to discover the value-added and non-value-added activities that assist in process improvement and eventually may lead to cost reduction. Work measurement techniques are used to identify the standard time of each activity at the lowest level of the task tree. A real case study at a private hospital is presented to demonstrate the proposed methodology.

  9. [Two cases of congenital airway obstruction managed with ex utero intrapartum treatment procedures: anesthetic implications].

    PubMed

    Manrique, S; Blasco, J; Munar, F; Andreu, E; Mateo, M D; Suescun, M C; López Gil, M V

    2007-01-01

    An ex utero intrapartum treatment (EXIT) procedure provides sufficient time to gain control of the potentially obstructed fetal upper airway while uterine placental circulation is maintained during cesarean section. We report 2 cases in which fetal congenital upper airway obstruction was managed without complications during EXIT procedures. We also discuss general considerations concerning the obstetric patient and the performance of intramuscular fetal anesthesia. Before the hysterotomy, sevoflurane at 1.5 minimum alveolar concentration was administered to assure sufficient uterine relaxation during EXIT. The 2 parturients remained hemodynamically stable during the procedure and uterine and placental perfusion was adequate. Nasotracheal intubation was possible in 1 fetus after a cervical mass was dissected. In the other, a tracheostomy was created. After the umbilical cord was clamped, the concentration of sevoflurane anesthetic gas was reduced and oxytocin and methylergometrine were administered to induce adequate uterine contractions within a few minutes. Both neonates survived the EXIT procedure with no complications.

  10. Analysis of accident sequences and source terms at waste treatment and storage facilities for waste generated by U.S. Department of Energy Waste Management Operations, Volume 1: Sections 1-9

    SciTech Connect

    Mueller, C.; Nabelssi, B.; Roglans-Ribas, J.

    1995-04-01

    This report documents the methodology, computational framework, and results of facility accident analyses performed for the U.S. Department of Energy (DOE) Waste Management Programmatic Environmental Impact Statement (WM PEIS). The accident sequences potentially important to human health risk are specified, their frequencies are assessed, and the resultant radiological and chemical source terms are evaluated. A personal computer-based computational framework and database have been developed that provide these results as input to the WM PEIS for calculation of human health risk impacts. The methodology is in compliance with the most recent guidance from DOE. It considers the spectrum of accident sequences that could occur in activities covered by the WM PEIS and uses a graded approach emphasizing the risk-dominant scenarios to facilitate discrimination among the various WM PEIS alternatives. Although it allows reasonable estimates of the risk impacts associated with each alternative, the main goal of the accident analysis methodology is to allow reliable estimates of the relative risks among the alternatives. The WM PEIS addresses management of five waste streams in the DOE complex: low-level waste (LLW), hazardous waste (HW), high-level waste (HLW), low-level mixed waste (LLMW), and transuranic waste (TRUW). Currently projected waste generation rates, storage inventories, and treatment process throughputs have been calculated for each of the waste streams. This report summarizes the accident analyses and aggregates the key results for each of the waste streams. Source terms are estimated and results are presented for each of the major DOE sites and facilities by WM PEIS alternative for each waste stream. The appendices identify the potential atmospheric release of each toxic chemical or radionuclide for each accident scenario studied. They also provide discussion of specific accident analysis data and guidance used or consulted in this report.

  11. Potential consequences of the Fukushima accident for off-site nuclear emergency management: a case study for Germany.

    PubMed

    Gering, F; Gerich, B; Wirth, E; Kirchner, G

    2013-07-01

    The Fukushima accident led to high radionuclide releases into the atmosphere for more than 3 weeks. This situation has not been assumed when the concepts of nuclear emergency preparedness were developed internationally. The results of simulations studying potential implications of Fukushima-like source terms on nuclear emergency preparedness are presented. Two hypothetical source terms are considered. Radiological consequences are assessed with the decision support system RODOS. Atmospheric dispersion calculations are based on meteorological monitoring data from June and December 2010, respectively, to study potential seasonal effects. Simulations are performed for two nuclear power plant sites in Northern and Southern Germany, respectively. These sites are chosen due to their differing meteorology and topography. Predicted radiation doses of members of the population are compared with dose reference levels actually recommended for initiating protective measures in Germany. Potential implications of general interest for nuclear emergency planning are discussed.

  12. Double Shell Tanks (DST) and Waste Feed Delivery Project Management Quality Affecting Procedures Management Plan

    SciTech Connect

    LUND, D.P.

    2000-09-25

    The purpose of the Double Shell Tanks (DST) and Waste Feed Delivery (WFD) Management Assessment Plan is to define how management assessments within DST h WFD will be conducted. The plan as written currently includes only WFD Project assessment topics. Other DST and WFD group assessment topics will be added in future revisions.

  13. Anesthetic management of a patient undergoing an ex utero intrapartum treatment (EXIT) procedure: a case report.

    PubMed

    Choleva, Abbie J

    2011-12-01

    The ex utero intrapartum treatment (EXIT) procedure involves partial delivery of the fetus with the fetal-placental circulation maintained. This allows for management of the obstructed fetal airway via direct laryngoscopy, bronchoscopy, tracheostomy, or surgical intervention. These complex and often challenging procedures have been performed about 100 times in the United States to date. Recent advances in prenatal diagnosis of fetal congenital malformations, in particular, abnormalities involving the fetal airway, have allowed for the development of the EXIT strategy to convert potentially catastrophic situations during fetal delivery to a controlled environment. Indications for the EXIT procedure have expanded to a variety of congenital abnormalities, including fetal neck masses, lung or mediastinal tumors, congenital high airway obstruction syndrome, conjoined twin separation, and acute respiratory distress syndrome requiring transitioning from EXIT to extracorporeal membrane oxygen transitioning. Various considerations must be managed by the anesthesia provider during the EXIT procedure to ensure positive maternal and fetal outcomes. Careful attention to achieving adequate uterine relaxation, maintaining maternal blood pressure, avoiding placental abruption, prioritizing fetal airway establishment, and providing return of uterine tone when indicated are examples of these considerations. In this case report, a parturient presented for an EXIT procedure secondary to fetal cystic hygroma.

  14. Introduction of the Space Shuttle Columbia Accident, Investigation Details, Findings and Crew Survival Investigation Report

    NASA Technical Reports Server (NTRS)

    Chandler, Michael

    2010-01-01

    As the Space Shuttle Program comes to an end, it is important that the lessons learned from the Columbia accident be captured and understood by those who will be developing future aerospace programs and supporting current programs. Aeromedical lessons learned from the Accident were presented at AsMA in 2005. This Panel will update that information, closeout the lessons learned, provide additional information on the accident and provide suggestions for the future. To set the stage, an overview of the accident is required. The Space Shuttle Columbia was returning to Earth with a crew of seven astronauts on 1Feb, 2003. It disintegrated along a track extending from California to Louisiana and observers along part of the track filmed the breakup of Columbia. Debris was recovered from Littlefield, Texas to Fort Polk, Louisiana, along a 567 statute mile track; the largest ever recorded debris field. The Columbia Accident Investigation Board (CAIB) concluded its investigation in August 2003, and released their findings in a report published in February 2004. NASA recognized the importance of capturing the lessons learned from the loss of Columbia and her crew and the Space Shuttle Program managers commissioned the Spacecraft Crew Survival Integrated Investigation Team (SCSIIT) to accomplish this. Their task was to perform a comprehensive analysis of the accident, focusing on factors and events affecting crew survival, and to develop recommendations for improving crew survival, including the design features, equipment, training and procedures intended to protect the crew. NASA released the Columbia Crew Survival Investigation Report in December 2008. Key personnel have been assembled to give you an overview of the Space Shuttle Columbia accident, the medical response, the medico-legal issues, the SCSIIT findings and recommendations and future NASA flight surgeon spacecraft accident response training. Educational Objectives: Set the stage for the Panel to address the

  15. Vascular Air Embolism During Bronchoscopy Procedures- Incidence, Pathophysiology, Diagnosis, Management and Outcomes

    PubMed Central

    Kanchustambham, Venkatkiran; Saladi, Swetha; Mehta, Kris; Mwangi, John; Jamkhana, Zafar

    2017-01-01

    Vascular air embolism (VAE) is a rare, but potentially fatal complication of invasive medical or surgical procedures. It is a very rare complication of bronchoscopy and is most frequently reported with therapeutic bronchoscopy with Argon plasma coagulation (APC) or neodymium-doped yttrium aluminum garnet (Nd-YAG) laser. Despite being rare, as a result of its high chance of mortality and morbidity, it is imperative that physicians have high clinical suspicion to allow for early recognition and treatment. In this article, we provide a concise review of the incidence, pathophysiology, diagnosis management and outcomes of air embolism during bronchoscopy procedures. PMID:28405537

  16. An ISP-27 accident scenario for analysis of Krsko Nuclear Power Plant SBLOCA

    SciTech Connect

    Petelin, S.; Mavko, B.; Gortnar, O.; Parzer, I.

    1994-12-31

    The reactor safety analysis group of Jozef Stefan Institute (IJS) has participated in analyses of International Standard Problem 27 (ISP-27), which was based on test 9.1 b performed at the BETHSY experimental facility (France). In addition, we realized the ISP-27 transient scenario in the analysis of a small-break loss-of-coolant accident (SBLOCA) for Krsko nuclear power plant (NPP). The objective was to evaluate the effectiveness of the ISP-27 proposed accident management procedure for a real NPP and to compare the physical phenomena known from experimental background with the phenomena predicted by simulation of a real plant transient.

  17. Air Traffic Management Technology Demostration: 1 Research and Procedural Testing of Routes

    NASA Technical Reports Server (NTRS)

    Wilson, Sara R.; Kibler, Jennifer L.; Hubbs, Clay E.; Smail, James W.

    2015-01-01

    NASA's Air Traffic Management Technology Demonstration-1 (ATD-1) will operationally demonstrate the feasibility of efficient arrival operations combining ground-based and airborne NASA technologies. The ATD-1 integrated system consists of the Traffic Management Advisor with Terminal Metering which generates precise time-based schedules to the runway and merge points; Controller Managed Spacing decision support tools which provide controllers with speed advisories and other information needed to meet the schedule; and Flight deck-based Interval Management avionics and procedures which allow flight crews to adjust their speed to achieve precise relative spacing. Initial studies identified air-ground challenges related to the integration of these three scheduling and spacing technologies, and NASA's airborne spacing algorithm was modified to address some of these challenges. The Research and Procedural Testing of Routes human-in-the-loop experiment was then conducted to assess the performance of the new spacing algorithm. The results of this experiment indicate that the algorithm performed as designed, and the pilot participants found the airborne spacing concept, air-ground procedures, and crew interface to be acceptable. However, the researchers concluded that the data revealed issues with the frequency of speed changes and speed reversals.

  18. Using Civilian Supply Chain Management Best Practices to Improve Army Supply Chain Management Procedures

    DTIC Science & Technology

    2017-06-09

    per response , including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...different practices used by civilian corporations that have been tested and proven to achieve enhanced capabilities and improve supply chain procedures... corporations , the Center for Army Lessons Learned, and Combat Training Centers can vastly improve Army logistics. The overall reason of this study is

  19. Evaluation of Flight Deck-Based Interval Management Crew Procedure Feasibility

    NASA Technical Reports Server (NTRS)

    Wilson, Sara R.; Murdoch, Jennifer L.; Hubbs, Clay E.; Swieringa, Kurt A.

    2013-01-01

    Air traffic demand is predicted to increase over the next 20 years, creating a need for new technologies and procedures to support this growth in a safe and efficient manner. The National Aeronautics and Space Administration's (NASA) Air Traffic Management Technology Demonstration - 1 (ATD-1) will operationally demonstrate the feasibility of efficient arrival operations combining ground-based and airborne NASA technologies. The integration of these technologies will increase throughput, reduce delay, conserve fuel, and minimize environmental impacts. The ground-based tools include Traffic Management Advisor with Terminal Metering for precise time-based scheduling and Controller Managed Spacing decision support tools for better managing aircraft delay with speed control. The core airborne technology in ATD-1 is Flight deck-based Interval Management (FIM). FIM tools provide pilots with speed commands calculated using information from Automatic Dependent Surveillance - Broadcast. The precise merging and spacing enabled by FIM avionics and flight crew procedures will reduce excess spacing buffers and result in higher terminal throughput. This paper describes a human-in-the-loop experiment designed to assess the acceptability and feasibility of the ATD-1 procedures used in a voice communications environment. This experiment utilized the ATD-1 integrated system of ground-based and airborne technologies. Pilot participants flew a high-fidelity fixed base simulator equipped with an airborne spacing algorithm and a FIM crew interface. Experiment scenarios involved multiple air traffic flows into the Dallas-Fort Worth Terminal Radar Control airspace. Results indicate that the proposed procedures were feasible for use by flight crews in a voice communications environment. The delivery accuracy at the achieve-by point was within +/- five seconds and the delivery precision was less than five seconds. Furthermore, FIM speed commands occurred at a rate of less than one per minute

  20. Impact of the Great East Japan Earthquake and Fukushima Nuclear Power Plant Accident on Assisted Reproductive Technology in Fukushima Prefecture: The Fukushima Health Management Survey.

    PubMed

    Hayashi, Masako; Fujimori, Keiya; Yasumura, Seiji; Nakai, Akihito

    2017-09-01

    The aim of the study was to evaluate the incidences and obstetric outcomes of women who conceived using assisted reproductive technology (ART) procedures in Fukushima Prefecture before and after the Great East Japan Earthquake and Fukushima nuclear power plant accident. Information was collected and analyzed from 12,070 women who conceived with or without ART in Fukushima Prefecture during the 9 months before and after the disaster. During the 9 months before and after the disaster, 138 (2.0%) and 102 (1.9%) women conceived with in vitro fertilization-embryo transfer (IVF-ET), respectively. The proportion of women who conceived with IVF-ET decreased during the 2 months immediately after the disaster, but returned to pre-disaster levels 3 months after the disaster. In the case of women who conceived without IVF-ET, the incidences of preterm birth and low birth weight increased after the disaster. In contrast, women who conceived with IVF-ET did not differ significantly in obstetric outcomes before and after the disaster but had a higher incidence of cesarean section and low birth weight compared to those conceived without IVF-ET, regardless of the study period. The influence of the disaster on woman who conceived using ART procedures was minimal.

  1. Impact of the Great East Japan Earthquake and Fukushima Nuclear Power Plant Accident on Assisted Reproductive Technology in Fukushima Prefecture: The Fukushima Health Management Survey

    PubMed Central

    Hayashi, Masako; Fujimori, Keiya; Yasumura, Seiji; Nakai, Akihito

    2017-01-01

    Background The aim of the study was to evaluate the incidences and obstetric outcomes of women who conceived using assisted reproductive technology (ART) procedures in Fukushima Prefecture before and after the Great East Japan Earthquake and Fukushima nuclear power plant accident. Methods Information was collected and analyzed from 12,070 women who conceived with or without ART in Fukushima Prefecture during the 9 months before and after the disaster. Results During the 9 months before and after the disaster, 138 (2.0%) and 102 (1.9%) women conceived with in vitro fertilization-embryo transfer (IVF-ET), respectively. The proportion of women who conceived with IVF-ET decreased during the 2 months immediately after the disaster, but returned to pre-disaster levels 3 months after the disaster. In the case of women who conceived without IVF-ET, the incidences of preterm birth and low birth weight increased after the disaster. In contrast, women who conceived with IVF-ET did not differ significantly in obstetric outcomes before and after the disaster but had a higher incidence of cesarean section and low birth weight compared to those conceived without IVF-ET, regardless of the study period. Conclusion The influence of the disaster on woman who conceived using ART procedures was minimal. PMID:28811855

  2. Use of artificial intelligence in severe accident diagnosis for PWRs

    SciTech Connect

    Wu, Zheng; Okrent, D.; Kastenberg, W.E.

    1995-12-31

    A combination approach of an expert system and neural networks is used to implement a prototype severe accident diagnostic system which would monitor the progression of the severe accident and provide necessary plant status information to assist the plant staff in accident management during the accident. The station blackout accident in a pressurized water reactor (PWR) is used as the study case. The current phase of research focus is on distinguishing different primary system failure modes and following the accident transient before and up to vessel breach.

  3. Perioperative atrial fibrillation: A systematic review of evolving therapeutic options in pharmacologic and procedural management

    PubMed Central

    Schleifer, J. William; Ramakrishna, Harish

    2015-01-01

    Given the high incidence of atrial fibrillation (AF) in the surgical population and the associated morbidity, physicians managing these complicated patients in the perioperative period need to be aware of the new and emerging trends in its therapy. The cornerstones of AF management have always been rate/rhythm control as well as anticoagulation. Restoration of sinus rhythm remains the fundamental philosophy as it maintains the atrial contribution to cardiac output and improves ventricular function. The recent years have seen a dramatic increase in the number of randomized AF trials that have made significant advances to our understanding of both pharmacologic and procedural management, from the introduction of the new generation of oral anticoagulants (NOAC's) to catheter approaches for AF ablation. This paper will summarize the newest data that will affect the perioperative management of these patients. PMID:26440243

  4. 40 CFR 68.168 - Five-year accident history.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident...

  5. 40 CFR 68.168 - Five-year accident history.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident...

  6. 40 CFR 68.168 - Five-year accident history.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident...

  7. 40 CFR 68.168 - Five-year accident history.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident...

  8. 40 CFR 68.168 - Five-year accident history.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident...

  9. 36 CFR 9.46 - Accidents and fires.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Accidents and fires. 9.46... MINERALS MANAGEMENT Non-Federal Oil and Gas Rights § 9.46 Accidents and fires. The operator shall take technologically feasible precautions to prevent accidents and fires, shall notify the Superintendent within...

  10. 36 CFR 9.46 - Accidents and fires.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Accidents and fires. 9.46... MINERALS MANAGEMENT Non-Federal Oil and Gas Rights § 9.46 Accidents and fires. The operator shall take technologically feasible precautions to prevent accidents and fires, shall notify the Superintendent within...

  11. 36 CFR 9.46 - Accidents and fires.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Accidents and fires. 9.46... MINERALS MANAGEMENT Non-Federal Oil and Gas Rights § 9.46 Accidents and fires. The operator shall take technologically feasible precautions to prevent accidents and fires, shall notify the Superintendent within...

  12. 36 CFR 9.46 - Accidents and fires.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Accidents and fires. 9.46... MINERALS MANAGEMENT Non-Federal Oil and Gas Rights § 9.46 Accidents and fires. The operator shall take technologically feasible precautions to prevent accidents and fires, shall notify the Superintendent within...

  13. Ultrasound-guided interventional procedures in pain management: Evidence-based medicine.

    PubMed

    Narouze, Samer N

    2010-01-01

    Recently, there has been a growing interest in the application of ultrasonography in pain medicine because ultrasound provides direct visualization of various soft tissues and real-time needle advancement and avoids exposing the health care provider and the patient to the risks of radiation. The machine itself is more affordable and transferrable than a fluoroscopy, computed tomography scan, or magnetic resonance imaging machine. These factors make ultrasonography an attractive adjunct to other imaging modalities in interventional pain management especially when those modalities are not available or feasible.The present article reviews the existing evidence that evaluates the role of ultrasonography in spine interventional procedures in pain management.

  14. System Configuration Management Implementation Procedure for the Canister Storage Building (CSB)

    SciTech Connect

    GARRISON, R.C.

    2000-09-22

    This document implements the procedure for providing configuration control for the monitoring and control systems associated with the operation of the Canister Storage Building (CSB). It identifies and defines the configuration items in the monitoring and control systems, provides configuration control of these items throughout the system life cycle, provides configuration status accounting, physical protection and control, and verifies the completeness and correctness of the items. It is written to comply with HNF-SD-SNF-CM-001, Spent Nuclear Fuel Configuration Management Plan (Forehand 1998), HNF-PRO-309, Computer Software Quality Assurance Requirements, HNF-PRO-2778, IRM Application Software System Life Cycle Standards, and applicable sections of administrative procedure AP-CM-6-037-00, SNF Project Process Automation Software and Equipment Configuration Management.

  15. Multi-procedure management in an eyeglasses-related open globe injury.

    PubMed

    Skopiński, Piotr; Woronkowicz, Małgorzata; Langwińska-Wośko, Ewa; Korwin, Magdalena; Kołodziejczyk, Wojciech; Ambroziak, Anna Maria

    2014-03-01

    We present a case of successful multi-procedure management of a patient with an open globe injury. A 47-year-old man sustained an injury to his left eye caused by glass fragments of his own spectacles shattered while he was protecting an unknown woman from physical assault at a bus stop. Over a span of 65 months the patient underwent multiple procedures including primary wound repair, penetrating keratoplasty combined with extracapsular cataract extraction, neodymium: YAG laser capsulotomy, and laser-assisted subepithelial keratectomy (LASEK), and had a successfully treated episode of corneal graft rejection. This sequence of treatment substantially improved his left eye vision from hand movements at the time of admission to 0.9-0.5 × 90 at the last follow-up nearly 10 years after the trauma. Proper initial surgical management of an open globe injury can create the possibility for virtually complete vision restoration.

  16. Clinical Presentation, Imaging, and Management of Complications due to Neurointerventional Procedures

    PubMed Central

    Davis, Matthew C.; Deveikis, John P.; Harrigan, Mark R.

    2015-01-01

    Neurointervention is a rapidly evolving and complex field practiced by clinicians with backgrounds ranging from neurosurgery to radiology, neurology, cardiology, and vascular surgery. New devices, techniques, and clinical applications create exciting opportunities for impacting patient care, but also carry the potential for new iatrogenic injuries. Every step of every neurointerventional procedure carries risk, and a thorough appreciation of potential complications is fundamental to maximizing safety. This article presents the most frequent and dangerous iatrogenic injuries, their presentation, identification, prevention, and management. PMID:26038618

  17. Static procedures for the management of the midface and lower face.

    PubMed

    Liu, Yuk Ming; Sherris, David A

    2008-05-01

    Facial reanimation for facial paralysis continues to be an evolving field in facial reconstruction. Static procedures in the management of mid and lower facial paralysis include the use of facial slings made from autologous tissue, freeze-dried acellular human dermis, and expanded polytetrafluoroethylene. A newly described suspension technique using a multivector suture suspension stands to expand the tools that can be used by the reconstructive surgeon. This article describes and contrasts each of these techniques.

  18. Effect of evacuation on liver function after the Fukushima Daiichi Nuclear Power Plant accident: The Fukushima Health Management Survey.

    PubMed

    Takahashi, Atsushi; Ohira, Tetsuya; Hosoya, Mitsuaki; Yasumura, Seiji; Nagai, Masato; Ohira, Hiromasa; Hashimoto, Shigeatsu; Satoh, Hiroaki; Sakai, Akira; Ohtsuru, Akira; Kawasaki, Yukihiko; Suzuki, Hitoshi; Kobashi, Gen; Ozasa, Kotaro; Yamashita, Shunichi; Kamiya, Kenji; Abe, Masafumi

    2017-04-01

    The Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident caused residents to switch from their normal lives to lives focused on evacuation. We evaluated liver function before and after this disaster to elucidate the effects of evacuation on liver function. This study was a longitudinal survey of 26,006 Japanese men and women living near the Fukushima Daiichi Nuclear Power Plant. This study was undertaken using data from annual health checkups conducted for persons aged 40-90 years between 2008 and 2010. Follow-up examinations were conducted from June 2011 to the end of March 2013, with a mean follow up of 1.6 years. Changes in liver function before and after the disaster were compared among evacuees and non-evacuees. We also assessed groups according to alcohol drinking status. The prevalence of liver dysfunction significantly increased in all participants from 16.4% before to 19.2% after the disaster. The incidence of liver dysfunction was significantly higher in evacuees than in non-evacuees. Multivariate logistic regression analysis showed that evacuation was significantly associated with liver dysfunction among residents. This is the first study to show that evacuation due to the Fukushima Daiichi nuclear power plant disaster was associated with an increase in liver dysfunction. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  19. Peroral endoscopic myotomy: procedural complications and pain management for the perioperative clinician

    PubMed Central

    Misra, Lopa; Fukami, Norio; Nikolic, Katarina; Trentman, Terrence L

    2017-01-01

    Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus. The aim of our study is to document perioperative pain and associated pain management for our initial patients undergoing POEM and to review the literature for perioperative complications of this procedure. Therefore, anesthetic and pain management for our initial eleven patients undergoing POEM were reviewed. Patient demographics, pre-POEM pain medication history, perioperative pain medication requirements, and post-POEM pain scores were examined. We found post-POEM pain was usually in the mild–moderate range; a combination of medications was effective (opioids, nonsteroidal anti-inflammatory drugs, acetaminophen). Our literature search revealed a wide frequency range of complications such as pneumoperitoneum and subcutaneous emphysema, with rare serious events such as capnopericardium leading to cardiac arrest. In conclusion, our experience with POEM suggests pain and can be managed adequately with a combination of medications; the procedure appears to be safe and reasonable to perform in an outpatient endoscopy unit. PMID:28260955

  20. Guidelines for accident prevention and emergency preparedness

    SciTech Connect

    Fthenakis, V.M.; Morris, S.C.; Moskowitz, P.D.

    1993-05-01

    This report reviews recent developments in the guidelines on chemical accident prevention, risk assessment, and management of chemical emergencies, principally in the United States and Europe, and discusses aspects of their application to developing countries. Such guidelines are either in the form of laws or regulations promulgated by governments, or of recommendations from international, professional, or non governmental organizations. In many cases, these guidelines specify lists of materials of concern and methods for evaluating safe usage of these materials and recommend areas of responsibility for different organizations; procedures to be included in planning, evaluation, and response; and appropriate levels of training for different classes of workers. Guidelines frequently address the right of communities to be informed of potential hazards and address ways for them to participate in planning and decision making.

  1. Remote control continuous mining machine crushing accident data study

    SciTech Connect

    2006-05-11

    A committee was formed to identify norms and trends in remote control continuous miner crushing accidents as part of US MSHA's efforts to reduce and eliminate these types of accidents. The committee was tasked with collecting, reviewing, and evaluating remote control accident data to identify significant factors that could possibly contribute to remote control accidents. The report identifies that these types of accidents commonly happen to experienced miners during routine mining activities, with the majority occurring while moving the miner from one face to another (place changing). Another common aspect of the accidents is that many of the victims are newly employed at the mine where the accident occurred. Training all employees to stay outside the turning radius of an energized remote control continuous miner, establishing this as a safe operating procedure, and consistently enforcing this practice among miners will reduce these types of accidents. 10 figs., 5 tabs., 7 apps.

  2. Severe accident simulation at Olkiuoto

    SciTech Connect

    Tirkkonen, H.; Saarenpaeae, T.; Cliff Po, L.C.

    1995-09-01

    A personal computer-based simulator was developed for the Olkiluoto nuclear plant in Finland for training in severe accident management. The generic software PCTRAN was expanded to model the plant-specific features of the ABB Atom designed BWR including its containment over-pressure protection and filtered vent systems. Scenarios including core heat-up, hydrogen generation, core melt and vessel penetration were developed in this work. Radiation leakage paths and dose rate distribution are presented graphically for operator use in diagnosis and mitigation of accidents. Operating on an graphically for operator use in diagnosis and mitigation of accidents. Operating on an 486 DX2-66, PCTRAN-TVO achieves a speed about 15 times faster than real-time. A convenient and user-friendly graphic interface allows full interactive control. In this paper a review of the component models and verification runs are presented.

  3. Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures

    PubMed Central

    Souza, Juliana; Santos-Pinto, Lourdes; Pansani, Cyneu

    2014-01-01

    ABSTRACT Aim: This paper reports two clinical cases in which the application of low-level laser therapy (LLLT) enhanced the postoperative symptoms after pediatric surgical procedures. Background: The uses of novel technologies allow more comfort to the patients and ensure a rapid procedure, and LLLT application has shown a positive effect in the prevention of discomfort after invasive procedures. Case description: Low-level laser therapy protocol was applied after surgical removal of supernumerary tooth and frenectomy resulting in less swallow and pain with no need of medication intake. Conclusion: The laser application was well accepted by both children and parents and showed a clinical efficiency in the follow-up examinations beyond the satisfactory quality of wound healing. Clinical significance: The LLLT approach is an excellent adjuvant therapy resource for delivery an optimal postoperative after surgical procedures in children. How to cite this article: Paschoal M, Souza J, Santos-Pinto L, Pansani C. Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures. Int J Clin Pediatr Dent 2014;7(2):125-129. PMID:25356012

  4. Correspondence model of occupational accidents.

    PubMed

    Conte, Juan C; Rubio, Emilio A; García, Ana I; Cano, Francisco J

    2011-09-01

    We present a new generalized model for the diagnosis and prediction of accidents among the Spanish workforce. Based on observational data of the accident rate in all Spanish companies over eleven years (7,519,732 accidents), we classified them in a new risk-injury contingency table (19×19). Through correspondence analysis, we obtained a structure composed of three axes whose combination identifies three separate risk and injury groups, which we used as a general Spanish pattern. The most likely or frequent relationships between the risk and injuries identified in the pattern facilitated the decision-making process in companies at an early stage of risk assessment. Each risk-injury group has its own characteristics, which are understandable within the phenomenological framework of the accident. The main advantages of this model are its potential application to any other country and the feasibility of contrasting different country results. One limiting factor, however, is the need to set a common classification framework for risks and injuries to enhance comparison, a framework that does not exist today. The model aims to manage work-related accidents automatically at any level.

  5. Early reoperation performed for the management of complications in patients undergoing general thoracic surgical procedures

    PubMed Central

    Foroulis, Christophoros N.; Kleontas, Athanasios; Karatzopoulos, Avgerinos; Nana, Chryssoula; Tagarakis, George; Tossios, Paschalis; Anastasiadis, Kyriakos

    2014-01-01

    Objective To detect the rate and predisposing factors for the development of postoperative complications requiring re-operation for their control in the immediate postoperative period. Methods During the time period 2009-2012, 719 patients (male: 71.62%, mean age: 54±19 years) who underwent a wide range of general thoracic surgery procedures, were retrospectively collected. Data of patients who underwent early re-operation for the management of postoperative complications were assessed for identification of the responsible causative factors. Results Overall, 33/719 patients (4.6%) underwent early re-operation to control postoperative complications. Early re-operation was obviated by the need to control bleeding or to drain clotted hemothoraces in nine cases (27.3%), to manage a prolonged air leak in six cases (18.2%), to drain a post-thoracotomy empyema in five cases (15.2%), to revise the thoracotomy incision or an ischemic musculocutaneous flap in five cases (15.2%), to manage a bronchopleural fistula in four cases (12.1%), to manage persistent atelectasis of the remaining lung in two cases (6.1%), to cease a chyle leak in one case (3%) and to plicate the right hemidiaphragm in another one case (3%). The factors responsible for the development of complications requiring reopening of the chest for their management were technical in 17 cases (51.5%), initial surgery for lung or pleural infections in 9 (27.3%), the recent antiplatelet drug administration in 4 (12.1%) and advanced lung emphysema in 3 (9.1%). Mortality of re-operations was 6.1% (2/33) and it was associated with the need to proceed with completion pneumonectomy in the two cases with persistent atelectasis of the remaining lung and permanent parenchymal damage. The majority of complications requiring reoperation were observed after lung parenchyma resection (17 out of the 228 procedures/7.4%) or pleurectomy (7 out of the 106 procedures/6.5%). Reoperations after video-assisted thoracic surgery (VATS

  6. Airway Management During Upper GI Endoscopic Procedures: State of the Art Review.

    PubMed

    Goudra, Basavana; Singh, Preet Mohinder

    2017-01-01

    With the growing popularity of propofol mediated deep sedation for upper gastrointestinal (GI) endoscopic procedures, challenges are being felt and appreciated. Research suggests that management of the airway is anything but routine in this setting. Although many studies and meta-analyses have demonstrated the safety of propofol sedation administered by registered nurses under the supervision of gastroenterologists (likely related to the lighter degrees of sedation than those provided by anesthesia providers and is under medicolegal controversy in the United States), there is no agreement on the optimum airway management for procedures such as endoscopic retrograde cholangiopancreatography. Failure to rescue an airway at an appropriate time has led to disastrous consequences. Inability to evaluate and appreciate the risk factors for aspiration can ruin the day for both the patient and the health care providers. This review apprises the reader of various aspects of airway management relevant to the practice of sedation during upper GI endoscopy. New devices and modification of existing devices are discussed in detail. Recognizing the fact that appropriate monitoring is important for timely recognition and management of potential airway disasters, these issues are explored thoroughly.

  7. Human-Centered Technologies and Procedures for Future Air Traffic Management

    NASA Technical Reports Server (NTRS)

    Smith, Philip; Woods, David; McCoy, Elaine; Billings, Charles; Sarter, Nadine; Denning, Rebecca; Dekker, Sidney

    1997-01-01

    The use of various methodologies to predict the impact of future Air Traffic Management (ATM) concepts and technologies is explored. The emphasis has been on the importance of modeling coordination and cooperation among multiple agents within this system, and on understanding how the interactions among these agents will be influenced as new roles, responsibilities, procedures and technologies are introduced. To accomplish this, we have been collecting data on performance under the current air traffic management system, identifying critical problem areas and looking for examples suggestive of general approaches for solving such problems. Using the results of these field studies, we have developed a set of concrete scenarios centered around future designs, and have studied performance in these scenarios with a set of 40 controllers, dispatchers, pilots and traffic managers.

  8. [Standard operating procedures and operating room management: Improvement of patient safety and the efficiency of processes].

    PubMed

    Bleyl, Jörg U; Heller, Axel R

    2008-01-01

    Financial pressures have led the way more efficiency in health care management. To decrease hospital costs a more proficient use of personal resources is required. The drive to increase efficiency with the concomitant increase in workload can cause a reduction in quality of patient care and of patient security. A professional operating room (OR) management and the introduction of standard operating procedures (SOP) have helped to optimise workflow in and around the OR. OR management can control an efficient workflow and generate data concerning performance, costs and quality. SOPs lead to a standardisation of workflow in the OR and in patient treatment modalities. This guaranties a high quality in patient care and more safety despite an increase in work-load.

  9. Designing an Experimental "Accident"

    ERIC Educational Resources Information Center

    Picker, Lester

    1974-01-01

    Describes an experimental "accident" that resulted in much student learning, seeks help in the identification of nematodes, and suggests biology teachers introduce similar accidents into their teaching to stimulate student interest. (PEB)

  10. Management of Agricultural Weather Risks: traditional procedures and new management strategies

    NASA Astrophysics Data System (ADS)

    Burgaz, F.

    2009-04-01

    Throughout history, agriculture has progressed as an outcome of farmers' efforts to design and apply adaptation strategies aiming to mitigate the impact of adverse meteorological phenomena on their farms' economy. The survival and sustainability of farmholdings, regardless of size or type of production, is directly related to their capacity to withstand the consequences of such phenomena and continue to yield a harvest year after year. While substantial differences can be identified in the intensity and frequency of the damage borne, depending on the country, region and type of production, no farm is exempt from the effects of uncontrollable risks. In this endeavour to mitigate such consequences and successfully manage natural risks, the first protective step must be taken by the farm itself, which must adopt measures that pursue more favourable crop development or a heightened ability to handle risks and their adverse effects. But when the damage inflicted is of an intensity that cannot be accommodated by the farmer, instruments must be deployed that spread or transfer risk to third parties, a process known as risk insurance. Experience shows that of the various such instruments in place, insurance constitutes the most appropriate risk management model and the one that has reached the highest levels of development and acceptance among farmers.

  11. The role of safety analysis in accident prevention.

    PubMed

    Suokas, J

    1988-02-01

    The need for safety analysis has grown in the fields of nuclear industry, civil and military aviation and space technology where the potential for accidents with far-reaching consequences for employees, the public and the environment is most apparent. Later the use of safety analysis has spread widely to other industrial branches. General systems theory, accident theories and scientific management represent domains that have influenced the development of safety analysis. These relations are shortly presented and the common methods employed in safety analysis are described and structured according to the aim of the search and to the search strategy. A framework for the evaluation of the coverage of the search procedures employed in different methods of safety analysis is presented. The framework is then used in an heuristic and in an empiric evaluation of hazard and operability study (HAZOP), work safety analysis (WSA), action error analysis (AEA) and management oversight and risk tree (MORT). Finally, some recommendations on the use of safety analysis for preventing accidents are presented.

  12. Accident prevention in radiotherapy

    PubMed Central

    Holmberg, O

    2007-01-01

    In order to prevent accidents in radiotherapy, it is important to learn from accidents that have occurred previously. Lessons learned from a number of accidents are summarised and underlying patterns are looked for in this paper. Accidents can be prevented by applying several safety layers of preventive actions. Categories of these preventive actions are discussed together with specific actions belonging to each category of safety layer. PMID:21614274

  13. Prevention and Management of Procedural Pain in the Neonate: An Update.

    PubMed

    2016-02-01

    The prevention of pain in neonates should be the goal of all pediatricians and health care professionals who work with neonates, not only because it is ethical but also because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor, yet painful procedures. Therefore, every health care facility caring for neonates should implement (1) a pain-prevention program that includes strategies for minimizing the number of painful procedures performed and (2) a pain assessment and management plan that includes routine assessment of pain, pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and measures for minimizing pain associated with surgery and other major procedures.

  14. Management of vaginal extrusion after tension-free vaginal tape procedure for urodynamic stress incontinence.

    PubMed

    Giri, Subhasis K; Sil, Debasri; Narasimhulu, Girish; Flood, Hugh D; Skehan, Mark; Drumm, John

    2007-06-01

    To report our experience in the management of vaginal extrusion after the tension-free vaginal tape (TVT) procedure for urodynamic stress incontinence. Five patients diagnosed with vaginal extrusion after a TVT procedure performed at our institution were identified. We reviewed the patients' records retrospectively. The interval from TVT placement to diagnosis, presenting symptoms and signs, duration of symptoms, diagnostic test findings, treatment, and postoperative results were recorded. Patients were followed up for at least 12 months. From January 2001 to June 2004, a total of 166 patients underwent the TVT procedure. Of these, 5 patients (3%) were diagnosed with isolated vaginal extrusion 4 to 40 months postoperatively. No cases of urethral or bladder erosion occurred in this series. The symptoms included vaginal discharge, pain, bleeding, and dyspareunia. The eroded margin of the vaginal mucosa was trimmed, mobilized, and closed over the tape with interrupted vertical mattress sutures in a single layer using 2-0 polyglactin 910 to avoid mucosal inversion. All patients remained symptom free without any evidence of defective healing or additional extrusion at a minimal follow-up of 12 months. Primary reclosure of the vaginal mucosa over the TVT tape is an effective first-line treatment option for vaginal extrusion without compromising continence. Patients undergoing the TVT procedure should be adequately counseled about the possibility of this complication and the available treatment options.

  15. Long-term follow-up of radiation accident patients in Peru: review of two cases.

    PubMed

    Barriga, L E; Zaharia, M; Pinillos, L; Moscol, A; Heredia, A; Sarria, G; Marquina, J; Barriga, O; Picon, C

    2012-10-01

    Overexposure to radioactive sources used in radiotherapy or industrial radiography may result in severe health consequences. This report assesses the initial clinical status and the medical and psychological long-term follow-up of two radiation accident patients from Peru during the mid-to-late 1990s: one patient exposed to a radiotherapy (60)Co source in Arequipa, the other patient to a (192)Ir source in Yanango. Commonalities and differences are described. The main causes in both accidents were human error and the failure to apply appropriate safety guidelines and standard operating procedures. Education and training of the personnel working with radiation sources are essential to prevent accidents. The experience gained from the medical management of the two patients is valuable for future treatment of such patients.

  16. Pain management procedures used by dental and maxillofacial surgeons: an investigation with special regard to odontalgia.

    PubMed

    Wirz, Stefan; Wartenberg, Hans Christian; Nadstawek, Joachim

    2005-12-22

    Little is known about the procedures used by German dental and maxillofacial surgeons treating patients suffering from chronic orofacial pain (COP). This study aimed to evaluate the ambulatory management of COP. Using a standardized questionnaire we collected data of dental and maxillofacial surgeons treating patients with COP. Therapists described variables as patients' demographics, chronic pain disorders and their aetiologies, own diagnostic and treatment principles during a period of 3 months. Although only 13.5% of the 520 addressed therapists returned completely evaluable questionnaires, 985 patients with COP could be identified. An orofacial pain syndrome named atypical odontalgia (17.0 %) was frequent. Although those patients revealed signs of chronification, pain therapists were rarely involved (12.5%). For assessing pain the use of Analogue Scales (7%) or interventional diagnostics (4.6%) was uncommon. Despite the fact that surgical procedures are cofactors of COP therapists preferred further surgery (41.9%) and neglected the prescription of analgesics (15.7%). However, most therapists self-evaluated the efficacy of their pain management as good (69.7 %). Often ambulatory dental and maxillofacial surgeons do not follow guidelines for COP management despite a high prevalence of severe orofacial pain syndromes.

  17. Pain management procedures used by dental and maxillofacial surgeons: an investigation with special regard to odontalgia

    PubMed Central

    Wirz, Stefan; Wartenberg, Hans Christian; Nadstawek, Joachim

    2005-01-01

    Background Little is known about the procedures used by German dental and maxillofacial surgeons treating patients suffering from chronic orofacial pain (COP). This study aimed to evaluate the ambulatory management of COP. Methods Using a standardized questionnaire we collected data of dental and maxillofacial surgeons treating patients with COP. Therapists described variables as patients' demographics, chronic pain disorders and their aetiologies, own diagnostic and treatment principles during a period of 3 months. Results Although only 13.5% of the 520 addressed therapists returned completely evaluable questionnaires, 985 patients with COP could be identified. An orofacial pain syndrome named atypical odontalgia (17.0 %) was frequent. Although those patients revealed signs of chronification, pain therapists were rarely involved (12.5%). For assessing pain the use of Analogue Scales (7%) or interventional diagnostics (4.6%) was uncommon. Despite the fact that surgical procedures are cofactors of COP therapists preferred further surgery (41.9%) and neglected the prescription of analgesics (15.7%). However, most therapists self-evaluated the efficacy of their pain management as good (69.7 %). Conclusion Often ambulatory dental and maxillofacial surgeons do not follow guidelines for COP management despite a high prevalence of severe orofacial pain syndromes. PMID:16372908

  18. Human Factors in Cabin Accident Investigations

    NASA Technical Reports Server (NTRS)

    Chute, Rebecca D.; Rosekind, Mark R. (Technical Monitor)

    1996-01-01

    Human factors has become an integral part of the accident investigation protocol. However, much of the investigative process remains focussed on the flight deck, airframe, and power plant systems. As a consequence, little data has been collected regarding the human factors issues within and involving the cabin during an accident. Therefore, the possibility exists that contributing factors that lie within that domain may be overlooked. The FAA Office of Accident Investigation is sponsoring a two-day workshop on cabin safety accident investigation. This course, within the workshop, will be of two hours duration and will explore relevant areas of human factors research. Specifically, the three areas of discussion are: Information transfer and resource management, fatigue and other physical stressors, and the human/machine interface. Integration of these areas will be accomplished by providing a suggested checklist of specific cabin-related human factors questions for investigators to probe following an accident.

  19. Dialectical Behavior Therapy and Eating Disorders: The Use of Contingency Management Procedures to Manage Dialectical Dilemmas.

    PubMed

    Wisniewski, Lucene; Ben-Porath, Denise D

    2015-01-01

    Several researchers have adapted and/or applied dialectical behavior therapy (DBT) for populations with eating disorders. There is a growing body of research that indicates that DBT is an effective treatment option for this population, including those who have co-occurring Axis II disorders. The goal of the current paper is to summarize the research conducted in the area of DBT with those individuals who present with eating disorders only as well as those who present with both eating disorders and Axis II disorders. We also describe a dialectical dilemma, apparent compliance vs. active defiance, which is commonly observed in the group with comorbidities A DBT change strategy, contingency management, is discussed as an intervention to target apparent compliance and active defiance.

  20. Management of coronal discolouration following a regenerative endodontic procedure in a maxillary incisor.

    PubMed

    D'Mello, G; Moloney, L

    2017-03-01

    Pulpal necrosis and infection in an immature anterior tooth subsequent to traumatic injury is a challenging situation. Regenerative endodontics, resulting in continued development of the tooth, provides a biological response to this clinical challenge. Regenerative endodontic procedures require disinfection of the infected root canal and sealing of the pulp canal space. Mineral trioxide aggregate (MTA) provides a good seal, is biocompatible and allows the formation of a hard tissue to occur within the root canal. MTA, however, can lead to significant staining of the crown of the tooth that is difficult to mask. This case report describes the management of discolouration in an 11 year old girl subsequent to a regenerative endodontic procedure in an immature traumatized maxillary central incisor. © 2016 Australian Dental Association.

  1. [EXIT procedure in the management of severe foetal airway obstruction. the paediatric otolaryngologist's perspective].

    PubMed

    Pellicer, Marc; Pumarola, Félix; Peiró, José Luis; Martínez Ibáñez, Vicente; García Vaquero, Juan Antono; Carreras, Elena; Manrique, Susana; Vinzo, Joan; Perelló, Enrique

    2007-12-01

    The ex-utero intrapartum treatment (EXIT) procedure is a technique designed to allow partial foetal delivery via caesarean section with establishment of a safe foetal airway by either intubation, bronchoscopy, or tracheostomy while foetal oxygenation is maintained through utero-placental circulation. The most common indication for the EXIT procedure is the presence of foetal airway obstruction, which is usually caused by a prenatal diagnosed neck mass. We report three cases of head and neck tumours with airway obstruction treated by means of EXIT and with different solutions in the management of the airway. With the involvement of Paediatric Otolaryngologists in EXIT, new indications and select variations from the standard EXIT protocol should be considered.

  2. Interventional Spine Procedures for Management of Chronic Low Back Pain—A Primer

    PubMed Central

    Iannuccilli, Jason D.; Prince, Ethan A.; Soares, Gregory M.

    2013-01-01

    Chronic low back pain is a common clinical condition. Percutaneous fluoroscopic-guided interventions are safe and effective procedures for the management of chronic low back pain, which can be performed in an outpatient setting. Interventional radiologists already possess the technical skills necessary to perform these interventions effectively so that they may be incorporated into a busy outpatient practice. This article provides a basic approach to the evaluation of patients with low back pain, as well as a review of techniques used to perform the most common interventions using fluoroscopic guidance. PMID:24436553

  3. System Configuration Management Implementation Procedure for the Canister Storage Building (CSB)

    SciTech Connect

    GARRISON, R.C.

    2000-11-28

    This document provides configuration management for the Distributed Control System (DCS), the Gaseous Effluent Monitoring System (GEMS-100) System, the Heating Ventilation and Air Conditioning (HVAC) Programmable Logic Controller (PLC), the Canister Receiving Crane (CRC) CRN-001 PLC, and both North and South vestibule door interlock system PLCs at the Canister Storage Building (CSB). This procedure identifies and defines software configuration items in the CSB control and monitoring systems, and defines configuration control throughout the system life cycle. Components of this control include: configuration status accounting; physical protection and control; and verification of the completeness and correctness of these items.

  4. Pain and anxiety management for pediatric dental procedures using various combinations of sedative drugs: A review.

    PubMed

    Gazal, Giath; Fareed, Wamiq Musheer; Zafar, Muhammad Sohail; Al-Samadani, Khalid H

    2016-07-01

    For fearful and uncooperative children behavioral management techniques are used. In order to control the pain and anxiety in pedodontic patients, pharmacologic sedation, anesthesia and analgesia are commonly used. Midazolam is commonly used as an oral sedation agent in children; it has several features such as safety of use, quick onset and certain degree of amnesia that makes it a desirable sedation agent in children. This review paper discusses various aspects of oral midazolam, ketamine and their combinations in conscious sedation including, advantages of oral route of sedation, pharmacokinetics, range of oral doses, and antagonists for clinical dental treatment procedures.

  5. Data management tools and operational procedures in ATLAS : Example of the German cloud

    NASA Astrophysics Data System (ADS)

    Serfon, Cédric

    2010-04-01

    A set of tools have been developed to ensure the Data Management operations (deletion, consistency checks) within the German cloud for ATLAS. These tools are described hereafter and presented in the context of the operational procedures of the German cloud. A particular emphasis is put on the consistency checks between the different catalogs (LFC, DQ2 Central Catalogs) and the files stored on the Storage Element. These consistency checks are crucial to be sure that all the data stored in the sites are actually available for the users and to get rid of non registered files also known as Dark Data.

  6. Management and clinical outcomes in patients treated with apixaban vs warfarin undergoing procedures

    PubMed Central

    Alexander, John H.; Wallentin, Lars; Wojdyla, Daniel M.; Thomas, Laine; Hanna, Michael; Al-Khatib, Sana M.; Dorian, Paul; Ansell, Jack; Commerford, Patrick; Flaker, Greg; Lanas, Fernando; Vinereanu, Dragos; Xavier, Denis; Hylek, Elaine M.; Held, Claes; Verheugt, Freek W. A.; Granger, Christopher B.; Lopes, Renato D.

    2014-01-01

    Using data from ARISTOTLE, we describe the periprocedural management of anticoagulation and rates of subsequent clinical outcomes among patients chronically anticoagulated with warfarin or apixaban. We recorded whether (and for how long) anticoagulant therapy was interrupted preprocedure, whether bridging therapy was used, and the proportion of patients who experienced important clinical outcomes during the 30 days postprocedure. Of 10 674 procedures performed during follow-up in 5924 patients, 9260 were included in this analysis. Anticoagulant treatment was not interrupted preprocedure 37.5% of the time. During the 30 days postprocedure, stroke or systemic embolism occurred after 16/4624 (0.35%) procedures among apixaban-treated patients and 26/4530 (0.57%) procedures among warfarin-treated patients (odds ratio [OR] 0.601; 95% confidence interval [CI] 0.322-1.120). Major bleeding occurred in 74/4560 (1.62%) procedures in the apixaban arm and 86/4454 (1.93%) in the warfarin arm (OR 0.846; 95% CI 0.614-1.166). The risk of death was similar with apixaban (54/4624 [1.17%]) and warfarin (49/4530 [1.08%]) (OR 1.082; 95% CI 0.733-1.598). Among patients in ARISTOTLE, the 30-day postprocedure stroke, death, and major bleeding rates were low and similar in apixaban- and warfarin-treated patients, regardless of whether anticoagulation was stopped beforehand. Our findings suggest that many patients on chronic anticoagulation can safely undergo procedures; some will not require a preprocedure interruption of anticoagulation. ARISTOTLE was registered at www.clinicaltrials.gov as #NCT00412984. PMID:25320240

  7. Biosecurity procedures for the environmental management of carcasses burial sites in Korea.

    PubMed

    Kim, Geon-Ha; Pramanik, Sudipta

    2016-12-01

    Avian influenza and foot-and-mouth disease are two main contagious pathogenic viral disease which are responsible for the massive burials of livestock in Korea since burial is the primary measure to control these outbreaks. Biosecurity is a set of preventive measures designed to prevent the risk of spreading of these infectious diseases. The main objective of this paper is to discuss about the requirements of biosecurity and develop protocol outlines for environmental management of burial sites in Korea. Current practice prescribes to minimize the potential for on-farm pollution and the spread of the infectious diseases. Specific biosecurity procedures such as proper assessment of leachate quality, safe handling and disposal of leachate, adequate leachate pollution monitoring, necessary seasonal management of burial site, and appropriate sterilization process must be carried out to prevent the indirect transmission of pathogens from the burial sites. Policy makers should acquire robust knowledge of biosecurity for establishing more effective future legislation for carcasses disposal in Korea.

  8. The unique contribution of the nursing intervention pain management on length of stay in older patients undergoing hip procedures.

    PubMed

    Kerr, Peg; Shever, Leah; Titler, Marita G; Qin, Rui; Kim, Taikyoung; Picone, Debra M

    2010-02-01

    The purpose of this study was to examine the unique contribution of the nursing intervention pain management on length of stay (LOS) for 568 older patients hospitalized for hip procedures. Propensity-score-adjusted analysis was used to determine the effect of pain management on LOS. The LOS for hospitalizations that received pain management was 0.78 day longer than that for hospitalizations that did not receive pain management. Other variables that were predictors of LOS included several context-of-care variables (e.g., time spent in the intensive care unit, registered nurse skill mix, etc.), number of medical procedures and unique medications, and several other nursing interventions.

  9. Report: EPA Needs Policies and Procedures to Manage Public Pesticide Petitions in a Transparent and Efficient Manner

    EPA Pesticide Factsheets

    Report #16-P-0019, October 27, 2015. OPP’s lack of policies and procedures to manage public pesticide petitions in a transparent and efficient manner can result in unreasonable delay lawsuits costing the agency time and resources.

  10. Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory.

    PubMed

    Hilário, Thamires de Souza; Santos, Simone Marques Dos; Kruger, Juliana; Goes, Martha Georgina; Casco, Márcia Flores; Rabelo-Silva, Eneida Rejane

    2017-05-25

    To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Cross-sectional study with retrospective data collection. Overall, 345 patients were included; 116 (34%) experienced post-procedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. Describir cómo se evalúa el dolor (características, localización e intensidad) y su manejo en la práctica clínica en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterización. Estudio transversal con recolección retrospectiva de datos. En total, se incluyeron 345 pacientes; 116 (34%) experimentaron dolor post-procedimiento; en 107 (92%), no se registraron las características del dolor; la localización del dolor se informó en el 100% de los pacientes, y su intensidad en 111 (96%); el manejo fue en gran medida farmacológico; de los pacientes que recibieron algún tipo de tratamiento (n=71), 42 (59%) fueron sometidos a reevaluación del dolor. La ubicación y la intensidad del dolor se informan bien en la práctica clínica. El manejo farmacológico del dolor sigue siendo frecuente. Se necesitan esfuerzos adicionales para asegurar el registro de las características del dolor y su reevaluación después de las intervenciones.

  11. 40 CFR 68.75 - Management of change.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Management of change. 68.75 Section 68...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.75 Management of change. (a) The owner or operator shall establish and implement written procedures to manage changes (except...

  12. 40 CFR 68.75 - Management of change.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Management of change. 68.75 Section 68...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.75 Management of change. (a) The owner or operator shall establish and implement written procedures to manage changes (except...

  13. 40 CFR 68.75 - Management of change.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Management of change. 68.75 Section 68...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.75 Management of change. (a) The owner or operator shall establish and implement written procedures to manage changes (except for...

  14. Access site management after peripheral percutaneous transluminal procedures: Neptune pad compared with conventional manual compression.

    PubMed

    Mlekusch, Wolfgang; Minar, Erich; Dick, Petra; Sabeti, Schila; Bartok, Andrea; Haumer, Markus; Bonelli, Michael; Vormittag, Laurenz; Koppensteiner, Renate; Schillinger, Martin

    2008-12-01

    To investigate the safety and efficacy of the procoagulant wound dressing Neptune Pad (Biotronik, Berlin, Germany) compared with those of conventional manual compression for access site management after peripheral percutaneous interventions. The study was approved by the institutional ethics committee, and all patients gave written informed consent. Two hundred one consecutive patients were enrolled and were randomly assigned to be treated with the Neptune Pad (n = 100) or conventional manual compression (n = 101). Patients were followed up clinically until hospital discharge and with duplex ultrasonography at 24 hours after the procedure to evaluate occurrence of access site complications. Time to hemostasis and time to ambulation were recorded, and patient and physician discomfort were measured by using a visual analogue scale. The risk for access site complications was not significantly different between the Neptune Pad group and the conventional compression group (adjusted odds ratio, 1.15; 95% confidence interval: 0.47, 2.84; P = .76). Time to hemostasis was marginally reduced in the Neptune Pad group. Patient and physician discomfort were lessened with use of the device. The hemostatic device Neptune Pad does not improve the safety of access site management after peripheral percutaneous procedures. Markedly improved comfort was noted among patients in the Neptune Pad group and by the physicians obtaining hemostasis. RSNA, 2008

  15. Rehabilitation procedures in the management of gait disorders in the elderly.

    PubMed

    Gandolfi, M; Dimitrova, E; Nicolli, F; Modenese, A; Serina, A; Waldner, A; Tinazzi, M; Squintani, G; Smania, N; Geroin, C

    2015-10-01

    Gait disorders are common and very disabling in elderly people, leading to an increase of risk of falling and reductions in quality of life. So far, many clinical classifications of gait disorders in the elderly population have been proposed. Here we suggest a novel categorization of gait disorders in elderly people, which takes into account the several resources required during gait. The biomechanical constraints, movement and sensory strategies, orientation in space, control of dynamics and cognitive processing are essential to perform safely gait. Moreover, the strictly connection between gait and balance has been discussed. According to this perspective, a literature search was performed including studies investigating the rehabilitation procedures in the management of balance and gait disorders in elderly people. Training aimed at improving muscle strength and flexibility, movement strategies, sensorimotor integration and sensory reweighting processes, balance in static and dynamic conditions and cognitive strategies have been proposed as possible therapeutic approaches in elderly people affected by gait disorders. Moreover, the role of new technological devices in improving balance and gait control has been also described. A multidisciplinary and interdisciplinary approach is fundamental for the management of gait disorders in elderly people. Rehabilitation procedures should take into consideration all the potential constraints involved in gait disorders in order to select the most appropriate intervention.

  16. Simulation of time-control procedures for terminal area flow management

    NASA Technical Reports Server (NTRS)

    Alcabin, M.; Erzberger, H.; Tobias, L.; Obrien, P. J.

    1985-01-01

    Simulations of a terminal area traffic-management system incorporating automated scheduling and time-control (four-dimensional) techniques conducted at NASA Ames Research Center jointly with the Federal Aviation Administration, have shown that efficient procedures can be developed for handling a mix of 4D-equipped and conventionally equipped aircraft. A crucial role in this system is played by an ATC host computer algorithm, referred to as a speed advisory, that allows controllers to maintain accurate time schedules of the conventionally equipped aircraft in the traffic mix. Results are of the most recent simulations in which two important special cases were investigated. First, the effects of a speed advisory on touchdown time scheduling are examined, when unequipped aircraft are constrained to follow fuel-optimized profiles in the near-terminal area, and rescheduling procedures are developed to handle missed approaches of 4D-equipped aircraft. Various performance measures, including controller opinion, are used to evaluate the effectiveness of the procedures.

  17. Simulation of time-control procedures for terminal area flow management

    NASA Technical Reports Server (NTRS)

    Alcabin, M.; Erzberger, H.; Tobias, L.; Obrien, P. J.

    1985-01-01

    Simulations of a terminal area traffic-management system incorporating automated scheduling and time-control (four-dimensional) techniques conducted at NASA Ames Research Center jointly with the Federal Aviation Administration, have shown that efficient procedures can be developed for handling a mix of 4D-equipped and conventionally equipped aircraft. A crucial role in this system is played by an ATC host computer algorithm, referred to as a speed advisory, that allows controllers to maintain accurate time schedules of the conventionally equipped aircraft in the traffic mix. Results are of the most recent simulations in which two important special cases were investigated. First, the effects of a speed advisory on touchdown time scheduling are examined, when unequipped aircraft are constrained to follow fuel-optimized profiles in the near-terminal area, and rescheduling procedures are developed to handle missed approaches of 4D-equipped aircraft. Various performance measures, including controller opinion, are used to evaluate the effectiveness of the procedures.

  18. [Intrapartum management strategies for congenital cervical teratoma: the EXIT procedure (ex utero intrapartum treatment)].

    PubMed

    Nascimento, Glaucius C; De Souza, Alex S Rolland; Lima, Marcelo M S; Guerra, Gláucia V; Meneses, Jucille A; Cardoso, Alexandre S; Azevedo, Katarinna S

    2007-01-01

    Cervical teratomas are 3 to 5% of all teratomas and have an incidence of 1:20,000 to 1:40,000 live-borns. M.J.F., 31-years-old, had done a routine scan during pregnancy that evidenced a large fetal neck mass with teratoma cervical sonographic aspect. An interdisciplinary reunion decided for expectant management until pregnancy term when C section with EXIT procedure would be performed. At 34 weeks occurred spontaneous preterm labor and the interdisciplinary team was contacted. After head exteriorization a large neck mass was noticed. The EXIT procedure was performed allowing a tranquil orotracheal intubation while placental circulation was sustained. At third day the patient presented hypoxia, decreased heart rate and central cyanosis developing cardiorespiratory failure with unsuccessful response to resuscitation. Cervical teratoma is a rare fetal condition that is very important an interdisciplinary approach performing EXIT procedure to allow an adequate respiratory assistance at delivery. Intensive neonatal care is essential to improve patient outcome.

  19. Visualization of Traffic Accidents

    NASA Technical Reports Server (NTRS)

    Wang, Jie; Shen, Yuzhong; Khattak, Asad

    2010-01-01

    Traffic accidents have tremendous impact on society. Annually approximately 6.4 million vehicle accidents are reported by police in the US and nearly half of them result in catastrophic injuries. Visualizations of traffic accidents using geographic information systems (GIS) greatly facilitate handling and analysis of traffic accidents in many aspects. Environmental Systems Research Institute (ESRI), Inc. is the world leader in GIS research and development. ArcGIS, a software package developed by ESRI, has the capabilities to display events associated with a road network, such as accident locations, and pavement quality. But when event locations related to a road network are processed, the existing algorithm used by ArcGIS does not utilize all the information related to the routes of the road network and produces erroneous visualization results of event locations. This software bug causes serious problems for applications in which accurate location information is critical for emergency responses, such as traffic accidents. This paper aims to address this problem and proposes an improved method that utilizes all relevant information of traffic accidents, namely, route number, direction, and mile post, and extracts correct event locations for accurate traffic accident visualization and analysis. The proposed method generates a new shape file for traffic accidents and displays them on top of the existing road network in ArcGIS. Visualization of traffic accidents along Hampton Roads Bridge Tunnel is included to demonstrate the effectiveness of the proposed method.

  20. Developing techniques for cause-responsibility analysis of occupational accidents.

    PubMed

    Jabbari, Mousa; Ghorbani, Roghayeh

    2016-11-01

    The aim of this study was to specify the causes of occupational accidents, determine social responsibility and the role of groups involved in work-related accidents. This study develops occupational accidents causes tree, occupational accidents responsibility tree, and occupational accidents component-responsibility analysis worksheet; based on these methods, it develops cause-responsibility analysis (CRA) techniques, and for testing them, analyzes 100 fatal/disabling occupational accidents in the construction setting that were randomly selected from all the work-related accidents in Tehran, Iran, over a 5-year period (2010-2014). The main result of this study involves two techniques for CRA: occupational accidents tree analysis (OATA) and occupational accidents components analysis (OACA), used in parallel for determination of responsible groups and responsibilities rate. From the results, we find that the management group of construction projects has 74.65% responsibility of work-related accidents. The developed techniques are purposeful for occupational accidents investigation/analysis, especially for the determination of detailed list of tasks, responsibilities, and their rates. Therefore, it is useful for preventing work-related accidents by focusing on the responsible group's duties.

  1. [What has been brought to residents and communities by the nuclear power plant accident? Special and serious disaster relief procedure modification after the 2011 Tohoku earthquake and tsunami in Fukushima].

    PubMed

    Ishikawa, Kazunobu

    2011-01-01

    After the catastrophic 2011 Tohoku earthquake and tsunami which struck cities and towns on the Japanese Pacific coast, Fukushima has been the focus of special and serious disaster relief procedures modification regarding nuclear power plant accidents. To date, the Japanese government has repeatedly issued evacuation orders to more than 100,000 residents. Huge numbers of refugees are still uncertain if they can return home and re-cultivate their farm land. Ambiguous public announcements concerning the radiation risks seem to have aggravated feelings of insecurity, fear and the desire to escape, both at home and abroad. This disaster has seriously undermined trust internationally and locally in Fukushima. Harmful rumors added further difficulties. In response to this disaster, local government, medical institutions, care facilities, police, emergency services and the self-defense forces continue to put their utmost effort into reconstruction. This seismic disaster has reminded us that supplies of water, electricity, gas, gasoline and telephone/communication facilities are essential prerequisites for reconstruction and daily life. Disaster and radiation medical association teams actively participated in the rescue efforts, and a number of organized medical teams cared for about 15,000 refugees in 100 shelters. We also visited home-bound patients, who were unable to evacuate from the 20-30 km inner evacuation area. In this relief role, we need to consider the following; (1) professionals, both healthcare and nuclear engineers, must always be prepared for unexpected circumstances, (2) the daily organic cooperation of individuals and units is closely linked to readiness against sudden risks, and (3) appropriate accountability is essential to assuage the fears of residents and refugees. A sincere learning process may benefit those innocent refugees who may be forced to abandon their homes permanently.

  2. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    PubMed Central

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months. PMID:8894865

  3. Influence of pressurizer relief valves on success of ``feed and bleed`` procedure

    SciTech Connect

    Petelin, S.; Mavko, B.; Gortnar, O.

    1994-12-31

    The RELAP5/MOD3.1 analysis of the accident with total loss of secondary heat sink was performed for Krsko nuclear power plant which is a two loop Westinghouse PWR power plant of 1,876 MW thermal power. In the study of ``feed and bleed`` accident managing the particular attention was given to the emergency operating procedures foreseen operator actions. This paper deals with the modeling of saturated liquid and two-phase mixture critical discharge through the pressurizer power operated relief valves and aims to evaluate its influence on the simulation of other thermal-hydraulic processes in the reactor coolant system. The time evolution of simulated accident and the determination of the longest allowed operator response time for the successful accident managing were shown to be much dependent on the prediction of critical flow through the pressurizer relief valves.

  4. Los Alamos National Laboratory emergency management plan. Revision 1

    SciTech Connect

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents, transportation accidents, electrical accidents, and natural disasters.

  5. Laser accidents: Being Prepared

    SciTech Connect

    Barat, K

    2003-01-24

    The goal of the Laser Safety Officer and any laser safety program is to prevent a laser accident from occurring, in particular an injury to a person's eyes. Most laser safety courses talk about laser accidents, causes, and types of injury. The purpose of this presentation is to present a plan for safety offices and users to follow in case of accident or injury from laser radiation.

  6. Generic procedure for designing and implementing plan management systems for space science missions operations

    NASA Astrophysics Data System (ADS)

    Chaizy, P. A.; Dimbylow, T. G.; Allan, P. M.; Hapgood, M. A.

    2011-09-01

    This paper is one of the components of a larger framework of activities whose purpose is to improve the performance and productivity of space mission systems, i.e. to increase both what can be achieved and the cost effectiveness of this achievement. Some of these activities introduced the concept of Functional Architecture Module (FAM); FAMs are basic blocks used to build the functional architecture of Plan Management Systems (PMS). They also highlighted the need to involve Science Operations Planning Expertise (SOPE) during the Mission Design Phase (MDP) in order to design and implement efficiently operation planning systems. We define SOPE as the expertise held by people who have both theoretical and practical experience in operations planning, in general, and in space science operations planning in particular. Using ESA's methodology for studying and selecting science missions we also define the MDP as the combination of the Mission Assessment and Mission Definition Phases. However, there is no generic procedure on how to use FAMs efficiently and systematically, for each new mission, in order to analyse the cost and feasibility of new missions as well as to optimise the functional design of new PMS; the purpose of such a procedure is to build more rapidly and cheaply such PMS as well as to make the latter more reliable and cheaper to run. This is why the purpose of this paper is to provide an embryo of such a generic procedure and to show that the latter needs to be applied by people with SOPE during the MDP. The procedure described here proposes some initial guidelines to identify both the various possible high level functional scenarii, for a given set of possible requirements, and the information that needs to be associated with each scenario. It also introduces the concept of catalogue of generic functional scenarii of PMS for space science missions. The information associated with each catalogued scenarii will have been identified by the above procedure and

  7. Managing the Fukushima challenge.

    PubMed

    Suzuki, Atsuyuki

    2014-07-01

    The Fukushima Daiichi accident raises a fundamental question: Can science and technology prevent the inevitability of serious accidents, especially those with low probabilities and high consequences? This question reminds us of a longstanding challenge with the trans-sciences, originally addressed by Alvin Weinberg well before the Three Mile Island and Chernobyl accidents. This article, revisiting Weinberg's issue, aims at gaining insights from the accident with a special emphasis on the sociotechnical or human behavioral aspects lying behind the accident's causes. In particular, an innovative method for managing the challenge is explored referring to behavioral science approaches to a decision-making process on risk management; such as managing human behavioral risks with information asymmetry, seeking a rational consensus with communicative action, and pursuing procedural rationality through interactions with the outer environment. In short, this article describes the emerging need for Japan to transform its national safety management institutions so that these might be based on interactive communication with parties inside and outside Japan.

  8. Managing the Fukushima Challenge

    PubMed Central

    Suzuki, Atsuyuki

    2014-01-01

    The Fukushima Daiichi accident raises a fundamental question: Can science and technology prevent the inevitability of serious accidents, especially those with low probabilities and high consequences? This question reminds us of a longstanding challenge with the trans-sciences, originally addressed by Alvin Weinberg well before the Three Mile Island and Chernobyl accidents. This article, revisiting Weinberg's issue, aims at gaining insights from the accident with a special emphasis on the sociotechnical or human behavioral aspects lying behind the accident's causes. In particular, an innovative method for managing the challenge is explored referring to behavioral science approaches to a decision-making process on risk management; such as managing human behavioral risks with information asymmetry, seeking a rational consensus with communicative action, and pursuing procedural rationality through interactions with the outer environment. In short, this article describes the emerging need for Japan to transform its national safety management institutions so that these might be based on interactive communication with parties inside and outside Japan. PMID:24954604

  9. Accident mortality among children

    PubMed Central

    Swaroop, S.; Albrecht, R. M.; Grab, B.

    1956-01-01

    The authors present statistics on mortality from accidents, with special reference to those relating to the age-group 1-19 years. For a number of countries figures are given for the proportional mortality from accidents (the number of accident deaths expressed as a percentage of the number of deaths from all causes) and for the specific death-rates, per 100 000 population, from all causes of death, from selected causes, from all causes of accidents, and from various types of accident. From these figures it appears that, in most countries, accidents are becoming relatively increasingly prominent as a cause of death in childhood, primarily because of the conquest of other causes of death—such as infectious and parasitic diseases, which formerly took a heavy toll of children and adolescents—but also to some extent because the death-rate from motor-vehicle accidents is rising and cancelling out the reduction in the rate for other causes of accidental death. In the authors' opinion, further epidemiological investigations into accident causation are required for the purpose of devising quicker and more effective methods of accident prevention. PMID:13383361

  10. [Accidents with the "paraglider"].

    PubMed

    Lang, T H; Dengg, C; Gabl, M

    1988-09-01

    With a collective of 46 patients we show the details and kinds of accidents caused by paragliding. The base for the casuistry of the accidents was a questionnaire which was answered by most of the injured persons. These were questions about the theoretical and practical training, the course of the flight during the different phases, and the subjective point of view of the course of the accident. The patterns of the injuries showed a high incidence of injuries of the spinal column and high risks for the ankles. At the end, we give some advice how to prevent these accidents.

  11. Transport Aircraft Accident Dynamics

    DTIC Science & Technology

    1982-03-01

    SA Contracti’ Report 165850 S,">.AA 11’ýport No. VL)T-FAR-CT-8Z-T0 i0 u; S𔃺/3!D35" *. T -ansport Aircraft Accident Dynamics Reproduced From Srt...City, New Jersey 08405 84 04-. , NASA Contractor Report FAA Report No. Dbr-MA -C7 ,-70 TRANSPORT AIRCRAFT. ACCIDENT DYNAMICS I A. COMINSKY, et al...transport aircraft accidents , the association between structural systems and accident injuries and the identification of typical scenarios. This report

  12. Quantitative evaluation of geodiversity: development of methodological procedures with application to territorial management

    NASA Astrophysics Data System (ADS)

    Forte, J.; Brilha, J.; Pereira, D.; Nolasco, M.

    2012-04-01

    Although geodiversity is considered the setting for biodiversity, there is still a huge gap in the social recognition of these two concepts. The concept of geodiversity, less developed, is now making its own way as a robust and fundamental idea concerning the abiotic component of nature. From a conservationist point of view, the lack of a broader knowledge concerning the type and spatial variation of geodiversity, as well as its relationship with biodiversity, makes the protection and management of natural or semi-natural areas incomplete. There is a growing need to understand the patterns of geodiversity in different landscapes and to translate this knowledge for territorial management in a practical and effective point of view. This kind of management can also represent an important tool for the development of sustainable tourism, particularly geotourism, which can bring benefits not only for the environment, but also for social and economic purposes. The quantification of geodiversity is an important step in all this process but still few researchers are investing in the development of a proper methodology. The assessment methodologies that were published so far are mainly focused on the evaluation of geomorphological elements, sometimes complemented with information about lithology, soils, hidrology, morphometric variables, climatic surfaces and geosites. This results in very dissimilar areas at very different spatial scales, showing the complexity of the task and the need of further research. This current work aims the development of an effective methodology for the assessment of the maximum elements of geodiversity possible (rocks, minerals, fossils, landforms, soils), based on GIS routines. The main determinant factor for the quantitative assessment is scale, but other factors are also very important, such as the existence of suitable spatial data with sufficient degree of detail. It is expected to attain the proper procedures in order to assess geodiversity

  13. The utility of self-management procedures in modifying the classroom behaviors of mentally retarded adolescents.

    PubMed

    Long, J D; Williams, R L

    1976-01-01

    Self-management procedures including the self-recording of points, the self-graphing of progress, and the self-selecting of free time activities were applied to the classroom behaviors of 12-year-old educable mentally retarded subjects. Students were first awarded points for specified appropriate behaviors. Then during the last two treatment phases, they graphed their points earnings and used these points to earn free time activities. A multiple baseline design was used in appraising the comparative effects of these three treatment conditions during spelling and reading periods. All three treatment conditions produced higher rates of appropriate behavior than did baseline conditions; however, the highest levels of appropriate behavior were achieved during the self-selected free time phases.

  14. Laparoscopic antireflux procedures in the management of gastroesophageal reflux following esophageal atresia repair.

    PubMed

    Esposito, Ciro; Langer, Jacob C; Schaarschmidt, Klaus; Mattioli, Girolamo; Sauer, Carolien; Centonze, Antonella; Cigliano, Bruno; Settimi, Alessandro; Jasonni, Vincenzo

    2005-03-01

    The validity of open fundoplication after esophageal atresia (EA) repair is still disputed. The authors have retrospectively evaluated the results achieved in their centers using laparoscopic antireflux procedures (LARP) in children operated for EA at birth. From 1998 to 2002, 350 children underwent LARP. Of these, 21 (6%) underwent EA repair at birth. Our study focused only on the management of these 21 patients; 5 of them (23.8%) were neurologically impaired children (NIC). All underwent LARP, 9 patients according to Nissen, 9 according to Thal, and 3 according to Toupet. The 5 NIC with feeding problems underwent concomitant g-tube placement during the same procedure. All the procedures were completed in laparoscopy, without intraoperative complications. The mean operative time was 65 minutes (range 45-140). We had no mortality in our series. Hospital stay varied from 2 to 9 days (median 3 days). At a maximum follow-up of 6 years, all patients were evaluated with a 24-hours pH-metry and barium swallow. The 16 neurologically normal children were free of symptoms at the last follow-up; five of them (31.2%) had mild dysphagia, which disappeared spontaneously within 3-6 months. One girl experienced an important episode of aspiration 2 years after the LARP, although there was no evidence of reflux at the follow-up examinations. As for the 5 NIC, one patient eats only through a g-tube, the other 4 undergo mixed feeding (g-tube and mouth); none have signs of GER, but two of them still present respiratory symptoms, and one has delayed gastric emptying. In our experience laparoscopic antireflux surgery is an appropriate treatment of GER in children operated for EA at birth, independently of the antireflux mechanism adopted; the 31.2% rate of short-term dysphagia presenting as residual respiratory symptoms may be due to a primary dysmotility of the esophagus consequent to the esophageal atresia.

  15. The application of surgical procedure manager (SPM): first experience with FESS.

    PubMed

    Feige, Katharina; Gollnick, Iris; Schmitz, Pia; Strauss, Gero

    2017-07-07

    In our hypothesis, the newly developed program SPM (surgical procedure manager) will ensure successful standardization and efficiency of the FESS (functional endoscopic sinus surgery) and therefore make a decisive contribution in terms of economization and improvement of intraoperative quality. Between 27th March 2015 and 8th October 2015, data from 259 FESS procedures were collected using the SPM. The study took place at the surgical desk, an operating room in the ACQUA clinic in Leipzig, Germany. 233 FESS (90%) of the total FESS (n = 259, 100%) were conducted entirely with SPM. 26 SPM terminations (10%) of 259 FESS remain, which are classified as actual SPM terminations-when the surgeon intentionally stops the SPM. The maximum time slot decreased clearly from 1 h 39 min (period A) to 1 h 10 min (period B). A time reduction can also be seen with the minimum duration of 13.5 min compared to 11 min. The variability of the time slot also decreases since the standard deviation is reduced by 4.5 min. On the basis of available recordings it can be postulated that the application of SPM is suitable for standardization for FESS. Standardization by means of SPM and minimal development can be recognized over a period of time. The SPM makes it possible to transfer the general advantages of mechanization on a concrete FESS and do not influence the medical processes nor even restrict the medical freedom. The users are still entirely free in the implementation of the respective procedure.

  16. Peroral endoscopic myotomy—initial experience with anesthetic management of 24 procedures and systematic review

    PubMed Central

    Goudra, Basavana; Singh, Preet Mohinder; Gouda, Gowri; Sinha, Ashish C.

    2016-01-01

    Background: Peroral endoscopic myotomy (POEM) is a novel method of treating achalasia of the esophagus. Very little data are available to guide the anesthesia providers caring for these patients. The anesthetic challenges are primarily related to the risk of pulmonary aspiration. There is also a potential risk of pneumomediastinum, pneumoperitoneum, subcutaneous, or submucosal emphysema, as a result of carbon dioxide tracking into the soft tissues surrounding the esophagus and lower esophageal sphincter. Methods: In this retrospective study, electronic charts of 24 patients who underwent POEM over 18 months were reviewed. Demographic data, fasting status, relevant aspiration risks, anesthetic technique, and postoperative care measures were extracted. Results: Fasting times for both solids and liquids were variable. None of the patients underwent preprocedural esophageal emptying. Standard induction and intubation were performed in 16, rapid sequence induction (RSI) with cricoid pressure in seven, and modified rapid sequence without application of cricoid pressure in one of the patients. One of the patients aspirated at induction, and the procedure was aborted. However, the procedure was performed successfully after a few weeks, this time a RSI with cricoid pressure was chosen. Conclusion: As there are no guidelines for the perioperative management of patients presenting for POEM presently, certain recommendations can be made. Preprocedural esophageal emptying should be considered in patients considered as high-risk, although cultural factors might preclude such an approach. Induction and intubation in a semi-reclining position might be useful. Although debatable, use of RSI with cricoid pressure should be strongly considered. PMID:27212764

  17. 41 CFR 102-74.355 - With what accident and fire prevention standards must Federal facilities comply?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.355 With what accident and fire prevention standards must Federal facilities comply? To the... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false With what accident and...

  18. 41 CFR 102-74.355 - With what accident and fire prevention standards must Federal facilities comply?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.355 With what accident and fire prevention standards must Federal facilities comply? To the... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false With what accident and...

  19. 41 CFR 102-74.355 - With what accident and fire prevention standards must Federal facilities comply?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.355 With what accident and fire prevention standards must Federal facilities comply? To the... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false With what accident and...

  20. 10 CFR 71.73 - Hypothetical accident conditions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Package, Special Form, and LSA-III Tests 2 § 71.73 Hypothetical accident conditions. (a) Test procedures. Evaluation for hypothetical accident conditions is to be based on sequential application of the...

  1. 10 CFR 71.73 - Hypothetical accident conditions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Package, Special Form, and LSA-III Tests 2 § 71.73 Hypothetical accident conditions. (a) Test procedures. Evaluation for hypothetical accident conditions is to be based on sequential application of the...

  2. 10 CFR 71.73 - Hypothetical accident conditions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Package, Special Form, and LSA-III Tests 2 § 71.73 Hypothetical accident conditions. (a) Test procedures. Evaluation for hypothetical accident conditions is to be based on sequential application of the...

  3. 10 CFR 71.73 - Hypothetical accident conditions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Package, Special Form, and LSA-III Tests 2 § 71.73 Hypothetical accident conditions. (a) Test procedures. Evaluation for hypothetical accident conditions is to be based on sequential application of the...

  4. 10 CFR 71.73 - Hypothetical accident conditions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Package, Special Form, and LSA-III Tests 2 § 71.73 Hypothetical accident conditions. (a) Test procedures. Evaluation for hypothetical accident conditions is to be based on sequential application of the...

  5. Becoming an expert carer: the process of family carers learning to manage technical health procedures at home.

    PubMed

    McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William

    2016-09-01

    To describe the learning process of family carers who manage technical health procedures (such as enteral tube feeding, intravenous therapy, dialysis or tracheostomy care) at home. Increasingly, complex procedures are being undertaken at home but little attention has been paid to the experiences of family carers who manage such procedures. Grounded theory, following Charmaz's constructivist approach. Interviews with 26 family carers who managed technical health procedures and 15 health professionals who taught carers such procedures. Data collection took place in New Zealand over 19 months during 2011-2013. Grounded theory procedures of iterative data collection, coding and analysis were followed, with the gradual development of theoretical ideas. The learning journey comprised three phases: (1) an initial, concentrated period of training; (2) novice carers taking responsibility for day-to-day care of procedures while continuing their learning; and (3) with time, experience and ongoing self-directed learning, the development of expertise. Teaching and support by health professionals (predominantly nurses) was focussed on the initial phase, but carers' learning continued throughout, developed through their own experience and using additional sources of information (notably the Internet and other carers). Further work is needed to determine the best educational process for carers, including where to locate training, who should teach them, optimal teaching methods and how structured or individualized teaching should be. Supporting carers well also benefits patient care. © 2016 John Wiley & Sons Ltd.

  6. 41 CFR 102-33.450 - How must we report accident and incident data?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... § 102-33.450 How must we report accident and incident data? You must report accident and incident data... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false How must we report accident and incident data? 102-33.450 Section 102-33.450 Public Contracts and Property Management Federal...

  7. 41 CFR 102-33.450 - How must we report accident and incident data?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... § 102-33.450 How must we report accident and incident data? You must report accident and incident data... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false How must we report accident and incident data? 102-33.450 Section 102-33.450 Public Contracts and Property Management Federal...

  8. 41 CFR 102-33.450 - How must we report accident and incident data?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 102-33.450 How must we report accident and incident data? You must report accident and incident data... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false How must we report accident and incident data? 102-33.450 Section 102-33.450 Public Contracts and Property Management Federal...

  9. 41 CFR 102-33.450 - How must we report accident and incident data?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... § 102-33.450 How must we report accident and incident data? You must report accident and incident data... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false How must we report accident and incident data? 102-33.450 Section 102-33.450 Public Contracts and Property Management Federal...

  10. Red River Wildlife Management Area HEP Report, Habitat Evaluation Procedures, Technical Report 2004.

    SciTech Connect

    Ashley, Paul

    2004-11-01

    A habitat evaluation procedures (HEP) analysis conducted on the 314-acre Red River Wildlife Management Area (RRWMA) managed by the Idaho Department of Fish and Game resulted in 401.38 habitat units (HUs). Habitat variables from six habitat suitability index (HSI) models, comprised of mink (Mustela vison), mallard (Anas platyrhynchos), common snipe (Capella gallinago), black-capped chickadee (Parus altricapillus), yellow warbler (Dendroica petechia), and white-tailed deer (Odocoileus virginianus), were measured by Regional HEP Team (RHT) members in August 2004. Cover types included wet meadow, riverine, riparian shrub, conifer forest, conifer forest wetland, and urban. HSI model outputs indicate that the shrub component is lacking in riparian shrub and conifer forest cover types and that snag density should be increased in conifer stands. The quality of wet meadow habitat, comprised primarily of introduced grass species and sedges, could be improved through development of ephemeral open water ponds and increasing the amount of persistent wetland herbaceous vegetation e.g. cattails (Typha spp.) and bulrushes (Scirpus spp.).

  11. Psychological distress of residents in Kawauchi village, Fukushima Prefecture after the accident at Fukushima Daiichi Nuclear Power Station: the Fukushima Health Management Survey.

    PubMed

    Yoshida, Koji; Shinkawa, Tetsuko; Urata, Hideko; Nakashima, Kanami; Orita, Makiko; Yasui, Kiyotaka; Kumagai, Atsushi; Ohtsuru, Akira; Yabe, Hirooki; Maeda, Masaharu; Hayashida, Naomi; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru

    2016-01-01

    To shed light on the mental health of evacuees after the accident at Fukushima Daiichi Nuclear Power Station (FDNPS), we evaluate the results of the Fukushima Health Management Survey (FHMS) of the residents at Kawauchi village in Fukushima, which is located less than 30 km from the FDNPS. We conducted the cross-sectional study within the framework of the FHMS. Exposure values were "anorexia," "subjective feelings about health," "feelings about sleep satisfaction," and "bereavement caused by the disaster," confounding variables were "age" and "sex," and outcome variables were "K6 points." We collected data from the FHMS, and employed the Kessler Psychological Distress Scale (K6) and the posttraumatic stress disorder (PTSD) Checklist Stressor-Specific Version (PCL-S) to carry out the research. A total of 13 or greater was the cut-off for identifying serious mental illness using the K6 scale. The study subjects included residents (n = 542) of over 30 years of age from Kawauchi village, and data were used from the period of January 1, 2012 to October 31, 2012. A total of 474 residents (87.5%) scored less than 13 points in the K6 and 68 (12.6%) scored 13 points or more. The proportion of elderly residents (over 65 years old) among people with K6 score above the cut-off was higher than that among people with K6 score below the cut-off (44.1 vs 31.0%, p < 0.05). In addition, the proportion of residents with anorexia and mental illness among people with K6 score above the cut-off was higher than among people with K6 score below the cut-off (p < 0.001 and p < 0.05, respectively). The amount of residents who scored 44 points or more in the PCL-S among people with K6 score above the cut-off was also considerably higher than among people with K6 score below the cut-off (79.4 vs 12.9%, p < 0.001). Interestingly, the proportion of residents who scored more than among people with K6 score above the cut-off and the among people with PCL-S score above the cut-off in Kawauchi was

  12. Psychological distress of residents in Kawauchi village, Fukushima Prefecture after the accident at Fukushima Daiichi Nuclear Power Station: the Fukushima Health Management Survey

    PubMed Central

    Yoshida, Koji; Shinkawa, Tetsuko; Urata, Hideko; Nakashima, Kanami; Orita, Makiko; Yasui, Kiyotaka; Kumagai, Atsushi; Ohtsuru, Akira; Yabe, Hirooki; Maeda, Masaharu; Hayashida, Naomi; Kudo, Takashi; Yamashita, Shunichi

    2016-01-01

    Background To shed light on the mental health of evacuees after the accident at Fukushima Daiichi Nuclear Power Station (FDNPS), we evaluate the results of the Fukushima Health Management Survey (FHMS) of the residents at Kawauchi village in Fukushima, which is located less than 30 km from the FDNPS. Methods We conducted the cross-sectional study within the framework of the FHMS. Exposure values were “anorexia,” “subjective feelings about health,” “feelings about sleep satisfaction,” and “bereavement caused by the disaster,” confounding variables were “age” and “sex,” and outcome variables were “K6 points.” We collected data from the FHMS, and employed the Kessler Psychological Distress Scale (K6) and the posttraumatic stress disorder (PTSD) Checklist Stressor-Specific Version (PCL-S) to carry out the research. A total of 13 or greater was the cut-off for identifying serious mental illness using the K6 scale. The study subjects included residents (n = 542) of over 30 years of age from Kawauchi village, and data were used from the period of January 1, 2012 to October 31, 2012. Results A total of 474 residents (87.5%) scored less than 13 points in the K6 and 68 (12.6%) scored 13 points or more. The proportion of elderly residents (over 65 years old) among people with K6 score above the cut-off was higher than that among people with K6 score below the cut-off (44.1 vs 31.0%, p < 0.05). In addition, the proportion of residents with anorexia and mental illness among people with K6 score above the cut-off was higher than among people with K6 score below the cut-off (p < 0.001 and p < 0.05, respectively). The amount of residents who scored 44 points or more in the PCL-S among people with K6 score above the cut-off was also considerably higher than among people with K6 score below the cut-off (79.4 vs 12.9%, p < 0.001). Interestingly, the proportion of residents who scored more than among people with K6 score above the cut-off and the among

  13. The work of the South Manchester Accident Rescue Team (SMART).

    PubMed

    Redmond, A D

    1990-01-01

    Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment. Skill in anaesthesia, monitoring and operating, if tested only in these circumstances may be found to be gravely inadequate when exposed to the fluctuant and hostile environment at the site. Doctors who wish to do this sort of work or are designated to do it, must undergo regular and frequent training, especially if they are not trained in accident and emergency departments. This has long been recognised by the British Association for Immediate Care. In combination with the Royal College of Surgeons of Edinburgh they have now established a diploma in Immediate Medical Care. In urban areas the need for a doctor to attend at the scene of an accident is usually limited to entrapment. These occasions are likely to be infrequent and this can result in a lack of preparedness for such events. Interhospital transfer, primarily from peripheral hospitals to the specialist services of a teaching hospital, often involves critically ill and injured patients. The management of these cases by the mobile team provides regular, frequent exposure to working in a 'hostile' environment. Relationships with the rescue services are developed and staff become familiar with equipment and call-out procedures. The care of transported patients is improved. None of our patients have died in transit or within 6 h of arrival at base.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Instrumentation availability during severe accidents for a boiling water reactor with a Mark I containment

    SciTech Connect

    Arcieri, W.C.; Hanson, D.J. )

    1992-02-01

    In support of the US Nuclear Regulatory Commission Accident Management Research Program, the availability of instruments to supply accident management information during a broad range of severe accidents is evaluated for a Boiling Water Reactor with a Mark I containment. Results from this evaluation include: (1) the identification of plant conditions that would impact instrument performance and information needs during severe accidents; (2) the definition of envelopes of parameters that would be important in assessing the performance of plant instrumentation for a broad range of severe accident sequences; and (3) assessment of the availability of plant instrumentation during severe accidents.

  15. Columbia Accident Investigation Board

    NASA Image and Video Library

    2003-02-13

    Members of the Columbia Accident Investigation Board examine pieces of Columbia debris in the RLV Hangar. The debris was shipped from the collection point at Barksdale Air Force Base, Shreveport, La. As part of the ongoing investigation into the tragic accident that claimed Columbia and her crew of seven, workers will attempt to reconstruct the orbiter inside the RLV.

  16. Farm accidents in children.

    PubMed

    Cameron, D; Bishop, C; Sibert, J R

    1992-07-04

    To examine the problem of accidental injury to children on farms. Prospective county based study of children presenting to accident and emergency departments over 12 months with injuries sustained in a farm setting and nationwide review of fatal childhood farm accidents over the four years April 1986 to March 1990. Accident and emergency departments in Aberystwyth, Carmarthen, Haverfordwest, and Llanelli and fatal accidents in England, Scotland, and Wales notified to the Health and Safety Executive register. Children aged under 16. Death or injury after farm related accidents. 65 accidents were recorded, including 18 fractures. Nine accidents necessitated admission to hospital for a mean of two (range one to four) days. 13 incidents were related to tractors and other machinery; 24 were due to falls. None of these incidents were reported under the statutory notification scheme. 33 deaths were notified, eight related to tractors and allied machinery and 10 related to falling objects. Although safety is improving, the farm remains a dangerous environment for children. Enforcement of existing safety legislation with significant penalties and targeting of safety education will help reduce accident rates further.

  17. Anatomy of an Accident.

    ERIC Educational Resources Information Center

    Mobley, Michael

    1984-01-01

    The findings of industrial safety engineers in the areas of accident causation and prevention are wholly applicable to adventure programs. Adventure education instructors can use safety engineering concepts to assess the risk in a particular activity, understand factors that cause accidents, and intervene to minimize injuries and damages if…

  18. Accidents on hospital wards.

    PubMed Central

    Levene, S; Bonfield, G

    1991-01-01

    Eight hospitals reported 781 non-iatrogenic accidents occurring to patients and visitors under 16 years of age during an 18 month period up to October 1989. Accidents more often involved boys and children aged 3 to 5 years old. Falls from a height, slips, and striking accidents were common by day and falls by night. A total of 41% of accidents to inpatients occurred when parents were present. Only three accidents were serious. Altogether 27% involved beds and cots, and only one consequent injury was more than minor. Data collected routinely in case of medicolegal action can be presented in a form that may facilitate preventative work. Potentially remediable causes for concern include falls from beds and cots and the use of makeshift equipment. PMID:1929510

  19. Radiological accident and incident in Thailand: lesson to be learned.

    PubMed

    Ya-anant, Nanthavan; Tiyapun, Kanokrat; Saiyut, Kittiphong

    2011-07-01

    Radioactive materials in Thailand have been used in medicine, research and industry for more than 50 y. Several radiological accident and incidents happened in the past 10 y. A serious one was the radiological accident that occurred in Samut Prakan, Thailand in 2000. The serious radiological accident occurred when the (60)Co head was partially dismantled, taken from that storage to sell as scrap metal. Three victims died and 10 people received high dose from the source. The lesson learned from the radiological accident in Samut Prakan was to improve in many subjects, such as efficiency in Ministerial Regulations and Atomic Energy Act, emergency response and etc. In addition to the serious accident, there are also some small incidents that occurred, such as detection of contaminated scrap metals from the re-cycling of scrap metals from steel factories. Therefore, the radiation protection infrastructure was established after the accident. Laws and regulations of radiation safety and the relevant regulatory procedures must be revised.

  20. [Accidents and injuries at work].

    PubMed

    Standke, W

    2014-06-01

    In the case of an accident at work, the person concerned is insured by law according to the guidelines of the Sozialgesetzbuch VII as far as the injuries have been caused by this accident. The most important source of information on the incident in question is the accident report that has to be sent to the responsible institution for statutory accident insurance and prevention by the employer, if the accident of the injured person is fatal or leads to an incapacity to work for more than 3 days (= reportable accident). Data concerning accidents like these are sent to the Deutsche Gesetzliche Unfallversicherung (DGUV) as part of a random sample survey by the institutions for statutory accident insurance and prevention and are analyzed statistically. Thus the key issues of accidents can be established and used for effective prevention. Although the success of effective accident prevention is undisputed, there were still 919,025 occupational accidents in 2011, with clear gender-related differences. Most occupational accidents involve the upper and lower extremities. Accidents are analyzed comprehensively and the results are published and made available to all interested parties in an effort to improve public awareness of possible accidents. Apart from reportable accidents, data on the new occupational accident pensions are also gathered and analyzed statistically. Thus, additional information is gained on accidents with extremely serious consequences and partly permanent injuries for the accident victims.

  1. 49 CFR 831.13 - Flow and dissemination of accident or incident information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Flow and dissemination of accident or incident...) NATIONAL TRANSPORTATION SAFETY BOARD ACCIDENT/INCIDENT INVESTIGATION PROCEDURES § 831.13 Flow and dissemination of accident or incident information. (a) Release of information during the field...

  2. 49 CFR 831.13 - Flow and dissemination of accident or incident information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Flow and dissemination of accident or incident...) NATIONAL TRANSPORTATION SAFETY BOARD ACCIDENT/INCIDENT INVESTIGATION PROCEDURES § 831.13 Flow and dissemination of accident or incident information. (a) Release of information during the field...

  3. 49 CFR 831.13 - Flow and dissemination of accident or incident information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Flow and dissemination of accident or incident...) NATIONAL TRANSPORTATION SAFETY BOARD ACCIDENT/INCIDENT INVESTIGATION PROCEDURES § 831.13 Flow and dissemination of accident or incident information. (a) Release of information during the field...

  4. Non-pharmacological management of infant and young child procedural pain.

    PubMed

    Pillai Riddell, Rebecca R; Racine, Nicole M; Gennis, Hannah G; Turcotte, Kara; Uman, Lindsay S; Horton, Rachel E; Ahola Kohut, Sara; Hillgrove Stuart, Jessica; Stevens, Bonnie; Lisi, Diana M

    2015-12-02

    Infant acute pain and distress is commonplace. Infancy is a period of exponential development. Unrelieved pain and distress can have implications across the lifespan.  This is an update of a previously published review in the Cochrane Database of Systematic Reviews, Issue 10 2011 entitled 'Non-pharmacological management of infant and young child procedural pain'. To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding kangaroo care, and music. Analyses were run separately for infant age (preterm, neonate, older) and pain response (pain reactivity, immediate pain regulation).  For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 2 of 12, 2015), MEDLINE-Ovid platform (March 2015), EMBASE-OVID platform (April 2011 to March 2015), PsycINFO-OVID platform (April 2011 to February 2015), and CINAHL-EBSCO platform (April 2011 to March 2015). We also searched reference lists and contacted researchers via electronic list-serves. New studies were incorporated into the review. We refined search strategies with a Cochrane-affiliated librarian. For this update, nine articles from the original 2011 review pertaining to Kangaroo Care were excluded, but 21 additional studies were added. Participants included infants from birth to three years. Only randomised controlled trials (RCTs) or RCT cross-overs that had a no-treatment control comparison were eligible for inclusion in the analyses. However, when the additive effects of a non-pharmacological intervention could be assessed, these studies were also included. We examined studies that met all inclusion criteria except for study design (e.g. had an active control) to qualitatively contextualize results. There were 63 included articles in the current update. Study quality ratings and risk of bias were based on the Cochrane Risk of Bias Tool and GRADE approach. We analysed the standardized mean

  5. Persistence of airline accidents.

    PubMed

    Barros, Carlos Pestana; Faria, Joao Ricardo; Gil-Alana, Luis Alberiko

    2010-10-01

    This paper expands on air travel accident research by examining the relationship between air travel accidents and airline traffic or volume in the period from 1927-2006. The theoretical model is based on a representative airline company that aims to maximise its profits, and it utilises a fractional integration approach in order to determine whether there is a persistent pattern over time with respect to air accidents and air traffic. Furthermore, the paper analyses how airline accidents are related to traffic using a fractional cointegration approach. It finds that airline accidents are persistent and that a (non-stationary) fractional cointegration relationship exists between total airline accidents and airline passengers, airline miles and airline revenues, with shocks that affect the long-run equilibrium disappearing in the very long term. Moreover, this relation is negative, which might be due to the fact that air travel is becoming safer and there is greater competition in the airline industry. Policy implications are derived for countering accident events, based on competition and regulation. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

  6. Bicycle accidents in childhood.

    PubMed

    Nixon, J; Clacher, R; Pearn, J; Corcoran, A

    1987-05-16

    The results of a 10 year study of bicycle fatalities and an eight year study of serious non-fatalities are reported for urban Brisbane (population 1,000,000). There were 845 serious non-fatal bicycle accidents and 46 fatalities during the study. Boys were involved in 86% of accidents. Boys have an accident rate of 134.21 per 100,000 population at risk and a fatality rate of 5.06 per 100,000 at risk. Serious bicycle accidents have increased by 50% in this decade; but considering fatal cases alone, no secular trend was evident over the 10 year period of the study. This suggests that an increase in the overall rate of bicycle accidents has been in part compensated by less serious injuries. In 70% of fatalities children had head injuries, and 87% of fatalities followed a collision between a cyclist and a motor vehicle or a train. Bicycle accidents on the roads most commonly occur to boys aged between 12 and 14 years on a straight road at "mid-block" between 3 and 5 pm in clear weather conditions and in daylight. It is concluded that injuries and fatalities after bicycle accidents can be reduced by protecting children's heads, separating child cyclists from other road traffic, or educating and training both cyclists and other road users in safe behaviour. The compulsory use of helmets and the restriction of access to the roads by child cyclists to reduce injuries are, however, still controversial in many areas.

  7. Accident Tolerant Fuel Analysis

    SciTech Connect

    Smith, Curtis; Chichester, Heather; Johns, Jesse; Teague, Melissa; Tonks, Michael; Youngblood, Robert

    2014-09-01

    Safety is central to the design, licensing, operation, and economics of Nuclear Power Plants (NPPs). Consequently, the ability to better characterize and quantify safety margin holds the key to improved decision making about light water reactor design, operation, and plant life extension. A systematic approach to characterization of safety margins and the subsequent margins management options represents a vital input to the licensee and regulatory analysis and decision making that will be involved. The purpose of the Risk Informed Safety Margin Characterization (RISMC) Pathway research and development (R&D) is to support plant decisions for risk-informed margins management by improving economics and reliability, and sustaining safety, of current NPPs. Goals of the RISMC Pathway are twofold: (1) Develop and demonstrate a risk-assessment method coupled to safety margin quantification that can be used by NPP decision makers as part of their margin recovery strategies. (2) Create an advanced “RISMC toolkit” that enables more accurate representation of NPP safety margin. In order to carry out the R&D needed for the Pathway, the Idaho National Laboratory is performing a series of case studies that will explore methods- and tools-development issues, in addition to being of current interest in their own right. One such study is a comparative analysis of safety margins of plants using different fuel cladding types: specifically, a comparison between current-technology Zircaloy cladding and a notional “accident-tolerant” (e.g., SiC-based) cladding. The present report begins the process of applying capabilities that are still under development to the problem of assessing new fuel designs. The approach and lessons learned from this case study will be included in future Technical Basis Guides produced by the RISMC Pathway. These guides will be the mechanism for developing the specifications for RISMC tools and for defining how plant decision makers should propose and

  8. Accident Tolerant Fuel Analysis

    SciTech Connect

    Curtis Smith; Heather Chichester; Jesse Johns; Melissa Teague; Michael Tonks; Robert Youngblood

    2014-09-01

    Safety is central to the design, licensing, operation, and economics of Nuclear Power Plants (NPPs). Consequently, the ability to better characterize and quantify safety margin holds the key to improved decision making about light water reactor design, operation, and plant life extension. A systematic approach to characterization of safety margins and the subsequent margins management options represents a vital input to the licensee and regulatory analysis and decision making that will be involved. The purpose of the Risk Informed Safety Margin Characterization (RISMC) Pathway research and development (R&D) is to support plant decisions for risk-informed margins management by improving economics and reliability, and sustaining safety, of current NPPs. Goals of the RISMC Pathway are twofold: (1) Develop and demonstrate a risk-assessment method coupled to safety margin quantification that can be used by NPP decision makers as part of their margin recovery strategies. (2) Create an advanced “RISMC toolkit” that enables more accurate representation of NPP safety margin. In order to carry out the R&D needed for the Pathway, the Idaho National Laboratory is performing a series of case studies that will explore methods- and tools-development issues, in addition to being of current interest in their own right. One such study is a comparative analysis of safety margins of plants using different fuel cladding types: specifically, a comparison between current-technology Zircaloy cladding and a notional “accident-tolerant” (e.g., SiC-based) cladding. The present report begins the process of applying capabilities that are still under development to the problem of assessing new fuel designs. The approach and lessons learned from this case study will be included in future Technical Basis Guides produced by the RISMC Pathway. These guides will be the mechanism for developing the specifications for RISMC tools and for defining how plant decision makers should propose and

  9. Anthropotechnological analysis of industrial accidents in Brazil.

    PubMed Central

    Binder, M. C.; de Almeida, I. M.; Monteau, M.

    1999-01-01

    The Brazilian Ministry of Labour has been attempting to modify the norms used to analyse industrial accidents in the country. For this purpose, in 1994 it tried to make compulsory use of the causal tree approach to accident analysis, an approach developed in France during the 1970s, without having previously determined whether it is suitable for use under the industrial safety conditions that prevail in most Brazilian firms. In addition, opposition from Brazilian employers has blocked the proposed changes to the norms. The present study employed anthropotechnology to analyse experimental application of the causal tree method to work-related accidents in industrial firms in the region of Botucatu, São Paulo. Three work-related accidents were examined in three industrial firms representative of local, national and multinational companies. On the basis of the accidents analysed in this study, the rationale for the use of the causal tree method in Brazil can be summarized for each type of firm as follows: the method is redundant if there is a predominance of the type of risk whose elimination or neutralization requires adoption of conventional industrial safety measures (firm representative of local enterprises); the method is worth while if the company's specific technical risks have already largely been eliminated (firm representative of national enterprises); and the method is particularly appropriate if the firm has a good safety record and the causes of accidents are primarily related to industrial organization and management (multinational enterprise). PMID:10680249

  10. Conduction disturbances after transcatheter aortic valve implantation procedures – predictors and management

    PubMed Central

    Reguła, Rafał; Bujak, Kamil; Chodór, Piotr; Długaszek, Michał; Gąsior, Mariusz

    2016-01-01

    Transcatheter aortic valve implantation (TAVI) has become a safe and efficient alternative to cardiac surgery in patients with severe aortic stenosis. In many countries the number of performed TAVI procedures equals the number of surgical implantations. Indications for TAVI are becoming more liberal, allowing a wider spectrum of patients to benefit from the advantages of transcatheter therapy. Due to its invasive nature, TAVI is associated with some complications such as conduction disturbances. Although these disturbances are usually not lethal, they have a great influence on patients’ state and long term-survival. The most relevant and common are His’ bundle branch blocks, atrioventricular blocks, and need for permanent pacemaker implantation. With the frequency at 10% to even 50%, conduction abnormalities are among the most important TAVI-related adverse events. Risk factors for conduction disturbances include age, anatomy of the heart, periprocedural factors, type of implanted valve, and comorbidities. Severity of occurring complications varies; therefore selection of a proper treatment approach is required. Considered as the most effective management, permanent pacemaker implantation turned out to negatively influence both recovery and survival. Moreover, there is no expert consensus on use of resynchronization therapy after TAVI. In this paper, the authors present a comprehensive analysis of the most common conduction disturbances accompanying TAVI, factors related to their occurrence, and treatment approach. PMID:27625682

  11. Long Term Results of Innovative Procedure in Surgical Management of Chronic Lymphedema

    PubMed Central

    Mousavi, Seyed R.

    2016-01-01

    Background: Lymphedema is the result of impaired lymphatic drainage by the affected organ. This abnormality can be primary or secondary. Different operative approaches have been introduced to treat chronic lymphedema. Materials and Methods: This retrospective study included 816 patients who were diagnosed with chronic lower extremity lymphedema and did not respond to non-operative management for at least six months. Data was collected over 25 years, between March 1987 and March 2013. Doppler ultrasonography of the deep venous system was routinely undertaken in all patients to confirm patency. The patients underwent surgery and their progress was followed for at least one year postoperatively. Results: All patients were operated by the suggested technique and long term fallow-up which is a modified form of the Homan’s technique. The outcome was excellent, and 89.2% of patients were free of complication and 2% had poor results. The most common complication was wound seroma and wound infection. Conclusion: The long term results and considering the difficulties associated with the treatment of chronic lymphedema and the variety of surgical options, our method achieved excellent results, and may be proposed for the standard operative procedure for treating intractable forms of this disease. PMID:27990192

  12. Emergency medicine tools to manage smallpox (vaccinia) vaccination complications: clinical practice guideline and policies and procedures.

    PubMed

    Thorne, Craig D; Hirshon, Jon Mark; Himes, Carrie D; McDiarmid, Melissa A

    2003-11-01

    In December 2002, the federal government began a program to immunize approximately 500000 civilian public health and health care workers with smallpox (vaccinia) vaccine as a part of our pre-event defense against bioterrorism. First responders will likely follow, and the general US population might be offered vaccination in the next 1 to 2 years. Recent reports that suggest the possible association of the vaccine to adverse cardiac events (including deaths), liability concerns for hospitals, and the availability of compensation for workers with vaccine complications have significantly reduced voluntary participation. Vaccinees might experience robust primary takes or serious adverse events, including viral or even bacterial cellulitides, encephalitis, progressive skin destruction, and other life-threatening complications. With the increasing prevalence of immune suppression from both diseases and immunosuppressive medications, complications might be seen in higher frequency than previously reported. Emergency medicine providers and staff must become familiar with clinical presentations and management of vaccine complications. In addition, policies and procedures must be developed to prevent unimmunized providers from inadvertently contacting the active vaccination sites of their patients and, if the providers themselves have active vaccination sites, to protect their patients and their own families.

  13. 41 CFR 102-74.360 - What are the specific accident and fire prevention responsibilities of occupant agencies?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... accident and fire prevention responsibilities of occupant agencies? 102-74.360 Section 102-74.360 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.360 What are the specific accident and fire prevention responsibilities of occupant agencies...

  14. 41 CFR 102-74.360 - What are the specific accident and fire prevention responsibilities of occupant agencies?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accident and fire prevention responsibilities of occupant agencies? 102-74.360 Section 102-74.360 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.360 What are the specific accident and fire prevention responsibilities of occupant agencies...

  15. 41 CFR 102-74.360 - What are the specific accident and fire prevention responsibilities of occupant agencies?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accident and fire prevention responsibilities of occupant agencies? 102-74.360 Section 102-74.360 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.360 What are the specific accident and fire prevention responsibilities of occupant agencies...

  16. 41 CFR 102-74.360 - What are the specific accident and fire prevention responsibilities of occupant agencies?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... accident and fire prevention responsibilities of occupant agencies? 102-74.360 Section 102-74.360 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Accident and Fire Prevention § 102-74.360 What are the specific accident and fire prevention responsibilities of occupant agencies...

  17. Lessons learned from early criticality accidents

    SciTech Connect

    Malenfant, R.E.

    1996-06-01

    Four accidents involving the approach to criticality occurred during the period July, 1945, through May, 1996. These have been described in the format of the OPERATING EXPERIENCE WEEKLY SUMMARY which is distributed by the Office of Nuclear and Facility Safety. Although the lessons learned have been incorporated in standards, codes, and formal procedures during the last fifty years, this is their first presentation in this format. It is particularly appropriate that they be presented in the forum of the Nuclear Criticality Technology Safety Project Workshop closest to the fiftieth anniversary of the last of the four accidents, and that which was most instrumental in demonstrating the need to incorporate lessons learned.

  18. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of management rights. 9701.512 Section 9701.512 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Labor-Management Relations § 9701.512...

  19. 5 CFR 9701.512 - Conferring on procedures for the exercise of management rights.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of management rights. 9701.512 Section 9701.512 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Labor-Management Relations §...

  20. 46 CFR 122.208 - Accidents to machinery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Accidents to machinery. 122.208 Section 122.208 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150... Voyage Records § 122.208 Accidents to machinery. The owner, managing operator, or master shall...

  1. 46 CFR 122.208 - Accidents to machinery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Accidents to machinery. 122.208 Section 122.208 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150... Voyage Records § 122.208 Accidents to machinery. The owner, managing operator, or master shall...

  2. 46 CFR 122.208 - Accidents to machinery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Accidents to machinery. 122.208 Section 122.208 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150... Voyage Records § 122.208 Accidents to machinery. The owner, managing operator, or master shall...

  3. 46 CFR 122.208 - Accidents to machinery.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Accidents to machinery. 122.208 Section 122.208 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150... Voyage Records § 122.208 Accidents to machinery. The owner, managing operator, or master shall...

  4. 46 CFR 122.208 - Accidents to machinery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Accidents to machinery. 122.208 Section 122.208 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150... Voyage Records § 122.208 Accidents to machinery. The owner, managing operator, or master shall...

  5. 36 CFR 9.46 - Accidents and fires.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Accidents and fires. 9.46 Section 9.46 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Non-Federal Oil and Gas Rights § 9.46 Accidents and fires. The operator shall take...

  6. A Study of Program Management Procedures in the Campus-Based and Basic Grant Programs. Site Visit Report.

    ERIC Educational Resources Information Center

    Ellis, Richard, Ed.; Puma, Michael, Ed.

    Site visits to a sample of 173 colleges, universities, vocational-technical schools, and other postsecondary institutions--conducted to examine the procedures used to manage federal Basic Educational Opportunity Grant (BEOG) and campus-based student financial assistance programs--are summarized. This report deals only with the conduct of the…

  7. Response of School Districts to the New York State Concussion Awareness and Management Act: Review of Policies and Procedures

    ERIC Educational Resources Information Center

    Kajankova, Maria; Oswald, Jennifer M.; Terranova, Lauren M.; Kaplen, Michael V.; Ambrose, Anne F.; Spielman, Lisa A.; Gordon, Wayne A.

    2017-01-01

    Background: By 2014, all states implemented concussion laws that schools must translate into daily practice; yet, limited knowledge exists regarding implementation of these laws. We examined the extent to which concussion management policies and procedure (P&P) documents of New York State school districts comply with the State's Concussion…

  8. Motorcyclists' speed and "looked-but-failed-to-see" accidents.

    PubMed

    Clabaux, Nicolas; Brenac, Thierry; Perrin, Christophe; Magnin, Joël; Canu, Bastien; Van Elslande, Pierre

    2012-11-01

    Previous research on motorcycle crashes has shown the frequency and severity of accidents in which a non-priority road user failed to give way to an approaching motorcyclist without seeing him/her, even though the road user had looked in the approaching motorcycle's direction and the motorcycle was visible. These accidents are usually called "looked-but-failed-to-see" (LBFS) accidents. This article deals with the effects that the motorcyclist's speed has in these accidents. It is based on the in-depth study and precise kinematic reconstruction of 44 accident cases involving a motorcyclist and another road user, all occurring in intersections. The results show that, in urban environments, the initial speeds of motorcyclists involved in "looked-but-failed-to-see" accidents are significantly higher than in other accidents at intersections. In rural environments, the difference in speed between LBFS accidents and other accidents is not significant, but further investigations would be necessary to draw any conclusions. These results suggest that speed management, through road design or by other means, could contribute to preventing "looked-but-failed-to-see" motorcycle accidents, at least in urban environments. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Quality function deployment applied to local traffic accident reduction.

    PubMed

    Sohn, S Y

    1999-11-01

    One of the major tasks of police stations is the management of local road traffic accidents. Proper prevention policy which reflects the local accident characteristics could immensely help individual police stations in decreasing various severity levels of road traffic accidents. In order to relate accident variation to local driving environmental characteristics, we use both cluster analysis and Poisson regression. The fitted result at the level of each cluster for each type of accident severity is utilized as an input to quality function deployment. Quality function deployment (QFD) has been applied to customer satisfaction in various industrial quality improvement settings, where several types of customer requirements are related to various control factors. We show how QFD enables one to set priorities on various road accident control policies to which each police station has to pay particular attention.

  10. Causation of severe and fatal accidents in the manufacturing sector.

    PubMed

    Carrillo-Castrillo, Jesús A; Rubio-Romero, Juan C; Onieva, Luis

    2013-01-01

    The main purpose of this paper is to identify the most frequent causes of accidents in the manufacturing sector in Andalusia, Spain, to help safety practitioners in the task of prioritizing preventive actions. Official accident investigation reports are analyzed. A causation pattern is identified with the proportion of causes of each of the different possible groups of causes. We found evidence of a differential causation between slight and nonslight accidents. We have also found significant differences in accident causation depending on the mechanism of the accident. These results can be used to prioritize preventive actions to combat the most likely causes of each accident mechanism. We have also done research on the associations of certain latent causes with specific active (immediate) causes. These relationships show how organizational and safety management can contribute to the prevention of active failures.

  11. Accident resistant transport container

    DOEpatents

    Anderson, J.A.; Cole, K.K.

    The invention relates to a container for the safe air transport of plutonium having several intermediate wood layers and a load spreader intermediate an inner container and an outer shell for mitigation of shock during a hypothetical accident.

  12. Accident resistant transport container

    DOEpatents

    Andersen, John A.; Cole, James K.

    1980-01-01

    The invention relates to a container for the safe air transport of plutonium having several intermediate wood layers and a load spreader intermediate an inner container and an outer shell for mitigation of shock during a hypothetical accident.

  13. Development of Database for Accident Analysis in Indian Mines

    NASA Astrophysics Data System (ADS)

    Tripathy, Debi Prasad; Guru Raghavendra Reddy, K.

    2016-10-01

    Mining is a hazardous industry and high accident rates associated with underground mining is a cause of deep concern. Technological developments notwithstanding, rate of fatal accidents and reportable incidents have not shown corresponding levels of decline. This paper argues that adoption of appropriate safety standards by both mine management and the government may result in appreciable reduction in accident frequency. This can be achieved by using the technology in improving the working conditions, sensitising workers and managers about causes and prevention of accidents. Inputs required for a detailed analysis of an accident include information on location, time, type, cost of accident, victim, nature of injury, personal and environmental factors etc. Such information can be generated from data available in the standard coded accident report form. This paper presents a web based application for accident analysis in Indian mines during 2001-2013. An accident database (SafeStat) prototype based on Intranet of the TCP/IP agreement, as developed by the authors, is also discussed.

  14. Nonpharmacological management of pain during common needle puncture procedures in infants: current research evidence and practical considerations.

    PubMed

    McNair, Carol; Campbell Yeo, Marsha; Johnston, Celeste; Taddio, Anna

    2013-09-01

    All infants undergo painful procedures involving skin puncture as part of routine medical care. Pain from needle puncture procedures is suboptimally managed. Numerous nonpharmacologic interventions are available for these painful procedures, including swaddling, holding, skin-to-skin care, pacifier, sweet-tasting solutions, and breast-feeding. Adoption of nonpharmacologic pain-relieving interventions into routine clinical practice is feasible and should be a standard of care in the delivery of quality health care for infants. This review summarizes current knowledge about the epidemiology of pain from common needle puncture procedures in infants, the effectiveness of nonpharmacologic interventions, implementation considerations, and unanswered questions for future research. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Vulnerability assessment of chemical industry facilities in South Korea based on the chemical accident history

    NASA Astrophysics Data System (ADS)

    Heo, S.; Lee, W. K.; Jong-Ryeul, S.; Kim, M. I.

    2016-12-01

    The use of chemical compounds are keep increasing because of their use in manufacturing industry. Chemical accident is growing as the consequence of the chemical use increment. Devastating damages from chemical accidents are far enough to aware people's cautious about the risk of the chemical accident. In South Korea, Gumi Hydrofluoric acid leaking accident triggered the importance of risk management and emphasized the preventing the accident over the damage reducing process after the accident occurs. Gumi accident encouraged the government data base construction relate to the chemical accident. As the result of this effort Chemical Safety-Clearing-house (CSC) have started to record the chemical accident information and damages according to the Harmful Chemical Substance Control Act (HCSC). CSC provide details information about the chemical accidents from 2002 to present. The detail informations are including title of company, address, business type, accident dates, accident types, accident chemical compounds, human damages inside of the chemical industry facilities, human damage outside of the chemical industry facilities, financial damages inside of the chemical industry facilities, and financial damages outside of the chemical industry facilities, environmental damages and response to the chemical accident. Collected the chemical accident history of South Korea from 2002 to 2015 and provide the spatial information to the each accident records based on their address. With the spatial information, compute the data on ArcGIS for the spatial-temporal analysis. The spatial-temporal information of chemical accident is organized by the chemical accident types, damages, and damages on environment and conduct the spatial proximity with local community and environmental receptors. Find the chemical accident vulnerable area of South Korea from 2002 to 2015 and add the vulnerable area of total period to examine the historically vulnerable area from the chemical accident in

  16. Normal accidents: human error and medical equipment design.

    PubMed

    Dain, Steven

    2002-01-01

    High-risk systems, which are typical of our technologically complex era, include not just nuclear power plants but also hospitals, anesthesia systems, and the practice of medicine and perfusion. In high-risk systems, no matter how effective safety devices are, some types of accidents are inevitable because the system's complexity leads to multiple and unexpected interactions. It is important for healthcare providers to apply a risk assessment and management process to decisions involving new equipment and procedures or staffing matters in order to minimize the residual risks of latent errors, which are amenable to correction because of the large window of opportunity for their detection. This article provides an introduction to basic risk management and error theory principles and examines ways in which they can be applied to reduce and mitigate the inevitable human errors that accompany high-risk systems. The article also discusses "human factor engineering" (HFE), the process which is used to design equipment/ human interfaces in order to mitigate design errors. The HFE process involves interaction between designers and endusers to produce a series of continuous refinements that are incorporated into the final product. The article also examines common design problems encountered in the operating room that may predispose operators to commit errors resulting in harm to the patient. While recognizing that errors and accidents are unavoidable, organizations that function within a high-risk system must adopt a "safety culture" that anticipates problems and acts aggressively through an anonymous, "blameless" reporting mechanism to resolve them. We must continuously examine and improve the design of equipment and procedures, personnel, supplies and materials, and the environment in which we work to reduce error and minimize its effects. Healthcare providers must take a leading role in the day-to-day management of the "Perioperative System" and be a role model in

  17. [The implementation of an independent and differentiated pain management SOP (Standard Operating Procedure) for the interdisciplinary intensive care unit].

    PubMed

    Aust, Hansjörg; Wulf, Hinnerk; Vassiliou, Timon

    2013-03-01

    Up to the present day, pain management in the ICU (Intensive Care Units) is a unresolved clinical problem due to patient heterogeneity with complex variation in etiopathology and treatment of the underlying diseases. Therefore, therapeutic strategies in terms of standard operating procedure (SOP) are a necessary to improve the pain management for intensive care patients. Common guidelines for analgosedation are often inadequate to reflect the clinical situation. In particular, for an ICU setting without permanent presence of a physician a missing pain management SOP resulting in delayed pain therapy caused by a therapeutic uncertainty of the nurse staff. In addition to our pre-existing SOP for analgosedation we implemented a pain management SOP for our interdisciplinary, anaesthesiologic ICU. A exploratory survey among the nurse staff was conducted to assess the efficacy of the SOP. The results of the evaluation after a 6 month follow-up indicated a faster onset of pain management and good acceptance by the nursing staff.

  18. Habitat Evaluation Procedures (HEP) Report; Yakama Nation Wildlife Management Areas, Technical Report 1999-2000.

    SciTech Connect

    Raedeke, Kenneth; Raedeke, Dorothy

    2000-06-01

    Construction of the Dalles, Bonneville, McNary, and John Day Dams on the Columbia River by the federal government resulted in a substantial loss of riparian bottomland along the Columbia River. Impacts associated with the Mid-Columbia Projects were assessed for several wildlife species using the Habitat Evaluation Procedures (HEP) developed by the U.S. Fish and Wildlife Service (USDI-FWS 1980). The studies documented the loss of riparian habitat and established a baseline against which mitigation measures could be developed (USDI-FWS 1990 and USDE-BPA 1990). The impact assessments established a mitigation goal, a portion of which would be satisfied by the creation, restoration, and enhancement of riparian lands on tributaries to the Columbia River, including the Yakima Valley. The Yakama Nation (YN), the Northwest Power Planning Council, and the Bonneville Power Administration have agreed that the Yakama Nation would be funded to implement habitat restoration on lands within and adjacent to their reservation. Some of the targeted lands are owned by the Yakama Nation, some are trust lands, and some lands have been in private ownership. Since the early 1990s, the Yakama Nation has been in the process of assembling riparian lands into Wildlife Management Areas, and restoring natural hydrology and natural cover-types on these lands. The Northwest Power Planning Council, through the Bonneville Power Administration, has supported the program. HEP studies were performed by the Yakama Nation in 1990 (Bich et al. 1991) to establish baseline conditions and inventory wildlife habitat at the initiation of the restoration project. The 1990 HEP used a simplified version of the HEP to quantify baseline conditions. The present assessment is designed to evaluate the progress of the mitigation plan in meeting its stated goals. The 1999 HEP assessment has two distinct tasks: (1) Evaluation of the mitigation plan as currently implemented using the simplified YN HEP methodologies for

  19. Loss of Coolant Accident (LOCA) / Emergency Core Coolant System (ECCS Evaluation of Risk-Informed Margins Management Strategies for a Representative Pressurized Water Reactor (PWR)

    SciTech Connect

    Szilard, Ronaldo Henriques

    2016-09-01

    A Risk Informed Safety Margin Characterization (RISMC) toolkit and methodology are proposed for investigating nuclear power plant core, fuels design and safety analysis, including postulated Loss-of-Coolant Accident (LOCA) analysis. This toolkit, under an integrated evaluation model framework, is name LOCA toolkit for the US (LOTUS). This demonstration includes coupled analysis of core design, fuel design, thermal hydraulics and systems analysis, using advanced risk analysis tools and methods to investigate a wide range of results.

  20. Single visit approach for management of cervical intraepithelial neoplasia by visual inspection & loop electrosurgical excision procedure

    PubMed Central

    Singla, Shilpa; Mathur, Sandeep; Kriplani, Alka; Agarwal, Nutan; Garg, Pradeep; Bhatla, Neerja

    2012-01-01

    Background & objectives: Developing a feasible and sustainable model of cervical cancer screening in developing countries continues to be a challenge because of lack of facilities and awareness in the population and poor compliance with screening and treatment. This study was aimed to evaluate a single visit approach (SVA) for the management of cervical intraepithelial neoplasia (CIN) using visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) along with loop electrosurgical excision procedure (LEEP) in women attending Gynaecology OPD in a tertiary care hospital in north India. Methods: In this hospital-based study, 450 women receiving opportunistic screening by conventional Pap cytology were also screened by VIA and VILI. VIA/VILI positive cases underwent same-day colposcopy and biopsy of all lesions. If the modified Reid score was >3, the patient underwent LEEP at the same visit. Results: Of the 450 women screened, 86 (19.1%) and 92 (20.5%) women were VIA and VILI positive, respectively. Detection rates of VIA, VILI and cytology findings at ASCUS threshold were 33.3, 35.5 and 24.4 per 1000, women, respectively to detect a lesion >CIN1. For detection of CIN2+ lesion, detection rates of VIA, VILI and cytology were 20, 22.2 and 22.2 per 1000 women, respectively. Sixteen patients with Reid score >3 underwent the See-and-treat protocol. The overtreatment rate was 12.5 per cent and the efficacy of LEEP was 81.3 per cent. There were no major complications. Interpretation & conclusions: The sensitivity of VIA/VILI was comparable to cytology. A single visit approach using visual screening methods at community level by trained paramedical personnel followed by a combination of ablative and excisional therapy can help to decrease the incidence of cervical neoplasia. PMID:22771589

  1. Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

    PubMed Central

    O’Connor, Rory C; Fawthrop, Fiona; Salha, Rami; Sidebottom, Andrew J

    2017-01-01

    Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients. Symptom deterioration does not necessarily follow disease progression, but when it does, TMJ arthroscopy and arthrocentesis can help modulate pain, increase mouth opening, and relieve locking. These minimally invasive procedures have few complications and can be repeated. Operations to repair or remove a damaged intra-articular disc or to refine joint anatomy are used in select cases. Total TMJ replacement is reserved for patients where joint collapse or fusion has occurred or in whom other treatments have failed to provide adequate symptomatic control. It yields excellent outcomes and is approved by the National Institute of Health and Care Excellence (NICE), UK. Knowledge of the assessment and treatment of the TMJ, which differs from other joints affected by inflammatory arthritis due to its unique anatomy and function, is not widespread outside of the field of oral and maxillofacial surgery. The aim of this article is to highlight the peculiarities of TMJ disease secondary to rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis and how to best manage these ailments, which should help guide when referral to a specialist TMJ surgeon is appropriate. PMID:28638693

  2. IMMEDIATE MENTAL CONSEQUENCES OF THE GREAT EAST JAPAN EARTHQUAKE AND FUKUSHIMA NUCLEAR POWER PLANT ACCIDENT ON MOTHERS EXPERIENCING MISCARRIAGE, ABORTION, AND STILLBIRTH: THE FUKUSHIMA HEALTH MANAGEMENT SURVEY.

    PubMed

    Yoshida-Komiya, Hiromi; Goto, Aya; Yasumura, Seiji; Fujimori, Keiya; Abe, Masafumi

    2015-01-01

    The Fukushima Pregnancy and Birth Survey was launched to monitor pregnant mothers' health after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant (NPP) accident. Several lines of investigations have indicated that a disaster impacts maternal mental health with childbirth. However, there is no research regarding mental health of mothers with fetal loss after a disaster. In this report, we focus on those women immediately after the Great East Japan Earthquake and Fukushima NPP accident and discuss their support needs. Data regarding 61 miscarriages, 5 abortions, and 22 stillbirths were analyzed among the women who were pregnant at the time of the accident in the present study. We used a two-item case-finding instrument for depression screening, and compared the childbirth group with the fetal loss groups. We also analyzed mothers' opinions written as free-form text. Among the three fetal loss groups, the proportion of positive depression screens was significantly higher in the miscarriage and stillbirth group than in the childbirth group. Mothers' opinions were grouped into six categories, with pregnancy-related items being most common, especially in the miscarriage and stillbirth groups. A higher proportion of Fukushima mothers with fetal loss, especially those with miscarriage and stillbirth, had depressive symptoms compared to those who experienced childbirth. Health care providers need to pay close attention to this vulnerable group and respond to their concerns regarding the effects on their fertility.

  3. IMMEDIATE MENTAL CONSEQUENCES OF THE GREAT EAST JAPAN EARTHQUAKE AND FUKUSHIMA NUCLEAR POWER PLANT ACCIDENT ON MOTHERS EXPERIENCING MISCARRIAGE, ABORTION, AND STILLBIRTH: THE FUKUSHIMA HEALTH MANAGEMENT SURVEY

    PubMed Central

    YOSHIDA-KOMIYA, HIROMI; GOTO, AYA; YASUMURA, SEIJI; FUJIMORI, KEIYA; ABE, MASAFUMI; FOR THE PREGNANCY AND BIRTH SURVEY GROUP OF THE FUKUSHIMA HEALTH MANAGEMENT SURVEY

    2015-01-01

    ABSTRACT Background: The Fukushima Pregnancy and Birth Survey was launched to monitor pregnant mothers’ health after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant (NPP) accident. Several lines of investigations have indicated that a disaster impacts maternal mental health with childbirth. However, there is no research regarding mental health of mothers with fetal loss after a disaster. In this report, we focus on those women immediately after the Great East Japan Earthquake and Fukushima NPP accident and discuss their support needs. Materials and Methods: Data regarding 61 miscarriages, 5 abortions, and 22 stillbirths were analyzed among the women who were pregnant at the time of the accident in the present study. We used a two-item case-finding instrument for depression screening, and compared the childbirth group with the fetal loss groups. We also analyzed mothers’ opinions written as free-form text. Results: Among the three fetal loss groups, the proportion of positive depression screens was significantly higher in the miscarriage and stillbirth group than in the childbirth group. Mothers’ opinions were grouped into six categories, with pregnancy-related items being most common, especially in the miscarriage and stillbirth groups. Conclusion: A higher proportion of Fukushima mothers with fetal loss, especially those with miscarriage and stillbirth, had depressive symptoms compared to those who experienced childbirth. Health care providers need to pay close attention to this vulnerable group and respond to their concerns regarding the effects on their fertility. PMID:26063510

  4. Columbia Accident Investigation Board Report. Volume Five

    NASA Technical Reports Server (NTRS)

    Gehmann, H. W.; Barry, J. L.; Deal, D. W.; Hallock, J. N.; Hess, K. W.

    2003-01-01

    Volume V of the Report contains appendices that were not cited in VolumeI. These consist of documents produced by NASA and other organizations, which were provided to the Columbia Accident Investigation Board in support of its inquiry into the February 1, 2003 destruction of the Space Shuttle Columbia The contents include:. Appendix G.1 Requirements and Procedures for Certification of Flight Readiness; Appendix G.2 Appendix R, Space Shuttle Program Contingency Action Plan; Appendix G.3 CAIB Charter, with Revisions; Appendix G.4 Group 1 Matrix Brief on Maintenance, Material, and Management; Appendix G.5 Vehicle Data Mapping(VDM) Team Final Report, Jun 13, 2003; Appendix G.6 SRB Working Group Presentation to CAIB; Appendix G. 7 Starfire Team Final Report, Jun 3, 2003; Appendix G.8 Using the Data and Observations from Flight STS-107, Executive Summary; Appendix G.9 Contracts, Incentives, and Safety/Technical Excellence; Appendix G.10 Detailed Summaries: Rogers Commission Report, ASAP Report, SIAT Report; Appendix G.11 Foam Application and Production Chart; Appendix G.12 Crew Survivability Report; and Appendix G.12 Aero/Aerothermal/ Thermal/Structures Team FinalReport, August 6, 2003.

  5. Columbia Accident Investigation Board Report. Volume Five

    NASA Technical Reports Server (NTRS)

    Gehmann, H. W.; Barry, J. L.; Deal, D. W.; Hallock, J. N.; Hess, K. W.

    2003-01-01

    Volume V of the Report contains appendices that were not cited in VolumeI. These consist of documents produced by NASA and other organizations, which were provided to the Columbia Accident Investigation Board in support of its inquiry into the February 1, 2003 destruction of the Space Shuttle Columbia The contents include:. Appendix G.1 Requirements and Procedures for Certification of Flight Readiness; Appendix G.2 Appendix R, Space Shuttle Program Contingency Action Plan; Appendix G.3 CAIB Charter, with Revisions; Appendix G.4 Group 1 Matrix Brief on Maintenance, Material, and Management; Appendix G.5 Vehicle Data Mapping(VDM) Team Final Report, Jun 13, 2003; Appendix G.6 SRB Working Group Presentation to CAIB; Appendix G. 7 Starfire Team Final Report, Jun 3, 2003; Appendix G.8 Using the Data and Observations from Flight STS-107, Executive Summary; Appendix G.9 Contracts, Incentives, and Safety/Technical Excellence; Appendix G.10 Detailed Summaries: Rogers Commission Report, ASAP Report, SIAT Report; Appendix G.11 Foam Application and Production Chart; Appendix G.12 Crew Survivability Report; and Appendix G.12 Aero/Aerothermal/ Thermal/Structures Team FinalReport, August 6, 2003.

  6. Habitat Evaluation Procedures (HEP) Report; Precious Lands Wildlife Management Area, Technical Report 2000-2003.

    SciTech Connect

    Kozusko, Shana

    2003-12-01

    The Nez Perce Tribe (NPT) currently manages a 15,325 acre parcel of land known as the Precious Lands Wildlife Management Area that was purchased as mitigation for losses incurred by construction of the four lower Snake River dams. The Management Area is located in northern Wallowa County, Oregon and southern Asotin County, Washington (Figure 1). It is divided into three management parcels--the Buford parcel is located on Buford Creek and straddles the WA-OR state line, and the Tamarack and Basin parcels are contiguous to each other and located between the Joseph Creek and Cottonwood Creek drainages in Wallowa County, OR. The project was developed under the Pacific Northwest Electric Power Planning and Conservation Act of 1980 (P.L. 96-501), with funding from the Bonneville Power Administration (BPA). The acreage protected under this contract will be credited to BPA as habitat permanently dedicated to wildlife and wildlife mitigation. A modeling strategy known as Habitat Evaluation Procedure (HEP) was developed by the U.S. Fish and Wildlife Service and adopted by BPA as a habitat equivalency accounting system. Nine wildlife species models were used to evaluate distinct cover type features and provide a measure of habitat quality. Models measure a wide range of life requisite variables for each species and monitor overall trends in vegetation community health and diversity. One product of HEP is an evaluation of habitat quality expressed in Habitat Units (HUs). This HU accounting system is used to determine the amount of credit BPA receives for mitigation lands. After construction of the four lower Snake River dams, a HEP loss assessment was conducted to determine how many Habitat Units were inundated behind the dams. Twelve target species were used in that evaluation: Canada goose, mallard, river otter, downy woodpecker, song sparrow, yellow warbler, marsh wren, western meadowlark, chukar, ring-necked pheasant, California quail, and mule deer. The U.S. Army Corp of

  7. Utilization of accident databases and fuzzy sets to estimate frequency of HazMat transport accidents.

    PubMed

    Qiao, Yuanhua; Keren, Nir; Mannan, M Sam

    2009-08-15

    Risk assessment and management of transportation of hazardous materials (HazMat) require the estimation of accident frequency. This paper presents a methodology to estimate hazardous materials transportation accident frequency by utilizing publicly available databases and expert knowledge. The estimation process addresses route-dependent and route-independent variables. Negative binomial regression is applied to an analysis of the Department of Public Safety (DPS) accident database to derive basic accident frequency as a function of route-dependent variables, while the effects of route-independent variables are modeled by fuzzy logic. The integrated methodology provides the basis for an overall transportation risk analysis, which can be used later to develop a decision support system.

  8. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016.

    PubMed

    Coté, Charles J; Wilson, Stephen

    2016-01-01

    The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase the potential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions. This report was developed through a collaborative effort of the American Academy of Pediatrics and the American Academy of Pediatric Dentistry to offer pediatric providers updated information and guidance in delivering safe sedation to children.

  9. Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research.

    PubMed

    Nordquist, Rebecca E; van der Staay, Franz Josef; van Eerdenburg, Frank J C M; Velkers, Francisca C; Fijn, Lisa; Arndt, Saskia S

    2017-02-21

    A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting "robust" animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific evidence about the welfare effects of current practices in farming such as mutilating procedures, management practices, and housing conditions is steadily growing, the gain in knowledge needs a boost through more scientific research. Considering the huge number of animals whose welfare is affected, all possible effort must be made to improve their welfare as quickly as possible in order to ban welfare-compromising procedures and practices as soon as possible.

  10. The Effectiveness of Distraction as Procedural Pain Management Technique in Pediatric Oncology Patients: A Meta-analysis and Systematic Review.

    PubMed

    Bukola, Ibitoye M; Paula, Dawson

    2017-07-14

    Diagnostic tests and treatment regimens for pediatric cancers involve invasive and painful procedures. Effective management of such pain has been shown to be suboptimal in many parts of the world, often because of the cost and limited availability of appropriate medications. Current evidence suggests that distraction (a relatively low-cost technique) is a promising intervention for procedural pain management. There is, however, limited evidence demonstrating its effectiveness in pediatric oncology patients. A systematic review was conducted to ascertain the effectiveness of distraction as a procedural pain management technique in pediatric oncology patients. Using a comprehensive search strategy, MEDLINE, PsycINFO, Cochrane Library, AMED, CINAHL, Web of Science, and EMBASE electronic databases were searched for studies comparing distraction techniques to standard care/any intervention. Using the selected studies, a systematic review and meta-analysis of randomized controlled trials was conducted. Two hundred ninety-nine studies were identified, with seven randomized control trials identified as eligible for inclusion. Pain was assessed using self-report, observer-report, and physiological measures. A meta-analysis of four studies showed distraction as effective in reducing procedural pain, based on self-reported pain. A meta-analysis of three studies, based on pulse rates, demonstrated similar results. For observer-reported pain, limited evidence supported the effectiveness of distraction. This systematic review demonstrates that distraction is a promising intervention for procedural pain. Future research should assess effectiveness of distraction in varied populations, to explore evidence of cultural influences on pain expression, measurement, and management approaches. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.

  11. A Qualitative Study on Organizational Factors Affecting Occupational Accidents

    PubMed Central

    ESKANDARI, Davood; JAFARI, Mohammad Javad; MEHRABI, Yadollah; KIAN, Mostafa Pouya; CHARKHAND, Hossein; MIRGHOTBI, Mostafa

    2017-01-01

    Background: Technical, human, operational and organizational factors have been influencing the sequence of occupational accidents. Among them, organizational factors play a major role in causing occupational accidents. The aim of this research was to understand the Iranian safety experts’ experiences and perception of organizational factors. Methods: This qualitative study was conducted in 2015 by using the content analysis technique. Data were collected through semi-structured interviews with 17 safety experts working in Iranian universities and industries and analyzed with a conventional qualitative content analysis method using the MAXQDA software. Results: Eleven organizational factors’ sub-themes were identified: management commitment, management participation, employee involvement, communication, blame culture, education and training, job satisfaction, interpersonal relationship, supervision, continuous improvement, and reward system. The participants considered these factors as effective on occupational accidents. Conclusion: The mentioned 11 organizational factors are probably involved in occupational accidents in Iran. Naturally, improving organizational factors can increase the safety performance and reduce occupational accidents. PMID:28435824

  12. Bicycle accidents in childhood.

    PubMed Central

    Nixon, J; Clacher, R; Pearn, J; Corcoran, A

    1987-01-01

    The results of a 10 year study of bicycle fatalities and an eight year study of serious non-fatalities are reported for urban Brisbane (population 1,000,000). There were 845 serious non-fatal bicycle accidents and 46 fatalities during the study. Boys were involved in 86% of accidents. Boys have an accident rate of 134.21 per 100,000 population at risk and a fatality rate of 5.06 per 100,000 at risk. Serious bicycle accidents have increased by 50% in this decade; but considering fatal cases alone, no secular trend was evident over the 10 year period of the study. This suggests that an increase in the overall rate of bicycle accidents has been in part compensated by less serious injuries. In 70% of fatalities children had head injuries, and 87% of fatalities followed a collision between a cyclist and a motor vehicle or a train. Bicycle accidents on the roads most commonly occur to boys aged between 12 and 14 years on a straight road at "mid-block" between 3 and 5 pm in clear weather conditions and in daylight. It is concluded that injuries and fatalities after bicycle accidents can be reduced by protecting children's heads, separating child cyclists from other road traffic, or educating and training both cyclists and other road users in safe behaviour. The compulsory use of helmets and the restriction of access to the roads by child cyclists to reduce injuries are, however, still controversial in many areas. PMID:3109611

  13. Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research

    PubMed Central

    Nordquist, Rebecca E.; van der Staay, Franz Josef; van Eerdenburg, Frank J. C. M.; Velkers, Francisca C.; Fijn, Lisa; Arndt, Saskia S.

    2017-01-01

    Simple summary Intensive farming systems are confronted with a number of animal welfare issues such as injuries from horns in cattle and feather pecking in poultry. To solve these problems, mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are applied routinely. These and other procedures such as early maternal separation, overcrowding, and barren housing conditions impair animal welfare. Scientific underpinning of the efficacy of these interventions and management practices is poor. We advocate that all stakeholders, in particular animal scientists and veterinarians, take the lead in evaluating common, putative mutilating and welfare reducing procedures and management practices to develop better, scientifically supported alternatives, focused on adaptation of the environment to the animals, to ensure uncompromised animal welfare. Abstract A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting “robust” animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific

  14. [Error prevention through management of complications in urology: standard operating procedures from commercial aviation as a model].

    PubMed

    Kranz, J; Sommer, K-J; Steffens, J

    2014-05-01

    Patient safety and risk/complication management rank among the current megatrends in modern medicine, which has undoubtedly become more complex. In time-critical, error-prone and difficult situations, which often occur repeatedly in everyday clinical practice, guidelines are inappropriate for acting rapidly and intelligently. With the establishment and consistent use of standard operating procedures like in commercial aviation, a possible strategic approach is available. These medical aids to decision-making - quick reference cards - are short, optimized instructions that enable a standardized procedure in case of medical claims.

  15. Performance of the Seven-Step Procedure in Problem-Based Hospitality Management Education

    ERIC Educational Resources Information Center

    Zwaal, Wichard; Otting, Hans

    2016-01-01

    The study focuses on the seven-step procedure (SSP) in problem-based learning (PBL). The way students apply the seven-step procedure will help us understand how students work in a problem-based learning curriculum. So far, little is known about how students rate the performance and importance of the different steps, the amount of time they spend…

  16. Perioperative management of patients with left ventricular assist devices undergoing noncardiac procedures: a survey of current practices.

    PubMed

    Sheu, Richard; Joshi, Brijen; High, Kane; Thinh Pham, Duc; Ferreira, Renata; Cobey, Frederick

    2015-02-01

    To describe perioperative management of patients with left ventricular assist devices (LVAD) in noncardiac procedures. Survey of (1) respondent demographic characteristics, (2) anesthetic practices for LVAD patients having endoscopies, and (3) low-risk surgeries requiring general anesthesia. Internet-based. Society of Cardiovascular Anesthesiologists membership. None. Inpatient endoscopic procedures were done mainly in the endoscopy suite (71.7%) by a solo practitioner or 1:1 staffing ratio 59% of the time. LVAD-specific support personnel were present in more than 80% of all procedures. Both endoscopy and surgical patients used post-anesthesia recovery units and intensive care units for recovery; however, compared with endoscopy patients, surgical patients recovered in the ICU more frequently (45.5% v 29.1%, p<0.001). In addition, 18% of endoscopy patients recovered on site. Regarding patient monitoring, more than 90% of responders used electrocardiogram, pulse oximetry, end-tidal CO2, and blood pressure monitors on LVAD patients. Responders reported using arterial catheters to monitor blood pressure in 49% of endoscopy cases and 71% of surgical patients. The reported use of invasive monitors by individual clinicians was related inversely to institutional LVAD volume (p = 0.04 and p = 0.01 in endoscopy and surgical procedures, respectively). This survey found heterogeneity in hospital resource utilization for noncardiac LVAD procedures. There was a decrease in the use of invasive monitors with increased institutional LVAD volume in both endoscopy and surgical procedures. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Drudgery, accidents and injuries in Indian agriculture.

    PubMed

    Nag, Pranab Kumar; Nag, Anjali

    2004-04-01

    The Indian farming employs 225 million workforce to cover 140 million hectares of total cultivated land. In spite of rapid farm mechanization (e.g., 149 million farm machinery), the vast resource-poor family farming has primary dependence on traditional methods (e.g., 520 million hand tools and 37 million animal-drawn implements are in operation). The work drudgery, the traumatic accidents and injuries are the major concerns to examine options for ergonomics intervention and betterment of work in crop production activities. This review summarizes human energy expenditure in crop production activities, to assess the job severity, tools and machinery, and formulate the basis to reorganize work and work methods. While the farm mechanization is more in the northern India, the accidents were more in the villages in southern India. On average of the four regions, the tractor incidents (overturning, falling from the tractor, etc.) were highest (27.7%), followed by thresher (14.6%), sprayer/duster (12.2%), sugarcane crusher (8.1%) and chaff cutter (7.8%) accidents. Most of the fatal accidents resulted from the powered machinery, with the annual fatality rate estimated as 22 per 100,000 farmers. The hand tools related injuries (8% of the total accidents) were non-fatal in nature. In spite of the enactment of legislation, the shortcomings in production and monitoring of the machinery in field use may be responsible for the high rate of accidents (e.g., 42 thresher accidents/1,000 mechanical threshers/year in southern India). Due to the lack of technical capability of the local artisans, adhering to safety and design standards is impractical to the implements fabricated in the rural areas. The analysis emphasizes that the effective safety and health management may be possible through legislative enabling of the local infra-structure, such as block development authority and primary health services, to permeate occupational health and safe work practices in the farming sector.

  18. The 'Whip-Stow' procedure: an innovative modification to the whipple procedure in the management of premalignant and malignant pancreatic head disease.

    PubMed

    Jeyarajah, D Rohan; Khithani, Amit; Curtis, David; Galanopoulos, Christos A

    2010-01-01

    Pancreaticoduodenectomy (PD) is the standard of care in the treatment of premalignant and malignant diseases of the head of the pancreas. Variability exists in anastomosis with the pancreatic remnant. This work describes a safe and easy modification for the pancreatic anastomosis after PD. Ten patients underwent the "Whip-Stow" procedure for the management of the pancreatic remnant. PD combined with a Puestow (lateral pancreaticojejunostomy [LPJ]) was completed using a running single-layer, 4-0 Prolene obeying a duct-to-mucosa technique. LPJ and pancreaticogastrostomy (PG) historical leak rates are reported to be 13.9 and 15.8 per cent, respectively. Mortality, leak, and postoperative bleeding rates were 0 per cent in all patients. The Whip-Stow was completed without loops or microscope with a 4-0 single-layer suture decreasing the time and complexity of the anastomosis. Average time was 12 minutes as compared with the 50 minutes of a 5 or 6-0 interrupted, multilayered duct-mucosa anastomosis. Benefits included a long-segment LPJ. In this study, the Whip-Stow procedure has proven to be a safe and simple approach to pancreatic anastomosis in selected patients. This new technique provides the benefit of technical ease while obeying the age old principles of obtaining a wide duct to mucosa anastomosis.

  19. The Tokaimura Nuclear Accident: A Tragedy of Human Errors.

    ERIC Educational Resources Information Center

    Ryan, Michael E.

    2001-01-01

    Discusses nuclear power and the consequences of a nuclear accident. Covers issues ranging from chemical process safety to risk management of chemical industries to the ethical responsibilities of the chemical engineer. (Author/ASK)

  20. The Tokaimura Nuclear Accident: A Tragedy of Human Errors.

    ERIC Educational Resources Information Center

    Ryan, Michael E.

    2001-01-01

    Discusses nuclear power and the consequences of a nuclear accident. Covers issues ranging from chemical process safety to risk management of chemical industries to the ethical responsibilities of the chemical engineer. (Author/ASK)

  1. [Accidents affecting potato harvesters].

    PubMed

    Hansen, J U

    1993-09-27

    During industrialization in agriculture, many farming machines have been introduced. It is well-known that farming is a dangerous workplace and that farm machinery cause many serious accidents every year. Four cases of accidents with potato harvesters are discussed. In three of four cases the farmers were injured while cleaning the machine without stopping it, which probably was the main cause of the accidents. Farmers are in general not careful enough when using farm machinery. Every year, farmers in Denmark are severely invalided in accidents with potato harvesters. A strategy to lower the accidents is proposed: 1. Information of farmers, farmer schools, machine constructors and importers about mechanisms of injury. 2. A better education of farmers in using potato harvesters (and other farming machines). 3. Better fencing of the potato harvesters. 4. If possibly constructional changes in the potato harvesters so things will not get stuck, or so that the machine will stop if things stuck. 5. Installation of switches on potato harvesters, which can be reached from all positions, stopping the machines immediately, or a remote switch control carried by the farmer.

  2. School accidents in Austria.

    PubMed

    Schalamon, Johannes; Eberl, Robert; Ainoedhofer, Herwig; Singer, Georg; Spitzer, Peter; Mayr, Johannes; Schober, Peter H; Hoellwarth, Michael E

    2007-09-01

    The aim of this study was to obtain information about the mechanisms and types of injuries in school in Austria. Children between 0 and 18 years of age presenting with injuries at the trauma outpatient in the Department of Pediatric Surgery in Graz and six participating hospitals in Austria were evaluated over a 2-year prospective survey. A total of 28,983 pediatric trauma cases were registered. Personal data, site of the accident, circumstances and mechanisms of accident and the related diagnosis were evaluated. At the Department of Pediatric Surgery in Graz 21,582 questionnaires were completed, out of which 2,148 children had school accidents (10%). The remaining 7,401 questionnaires from peripheral hospitals included 890 school accidents (12%). The male/female ratio was 3:2. In general, sport injuries were a predominant cause of severe trauma (42% severe injuries), compared with other activities in and outside of the school building (26% severe injuries). Injuries during ball-sports contributed to 44% of severe injuries. The upper extremity was most frequently injured (34%), followed by lower extremity (32%), head and neck area (26%) and injuries to thorax and abdomen (8%). Half of all school related injuries occur in children between 10 and 13 years of age. There are typical gender related mechanisms of accident: Boys get frequently injured during soccer, violence, and collisions in and outside of the school building and during craft work. Girls have the highest risk of injuries at ball sports other than soccer.

  3. Non-pharmacological management of infant and young child procedural pain.

    PubMed

    Pillai Riddell, Rebecca R; Racine, Nicole M; Turcotte, Kara; Uman, Lindsay S; Horton, Rachel E; Din Osmun, Laila; Ahola Kohut, Sara; Hillgrove Stuart, Jessica; Stevens, Bonnie; Gerwitz-Stern, Alanna

    2011-10-05

    -0.21), and swaddling/facilitated tucking (preterm: SMD -0.97; 95% CI -1.63 to -0.31). For immediate pain-related regulation, the largest SMDs were: non-nutritive sucking-related interventions (preterm: SMD -0.38; 95% CI -0.59 to -0.17; neonate: SMD -0.90, 95% CI -1.54 to -0.25), kangaroo care (SMD -0.77, 95% CI -1.50 to -0.03), swaddling/facilitated tucking (preterm: SMD -0.75; 95% CI -1.14 to -0.36), and rocking/holding (neonate: SMD -0.75; 95% CI -1.20 to -0.30). The presence of significant heterogeneity limited our confidence in the lack of findings for certain analyses. There is evidence that different non-pharmacological interventions can be used with preterms, neonates, and older infants to significantly manage pain behaviors associated with acutely painful procedures.

  4. Medical and related aspects of the Goiania accident: An overview

    SciTech Connect

    Oliveira, A.R.; Hunt, J.G.; Valverde, N.J.; Brandao-Mello, C.E.; Farina, R. )

    1991-01-01

    On 13 September 1987, a radiation accident occurred in the city of Goiania in Central Brazil. Approximately 250 people were exposed to a 137Cs source from an abandoned radiotherapy unit. At least 14 patients showed some degree of bone marrow depression, and eight developed the classical signs and symptoms of acute radiation syndrome (ARS). Twenty-eight people presented local radiation injuries ranging from first to third degree, and 104 individuals showed evidence of internal contamination. This paper describes the circumstances of the event, the first-aid measures taken, the criteria adopted for triage of the exposed population, and the radiation protection procedures used during the clinical management of the irradiated individuals.

  5. Road Traffic Accident Analysis of Ajmer City Using Remote Sensing and GIS Technology

    NASA Astrophysics Data System (ADS)

    Bhalla, P.; Tripathi, S.; Palria, S.

    2014-12-01

    With advancement in technology, new and sophisticated models of vehicle are available and their numbers are increasing day by day. A traffic accident has multi-facet characteristics associated with it. In India 93% of crashes occur due to Human induced factor (wholly or partly). For proper traffic accident analysis use of GIS technology has become an inevitable tool. The traditional accident database is a summary spreadsheet format using codes and mileposts to denote location, type and severity of accidents. Geo-referenced accident database is location-referenced. It incorporates a GIS graphical interface with the accident information to allow for query searches on various accident attributes. Ajmer city, headquarter of Ajmer district, Rajasthan has been selected as the study area. According to Police records, 1531 accidents occur during 2009-2013. Maximum accident occurs in 2009 and the maximum death in 2013. Cars, jeeps, auto, pickup and tempo are mostly responsible for accidents and that the occurrence of accidents is mostly concentrated between 4PM to 10PM. GIS has proved to be a good tool for analyzing multifaceted nature of accidents. While road safety is a critical issue, yet it is handled in an adhoc manner. This Study is a demonstration of application of GIS for developing an efficient database on road accidents taking Ajmer City as a study. If such type of database is developed for other cities, a proper analysis of accidents can be undertaken and suitable management strategies for traffic regulation can be successfully proposed.

  6. Interventional techniques in managing persistent pain after vertebral augmentation procedures: a retrospective evaluation.

    PubMed

    Georgy, Bassem A

    2007-09-01

    Based on systematic reviews, it appears that at least 10% of patients may continue to suffer with residual or persistent pain after successful vertebral or sacral augmentation procedures. To report and evaluate the incidence and prevalence of different spinal injections in patients who received vertebroplasty, kyphoplasty, and sacroplasty procedures for both benign and malignant compression fractures. A retrospective case review. Retrospective review of all cases of vertebroplasty, sacroplasty, and kyphoplasty performed in a 12-month period in a single outpatient setting of interventional radiology was conducted. In a 12-month period starting from October 2005 to September 2006, 144 patients underwent cement augmentation procedures. Of the 144, 34 patients required a spinal injection procedure for residual or persistent pain within a 1-year period after the augmentation procedure. Twenty-four patients required epidural steroid injections, 6 patients required intercostal nerve blocks, 5 patients required trigger point injections, 5 patients required sacroiliac joint injections, and 1 patient required facet joint injections. Nine patients who required lumbar epidural steroid injections and all patients who required intercostal nerve blocks and had underwent a thoracic cement augmentation procedure. A small proportion of patients undergoing percutaneous cement augmentation for vertebral compression fractures or sacral insufficiency fractures potentially require spinal injections to treat residual pain after the procedure.

  7. Developing site-specific interactive environmental management tools: An exciting method of communicating training, procedures, and other information

    SciTech Connect

    Jaeckels, J.M.

    1999-07-01

    Environmental managers are faced with numerous programs that must be communicated throughout their organizations. Among these are regulatory training programs, internal environmental policy, regulatory guidance/procedures and internal guidance/procedures. Traditional methods of delivering this type of information are typically confined to written materials and classroom training. There are many challenges faced by environmental managers with these traditional approaches including: determining if recipients of written plans or procedures are reading and comprehending the information; scheduling training sessions to reach all affected people across multiple schedules/shifts; and maintaining adequate training records. In addition, current trends toward performance-based or competency-based training requires a more consistent method of measuring and documenting performance. The use of interactive computer applications to present training or procedural information is a new and exciting tool for delivering environmental information to employees. Site-specific pictures, text, sound, and even video can be combined with multimedia software to create informative and highly interactive applications. Some of the applications that can be produced include integrated environmental training, educational pieces, and interactive environmental procedures. They can be executed from a CD-ROM, hard drive, network or a company Intranet. Collectively, the authors refer to these as interactive environmental management tools (IEMTs). This paper focuses on site-specific, interactive training as an example of an IEMT. Interactive training not only delivers a highly effective message, but can also be designed to focus on site-specific environmental issues that are unique to each company. Interactive training also lends itself well to automated record keeping functions and to reaching all affected employees.

  8. Societal and ethical aspects of the Fukushima accident.

    PubMed

    Oughton, Deborah

    2016-10-01

    The Fukushima Nuclear Power Station accident in Japan in 2011 was a poignant reminder that radioactive contamination of the environment has consequences that encompass far more than health risks from exposure to radiation. Both the accident and remediation measures have resulted in serious societal impacts and raise questions about the ethical aspects of risk management. This article presents a brief review of some of these issues and compares similarities and differences with the lessons learned from the 1986 Chernobyl Nuclear Power Plant accident in Ukraine. Integr Environ Assess Manag 2016;12:651-653. © 2016 SETAC. © 2016 SETAC.

  9. Comparison of childhood thyroid cancer prevalence among 3 areas based on external radiation dose after the Fukushima Daiichi nuclear power plant accident: The Fukushima health management survey.

    PubMed

    Ohira, Tetsuya; Takahashi, Hideto; Yasumura, Seiji; Ohtsuru, Akira; Midorikawa, Sanae; Suzuki, Satoru; Fukushima, Toshihiko; Shimura, Hiroki; Ishikawa, Tetsuo; Sakai, Akira; Yamashita, Shunichi; Tanigawa, Koichi; Ohto, Hitoshi; Abe, Masafumi; Suzuki, Shinichi

    2016-08-01

    The 2011 Great East Japan Earthquake led to a subsequent nuclear accident at the Fukushima Daiichi Nuclear Power Plant. In its wake, we sought to examine the association between external radiation dose and thyroid cancer in Fukushima Prefecture. We applied a cross-sectional study design with 300,476 participants aged 18 years and younger who underwent thyroid examinations between October 2011 and June 2015. Areas within Fukushima Prefecture were divided into three groups based on individual external doses (≥1% of 5 mSv, <99% of 1 mSv/y, and the other). The odds ratios (ORs) and 95% confidence intervals of thyroid cancer for all areas, with the lowest dose area as reference, were calculated using logistic regression models adjusted for age and sex. Furthermore, the ORs of thyroid cancer for individual external doses of 1 mSv or more and 2 mSv or more, with the external dose less than 1 mSv as reference, were calculated. Prevalence of thyroid cancer for the location groups were 48/100,000 for the highest dose area, 36/100,000 for the middle dose area, and 41/100,000 for the lowest dose area. Compared with the lowest dose area, age-, and sex-adjusted ORs (95% confidence intervals) for the highest-dose and middle-dose areas were 1.49 (0.36-6.23) and 1.00 (0.67-1.50), respectively. The duration between accident and thyroid examination was not associated with thyroid cancer prevalence. There were no significant associations between individual external doses and prevalence of thyroid cancer. External radiation dose was not associated with thyroid cancer prevalence among Fukushima children within the first 4 years after the nuclear accident.

  10. Injuries are not accidents

    PubMed Central

    Gutiérrez, María Isabel

    2014-01-01

    Injuries are the result of an acute exposure to exhort of energy or a consequence of a deficiency in a vital element that exceeds physiological thresholds resulting threatens life. They are classified as intentional or unintentional. Injuries are considered a global health issue because they cause more than 5 million deaths per year worldwide and they are an important contributor to the burden of disease, especially affecting people of low socioeconomic status in low- and middle-income countries. A common misconception exists where injuries are thought to be the same as accidents; however, accidents are largely used as chance events, without taken in consideration that all these are preventable. This review discusses injuries and accidents in the context of road traffic and emphasizes injuries as preventable events. An understanding of the essence of injuries enables the standardization of terminology in public use and facilitates the development of a culture of prevention among all of us. PMID:25386040

  11. Pain of chronic sacro-iliac joint atrhopathy: managed successfully with conventional bipolar radiofrequency procedure: a case report.

    PubMed

    Ghazali, Awisul; Das, Gautam; Horani, Khaled; Anand Kumar, Gs; Mehta, Palak; Dutta, Debjyoti

    2012-01-01

    Chronic sacroiliac (SI) joint pain constitutes 16% to 30% of the total prevalence of chronic low back pain, which is commonly unilateral. Apart from conservative management, various interventional pain management procedures have been reported. Intraarticular deposteroid injection has been described as the most evidence-based, but different various radio frequency (RF) procedures have been described with varied success. Conventional bipolar RF is relatively new in the management of SI joint pain. We have successfully managed pain of the SI joint origin. A 53-year-old female who presented with unilateral back pain with radiation to the leg was diagnosed with pain from SI joint arthropathy by clinical and diagnostic interventional procedures. She was treated conservatively without any result. Deposteriod gave good but very short-term relief. She underwent a bipolar RF procedure. An RF needle was placed at the L5 medial branch, and 2 were placed on each lateral side of the sacral foramina for the lateral branches of the S1, S2, and S3 nerve roots. Conventional RF was performed at 80°C for 90 seconds. This case report supports the use of bipolar RF nerve ablation for chronic sacroiliac joint pain that does abate with deposteroid injection. In this patient, the Rt L5 medial branch nerve was ablated using conventional RF technique, followed by conventional bipolar RF nerve ablation for the S1, S2 and S3 lateral branches. We recommend the use of bipolar RF nerve ablation for chronic sacroiliac joint pain that has an inadequate response to deposteroid injection.

  12. 41 CFR 102-80.80 - With what general accident and fire prevention policy must Federal agencies comply?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accident and fire prevention policy must Federal agencies comply? 102-80.80 Section 102-80.80 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention § 102-80.80 With what general accident and fire prevention policy must Federal agencies comply? Federal...

  13. 41 CFR 102-80.80 - With what general accident and fire prevention policy must Federal agencies comply?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... accident and fire prevention policy must Federal agencies comply? 102-80.80 Section 102-80.80 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention § 102-80.80 With what general accident and fire prevention policy must Federal agencies comply? Federal...

  14. 41 CFR 102-80.80 - With what general accident and fire prevention policy must Federal agencies comply?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accident and fire prevention policy must Federal agencies comply? 102-80.80 Section 102-80.80 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention § 102-80.80 With what general accident and fire prevention policy must Federal agencies comply?...

  15. 41 CFR 102-80.80 - With what general accident and fire prevention policy must Federal agencies comply?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... accident and fire prevention policy must Federal agencies comply? 102-80.80 Section 102-80.80 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention § 102-80.80 With what general accident and fire prevention policy must Federal agencies comply?...

  16. Who by accident? The social morphology of car accidents.

    PubMed

    Factor, Roni; Yair, Gad; Mahalel, David

    2010-09-01

    Prior studies in the sociology of accidents have shown that different social groups have different rates of accident involvement. This study extends those studies by implementing Bourdieu's relational perspective of social space to systematically explore the homology between drivers' social characteristics and their involvement in specific types of motor vehicle accident. Using a large database that merges official Israeli road-accident records with socioeconomic data from two censuses, this research maps the social order of road accidents through multiple correspondence analysis. Extending prior studies, the results show that different social groups indeed tend to be involved in motor vehicle accidents of different types and severity. For example, we find that drivers from low socioeconomic backgrounds are overinvolved in severe accidents with fatal outcomes. The new findings reported here shed light on the social regularity of road accidents and expose new facets in the social organization of death.

  17. Successful management of bleeding after dental procedures with application of blood stopper: a single center prospective trial.

    PubMed

    Beyazit, Yavuz; Kart, Tayyar; Kuscu, Ahmet; Arslan, Alper; Kurt, Mevlut; Aktas, Bora; Kekilli, Murat; Haznedaroglu, Ibrahim

    2011-09-01

    Ankaferd Blood Stopper (ABS), as an herbal complementary medicine, has been approved for the management of clinical hemorrhages in Turkey, including dental interventions. Basic, preclinical and clinical studies disclosed the settings of the topical hemostatic use of ABS. The aim of this study is therefore to assess the efficacy and safety of ABS as an antihemorrhagic agent in the bleedings associated with dental procedures in patients with normal and impaired hemostasis. ABS has been topically applied by homogeneously spraying to the 113 patients during dental interventions within its on-label indications. A median of 0.5 ml (IQR:0.5-1 ml) ABS was administered after tooth extraction with prolonged hemorrhages. After the administration, bleeding stopped in less than 10 seconds in 59 (52.2%) patients, and below 22.5 seconds (IQR: 18, 8-30) in 54 patients (47.8%). A total of 141 procedures were performed in these 113 patients, and nearly 72.5 ml ABS was used with a total cost of 98 €. ABS as a new herbal medicine was found to be an effective method for controlling bleeding related to dental procedures. No patient had wound infection and the healing process appeared to be normal. Topical ABS could be useful for the local hemostasis and wound healing in periodontal surgeries. In this prospective study ABS, for the first time, has demonstrated its potential for being an effective hemostatic agent for the management of bleedings due to dental procedures.

  18. Criticality accident alarm system

    SciTech Connect

    Malenfant, R.E.

    1991-01-01

    The American National Standard ANSI/ANS-8.3-1986, Criticality Accident Alarm System provides guidance for the establishment and maintenance of an alarm system to initiate personnel evacuation in the event of inadvertent criticality. In addition to identifying the physical features of the components of the system, the characteristics of accidents of concern are carefully delineated. Unfortunately, this ANSI Standard has led to considerable confusion in interpretation, and there is evidence that the minimum accident of concern'' may not be appropriate. Furthermore, although intended as a guide, the provisions of the standard are being rigorously applied, sometimes with interpretations that are not consistent. Although the standard is clear in the use of absorbed dose in free air of 20 rad, at least one installation has interpreted the requirement to apply to dose in soft tissue. The standard is also clear in specifying the response to both neutrons and gamma rays. An assembly of uranyl fluoride enriched to 5% {sup 235}U was operated to simulate a potential accident. The dose, delivered in a free run excursion 2 m from the surface of the vessel, was greater than 500 rad, without ever exceeding a rate of 20 rad/min, which is the set point for activating an alarm that meets the standard. The presence of an alarm system would not have prevented any of the five major accidents in chemical operations nor is it absolutely certain that the alarms were solely responsible for reducing personnel exposures following the accident. Nevertheless, criticality alarm systems are now the subject of great effort and expense. 13 refs.

  19. Anesthetic management of the ex utero intrapartum treatment (EXIT) procedure -A case report-.

    PubMed

    Lee, Heeseung; Ryu, Jung Wan; Kim, Dong Yeon; Lee, Guie Yong

    2010-12-01

    The ex utero intrapartum treatment (EXIT) procedure is a very rare technique performed in cases of fetal congenital malformations. The EXIT procedure increases the rate of survival at delivery by maintaining the uteroplacental circulation until the airway of the fetus is secured. To maintain the uteroplacental circulation, a higher dose of inhalational anesthetics and/or intravenous nitroglycerin can be used as compared to conventional Cesarean section. The aim of this report is to share our anesthetic experience during the EXIT procedure with members of the Korean society of anesthesiology for the first time, and to highlight the maternal implications of the use of inhalational anesthetics and nitroglycerin during Cesarean section for the EXIT procedure.

  20. [Travel and accidents].

    PubMed

    Cha, Olivier

    2015-04-01

    Traumatic pathologies are the most frequent medical events to be observed among French travellers. Accidents on the public highway by lack of respect of the fundamental rules of road security, particularly abroad, traffic conditions in bad repair in numerous emergent countries, usually the destination of mass tourism and underdeveloped organization of health care and local urgency help. Sports activities are also a source of accidents. A good physical training is essential. Drowning is a real plague, especially among children due to a lack of vigilance. Preventive measures are simple, keep them constantly in mind and apply them carefully so as to have beautiful memories of our trip back home.