47 CFR 11.52 - EAS code and Attention Signal Monitoring requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... technologies, such as instant messaging and email) the distribution of Common Alert Protocol (CAP)-formatted... Integrated Public Alert and Warning System (IPAWS) to enable (whether through “pull” interface technologies...

47 CFR 11.52 - EAS code and Attention Signal Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... technologies, such as instant messaging and email) the distribution of Common Alert Protocol (CAP)-formatted... Integrated Public Alert and Warning System (IPAWS) to enable (whether through “pull” interface technologies...

47 CFR 10.460 - Retransmission frequency. [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Retransmission frequency. [Reserved] 10.460 Section 10.460 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.460 Retransmission frequency. [Reserved] ...

47 CFR 10.470 - Roaming.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Roaming. 10.470 Section 10.470 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.470 Roaming. When, pursuant to a roaming agreement (see § 20.12 of this chapter), a...

Managing the Alert Process at NewYork-Presbyterian Hospital

PubMed Central

Kuperman, Gilad J; Diamente, Rosanna; Khatu, Vrinda; Chan-Kraushar, Terri; Stetson, Pete; Boyer, Aurelia; Cooper, Mary

2005-01-01

Clinical decision support can improve the quality of care, but requires substantial knowledge management activities. At NewYork-Presbyterian Hospital in New York City, we have implemented a formal alert management process whereby only hospital committees and departments can request alerts. An explicit requestor, who will help resolve the details of the alert logic and the alert message must be identified. Alerts must be requested in writing using a structured alert request form. Alert requests are reviewed by the Alert Committee and then forwarded to the Information Systems department for a software development estimate. The model required that clinical committees and departments become more actively involved in the development of alerts than had previously been necessary. In the 12 months following implementation, 10 alert requests were received. The model has been well received. A lot of the knowledge engineering work has been distributed and burden has been removed from scarce medical informatics resources. PMID:16779073

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

47 CFR 10.10 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Definitions. 10.10 Section 10.10 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM General Information § 10.10 Definitions. (a) Alert Message. An Alert Message is a message that is intended to provide the...

Supporting the patient's role in guideline compliance: a controlled study.

PubMed

Rosenberg, Stephen N; Shnaiden, Tatiana L; Wegh, Arnold A; Juster, Iver A

2008-11-01

Clinical messages alerting physicians to gaps in the care of specific patients have been shown to increase compliance with evidence-based guidelines. This study sought to measure any additional impact on compliance when alerting messages also were sent to patients. For alerts that were generated by computerized clinical rules applied to claims, compliance was determined by subsequent claims evidence (eg, that recommended tests were performed). Compliance was measured in the baseline year and the study year for 4 study group employers (combined membership >100,000) that chose to add patient messaging in the study year, and 28 similar control group employers (combined membership >700,000) that maintained physician messaging but did not add patient messaging. The impact of patient messaging was assessed by comparing changes in compliance from baseline to study year in the 2 groups. Multiple logistic regression was used to control for differences between the groups. Because a given member or physician could receive multiple alerts, generalized estimating equations with clustering by patient and physician were used. Controlling for differences in age, sex, and the severity and types of clinical alerts between the study and control groups, the addition of patient messaging increased compliance by 12.5% (P <.001). This increase was primarily because of improved responses to alerts regarding the need for screening, diagnostic, and monitoring tests. Supplementing clinical alerts to physicians with messages directly to their patients produced a statistically significant increase in compliance with the evidence-based guidelines underlying the alerts.

47 CFR 80.335 - Procedures for canceling false distress alerts.

Code of Federal Regulations, 2014 CFR

2014-10-01

... priority message by way of the same land earth station through which the false distress alert was sent.... 80.335 Section 80.335 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress...

47 CFR 80.335 - Procedures for canceling false distress alerts.

Code of Federal Regulations, 2013 CFR

2013-10-01

... priority message by way of the same land earth station through which the false distress alert was sent.... 80.335 Section 80.335 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress...

47 CFR 80.335 - Procedures for canceling false distress alerts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... priority message by way of the same land earth station through which the false distress alert was sent.... 80.335 Section 80.335 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress...

47 CFR 80.335 - Procedures for canceling false distress alerts.

Code of Federal Regulations, 2012 CFR

2012-10-01

... priority message by way of the same land earth station through which the false distress alert was sent.... 80.335 Section 80.335 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress...

47 CFR 80.335 - Procedures for canceling false distress alerts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... priority message by way of the same land earth station through which the false distress alert was sent.... 80.335 Section 80.335 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress...

Developing an Early-Alert System to Promote Student Visits to Tutor Center

ERIC Educational Resources Information Center

Cai, Qijie; Lewis, Carrie L.; Higdon, Jude

2015-01-01

An early-alert system (MavCLASS) was developed and piloted in a large gateway math class with 611 freshman students to identify academically at-risk students and provide alert messages. It was found that there was significant association between the alert messages students received and their visits to the university's tutor center. Further, the…

Delivering Alert Messages to Members of a Work Force

NASA Technical Reports Server (NTRS)

Loftis, Julia; Nickens, Stephanie; Pell, Melissa; Pell, Vince

2008-01-01

Global Alert Resolution Network (GARNET) is a software system for delivering emergency alerts as well as less-urgent messages to members of the Goddard Space Flight Center work force via an intranet or the Internet, and can be adapted to similar use in other large organizations.

Engine monitoring display study

NASA Technical Reports Server (NTRS)

Hornsby, Mary E.

1992-01-01

The current study is part of a larger NASA effort to develop displays for an engine-monitoring system to enable the crew to monitor engine parameter trends more effectively. The objective was to evaluate the operational utility of adding three types of information to the basic Boeing Engine Indicating and Crew Alerting System (EICAS) display formats: alphanumeric alerting messages for engine parameters whose values exceed caution or warning limits; alphanumeric messages to monitor engine parameters that deviate from expected values; and a graphic depiction of the range of expected values for current conditions. Ten training and line pilots each flew 15 simulated flight scenarios with five variants of the basic EICAS format; these variants included different combinations of the added information. The pilots detected engine problems more quickly when engine alerting messages were included in the display; adding a graphic depiction of the range of expected values did not affect detection speed. The pilots rated both types of alphanumeric messages (alert and monitor parameter) as more useful and easier to interpret than the graphic depiction. Integrating engine parameter messages into the EICAS alerting system appears to be both useful and preferred.

CAUSE Resiliency (West Coast) Experiment Final Report

DTIC Science & Technology

2012-10-01

implemented in BCeMap and can therefore consume alerting messages direct from MASAS. This would solve the issue with the update frequency and speed of the...in production for use by the Provincial Emergency Operations Centres and brings together multiple static layers together with several dynamic data...executive order established the requirement for an “effective, reliable, integrated, flexible, and comprehensive system to alert and warn the

47 CFR 10.240 - Notification to new subscribers of non-participation in CMAS.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CMAS Alert Messages, in part or in whole, shall provide clear and conspicuous notice, which takes into... to provide Alert messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third... availability of this service and wireless emergency alert capable devices, please ask a sales representative...

47 CFR 10.240 - Notification to new subscribers of non-participation in CMAS.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CMAS Alert Messages, in part or in whole, shall provide clear and conspicuous notice, which takes into... to provide Alert messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third... availability of this service and wireless emergency alert capable devices, please ask a sales representative...

The Hub Population Health System: distributed ad hoc queries and alerts

PubMed Central

Anane, Sheila; Taverna, John; Amirfar, Sam; Stubbs-Dame, Remle; Singer, Jesse

2011-01-01

The Hub Population Health System enables the creation and distribution of queries for aggregate count information, clinical decision support alerts at the point-of-care for patients who meet specified conditions, and secure messages sent directly to provider electronic health record (EHR) inboxes. Using a metronidazole medication recall, the New York City Department of Health was able to determine the number of affected patients and message providers, and distribute an alert to participating practices. As of September 2011, the system is live in 400 practices and within a year will have over 532 practices with 2500 providers, representing over 2.5 million New Yorkers. The Hub can help public health experts to evaluate population health and quality improvement activities throughout the ambulatory care network. Multiple EHR vendors are building these features in partnership with the department's regional extension center in anticipation of new meaningful use requirements. PMID:22071531

47 CFR 10.350 - CMAS Testing requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... later than the date of deployment of the CMAS, of CMAS components. (a) Required monthly tests. Testing... a required monthly test (RMT) message initiated by the Federal Alert Gateway Administrator. (2... maintenance windows. (3) A Participating CMS Provider may forego an RMT if the RMT is pre-empted by actual...

A digital simulation of message traffic for natural disaster warning communications satellite

NASA Technical Reports Server (NTRS)

Hein, G. F.; Stevenson, S. M.

1972-01-01

Various types of weather communications are required to alert industries and the general public about the impending occurrence of tornados, hurricanes, snowstorms, floods, etc. A natural disaster warning satellite system has been proposed for meeting the communications requirements of the National Oceanic and Atmospheric Administration. Message traffic for a communications satellite was simulated with a digital computer in order to determine the number of communications channels to meet system requirements. Poisson inputs are used for arrivals and an exponential distribution is used for service.

Alert!: In Emergencies, Schools Use Technology to Get the Message out Quickly

ERIC Educational Resources Information Center

Violino, Bob

2008-01-01

This article describes how a growing number of community colleges have begun deploying emergency alert systems that can be used to send information via e-mail and text messaging directly to students' cell phones and other portable devices. Such systems enable authorized campus administrators to send messages to thousands of people within minutes.…

IP telephony based danger alert communication system and its implementation

NASA Astrophysics Data System (ADS)

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

2013-05-01

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

Using electronic health record alerts to provide public health situational awareness to clinicians.

PubMed

Lurio, Joseph; Morrison, Frances P; Pichardo, Michelle; Berg, Rachel; Buck, Michael D; Wu, Winfred; Kitson, Kwame; Mostashari, Farzad; Calman, Neil

2010-01-01

Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are described. Electronic alerts have the potential to improve management of diseases during an outbreak, including appropriate laboratory testing, management guidance, and diagnostic assistance as well as to enhance bi-directional data exchange between clinical and public health organizations.

Using electronic health record alerts to provide public health situational awareness to clinicians

PubMed Central

Lurio, Joseph; Pichardo, Michelle; Berg, Rachel; Buck, Michael D; Wu, Winfred; Kitson, Kwame; Mostashari, Farzad; Calman, Neil

2010-01-01

Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are described. Electronic alerts have the potential to improve management of diseases during an outbreak, including appropriate laboratory testing, management guidance, and diagnostic assistance as well as to enhance bi-directional data exchange between clinical and public health organizations. PMID:20190067

Cockpit Interfaces, Displays, and Alerting Messages for the Interval Management Alternative Clearances (IMAC) Experiment

NASA Technical Reports Server (NTRS)

Baxley, Brian T.; Palmer, Michael T.; Swieringa, Kurt A.

2015-01-01

This document describes the IM cockpit interfaces, displays, and alerting capabilities that were developed for and used in the IMAC experiment, which was conducted at NASA Langley in the summer of 2015. Specifically, this document includes: (1) screen layouts for each page of the interface; (2) step-by-step instructions for data entry, data verification and input error correction; (3) algorithm state messages and error condition alerting messages; (4) aircraft speed guidance and deviation indications; and (5) graphical display of the spatial relationships between the Ownship aircraft and the Target aircraft. The controller displays for IM will be described in a separate document.

Important imaging finding e-mail alert system: experience after 3 years of implementation.

PubMed

Abujudeh, Hani H; Kaewlai, Rathachai; Choy, Garry; Whelton, Dianne G; Rosenthal, Daniel I

2009-09-01

To evaluate the effectiveness of an important finding alert (IFA) system that uses e-mail technology to alert referring physicians to an important but nonurgent imaging finding. The institutional review board approved the study; the requirement for informed consent was waived. The authors retrospectively reviewed the radiology reports generated from January 2005 to December 2007 to determine how many reports contained an IFA statement, how many IFA messages were sent, and how many such messages were viewed by referring physicians. They reviewed 1000 randomly selected radiology reports that contained the IFA statement to identify the imaging modalities and findings that triggered the radiologists' use of the IFA system. A total of 1540254 radiology reports were generated during the 3-year period. A total of 56 691 (3.7%) reports contained the IFA statement. IFA e-mail messages were sent for 52 883 (93.3%) of the 56 691 reports, and 42 285 (74.6%) of the 56 691 reports were viewed by the referring physicians. The most common important but nonurgent findings were definitive (449 [44.9%] of 1000 reports) and indeterminate (260 [26.0%] of 1000 reports) abnormalities. More than half (n = 503) of the alerts were related to computed tomographic examinations, and the majority (n = 677, 67.7%) of them were initiated by thoracic and abdominal radiologists. The IFA system is a potentially useful method of communicating nonurgent but important imaging findings with use of e-mail technology.

For Emergency Alerts, Some Colleges Try Sirens

ERIC Educational Resources Information Center

Young, Jeffrey R.

2008-01-01

Colleges and universities, ever more mindful of campus safety, are installing outdoor sirens. The systems can blast spoken messages or tone alerts of danger--and one of the preset messages on many of the public-address systems warns: "There is a shooter on campus. Seek shelter immediately." As college officials reviewed their…

77 FR 16688 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

... the approximately three and one half-year window it is providing for intermediary device users is..., including the originator, event, location and the valid time period of the EAS message, from the CAP text... event, which it believes would provide more visual information to alert message viewers. The Commission...

47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

Code of Federal Regulations, 2013 CFR

2013-10-01

...), and Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1...) “Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1.0” (Oct...

47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

Code of Federal Regulations, 2012 CFR

2012-10-01

...), and Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1...) “Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1.0” (Oct...

47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

Code of Federal Regulations, 2014 CFR

2014-10-01

...), and Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1...) “Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1.0” (Oct...

A Novel Free Flap Monitoring System Using Tissue Oximetry with Text Message Alerts.

PubMed

Ricci, Joseph A; Vargas, Christina R; Lin, Samuel J; Tobias, Adam M; Taghinia, Amir H; Lee, Bernard T

2016-06-01

Background The time to detection of vascular compromise is a significant predictor of free flap salvage outcomes as early reexploration improves salvage rates. Continuous transcutaneous near-infrared tissue oximetry is an objective, quantitative method of detecting flap vascular compromise and has been shown to allow earlier reexploration and higher salvage rates than clinical assessment alone. We designed a novel text messaging system to improve communication using tissue oximetry monitoring. Methods A retrospective review was performed of a prospectively collected database of all microsurgical breast reconstructions from 2008 to 2015. A novel text messaging system was introduced in 2013 and programmed to send text messages alert when the tissue oximetry readings suggested potential flap compromise based on established thresholds. Patient demographics and complications, including rate of reexploration and flap loss were assessed. Results There were 900 autologous microsurgical breast free flaps during the study period: 614 were monitored with standard clinical monitoring and tissue oximetry compared with 286 flaps with the additional text messaging system. There were 27 unplanned returns to the operating room in the tissue oximetry group and 5 in the text messaging group with 1 complete flap loss in each group. Reexploration occurred sooner as a result of these text message alerts (17.5 vs. 26.6 hours postoperatively), however, it did not achieve statistical significance. Conclusions We were able to demonstrate the use of a novel text messaging system for tissue oximetry. This alert system shows promise in identifying impending flap loss with rapid notification of the surgical team. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

47 CFR 80.1111 - Distress alerting.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

77 FR 26701 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this document, the Federal Communications Commission (Commission) amends its rules governing the Emergency Alert... the manner in which EAS Participants must be able to receive alert messages formatted in the Common...

Proactive authenticated notifications for health practitioners: two way human computer interaction through phone.

PubMed

Majeed, Raphael W; Stöhr, Mark R; Röhrig, Rainer

2012-01-01

Notifications and alerts play an important role in clinical daily routine. Rising prevalence of clinical decision support systems and electronic health records also result in increasing demands on notification systems. Failure adequately to communicate a critical value is a potential cause of adverse events. Critical laboratory values and changing vital data depend on timely notifications of medical staff. Vital monitors and medical devices rely on acoustic signals for alerting which are prone to "alert fatigue" and require medical staff to be present within audible range. Personal computers are unsuitable to display time critical notification messages, since the targeted medical staff are not always operating or watching the computer. On the other hand, mobile phones and smart devices enjoy increasing popularity. Previous notification systems sending text messages to mobile phones depend on asynchronous confirmations. By utilizing an automated telephony server, we provide a method to deliver notifications quickly and independently of the recipients' whereabouts while allowing immediate feedback and confirmations. Evaluation results suggest the feasibility of the proposed notification system for real-time notifications.

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

PubMed

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

2014-01-01

Computerized alert and reminder systems have been widely accepted and applied to various patient care settings, with increasing numbers of clinical laboratories communicating critical laboratory test values to professionals via either manual notification or automated alerting systems/computerized reminders. Warfarin, an oral anticoagulant, exhibits narrow therapeutic range between treatment response and adverse events. It requires close monitoring of prothrombin time (PT)/international normalized ratio (INR) to ensure patient safety. This study was aimed to evaluate clinical outcomes of patients on warfarin therapy following implementation of a Personal Handy-phone System-based (PHS) alert system capable of generating and delivering text messages to communicate critical PT/INR laboratory results to practitioners' mobile phones in a large tertiary teaching hospital. A retrospective analysis was performed comparing patient clinical outcomes and physician prescribing behavior following conversion from a manual laboratory result alert system to an automated system. Clinical outcomes and practitioner responses to both alert systems were compared. Complications to warfarin therapy, warfarin utilization, and PT/INR results were evaluated for both systems, as well as clinician time to read alert messages, time to warfarin therapy modification, and monitoring frequency. No significant differences were detected in major hemorrhage and thromboembolism, warfarin prescribing patterns, PT/INR results, warfarin therapy modification, or monitoring frequency following implementation of the PHS text alert system. In both study periods, approximately 80% of critical results led to warfarin discontinuation or dose reduction. Senior physicians' follow-up response time to critical results was significantly decreased in the PHS alert study period (46.3% responded within 1 day) compared to the manual notification study period (24.7%; P = 0.015). No difference in follow-up response time was detected for junior physicians. Implementation of an automated PHS-based text alert system did not adversely impact clinical or safety outcomes of patients on warfarin therapy. Approximately 80% immediate recognition of text alerts was achieved. The potential benefits of an automated PHS alert for senior physicians were demonstrated.

47 CFR 11.31 - EAS protocol.

Code of Federal Regulations, 2013 CFR

2013-10-01

... End Of Message (EOM) Codes. (1) The Preamble and EAS Codes must use Audio Frequency Shift Keying at a rate of 520.83 bits per second to transmit the codes. Mark frequency is 2083.3 Hz and space frequency... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11...

47 CFR 11.31 - EAS protocol.

Code of Federal Regulations, 2014 CFR

2014-10-01

... End Of Message (EOM) Codes. (1) The Preamble and EAS Codes must use Audio Frequency Shift Keying at a rate of 520.83 bits per second to transmit the codes. Mark frequency is 2083.3 Hz and space frequency... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11...

47 CFR 11.31 - EAS protocol.

Code of Federal Regulations, 2010 CFR

2010-10-01

... End Of Message (EOM) Codes. (1) The Preamble and EAS Codes must use Audio Frequency Shift Keying at a rate of 520.83 bits per second to transmit the codes. Mark frequency is 2083.3 Hz and space frequency... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11...

47 CFR 11.31 - EAS protocol.

Code of Federal Regulations, 2012 CFR

2012-10-01

... End Of Message (EOM) Codes. (1) The Preamble and EAS Codes must use Audio Frequency Shift Keying at a rate of 520.83 bits per second to transmit the codes. Mark frequency is 2083.3 Hz and space frequency... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11...

47 CFR 11.31 - EAS protocol.

Code of Federal Regulations, 2011 CFR

2011-10-01

... End Of Message (EOM) Codes. (1) The Preamble and EAS Codes must use Audio Frequency Shift Keying at a rate of 520.83 bits per second to transmit the codes. Mark frequency is 2083.3 Hz and space frequency... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) Equipment Requirements § 11...

Alerting prefixes for speech warning messages. [in helicopters

NASA Technical Reports Server (NTRS)

Bucher, N. M.; Voorhees, J. W.; Karl, R. L.; Werner, E.

1984-01-01

A major question posed by the design of an integrated voice information display/warning system for next-generation helicopter cockpits is whether an alerting prefix should precede voice warning messages; if so, the characteristics desirable in such a cue must also be addressed. Attention is presently given to the results of a study which ascertained pilot response time and response accuracy to messages preceded by either neutral cues or the cognitively appropriate semantic cues. Both verbal cues and messages were spoken in direct, phoneme-synthesized speech, and a training manipulation was included to determine the extent to which previous exposure to speech thus produced facilitates these messages' comprehension. Results are discussed in terms of the importance of human factors research in cockpit display design.

Development of a staff recall system for mass casualty incidents using cell phone text messaging.

PubMed

Epstein, Richard H; Ekbatani, Ali; Kaplan, Javier; Shechter, Ronen; Grunwald, Zvi

2010-03-01

After a mass casualty incident (MCI), rapid mobilization of hospital personnel is required because of an expected surge of victims. Risk assessment of our department's manual phone tree recall system revealed multiple weaknesses that would limit an effective response. Because cell phone use is widespread within the department, we developed and tested a staff recall system, based in our anesthesia information management system (AIMS), using Short Message Service (SMS) text messaging. We sent test text messages to anesthesia staff members' cell phone numbers, determined the distance from their home to the hospital, and stored this information in our AIMS. Latency testing for the time from transmission of SMS test messages from the server to return of an e-mail reply was determined at 2 different times on 2 different dates, 1 of which was a busy holiday weekend, using volunteers within the department. Two unannounced simulated disaster recall drills were conducted, with text messages sent asking for the anticipated time to return to the hospital. A timeline of available staff on site was determined. Reasons for failure to respond to the disaster notification message were tabulated. Latency data were fit by a log-normal distribution with an average of 82 seconds from message transmission to e-mail reply. Replies to the simulated disaster alert were received from approximately 50% of staff, with 16 projecting that they would have been able to be back at the hospital within 30 minutes on both dates. There would have been 21 and 23 staff in-house at 30 minutes, and 32 and 37 staff in-house at 60 minutes on the first and second test date, respectively, including in-house staff. Of the nonresponders to the alert, 48% indicated that their cell phone was not with them or was turned off, whereas 22% missed the message. Our SMS staff recall system is likely to be able to rapidly mobilize sufficient numbers of anesthesia personnel in response to an MCI, but actual performance cannot be predicted with confidence. Using our AIMS as the source for contact information and from which to send messages was simple, inexpensive, and easy to implement. Updating contact information, periodic testing, and analysis of responses to simulated disaster alerts are essential for the effective functioning of such a system. However, maintenance of alternative methods of communication is recommended, because there may be more significant message transmission delays and failures during an actual MCI, and not all staff will receive the text message in a timely fashion.

Humanizing Aggregated Data: Developing Personas to Prioritize User Needs for Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Burkett, E. R.; Jayanty, N. K.; Sellnow, D. D.; Given, D. D.; DeGroot, R. M.

2016-12-01

Methods that use storytelling to gather and synthesize data from people can be advantageous in understanding user needs and designing successful communication products. Using a multidisciplinary approach, we research and prioritize user needs for the ShakeAlert Earthquake Early Warning system (http://pubs.usgs.gov/fs/2014/3083/), drawing on best practices from social and behavioral science, risk communication, and human-centered design. We apply quantitative and qualitative human data collection methods including user surveys, interviews, journey maps, personas, and scenarios. Human-centered design methods leverage storytelling (a) in the acquisition of qualitative behavioral data (e.g. with journey mapping), (b) through goal-driven behaviors and needs that are synthesized into a persona as a composite model of the data, and (c) within context scenarios (the story plot or projected circumstances) in which the persona is placed in context to inform the design of relevant and usable products or services. ShakeAlert, operated by the USGS and partners, has transitioned into a production prototype phase in which users are permitted to begin testing pilot implementations to take protective actions in response to an earthquake alert. While a subset of responses will be automated (e.g., opening fire house doors), other applications of the technology will alert individuals by broadcast, public address, or mobile device notifications and require self-protective behavioral decisions (e.g., "Drop, Cover, and Hold On"). To better understand ShakeAlert user decisions and needs, we use human-centered design methods to synthesize aggregated behavioral data into "personas," which model the common behavioral patterns that can be used to guide plans for the ShakeAlert interface, messaging, and training. We present user data, methods, and resulting personas that will inform decisions moving forward to shape ShakeAlert messaging and training that will be most usable by alert recipients.

47 CFR 10.420 - Message elements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Message elements. 10.420 Section 10.420... § 10.420 Message elements. A WEA Alert Message processed by a Participating CMS Provider shall include five mandatory CAP elements—Event Type; Area Affected; Recommended Action; Expiration Time (with time...

47 CFR 10.420 - Message elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Message elements. 10.420 Section 10.420... § 10.420 Message elements. A WEA Alert Message processed by a Participating CMS Provider shall include five mandatory CAP elements—Event Type; Area Affected; Recommended Action; Expiration Time (with time...

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

NASA Astrophysics Data System (ADS)

Otto, R.

2008-07-01

Nearly every large organization uses a tool to broadcast messages and information across the internal campus (messages like alerts announcing interruption in services or just information about upcoming events). These tools typically allow administrators (operators) to send 'targeted' messages which are sent only to specific groups of users or computers, e/g only those located in a specified building or connected to a particular computing service. CERN has a long history of such tools: CERNVMS's SPM_quotMESSAGE command, Zephyr [2] and the most recent the NICE Alerter based on the NNTP protocol. The NICE Alerter used on all Windows-based computers had to be phased out as a consequence of phasing out NNTP at CERN. The new solution to broadcast information messages on the CERN campus continues to provide the service based on cross-platform technologies, hence minimizing custom developments and relying on commercial software as much as possible. The new system, called CERN Alerter, is based on RSS (Really Simple Syndication) [9] for the transport protocol and uses Microsoft SharePoint as the backend for database and posting interface. The windows-based client relies on Internet Explorer 7.0 with custom code to trigger the window pop-ups and the notifications for new events. Linux and Mac OS X clients could also rely on any RSS readers to subscribe to targeted notifications. The paper covers the architecture and implementation aspects of the new system.

Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support

PubMed Central

Seidling, Hanna M; Phansalkar, Shobha; Seger, Diane L; Paterno, Marilyn D; Shaykevich, Shimon; Haefeli, Walter E

2011-01-01

Background Clinical decision support systems can prevent knowledge-based prescription errors and improve patient outcomes. The clinical effectiveness of these systems, however, is substantially limited by poor user acceptance of presented warnings. To enhance alert acceptance it may be useful to quantify the impact of potential modulators of acceptance. Methods We built a logistic regression model to predict alert acceptance of drug–drug interaction (DDI) alerts in three different settings. Ten variables from the clinical and human factors literature were evaluated as potential modulators of provider alert acceptance. ORs were calculated for the impact of knowledge quality, alert display, textual information, prioritization, setting, patient age, dose-dependent toxicity, alert frequency, alert level, and required acknowledgment on acceptance of the DDI alert. Results 50 788 DDI alerts were analyzed. Providers accepted only 1.4% of non-interruptive alerts. For interruptive alerts, user acceptance positively correlated with frequency of the alert (OR 1.30, 95% CI 1.23 to 1.38), quality of display (4.75, 3.87 to 5.84), and alert level (1.74, 1.63 to 1.86). Alert acceptance was higher in inpatients (2.63, 2.32 to 2.97) and for drugs with dose-dependent toxicity (1.13, 1.07 to 1.21). The textual information influenced the mode of reaction and providers were more likely to modify the prescription if the message contained detailed advice on how to manage the DDI. Conclusion We evaluated potential modulators of alert acceptance by assessing content and human factors issues, and quantified the impact of a number of specific factors which influence alert acceptance. This information may help improve clinical decision support systems design. PMID:21571746

Remote monitoring and security alert based on motion detection using mobile

NASA Astrophysics Data System (ADS)

Suganya Devi, K.; Srinivasan, P.

2016-03-01

Background model does not have any robust solution and constitutes one of the main problems in surveillance systems. The aim of the paper is to provide a mobile based security to a remote monitoring system through a WAP using GSM modem. It is most designed to provide durability and versatility for a wide variety of indoor and outdoor applications. It is compatible with both narrow and band networks and provides simultaneous image detection. The communicator provides remote control, event driven recording, including pre-alarm and post-alarm and image motion detection. The web cam allowing them to be mounted either to a ceiling or wall without requiring bracket, with the use of web cam. We could continuously monitoring status in the client system through the web. If any intruder arrives in the client system, server will provide an alert to the mobile (what we are set in the message that message send to the authorized person) and the client can view the image using WAP.

Maximizing Trust in the Wireless Emergency Alerts (WEA) Service

DTIC Science & Technology

2014-02-01

Homeland Security under Contract No. FA8721-05-C-0003 with Carnegie Mellon University for the operation of the Software En - gineering Institute, a...AOs will protect their alert-generating systems from misuse. A compro- mised alert-generating system could overload the IPAWS-OPEN message validation...greater accessibility, such as accessing the WEA service re- motely from the scene of an incident. Although we are currently unaware of any alerting

Wearable Smart System for Visually Impaired People

PubMed Central

2018-01-01

In this paper, we present a wearable smart system to help visually impaired persons (VIPs) walk by themselves through the streets, navigate in public places, and seek assistance. The main components of the system are a microcontroller board, various sensors, cellular communication and GPS modules, and a solar panel. The system employs a set of sensors to track the path and alert the user of obstacles in front of them. The user is alerted by a sound emitted through a buzzer and by vibrations on the wrist, which is helpful when the user has hearing loss or is in a noisy environment. In addition, the system alerts people in the surroundings when the user stumbles over or requires assistance, and the alert, along with the system location, is sent as a phone message to registered mobile phones of family members and caregivers. In addition, the registered phones can be used to retrieve the system location whenever required and activate real-time tracking of the VIP. We tested the system prototype and verified its functionality and effectiveness. The proposed system has more features than other similar systems. We expect it to be a useful tool to improve the quality of life of VIPs. PMID:29533970

Wearable Smart System for Visually Impaired People.

PubMed

Ramadhan, Ali Jasim

2018-03-13

In this paper, we present a wearable smart system to help visually impaired persons (VIPs) walk by themselves through the streets, navigate in public places, and seek assistance. The main components of the system are a microcontroller board, various sensors, cellular communication and GPS modules, and a solar panel. The system employs a set of sensors to track the path and alert the user of obstacles in front of them. The user is alerted by a sound emitted through a buzzer and by vibrations on the wrist, which is helpful when the user has hearing loss or is in a noisy environment. In addition, the system alerts people in the surroundings when the user stumbles over or requires assistance, and the alert, along with the system location, is sent as a phone message to registered mobile phones of family members and caregivers. In addition, the registered phones can be used to retrieve the system location whenever required and activate real-time tracking of the VIP. We tested the system prototype and verified its functionality and effectiveness. The proposed system has more features than other similar systems. We expect it to be a useful tool to improve the quality of life of VIPs.

Impact of community-delivered SMS alerts on dog-owner participation during a mass rabies vaccination campaign, Haiti 2017.

PubMed

Cleaton, Julie M; Wallace, Ryan M; Crowdis, Kelly; Gibson, Andy; Monroe, Benjamin; Ludder, Fleurinord; Etheart, Melissa D; Natal Vigilato, Marco Antonio; King, Alasdair

2018-04-19

Haiti has historically vaccinated between 100,000 and 300,000 dogs annually against rabies, however national authorities have not been able to reach and maintain the 70% coverage required to eliminate the canine rabies virus variant. Haiti conducts massive dog vaccination campaigns on an annual basis and utilizes both central point and door-to-door methods. These methods require that dog owners are aware of the dates and locations of the campaign. To improve this awareness among dog owners, 600,000 text messages were sent to phones in two Haitian communes (Gonaives and Saint-Marc) to remind dog owners to attend the campaign. Text messages were delivered on the second day and at the mid-point of the campaign. A post-campaign household survey was conducted to assess dog owner's perception of the text messages and the impact on their participation in the vaccination campaign. Overall, 147 of 160 (91.9%) text-receiving dog owners indicated the text was helpful, and 162 of 187 (86.6%) responding dog owners said they would like to receive text reminders during future rabies vaccination campaigns. In areas hosting one-day central point campaigns, dog owners who received the text were 2.0 (95% CI 1.1, 3.6) times more likely to have participated in the campaign (73.1% attendance among those who received the text vs 36.4% among those who did not). In areas incorporating door-to-door vaccination over multiple days there was no significant difference in participation between dog owners who did and did not receive a text. Text message reminders were well-received and significantly improved campaign attendance, indicating that short message service (SMS) alerts may be a successful strategy in low resource areas with large free roaming dog populations. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Subtlenoise: sonification of distributed computing operations

NASA Astrophysics Data System (ADS)

Love, P. A.

2015-12-01

The operation of distributed computing systems requires comprehensive monitoring to ensure reliability and robustness. There are two components found in most monitoring systems: one being visually rich time-series graphs and another being notification systems for alerting operators under certain pre-defined conditions. In this paper the sonification of monitoring messages is explored using an architecture that fits easily within existing infrastructures based on mature opensource technologies such as ZeroMQ, Logstash, and Supercollider (a synth engine). Message attributes are mapped onto audio attributes based on broad classification of the message (continuous or discrete metrics) but keeping the audio stream subtle in nature. The benefits of audio rendering are described in the context of distributed computing operations and may provide a less intrusive way to understand the operational health of these systems.

Field Test of Slow Moving Traffic Alerting System on Freeways in Las Vegas, Nevada : Assessment of the Effectiveness of the Dynamic Message Signs on the Freeways in Las Vegas, Nevada.

DOT National Transportation Integrated Search

2015-10-17

It has been perceived that the travelers do not respond to the incident messages on the dynamic message signs in the Las Vegas area in Nevada. The objective of the study is to evaluate whether dynamic message signs (DMS) in the Las Vegas freeway syst...

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

PubMed

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

2011-02-01

Bar code medication administration (BCMA) technology is gaining acceptance for its ability to prevent medication administration errors. However, studies suggest that improper use of BCMA technology can yield unsatisfactory error prevention and introduction of new potential medication errors. To evaluate the incidence of high-alert medication BCMA triggers and alert types and discuss the type of nursing and pharmacy workarounds occurring with the use of BCMA technology and the electronic medication administration record (eMAR). Medication scanning and override reports from January 1, 2008, through November 30, 2008, for all adult medical/surgical units were retrospectively evaluated for high-alert medication system triggers, alert types, and override reason documentation. An observational study of nursing workarounds on an adult medicine step-down unit was performed and an analysis of potential pharmacy workarounds affecting BCMA and the eMAR was also conducted. Seventeen percent of scanned medications triggered an error alert of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages. Clinician override reasons for alerts were documented in only 23% of administrations. Observational studies assessing for nursing workarounds revealed a median of 3 clinician workarounds per administration. Specific nursing workarounds included a failure to scan medications/patient armband and scanning the bar code once the dosage has been removed from the unit-dose packaging. Analysis of pharmacy order entry process workarounds revealed the potential for missed doses, duplicate doses, and doses being scheduled at the wrong time. BCMA has the potential to prevent high-alert medication errors by alerting clinicians through alert messages. Nursing and pharmacy workarounds can limit the recognition of optimal safety outcomes and therefore workflow processes must be continually analyzed and restructured to yield the intended full benefits of BCMA technology. © 2011 SAGE Publications.

INITIATE: An Intelligent Adaptive Alert Environment.

PubMed

Jafarpour, Borna; Abidi, Samina Raza; Ahmad, Ahmad Marwan; Abidi, Syed Sibte Raza

2015-01-01

Exposure to a large volume of alerts generated by medical Alert Generating Systems (AGS) such as drug-drug interaction softwares or clinical decision support systems over-whelms users and causes alert fatigue in them. Some of alert fatigue effects are ignoring crucial alerts and longer response times. A common approach to avoid alert fatigue is to devise mechanisms in AGS to stop them from generating alerts that are deemed irrelevant. In this paper, we present a novel framework called INITIATE: an INtellIgent adapTIve AlerT Environment to avoid alert fatigue by managing alerts generated by one or more AGS. We have identified and categories the lifecycle of different alerts and have developed alert management logic as per the alerts' lifecycle. Our framework incorporates an ontology that represents the alert management strategy and an alert management engine that executes this strategy. Our alert management framework offers the following features: (1) Adaptability based on users' feedback; (2) Personalization and aggregation of messages; and (3) Connection to Electronic Medical Records by implementing a HL7 Clinical Document Architecture parser.

Lessons from Hawaii: A Blessing in Disguise.

PubMed

Deitchman, Scott; Dallas, Cham E; Burkle, Frederick

2018-03-20

On January 13, 2018, Hawaii experienced an erroneous alert that falsely warned of an imminent ballistic missile strike. Rather than focus on the inconvenience caused by the false alert, we used reporting of the event to identify the missing elements that would characterize a system that could save lives by alerting and informing the public in a nuclear detonation. These include warnings that contain essential information rather than directing recipients to secondary sources; a system that issues alerts directly from federal agencies that will have the earliest warning; a robust multimodal alerting system that can deliver messages before and after the detonation; and swift activation of federal agencies immediately upon warning.

Providing Focus via a Social Media Exploitation Strategy

DTIC Science & Technology

2014-06-01

networking sites, video/photo sharing websites, forums, message boards, blogs and user -generated content in general as a way to determine the volume...that are constantly being updated by users around the world provide an excellent near-real time sensor. This sensor can be used to alert analysts...using the platform is to mine the profiles provided by the various platforms. At a minimum, users require a username, but there is usually a large

Predictive Information: Status or Alert Information?

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.; Bruneau, Daniel; Press, Hayes N.

2008-01-01

Previous research investigating the efficacy of predictive information for detecting and diagnosing aircraft system failures found that subjects like to have predictive information concerning when a parameter would reach an alert range. This research focused on where the predictive information should be located, whether the information should be more closely associated with the parameter information or with the alert information. Each subject saw 3 forms of predictive information: (1) none, (2) a predictive alert message, and (3) predictive information on the status display. Generally, subjects performed better and preferred to have predictive information available although the difference between status and alert predictive information was minimal. Overall, for detection and recalling what happened, status predictive information is best; however for diagnosis, alert predictive information holds a slight edge.

Generalized Philosophy of Alerting with Applications for Parallel Approach Collision Prevention

NASA Technical Reports Server (NTRS)

Winder, Lee F.; Kuchar, James K.

2000-01-01

The goal of the research was to develop formal guidelines for the design of hazard avoidance systems. An alerting system is automation designed to reduce the likelihood of undesirable outcomes that are due to rare failures in a human-controlled system. It accomplishes this by monitoring the system, and issuing warning messages to the human operators when thought necessary to head off a problem. On examination of existing and recently proposed logics for alerting it appears that few commonly accepted principles guide the design process. Different logics intended to address the same hazards may take disparate forms and emphasize different aspects of performance, because each reflects the intuitive priorities of a different designer. Because performance must be satisfactory to all users of an alerting system (implying a universal meaning of acceptable performance) and not just one designer, a proposed logic often undergoes significant piecemeal modification before gamma general acceptance. This report is an initial attempt to clarify the common performance goals by which an alerting system is ultimately judged. A better understanding of these goals will hopefully allow designers to reach the final logic in a quicker, more direct and repeatable manner. As a case study, this report compares three alerting logics for collision prevention during independent approaches to parallel runways, and outlines a fourth alternative incorporating elements of the first three, but satisfying stated requirements. Three existing logics for parallel approach alerting are described. Each follows from different intuitive principles. The logics are presented as examples of three "philosophies" of alerting system design.

iFall: an Android application for fall monitoring and response.

PubMed

Sposaro, Frank; Tyson, Gary

2009-01-01

Injuries due to falls are among the leading causes of hospitalization in elderly persons, often resulting in a rapid decline in quality of life or death. Rapid response can improve the patients outcome, but this is often lacking when the injured person lives alone and the nature of the injury complicates calling for help. This paper presents an alert system for fall detection using common commercially available electronic devices to both detect the fall and alert authorities. We use an Android-based smart phone with an integrated tri-axial accelerometer. Data from the accelerometer is evaluated with several threshold based algorithms and position data to determine a fall. The threshold is adaptive based on user provided parameters such as: height, weight, and level of activity. The algorithm adapts to unique movements that a phone experiences as opposed to similar systems which require users to mount accelerometers to their chest or trunk. If a fall is suspected a notification is raised requiring the user's response. If the user does not respond, the system alerts pre-specified social contacts with an informational message via SMS. If a contact responds the system commits an audible notification, automatically connects, and enables the speakerphone. If a social contact confirms a fall, an appropriate emergency service is alerted. Our system provides a realizable, cost effective solution to fall detection using a simple graphical interface while not overwhelming the user with uncomfortable sensors.

Cockpit display of hazardous weather information

NASA Technical Reports Server (NTRS)

Hansman, R. John, Jr.; Wanke, Craig

1991-01-01

Information transfer and display issues associated with the dissemination of hazardous weather warnings are studied in the context of wind shear alerts. Operational and developmental wind shear detection systems are briefly reviewed. The July 11, 1988 microburst events observed as part of the Denver Terminal Doppler Weather Radar (TDWR) operational evaluation are analyzed in terms of information transfer and the effectiveness of the microburst alerts. Information transfer, message content and display issues associated with microburst alerts generated from ground based sources (Doppler Radar, Low Level Wind Shear Alert System, and Pilot Reports) are evaluated by means fo pilot opinion surveys and part task simulator studies.

Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

PubMed Central

Krall, M. A.; Sittig, D. F.

2001-01-01

There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use". PMID:11825206

Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

PubMed

Krall, M A; Sittig, D F

2001-01-01

There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use".

Alerting the general population to genetic risks: the value of health messages communicating the existence of genetic risk factors for public health promotion.

PubMed

Smerecnik, Chris M R; Mesters, Ilse; de Vries, Nanne K; de Vries, Hein

2009-11-01

Health messages alerting the public to previously unknown genetic risk factors for multifactorial diseases are a potentially useful strategy to create public awareness, and may be an important first step in promoting public health. However, there is a lack of evidence-based insight into its impact on individuals who were unaware of the existence of genetic risk factors at the moment of information exposure. The authors conducted 3 experimental studies with health messages communicating information about genetic risk factors for salt sensitivity (Studies 1A and 1B) and heightened cholesterol (Study 2) compared with general information without reference to genetic risk factors as a between-subjects variable and risk perception and intention to engage in preventive behavior as dependent variables. All 3 studies revealed lower perceived susceptibility among participants who received information on genetic risk factors, which was associated with lowered intentions to engage in preventive behavior. In Studies 1A and 1B, these effects were observed only for previously unaware individuals, whereas in Study 2, they were observed for the entire sample. Alerting the public to the existence of genetic risk factors may not necessarily be beneficial to public health. Public health promoters should be aware of the possible adverse effects of alerting the general population to genetic risk factors, and should simultaneously educate the public about the meaning and consequences of such factors. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Homeless patients' perceptions about using cell phones to manage medications and attend appointments.

PubMed

Moczygemba, Leticia R; Cox, Lauren S; Marks, Samantha A; Robinson, Margaret A; Goode, Jean-Venable R; Jafari, Nellie

2017-06-01

The objectives of this study were to (1) describe homeless persons' access and use of cell phones and their perceptions about using cell phone alerts to help manage medications and attend health care appointments and (2) identify demographic characteristics, medication use and appointment history and perceptions associated with interest in receiving cell phone alerts to manage medications and appointments. A cross-sectional survey was conducted in 2013 at a homeless clinic in Virginia. The questionnaire comprised items about cell phone usage, ownership and functions such as text messaging. Participants reported medication use and appointment history, perceptions about cell phone alerts and interest in receiving alerts to manage medications and appointments. Descriptive statistics for all variables are reported. Logistic regression was used to examine predictors of interest in using a cell phone to manage medications and appointments. A total of 290 participants completed the survey; 89% had a cell phone. Seventy-seven percent were interested in appointment reminders, whereas 66%, 60% and 54% were interested in refill reminders, medication taking reminders and medication information messages respectively. Those who believed reminders were helpful were more likely to be interested in medication taking, refill and appointment reminder messages compared to those who did not believe reminders were helpful. A history of running out of medicine and forgetting appointments were predictors of interest in refill and appointment reminders. Mobile technology is a feasible method for communicating medication and appointment information to those experiencing or at risk for homelessness. © 2016 Royal Pharmaceutical Society.

A hazard-independent approach for the standardised multi-channel dissemination of warning messages

NASA Astrophysics Data System (ADS)

Esbri Palomares, M. A.; Hammitzsch, M.; Lendholt, M.

2012-04-01

The tsunami disaster affecting the Indian Ocean region on Christmas 2004 demonstrated very clearly the shortcomings in tsunami detection, public warning processes as well as intergovernmental warning message exchange in the Indian Ocean region. In that regard, early warning systems require that the dissemination of early warning messages has to be executed in way that ensures that the message delivery is timely; the message content is understandable, usable and accurate. To that end, diverse and multiple dissemination channels must be used to increase the chance of the messages reaching all affected persons in a hazard scenario. In addition to this, usage of internationally accepted standards for the warning dissemination such as the Common Alerting Protocol (CAP) and Emergency Data Exchange Language (EDXL) Distribution Element specified by the Organization for the Advancement of Structured Information Standards (OASIS) increase the interoperability among different warning systems enabling thus the concept of system-of-systems proposed by GEOSS. The project Distant Early Warning System (DEWS), co-funded by the European Commission under the 6th Framework Programme, aims at strengthening the early warning capacities by building an innovative generation of interoperable tsunami early warning systems based on the above mentioned concepts following a Service-oriented Architecture (SOA) approach. The project focuses on the downstream part of the hazard information processing where customized, user-tailored warning messages and alerts flow from the warning centre to the responsible authorities and/or the public with their different needs and responsibilities. The information logistics services within DEWS generate tailored EDXL-DE/CAP warning messages for each user that must receive the message according to their preferences, e.g., settings for language, interested areas, dissemination channels, etc.. However, the significant difference in the implementation and capabilities of different dissemination channels such as SMS, email and television, have bearing on the information processing required for delivery and consumption of a DEWS EDXL-DE/CAP message over each dissemination channel. These messages may include additional information in the form of maps, graphs, documents, sensor observations, etc. Therefore, the generated messages are pre-processed by channel adaptors in the information dissemination services converting it into a format that is suitable for end-to-end delivery over the dissemination channels without any semantic distortion. The approach followed by DEWS for disseminating warnings not only relies on traditional communication ways used by the already established early warnings such as the delivery of faxes and phone calls but takes into consideration the use of other broadly used communication channels such as SMS, email, narrowcast and broadcast television, instant messaging, Voice over IP, and radio. It also takes advantage of social media channels like RSS feeds, Facebook, Twitter, etc., enabling a multiplier effect, like in the case of radio and television, and thus allowing to create mash-ups by aggregating other sources of information to the original message. Finally, status information is also important in order to assess and understand whether the process of disseminating the warning to the message consumers has been successfully completed or the process failed at some point of the dissemination chain. To that end, CAP-based messages generated within the information dissemination services provide the semantics for those fields that are of interest within the context of reporting the warning dissemination status in DEWS.

Operational Test and Evaluation Handbook for Aircrew Training Devices. Volume I. Planning and Management.

DTIC Science & Technology

1982-02-01

of i, nd to (! Lvel op an awareness of the T&E roles and responsioi Ii ties Viir~dte various Air Force organizations involved in the T&EC process... mathematical models to determine controller messages and issue controller messages using computer generated speech. AUTOMATED PERFORMANCE ALERTS: Signals

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

PubMed

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

2012-01-01

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

Study of Integration Considerations for Wireless Emergency Alerts

DTIC Science & Technology

2014-02-01

affect adoption. Section 4 presents a list of overall considerations for integrating a WEA messaging solution into an existing emergency management...in a product may negatively affect another de- sired quality. This section offers considerations for balancing an organization’s priorities con... affect what emergency management agencies can, should, and must do with respect to conducting exercises and issuing alerts. More information about

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

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

Earthquake Early Warning: User Education and Designing Effective Messages

NASA Astrophysics Data System (ADS)

Burkett, E. R.; Sellnow, D. D.; Jones, L.; Sellnow, T. L.

2014-12-01

The U.S. Geological Survey (USGS) and partners are transitioning from test-user trials of a demonstration earthquake early warning system (ShakeAlert) to deciding and preparing how to implement the release of earthquake early warning information, alert messages, and products to the public and other stakeholders. An earthquake early warning system uses seismic station networks to rapidly gather information about an occurring earthquake and send notifications to user devices ahead of the arrival of potentially damaging ground shaking at their locations. Earthquake early warning alerts can thereby allow time for actions to protect lives and property before arrival of damaging shaking, if users are properly educated on how to use and react to such notifications. A collaboration team of risk communications researchers and earth scientists is researching the effectiveness of a chosen subset of potential earthquake early warning interface designs and messages, which could be displayed on a device such as a smartphone. Preliminary results indicate, for instance, that users prefer alerts that include 1) a map to relate their location to the earthquake and 2) instructions for what to do in response to the expected level of shaking. A number of important factors must be considered to design a message that will promote appropriate self-protective behavior. While users prefer to see a map, how much information can be processed in limited time? Are graphical representations of wavefronts helpful or confusing? The most important factor to promote a helpful response is the predicted earthquake intensity, or how strong the expected shaking will be at the user's location. Unlike Japanese users of early warning, few Californians are familiar with the earthquake intensity scale, so we are exploring how differentiating instructions between intensity levels (e.g., "Be aware" for lower shaking levels and "Drop, cover, hold on" at high levels) can be paired with self-directed supplemental information to increase the public's understanding of earthquake shaking and protective behaviors.

Cockpit display of hazardous weather information

NASA Technical Reports Server (NTRS)

Hansman, R. John, Jr.; Wanke, Craig

1990-01-01

Information transfer and display issues associated with the dissemination of hazardous weather warnings are studied in the context of windshear alerts. Operational and developmental windshear detection systems are briefly reviewed. The July 11, 1988 microburst events observed as part of the Denver Terminal Doppler Weather Radar (TDWR) operational evaluation are analyzed in terms of information transfer and the effectiveness of the microburst alerts. Information transfer, message content and display issues associated with microburst alerts generated from ground based sources are evaluated by means of pilot opinion surveys and part task simulator studies.

Cockpit display of hazardous weather information

NASA Technical Reports Server (NTRS)

Hansman, R. John, Jr.; Wanke, Craig

1989-01-01

Information transfer and display issues associated with the dissemination of hazardous-weather warnings are studied in the context of wind-shear alerts. Operational and developmental wind-shear detection systems are briefly reviewed. The July 11, 1988 microburst events observed as part of the Denver TDWR operational evaluation are analyzed in terms of information transfer and the effectiveness of the microburst alerts. Information transfer, message content, and display issues associated with microburst alerts generated from ground-based sources (Doppler radars, LLWAS, and PIREPS) are evaluated by means of pilot opinion surveys and part-task simulator studies.

Community Alert: Using Text Messaging and Social Media to Improve Campus Emergency Planning

ERIC Educational Resources Information Center

Connolly, Maureen

2014-01-01

This article describes emergency management and the part that social media technologies and mobile messaging have made when they are included as part of the campus emergency plan. Administrators have found that ample notification and preparedness must be built into campus communication systems. Social media platforms such as Twitter and Facebook…

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

PubMed

Baldwin, Carryl L

2011-04-01

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

Exploring Machine Learning Techniques Using Patient Interactions in Online Health Forums to Classify Drug Safety

ERIC Educational Resources Information Center

Chee, Brant Wah Kwong

2011-01-01

This dissertation explores the use of personal health messages collected from online message forums to predict drug safety using natural language processing and machine learning techniques. Drug safety is defined as any drug with an active safety alert from the US Food and Drug Administration (FDA). It is believed that this is the first…

Effectiveness of a Mobile Short-Message-Service–Based Disease Outbreak Alert System in Kenya

PubMed Central

Njeru, Ian; Zurovac, Dejan; Tipo, Shikanga O; Kareko, David; Mwau, Matilu; Morita, Kouichi

2016-01-01

We conducted a randomized, controlled trial to test the effectiveness of a text-messaging system used for notification of disease outbreaks in Kenya. Health facilities that used the system had more timely notifications than those that did not (19.2% vs. 2.6%), indicating that technology can enhance disease surveillance in resource-limited settings. PMID:26981628

Cardiac Care Assistance using Self Configured Sensor Network—a Remote Patient Monitoring System

NASA Astrophysics Data System (ADS)

Sarma Dhulipala, V. R.; Kanagachidambaresan, G. R.

2014-04-01

Pervasive health care systems are used to monitor patients remotely without disturbing the normal day-to-day activities in real-time. Wearable physiological sensors required to monitor various significant ecological parameters of the patients are connected to Body Central Unit (BCU). Body Sensor Network (BSN) updates data in real-time and are designed to transmit alerts against abnormalities which enables quick response by medical units in case of an emergency. BSN helps monitoring patient without any need for attention to the subject. BSN helps in reducing the stress and strain caused by hospital environment. In this paper, mathematical models for heartbeat signal, electro cardio graph (ECG) signal and pulse rate are introduced. These signals are compared and their RMS difference-fast Fourier transforms (PRD-FFT) are processed. In the context of cardiac arrest, alert messages of these parameters and first aid for post-surgical operations has been suggested.

The Effects of Subthreshold Priming Alerts on Pilots in the USAARL TH-67 Microsim

DTIC Science & Technology

2009-06-01

subthreshold priming, subliminal messaging, cockpit displays UNCLAS UNCLAS UNCLAS SAR 46 Loraine Parish St. Onge, PhD 334-255-6906 Reset...of subliminally alerting pilots of or preparing pilots for changing situations and trends without interrupting their primary cognitive task...results under certain priming durations. Three studies by Strahan, Spencer, and Zann (2002) suggest that subliminal priming can be used to enhance

Hallux Rigidus

MedlinePlus

... in the big toe during use (walking, standing, bending, etc.) Pain and stiffness aggravated by cold, damp ... ps.position.alert.message}} Getting your location, one moment... Please enter a 5-digit zip code. Please ...

Going Barefoot? Beware!

MedlinePlus

... can conceal sharp objects underwater. People living with diabetes should never go barefoot, even indoors, because their nervous system may not ... Use your current position? {{ps.position.alert.message}} Getting your location, one ...

Early warning of active fire hotspots through NASA FIRMS fire information system

NASA Astrophysics Data System (ADS)

Ilavajhala, S.; Davies, D.; Schmaltz, J. E.; Murphy, K. J.

2014-12-01

Forest fires and wildfires can threaten ecosystems, wildlife, property, and often, large swaths of populations. Early warning of active fire hotspots plays a crucial role in planning, managing, and mitigating the damaging effects of wildfires. The NASA Fire Information for Resource Management System (FIRMS) has been providing active fire location information to users in easy-to-use formats for the better part of last decade, with a view to improving the alerting mechanisms and response times to fight forest and wildfires. FIRMS utilizes fires flagged as hotspots by the MODIS instrument flying aboard the Aqua and Terra satellites and sends early warning of detected hotspots via email in near real-time or as daily and weekly summaries. The email alerts can also be customized to send alerts for a particular region of interest, a country, or a specific protected area or park. In addition, a web mapping component, named "Web Fire Mapper" helps query and visualize hotspots. A newer version of Web Fire Mapper is being developed to enhance the existing visualization and alerting capabilities. Plans include supporting near real-time imagery from Aqua and Terra satellites to provide a more helpful context while viewing fires. Plans are also underway to upgrade the email alerts system to provide mobile-formatted messages and short text messages (SMS). The newer version of FIRMS will also allow users to obtain geo-located image snapshots, which can be imported into local GIS software by stakeholders to help further analyses. This talk will discuss the FIRMS system, its enhancements and its role in helping map, alert, and monitor fire hotspots by providing quick data visualization, querying, and download capabilities.

Tarsal Tunnel Syndrome

MedlinePlus

... of feeling. During this examination, the surgeon will position the foot and tap on the nerve to ... a city or last name. Use your current position? {{ps.position.alert.message}} Getting your location, one ...

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

PubMed

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

2015-07-29

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

Osteoarthritis of the Foot and Ankle

MedlinePlus

... in or near the joint Difficulty walking or bending the joint Some patients with osteoarthritis also develop ... ps.position.alert.message}} Getting your location, one moment... Please enter a 5-digit zip code. Please ...

Bunions (Hallux Abducto Valgus)

MedlinePlus

... a city or last name. Use your current position? {{ps.position.alert.message}} Getting your location, one moment... Please ... and Ankle Surgeons (ACFAS), All Rights Reserved. Privacy Statement | Disclaimer | Terms and Conditions | Site Map 8725 West ...

A CCTV system with SMS alert (CMDSA): An implementation of pixel processing algorithm for motion detection

NASA Astrophysics Data System (ADS)

Rahman, Nurul Hidayah Ab; Abdullah, Nurul Azma; Hamid, Isredza Rahmi A.; Wen, Chuah Chai; Jelani, Mohamad Shafiqur Rahman Mohd

2017-10-01

Closed-Circuit TV (CCTV) system is one of the technologies in surveillance field to solve the problem of detection and monitoring by providing extra features such as email alert or motion detection. However, detecting and alerting the admin on CCTV system may complicate due to the complexity to integrate the main program with an external Application Programming Interface (API). In this study, pixel processing algorithm is applied due to its efficiency and SMS alert is added as an alternative solution for users who opted out email alert system or have no Internet connection. A CCTV system with SMS alert (CMDSA) was developed using evolutionary prototyping methodology. The system interface was implemented using Microsoft Visual Studio while the backend components, which are database and coding, were implemented on SQLite database and C# programming language, respectively. The main modules of CMDSA are motion detection, capturing and saving video, image processing and Short Message Service (SMS) alert functions. Subsequently, the system is able to reduce the processing time making the detection process become faster, reduce the space and memory used to run the program and alerting the system admin instantly.

Airborne Data Link Study Report

DOT National Transportation Integrated Search

1996-01-01

This report represents evaluations of Data Link products and services in a simulated aviation opearation. The study addresses key issues related to alerting schemes for Data Link messages, positioning of Data Link displays, and mode of presentation o...

Joint Seismic-Geodetic Algorithm for Finite-Fault Detection and Slip Inversion in the West Coast ShakeAlert System

NASA Astrophysics Data System (ADS)

Smith, D. E.; Felizardo, C.; Minson, S. E.; Boese, M.; Langbein, J. O.; Murray, J. R.

2016-12-01

Finite-fault source algorithms can greatly benefit earthquake early warning (EEW) systems. Estimates of finite-fault parameters provide spatial information, which can significantly improve real-time shaking calculations and help with disaster response. In this project, we have focused on integrating a finite-fault seismic-geodetic algorithm into the West Coast ShakeAlert framework. The seismic part is FinDer 2, a C++ version of the algorithm developed by Böse et al. (2012). It interpolates peak ground accelerations and calculates the best fault length and strike from template matching. The geodetic part is a C++ version of BEFORES, the algorithm developed by Minson et al. (2014) that uses a Bayesian methodology to search for the most probable slip distribution on a fault of unknown orientation. Ultimately, these two will be used together where FinDer generates a Bayesian prior for BEFORES via the methodology of Minson et al. (2015), and the joint solution will generate estimates of finite-fault extent, strike, dip, best slip distribution, and magnitude. We have created C++ versions of both FinDer and BEFORES using open source libraries and have developed a C++ Application Protocol Interface (API) for them both. Their APIs allow FinDer and BEFORES to contribute to the ShakeAlert system via an open source messaging system, ActiveMQ. FinDer has been receiving real-time data, detecting earthquakes, and reporting messages on the development system for several months. We are also testing FinDer extensively with Earthworm tankplayer files. BEFORES has been tested with ActiveMQ messaging in the ShakeAlert framework, and works off a FinDer trigger. We are finishing the FinDer-BEFORES connections in this framework, and testing this system via seismic-geodetic tankplayer files. This will include actual and simulated data.

That Pain in Your Back Could be Linked to Your Feet

MedlinePlus

... hurts, so you change your gait to avoid bending the joint when you walk. Changing your gait ... ps.position.alert.message}} Getting your location, one moment... Please enter a 5-digit zip code. Please ...

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

PubMed Central

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

2015-01-01

V-Alert is a cooperative application to be deployed in the frame of Smart Cities with the aim of reducing the probability of accidents involving Vulnerable Road Users (VRU) and vehicles. The architecture of V-Alert combines short- and long-range communication technologies in order to provide more time to the drivers and VRU to take the appropriate maneuver and avoid a possible collision. The information generated by mobile sensors (vehicles and cyclists) is sent over this heterogeneous communication architecture and processed in a central server, the Drivers Cloud, which is in charge of generating the messages that are shown on the drivers’ and cyclists’ Human Machine Interface (HMI). First of all, V-Alert has been tested in a simulated scenario to check the communications architecture in a complex scenario and, once it was validated, all the elements of V-Alert have been moved to a real scenario to check the application reliability. All the results are shown along the length of this paper. PMID:26230695

Bringing text display digital radio to consumers with hearing loss.

PubMed

Sheffield, Ellyn G; Starling, Michael; Schwab, Daniel

2011-01-01

Radio is migrating to digital transmission, expanding its offerings to include captioning for individuals with hearing loss. Text display radio requires a large amount of word throughput with minimal screen display area, making good user interface design crucial to its success. In two experiments, we presented hearing, hard-of-hearing, and deaf consumers with National Public Radio stories converted to text and examined their preferences for and reactions to midsized and small radio text displays. We focused on physical display attributes such as text color, font style, line length, and scrolling type as well as emergency alert messages and emergency prompts for drivers, announcer identification schemes, and synchronization of audio and text. Results suggest that midsized, Global Positioning System (GPS)-style displays were well liked, synchronization of audio and text was important to comprehension and retrieval of story details, identification of announcers was served best with a combination of name change in parenthesis and color change, and a mixture of color and flashing symbols was preferred for emergency alerting.

Psychological impact on dispatched local lay rescuers performing bystander cardiopulmonary resuscitation.

PubMed

Zijlstra, Jolande A; Beesems, Stefanie G; De Haan, Rob J; Koster, Rudolph W

2015-07-01

We studied the short-term psychological impact and post-traumatic stress disorder (PTSD)-related symptoms in lay rescuers performing cardiopulmonary resuscitation (CPR) after a text message (TM)-alert for out-of-hospital-cardiac arrest, and assessed which factors contribute to a higher level of PTSD-related symptoms. The lay rescuers received a TM-alert and simultaneously an email with a link to an online questionnaire. We analyzed all questionnaires from February 2013 until October 2014 measuring the short-term psychological impact. We interviewed by telephone all first arriving lay rescuers performing bystander CPR and assessed PTSD-related symptoms with the Impact of Event Scale (IES) 4-6 weeks after the resuscitation. IES-scores 0-8 reflected no stress, 9-25 mild, 26-43 moderate, and 44-75 severe stress. A score ≥ 26 indicated PTSD symptomatology. Of all alerted lay rescuers, 6572 completed the online questionnaire. Of these, 1955 responded to the alert and 507 assisted in the resuscitation. We interviewed 203 first arriving rescuers of whom 189 completed the IES. Of these, 41% perceived no/mild short-term impact, 46% bearable impact and 13% severe impact. On the IES, 81% scored no stress and 19% scored mild stress. None scored moderate or severe stress. Using a multivariable logistic regression model we identified three factors with an independent impact on mild stress level: no automated external defibrillator connected by the lay rescuer, severe short-term impact, and no (very) positive experience. Lay rescuers alerted by text messages, do not show PTSD-related symptoms 4-6 weeks after performing bystander CPR, even if they perceive severe short-term psychological impact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Electronic Health Record Alert-Related Workload as a Predictor of Burnout in Primary Care Providers.

PubMed

Gregory, Megan E; Russo, Elise; Singh, Hardeep

2017-07-05

Electronic health records (EHRs) have been shown to increase physician workload. One EHR feature that contributes to increased workload is asynchronous alerts (also known as inbox notifications) related to test results, referral responses, medication refill requests, and messages from physicians and other health care professionals. This alert-related workload results in negative cognitive outcomes, but its effect on affective outcomes, such as burnout, has been understudied. To examine EHR alert-related workload (both objective and subjective) as a predictor of burnout in primary care providers (PCPs), in order to ultimately inform interventions aimed at reducing burnout due to alert workload. A cross-sectional questionnaire and focus group of 16 PCPs at a large medical center in the southern United States. Subjective, but not objective, alert workload was related to two of the three dimensions of burnout, including physical fatigue (p = 0.02) and cognitive weariness (p = 0.04), when controlling for organizational tenure. To reduce alert workload and subsequent burnout, participants indicated a desire to have protected time for alert management, fewer unnecessary alerts, and improvements to the EHR system. Burnout associated with alert workload may be in part due to subjective differences at an individual level, and not solely a function of the objective work environment. This suggests the need for both individual and organizational-level interventions to improve alert workload and subsequent burnout. Additional research should confirm these findings in larger, more representative samples.

WAN Optimization: A Business Process Reengineering and Knowledge Value Added Approach

DTIC Science & Technology

2011-03-01

processing is not affected. Reliability The Customer or Order systems are unavailable. If either fails, order processing halts and alerts are...online immediately, and sends a fax to the customer who orders the container. The whole order processing process can be completed in one day. IT plays...Messages build up in the OrderQ until the email server restarts. Messages are then sent by the SendEmail component to remove the backlog. Order

FIM Avionics Operations Manual

NASA Technical Reports Server (NTRS)

Alves, Erin E.

2017-01-01

This document describes the operation and use of the Flight Interval Management (FIM) Application installed on an electronic flight bag (EFB). Specifically, this document includes: 1) screen layouts for each page of the interface; 2) step-by-step instructions for data entry, data verification, and input error correction; 3) algorithm state messages and error condition alerting messages; 4) aircraft speed guidance and deviation indications; and 5) graphical display of the spatial relationships between the Ownship aircraft and the Target aircraft.

Vibration signaling in mobile devices for emergency alerting: a study with deaf evaluators.

PubMed

Harkins, Judith; Tucker, Paula E; Williams, Norman; Sauro, Jeff

2010-01-01

In the United States, a nationwide Commercial Mobile Alert Service (CMAS) is being planned to alert cellular mobile device subscribers to emergencies occurring near the location of the mobile device. The plan specifies a unique audio attention signal as well as a unique vibration attention signal (for mobile devices set to vibrate) to identify that the incoming message pertains to an emergency. Ratings of vibration signals of varying lengths and patterns were obtained from 44 deaf users of mobile devices for the perceived effectiveness of the signal in getting their attention in an emergency situation. Longer signals received higher ratings than shorter ones, and three signals with temporal on-off patterns were rated significantly better than a constant vibration. The U.S. government's recommended vibration signal for the CMAS, an important feature for access to emergency alerts by deaf persons, is supported by the results of the study.

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial.

PubMed

Patterson, Paul Daniel; Moore, Charity G; Weaver, Matthew D; Buysse, Daniel J; Suffoletto, Brian P; Callaway, Clifton W; Yealy, Donald M

2014-06-21

Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes 'alertness behaviors'. The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Clinicaltrials.gov NCT02063737, Registered on 10 January 2014.

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial

PubMed Central

2014-01-01

Background Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. Methods/Design We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes ‘alertness behaviors’. Discussion The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Trial Registration Clinicaltrials.gov NCT02063737, Registered on 10 January 2014 PMID:24952387

Evaluation of medication alerts in electronic health records for compliance with human factors principles

PubMed Central

Phansalkar, Shobha; Zachariah, Marianne; Seidling, Hanna M; Mendes, Chantal; Volk, Lynn; Bates, David W

2014-01-01

Introduction Increasing the adoption of electronic health records (EHRs) with integrated clinical decision support (CDS) is a key initiative of the current US healthcare administration. High over-ride rates of CDS alerts strongly limit these potential benefits. As a result, EHR designers aspire to improve alert design to achieve better acceptance rates. In this study, we evaluated drug–drug interaction (DDI) alerts generated in EHRs and compared them for compliance with human factors principles. Methods We utilized a previously validated questionnaire, the I-MeDeSA, to assess compliance with nine human factors principles of DDI alerts generated in 14 EHRs. Two reviewers independently assigned scores evaluating the human factors characteristics of each EHR. Rankings were assigned based on these scores and recommendations for appropriate alert design were derived. Results The 14 EHRs evaluated in this study received scores ranging from 8 to 18.33, with a maximum possible score of 26. Cohen's κ (κ=0.86) reflected excellent agreement among reviewers. The six vendor products tied for second and third place rankings, while the top system and bottom five systems were home-grown products. The most common weaknesses included the absence of characteristics such as alert prioritization, clear and concise alert messages indicating interacting drugs, actions for clinical management, and a statement indicating the consequences of over-riding the alert. Conclusions We provided detailed analyses of the human factors principles which were assessed and described our recommendations for effective alert design. Future studies should assess whether adherence to these recommendations can improve alert acceptance. PMID:24780721

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

NASA Astrophysics Data System (ADS)

Li, Chao

2017-04-01

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

Design and Implementation of Vehicle Navigation System in Urban Environments using Internet of Things (Iot)

NASA Astrophysics Data System (ADS)

Godavarthi, Bhavana; Nalajala, Paparao; Ganapuram, Vasavi

2017-08-01

Advanced vehicle monitoring and tracking system based on embedded Linux board and android application is designed and implemented for monitoring the school vehicle from any location A to location B at real time. The present system would make good use of new technology that based on embedded Linux namely Raspberry Pi and Smartphone android application. This system works on GPS/GPRS/GSM SIM900A. GPS finds the current location of the vehicle, GPRS sends the tracking information to the server and the GSM is used for sending alert message to vehicle’s owner mobile. This system is placed inside the vehicle whose position is to be determined on the web page and monitored at real time. There is a comparison between the current vehicle path already specified paths into the file system. Inside the raspberry pi’s file system taken from vehicle owners through android phone using android application. Means the selection of path from location A to B takes place from vehicle owner’s android application which gives more safety and secures traveling to the traveler. Hence the driver drives the vehicle only on the vehicle owner’s specified path. The driver drives the vehicle only on the vehicle owner’s specified path but if the driver drives in wrong path the message alert will be sent from this system to the vehicle owners mobile and also sent speakers alert to driver through audio jack. If the vehicles speed goes beyond the specified value of the speed, then warning message will be sent to owner mobile. This system also takes care of the traveler’s safety by using Gas leakage and Temperature sensors

Baiting Inside Attackers using Decoy Documents

DTIC Science & Technology

2008-09-16

viewed. Animated images allow the senders to monitor how long the message was displayed. The web bugs operate without alerting the user of the...Military Computer Security Policies”. IEEE Symposium on Security and Privacy, 1987. [5] Demers, A., Gehrke, J., Hong, M., Panda , B., Riedewald, M., Sharma

Real-Time Fatigue Reduction in Emergency Care Clinicians: The SleepTrackTXT Randomized Trial

PubMed Central

Patterson, P. Daniel; Buysse, Daniel J.; Weaver, Matthew D.; Doman, Jack M.; Moore, Charity G.; Suffoletto, Brian P.; McManigle, Kyle L.; Callaway, Clifton W.; Yealy, Donald M.

2015-01-01

Background We assessed performance characteristics and impact of a mobile phone text-message intervention for reducing intra-shift fatigue among emergency clinician shift workers. Methods We used a randomized controlled trial of 100 participants. All participants received text-message assessments at the start, every 4-hours during, and at end of scheduled shifts over a 90-day period. Text-message queries measured self-rated sleepiness, fatigue, and difficulty with concentration. Additional text-messages were sent to intervention participants to promote alertness. A performance measure of interest was compliance with answering text-messages. Results Ninety-nine participants documented 2,621 shifts and responded to 36,073 of 40,947 text-messages (88% compliance rate). Intervention participants reported lower mean fatigue and sleepiness at 4 hours, 8 hours, and at the end of 12-hour shifts compared to controls (p<0.05). Intervention participants reported better sleep quality at 90-days compared to baseline (p=0.01). Conclusions We showed feasibility and short-term efficacy of a text-message based assessment and intervention tool. PMID:26305869

The design and implementation of an open-source, data-driven cohort recruitment system: the Duke Integrated Subject Cohort and Enrollment Research Network (DISCERN).

PubMed

Ferranti, Jeffrey M; Gilbert, William; McCall, Jonathan; Shang, Howard; Barros, Tanya; Horvath, Monica M

2012-06-01

Failure to reach research subject recruitment goals is a significant impediment to the success of many clinical trials. Implementation of health-information technology has allowed retrospective analysis of data for cohort identification and recruitment, but few institutions have also leveraged real-time streams to support such activities. Duke Medicine has deployed a hybrid solution, The Duke Integrated Subject Cohort and Enrollment Research Network (DISCERN), that combines both retrospective warehouse data and clinical events contained in prospective Health Level 7 (HL7) messages to immediately alert study personnel of potential recruits as they become eligible. DISCERN analyzes more than 500000 messages daily in service of 12 projects. Users may receive results via email, text pages, or on-demand reports. Preliminary results suggest DISCERN's unique ability to reason over both retrospective and real-time data increases study enrollment rates while reducing the time required to complete recruitment-related tasks. The authors have introduced a preconfigured DISCERN function as a self-service feature for users. The DISCERN framework is adoptable primarily by organizations using both HL7 message streams and a data warehouse. More efficient recruitment may exacerbate competition for research subjects, and investigators uncomfortable with new technology may find themselves at a competitive disadvantage in recruitment. DISCERN's hybrid framework for identifying real-time clinical events housed in HL7 messages complements the traditional approach of using retrospective warehoused data. DISCERN is helpful in instances when the required clinical data may not be loaded into the warehouse and thus must be captured contemporaneously during patient care. Use of an open-source tool supports generalizability to other institutions at minimal cost.

Implementation of a closed-loop reporting system for critical values and clinical communication in compliance with goals of the joint commission.

PubMed

Parl, Fritz F; O'Leary, Mandy F; Kaiser, Allen B; Paulett, John M; Statnikova, Kristina; Shultz, Edward K

2010-03-01

Current practices of reporting critical laboratory values make it challenging to measure and assess the timeliness of receipt by the treating physician as required by The Joint Commission's 2008 National Patient Safety Goals. A multidisciplinary team of laboratorians, clinicians, and information technology experts developed an electronic ALERTS system that reports critical values via the laboratory and hospital information systems to alphanumeric pagers of clinicians and ensures failsafe notification, instant documentation, automatic tracking, escalation, and reporting of critical value alerts. A method for automated acknowledgment of message receipt was incorporated into the system design. The ALERTS system has been applied to inpatients and eliminated approximately 9000 phone calls a year made by medical technologists. Although a small number of phone calls were still made as a result of pages not acknowledged by clinicians within 10 min, they were made by telephone operators, who either contacted the same physician who was initially paged by the automated system or identified and contacted alternate physicians or the patient's nurse. Overall, documentation of physician acknowledgment of receipt in the electronic medical record increased to 95% of critical values over 9 months, while the median time decreased to <3 min. We improved laboratory efficiency and physician communication by developing an electronic system for reporting of critical values that is in compliance with The Joint Commission's goals.

Evaluating the use of cell phone messaging for community Ebola syndromic surveillance in high risked settings in Southern Sierra Leone.

PubMed

Jia, Kangbai; Mohamed, Koroma

2015-09-01

Most underdeveloped countries do not meet core disease outbreak surveillance because of the lack of human resources, laboratory and infrastructural facilities. The use of cell phone technology for disease outbreak syndromic surveillance is a new phenomenon in Sierra Leone despite its successes in other developing countries like Sri Lanka. In this study we set to evaluate the effectiveness of using cell phone technology for Ebola hemorrhagic fever syndromic surveillance in a high risked community in Sierra Leone. This study evaluated the effectiveness of using cell phone messaging (text and calls) for community Ebola hemorrhagic fever syndromic surveillance in high risked community in southern Sierra Leone. All cell phone syndromic surveillance data used for this study was reported as cell phone alert messages-texts and voice calls; by the Moyamba District Health Management Team for both Ebola hemorrhagic fever suspect and mortalities. We conducted a longitudinal data analysis of the monthly cumulative confirmed Ebola hemorrhagic fever cases and mortalities collected by both the traditional sentinel and community cell phone syndromic surveillance from August 2014 to October 2014. A total of 129 and 49 Ebola hemorrhagic fever suspect and confirmed cases respectively were recorded using the community Ebola syndromic surveillance cell phone alert system by the Moyamba District Health Management Team in October 2014. The average number of Ebola hemorrhagic fever suspects and confirmed cases for October 2014 were 4.16 (Std.dev 3.76) and 1.58 (Std.dev 1.43) respectively. Thirty-four percent (n=76) of the community Ebola syndromic surveillance cell phone alerts that were followed-up within 24 hours reported Ebola hemorrhagic fever suspect cases while 65.92% (n=147) reported mortality. Our study suggests some form of underreporting by the traditional sentinel Ebola hemorrhagic fever disease surveillance system in Moyamba District southern Sierra Leone for August-September 2014. Cell phone messaging technology can be effectively use as a tool for community epidemic surveillance from peripheral health care facilities to higher levels.

Pilot evaluation of a method to assess prescribers' information processing of medication alerts.

PubMed

Russ, Alissa L; Melton, Brittany L; Daggy, Joanne K; Saleem, Jason J

2017-02-01

Prescribers commonly receive alerts during medication ordering. Prescribers work in a complex, time-pressured environment; to enhance the effectiveness of safety alerts, the effort needed to cognitively process these alerts should be minimized. Methods to evaluate the extent to which computerized alerts support prescribers' information processing are lacking. To develop a methodological protocol to assess the extent to which alerts support prescribers' information processing at-a-glance; specifically, the incorporation of information into their working memory. We hypothesized that the method would be feasible and that we would be able to detect a significant difference in prescribers' information processing with a revised alert display that incorporates warning design guidelines compared to the original alert display. A counterbalanced, within-subject study was conducted with 20 prescribers in a human-computer interaction laboratory. We tested a single alert that was displayed in two different ways. Prescribers were informed that an alert would appear for 10s. After the alert was shown, a white screen was displayed, and prescribers were asked to verbally describe what they saw; indicate how many total warnings; and describe anything else they remembered about the alert. We measured information processing via the accuracy of prescribers' free recall and their ability to identify that three warning messages were present. Two analysts independently evaluated participants' responses against a comprehensive catalog of alert elements and then discussed discrepancies until reaching consensus. This feasibility study demonstrated that the method seemed to be effective for evaluating prescribers' information processing of medication alert displays. With this method, we were able to detect significant differences in prescribers' recall of alert information. The proportion of total data elements that prescribers were able to accurately recall was significantly greater for the revised versus original alert display (p=0.006). With the revised display, more prescribers accurately reported that three warnings were shown (p=0.002). The methodological protocol was feasible for evaluating the alert display and yielded important findings on prescribers' information processing. Study methods supplement traditional usability evaluation methods and may be useful for evaluating information processing of other healthcare technologies. Published by Elsevier Inc.

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.320 Provider alert gateway requirements. This section specifies the functions...

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.320 Provider alert gateway requirements. This section specifies the functions...

Digynic triploidy: utility and challenges of noninvasive prenatal testing

PubMed Central

Fleischer, Julie; Shenoy, Archana; Goetzinger, Katherine; Cottrell, Catherine E; Baldridge, Dustin; White, Frances V; Shinawi, Marwan

2015-01-01

Key Clinical Message Low fraction fetal DNA in noninvasive prenatal testing in the context of fetal growth restriction and multiple congenital anomalies should alert medical professionals to the possibility of digynic triploidy. Single-nucleotide polymorphism microarray can detect the parental origin of triploidy and explain its mechanism. PMID:26185638

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.320 Provider alert gateway requirements. This section specifies the functions...

Geoethical issues involved in Tsunami Warning System concepts and operations

NASA Astrophysics Data System (ADS)

Charalampakis, Marinos; Papadopoulos, Gerassimos A.; Tinti, Stefano

2016-04-01

The main goal of a Tsunami Warning System (TWS) is to mitigate the effect of an incoming tsunami by alerting coastal population early enough to allow people to evacuate safely from inundation zones. Though this representation might seem oversimplified, nonetheless, achieving successfully this goal requires a positive synergy of geoscience, communication, emergency management, technology, education, social sciences, politics. Geoethical issues arise always when there is an interaction between geoscience and society, and TWS is a paradigmatic case where interaction is very strong and is made critical because a) the formulation of the tsunami alert has to be made in a time as short as possible and therefore on uncertain data, and b) any evaluation error (underestimation or overestimation) can lead to serious (and sometimes catastrophic) consequences involving wide areas and a large amount of population. From the geoethical point of view three issues are critical: how to (i) combine forecasts and uncertainties reasonably and usefully, (ii) cope and possibly solve the dilemma whether it is better over-alerting or under-alerting population and (iii) deal with responsibility and liability of geoscientists, TWS operators, emergency operators and coastal population. The discussion will be based on the experience of the Hellenic National Tsunami Warning Center (HL-NTWC, Greece), which operates on 24/7 basis as a special unit of the Institute of Geodynamics, National Observatory of Athens, and acts also as Candidate Tsunami Service Provider (CTSP) in the framework of the North-Eastern Atlantic, the Mediterranean and connected seas Tsunami Warning System (NEAMTWS) of the IOC/UNESCO. Since August 2012, when HL-NTWC was officially declared as operational, 14 tsunami warning messages have been disseminated to a large number of subscribers after strong submarine earthquakes occurring in Greece and elsewhere in the eastern Mediterranean. It is recognized that the alerting process and procedure are quite complex and deserve an open and wide debate, that at the moment seems to be absent from media, scientific community and society, very likely until the next tsunami disaster.

Alerting device and method for reminding a person of a risk

DOEpatents

Runyon, Larry [Richland, WA; Gunter, Wayne M [West Richland, WA; Pratt, Richard M [Richland, WA

2001-11-27

An alerting device and method to remind personnel of a risk is disclosed. The device has at least two sensors, a logic controller, a power source, and an annunciator that delivers a visual message, with or without an audible alarm, about a risk to a person when the sensors detect the person exiting a predetermined space. In particular, the present invention reminds a person of a security, safety, or health risk upon exiting a predetermined space. More particularly, the present invention reminds a person of an information security risk relating to sensitive, proprietary, confidential, trade secret, classified, or intellectual property information.

Passive pavement-mounted acoustical linguistic drive alert system and method

DOEpatents

Kisner, Roger A.; Anderson, Richard L.; Carnal, Charles L.; Hylton, James O.; Stevens, Samuel S.

2001-01-01

Systems and methods are described for passive pavement-mounted acoustical alert of the occupants of a vehicle. A method of notifying a vehicle occupant includes providing a driving medium upon which a vehicle is to be driven; and texturing a portion of the driving medium such that the textured portion interacts with the vehicle to produce audible signals, the textured portion pattern such that a linguistic message is encoded into the audible signals. The systems and methods provide advantages because information can be conveyed to the occupants of the vehicle based on the location of the vehicle relative to the textured surface.

47 CFR 10.240 - Notification to new subscribers of non-participation in WEA.

Code of Federal Regulations, 2013 CFR

2013-10-01

... part or in whole, shall provide clear and conspicuous notice, which takes into account the needs of... messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third party reseller... emergency alert capable devices, please ask a sales representative, or go to [[CMS provider's URL

47 CFR 10.240 - Notification to new subscribers of non-participation in WEA.

Code of Federal Regulations, 2014 CFR

2014-10-01

... part or in whole, shall provide clear and conspicuous notice, which takes into account the needs of... messages at the point-of-sale. (b) The point-of-sale includes stores, kiosks, third party reseller... emergency alert capable devices, please ask a sales representative, or go to [[CMS provider's URL

Alert Notification System Router

NASA Technical Reports Server (NTRS)

Gurganus, Joseph; Carey, Everett; Antonucci, Robert; Hitchener, Peter

2009-01-01

The Alert Notification System Router (ANSR) software provides satellite operators with notifications of key events through pagers, cell phones, and e-mail. Written in Java, this application is specifically designed to meet the mission-critical standards for mission operations while operating on a variety of hardware environments. ANSR is a software component that runs inside the Mission Operations Center (MOC). It connects to the mission's message bus using the GMSEC [Goddard Space Flight Center (GSFC) Mission Services Evolution Center (GMSEC)] standard. Other components, such as automation and monitoring components, can use ANSR to send directives to notify users or groups. The ANSR system, in addition to notifying users, can check for message acknowledgements from a user and escalate the notification to another user if there is no acknowledgement. When a firewall prevents ANSR from accessing the Internet directly, proxies can be run on the other side of the wall. These proxies can be configured to access the Internet, notify users, and poll for their responses. Multiple ANSRs can be run in parallel, providing a seamless failover capability in the event that one ANSR system becomes incapacitated.

Event-based surveillance of food- and waterborne diseases in Europe: urgent inquiries (outbreak alerts) during 2008 to 2013.

PubMed

Gossner, C M; de Jong, B; Hoebe, C J; Coulombier, D

2015-06-25

During 2008 to 2013, 215 outbreak alerts, also known as 'urgent inquiries' (UI), for food- and waterborne diseases were launched in Europe, the majority of them (135; 63%) being related to salmonellosis. For 110 (51%) UI, a potential food vehicle of infection was identified, with vegetables being the most reported category (34;31%). A total of 28% (n = 60) of the outbreaks reported had an international dimension, involving at least two countries (mean: 4; standard deviation: 2; range:2–14). Participating countries posted 2,343 messages(initial posts and replies, excluding updates), with a median of 11 messages per urgent inquiry (range:1–28). Of 60 multicountry UI, 50 involved between two and four countries. The UI allowed early detection of multicountry outbreaks, facilitated the identification of the suspected vehicles and consequently contributed to the timely implementation of control measures. The introduction of an epidemic intelligence information system platform in 2010 has strengthened the role of the Food- and Waterborne Diseases and Zoonoses network in facilitating timely exchange of information between public health authorities of the participating countries.

Physicians’ use of computerized clinical decision supports to improve medication management in the elderly – the Seniors Medication Alert and Review Technology intervention

PubMed Central

Alagiakrishnan, Kannayiram; Wilson, Patricia; Sadowski, Cheryl A; Rolfson, Darryl; Ballermann, Mark; Ausford, Allen; Vermeer, Karla; Mohindra, Kunal; Romney, Jacques; Hayward, Robert S

2016-01-01

Background Elderly people (aged 65 years or more) are at increased risk of polypharmacy (five or more medications), inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS) within an electronic medical record (EMR) could improve medication safety. Methods Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR). The “Seniors Medication Alert and Review Technologies” (SMART) intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages) and active (order-entry alerts) prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed. Results Analysis of subjective data revealed that most clinicians agreed that CDS appeared at appropriate times during patient care. Although managing alerts incurred a modest time burden, most also agreed that workflow was not disrupted. Prevalent concerns related to clinician accountability and potential liability. Approximately 36% of eligible encounters triggered at least one SMART alert, with GFR alert, and most frequent medication warnings were with hypnotics and anticholinergics. Approximately 25% of alerts were overridden and ~15% elicited an evidence check. Conclusion While most SMART alerts validated clinician choices, they were received as valuable reminders for evidence-informed care and education. Data from this study may aid other attempts to implement Beers’ Criteria in ambulatory care EMRs. PMID:26869776

CISN ShakeAlert Earthquake Early Warning System Monitoring Tools

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

A Pilot Health Information Technology-Based Effort to Increase the Quality of Transitions From Skilled Nursing Facility to Home: Compelling Evidence of High Rate of Adverse Outcomes.

PubMed

Donovan, Jennifer L; Kanaan, Abir O; Gurwitz, Jerry H; Tjia, Jennifer; Cutrona, Sarah L; Garber, Lawrence; Preusse, Peggy; Field, Terry S

2016-04-01

Older adults are often transferred from hospitals to skilled nursing facilities (SNFs) for post-acute care. Patients may be at risk for adverse outcomes after SNF discharges, but little research has focused on this period. Assessment of the feasibility of a transitional care intervention based on a combination of manual information transmission and health information technology to provide automated alert messages to primary care physicians and staff; pre-post analysis to assess potential impact. A multispecialty group practice. Adults aged 65 and older, discharged from SNFs to home; comparison group drawn from SNF discharges during the previous 1.5 years, matched on facility, patient age, and sex. For the pre-post analysis, we tracked rehospitalization within 30 days after discharge and adverse drug events within 45 days. The intervention was developed and implemented with manual transmission of information between 8 SNFs and the group practice followed by entry into the electronic health record. The process required a 5-day delay during which a large portion of the adverse events occurred. Over a 1-year period, automated alert messages were delivered to physicians and staff for the 313 eligible patients discharged from the 8 SNFs to home. We compared outcomes to those of individually matched discharges from the previous 1.5 years and found similar percentages with 30-day rehospitalizations (31% vs 30%, adjusted HR 1.06, 95% CI 0.80-1.4). Within the adverse drug event (ADE) study, 30% of the discharges during the intervention period and 30% of matched discharges had ADEs within 45 days. Older adults discharged from SNFs are at high risk of adverse outcomes immediately following discharge. Simply providing alerts to outpatient physicians, especially if delivered multiple days after discharge, is unlikely to have any impact on reducing these rates. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Response time effects of alerting tone and semantic context for synthesized voice cockpit warnings

NASA Technical Reports Server (NTRS)

Simpson, C. A.; Williams, D. H.

1980-01-01

Some handbooks and human factors design guides have recommended that a voice warning should be preceded by a tone to attract attention to the warning. As far as can be determined from a search of the literature, no experimental evidence supporting this exists. A fixed-base simulator flown by airline pilots was used to test the hypothesis that the total 'system-time' to respond to a synthesized voice cockpit warning would be longer when the message was preceded by a tone because the voice itself was expected to perform both the alerting and the information transfer functions. The simulation included realistic ATC radio voice communications, synthesized engine noise, cockpit conversation, and realistic flight routes. The effect of a tone before a voice warning was to lengthen response time; that is, responses were slower with an alerting tone. Lengthening the voice warning with another work, however, did not increase response time.

Personalised electronic messages to improve sun protection in young adults.

PubMed

Mair, Sarah; Soyer, H Peter; Youl, Philippa; Hurst, Cameron; Marshall, Alison; Janda, Monika

2012-07-01

We studied the acceptability and feasibility of delivering sun protection messages via electronic media such as short message services (SMS) to people aged 18-40 years. An online survey was conducted using a pre-established panel of volunteers. We compared the characteristics of those who indicated that they would like to be alerted to the UV index, with those who would not, using bivariate logistic regression. Characteristics found to be associated with a desire to receive such advice were entered into a multivariate logistic regression analysis. The median age of the 141 participants was 34 years. Overall, 80% of participants agreed that they would like to receive some form of sun protection advice. Of these, 20% preferred to receive it via SMS and 42% via email. Willingness to receive electronic messages about the UV index was associated with being unsure about whether a suntanned person would look healthy and greater use of sun protection in the past. Careful attention to message framing and timing of message delivery, and focus on the short-term effects of sun exposure such as sunburn and skin ageing should increase the acceptability of such messages to young people. Sun protection messages delivered to young adults via electronic media appear to be feasible and acceptable.

A Prototype External Event Broker for LSST

NASA Astrophysics Data System (ADS)

Elan Alvarez, Gabriella; Stassun, Keivan; Burger, Dan; Siverd, Robert; Cox, Donald

2015-01-01

LSST plans to have an alerts system that will automatically identify various types of "events" appearing in the LSST data stream. These events will include things such as supernovae, moving objects, and many other types, and it is expected that there will be millions of events nightly. It is expected that there may be tens of millions of events each night. To help the LSST community parse and make full advantage of the LSST alerts stream, we are working to design an external "events alert broker" that will generate real-time notification of LSST events to users and/or robotic telescope facilities based on user-specified criteria. For example, users will be able to specify that they wish to be notified immediately via text message of urgent events, such as GRB counterparts, or notified only occasionally in digest form of less time-sensitive events, such as eclipsing binaries. This poster will summarize results from a survey of scientists for the most important features that such an alerts notification service needs to provide, and will present a preliminary design for our external event broker.

A lightweight Web of Things Open Platform to facilitate context data management and personalized healthcare services creation.

PubMed

Corredor, Iván; Metola, Eduardo; Bernardos, Ana M; Tarrío, Paula; Casar, José R

2014-04-29

In the last few years, many health monitoring systems have been designed to fullfil the needs of a large range of scenarios. Although many of those systems provide good ad hoc solutions, most of them lack of mechanisms that allow them to be easily reused. This paper is focused on describing an open platform, the micro Web of Things Open Platform (µWoTOP), which has been conceived to improve the connectivity and reusability of context data to deliver different kinds of health, wellness and ambient home care services. µWoTOP is based on a resource-oriented architecture which may be embedded in mobile and resource constrained devices enabling access to biometric, ambient or activity sensors and actuator resources through uniform interfaces defined according to a RESTful fashion. Additionally, µWoTOP manages two communication modes which allow delivering user context information according to different methods, depending on the requirements of the consumer application. It also generates alert messages based on standards related to health care and risk management, such as the Common Alerting Protocol, in order to make its outputs compatible with existing systems.

A Lightweight Web of Things Open Platform to Facilitate Context Data Management and Personalized Healthcare Services Creation

PubMed Central

Corredor, Iván; Metola, Eduardo; Bernardos, Ana M.; Tarrío, Paula; Casar, José R.

2014-01-01

In the last few years, many health monitoring systems have been designed to fullfil the needs of a large range of scenarios. Although many of those systems provide good ad hoc solutions, most of them lack of mechanisms that allow them to be easily reused. This paper is focused on describing an open platform, the micro Web of Things Open Platform (µWoTOP), which has been conceived to improve the connectivity and reusability of context data to deliver different kinds of health, wellness and ambient home care services. µWoTOP is based on a resource-oriented architecture which may be embedded in mobile and resource constrained devices enabling access to biometric, ambient or activity sensors and actuator resources through uniform interfaces defined according to a RESTful fashion. Additionally, µWoTOP manages two communication modes which allow delivering user context information according to different methods, depending on the requirements of the consumer application. It also generates alert messages based on standards related to health care and risk management, such as the Common Alerting Protocol, in order to make its outputs compatible with existing systems. PMID:24785542

Implementation of Advanced Inventory Management Functionality in Automated Dispensing Cabinets

PubMed Central

Webb, Aaron; Lund, Jim

2015-01-01

Background: Automated dispensing cabinets (ADCs) are an integral component of distribution models in pharmacy departments across the country. There are significant challenges to optimizing ADC inventory management while minimizing use of labor and capital resources. The role of enhanced inventory control functionality is not fully defined. Objective: The aim of this project is to improve ADC inventory management by leveraging dynamic inventory standards and a low inventory alert platform. Methods: Two interventional groups and 1 historical control were included in the study. Each intervention group consisted of 6 ADCs that tested enhanced inventory management functionality. Interventions included dynamic inventory standards and a low inventory alert messaging system. Following separate implementation of each platform, dynamic inventory and low inventory alert systems were applied concurrently to all 12 ADCs. Outcome measures included number and duration of daily stockouts, ADC inventory turns, and number of phone calls related to stockouts received by pharmacy staff. Results: Low inventory alerts reduced both the number and duration of stockouts. Dynamic inventory standards reduced the number of daily stockouts without changing the inventory turns and duration of stockouts. No change was observed in number of calls related to stockouts made to pharmacy staff. Conclusions: Low inventory alerts and dynamic inventory standards are feasible mechanisms to help optimize ADC inventory management while minimizing labor and capital resources. PMID:26448672

XHTML Vocabulary

Science.gov Websites

content of resource. contentinfo contains meta information about the content on the page or the page as a Applications Vocabulary alert A message with important, and usually time-sensitive, information. Also see : true, false, or mixed. columnheader A cell containing header information for a column. combobox A

75 FR 68177 - Airworthiness Directives; The Boeing Company Model 757 and 767 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... and FUEL CONFIG discrete signals from the fuel quantity processor unit, and alerts the flightcrew of a... the FUEL CONFIG discrete signal, which disables both the FUEL CONFIG and LOW FUEL messages. Such... depleted below the minimum of 2,200 pounds. The EICAS receives both the LOW FUEL and FUEL CONFIG discrete...

Environment Agency England flood warning systems

NASA Astrophysics Data System (ADS)

Strong, Chris; Walters, Mark; Haynes, Elizabeth; Dobson, Peter

2015-04-01

Context In England around 5 million homes are at risk of flooding. We invest significantly in flood prevention and management schemes but we can never prevent all flooding. Early alerting systems are fundamental to helping us reduce the impacts of flooding. The Environment Agency has had the responsibility for flood warning since 1996. In 2006 we invested in a new dissemination system that would send direct messages to pre-identified recipients via a range of channels. Since then we have continuously improved the system and service we offer. In 2010 we introduced an 'opt-out' service where we pre-registered landline numbers in flood risk areas, significantly increasing the customer base. The service has performed exceptionally well under intense flood conditions. Over a period of 3 days in December 2013, when England was experiencing an east coast storm surge, the system sent nearly 350,000 telephone messages, 85,000 emails and 70,000 text messages, with a peak call rate of around 37,000 per hour and 100% availability. The Floodline Warnings Direct (FWD) System FWD provides warnings in advance of flooding so that people at risk and responders can take action to minimise the impact of the flood. Warnings are sent via telephone, fax, text message, pager or e-mail to over 1.1 million properties located within flood risk areas in England. Triggers for issuing alerts and warnings include attained and forecast river levels and rainfall in some rapidly responding locations. There are three levels of warning: Flood Alert, Flood Warning and Severe Flood Warning, and a stand down message. The warnings can be updated to include relevant information to help inform those at risk. Working with our current provider Fujitsu, the system is under a programme of continuous improvement including expanding the 'opt-out' service to mobile phone numbers registered to at risk addresses, allowing mobile registration to the system for people 'on the move' and providing access to registration via third parties. The 'Future Flood Warning System' Our research shows that people want more choice on how they access and receive warnings. Many want a service tailored to their own risk, rather than that of their community. They also want more information about the forecast and the situation to that they can make decisions personal to their circumstances. Our future flood warning system will build upon the success of our existing service and will aim to: • provide our customers with a more flexible and personalised self-service approach which caters for the diverse range of user needs • alert people wherever they are, not just in properties • be flexible enough to respond to user feedback to make improvements and utilise new technology as it becomes available • provide real-time visualisation of system performance, to assist our flood response • capture greater levels of information from the recipients of our warnings • be efficient for operators of the system and utilise automation where relevant • take a risk based approach to resilience to provide the highest level of reliability when needed at a reduced cost

Notification of abnormal lab test results in an electronic medical record: do any safety concerns remain?

PubMed Central

Singh, Hardeep; Thomas, Eric J.; Sittig, Dean F.; Wilson, Lindsey; Espadas, Donna; Khan, Myrna M.; Petersen, Laura A.

2010-01-01

Background: Follow-up of abnormal outpatient laboratory test results is a major patient safety concern. Electronic medical records can potentially address this concern through automated notification. We examined whether automated notifications of abnormal laboratory results (alerts) in an integrated electronic medical record resulted in timely follow-up actions. Methods: We studied four alerts: hemoglobin A1c (HbA1c) ≥15%, positive hepatitis C antibody (HCV), prostate specific antigen (PSA) ≥15 ng/mL, and thyroid stimulating hormone (TSH) ≥ 15 mIU/L. An alert tracking system determined whether the alert was acknowledged (i.e. provider clicked on and opened the message) within two weeks of transmission; acknowledged alerts were considered read. Within 30 days of result transmission, record review and provider contact determined follow-up actions (e.g. patient contact, treatment etc.). Multivariable logistic regression models analyzed predictors for lack of timely follow-up. Results: Between May 2008 and December 2008, 78,158 tests (HbA1c, HCV, TSH and PSA) were performed, of which 1163 (1.48%) were transmitted as alerts; 10.2% of these (119/1163) were unacknowledged. Timely follow-up was lacking in 79 (6.8%) and was statistically not different for acknowledged and unacknowledged alerts (6.4% vs. 10.1%; p =.13). Two-hundred two alerts (17.4% of 1163) arose from unnecessarily ordered (redundant) tests. Alerts for a new versus known diagnosis were more likely to lack timely follow-up (OR: 7.35; 95% CI: 4.16-12.97) whereas alerts related to redundant tests were less likely to lack timely follow-up (OR: 0.24; 95% CI: 0.07-0.84). Conclusions: Safety concerns related to timely patient follow-up remain despite automated notification of non-life threatening abnormal laboratory results in the outpatient setting. PMID:20193832

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM... that each Participating Commercial Mobile Service provider is required to support and perform at its...

Exploring bi-directional and SMS messaging for communications between Public Health Agencies and their stakeholders: a qualitative study.

PubMed

Revere, Debra; Calhoun, Rebecca; Baseman, Janet; Oberle, Mark

2015-07-08

Communication technologies that enable bi-directional/two-way communications and cell phone texting (SMS) between public health agencies and their stakeholders may improve public health surveillance, ensure targeted distribution of alerts to hard-to-reach populations, reduce mortality and morbidity in an emergency, and enable a crucial feedback loop between public health agencies and the communities they serve. Building on prior work regarding health care provider preferences for receiving one-way public health communications by email, fax or SMS, we conducted a formative, exploratory study to understand how a bi-directional system and the incorporation of SMS in that system might be used as a strategy to send and receive messages between public health agencies and community-based organizations which serve vulnerable populations, health care providers, and public health workers. Our research question: Under what conditions and/or situations might public health agencies utilize bi-directional and/or SMS messaging for disseminating time-sensitive public health information (alerts, advisories, updates, etc.) to their stakeholders? A mixed methods (qualitative and quantitative) study was conducted between April and July 2014. Data collection included a survey distributed to health care providers and semi-structured interviews with providers, community- and government-based organization leaders and directors, and public health agency internal workforce staff. Survey respondents and interviewees were asked about their exposure to public health messages, how these messages are received and how the information in these messages are handled, and in what situations (for example, a local vs. a national event, a pandemic or emergency vs. a health update) a bi-directional and/or SMS messaging system might improve communications between public health agencies and their stakeholder group. Interview and survey data were qualitatively analyzed. Thematic codes were quantitized into dichotomous variables of 0 or 1 on a per respondent basis to enumerate the presence or absence of each thematic code, enable quantitative analysis, and inform interpretation of findings. Five major themes emerged from synthesizing survey and interview results: 1) Regardless of situational context (emergency vs. non-urgent) and message recipient (stakeholder group), e-mail is a favored modality for receiving public health messages; 2) The decision to use bi-directional, SMS or multiple communication strategies is complex and public health agencies' need to manage messaging concerns/barriers and benefits for all parties; 3) Both public health agencies and their stakeholders share similar values/uses and concerns regarding two-way public health messaging and SMS; 4) Public health is highly trusted, thus thoughtful, effective messaging will ensure continuation of this goodwill; and 5) Information reciprocity between public health agencies and stakeholders who share their information is essential. Multiple communication strategies might be utilized but the choice of a specific strategy needs to balance message content (emergency vs. routine communications), delivery (one- vs. two-way), channel (SMS, email, etc.), and public health agency burden with stakeholder preferences and technical capabilities, all while mitigating the risk of message overload and disregard of important communications by recipients.

Tsunami.gov: NOAA's Tsunami Information Portal

NASA Astrophysics Data System (ADS)

Shiro, B.; Carrick, J.; Hellman, S. B.; Bernard, M.; Dildine, W. P.

2014-12-01

We present the new Tsunami.gov website, which delivers a single authoritative source of tsunami information for the public and emergency management communities. The site efficiently merges information from NOAA's Tsunami Warning Centers (TWC's) by way of a comprehensive XML feed called Tsunami Event XML (TEX). The resulting unified view allows users to quickly see the latest tsunami alert status in geographic context without having to understand complex TWC areas of responsibility. The new site provides for the creation of a wide range of products beyond the traditional ASCII-based tsunami messages. The publication of modern formats such as Common Alerting Protocol (CAP) can drive geographically aware emergency alert systems like FEMA's Integrated Public Alert and Warning System (IPAWS). Supported are other popular information delivery systems, including email, text messaging, and social media updates. The Tsunami.gov portal allows NOAA staff to easily edit content and provides the facility for users to customize their viewing experience. In addition to access by the public, emergency managers and government officials may be offered the capability to log into the portal for special access rights to decision-making and administrative resources relevant to their respective tsunami warning systems. The site follows modern HTML5 responsive design practices for optimized use on mobile as well as non-mobile platforms. It meets all federal security and accessibility standards. Moving forward, we hope to expand Tsunami.gov to encompass tsunami-related content currently offered on separate websites, including the NOAA Tsunami Website, National Tsunami Hazard Mitigation Program, NOAA Center for Tsunami Research, National Geophysical Data Center's Tsunami Database, and National Data Buoy Center's DART Program. This project is part of the larger Tsunami Information Technology Modernization Project, which is consolidating the software architectures of NOAA's existing TWC's into a single system. We welcome your feedback to help Tsunami.gov become an effective public resource for tsunami information and a medium to enable better global tsunami warning coordination.

A Matter of Urgency: Reducing Clinical Text Message Interruptions During Educational Sessions.

PubMed

Mendel, Arielle; Lott, Anthony; Lo, Lisha; Wu, Robert

2018-04-25

Text messaging is increasingly replacing paging as a tool to reach physicians on medical wards. However, this phenomenon has resulted in high volumes of nonurgent messages that can disrupt the learning climate. Our objective was to reduce nonurgent educational interruptions to residents on general internal medicine. This was a quality improvement project conducted at an academic hospital network. Measurements and interventions took place on 8 general internal medicine inpatient teaching teams. Interventions included (1) refining the clinical communication process in collaboration with nursing leadership; (2) disseminating guidelines with posters at nursing stations; (3) introducing a noninterrupting option for message senders; (4) audit and feedback of messages; (5) adding an alert for message senders advising if a message would interrupt educational sessions; and (6) training and support to nurses and residents. Interruptions (text messages, phone calls, emails) received by institution-supplied team smartphones were tracked during educational hours using statistical process control charts. A 1-month record of text message content was analyzed for urgency at baseline and following the interventions. The interruption frequency decreased from a mean of 0.92 (95% CI, 0.88 to 0.97) to 0.59 (95% CI, 0.51 to0.67) messages per team per educational hour from January 2014 to December 2016. The proportion of nonurgent educational interruptions decreased from 223/273 (82%) messages over one month to 123/182 (68%; P < .01). Creation of communication guidelines and modification of text message interface with feedback from end-users were associated with a reduction in nonurgent educational interruptions. Continuous audit and feedback may be necessary to minimize nonurgent messages that disrupt educational sessions. © 2018 Society of Hospital Medicine.

Faster from the Depths to Decision: Collecting, Distributing, and Applying Data from NOAA`s Deep-Sea Tsunameters

NASA Astrophysics Data System (ADS)

Bouchard, R. H.; Wang, D.; Branski, F.

2008-05-01

The National Oceanic and Atmospheric Administration (NOAA) operates two tsunami warning centers (TWCs): the West Coast/Alaska Tsunami Warning Center (ATWC) and Pacific Tsunami Warning Center (PTWC). ATWC provides tsunami alerts to Canadian coastal regions, Virgin Islands, Puerto Rico, and the coasts of continental US and Alaska. PTWC provides local/regional tsunami alerts/advisories to the state of Hawaii. An operational center of the Tsunami Warning System of the Pacific, it provides tsunami alerts to most countries of the Pacific Rim. PTWC also provides tsunami alerts for the Caribbean and Indian Ocean countries on an interim basis. The TWCs aim to issue first tsunami bulletins within 10-15 minutes of the earthquake for tele-tsunamis and within a few minutes for local tsunamis. The TWCs have a requirement for offshore tsunami detection in real-time with a data latency of 1 minute or less. Offshore detection of tsunamis is the purpose of NOAA`s recently completed 39-station array of deep-sea tsunameters. The tsunameters, employing the second-generation DART (Deep-ocean Assessment and Reporting of Tsunamis) technology, can speed tsunami detection information to the TWCs in less than 3 minutes from depths of 6000 meters in the Pacific and Western Atlantic oceans. The tsunameters consist of a Bottom Pressure Recorder (BPR) and a surface buoy. Communication from the BPR to the buoy is via underwater acoustic transmissions. Satellite communications carry the data from the buoy to NOAA`s National Data Buoy Center (NDBC), which operates the tsunameters. The BPRs make pressure measurements, converts them to an equivalent water-column height, and passes them through a tsunami detection algorithm. If the algorithm detects a sufficient change in the height, the tsunameter goes into a rapid reporting mode or Event Mode. The acoustic modem-satellite telecommunications path takes approximately 50 seconds to reach the NDBC server. In a few seconds, NDBC reformats the data and pushes them as messages to the National Weather Service Telecommunications Gateway also known as World Meteorological Organization (WMO) Regional Telecommunication Hub (RTH) Washington. RTH Washington can route more than 50 routine messages per second with reliability for all dissemination to all of its users of 99.9 percent. It provides a latency for high priority traffic of 10 seconds or less and routinely handles 1.2 TB of information per day. Its switching centers are on the Main Trunk Network of the WMO`s Global Telecommunication System (GTS), which provides international distribution of the tsunameter data. The GTS is required to deliver tsunami data and warnings to any connected center within two minutes anywhere in the world. TWCs receive the tsunameter data from RTH Washington via GTS circuits, or download the data from servers at the RTH, in the event the GTS circuits fails. TWCs display the data in real-time in their operations. When a tsunameter goes into Event Mode, the TWCs receive alerts. After subtracting the tide, tsunameter signals can measure tsunamis as small as a few millimeters. The usefulness of the tsunameter data at TWCs was demonstrated in some of the recent events in the Pacific Ocean (Kuril Tsunamis of November 2006 and January 2007, Peru Tsunamis of August 2007 and September 2007) and the Indian Ocean (Southern Sumatra Tsunami of September 2007).

An automated DICOM database capable of arbitrary data mining (including radiation dose indicators) for quality monitoring.

PubMed

Wang, Shanshan; Pavlicek, William; Roberts, Catherine C; Langer, Steve G; Zhang, Muhong; Hu, Mengqi; Morin, Richard L; Schueler, Beth A; Wellnitz, Clinton V; Wu, Teresa

2011-04-01

The U.S. National Press has brought to full public discussion concerns regarding the use of medical radiation, specifically x-ray computed tomography (CT), in diagnosis. A need exists for developing methods whereby assurance is given that all diagnostic medical radiation use is properly prescribed, and all patients' radiation exposure is monitored. The "DICOM Index Tracker©" (DIT) transparently captures desired digital imaging and communications in medicine (DICOM) tags from CT, nuclear imaging equipment, and other DICOM devices across an enterprise. Its initial use is recording, monitoring, and providing automatic alerts to medical professionals of excursions beyond internally determined trigger action levels of radiation. A flexible knowledge base, aware of equipment in use, enables automatic alerts to system administrators of newly identified equipment models or software versions so that DIT can be adapted to the new equipment or software. A dosimetry module accepts mammography breast organ dose, skin air kerma values from XA modalities, exposure indices from computed radiography, etc. upon receipt. The American Association of Physicists in Medicine recommended a methodology for effective dose calculations which are performed with CT units having DICOM structured dose reports. Web interface reporting is provided for accessing the database in real-time. DIT is DICOM-compliant and, thus, is standardized for international comparisons. Automatic alerts currently in use include: email, cell phone text message, and internal pager text messaging. This system extends the utility of DICOM for standardizing the capturing and computing of radiation dose as well as other quality measures.

Assessing Disaster Preparedness among Latino Migrant and Seasonal Farmworkers in Eastern North Carolina

PubMed Central

Burke, Sloane; Bethel, Jeffrey W.; Foreman Britt, Amber

2012-01-01

Natural disasters including hurricanes, floods, earthquakes, tornadoes, and fires often involve substantial physical and mental impacts on affected populations and thus are public health priorities. Limited research shows that vulnerable populations such as the low-income, socially isolated migrant and seasonal farmworkers (MSFW) are particularly susceptible to the effects of natural disasters. This research project assessed the awareness, perceived risk, and practices regarding disaster preparedness and response resources and identified barriers to utilization of community and government services during or after a natural disaster among Latino MSFWs’ and their families. Qualitative (N = 21) focus groups (3) and quantitative (N = 57) survey methodology was implemented with Latino MSFWs temporarily residing in rural eastern North Carolina to assess perceived and actual risk for natural disasters. Hurricanes were a top concern among the sample population, many participants shared they lacked proper resources for an emergency (no emergency kit in the house, no evacuation plan, no home internet, a lack of knowledge of what should be included in an emergency kit, etc.). Transportation and language were found to be additional barriers. Emergency broadcasts in Spanish and text message alerts were identified by the population to be helpful for disaster alerts. FEMA, American Red Cross, local schools and the migrant clinic were trusted places for assistance and information. In summary, tailored materials, emergency alerts, text messages, and news coverage concerning disaster threats should be provided in the population’s native language and when feasible delivered in a culturally appropriate mechanism such as “charlas” (talks) and brochures. PMID:23202674

Influencing Anesthesia Provider Behavior Using Anesthesia Information Management System Data for Near Real-Time Alerts and Post Hoc Reports.

PubMed

Epstein, Richard H; Dexter, Franklin; Patel, Neil

2015-09-01

In this review article, we address issues related to using data from anesthesia information management systems (AIMS) to deliver near real-time alerts via AIMS workstation popups and/or alphanumeric pagers and post hoc reports via e-mail. We focus on reports and alerts for influencing the behavior of anesthesia providers (i.e., anesthesiologists, anesthesia residents, and nurse anesthetists). Multiple studies have shown that anesthesia clinical decision support (CDS) improves adherence to protocols and increases financial performance through facilitation of billing, regulatory, and compliance documentation; however, improved clinical outcomes have not been demonstrated. We inform developers and users of feedback systems about the multitude of concerns to consider during development and implementation of CDS to increase its effectiveness and to mitigate its potentially disruptive aspects. We discuss the timing and modalities used to deliver messages, implications of outlier-only versus individualized feedback, the need to consider possible unintended consequences of such feedback, regulations, sustainability, and portability among systems. We discuss statistical issues related to the appropriate evaluation of CDS efficacy. We provide a systematic review of the published literature (indexed in PubMed) of anesthesia CDS and offer 2 case studies of CDS interventions using AIMS data from our own institution illustrating the salient points. Because of the considerable expense and complexity of maintaining near real-time CDS systems, as compared with providing individual reports via e-mail after the fact, we suggest that if the same goal can be accomplished via delayed reporting versus immediate feedback, the former approach is preferable. Nevertheless, some processes require near real-time alerts to produce the desired improvement. Post hoc e-mail reporting from enterprise-wide electronic health record systems is straightforward and can be accomplished using system-independent pathways (e.g., via built-in e-mail support provided by the relational database management system). However, for some of these enterprise-wide systems, near real-time data access, necessary for CDS that generates concurrent alerts, has been challenging to implement.

Skylab short-lived event alert program

NASA Technical Reports Server (NTRS)

Citron, R. A.

1974-01-01

During the three manned Skylab missions, the Center for Short-Lived Phenomena (CSLP) reported a total of 39 significant events to the Johnson Space Center (JSC) as part of the Skylab Short-Lived Event Alert Program. The telegraphed daily status reports included the names and locations of the events, the track number and revolution number during which the event could be observed, the time (GMT) to within plus or minus 2 sec when Skylab was closest to the event area, and the light condition (daylight or darkness) at that time and place. The messages sent to JSC during the Skylab 4 mission also included information pertaining to ground-truth studies and observations being conducted on the events. Photographic priorities were assigned for each event.

Volcano warning systems: Chapter 67

USGS Publications Warehouse

Gregg, Chris E.; Houghton, Bruce F.; Ewert, John W.

2015-01-01

Messages conveying volcano alert level such as Watches and Warnings are designed to provide people with risk information before, during, and after eruptions. Information is communicated to people from volcano observatories and emergency management agencies and from informal sources and social and environmental cues. Any individual or agency can be both a message sender and a recipient and multiple messages received from multiple sources is the norm in a volcanic crisis. Significant challenges to developing effective warning systems for volcanic hazards stem from the great diversity in unrest, eruption, and post-eruption processes and the rapidly advancing digital technologies that people use to seek real-time risk information. Challenges also involve the need to invest resources before unrest to help people develop shared mental models of important risk factors. Two populations of people are the target of volcano notifications–ground- and aviation-based populations, and volcano warning systems must address both distinctly different populations.

The agile alert system for gamma-ray transients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bulgarelli, A.; Trifoglio, M.; Gianotti, F.

2014-01-20

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

The AGILE Alert System for Gamma-Ray Transients

NASA Astrophysics Data System (ADS)

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

2014-01-01

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

Health messages on television commercials.

PubMed

Wallack, L; Dorfman, L

1992-01-01

Television is an important source of health information in the United States, yet little research has focused on the presentation of general health issues on television. This preliminary study reports on the health-related content of television commercials found on a typical television day. We conducted a content analysis of a composite day of television comprising 20 hours randomly selected over a three week period (April-May 1989). Findings are presented regarding health messages found in commercial time--advertisements, public service announcements (PSAs), editorials, and promotions for upcoming programs. Overall, 31% of the 654 commercial spots contained health messages. Most health messages were claims of good nutrition in food and beverage advertisements. PSAs comprise 1.4% of the 20-hour sample and 5.8% of the commercial time. Health messages appeared in 38% of PSAs, accounting for less than seven minutes. Not one PSA addressed tobacco, alcohol, or diet--the three leading behavioral risk factors for poor health. PSAs are usually seen as a mechanism by which the public health community can alert the public to important health issues. Given the declining pool of PSA time, public health educators will need to seek alternative strategies for influencing television content, such as media advocacy. In addition, further research on audience interpretation and response to commercial messages is suggested.

Reducing duplicate testing: a comparison of two clinical decision support tools.

PubMed

Procop, Gary W; Keating, Catherine; Stagno, Paul; Kottke-Marchant, Kandice; Partin, Mary; Tuttle, Robert; Wyllie, Robert

2015-05-01

Unnecessary duplicate laboratory testing is common and costly. Systems-based means to avert unnecessary testing should be investigated and employed. We compared the effectiveness and cost savings associated with two clinical decision support tools to stop duplicate testing. The Hard Stop required telephone contact with the laboratory and justification to have the duplicate test performed, whereas the Smart Alert allowed the provider to bypass the alert at the point of order entry without justification. The Hard Stop alert was significantly more effective than the Smart Alert (92.3% vs 42.6%, respectively; P < .0001). The cost savings realized per alert activation was $16.08/alert for the Hard Stop alert vs $3.52/alert for the Smart Alert. Structural and process changes that require laboratory contact and justification for duplicate testing are more effective than interventions that allow providers to bypass alerts without justification at point of computerized physician order entry. Copyright© by the American Society for Clinical Pathology.

Designing and Implementation of a Heart Failure Telemonitoring System

PubMed Central

Safdari, Reza; Jafarpour, Maryam; Mokhtaran, Mehrshad; Naderi, Nasim

2017-01-01

Introduction: The aim of this study was to identify patients at-risk, enhancing self-care management of HF patients at home and reduce the disease exacerbations and readmissions. Method: In this research according to standard heart failure guidelines and Semi-structured interviews with 10 heart failure Specialists, a draft heart failure rule set for alerts and patient instructions was developed. Eventually, the clinical champion of the project vetted the rule set. Also we designed a transactional system to enhance monitoring and follow up of CHF patients. With this system, CHF patients are required to measure their physiological measurements (vital signs and body weight) every day and to submit their symptoms using the app. additionally, based on their data, they will receive customized notifications and motivation messages to classify risk of disease exacerbation. The architecture of system comprised of six major components: 1) a patient data collection suite including a mobile app and website; 2) Data Receiver; 3) Database; 4) a Specialists expert Panel; 5) Rule engine classifier; 6) Notifier engine. Results: This system has implemented in Iran for the first time and we are currently in the testing phase with 10 patients to evaluate the technical performance of our system. The developed expert system generates alerts and instructions based on the patient’s data and the notify engine notifies responsible nurses and physicians and sometimes patients. Detailed analysis of those results will be reported in a future report. Conclusion: This study is based on the design of a telemonitoring system for heart failure self-care that intents to overcome the gap that occurs when patients discharge from the hospital and tries to accurate requirement of readmission. A rule set for classifying and resulting automated alerts and patient instructions for heart failure telemonitoring was developed. It also facilitates daily communication among patients and heart failure clinicians so any deterioration in health could be identified immediately. PMID:29114106

Designing and Implementation of a Heart Failure Telemonitoring System.

PubMed

Safdari, Reza; Jafarpour, Maryam; Mokhtaran, Mehrshad; Naderi, Nasim

2017-09-01

The aim of this study was to identify patients at-risk, enhancing self-care management of HF patients at home and reduce the disease exacerbations and readmissions. In this research according to standard heart failure guidelines and Semi-structured interviews with 10 heart failure Specialists, a draft heart failure rule set for alerts and patient instructions was developed. Eventually, the clinical champion of the project vetted the rule set. Also we designed a transactional system to enhance monitoring and follow up of CHF patients. With this system, CHF patients are required to measure their physiological measurements (vital signs and body weight) every day and to submit their symptoms using the app. additionally, based on their data, they will receive customized notifications and motivation messages to classify risk of disease exacerbation. The architecture of system comprised of six major components: 1) a patient data collection suite including a mobile app and website; 2) Data Receiver; 3) Database; 4) a Specialists expert Panel; 5) Rule engine classifier; 6) Notifier engine. This system has implemented in Iran for the first time and we are currently in the testing phase with 10 patients to evaluate the technical performance of our system. The developed expert system generates alerts and instructions based on the patient's data and the notify engine notifies responsible nurses and physicians and sometimes patients. Detailed analysis of those results will be reported in a future report. This study is based on the design of a telemonitoring system for heart failure self-care that intents to overcome the gap that occurs when patients discharge from the hospital and tries to accurate requirement of readmission. A rule set for classifying and resulting automated alerts and patient instructions for heart failure telemonitoring was developed. It also facilitates daily communication among patients and heart failure clinicians so any deterioration in health could be identified immediately.

Performance of cardiopulmonary resuscitation feedback systems in a long-distance train with distributed traction.

PubMed

González-Otero, Digna M; de Gauna, Sofía Ruiz; Ruiz, Jesus; Rivero, Raquel; Gutierrez, J J; Saiz, Purificación; Russell, James K

2018-04-20

Out-of-hospital cardiac arrest is common in public locations, including public transportation sites. Feedback devices are increasingly being used to improve chest-compression quality. However, their performance during public transportation has not been studied yet. To test two CPR feedback devices representative of the current technologies (accelerometer and electromag- netic-field) in a long-distance train. Volunteers applied compressions on a manikin during the train route using both feedback devices. Depth and rate measurements computed by the devices were compared to the gold-standard values. Sixty-four 4-min records were acquired. The accelerometer-based device provided visual help in all experiments. Median absolute errors in depth and rate were 2.4 mm and 1.3 compressions per minute (cpm) during conventional speed, and 2.5 mm and 1.2 cpm during high speed. The electromagnetic-field-based device never provided CPR feedback; alert messages were shown instead. However, measurements were stored in its internal memory. Absolute errors for depth and rate were 2.6 mm and 0.7 cpm during conventional speed, and 2.6 mm and 0.7 cpm during high speed. Both devices were accurate despite the accelerations and the electromagnetic interferences induced by the train. However, the electromagnetic-field-based device would require modifications to avoid excessive alerts impeding feedback.

Health monitoring of offshore structures using wireless sensor network: experimental investigations

NASA Astrophysics Data System (ADS)

Chandrasekaran, Srinivasan; Chitambaram, Thailammai

2016-04-01

This paper presents a detailed methodology of deploying wireless sensor network in offshore structures for structural health monitoring (SHM). Traditional SHM is carried out by visual inspections and wired systems, which are complicated and requires larger installation space to deploy while decommissioning is a tedious process. Wireless sensor networks can enhance the art of health monitoring with deployment of scalable and dense sensor network, which consumes lesser space and lower power consumption. Proposed methodology is mainly focused to determine the status of serviceability of large floating platforms under environmental loads using wireless sensors. Data acquired by the servers will analyze the data for their exceedance with respect to the threshold values. On failure, SHM architecture will trigger an alarm or an early warning in the form of alert messages to alert the engineer-in-charge on board; emergency response plans can then be subsequently activated, which shall minimize the risk involved apart from mitigating economic losses occurring from the accidents. In the present study, wired and wireless sensors are installed in the experimental model and the structural response, acquired is compared. The wireless system comprises of Raspberry pi board, which is programmed to transmit the acquired data to the server using Wi-Fi adapter. Data is then hosted in the webpage for further post-processing, as desired.

A mobile care system with alert mechanism.

PubMed

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

2007-09-01

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

Web-based Tsunami Early Warning System: a case study of the 2010 Kepulaunan Mentawai Earthquake and Tsunami

NASA Astrophysics Data System (ADS)

Ulutas, E.; Inan, A.; Annunziato, A.

2012-06-01

This study analyzes the response of the Global Disasters Alerts and Coordination System (GDACS) in relation to a case study: the Kepulaunan Mentawai earthquake and related tsunami, which occurred on 25 October 2010. The GDACS, developed by the European Commission Joint Research Center, combines existing web-based disaster information management systems with the aim to alert the international community in case of major disasters. The tsunami simulation system is an integral part of the GDACS. In more detail, the study aims to assess the tsunami hazard on the Mentawai and Sumatra coasts: the tsunami heights and arrival times have been estimated employing three propagation models based on the long wave theory. The analysis was performed in three stages: (1) pre-calculated simulations by using the tsunami scenario database for that region, used by the GDACS system to estimate the alert level; (2) near-real-time simulated tsunami forecasts, automatically performed by the GDACS system whenever a new earthquake is detected by the seismological data providers; and (3) post-event tsunami calculations using GCMT (Global Centroid Moment Tensor) fault mechanism solutions proposed by US Geological Survey (USGS) for this event. The GDACS system estimates the alert level based on the first type of calculations and on that basis sends alert messages to its users; the second type of calculations is available within 30-40 min after the notification of the event but does not change the estimated alert level. The third type of calculations is performed to improve the initial estimations and to have a better understanding of the extent of the possible damage. The automatic alert level for the earthquake was given between Green and Orange Alert, which, in the logic of GDACS, means no need or moderate need of international humanitarian assistance; however, the earthquake generated 3 to 9 m tsunami run-up along southwestern coasts of the Pagai Islands where 431 people died. The post-event calculations indicated medium-high humanitarian impacts.

[Effectiveness of an intervention to provide information to patients with hypertension as short text messages and reminders sent to their mobile phone (HTA-Alert)].

PubMed

Márquez Contreras, E; de la Figuera von Wichmann, M; Gil Guillén, V; Ylla-Catalá, A; Figueras, M; Balaña, M; Naval, J

2004-11-15

To analyze the effect of an intervention to provide information with mobile phone text messages to patients with hypertension on compliance with therapy for hypertension. Comparative, controlled, multicenter, randomized cluster study. 26 primary care health centers in Spain. 26 researchers were randomized to a control group or an intervention group (52 patients each, for a total of 104 patients). All patients were receiving monotherapy for uncontrolled hypertension. Patients in the control group received their physician's usual interventions. Patients in the intervention group received messages and reminders sent to their mobile phones 2 days per week during 4 months. Tablets were counted and blood pressure was measured at the start of the study and 1, 3, and 6 months later. The percentage of compliers, mean percentage of compliance and degree of control of hypertension were compared. The reduction in absolute and relative risk was calculated, as was the number of individuals needed to treat to avoid noncompliance. The results were evaluated for a total of 67 individuals (34 in the intervention group and 33 in the control group). The rate of compliance was 85.1% (CI, 74.9%-95.3%) overall, 85.7% (CI, 70.5%-100.9%) in the control group and 84.4% in the intervention group (CI, 70.7%-95.3%) (P=NS). Mean percentage compliance was 90.2%+/-16.3% overall, 88.1%+/-20.8% in the control group and 91.9%+/-11.6% in the intervention group (P=NS). The percentage of patients whose hypertension was controlled at the end of the study was 51.5% (CI, 34.4%-68.6%) in the control group and 64.7% (CI, 48.6%-80.8%) in the intervention group (P=NS). The telephone messaging intervention with alerts and reminders sent to mobile phones did not improve compliance with therapy in patients with hypertension.

CISN Display Progress to Date - Reliable Delivery of Real-Time Earthquake Information, and ShakeMap to Critical End Users

NASA Astrophysics Data System (ADS)

Rico, H.; Hauksson, E.; Thomas, E.; Friberg, P.; Frechette, K.; Given, D.

2003-12-01

The California Integrated Seismic Network (CISN) has collaborated to develop a next-generation earthquake notification system that is nearing its first operations-ready release. The CISN Display actively alerts users of seismic data, and vital earthquake hazards information following a significant event. It will primarily replace the Caltech/USGS Broadcast of Earthquakes (CUBE) and Rapid Earthquake Data Integration (REDI) Display as the principal means of delivering geographical seismic data to emergency operations centers, utility companies and media outlets. A subsequent goal is to provide automated access to the many Web products produced by regional seismic networks after an earthquake. Another aim is to create a highly configurable client, allowing user organizations to overlay infrastructure data critical to their roles as first-responders, or lifeline operators. And the final goal is to integrate these requirements, into a package offering several layers of reliability to ensure delivery of services. Central to the CISN Display's role as a gateway to Web-based earthquake products is its comprehensive XML-messaging schema. The message model uses many of the same attributes in the CUBE format, but extends the old standard by provisioning additional elements for products currently available, and others yet to be considered. The client consumes these XML-messages, sorts them through a resident Quake Data Merge filter, and posts updates that also include hyperlinks associated to specific event IDs on the display map. Earthquake products available for delivery to the CISN Display are ShakeMap, focal mechanisms, waveform data, felt reports, aftershock forecasts and earthquake commentaries. By design the XML-message schema can evolve as products and information needs change, without breaking existing applications that rely on it. The latest version of the CISN Display can also automatically download ShakeMaps and display shaking intensity within the GIS system. This can give Emergency Response managers' information needed to allocate limited personnel and resources after a major event. The shaking intensity shape files may be downloaded out-of-band to the client computer, and with the GIS mapping tool, users can plot organizational assets on the CISN Display map and analyze their inventory against potentially damaged areas. Lastly, in support of a robust design is a well-established and reliable set of communication protocols. To achieve a state-full server connection and messaging via a signaling channel the application uses a Common Object Request Broker Architecture (CORBA). The client responds to keep-alive signals from the server, and alerts users of changes in the connection status. This full-featured messaging service will allow the system to trigger a reconnect strategy whenever the client detects a loss of connectivity. This sets the CISN Display apart from its predecessors, which do not provide a failover mechanism, or a state of connection. Thus by building on past programming successes and advances in proven Internet technologies, the CISN Display will augment the emergency responder's ability to make informed decisions following a potentially damaging earthquake.

Leveraging Service Oriented Architecture to Enhance Information Sharing for Surface Transportation Security

DTIC Science & Technology

2008-09-01

telephone, conference calls, emails, alert notifications, and blackberry . The RDTSF holds conference calls with its stakeholders to provide routine... tunnels ) is monitored by CCTV cameras with live feeds to WMATA’s Operations Control Center (OCC) to detect unauthorized entry into areas not intended for...message by email, blackberry and phone to the Security Coordinators. Dissemination of classified information however, is generally handled through the

Defense in Depth Added to Malicious Activities Simulation Tools (MAST)

DTIC Science & Technology

2015-09-01

cipher suites. The TLS Handshake is a combination of three components: handshake, change cipher spec, and alert. 41 (1) The Handshake ( Hello ) The...TLS Handshake, specifically the “ Hello ” portion, is designed to negotiate session parameters (cipher suite). The client informs the server of the...protocols and standards that it supports and then the server selects the highest common protocols and standards. Specifically, the Client Hello message

PubMed Informer: Monitoring MEDLINE/PubMed through E-mail Alerts, SMS, PDA downloads and RSS feeds

PubMed Central

Muin, Michael; Fontelo, Paul; Ackerman, Michael

2005-01-01

Summary PubMed Informer is a Web-based monitoring tool for topics of interest from MEDLINE/PubMed primarily designed for healthcare professionals. Five tracking methods are available: Web access, e-mail, Short Message Service (SMS), PDA downloads and RSS feeds. PubMed Informer delivers focused search updates and specific information to users with varying information-seeking practices. PMID:16779344

Feedback mechanisms including real-time electronic alerts to achieve near 100% timely prophylactic antibiotic administration in surgical cases.

PubMed

Nair, Bala G; Newman, Shu-Fang; Peterson, Gene N; Wu, Wei-Ying; Schwid, Howard A

2010-11-01

Administration of prophylactic antibiotics during surgery is generally performed by the anesthesia providers. Timely antibiotic administration within the optimal time window before incision is critical for prevention of surgical site infections. However, this often becomes a difficult task for the anesthesia team during the busy part of a case when the patient is being anesthetized. Starting with the implementation of an anesthesia information management system (AIMS), we designed and implemented several feedback mechanisms to improve compliance of proper antibiotic delivery and documentation. This included generating e-mail feedback of missed documentation, distributing monthly summary reports, and generating real-time electronic alerts with a decision support system. In 20,974 surgical cases for the period, June 2008 to January 2010, the interventions of AIMS install, e-mail feedback, summary reports, and real-time alerts changed antibiotic compliance by -1.5%, 2.3%, 4.9%, and 9.3%, respectively, when compared with the baseline value of 90.0% ± 2.9% when paper anesthesia records were used. Highest antibiotic compliance was achieved when using real-time alerts. With real-time alerts, monthly compliance was >99% for every month between June 2009 and January 2010. Installation of AIMS itself did not improve antibiotic compliance over that achieved with paper anesthesia records. However, real-time guidance and reminders through electronic messages generated by a computerized decision support system (Smart Anesthesia Messenger, or SAM) significantly improved compliance. With such a system a consistent compliance of >99% was achieved.

The OGC Sensor Web Enablement framework

NASA Astrophysics Data System (ADS)

Cox, S. J.; Botts, M.

2006-12-01

Sensor observations are at the core of natural sciences. Improvements in data-sharing technologies offer the promise of much greater utilisation of observational data. A key to this is interoperable data standards. The Open Geospatial Consortium's (OGC) Sensor Web Enablement initiative (SWE) is developing open standards for web interfaces for the discovery, exchange and processing of sensor observations, and tasking of sensor systems. The goal is to support the construction of complex sensor applications through real-time composition of service chains from standard components. The framework is based around a suite of standard interfaces, and standard encodings for the message transferred between services. The SWE interfaces include: Sensor Observation Service (SOS)-parameterized observation requests (by observation time, feature of interest, property, sensor); Sensor Planning Service (SPS)-tasking a sensor- system to undertake future observations; Sensor Alert Service (SAS)-subscription to an alert, usually triggered by a sensor result exceeding some value. The interface design generally follows the pattern established in the OGC Web Map Service (WMS) and Web Feature Service (WFS) interfaces, where the interaction between a client and service follows a standard sequence of requests and responses. The first obtains a general description of the service capabilities, followed by obtaining detail required to formulate a data request, and finally a request for a data instance or stream. These may be implemented in a stateless "REST" idiom, or using conventional "web-services" (SOAP) messaging. In a deployed system, the SWE interfaces are supplemented by Catalogue, data (WFS) and portrayal (WMS) services, as well as authentication and rights management. The standard SWE data formats are Observations and Measurements (O&M) which encodes observation metadata and results, Sensor Model Language (SensorML) which describes sensor-systems, Transducer Model Language (TML) which covers low-level data streams, and domain-specific GML Application Schemas for definitions of the target feature types. The SWE framework has been demonstrated in several interoperability testbeds. These were based around emergency management, security, contamination and environmental monitoring scenarios.

Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy

DTIC Science & Technology

2012-03-01

for the consumer at the mo- ment but will soon become a commoditized, basic requirement. For example, as the baby boomers grow older, mobile services...Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy The WEA Project Team March 2012 SPECIAL REPORT CMU/SEI-2012-TR-019 CERT...report presents a taxonomy developed for the Commercial Mobile Alert Service (CMAS). The CMAS Alerting Pipeline Taxonomy is a hierarchical classification

75 FR 72773 - Empowering Consumers to Avoid Bill Shock; Consumer Information and Disclosure

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... require mobile service providers to provide usage alerts and information that will assist consumers in... proposes rules that would require mobile service providers to provide usage alerts, such as voice or text... consumers, including methods such as providing voice or text alerts. In addition, the Commission seeks...

Knowledge Integration and Use-Case Analysis for a Customized Drug-Drug Interaction CDS Service

NASA Astrophysics Data System (ADS)

Kam, Hye Jin; Park, Man Young; Kim, Woojae; Yoon, Duk Yong; Ahn, Eun Kyoung; Park, Rae Woong

Clinical decision support systems (CDSSs) are thought to reduce adverse drug events (ADEs) by monitoring drug-drug interactions(DDIs). However, clinically improper or excessive alerts can result in high alert overrides. A tailored CDS service, which is appropriate for clinicians and their ordering situations, is required to increase alert acceptance. In this study, we conducted a 12-week pilot project adopting a tailed CDSS at an emergency department. The new CDSS was conducted via a stepwise integration of additional new rules. The alert status with changes in acceptance rate was analyzed. The most frequent DDI alerts were related to prescriptions of anti-inflammatory drugs. The percentages of alert overrides for each stage were 98.0%, 96.0%, 96.9%, and 98.1%, respectively. 91.5% of overridden alerts were related to discharge medications. To reduce the potential hazards of ADEs, the development of an effective customized DDI CDSS is required, via in-depth analysis on alert patterns and overridden reasons.

Upgrading the Space Shuttle Caution and Warning System

NASA Technical Reports Server (NTRS)

McCandless, Jeffrey W.; McCann, Robert S.; Hilty, Bruce T.

2005-01-01

A report describes the history and the continuing evolution of an avionic system aboard the space shuttle, denoted the caution and warning system, that generates visual and auditory displays to alert astronauts to malfunctions. The report focuses mainly on planned human-factors-oriented upgrades of an alphanumeric fault-summary display generated by the system. Such upgrades are needed because the display often becomes cluttered with extraneous messages that contribute to the difficulty of diagnosing malfunctions. In the first of two planned upgrades, the fault-summary display will be rebuilt with a more logical task-oriented graphical layout and multiple text fields for malfunction messages. In the second upgrade, information displayed will be changed, such that text fields will indicate only the sources (that is, root causes) of malfunctions; messages that are not operationally useful will no longer appear on the displays. These and other aspects of the upgrades are based on extensive collaboration among astronauts, engineers, and human-factors scientists. The report describes the human-factors principles applied in the upgrades.

Log Analysis Using Splunk Hadoop Connect

DTIC Science & Technology

2017-06-01

running a logging service puts a performance tax on the system and may cause the degradation of performance. More thorough 8 logging will cause a...several nodes. For example, a disk failure would affect all the tasks running on a particular node and generate an alert message not only for the disk...the commands that were executed from the " Run " command. The keylogger installation did not create any registry keys for the program itself. However

75 FR 25842 - Notice of a Grant With the Public Broadcasting Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... development of the Commercial Mobile Alert System (CMAS), a national system to distribute emergency alert...-27 (Feb. 8, 2006) (establishing the National Alert and Tsunami Warning Program); Section 606 of the... requirements to support the distribution of geographically targeted alerts by commercial mobile service...

Breaking Open the Black Box: Isolating the Most Potent Features of a Web and Mobile Phone-Based Intervention for Depression, Anxiety, and Stress.

PubMed

Whitton, Alexis E; Proudfoot, Judith; Clarke, Janine; Birch, Mary-Rose; Parker, Gordon; Manicavasagar, Vijaya; Hadzi-Pavlovic, Dusan

2015-01-01

Internet-delivered mental health (eMental Health) interventions produce treatment effects similar to those observed in face-to-face treatment. However, there is a large degree of variation in treatment effects observed from program to program, and eMental Health interventions remain somewhat of a black box in terms of the mechanisms by which they exert their therapeutic benefit. Trials of eMental Health interventions typically use large sample sizes and therefore provide an ideal context within which to systematically investigate the therapeutic benefit of specific program features. Furthermore, the growth and impact of mobile phone technology within eMental Health interventions provides an opportunity to examine associations between symptom improvement and the use of program features delivered across computer and mobile phone platforms. The objective of this study was to identify the patterns of program usage associated with treatment outcome in a randomized controlled trial (RCT) of a fully automated, mobile phone- and Web-based self-help program, "myCompass", for individuals with mild-to-moderate symptoms of depression, anxiety, and/or stress. The core features of the program include interactive psychotherapy modules, a symptom tracking feature, short motivational messages, symptom tracking reminders, and a diary, with many of these features accessible via both computer and mobile phone. Patterns of program usage were recorded for 231 participants with mild-to-moderate depression, anxiety, and/or stress, and who were randomly allocated to receive access to myCompass for seven weeks during the RCT. Depression, anxiety, stress, and functional impairment were examined at baseline and at eight weeks. Log data indicated that the most commonly used components were the short motivational messages (used by 68.4%, 158/231 of participants) and the symptom tracking feature (used by 61.5%, 142/231 of participants). Further, after controlling for baseline symptom severity, increased use of these alert features was associated with significant improvements in anxiety and functional impairment. Associations between use of symptom tracking reminders and improved treatment outcome remained significant after controlling for frequency of symptom tracking. Although correlations were not statistically significant, reminders received via SMS (ie, text message) were more strongly associated with symptom reduction than were reminders received via email. These findings indicate that alerts may be an especially potent component of eMental Health interventions, both via their association with enhanced program usage, as well as independently. Although there was evidence of a stronger association between symptom improvement and use of alerts via the mobile phone platform, the degree of overlap between use of email and SMS alerts may have precluded identification of alert delivery modalities that were most strongly associated with symptom reduction. Future research using random assignment to computer and mobile delivery is needed to fully determine the most ideal platform for delivery of this and other features of online interventions. Australian New Zealand Clinical Trials Registry (ACTRN): 12610000625077; http://www.anzctr.org.au/TrialSearch.aspx? (Archived by WebCite http://www.webcitation.org/6WPqHK0mQ).

Breaking Open the Black Box: Isolating the Most Potent Features of a Web and Mobile Phone-Based Intervention for Depression, Anxiety, and Stress

PubMed Central

Proudfoot, Judith; Clarke, Janine; Birch, Mary-Rose; Parker, Gordon; Manicavasagar, Vijaya; Hadzi-Pavlovic, Dusan

2015-01-01

Background Internet-delivered mental health (eMental Health) interventions produce treatment effects similar to those observed in face-to-face treatment. However, there is a large degree of variation in treatment effects observed from program to program, and eMental Health interventions remain somewhat of a black box in terms of the mechanisms by which they exert their therapeutic benefit. Trials of eMental Health interventions typically use large sample sizes and therefore provide an ideal context within which to systematically investigate the therapeutic benefit of specific program features. Furthermore, the growth and impact of mobile phone technology within eMental Health interventions provides an opportunity to examine associations between symptom improvement and the use of program features delivered across computer and mobile phone platforms. Objective The objective of this study was to identify the patterns of program usage associated with treatment outcome in a randomized controlled trial (RCT) of a fully automated, mobile phone- and Web-based self-help program, “myCompass”, for individuals with mild-to-moderate symptoms of depression, anxiety, and/or stress. The core features of the program include interactive psychotherapy modules, a symptom tracking feature, short motivational messages, symptom tracking reminders, and a diary, with many of these features accessible via both computer and mobile phone. Methods Patterns of program usage were recorded for 231 participants with mild-to-moderate depression, anxiety, and/or stress, and who were randomly allocated to receive access to myCompass for seven weeks during the RCT. Depression, anxiety, stress, and functional impairment were examined at baseline and at eight weeks. Results Log data indicated that the most commonly used components were the short motivational messages (used by 68.4%, 158/231 of participants) and the symptom tracking feature (used by 61.5%, 142/231 of participants). Further, after controlling for baseline symptom severity, increased use of these alert features was associated with significant improvements in anxiety and functional impairment. Associations between use of symptom tracking reminders and improved treatment outcome remained significant after controlling for frequency of symptom tracking. Although correlations were not statistically significant, reminders received via SMS (ie, text message) were more strongly associated with symptom reduction than were reminders received via email. Conclusions These findings indicate that alerts may be an especially potent component of eMental Health interventions, both via their association with enhanced program usage, as well as independently. Although there was evidence of a stronger association between symptom improvement and use of alerts via the mobile phone platform, the degree of overlap between use of email and SMS alerts may have precluded identification of alert delivery modalities that were most strongly associated with symptom reduction. Future research using random assignment to computer and mobile delivery is needed to fully determine the most ideal platform for delivery of this and other features of online interventions. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12610000625077; http://www.anzctr.org.au/TrialSearch.aspx? (Archived by WebCite http://www.webcitation.org/6WPqHK0mQ). PMID:26543909

Psychologist in a pocket: towards depression screening on mobile phones.

PubMed

Bitsch, Jó Ágila; Ramos, Roann; Ix, Tim; Ferrer-Cheng, Paula Glenda; Wehrle, Klaus

2015-01-01

Depression is the most prevalent clinical disorder and one of the main causes of disability. This makes early detection of depressive symptoms critical in its prevention and management. This paper presents and discusses the development of Psychologist in a Pocket (PiaP), a mental mHealth application for Android which screens and monitors for these symptoms, and-given the explicit permission of the user-alerts a trusted contact such as the mental health professional or a close friend, if it detects symptoms. All text inputted electronically-such as short message services, emails, social network posts-is analyzed based on keywords related to depression based on DSM-5 and ICD criteria as well as Beck's Cognitive Theory of Depression and the Self-Focus Model. Data evaluation and collection happen in the background, on-device, without requiring any user involvement. Currently, the application is in an early prototype phase entering initial clinical validation.

Warning Alert HITL Experiment Results

NASA Technical Reports Server (NTRS)

Monk, Kevin J.; Ferm, Lisa; Roberts, Zach

2018-01-01

Minimum Operational Performance Standards (MOPS) are being developed to support the integration of Unmanned Aircraft Systems (UAS) in the National Airspace (NAS). Input from subject matter experts and multiple research studies have informed display requirements for Detect-and-Avoid (DAA) systems aimed at supporting timely and appropriate pilot responses to collision hazards. Phase 1 DAA MOPS alerting is designed to inform pilots if an avoidance maneuver is necessary; the two highest alert levels - caution and warning - indicate how soon pilot action is required and whether there is adequate time to coordinate with the air traffic controller (ATC). Additional empirical support is needed to clarify the extent to which warning-level alerting impacts DAA task performance. The present study explores the differential effects of the auditory and visual cues provided by the DAA Warning alert, and performance implications compared to caution-only alerting are discussed.

A low-cost wireless system for autonomous generation of road safety alerts

NASA Astrophysics Data System (ADS)

Banks, B.; Harms, T.; Sedigh Sarvestani, S.; Bastianini, F.

2009-03-01

This paper describes an autonomous wireless system that generates road safety alerts, in the form of SMS and email messages, and sends them to motorists subscribed to the service. Drivers who regularly traverse a particular route are the main beneficiaries of the proposed system, which is intended for sparsely populated rural areas, where information available to drivers about road safety, especially bridge conditions, is very limited. At the heart of this system is the SmartBrick, a wireless system for remote structural health monitoring that has been presented in our previous work. Sensors on the SmartBrick network regularly collect data on water level, temperature, strain, and other parameters important to safety of a bridge. This information is stored on the device, and reported to a remote server over the GSM cellular infrastructure. The system generates alerts indicating hazardous road conditions when the data exceeds thresholds that can be remotely changed. The remote server and any number of designated authorities can be notified by email, FTP, and SMS. Drivers can view road conditions and subscribe to SMS and/or email alerts through a web page. The subscription-only form of alert generation has been deliberately selected to mitigate privacy concerns. The proposed system can significantly increase the safety of travel through rural areas. Real-time availability of information to transportation authorities and law enforcement officials facilitates early or proactive reaction to road hazards. Direct notification of drivers further increases the utility of the system in increasing the safety of the traveling public.

Analysis of UAS DAA Alerting in Fast-Time Simulations without DAA Mitigation

NASA Technical Reports Server (NTRS)

Thipphavong, David P.; Santiago, Confesor; Isaacson, Douglas R.; Lee, Seung Man; Park, Chunki; Refai, Mohamad Said; Snow, James

2015-01-01

Realization of the expected proliferation of Unmanned Aircraft System (UAS) operations in the National Airspace System (NAS) depends on the development and validation of performance standards for UAS Detect and Avoid (DAA) Systems. The RTCA Special Committee 228 is charged with leading the development of draft Minimum Operational Performance Standards (MOPS) for UAS DAA Systems. NASA, as a participating member of RTCA SC-228 is committed to supporting the development and validation of draft requirements for DAA alerting system performance. A recent study conducted using NASA's ACES (Airspace Concept Evaluation System) simulation capability begins to address questions surrounding the development of draft MOPS for DAA alerting systems. ACES simulations were conducted to study the performance of alerting systems proposed by the SC-228 DAA Alerting sub-group. Analysis included but was not limited to: 1) correct alert (and timeliness), 2) false alert (and severity and duration), 3) missed alert, and 4) probability of an alert type at the time of loss of well clear. The performance of DAA alerting systems when using intent vs. dead-reckoning for UAS ownship trajectories was also compared. The results will be used by SC-228 to inform decisions about the surveillance standards of UAS DAA systems and future requirements development and validation efforts.

The Impact of Alerting Designs on Air Traffic Controller's Eye Movement Patterns and Situation Awareness.

PubMed

Kearney, Peter; Li, Wen-Chin; Yu, Chung-San; Braithwaite, Graham

2018-06-26

This research investigated controller' situation awareness by comparing COOPANS's acoustic alerts with newly designed semantic alerts. The results demonstrate that ATCOs' visual scan patterns had significant differences between acoustic and semantic designs. ATCOs established different eye movement patterns on fixations number, fixation duration and saccade velocity. Effective decision support systems require human-centred design with effective stimuli to direct ATCO's attention to critical events. It is necessary to provide ATCOs with specific alerting information to reflect the nature of of the critical situation in order to minimize the side-effects of startle and inattentional deafness. Consequently, the design of a semantic alert can significantly reduce ATCOs' response time, therefore providing valuable extra time in a time-limited situation to formulate and execute resolution strategies in critical air safety events. The findings of this research indicate that the context-specified design of semantic alerts could improve ATCO's situational awareness and significantly reduce response time in the event of Short Term Conflict Alert activation which alerts to two aircraft having less than the required lateral or vertical separation.

Nursing, Pharmacy, and Prescriber Knowledge and Perceptions of High-Alert Medications in a Large, Academic Medical Hospital

PubMed Central

Engels, Melanie J.

2015-01-01

Background: High-alert medications pose a greater risk of causing significant harm to patients if used in error. The Joint Commission requires that hospitals define institution-specific high-alert medications and implement processes to ensure safe medication use. Method: Nursing, pharmacy, and prescribers were asked to voluntarily complete a 34-question survey to assess their knowledge, experience, and perceptions regarding high-alert medications in an academic hospital. Results: The majority of respondents identified the organization’s high-alert medications, the consequences of an error involving a high-alert medication, and the reversal agent. Most of the risk-reduction strategies within the institution were viewed as being effective by respondents. Forty-five percent of the respondents utilized a high-alert medication in the previous 24 hours. Only 14.2% had experienced an error with a high-alert medication in the previous 12 months, with 46% being near misses. The survey found the 5 rights for medication administration were not being utilized consistently. Respondents indicated that work experience or hospital orientation is the preferred learning experience for high-alert medications. Conclusions: This study assessed all disciplines involved in the medication use process. Perceptions about high-alert medications differ between disciplines. Ongoing discipline-specific education is required to ensure that individuals accept accountability in the medication use process and to close knowledge gaps on high-alert medications and risk-reduction strategies. PMID:26446747

75 FR 67201 - Flightcrew Alerting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

... airplanes concerning flightcrew alerting. These standards update definitions, prioritization, color... addressed regulations regarding definitions, prioritization, color requirements, and performance for... proposal: Reserving and limiting the use of alerting colors red, amber, or yellow on the flight deck...

Executable Architectures for Modeling Command and Control Processes

DTIC Science & Technology

2006-06-01

of introducing new NCES capabilities (such as the Federated Search ) to the ‘To Be’ model. 2 Table of Contents 1 INTRODUCTION...Conventional Method for SME Discovery ToBe.JCAS.3.2 Send Alert and/or Request OR AND ToBe.JCAS.3.4 Employ Federated Search for CAS-related Info JCAS.1.3.6.13...instant messaging, web browser, etc. • Federated Search – this capability provides a way to search enterprise contents across various search-enabled

An Obstacle Alerting System for Agricultural Application

NASA Technical Reports Server (NTRS)

DeMaio, Joe

2003-01-01

Wire strikes are a significant cause of helicopter accidents. The aircraft most at risk are aerial applicators. The present study examines the effectiveness of a wire alert delivered by way of the lightbar, a GPS-based guidance system for aerial application. The alert lead-time needed to avoid an invisible wire is compared with that to avoid a visible wire. A flight simulator was configured to simulate an agricultural application helicopter. Two pilots flew simulated spray runs in fields with visible wires, invisible wires, and no wires. The wire alert was effective in reducing wire strikes. A lead-time of 3.5 sec was required for the alert to be effective. The lead- time required was the same whether the pilot could see the wire or not.

Racial Socialization, Private Regard, and Behavior Problems in African American Youth: Global Self-Esteem as a Mediator

PubMed Central

Davis, BreAnna L.; Smith-Bynum, Mia A.; Saleem, Farzana T.; Francois, Tiffany; Lambert, Sharon F.

2017-01-01

Racial socialization messages appear to have varying impacts on the adjustment of African American youth. To further explore this, we examined how two types of racial socialization messages might influence African American youth internalizing and externalizing behavior. The Youth Self Report was used to measure these behavior outcomes. Given that racial socialization messages may not be directly linked to behavior outcomes, we considered private regard, an aspect of racial identity, to serve as a mediator. Additionally, we examined global self-esteem as a mediator of the complex dynamic between racial socialization messages and behavior outcomes. Adolescents in our study completed paper assessments. Majority of the participants were female (56 %) and reside in a metropolitan area in the Mid-Atlantic region. Adolescent’s ages ranged from 14 to 17 years with the average age being 15 years old. Path analysis revealed cultural pride and alertness to discrimination messages varied in their relation to private regard. Results also indicated a strong linkage between private regard, global self-esteem, and internalizing behaviors. Interestingly, the linkage between private regard, global self-esteem and externalizing behaviors was not as robust. Further, private regard appeared to directly and indirectly impact externalizing behaviors. The implications of these findings for racial socialization strategies, identity development (racial and global) as it pertains to behavior problems for African American adolescents are discussed. PMID:28546737

Timely Follow-Up of Abnormal Diagnostic Imaging Test Results in an Outpatient Setting: Are Electronic Medical Records Achieving Their Potential?

PubMed Central

Singh, Hardeep; Thomas, Eric J.; Mani, Shrinidi; Sittig, Dean; Arora, Harvinder; Espadas, Donna; Khan, Myrna M.; Petersen, Laura A.

2010-01-01

Background Given the fragmentation of outpatient care, timely follow-up of abnormal diagnostic test results remains a challenge. We hypothesized that an EMR that facilitates the transmission and availability of critical imaging results through either automated notification (alerting) or direct access to the primary report would eliminate this problem. Methods We studied critical imaging alert notifications in the outpatient setting of a tertiary care VA facility from November 2007 to June 2008. Tracking software determined whether the alert was acknowledged (i.e. provider opened the message for viewing) within two weeks of transmission; acknowledged alerts were considered read. We reviewed medical records and contacted providers to determine timely follow-up actions (e.g. ordering a follow-up test or consultation) within 4 weeks of transmission. Multivariable logistic regression models accounting for clustering effect by providers analyzed predictors for two outcomes; lack of acknowledgment and lack of timely follow-up. Results Of 123,638 studies (including X-rays, CT scans, ultrasounds, MRI and mammography), 1196 (0.97%) images generated alerts; 217 (18.1%) of these were unacknowledged. Alerts had a higher risk of being unacknowledged when ordering providers were trainees (OR, 5.58;95%CI, 2.86-10.89) and when dual (more than one provider alerted) as opposed to single communication was used (OR, 2.02;95%CI, 1.22-3.36). Timely follow-up was lacking in 92 (7.7% of all alerts) and was similar for acknowledged and unacknowledged alerts (7.3% vs. 9.7%;p=0.2). Risk for lack of timely follow-up was higher with dual communication (OR,1.99;95%CI, 1.06-3.48) but lower when additional verbal communication was used by the radiologist (OR, 0.12;95%CI: 0.04-0.38). Nearly all abnormal results lacking timely follow-up at 4 weeks were eventually found to have measurable clinical impact in terms of further diagnostic testing or treatment. Conclusions Critical imaging results may not receive timely follow-up actions even when providers receive and read results in an advanced, integrated EMR system. A multidisciplinary approach is needed to improve patient safety in this area. PMID:19786677

Disentangling the Lexicons of Disaster Response in Twitter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hodas, Nathan O.; Ver Steeg, Greg; Harrison, Joshua J.

Abstract: People around the world use social media platforms such as Twitter heavily to express their opinion about various as- pects of daily life. In the same way social media changes communication in daily life, it also is transforming the way individuals communicate during disasters and emergencies. Emergency officials have come to rely on social media to communicate alerts and updates. How do users communi- cate risk on social media? We used a novel information- theoretic unsupervised learning tool, CorEx, to extract and classify highly relevant words used by the public on Twit- ter during known emergencies, such as fires,more » explosions, and hurricanes. By utilizing the resulting classification strategy, authorities can use the derived language to craft more rel- evant risk communication to maximize the effectiveness of short-message broadcasts such as the Wireless Emergency Alerts (WEA) service.« less

Flight crew interface aspects of forward-looking airborne windshear detection systems

NASA Technical Reports Server (NTRS)

Anderson, Charles D.; Carbaugh, David C.

1993-01-01

The goal of this research effort was to conduct analyses and research which could provide guidelines for design of the crew interface of an integrated windshear system. Addressed were HF issues, crew/system requirements, candidate display formats, alerting criteria, and crew procedures. A survey identified five flight management issues as top priority: missed alert acceptability; avoidance distance needed; false alert acceptability; nuisance rate acceptability; and crew procedures. Results of a simulation study indicated that the warning time for a look-ahead alert needs to be between 11 and 36 seconds (target of 23 seconds) before the reactive system triggers in order to be effective. Pilots considered the standard go-around maneuver most appropriate for look-ahead alerts, and the escape maneuvers used did not require lateral turns. Prototype display formats were reviewed or developed for alerting the crew; providing guidance to avoid or escape windshear; and status displays to provide windshear situational awareness. The three alerting levels now in use were considered appropriate, with a fourth (time-critical) level as a possible addition, although many reviewers felt only two levels of alerting were needed. Another survey gathered expert opinion on what crew procedures and alerting criteria should be used for look-ahead, or integrated, windshear systems, with a wide diversity of opinion in these areas.

The Seismic Alert System of Mexico (SASMEX): Performance and Evolution

NASA Astrophysics Data System (ADS)

Espinosa Aranda, J.

2013-05-01

Originally the Seismic Alert System of Mexico (SASMEX) was proposed to integrate the Seismic Alert System of Mexico City (SAS), operating since 1991, with the Seismic Alert System of Oaxaca City (SASO), in services since 2003. And today, after the intense big earthquake activity observed in our world during 2010 and 2011, local governments of Mexico City, Oaxaca Estate, and the Mexican Ministry of the Interior have been promoting the expansion of this technological EEW development. Until 2012 SASMEX better coverage includes 48 new field seismic sensors (FS) deployed over the seismic region of Jalisco, Colima, Michoacan and Puebla, with someone enhancements over Guerrero and Oaxaca, to reach 97 FS. During 2013, 35 new FS has been proposed to SASMEX enhancements covering the Chiapas and Veracruz seismic regions. The SASMEX, with the support of the Mexico Valley Broadcasters Association (ARVM) since 1993, automatically issue Public and Preventive earthquake early warning signals in the Cities of Mexico, Toluca, Acapulco, Chilpancingo, and Oaxaca. The seismic warning range in each case is seated in accordance with local Civil Protection Authorities: Public Alert, if they expect strong earthquake effects, and Preventive Alert one, the effect could be moderated. Now the SASMEX warning time opportunity could be different to the 60 sec. average typically generated when SAS warned earthquake effects coming from Guerrero to Mexico City valley. Mexican EEW issued today reach: 16 Public and 62 Preventive Alert in Mexico City; 25 Public and 19 Preventive Alerts in Oaxaca City; also 14 Public and 4 Preventive Alerts in Acapulco; 14 Public and 5 Preventive Alerts in Chilpancingo. The earthquakes events registered by SASMEX FS until now reach 3448. With the support of private and Federal telecommunications infrastructure like, TELMEX, Federal Electric Commission, and the Mexican Security Ministry, it was developed a redundant communication system with pads to link the different Cities, trough VHF and UHF radio signals, Fiber Optics, and Satellite technologies, to reach more reliability and availability SASMEX functions and services. To increase the seismic early warning efficiency the Mexico City Historical Center Authorities, promoted the installation of the NOAA VHF radio transmitters system to cover the Mexico City valley, operating with the Specific Area Message Encoding (SAME) called NWR-SAME, and with the Emergency Alert Systems (EAS) protocol of United States. As an enhancement of the NOAA receiver protocol, it was innovated to permit fast Public Alert issue, in no more than 2 sec. The new receiver applied in Mexico is called SARMEX™. Local and federal authorities acquired 90,000 SARMEX™ receivers to be distributed manly in public schools of Mexican cities covered by the SASMEX™ signals; the measure with the aim to promote better natural hazard prevention attitude in the Mexican young population segment.

Airborne Data Link Operational Evaluation Test Plan

DTIC Science & Technology

1993-08-01

be provided by a combination of glare shield mounted, blue lens , aviation-type lamps and lighted distinctive message indicators on the CDUs or CDU...consist of either SELCAL sound only or SELCAL tone combined with forward primary field of view visual alerting (a blue light mounted on the glare shield in...INCORPORATED DOT/FAA/CT-TN93/30 9. Pe’form,"g Orgaoniatio Name end Address 10. Work Unit No. (TRAIS) CTA, INCORPORATED Suite 1000 11 Contac of Great me. 2500

Market study: Tactile paging system

NASA Technical Reports Server (NTRS)

1977-01-01

A market survey was conducted regarding the commercialization potential and key market factors relevant to a tactile paging system for deaf-blind people. The purpose of the tactile paging system is to communicate to the deaf-blind people in an institutional environment. The system consists of a main console and individual satellite wrist units. The console emits three signals by telemetry to the wrist com (receiving unit) which will measure approximately 2 x 4 x 3/4 inches and will be fastened to the wrist by a strap. The three vibration signals are fire alarm, time period indication, and a third signal which will alert the wearer of the wrist com to the fact that the pin on the top of the wrist is emitting a morse coded message. The Morse code message can be felt and recognized with the finger.

Sick Note to Fit Note: one trust’s project to improve usage by hospital clinicians

PubMed Central

Moran, Amy; Mainwaring, Cathryn; Keane, Oliver; Sanctuary, Thomas; Watson, Kathryn; Lasoye, Tunji

2018-01-01

Introduction In April 2010, the government introduced a new Statement of Fitness to Work or ’Fit Note' for patients requiring time off of work or adaptations to their work due to illness. Responsibility to issue these documents has shifted from primary to secondary care. Hospital clinicians are required to issue for inpatients and for outpatients where clinical responsibility has not been taken over by the general practitioner (GP). However, awareness of this change is lacking. Misdirecting patients to their GP for the sole purpose of receiving a ’Fit Note' is an unnecessary use of appointment time and negatively impacts on patients. King’s College Hospital NHS Trust receives a number of quality alerts from primary care regarding this issue. Methods A trust-wide educational initiative was designed and implemented to increase staff awareness of Fit Notes and their correct usage in order to reduce the number of patients being misdirected to their GP to obtain one. Interventions included direct staff engagement, a trust-wide promotional campaign and creation of an electronic version of the document. Results Uptake of the electronic version of the Fit Note has steadily increased and there has been a fall in the number of quality alerts received by the trust. However, staff awareness on the whole remains low. Conclusions Patients being misdirected to their general practice for Fit Notes is an important issue and one on which the baseline level of awareness among hospital clinicians is low. Challenges during this intervention have been in penetrating a trust of this size and getting the message across to staff. However, digitising the Fit Note can help to increase its use. PMID:29333499

Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.

PubMed

Caputo, Maria Luce; Muschietti, Sandro; Burkart, Roman; Benvenuti, Claudio; Conte, Giulio; Regoli, François; Mauri, Romano; Klersy, Catherine; Moccetti, Tiziano; Auricchio, Angelo

2017-05-01

We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP). The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander's call, the EMS dispatcher sends one ambulance and alerts the first-responders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called "traditional" first responders, and - if the scene was considered safe - lay responders as well. We evaluated the time from call to arrival of traditional first responders and/or lay responders when alerted either via SMS or the new developed mobile APP. Over the study period 593 OHCAs have occurred. Notification to the first responders network was sent via SMS in 198 cases and via mobile APP in 134 cases. Median time to first responder/lay responder arrival on scene was significantly reduced by the APP-based system (3.5 [2.8-5.2]) compared to the SMS-based system (5.6 [4.2-8.5] min, p 0.0001). The proportion of lay responders arriving first on the scene significantly increased (70% vs. 15%, p<0.01) with the APP. Earlier arrival of a first responder or of a lay responder determined a higher survival rate. The mobile APP system is highly efficient in the recruitment of first responders, significantly reducing the time to the initiation of CPR thus increasing survival rates. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

NAS-Wide Fast-Time Simulation Study for Evaluating Performance of UAS Detect-and-Avoid Alerting and Guidance Systems

NASA Technical Reports Server (NTRS)

Lee, Seung Man; Park, Chunki; Cone, Andrew Clayton; Thipphavong, David P.; Santiago, Confesor

2016-01-01

This presentation contains the analysis results of NAS-wide fast-time simulations with UAS and VFR traffic for a single day for evaluating the performance of Detect-and-Avoid (DAA) alerting and guidance systems. This purpose of this study was to help refine and validate MOPS alerting and guidance requirements. In this study, we generated plots of all performance metrics that are specified by RTCA SC-228 Minimum Operational Performance Standards (MOPS): 1) to evaluate the sensitivity of alerting parameters on the performance metrics of each DAA alert type: Preventive, Corrective, and Warning alerts and 2) to evaluate the effect of sensor uncertainty on DAA alerting and guidance performance.

Early testimonial learning: monitoring speech acts and speakers.

PubMed

Stephens, Elizabeth; Suarez, Sarah; Koenig, Melissa

2015-01-01

Testimony provides children with a rich source of knowledge about the world and the people in it. However, testimony is not guaranteed to be veridical, and speakers vary greatly in both knowledge and intent. In this chapter, we argue that children encounter two primary types of conflicts when learning from speakers: conflicts of knowledge and conflicts of interest. We review recent research on children's selective trust in testimony and propose two distinct mechanisms supporting early epistemic vigilance in response to the conflicts associated with speakers. The first section of the chapter focuses on the mechanism of coherence checking, which occurs during the process of message comprehension and facilitates children's comparison of information communicated through testimony to their prior knowledge, alerting them to inaccurate, inconsistent, irrational, and implausible messages. The second section focuses on source-monitoring processes. When children lack relevant prior knowledge with which to evaluate testimonial messages, they monitor speakers themselves for evidence of competence and morality, attending to cues such as confidence, consensus, access to information, prosocial and antisocial behavior, and group membership. © 2015 Elsevier Inc. All rights reserved.

Does wearable device bring distraction closer to drivers? Comparing smartphones and Google Glass.

PubMed

He, Jibo; McCarley, Jason S; Crager, Kirsten; Jadliwala, Murtuza; Hua, Lesheng; Huang, Sheng

2018-07-01

Head-up and wearable displays, such as Google Glass™, are sometimes marketed as safe in-vehicle alternatives to phone-based displays, as they allow drivers to receive messages without eye-off-the-road glances. However, head-up displays can still compromise driver performance (e.g., He et al., 2015b), as the distracting effect of interacting with any device will depend on the user's multitasking strategies. The present experiment examined drivers' interaction with a head-down smartphone display and a wearable head-up display. Participants performed a simulated driving task while receiving and responding to text messages via smartphone or the head-mounted display (HMD) on the Google Glass™. Incoming messages were signaled by an auditory alert, and responses were made vocally. When using Google Glass, participants' responses were quicker than that of smartphone, and the time to engage in a task did not vary according to lane-keeping difficulty. Results suggest that a willingness to engage more readily in distracting tasks may offset the potential safety benefits of wearable devices. Copyright © 2018 Elsevier Ltd. All rights reserved.

Products and Services Notice - Naval Oceanography Portal

Science.gov Websites

Tropical Cyclone Formation Alert, Northwest Pacific Ocean Issued as required when tropical cyclone PGTW Tropical Cyclone Formation Alert, North Indian Ocean Issued as required when TC formation is , Southwest Pacific Ocean Issued as required when TC formation is expected in 12-24 hours WTPS31-35 PGTW

Active Disaster Response System for a Smart Building

PubMed Central

Lin, Chun-Yen; Chu, Edward T.-H; Ku, Lun-Wei; Liu, Jane W. S.

2014-01-01

Disaster warning and surveillance systems have been widely applied to help the public be aware of an emergency. However, existing warning systems are unable to cooperate with household appliances or embedded controllers; that is, they cannot provide enough time for preparedness and evacuation, especially for disasters like earthquakes. In addition, the existing warning and surveillance systems are not responsible for collecting sufficient information inside a building for relief workers to conduct a proper rescue action after a disaster happens. In this paper, we describe the design and implementation of a proof of concept prototype, named the active disaster response system (ADRS), which automatically performs emergency tasks when an earthquake happens. ADRS can interpret Common Alerting Protocol (CAP) messages, published by an official agency, and actuate embedded controllers to perform emergency tasks to respond to the alerts. Examples of emergency tasks include opening doors and windows and cutting off power lines and gas valves. In addition, ADRS can maintain a temporary network by utilizing the embedded controllers; hence, victims trapped inside a building are still able to post emergency messages if the original network is disconnected. We conducted a field trial to evaluate the effectiveness of ADRS after an earthquake happened. Our results show that compared to manually operating emergency tasks, ADRS can reduce the operation time by up to 15 s, which is long enough for people to get under sturdy furniture, or to evacuate from the third floor to the first floor, or to run more than 100 m. PMID:25237897

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

78 FR 66252 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... actions are intended to alert pilots to avoid certain engine speeds during steady- state operations...%. The proposed requirements were intended to alert pilots to avoid certain engine speeds during steady... the RFMs, advising pilots of the change, and installing a decal as described in Bell Alert Service...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2013 CFR

2013-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2014 CFR

2014-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2011 CFR

2011-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2010 CFR

2010-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

47 CFR 80.334 - False distress alerts.

Code of Federal Regulations, 2012 CFR

2012-10-01

....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

CISN Display - Reliable Delivery of Real-time Earthquake Information, Including Rapid Notification and ShakeMap to Critical End Users

NASA Astrophysics Data System (ADS)

Rico, H.; Hauksson, E.; Thomas, E.; Friberg, P.; Given, D.

2002-12-01

The California Integrated Seismic Network (CISN) Display is part of a Web-enabled earthquake notification system alerting users in near real-time of seismicity, and also valuable geophysical information following a large earthquake. It will replace the Caltech/USGS Broadcast of Earthquakes (CUBE) and Rapid Earthquake Data Integration (REDI) Display as the principal means of delivering graphical earthquake information to users at emergency operations centers, and other organizations. Features distinguishing the CISN Display from other GUI tools are a state-full client/server relationship, a scalable message format supporting automated hyperlink creation, and a configurable platform-independent client with a GIS mapping tool; supporting the decision-making activities of critical users. The CISN Display is the front-end of a client/server architecture known as the QuakeWatch system. It is comprised of the CISN Display (and other potential clients), message queues, server, server "feeder" modules, and messaging middleware, schema and generators. It is written in Java, making it platform-independent, and offering the latest in Internet technologies. QuakeWatch's object-oriented design allows components to be easily upgraded through a well-defined set of application programming interfaces (APIs). Central to the CISN Display's role as a gateway to other earthquake products is its comprehensive XML-schema. The message model starts with the CUBE message format, but extends it by provisioning additional attributes for currently available products, and those yet to be considered. The supporting metadata in the XML-message provides the data necessary for the client to create a hyperlink and associate it with a unique event ID. Earthquake products deliverable to the CISN Display are ShakeMap, Ground Displacement, Focal Mechanisms, Rapid Notifications, OES Reports, and Earthquake Commentaries. Leveraging the power of the XML-format, the CISN Display provides prompt access to earthquake information on the Web. The links are automatically created when product generators deliver CUBE formatted packets to a Quake Data Distribution System (QDDS) hub (new distribution methods may be used later). The "feeder" modules tap into the QDDS hub and convert the packets into XML-messages. These messages are forwarded to message queues, and then distributed to clients where URLs are dynamically created for these products and linked to events on the CISN Display map. The products may be downloaded out-of-band; and with the inclusion of a GIS mapping tool users can plot organizational assets on the CISN Display map and overlay them against key spectral data, such as ground accelerations. This gives Emergency Response Managers information useful in allocating limited personnel and resources after a major event. At the heart of the system's robustness is a well-established and reliable set of communication protocols for best-effort delivery of data. For critical users a Common Object Request Broker Architecture (CORBA) state-full connection is used via a dedicated signaling channel. The system employs several CORBA methods that alert users of changes in the link status. Loss of connectivity triggers a strategy that attempts to reconnect through various physical and logical paths. Thus, by building on past application successes and proven Internet advances the CISN Display targets a specific audience by providing enhancements previously not available from other applications.

47 CFR 11.51 - EAS code and Attention Signal Transmission requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Message (EOM) codes using the EAS Protocol. The Attention Signal must precede any emergency audio message... audio messages. No Attention Signal is required for EAS messages that do not contain audio programming... EAS messages in the main audio channel. All DAB stations shall also transmit EAS messages on all audio...

47 CFR 11.51 - EAS code and Attention Signal Transmission requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Message (EOM) codes using the EAS Protocol. The Attention Signal must precede any emergency audio message... audio messages. No Attention Signal is required for EAS messages that do not contain audio programming... EAS messages in the main audio channel. All DAB stations shall also transmit EAS messages on all audio...

47 CFR 11.51 - EAS code and Attention Signal Transmission requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Message (EOM) codes using the EAS Protocol. The Attention Signal must precede any emergency audio message... audio messages. No Attention Signal is required for EAS messages that do not contain audio programming... EAS messages in the main audio channel. All DAB stations shall also transmit EAS messages on all audio...

Public Release of Estimated Impact-Based Earthquake Alerts - An Update to the U.S. Geological Survey PAGER System

NASA Astrophysics Data System (ADS)

Wald, D. J.; Jaiswal, K. S.; Marano, K.; Hearne, M.; Earle, P. S.; So, E.; Garcia, D.; Hayes, G. P.; Mathias, S.; Applegate, D.; Bausch, D.

2010-12-01

The U.S. Geological Survey (USGS) has begun publicly releasing earthquake alerts for significant earthquakes around the globe based on estimates of potential casualties and economic losses. These estimates should significantly enhance the utility of the USGS Prompt Assessment of Global Earthquakes for Response (PAGER) system that has been providing estimated ShakeMaps and computing population exposures to specific shaking intensities since 2007. Quantifying earthquake impacts and communicating loss estimates (and their uncertainties) to the public has been the culmination of several important new and evolving components of the system. First, the operational PAGER system now relies on empirically-based loss models that account for estimated shaking hazard, population exposure, and employ country-specific fatality and economic loss functions derived using analyses of losses due to recent and past earthquakes. In some countries, our empirical loss models are informed in part by PAGER’s semi-empirical and analytical loss models, and building exposure and vulnerability data sets, all of which are being developed in parallel to the empirical approach. Second, human and economic loss information is now portrayed as a supplement to existing intensity/exposure content on both PAGER summary alert (available via cell phone/email) messages and web pages. Loss calculations also include estimates of the economic impact with respect to the country’s gross domestic product. Third, in order to facilitate rapid and appropriate earthquake responses based on our probable loss estimates, in early 2010 we proposed a four-level Earthquake Impact Scale (EIS). Instead of simply issuing median estimates for losses—which can be easily misunderstood and misused—this scale provides ranges of losses from which potential responders can gauge expected overall impact from strong shaking. EIS is based on two complementary criteria: the estimated cost of damage, which is most suitable for U.S. domestic events; and estimated ranges of fatalities, which are generally more appropriate for global events, particularly in earthquake-vulnerable countries. Alert levels are characterized by alerts of green (little or no impact), yellow (regional impact and response), orange (national-scale impact and response), and red (international response). Corresponding fatality thresholds for yellow, orange, and red alert levels are 1, 100, and 1000, respectively. For damage impact, yellow, orange, and red thresholds are triggered when estimated US dollar losses reach 1 million, 100 million, and 1 billion+ levels, respectively. Finally, alerting protocols now explicitly support EIS-based alerts. Critical users can receive PAGER alerts i) based on the EIS-based alert level, in addition to or as an alternative to magnitude and population/intensity exposure-based alerts, and ii) optionally, based on user-selected regions of the world. The essence of PAGER’s impact-based alerting is that actionable loss information is now available in the immediate aftermath of significant earthquakes worldwide based on quantifiable, albeit uncertain, loss estimates provided by the USGS.

Alert Triage v 0.1 beta

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doak, Justin E.; Ingram, Joe; Johnson, Josh

2016-01-06

In the cyber security operations of a typical organization, data from multiple sources are monitored, and when certain conditions in the data are met, an alert is generated in an alert management system. Analysts inspect these alerts to decide if any deserve promotion to an event requiring further scrutiny. This triage process is manual, time-consuming, and detracts from the in-depth investigation of events. We have created a software system that uses supervised machine learning to automatically prioritize these alerts. In particular we utilize active learning to make efficient use of the pool of unlabeled alerts, thereby improving the performance ofmore » our ranking models over passive learning. We have demonstrated the effectiveness of our system on a large, real-world dataset of cyber security alerts.« less

Flood warnings in coastal areas: how do social and behavioural patterns influence alert services?

NASA Astrophysics Data System (ADS)

Pescaroli, G.; Magni, M.

2015-01-01

Many studies discuss the economic and technical aspects of flood warnings. Less attention has been given to the social and psychological patterns that affect alert services. In particular, the literature focuses on warnings activated in river basins or marine environments without providing clear evidence of relevance to Mediterranean coastal areas, even though these are subjected to growing flood risk related to climate change. This paper is a first attempt to bridge this gap. Our research develops an in- depth analysis of the village of Cesenatico on the Adriatic Sea coast. Here the municipality adopted two complementary warning systems: a siren and an alert via Short Message Service (SMS). The analysis focuses on a survey conducted in 2011 and 2012 with 228 participants. The relationships between social and behavioural variables and warning services are investigated, and so are flood preparedness and information dissemination. Qualitative evidence from informal interviews is used to support the understanding of key responses. The conclusions show how different social and behavioural patterns can influence the effectiveness and use of warning systems, regardless of the technology adopted and the structural mitigation measures implemented. Education, training and accountability are seen to be critical elements for improvement. Finally, the statistical output is used to suggest new questions and new directions for research.

Flood warnings in coastal areas: how do experience and information influence responses to alert services?

NASA Astrophysics Data System (ADS)

Pescaroli, G.; Magni, M.

2015-04-01

Many studies discuss the economic and technical aspects of flood warnings. Less attention has been given to the social and behavioural patterns that affect alert services. In particular, the literature focuses on warnings activated in river basins or marine environments without providing clear evidence on Mediterranean coastal areas, even though these are subjected to growing flood risk related to climate change. This paper is a first attempt to bridge this gap. Our research develops an in-depth analysis of the village of Cesenatico on the Adriatic Sea coast. Here the municipality adopted two complementary warning systems: a siren and an alert via short message service (SMS). The analysis focuses on a survey conducted in 2011 and 2012 with 228 participants. The relationships between social and behavioural variables and warning services are investigated as well as flood preparedness and information dissemination. Qualitative evidence from informal interviews is used to support the understanding of key responses. The conclusions show how different social and behavioural patterns can influence the effectiveness and use of warning systems, regardless of the technology adopted and the structural mitigation measures implemented. Education, training and accountability are seen to be critical elements for implementation. Finally, the statistical output is used to suggest new questions and new directions for research.

Clinical Decision Support Alert Appropriateness: A Review and Proposal for Improvement

PubMed Central

McCoy, Allison B.; Thomas, Eric J.; Krousel-Wood, Marie; Sittig, Dean F.

2014-01-01

Background Many healthcare providers are adopting clinical decision support (CDS) systems to improve patient safety and meet meaningful use requirements. Computerized alerts that prompt clinicians about drug-allergy, drug-drug, and drug-disease warnings or provide dosing guidance are most commonly implemented. Alert overrides, which occur when clinicians do not follow the guidance presented by the alert, can hinder improved patient outcomes. Methods We present a review of CDS alerts and describe a proposal to develop novel methods for evaluating and improving CDS alerts that builds upon traditional informatics approaches. Our proposal incorporates previously described models for predicting alert overrides that utilize retrospective chart review to determine which alerts are clinically relevant and which overrides are justifiable. Results Despite increasing implementations of CDS alerts, detailed evaluations rarely occur because of the extensive labor involved in manual chart reviews to determine alert and response appropriateness. Further, most studies have solely evaluated alert overrides that are appropriate or justifiable. Our proposal expands the use of web-based monitoring tools with an interactive dashboard for evaluating CDS alert and response appropriateness that incorporates the predictive models. The dashboard provides 2 views, an alert detail view and a patient detail view, to provide a full history of alerts and help put the patient's events in context. Conclusion The proposed research introduces several innovations to address the challenges and gaps in alert evaluations. This research can transform alert evaluation processes across healthcare settings, leading to improved CDS, reduced alert fatigue, and increased patient safety. PMID:24940129

78 FR 65202 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... engine speeds during steady-state operations. These actions are intended to alert pilots to avoid certain... operation between speeds of 71% and 92%. The proposed requirements were intended to alert pilots to avoid... amending the RFM, advising pilots of the change, and installing a decal as described in Bell Alert Service...

78 FR 65200 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... vibrations at certain engine speeds during steady- state operations. These actions are intended to alert... proposed requirements were intended to alert pilots to avoid certain engine speeds during steady-state... the change, and installing a decal as described in Bell Alert Service Bulletin (ASB) No. 407-05-67...

A Simple and Low-Cost Monitoring System to Investigate Environmental Conditions in a Biological Research Laboratory.

PubMed

Gurdita, Akshay; Vovko, Heather; Ungrin, Mark

2016-01-01

Basic equipment such as incubation and refrigeration systems plays a critical role in nearly all aspects of the traditional biological research laboratory. Their proper functioning is therefore essential to ensure reliable and repeatable experimental results. Despite this fact, in many academic laboratories little attention is paid to validating and monitoring their function, primarily due to the cost and/or technical complexity of available commercial solutions. We have therefore developed a simple and low-cost monitoring system that combines a "Raspberry Pi" single-board computer with USB-connected sensor interfaces to track and log parameters such as temperature and pressure, and send email alert messages as appropriate. The system is controlled by open-source software, and we have also generated scripts to automate software setup so that no background in programming is required to install and use it. We have applied it to investigate the behaviour of our own equipment, and present here the results along with the details of the monitoring system used to obtain them.

AN ELECTRONIC PRESCRIPTION ALERTING SYSTEM-IMPROVING THE DISCHARGE MEDICINES PROCESS.

PubMed

Bevan, Amanda; Patel, Niesh

2016-09-01

Whilst the prescribing of both in-patient and discharge medicines is electronic, there was no automatic notification to clinical pharmacists when a discharge prescription was ready to be screened. The notification required a member of medical or nursing staff to bleep their pharmacist informing them of a prescription's availability. This manual process led to a delay in pharmacist screening which impacted on discharge. Prescriptions designated for pre-packed or patient's own medicine use were not seen at all by a clinical pharmacist. The initial intention was to develop a text messaging service; however this was not possible due to significant cost implications and its inflexibility. To decrease the time to clinical pharmacist screening for children's discharge prescriptions. A clinical pharmacist prescription alerting system was designed and implemented. The hospital's eDischarge Summaries are created and stored in the Trust's EPR database. A database query is executed that examines documents that have been signed by a prescriber which contain drug orders. The query runs every 15 minutes, Monday to Friday from 0800-2000. The database query exports a HTML data extract which is then packaged and sent using Exchange.Email was preferred as users access hospital WiFi, only receiving notifications on those laptops or smartphones connected to the Trust's email application. The HTML is embedded within the email body. The email is sent to named individuals within a given distribution list. The function is scalable to support all areas using Trust eDischarge Summaries.The system was introduced in April 2015. Data from before (June 2014-January 2015) and after (June 2015) implementation was compared. Prior to the introduction of an electronic alerting system the average time from a prescriber signing a prescription to clinical pharmacist screening was 93 minutes. Three months after starting the new system this time has reduced to 62 minutes, a reduction of 31 minutes or 33%. During the same time period, the number of discharge prescriptions screened by pharmacists rose from 172 to 218, an increase in workload of 26%.It has been possible to intervene on prescriptions containing errors which the clinical pharmacists would not previously have screened. The use of an electronic messaging system has met its primary aim to decrease the time delay from signing to pharmacist screening it has also increased pharmacist efficiency as evidenced by the increased workload.One limitation of this system is that it requires a regular e-mail check, for available prescriptions. The report runs every 15 minutes, an email is only sent if a prescription is found.The notification of all discharge prescriptions containing medicines has led to the identification of errors which have required intervention, in those prescriptions that a pharmacist would not have previously seen. These interventions have been for children who have received pre-packed antibiotics directly from the wards or for those where we have provided one-stop dispensing.It is hoped to role out this system across other areas of the organisation which should also enjoy this significant improvement in discharge prescription turnaround. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The NAS Alert System: A look at the first eight years

USGS Publications Warehouse

Fuller, Pamela L.; Neilson, Matt; Huge, Dane H.

2013-01-01

The U.S. Geological Survey's Nonindigenous Aquatic Species (NAS) database program (http://nas.er.usgs.gov) tracks the distribution of introduced aquatic organisms across the United States. Awareness of, and timely response to, novel species introductions by those involved in nonindigenous aquatic species management and research requires a framework for rapid dissemination of occurrence data as it is incorporated into the NAS database. In May 2004, the NAS program developed an alert system to notify registered users of new introductions as part of a national early detection/rapid response system. This article summarizes information on system users and dispatched alerts from the system's inception through the end of 2011. The NAS alert system has registered over 1,700 users, with approximately 800 current subscribers. A total of 1,189 alerts had been transmitted through 2011. More alerts were sent for Florida (134 alerts) than for any other state. Fishes comprise the largest taxonomic group of alerts (440), with mollusks, plants, and crustaceans each containing over 100 alerts. Most alerts were for organisms that were intentionally released (414 alerts), with shipping, escape from captivity, and hitchhiking also representing major vectors. To explore the archive of sent alerts and to register, the search and signup page for the alert system can be found online at http://nas.er.usgs.gov/AlertSystem/default.aspx.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baker, J.; Modlin, C.W.; Frerking, C.J.

HIPROTECT (pronounced High-protect) is a system designed to protect national archaeological and natural treasures from destruction by vandals or looters. The system is being developed jointly by the Lawrence Livermore National Laboratory and the University of California at Riverside under the DOD Legacy Resource Management Program. Thousands of archaeological sites are located on military bases and national park lands. Treasure hunters or vandals are pillaging and destroying these sites at will, since the sites are generally located in remote areas, unattended and unprotected. The HIPROTECT system is designed to detect trespassers at the protected sites and to alert park officialsmore » or military officials of intrusions. An array of sensors is used to detect trespassers. The sensors are triggered when a person or vehicle approaches the site. Alarm messages are transmitted to alert park officials or law enforcement officials by way of a cellular telephone link. A video and audio system is included to assist the officials in verifying that an intrusion has occurred and to allow two-way communication with the intruders.« less

GSM module for wireless radiation monitoring system via SMS

NASA Astrophysics Data System (ADS)

Rahman, Nur Aira Abd; Hisyam Ibrahim, Noor; Lombigit, Lojius; Azman, Azraf; Jaafar, Zainudin; Arymaswati Abdullah, Nor; Hadzir Patai Mohamad, Glam

2018-01-01

A customised Global System for Mobile communication (GSM) module is designed for wireless radiation monitoring through Short Messaging Service (SMS). This module is able to receive serial data from radiation monitoring devices such as survey meter or area monitor and transmit the data as text SMS to a host server. It provides two-way communication for data transmission, status query, and configuration setup. The module hardware consists of GSM module, voltage level shifter, SIM circuit and Atmega328P microcontroller. Microcontroller provides control for sending, receiving and AT command processing to GSM module. The firmware is responsible to handle task related to communication between device and host server. It process all incoming SMS, extract, and store new configuration from Host, transmits alert/notification SMS when the radiation data reach/exceed threshold value, and transmits SMS data at every fixed interval according to configuration. Integration of this module with radiation survey/monitoring device will create mobile and wireless radiation monitoring system with prompt emergency alert at high-level radiation.

75 FR 28249 - Comment Sought on Measures Designed To Assist U.S. Wireless Consumers To Avoid “Bill Shock”

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-20

... feasibility of instituting usage alerts and cut-off mechanisms similar to those required under the European... other things, the Commission noted that advances in technology, including usage alerts delivered via... the kind and degree of information available to consumers.'' On the issue of usage alerts, the...

Physician response to a medication alert system in inpatients with levodopa-treated diseases

PubMed Central

Morris, Marie; Willis, Allison W.; Searles Nielsen, Susan; McCann, Franklin; Birke, Angela

2015-01-01

Objective: To evaluate the appropriateness of dopamine receptor antagonist prescriptions in hospitalized patients with dopamine-requiring diseases after implementation of an automated prescription alert system. Methods: We examined dopamine receptor antagonist prescriptions in hospitalized patients with dopamine-requiring diseases and physician response to an automated drug contraindication alert system at Barnes-Jewish Hospital from 2009 to 2013. A detailed review of patient medical records was performed for all alert events generated when a physician prescribed a dopamine receptor antagonist concurrently with a dopamine receptor agonist in hospitalized patients. Two movement disorders neurologists determined the appropriateness of each prescription, based on patient medical history, through consensus. Physician response to alert was compared by indication for the prescription and physician specialty. Results: Of 237 orders, 197 (83.1%) prescriptions for dopamine receptor antagonists were considered inappropriate. The prevalence of inappropriate dopamine receptor antagonist prescriptions per levodopa prescriptions was 16.10% (95% confidence interval 9.47, 22.73) in psychiatry, 7.51% (6.16, 8.86) in general medicine, 6.14% (4.49, 7.79) in the surgical specialties, and 0.85% (0.46, 1.25) in the neurologic/neurosurgical specialties. Of the inappropriate prescriptions, 146 (74.1%) were continued despite the alert. The strongest predictor of discontinuation of dopamine receptor antagonist medications was use of the medication to treat nausea or emesis (p < 0.001). Conclusions: Despite successfully identifying instances when dopamine antagonists were prescribed to patients with dopamine-requiring diseases, the alert system modestly affected physician prescribing behavior, highlighting the need for improved education of health care providers. PMID:26092916

Media Coverage of FDA Drug Safety Communications about Zolpidem: A Quantitative and Qualitative Analysis.

PubMed

Woloshin, Steve; Schwartz, Lisa M; Dejene, Sara; Rausch, Paula; Dal Pan, Gerald J; Zhou, Esther H; Kesselheim, Aaron S

2017-05-01

FDA issues Drug Safety Communications (DSCs) to alert health care professionals and the public about emerging safety information affecting prescription and over-the-counter drugs. News media may amplify DSCs, but it is unclear how DSC messaging is transmitted through the media. We conducted a content analysis of the lay media coverage reaching the broadest audience to characterize the amount and content of media coverage of two zolpidem DSCs from 2013. After the first DSC, zolpidem news stories increased from 19 stories/week in the preceding 3 months to 153 following its release. Most (81%) appeared in the lay media, and 64% focused on the DSC content. After the second DSC, news stories increased from 24 stories/week in the preceding 3 months to 39 following. Among the 100 unique lay media news stories, at least half correctly reported three key DSC messages: next-day impairment and drowsiness as common safety hazards, lower doses for some but not all zolpidem products, and women's higher risk for impairment. Other DSC messages were reported in fewer than one-third of stories, such as the warning that impairment can happen even when people feel fully awake. The first-but not the second-zolpidem DSC generated high-profile news coverage. The finding that some messages were widely reported but others were not emphasizes the importance of ensuring translation of key DSC content.

An evidence- and risk-based approach to a harmonized laboratory alert list in Australia and New Zealand.

PubMed

Campbell, Craig A; Lam, Que; Horvath, Andrea R

2018-04-19

Individual laboratories are required to compose an alert list for identifying critical and significant risk results. The high-risk result working party of the Royal College of Pathologists of Australasia (RCPA) and the Australasian Association of Clinical Biochemists (AACB) has developed a risk-based approach for a harmonized alert list for laboratories throughout Australia and New Zealand. The six-step process for alert threshold identification and assessment involves reviewing the literature, rating the available evidence, performing a risk analysis, assessing method transferability, considering workload implications and seeking endorsement from stakeholders. To demonstrate this approach, a worked example for deciding the upper alert threshold for potassium is described. The findings of the worked example are for infants aged 0-6 months, a recommended upper potassium alert threshold of >7.0 mmol/L in serum and >6.5 mmol/L in plasma, and for individuals older than 6 months, a threshold of >6.2 mmol/L in both serum and plasma. Limitations in defining alert thresholds include the lack of well-designed studies that measure the relationship between high-risk results and patient outcomes or the benefits of treatment to prevent harm, and the existence of a wide range of clinical practice guidelines with conflicting decision points at which treatment is required. The risk-based approach described presents a transparent, evidence- and consensus-based methodology that can be used by any laboratory when designing an alert list for local use. The RCPA-AACB harmonized alert list serves as a starter set for further local adaptation or adoption after consultation with clinical users.

Auditory decision aiding in supervisory control of multiple unmanned aerial vehicles.

PubMed

Donmez, Birsen; Cummings, M L; Graham, Hudson D

2009-10-01

This article is an investigation of the effectiveness of sonifications, which are continuous auditory alerts mapped to the state of a monitored task, in supporting unmanned aerial vehicle (UAV) supervisory control. UAV supervisory control requires monitoring a UAV across multiple tasks (e.g., course maintenance) via a predominantly visual display, which currently is supported with discrete auditory alerts. Sonification has been shown to enhance monitoring performance in domains such as anesthesiology by allowing an operator to immediately determine an entity's (e.g., patient) current and projected states, and is a promising alternative to discrete alerts in UAV control. However, minimal research compares sonification to discrete alerts, and no research assesses the effectiveness of sonification for monitoring multiple entities (e.g., multiple UAVs). The authors conducted an experiment with 39 military personnel, using a simulated setup. Participants controlled single and multiple UAVs and received sonifications or discrete alerts based on UAV course deviations and late target arrivals. Regardless of the number of UAVs supervised, the course deviation sonification resulted in reactions to course deviations that were 1.9 s faster, a 19% enhancement, compared with discrete alerts. However, course deviation sonifications interfered with the effectiveness of discrete late arrival alerts in general and with operator responses to late arrivals when supervising multiple vehicles. Sonifications can outperform discrete alerts when designed to aid operators to predict future states of monitored tasks. However, sonifications may mask other auditory alerts and interfere with other monitoring tasks that require divided attention. This research has implications for supervisory control display design.

Functional Characterization of the Cingulo-Opercular Network in the Maintenance of Tonic Alertness

PubMed Central

Sadaghiani, Sepideh; D'Esposito, Mark

2015-01-01

The complex processing architecture underlying attentional control requires delineation of the functional role of different control-related brain networks. A key component is the cingulo-opercular (CO) network composed of anterior insula/operculum, dorsal anterior cingulate cortex, and thalamus. Its function has been particularly difficult to characterize due to the network's pervasive activity and frequent co-activation with other control-related networks. We previously suggested this network to underlie intrinsically maintained tonic alertness. Here, we tested this hypothesis by separately manipulating the demand for selective attention and for tonic alertness in a two-factorial, continuous pitch discrimination paradigm. The 2 factors had independent behavioral effects. Functional imaging revealed that activity as well as functional connectivity in the CO network increased when the task required more tonic alertness. Conversely, heightened selective attention to pitch increased activity in the dorsal attention (DAT) network but not in the CO network. Across participants, performance accuracy showed dissociable correlation patterns with activity in the CO, DAT, and fronto-parietal (FP) control networks. These results support tonic alertness as a fundamental function of the CO network. They further the characterization of this function as the effortful process of maintaining cognitive faculties available for current processing requirements. PMID:24770711

Enforcement Alert: U.S. EPA Encourages Iron and Steel Minimills to Self Audits to Address Noncompliance with Environmental Requirements; Nucor Corp. agrees to Control Practices; Provides Model for Industry

EPA Pesticide Factsheets

This is the enforcement alert for U.S. EPA Encourages Iron and Steel Minimills to Self Audits to Address Noncompliance with Environmental Requirements; Nucor Corp. agrees to Control Practices; Provides Model for Industry

76 FR 24875 - Notice of Public Information Collection(s) Being Submitted for Review and Approval to the Office...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

...: 3060-1113. Title: Commercial Mobile Alert System (CMAS). Form No.: N/A. Type of Review: Revision of a..., Alert and Response Network (``WARN'') Act, including inter alia, a requirement that within 30 days of... the Commission indicating whether or not it intends to transmit emergency alerts as part of the...

For whom the bell tolls: Silver Alerts raise concerns regarding individual rights and governmental interests.

PubMed

Wasser, Tobias D; Fox, Patrick K

2013-01-01

The Silver Alert system was initially created to help protect missing persons who have cognitive impairments, particularly the elderly. The Silver Alert is modeled after the Amber Alert, created to help locate and safeguard missing children. Unlike the Amber Alert, however, in most states the Silver Alert applies to the elderly, adults with a mental impairment, or both, depending on the state. The goal of the Silver Alert system is the quick dissemination of information about missing persons to law enforcement personnel as well as to the general public. Previously, states notified law enforcement personnel of missing persons through teletype to other public safety jurisdictions to enlist their assistance in the retrieval of the missing person. Silver Alert programs substantially expand the notification to include the general public, who receive information through radio and television broadcasts as well as highway billboards. The programs serve a legitimate governmental interest by protecting a vulnerable population from possible harm. Yet, the implementation of these alerts can have unintended consequences, including the possible violation of an individual's right to privacy. Such consequences require careful consideration.

Evaluation of Helmet Mounted Display Alerting Symbology

NASA Technical Reports Server (NTRS)

DeMaio, Joe; Rutkowski, Michael (Technical Monitor)

2000-01-01

Proposed helicopter helmet mounted displays will be used to alert the pilot to a variety of conditions, from threats to equipment problems. The present research was performed under the NASA Safe All-weather Flight Operations Research (SAFOR) program supported by a joint Army/NASA research agreement. The purpose of the research was to examine ways to optimize the alerting effectiveness of helmet display symbology. The research used two approaches to increasing the effectiveness of alerts. One was to increase the ability of the alert to attract attention by using the entire display surface. The other was to include information about the required response in the alert itself. The investigation was conducted using the NASA Ames Research Center's six-degree-of-freedom vertical motion simulator (VMS) with a rotorcraft cockpit. Helmet display symbology was based on the AH-64's pilot night vision system (PNVS), cruise mode symbology. A standardized mission was developed, that consisted of 11 legs. The mission included four tasks, which allowed variation in the frequency of alerts. The general trend in the data points to a small benefit from both the full-screen alert and the partial information alert.

Alertness management : strategic naps in operational settings

DOT National Transportation Integrated Search

1995-01-01

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

More Than a Text Message: Dismantling Digital Triggers to Curate Behavior Change in Patient-Centered Health Interventions

PubMed Central

2017-01-01

Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change. However, little attention has been given to understanding the components of digital triggers. Using tailoring as an overarching framework, we separated digital triggers into 5 primary components: (1) who (sender), (2) how (stimulus type, delivery medium, heterogeneity), (3) when (delivered), (4) how much (frequency, intensity), and (5) what (trigger’s target, trigger’s structure, trigger’s narrative). We highlighted key considerations when tailoring each component and the pitfalls of ignoring common mistakes, such as alert fatigue and habituation. As evidenced throughout the paper, there is a broad literature base from which to draw when tailoring triggers to curate behavior change in health interventions. More research is needed, however, to examine differences in efficacy based on component tailoring, to best use triggers to facilitate behavior change over time, and to keep individuals engaged in physical and mental health behavior change efforts. Dismantling digital triggers into their component parts and reassembling them according to the gestalt of one’s change goals is the first step in this development work. PMID:28550001

A volcanic activity alert-level system for aviation: Review of its development and application in Alaska

USGS Publications Warehouse

Guffanti, Marianne C.; Miller, Thomas

2013-01-01

An alert-level system for communicating volcano hazard information to the aviation industry was devised by the Alaska Volcano Observatory (AVO) during the 1989–1990 eruption of Redoubt Volcano. The system uses a simple, color-coded ranking that focuses on volcanic ash emissions: Green—normal background; Yellow—signs of unrest; Orange—precursory unrest or minor ash eruption; Red—major ash eruption imminent or underway. The color code has been successfully applied on a regional scale in Alaska for a sustained period. During 2002–2011, elevated color codes were assigned by AVO to 13 volcanoes, eight of which erupted; for that decade, one or more Alaskan volcanoes were at Yellow on 67 % of days and at Orange or Red on 12 % of days. As evidence of its utility, the color code system is integrated into procedures of agencies responsible for air-traffic management and aviation meteorology in Alaska. Furthermore, it is endorsed as a key part of globally coordinated protocols established by the International Civil Aviation Organization to provide warnings of ash hazards to aviation worldwide. The color code and accompanying structured message (called a Volcano Observatory Notice for Aviation) comprise an effective early-warning message system according to the United Nations International Strategy for Disaster Reduction. The aviation color code system currently is used in the United States, Russia, New Zealand, Iceland, and partially in the Philippines, Papua New Guinea, and Indonesia. Although there are some barriers to implementation, with continued education and outreach to Volcano Observatories worldwide, greater use of the aviation color code system is achievable.

A volcanic activity alert-level system for aviation: review of its development and application in Alaska

USGS Publications Warehouse

Guffanti, Marianne; Miller, Thomas P.

2013-01-01

An alert-level system for communicating volcano hazard information to the aviation industry was devised by the Alaska Volcano Observatory (AVO) during the 1989–1990 eruption of Redoubt Volcano. The system uses a simple, color-coded ranking that focuses on volcanic ash emissions: Green—normal background; Yellow—signs of unrest; Orange—precursory unrest or minor ash eruption; Red—major ash eruption imminent or underway. The color code has been successfully applied on a regional scale in Alaska for a sustained period. During 2002–2011, elevated color codes were assigned by AVO to 13 volcanoes, eight of which erupted; for that decade, one or more Alaskan volcanoes were at Yellow on 67 % of days and at Orange or Red on 12 % of days. As evidence of its utility, the color code system is integrated into procedures of agencies responsible for air-traffic management and aviation meteorology in Alaska. Furthermore, it is endorsed as a key part of globally coordinated protocols established by the International Civil Aviation Organization to provide warnings of ash hazards to aviation worldwide. The color code and accompanying structured message (called a Volcano Observatory Notice for Aviation) comprise an effective early-warning message system according to the United Nations International Strategy for Disaster Reduction. The aviation color code system currently is used in the United States, Russia, New Zealand, Iceland, and partially in the Philippines, Papua New Guinea, and Indonesia. Although there are some barriers to implementation, with continued education and outreach to Volcano Observatories worldwide, greater use of the aviation color code system is achievable.

Wearable PPG sensor based alertness scoring system.

PubMed

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

2017-07-01

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

Lack of utility of a decision support system to mitigate delays in admission from the operating room to the postanesthesia care unit.

PubMed

Ehrenfeld, Jesse M; Dexter, Franklin; Rothman, Brian S; Minton, Betty Sue; Johnson, Diane; Sandberg, Warren S; Epstein, Richard H

2013-12-01

When the phase I postanesthesia care unit (PACU) is at capacity, completed cases need to be held in the operating room (OR), causing a "PACU delay." Statistical methods based on historical data can optimize PACU staffing to achieve the least possible labor cost at a given service level. A decision support process to alert PACU charge nurses that the PACU is at or near maximum census might be effective in lessening the incidence of delays and reducing over-utilized OR time, but only if alerts are timely (i.e., neither too late nor too early to act upon) and the PACU slot can be cleared quickly. We evaluated the maximum potential benefit of such a system, using assumptions deliberately biased toward showing utility. We extracted 3 years of electronic PACU data from a tertiary care medical center. At this hospital, PACU admissions were limited by neither inadequate PACU staffing nor insufficient PACU beds. We developed a model decision support system that simulated alerts to the PACU charge nurse. PACU census levels were reconstructed from the data at a 1-minute level of resolution and used to evaluate if subsequent delays would have been prevented by such alerts. The model assumed there was always a patient ready for discharge and an available hospital bed. The time from each alert until the maximum census was exceeded ("alert lead time") was determined. Alerts were judged to have utility if the alert lead time fell between various intervals from 15 or 30 minutes to 60, 75, or 90 minutes after triggering. In addition, utility for reducing over-utilized OR time was assessed using the model by determining if 2 patients arrived from 5 to 15 minutes of each other when the PACU census was at 1 patient less than the maximum census. At most, 23% of alerts arrived 30 to 60 minutes prior to the admission that resulted in the PACU exceeding the specified maximum capacity. When the notification window was extended to 15 to 90 minutes, the maximum utility was <50%. At most, 45% of alerts potentially would have resulted in reassigning the last available PACU slot to 1 OR versus another within 15 minutes of the original assignment. Despite multiple biases that favored effectiveness, the maximum potential benefit of a decision support system to mitigate PACU delays on the day on the surgery was below the 70% minimum threshold for utility of automated decision support messages, previously established via meta-analysis. Neither reduction in PACU delays nor reassigning promised PACU slots based on reducing over-utilized OR time were realized sufficiently to warrant further development of the system. Based on these results, the only evidence-based method of reducing PACU delays is to adjust PACU staffing and staff scheduling using computational algorithms to match the historical workload (e.g., as developed in 2001).

Personalized Alert Notifications and Evacuation Routes in Indoor Environments

PubMed Central

Aedo, Ignacio; Yu, Shuxin; Díaz, Paloma; Acuña, Pablo; Onorati, Teresa

2012-01-01

The preparedness phase is crucial in the emergency management process for reaching an adequate level of readiness to react to potential threats and hazards. During this phase, emergency plans are developed to establish, among other procedures, evacuation and emergency escape routes. Information and Communication Technologies (ICT) can support and improve these procedures providing appropriate, updated and accessible information to all people in the affected zone. Current emergency management and evacuation systems do not adapt information to the context and the profile of each person, so messages received in the emergency might be useless. In this paper, we propose a set of criteria that ICT-based systems could achieve in order to avoid this problem adapting emergency alerts and evacuation routes to different situations and people. Moreover, in order to prove the applicability of such criteria, we define a mechanism that can be used as a complement of traditional evacuation systems to provide personalized alerts and evacuation routes to all kinds of people during emergency situations in working places. This mechanism is composed by three main components: CAP-ONES for notifying emergency alerts, NERES for defining emergency plans and generating personalized evacuation routes, and iNeres as the interface to receive and visualize these routes on smartphones. The usability and understandability of proposed interface has been assessed through a user study performed in a fire simulation in an indoor environment. This evaluation demonstrated that users considered iNeres easy to understand, to learn and to use, and they also found very innovative the idea to use smartphones as a support for escaping instead of static signals on walls and doors. PMID:22969373

DOE Office of Scientific and Technical Information (OSTI.GOV)

Connell, Leonard W.; Edenburn, Michael W.; Fraley, Stanley K.

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

Results of a randomized controlled trial to assess the effects of a mobile SMS-based intervention on treatment adherence in HIV/AIDS-infected Brazilian women and impressions and satisfaction with respect to incoming messages

PubMed Central

da Costa, Thiago Martini; Barbosa, Bárbara Jaqueline Peres; e Costa, Durval Alex Gomes; Sigulem, Daniel; de Fátima Marin, Heimar; Filho, Adauto Castelo; Pisa, Ivan Torres

2013-01-01

Objective To assess whether a warning system based on mobile SMS messages increases the adherence of HIV-infected Brazilian women to antiretroviral drug-based treatment regimens and their impressions and satisfaction with respect to incoming messages. Design A randomized controlled trial was conducted from May 2009 to April 2010 with HIV-infected Brazilian women. All participants (n = 21) had a monthly multidisciplinary attendance; each participant was followed over a 4-month period, when adherence measures were obtained. Participants in the intervention group (n = 8) received SMS messages 30 min before their last scheduled time for a dose of medicine during the day. The messages were sent every Saturday and Sunday and on alternate days during the working week. Participants in the control group (n = 13) did not receive messages. Measurements Self-reported adherence, pill counting, microelectronic monitors (MEMS) and an interview about the impressions and satisfaction with respect to incoming messages. Results The HIV Alert System (HIVAS) was developed over 7 months during 2008 and 2009. After the study period, self-reported adherence indicated that 11 participants (84.62%) remained compliant in the control group (adherence exceeding 95%), whereas all 8 participants in the intervention group (100.00%) remained compliant. In contrast, the counting pills method indicated that the number of compliant participants was 5 (38.46%) for the control group and 4 (50.00%) for the intervention group. Microelectronic monitoring indicated that 6 participants in the control group (46.15%) were adherent during the entire 4-month period compared to 6 participants in the intervention group (75.00%). According to the feedback of the 8 participants who completed the research in the intervention group, along with the feedback of 3 patients who received SMS for less than 4 months, that is, did not complete the study, 9 (81.81%) believed that the SMS messages aided them in treatment adherence, and 10 (90.90%) responded that they would like to continue receiving SMS messages. SMS messaging can help Brazilian women living with HIV/AIDS to adhere to antiretroviral therapy for a period of at least 4 months. In general, the results are encouraging because the SMS messages stimulated more participants in the intervention group to be adherent to their treatment, and the patients were satisfied with the messages received, which were seen as reminders, incentives and signs of affection by the health clinic for a marginalized population. PMID:22296762

Real-time alerts and reminders using information systems.

PubMed

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

2011-09-01

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

19 CFR 4.7d - Container status messages.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Container status messages. 4.7d Section 4.7d... TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Arrival and Entry of Vessels § 4.7d Container status messages. (a) Container status messages required. In addition to the advance filing requirements pursuant...

Some human factors issues in the development and evaluation of cockpit alerting and warning systems

NASA Technical Reports Server (NTRS)

Randle, R. J., Jr.; Larsen, W. E.; Williams, D. H.

1980-01-01

A set of general guidelines for evaluating a newly developed cockpit alerting and warning system in terms of human factors issues are provided. Although the discussion centers around a general methodology, it is made specifically to the issues involved in alerting systems. An overall statement of the current operational problem is presented. Human factors problems with reference to existing alerting and warning systems are described. The methodology for proceeding through system development to system test is discussed. The differences between traditional human factors laboratory evaluations and those required for evaluation of complex man-machine systems under development are emphasized. Performance evaluation in the alerting and warning subsystem using a hypothetical sample system is explained.

Fast notification architecture for wireless sensor networks

NASA Astrophysics Data System (ADS)

Lee, Dong-Hahk

2013-03-01

In an emergency, since it is vital to transmit the message to the users immediately after analysing the data to prevent disaster, this article presents the deployment of a fast notification architecture for a wireless sensor network. The sensor nodes of the proposed architecture can monitor an emergency situation periodically and transmit the sensing data, immediately to the sink node. We decide on the grade of fire situation according to the decision rule using the sensing values of temperature, CO, smoke density and temperature increasing rate. On the other hand, to estimate the grade of air pollution, the sensing data, such as dust, formaldehyde, NO2, CO2, is applied to the given knowledge model. Since the sink node in the architecture has a ZigBee interface, it can transmit the alert messages in real time according to analysed results received from the host server to the terminals equipped with a SIM card-type ZigBee module. Also, the host server notifies the situation to the registered users who have cellular phone through short message service server of the cellular network. Thus, the proposed architecture can adapt an emergency situation dynamically compared to the conventional architecture using video processing. In the testbed, after generating air pollution and fire data, the terminal receives the message in less than 3 s. In the test results, this system can also be applied to buildings and public areas where many people gather together, to prevent unexpected disasters in urban settings.

Help Me Please!: Designing and Developing Application for Emergencies

NASA Astrophysics Data System (ADS)

Hong, Ng Ken; Hafit, Hanayanti; Wahid, Norfaradilla; Kasim, Shahreen; Yusof, Munirah Mohd

2017-08-01

Help Me Please! Application is an android platform emergency button application that is designed to transmit emergency messages to target receivers with real time information. The purpose of developing this application is to help people to notify any emergency circumstances via Short Message Service (SMS) in android platform. The application will receive the current location from Global Positioning System (GPS), will obtain the current time from the mobile device and send this information to the receivers when user presses the emergency button. Simultaneously, the application will keep sending the emergency alerts to receivers and will update to database based on the time interval set by user until user stop the function. Object-oriented Software Development model is employed to guide the development of this application with the knowledge of Java language and Android Studio. In conclusion, this application plays an important role in rescuing process when emergency circumstances happen. The rescue process will become more effective by notifying the emergency circumstances and send the current location of user to others in the early hours.

Orders on file but no labs drawn: investigation of machine and human errors caused by an interface idiosyncrasy.

PubMed

Schreiber, Richard; Sittig, Dean F; Ash, Joan; Wright, Adam

2017-09-01

In this report, we describe 2 instances in which expert use of an electronic health record (EHR) system interfaced to an external clinical laboratory information system led to unintended consequences wherein 2 patients failed to have laboratory tests drawn in a timely manner. In both events, user actions combined with the lack of an acknowledgment message describing the order cancellation from the external clinical system were the root causes. In 1 case, rapid, near-simultaneous order entry was the culprit; in the second, astute order management by a clinician, unaware of the lack of proper 2-way interface messaging from the external clinical system, led to the confusion. Although testing had shown that the laboratory system would cancel duplicate laboratory orders, it was thought that duplicate alerting in the new order entry system would prevent such events. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effect of directional speech warnings on road hazard detection.

PubMed

Serrano, Jesús; Di Stasi, Leandro L; Megías, Alberto; Catena, Andrés

2011-12-01

In the last 2 decades, cognitive science and the transportation psychology field have dedicated a lot of effort to designing advanced driver support systems. Verbal warning systems are increasingly being implemented in modern automobiles in an effort to increase road safety. The study presented here investigated the impact of directional speech alert messages on the participants' speed to judge whether or not naturalistic road scenes depicted a situation of impending danger. Thirty-eight volunteers performed a computer-based key-press reaction time task. Findings indicated that semantic content of verbal warning signals can be used for increasing driving safety and improving hazard detection. Furthermore, the classical result regarding signal accuracy is confirmed: directional informative speech messages lead to faster hazard detection compared to drivers who received a high rate of false alarms. Notwithstanding some study limitations (lack of driver experience and low ecological validity), this evidence could provide important information for the specification of future Human-Machine-interaction (HMI) design guidelines.

The Interplanetary Network II: 11 Months of Rapid, Precise GRB Localizations

NASA Astrophysics Data System (ADS)

Hurley, K.; Cline, T.; Mazets, E.; Golenetskii, S.; Trombka, J.; Feroci, M.; Kippen, R. M.; Barthelmy, S.; Frontera, F.; Guidorzi, C.; Montanari, E.

2000-10-01

Since December 1999 the 3rd Interplanetary Network has been producing small ( 10') error boxes at a rate of about one per week, and circulating them rapidly ( 24 h) via the GCN. As of June 2000, 24 such error boxes have been obtained; 18 of them have been searched in the radio and optical ranges for counterparts, resulting in four definite counterpart detections and three redshift determinations. We will review these results and explain the some of the lesser known IPN operations. In particular, we maintain an "early warning" list of potential observers with pagers and cell phones, and send messages to them to alert them to bursts for which error boxes will be obtained, allowing them to prepare for observations many hours before the complete spacecraft data are received and the GCN message is issued. As an interesting aside, now that the CGRO mission is terminated, the IPN consists entirely of non-NASA and/or non-astrophysics missions, specifically, Ulysses and Wind (Space Physics), NEAR (Planetary Physics), and BeppoSAX (ASI).

Automating slope monitoring in mines with terrestrial lidar scanners

NASA Astrophysics Data System (ADS)

Conforti, Dario

2014-05-01

Static terrestrial laser scanners (TLS) have been an important component of slope monitoring for some time, and many solutions for monitoring the progress of a slide have been devised over the years. However, all of these solutions have required users to operate the lidar equipment in the field, creating a high cost in time and resources, especially if the surveys must be performed very frequently. This paper presents a new solution for monitoring slides, developed using a TLS and an automated data acquisition, processing and analysis system. In this solution, a TLS is permanently mounted within sight of the target surface and connected to a control computer. The control software on the computer automatically triggers surveys according to a user-defined schedule, parses data into point clouds, and compares data against a baseline. The software can base the comparison against either the original survey of the site or the most recent survey, depending on whether the operator needs to measure the total or recent movement of the slide. If the displacement exceeds a user-defined safety threshold, the control computer transmits alerts via SMS text messaging and/or email, including graphs and tables describing the nature and size of the displacement. The solution can also be configured to trigger the external visual/audio alarm systems. If the survey areas contain high-traffic areas such as roads, the operator can mark them for exclusion in the comparison to prevent false alarms. To improve usability and safety, the control computer can connect to a local intranet and allow remote access through the software's web portal. This enables operators to perform most tasks with the TLS from their office, including reviewing displacement reports, downloading survey data, and adjusting the scan schedule. This solution has proved invaluable in automatically detecting and alerting users to potential danger within the monitored areas while lowering the cost and work required for monitoring. An explanation of the entire system and a post-acquisition data demonstration will be presented.

Feeling labeled, judged, lectured, and rejected by family and friends over depression: cautionary results for primary care clinicians from a multi-centered, qualitative study.

PubMed

Fernandez Y-Garcia, Erik; Duberstein, Paul; Paterniti, Debora A; Cipri, Camille S; Kravitz, Richard L; Epstein, Ronald M

2012-06-29

Family and friends may help patients seek out and engage in depression care. However, patients' social networks can also undermine depression treatment and recovery. In an effort to improve depression care in primary care settings, we sought to identify, categorize, and alert primary care clinicians to depression-related messages that patients hear from friends and family that patients perceive as unhelpful or detrimental. We conducted 15 focus groups in 3 cities. Participants (n = 116) with a personal history or knowledge of depression responded to open-ended questions about depression, including self-perceived barriers to care-seeking. Focus group conversations were audio-recorded and analyzed using iterative qualitative analysis. Four themes emerged related to negatively-received depression messages delivered by family and friends. Specifically, participants perceived these messages as making them feel labeled, judged, lectured to, and rejected by family and friends when discussing depression. Some participants also expressed their interpretation of their families' motivations for delivering the messages and described how hearing these messages affected depression care. The richness of our results reflects the complexity of communication within depression sufferers' social networks around this stigmatized issue. To leverage patients' social support networks effectively in depression care, primary care clinicians should be aware of both the potentially beneficial and detrimental aspects of social support. Specifically, clinicians should consider using open-ended queries into patients' experiences with discussing depression with family and friends as an initial step in the process. An open-ended approach may avoid future emotional trauma or stigmatization and assist patients in overcoming self-imposed barriers to depression discussion, symptom disclosure, treatment adherence and follow-up care.

Feeling labeled, judged, lectured, and rejected by family and friends over depression: Cautionary results for primary care clinicians from a multi-centered, qualitative study

PubMed Central

2012-01-01

Background Family and friends may help patients seek out and engage in depression care. However, patients’ social networks can also undermine depression treatment and recovery. In an effort to improve depression care in primary care settings, we sought to identify, categorize, and alert primary care clinicians to depression-related messages that patients hear from friends and family that patients perceive as unhelpful or detrimental. Methods We conducted 15 focus groups in 3 cities. Participants (n = 116) with a personal history or knowledge of depression responded to open-ended questions about depression, including self-perceived barriers to care-seeking. Focus group conversations were audio-recorded and analyzed using iterative qualitative analysis. Results Four themes emerged related to negatively-received depression messages delivered by family and friends. Specifically, participants perceived these messages as making them feel labeled, judged, lectured to, and rejected by family and friends when discussing depression. Some participants also expressed their interpretation of their families’ motivations for delivering the messages and described how hearing these messages affected depression care. Conclusions The richness of our results reflects the complexity of communication within depression sufferers’ social networks around this stigmatized issue. To leverage patients’ social support networks effectively in depression care, primary care clinicians should be aware of both the potentially beneficial and detrimental aspects of social support. Specifically, clinicians should consider using open-ended queries into patients’ experiences with discussing depression with family and friends as an initial step in the process. An open-ended approach may avoid future emotional trauma or stigmatization and assist patients in overcoming self-imposed barriers to depression discussion, symptom disclosure, treatment adherence and follow-up care. PMID:22747989

Chemical Safety Alert: Hazards of Delayed Coker Unit (DCU) Operations

EPA Pesticide Factsheets

EPA and OSHA jointly publish this Chemical Safety Alert/Safety and Health Information Bulletin (CSA/SHIB) to increase awareness. DCU is a severe form of thermal cracking requiring high temperatures for long periods, for refining crude oils.

Description of the AILS Alerting Algorithm

NASA Technical Reports Server (NTRS)

Samanant, Paul; Jackson, Mike

2000-01-01

This document provides a complete description of the Airborne Information for Lateral Spacing (AILS) alerting algorithms. The purpose of AILS is to provide separation assurance between aircraft during simultaneous approaches to closely spaced parallel runways. AILS will allow independent approaches to be flown in such situations where dependent approaches were previously required (typically under Instrument Meteorological Conditions (IMC)). This is achieved by providing multiple levels of alerting for pairs of aircraft that are in parallel approach situations. This document#s scope is comprehensive and covers everything from general overviews, definitions, and concepts down to algorithmic elements and equations. The entire algorithm is presented in complete and detailed pseudo-code format. This can be used by software programmers to program AILS into a software language. Additional supporting information is provided in the form of coordinate frame definitions, data requirements, calling requirements as well as all necessary pre-processing and post-processing requirements. This is important and required information for the implementation of AILS into an analysis, a simulation, or a real-time system.

Protocol for the 'e-Nudge trial': a randomised controlled trial of electronic feedback to reduce the cardiovascular risk of individuals in general practice [ISRCTN64828380

PubMed Central

Holt, Tim A; Thorogood, Margaret; Griffiths, Frances; Munday, Stephen

2006-01-01

Background Cardiovascular disease (including coronary heart disease and stroke) is a major cause of death and disability in the United Kingdom, and is to a large extent preventable, by lifestyle modification and drug therapy. The recent standardisation of electronic codes for cardiovascular risk variables through the United Kingdom's new General Practice contract provides an opportunity for the application of risk algorithms to identify high risk individuals. This randomised controlled trial will test the benefits of an automated system of alert messages and practice searches to identify those at highest risk of cardiovascular disease in primary care databases. Design Patients over 50 years old in practice databases will be randomised to the intervention group that will receive the alert messages and searches, and a control group who will continue to receive usual care. In addition to those at high estimated risk, potentially high risk patients will be identified who have insufficient data to allow a risk estimate to be made. Further groups identified will be those with possible undiagnosed diabetes, based either on elevated past recorded blood glucose measurements, or an absence of recent blood glucose measurement in those with established cardiovascular disease. Outcome measures The intervention will be applied for two years, and outcome data will be collected for a further year. The primary outcome measure will be the annual rate of cardiovascular events in the intervention and control arms of the study. Secondary measures include the proportion of patients at high estimated cardiovascular risk, the proportion of patients with missing data for a risk estimate, and the proportion with undefined diabetes status at the end of the trial. PMID:16646967

More Than a Text Message: Dismantling Digital Triggers to Curate Behavior Change in Patient-Centered Health Interventions.

PubMed

Muench, Frederick; Baumel, Amit

2017-05-26

Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change. However, little attention has been given to understanding the components of digital triggers. Using tailoring as an overarching framework, we separated digital triggers into 5 primary components: (1) who (sender), (2) how (stimulus type, delivery medium, heterogeneity), (3) when (delivered), (4) how much (frequency, intensity), and (5) what (trigger's target, trigger's structure, trigger's narrative). We highlighted key considerations when tailoring each component and the pitfalls of ignoring common mistakes, such as alert fatigue and habituation. As evidenced throughout the paper, there is a broad literature base from which to draw when tailoring triggers to curate behavior change in health interventions. More research is needed, however, to examine differences in efficacy based on component tailoring, to best use triggers to facilitate behavior change over time, and to keep individuals engaged in physical and mental health behavior change efforts. Dismantling digital triggers into their component parts and reassembling them according to the gestalt of one's change goals is the first step in this development work. ©Frederick Muench, Amit Baumel. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.05.2017.

Behavioural consequences of child abuse

PubMed Central

Al Odhayani, Abdulaziz; Watson, William J.; Watson, Lindsay

2013-01-01

Abstract Objective To discuss the consequences of abuse on childhood behavioural development, to highlight some behavioural clues that might alert physicians to ongoing child abuse, and to explore the specific role of the family physician in this clinical situation. Sources of information A systematic search was used to review relevant research, clinical review articles, and child protection agency websites. Main message A child’s behaviour is an outward manifestation of inner stability and security. It is a lens through which the family physician can observe the development of the child throughout his or her life. All types of abuse are damaging to children—physically, emotionally, and psychologically—and can cause long-term difficulties with behaviour and mental health development. Family physicians need to be aware of and alert to the indicators of child abuse and neglect so that appropriate interventions can be provided to improve outcomes for those children. Conclusion Child abuse might cause disordered psychological development and behaviour problems. Family physicians have an important role in recognizing behaviour clues that suggest child abuse and in providing help to protect children. PMID:23946022

BEMFAM delivers AIDS alert.

PubMed

1993-05-01

The Sociedade Civil Bem-Estar Familiar (BEMFAM) of Brazil developed a project using integrated communication strategies to alert prostitutes and their clients about the risks of contracting HIV. The project specifically promoted condom use and was conducted within the context of BEMFAM's Integrated Family Planning Program. Villa Mimoza, a prostitution zone in the Estacio neighborhood of Rio de Janeiro, was the site of the intervention. This neighborhood harbors 44 houses of prostitution where an estimated 500 female prostitutes receive clients. An agreement was reached with the Association of Prostitutes of the State of Rio de Janeiro whereby it would help mobilize local women, merchants, brothel owners, and clients. Initial needs were assessed by BEMFAM and AIDSCOM through questionnaires and focus groups. It was subsequently resolved that radio programs, counter displays of educational materials in brothels, and posters in brothel rooms would be the most effective channels through which to carry integrated, effective messages to the community. Final evaluation found a change in attitude and an awareness of the importance of measures to prevent AIDS along with a prevalent increase in condom use.

Design of a steering stabilizer based on CAN bus

NASA Astrophysics Data System (ADS)

Zhan, Zhaomin; Yan, Yibin

2018-04-01

This design realizes a posture correction device of griping steering wheel based on CAN bus, which is embedded in the steering wheel of vehicles. The system aims to detect the drivers' abnormal griping postures and provides drivers with classification alerts, by combining the recorded griping postures data and the vehicle speed data that are obtained via the CAN bus. The warning information are automatically stored and retained in the device for 12 months. To enhance the alerting effect, the count of this warning message for both the latest month and the last 12 months are displayed on the dashboard panel. In addition to prevent itself from being blocked and self-detect any faults in advance, the appliance also provide a self-test function, which will communicate with the integrated instrument system in vehicle and do simulation test right after the vehicle power on. This appliance can help to urge and ensure drivers to operate the steering wheel correctly, effectively, and timely; prevent some typical incorrect behaviors which commonly happen along with the change of griping postures, such as the using cellphone, and ultimately, reduce the incidence of traffic accidents.

Final Report Program Plan for Search and Rescue Electronics Alerting and Locating System

DOT National Transportation Integrated Search

1974-02-01

This study investigates the requirements that exist for electronic devices for alerting and locating distress incidents and presents a plan for acquiring an adequate capability. Data are provided that bound the problem. Possible alternatives are exam...

21 CFR Appendix E to Subpart A of... - Elements To Be Considered in Developing a Two-Way Alert System

Code of Federal Regulations, 2011 CFR

2011-04-01

... what circumstances an alert is required —Standard Operating Procedures (SOP's) —Mechanism of health... mechanisms 3. Enforcement Procedures —Followup mechanisms —Corrective action procedures 4. Quality Assurance...

21 CFR Appendix E to Subpart A of... - Elements To Be Considered in Developing a Two-Way Alert System

Code of Federal Regulations, 2012 CFR

2012-04-01

... what circumstances an alert is required —Standard Operating Procedures (SOP's) —Mechanism of health... mechanisms 3. Enforcement Procedures —Followup mechanisms —Corrective action procedures 4. Quality Assurance...

21 CFR Appendix E to Subpart A of... - Elements To Be Considered in Developing a Two-Way Alert System

Code of Federal Regulations, 2014 CFR

2014-04-01

... what circumstances an alert is required —Standard Operating Procedures (SOP's) —Mechanism of health... mechanisms 3. Enforcement Procedures —Followup mechanisms —Corrective action procedures 4. Quality Assurance...

21 CFR Appendix E to Subpart A of... - Elements To Be Considered in Developing a Two-Way Alert System

Code of Federal Regulations, 2013 CFR

2013-04-01

... what circumstances an alert is required —Standard Operating Procedures (SOP's) —Mechanism of health... mechanisms 3. Enforcement Procedures —Followup mechanisms —Corrective action procedures 4. Quality Assurance...

A Simple and Low-Cost Monitoring System to Investigate Environmental Conditions in a Biological Research Laboratory

PubMed Central

Gurdita, Akshay; Vovko, Heather; Ungrin, Mark

2016-01-01

Basic equipment such as incubation and refrigeration systems plays a critical role in nearly all aspects of the traditional biological research laboratory. Their proper functioning is therefore essential to ensure reliable and repeatable experimental results. Despite this fact, in many academic laboratories little attention is paid to validating and monitoring their function, primarily due to the cost and/or technical complexity of available commercial solutions. We have therefore developed a simple and low-cost monitoring system that combines a “Raspberry Pi” single-board computer with USB-connected sensor interfaces to track and log parameters such as temperature and pressure, and send email alert messages as appropriate. The system is controlled by open-source software, and we have also generated scripts to automate software setup so that no background in programming is required to install and use it. We have applied it to investigate the behaviour of our own equipment, and present here the results along with the details of the monitoring system used to obtain them. PMID:26771659

In-vehicle low-cost signing system

NASA Astrophysics Data System (ADS)

Greneker, Eugene F.

1997-02-01

There are approximately 20 million police radar detectors used on the highways of the United States daily. A highway hazard safety warning system has been developed by the Georgia Tech Research Institute, working under the sponsorship of the radar detector industry, to communicate highway safety alerts to the driver of any vehicle equipped with a police radar detector. In addition, the system causes the new generation of detectors that are already available to display a safety warning message on an alpha-numeric display. The Safety Warning SystemTM consists of a transmitter and a radar detector receiver or stand-alone safety warning receiver/display system. The transmitter can be mounted on police cars, emergency vehicles, utility vehicles, highly repair vehicles, and on stationary structures at fixed locations along the highway. The reception range of the transmitted signal is between 0.5 and 1.0 miles, depending on terrain. The system to be described may be one of the first applications of in-vehicle signing in the Intelligent Transportation System to be implemented, because the required infrastructure of receivers already exists.

Effect of audio in-vehicle red light-running warning message on driving behavior based on a driving simulator experiment.

PubMed

Yan, Xuedong; Liu, Yang; Xu, Yongcun

2015-01-01

Drivers' incorrect decisions of crossing signalized intersections at the onset of the yellow change may lead to red light running (RLR), and RLR crashes result in substantial numbers of severe injuries and property damage. In recent years, some Intelligent Transport System (ITS) concepts have focused on reducing RLR by alerting drivers that they are about to violate the signal. The objective of this study is to conduct an experimental investigation on the effectiveness of the red light violation warning system using a voice message. In this study, the prototype concept of the RLR audio warning system was modeled and tested in a high-fidelity driving simulator. According to the concept, when a vehicle is approaching an intersection at the onset of yellow and the time to the intersection is longer than the yellow interval, the in-vehicle warning system can activate the following audio message "The red light is impending. Please decelerate!" The intent of the warning design is to encourage drivers who cannot clear an intersection during the yellow change interval to stop at the intersection. The experimental results showed that the warning message could decrease red light running violations by 84.3 percent. Based on the logistic regression analyses, drivers without a warning were about 86 times more likely to make go decisions at the onset of yellow and about 15 times more likely to run red lights than those with a warning. Additionally, it was found that the audio warning message could significantly reduce RLR severity because the RLR drivers' red-entry times without a warning were longer than those with a warning. This driving simulator study showed a promising effect of the audio in-vehicle warning message on reducing RLR violations and crashes. It is worthwhile to further develop the proposed technology in field applications.

Status of Public Earthquake Early Warning in the U.S

NASA Astrophysics Data System (ADS)

Given, D. D.

2013-12-01

Earthquake Early Warning (EEW) is a proven use of seismological science that can give people and businesses outside the epicentral area of a large earthquake up to a minute to take protective actions before the most destructive shaking hits them. Since 2006 several organizations have been collaborating to create such a system in the United States. These groups include the US Geological Survey, Caltech, UC Berkeley, the University of Washington, the Southern California Earthquake Center, the Swiss Federal Institute of Technology, Zürich, the California Office of Emergency Services, and the California Geological Survey. A demonstration version of the system, called ShakeAlert, began sending test notifications to selected users in California in January 2012. In August 2012 San Francisco's Bay Area Rapid Transit district began slowing and stopping trains in response to strong ground shaking. The next step in the project is to progress to a production prototype for the west coast. The system is built on top of the considerable technical and organizational earthquake monitoring infrastructure of the Advanced National Seismic System (ANSS). While a fully functional, robust, public EEW system will require significant new investment and development in several major areas, modest progress is being made with current resources. First, high-quality sensors must be installed with sufficient density, particularly near source faults. Where possible, we are upgrading and augmenting the existing ANSS networks on the west coast. Second, data telemetry from those sensors must be engineered for speed and reliability. Next, robust central processing infrastructure is being designed and built. Also, computer algorithms to detect and characterize the evolving earthquake must be further developed and tested. Last year the Gordon and Betty Moore Foundation funded USGS, Caltech, UCB and UW to accelerate R&D efforts. Every available means of distributing alerts must be used to insure the system's effectiveness. We have developed an internet-based UserDisplay application and a smartphone app based on Google Cloud Messaging. In addition, USGS has applied for authorization to alert over FEMA's Integrated Pubic Alert and Warning System. We are also working with private companies to develop alert distribution channels and end user implementation capabilities. Finally, because policy makers, institutional users, and the public must be educated about the system, social scientists and communicators are determining how to communicate the alerts most effectively. Progress is also being made in several related areas. Real-time GPS position data is becoming available on a large scale and algorithms are being developed to use these data to rapidly characterize the fault rupture as it propagates. New, advanced seismological and geodetic algorithms for the Cascadia megathrust and San Andreas fault are being developed. We are exploring public-private partnerships to develop commercial EEW applications. And Federal, State and local agencies are working out their roles and responsibilities in building, operating and educating users about the system. There is much more to be done and funding the creation and operation of this new capability is a challenge in the current budget climate. However, our goal is to build an EEW system before the next big earthquake rather than in its aftermath.

Text messaging to communicate with public health audiences: how the HIPAA Security Rule affects practice.

PubMed

Karasz, Hilary N; Eiden, Amy; Bogan, Sharon

2013-04-01

Text messaging is a powerful communication tool for public health purposes, particularly because of the potential to customize messages to meet individuals' needs. However, using text messaging to send personal health information requires analysis of laws addressing the protection of electronic health information. The Health Insurance Portability and Accountability Act (HIPAA) Security Rule is written with flexibility to account for changing technologies. In practice, however, the rule leads to uncertainty about how to make text messaging policy decisions. Text messaging to send health information can be implemented in a public health setting through 2 possible approaches: restructuring text messages to remove personal health information and retaining limited personal health information in the message but conducting a risk analysis and satisfying other requirements to meet the HIPAA Security Rule.

VOEventNet: An Open Source of Transient Alerts for Astronomers.

NASA Astrophysics Data System (ADS)

Drake, Andrew J.; Williams, R.; Graham, M. J.; Mahabal, A.; Djorgovski, S. G.; White, R. R.; Vestrand, W. T.; Bloom, J.

2007-12-01

Event based astronomy is acquiring an increasingly important role in astronomy as large time-domain surveys such as Palomar Transient Factory (PTF), Pan-STARRs, SkyMapper and Allan Telescope Array (ATA) surveys come online. These surveys are expected to discover thousands of transients each year ranging from near earth asteroids to distant SNe. Although the primary instruments for of these surveys are in place, in order to fully utilize these event discovery streams, automated alerting and follow-up is a necessity. For the past two years the VOEventNet network has been globally distributing information about transient astronomical events using the VOEvent format, a Virtual Observatory standard. Events messages are openly distributed so that follow-up can utilize the most appropriate resources available in order to characterize the nature of the transients. Since its inception VOEventNet has broadcast more than 3500 SDSSSS Supernova candidates, 3300 GRB alert and follow-up notices from GCN, 700 OGLE microlensing event candidates, and 4300 newly discovered asteroid and optical transient candidates from the Palomar Quest survey. Additional transient event streams are expected this season including optical transients from the Catalina Sky Survey. VOEventNet astronomical transient events streams are available to all astronomers via traditional HTML tables, RSS news-feeds, real-time publication (via Jabber and TCP), and Google Sky mashups. VOEventNet currently carries out optical transient event follow-up with the Palomar 60 and 200in (Caltech), Faulkes Telescopes North and South (LCOGTN), RAPTOR (LANL), and PARITEL (UCB; CfA).

Prevention of sexually transmitted infections using mobile devices and ubiquitous computing.

PubMed

Besoain, Felipe; Perez-Navarro, Antoni; Caylà, Joan A; Aviñó, Constanza Jacques; de Olalla, Patricia García

2015-05-03

Advances in the development of information and communication technologies have facilitated social interrelationships, but also sexual contacts without appropriate preventive measures. In this paper, we will focus on situations in which people use applications to meet sexual partners nearby, which could increase their chance of exposure to sexually transmitted infections (STI). How can we encourage users to adopt preventive measures without violating their privacy or infringing on the character of the application? To achieve the goal of preventing STI, we have used the design and creation methodology and have developed a prototype software package. This prototype follows the RESTful services principles and has two parts: an Android OS application with emphasis on ubiquitous computing and designed according to General Responsibility Assignment Software Patterns (GRASP), and a server with a web page. To choose the preventive messages, we performed a test in 17 men who have sex with men (MSM). Our software sends preventive notifications to users when it detects situations such as the activation of particular applications on their smartphones, or their proximity to areas with a high probability of intercourse (hot zones). The underlying idea is the same as that for warning messages on cigarette packets, since users read the message just when they are going to smoke. The messages used have been selected from a list that has been rated by the users themselves. The most popular message is "Enjoy sex and enjoy life. Do not expose yourself to HIV". The user is unaware of the software, which runs in the background. Ubiquitous computing may be useful for alerting users with preventive and educational messages. The proposed application is non-intrusive because: 1) the users themselves decide to install it and, therefore, users' privacy rights are preserved; 2) it sends a message that helps users think about taking appropriate preventive measures; and 3) it works in the background without interfering with users unless a trigger situation is detected. Thus, this type of application could become an important tool in the complex task of STI prevention.

Emerging Technologies: Web 2.0.

PubMed

Holt, Claire

2011-03-01

Web 2.0 has brought a change to how we communicate and disseminate information with the use of Twitter, Facebook, YouTube, instant messaging and blogging. This technology is beginning to be used in the health field for public awareness campaigns, emergency health alerts, medical education and remote healthcare services. Australian Health Information Managers will be called upon to reconcile their organisations' policies and procedures regarding the use of Web 2.0 technologies within the existing legal framework of privacy, confidentiality and consent. This article explores various applications of Web 2.0, their benefits and some of their potential legal and ethical implications when implemented in Australia.

Performance Evaluation of Evasion Maneuvers for Parallel Approach Collision Avoidance

NASA Technical Reports Server (NTRS)

Winder, Lee F.; Kuchar, James K.; Waller, Marvin (Technical Monitor)

2000-01-01

Current plans for independent instrument approaches to closely spaced parallel runways call for an automated pilot alerting system to ensure separation of aircraft in the case of a "blunder," or unexpected deviation from the a normal approach path. Resolution advisories by this system would require the pilot of an endangered aircraft to perform a trained evasion maneuver. The potential performance of two evasion maneuvers, referred to as the "turn-climb" and "climb-only," was estimated using an experimental NASA alerting logic (AILS) and a computer simulation of relative trajectory scenarios between two aircraft. One aircraft was equipped with the NASA alerting system, and maneuvered accordingly. Observation of the rates of different types of alerting failure allowed judgement of evasion maneuver performance. System Operating Characteristic (SOC) curves were used to assess the benefit of alerting with each maneuver.

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

PubMed

Kuo, Yu-Chun; Cheng, Shou-Hsia

2017-06-01

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

Practitioners’ Views on Computerized Drug–Drug Interaction Alerts in the VA System

PubMed Central

Ko, Yu; Abarca, Jacob; Malone, Daniel C.; Dare, Donna C.; Geraets, Doug; Houranieh, Antoun; Jones, William N.; Nichol, W. Paul; Schepers, Gregory P.; Wilhardt, Michelle

2007-01-01

Objectives To assess Veterans Affairs (VA) prescribers’ and pharmacists’ opinions about computer-generated drug–drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts. Design A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States. Measurements A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts. Results The overall response rate was 40% (prescribers: 36%; pharmacists: 59%). Both prescribers and pharmacists indicated that the CPOE system had a neutral to positive impact on their jobs. DDI alerts were not viewed as a waste of time and the majority (61%) of prescribers felt that DDI alerts had increased their potential to prescribe safely. However, only 30% of prescribers felt DDI alerts provided them with what they needed most of the time. Both prescribers and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73% and 82%, respectively) and more detailed information (65% and 89%, respectively). When asked about suggestions for improving DDI alerts, prescribers most preferred including management options whereas pharmacists most preferred making it more difficult to override lethal interactions. Prescribers and pharmacists reported primarily relying on electronic references for general drug information (62% and 55%, respectively) and DDI information (51% and 79%, respectively). Conclusion Respondents reported neutral to positive views regarding the effect of CPOE on their jobs. Their opinions suggest DDI alerts are useful but still require additional work to increase their clinical utility. PMID:17068346

On-Board GPS Clock Monitoring for Signal Integrity

DTIC Science & Technology

2010-11-01

to-alert requirements to permit primary reliance for safety -of-life applications. Augmentation systems are being developed and deployed to address...virtually no false alerts from the combined system . With three running, on-board AFSs , occasional breaks of the error threshold can be allowed if the... system can be assured of transfer to another AFS within a period shorter than the required TTA. With only two AFSs on board running and measured

Simultaneous message framing and error detection

NASA Technical Reports Server (NTRS)

Frey, A. H., Jr.

1968-01-01

Circuitry simultaneously inserts message framing information and detects noise errors in binary code data transmissions. Separate message groups are framed without requiring both framing bits and error-checking bits, and predetermined message sequence are separated from other message sequences without being hampered by intervening noise.

Emergency management response to a warning-level Alaska-source tsunami impacting California: Chapter J in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Miller, Kevin M.; Long, Kate

2013-01-01

This chapter is directed towards two audiences: Firstly, it targets nonemergency management readers, providing them with insight on the process and challenges facing emergency managers in responding to tsunami Warning, particularly given this “short fuse” scenario. It is called “short fuse” because there is only a 5.5-hour window following the earthquake before arrival of the tsunami within which to evaluate the threat, disseminate alert and warning messages, and respond. This action initiates a period when crisis communication is of paramount importance. An additional dynamic that is important to note is that within 15 minutes of the earthquake, the National Oceanic and Atmospheric Administration (NOAA) and the National Weather Service (NWS) will issue alert bulletins for the entire Pacific Coast. This is one-half the time actually presented by recent tsunamis from Japan, Chile, and Samoa. Second, the chapter provides emergency managers at all levels with insights into key considerations they may need to address in order to augment their existing plans and effectively respond to tsunami events. We look at emergency management response to the tsunami threat from three perspectives:“Top Down” (Threat analysis and Alert/Warning information from the Federal agency charged with Alert and Warning) “Bottom Up” (Emergency management’s Incident Command approach to responding to emergencies and disasters based on the needs of impacted local jurisdictions) “Across Time” (From the initiating earthquake event through emergency response) We focus on these questions: What are the government roles, relationships, and products that support Tsunami Alert and Warning dissemination? (Emergency Planning and Preparedness.) What roles, relationships, and products support emergency management response to Tsunami Warning and impact? (Engendering prudent public safety response.) What are the key emergency management activities, considerations, and challenges brought out by the SAFRR tsunami scenario? (Real emergencies) How do these activities, considerations, and challenges play out as the tsunami event unfolds across the “life” of the event? (Lessons)

MO-F-16A-06: Implementation of a Radiation Exposure Monitoring System for Surveillance of Multi-Modality Radiation Dose Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stewart, B; Kanal, K; Dickinson, R

2014-06-15

Purpose: We have implemented a commercially available Radiation Exposure Monitoring System (REMS) to enhance the processes of radiation dose data collection, analysis and alerting developed over the past decade at our sites of practice. REMS allows for consolidation of multiple radiation dose information sources and quicker alerting than previously developed processes. Methods: Thirty-nine x-ray producing imaging modalities were interfaced with the REMS: thirteen computed tomography scanners, sixteen angiography/interventional systems, nine digital radiography systems and one mammography system. A number of methodologies were used to provide dose data to the REMS: Modality Performed Procedure Step (MPPS) messages, DICOM Radiation Dose Structuredmore » Reports (RDSR), and DICOM header information. Once interfaced, the dosimetry information from each device underwent validation (first 15–20 exams) before release for viewing by end-users: physicians, medical physicists, technologists and administrators. Results: Before REMS, our diagnostic physics group pulled dosimetry data from seven disparate databases throughout the radiology, radiation oncology, cardiology, electrophysiology, anesthesiology/pain management and vascular surgery departments at two major medical centers and four associated outpatient clinics. With the REMS implementation, we now have one authoritative source of dose information for alerting, longitudinal analysis, dashboard/graphics generation and benchmarking. REMS provides immediate automatic dose alerts utilizing thresholds calculated through daily statistical analysis. This has streamlined our Closing the Loop process for estimated skin exposures in excess of our institutional specific substantial radiation dose level which relied on technologist notification of the diagnostic physics group and daily report from the radiology information system (RIS). REMS also automatically calculates the CT size-specific dose estimate (SSDE) as well as provides two-dimensional angulation dose maps for angiography/interventional procedures. Conclusion: REMS implementation has streamlined and consolidated the dosimetry data collection and analysis process at our institutions while eliminating manual entry error and providing immediate alerting and access to dosimetry data to both physicists and physicians. Brent Stewart has funded research through GE Healthcare.« less

Earthquake Early Warning: New Strategies for Seismic Hardware

NASA Astrophysics Data System (ADS)

Allardice, S.; Hill, P.

2017-12-01

Implementing Earthquake Early Warning System (EEWS) triggering algorithms into seismic networks has been a hot topic of discussion for some years now. With digitizer technology now available, such as the Güralp Minimus, with on average 40-60ms delay time (latency) from earthquake origin to issuing an alert the next step is to provide network operators with a simple interface for on board parameter calculations from a seismic station. A voting mechanism is implemented on board which mitigates the risk of false positives being communicated. Each Minimus can be configured to with a `score' from various sources i.e. Z channel on seismometer, N/S E/W channels on accelerometer and MEMS inside Minimus. If the score exceeds the set threshold then an alert is sent to the `Master Minimus'. The Master Minimus within the network will also be configured as to when the alert should be issued i.e. at least 3 stations must have triggered. Industry standard algorithms focus around the calculation of Peak Ground Acceleration (PGA), Peak Ground Velocity (PGV), Peak Ground Displacement (PGD) and C. Calculating these single station parameters on-board in order to stream only the results could help network operators with possible issues, such as restricted bandwidth. Developments on the Minimus allow these parameters to be calculated and distributed through Common Alert Protocol (CAP). CAP is the XML based data format used for exchanging and describing public warnings and emergencies. Whenever the trigger conditions are met the Minimus can send a signed UDP packet to the configured CAP receiver which can then send the alert via SMS, e-mail or CAP forwarding. Increasing network redundancy is also a consideration when developing these features, therefore the forwarding CAP message can be sent to multiple destinations. This allows for a hierarchical approach by which the single station (or network) parameters can be streamed to another Minimus, or data centre, or both, so that there is no one single point of failure. Developments on the Guralp Minimus to calculate these on board parameters which are capable of streaming single station parameters, accompanied with the ultra-low latency is the next generation of EEWS and Güralps contribution to the community.

Improving efficiency and reducing administrative burden through electronic communication.

PubMed

Cook, Katlyn E; Ludens, Gail M; Ghosh, Amit K; Mundell, William C; Fleming, Kevin C; Majka, Andrew J

2013-01-01

The InBox messaging system is an internal, electronic program used at Mayo Clinic, Rochester, MN, to facilitate the sending, receiving, and answering of patient-specific messages and alerts. A standardized InBox was implemented in the Division of General Internal Medicine to decrease the time physicians, physician assistants, and nurse practitioners (clinicians) spend on administrative tasks and to increase efficiency. Clinicians completed surveys and a preintervention InBox pilot test to determine inefficiencies related to administrative burdens and defects (message entry errors). Results were analyzed using Pareto diagrams, value stream mapping, and root cause analysis to prioritize administrative-burden inefficiencies to develop a new, standardized InBox. Clinicians and allied health staff were the target of this intervention and received standardized InBox training followed by a postintervention pilot test for clinicians. Sixteen of 28 individuals (57%) completed the preintervention survey. Twenty-eight clinicians participated in 2 separate 8-day pilot tests (before and after intervention) for the standardized InBox. The number of InBox defects was substantially reduced from 37 (Pilot 1) to 7 (Pilot 2). Frequent InBox defects decreased from 25% to 10%. More than half of clinicians believed the standardized InBox positively affected their work, and 100% of clinicians reported no negative affect on their work. This project demonstrated the successful implementation of the standardized InBox messaging system. Initial assessments show substantial reduction of InBox entry defects and administrative tasks completed by clinicians. The findings of this project suggest increased clinician and allied health staff efficiency, satisfaction, improved clinician work-life balance, and decreased clinician burden caused by administrative tasks.

Functional Requirements for the Next Generation of Mass Notification

ERIC Educational Resources Information Center

Trumbo, Berkly

2012-01-01

While the latest update to National Fire Protection Association (NFPA) redefines mass notification as "emergency communications systems" (ECS), the end user community is formulating expectations related to the future functionality of today's alerting solutions. Numerous best practices have surfaced since alerting technology began its rapid,…

Text Messaging to Communicate With Public Health Audiences: How the HIPAA Security Rule Affects Practice

PubMed Central

Karasz, Hilary N.; Eiden, Amy; Bogan, Sharon

2013-01-01

Text messaging is a powerful communication tool for public health purposes, particularly because of the potential to customize messages to meet individuals’ needs. However, using text messaging to send personal health information requires analysis of laws addressing the protection of electronic health information. The Health Insurance Portability and Accountability Act (HIPAA) Security Rule is written with flexibility to account for changing technologies. In practice, however, the rule leads to uncertainty about how to make text messaging policy decisions. Text messaging to send health information can be implemented in a public health setting through 2 possible approaches: restructuring text messages to remove personal health information and retaining limited personal health information in the message but conducting a risk analysis and satisfying other requirements to meet the HIPAA Security Rule. PMID:23409902

Intern Abstract for Spring 2016

NASA Technical Reports Server (NTRS)

Gibson, William

2016-01-01

The Human Interface Branch - EV3 - is evaluating Organic lighting-emitting diodes (OLEDs) as an upgrade for current displays on future spacecraft. OLEDs have many advantages over current displays. Conventional displays require constant backlighting which draws a lot of power, but with OLEDs they generate light themselves. OLEDs are lighter, and weight is always a concern with space launches. OLEDs also grant greater viewing angles. OLEDs have been in the commercial market for almost ten years now. What is not known is how they will perform in a space-like environment; specifically deep space far away from the Earth's magnetosphere. In this environment, the OLEDs can be expected to experience vacuum and galactic radiation. The intern's responsibility has been to prepare the OLED for a battery of tests. Unfortunately, it will not be ready for testing at the end of the internship. That being said much progress has been made: a) Developed procedures to safely disassemble the tablet. b) Inventoried and identified critical electronic components. c) 3D printed a testing apparatus. d) Wrote software in Python that will test the OLED screen while being radiated. e) Built circuits to restart the tablet and the test pattern, and ensure it doesn't fall asleep during radiation testing. f) Built enclosure that will house all of the electronics Also, the intern has been working on a way to take messages from a simulated Caution and Warnings system, process said messages into packets, send audio packets to a multicast address that audio boxes are listening to, and output spoken audio. Currently, Cautions and Warnings use a tone to alert crew members of a situation, and then crew members have to read through their checklists to determine what the tone means. In urgent situations, EV3 wants to deliver concise and specific alerts to the crew to facilitate any mitigation efforts on their part. Significant progress was made on this project: a) Open channel with the simulated Caution and Warning system to acquire messages. b) Configure audio boxes. c) Grab pre-recorded audio files. d) Packetize the audio stream. A third project that was assigned to implement LED indicator modules for an Omnibus project. The Omnibus project is investigating better ways designing lighting for the interior of spacecraft-both spacecraft lighting and avionics box status lighting indication. The current scheme contains too much of the blue light spectrum that disrupts the sleep cycle. The LED indicator modules are to simulate the indicators running on a spacecraft. Lighting data will be gathered by human factors personal and use in a model underdevelopment to model spacecraft lighting. Significant progress was made on this project: Designed circuit layout a) Tested LEDs at LETF. b) Created GUI for the indicators. c) Created code for the Arduino to run that will illuminate the indicator modules.

Promoting Safety in Hypnosis: A Clinical Instrument for the Assessment of Alertness.

PubMed

Howard, Hedy A

2017-04-01

Hypnosis has long demonstrated its power to facilitate various approaches to psychotherapy. Like other potent modalities, hypnosis may produce unwanted effects. Although its negative sequelae are usually mild and transient, more serious complications may occur. Recently, attention has been drawn to the powerful role of failures of dehypnosis or alerting/realerting in producing unwanted effects. Traditionally, alerting has been viewed as a relatively uncomplicated process that requires little more than the simple suggestion that the subject will return or awaken from trance, and exiting from trance has generally been considered the cessation of the phenomena suggested during induction and thereafter. Newer findings challenge these assumptions and suggest that restoring the subject to a prehypnotic baseline level of alertness is of equal or greater importance. Here, I describe the Howard Alertness Scale (HAS), with which subjects can be made aware of their baseline levels of alertness to help them understand the unique ways that their trance states differ from their normal alert states, and assess and measure their subjective perception of alertness before and after hypnosis. Furthermore, regular use of the HAS holds potential to enhance both the therapeutic alliance and the patient's sense of safety and mastery. The development and use of the HAS is discussed along with three vignettes illustrating its clinical application.

[Detection of Brucella with an automatic hemoculture system: Bact/Alert].

PubMed

Casas, J; Partal, Y; Llosá, J; Leiva, J; Navarro, J M; de la Rosa, M

1994-12-01

The ability of in vitro and in vivo detection of Brucella spp. with the Bact/Alert system was studied. Three strains of Brucella melitensis and two of Brucella abortus were used. Different dilutions of the five strains were performed in trypticase soy broth (TSB), achieving concentrations of 1 cfu/ml, 5 cfu/ml, 10 cfu/ml and 100 cfu/ml. Ten ml of each dilution and strain were inoculated into 5 aerobic bottles Bact/Alert and 5 biphasic Hemóline bottles. Furthermore, over a 9 month period, 8,216 bottles of Bact/Alert bottles from hospitalized patients and from the emergency department were processed in the authors' laboratory. The mean detection time for Brucella growth was from 2 to 3 days with the Bact/Alert system, and 14 days in the biphasic bottles. Former bottles processed in the authors' laboratory, 11 aerobic bottles belonged to 5 patients in whom brucelosis was confirmed by bloodculture. The Bact/Alert system detected Brucella melitensis in only on bottle at 2.9 days of incubation. In 7 bottles Bact/Alert detected B. melitensis by a blind pass of these bottles at 10 to 20 days of incubation. These results suggest that the Bact/Alert system does not totally solve the diagnosis of brucellosis. Blind passes of the bloodcultures are required.

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... must be identified by a unique IP address or domain name. (b) Authentication and validation. The CMS... alert gateway if a validation fails. (c) Security. The CMS provider gateway must support standardized IP... CMSP Name Unique identification of CMSP. CMSP gateway Address IP address or Domain Name Alternate IP...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

Intense illumination in the morning hours improved mood and alertness but not mental performance.

PubMed

Leichtfried, Veronika; Mair-Raggautz, Maria; Schaeffer, Viktoria; Hammerer-Lercher, Angelika; Mair, Gerald; Bartenbach, Christian; Canazei, Markus; Schobersberger, Wolfgang

2015-01-01

Cognitive performance and alertness are two determinants for work efficiency, varying throughout the day and depending on bright light. We conducted a prospective crossover study evaluating the impacts of exposure to an intense, early morning illumination on sustained attention, alertness, mood, and serum melatonin levels in 33 healthy individuals. Compared with a dim illumination, the intense illumination negatively impacted performance requiring sustained attention; however, it positively impacted subjective alertness and mood and had no impact on serum melatonin levels. These results suggest that brief exposure to bright light in the morning hours can improve subjective measures of mood and alertness, but can also have detrimental effects on mental performance as a result of visual distraction. Therefore, it is important that adequate lighting should correspond to both non-visual and visual demands. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Age and automation interact to influence performance of a simulated luggage screening task.

PubMed

Wiegmann, Douglas; McCarley, Jason S; Kramer, Arthur F; Wickens, Christopher D

2006-08-01

An experiment examined the impact of automation on young and old adults' abilities to detect threat objects in a simulated baggage-screening task. Younger and older adult participants viewed X-ray images of cluttered baggage, 20% of which contained a hidden knife. Some participants were provided an automated aid with a hit rate of 0.90 and a false alarm rate of 0.25. The aid provided assistance to participants in one of three forms: a text message that appeared before the stimulus image; a text message that appeared following the stimulus image; or a spatial cue concurrent with the stimulus image. Control participants performed the task with no assistance from an aid. Spatial cuing improved performance for both age groups. Text cuing improved young adults' performance, but had no benefit for older participants. Effects were similar whether the text cue preceded or followed the search stimulus itself. Results indicate that spatial cuing rather than text alerts may be more effective in aiding performance during a baggage screening task and such benefits are likely to occur regardless of operator age.

Increased appropriateness of customized alert acknowledgement reasons for overridden medication alerts in a computerized provider order entry system.

PubMed

Dekarske, Brian M; Zimmerman, Christopher R; Chang, Robert; Grant, Paul J; Chaffee, Bruce W

2015-12-01

Computerized provider order entry systems commonly contain alerting mechanisms for patient allergies, incorrect doses, or drug-drug interactions when ordering medications. Providers have the option to override (bypass) these alerts and continue with the order unchanged. This study examines the effect of customizing medication alert override options on the appropriateness of override selection related to patient allergies, drug dosing, and drug-drug interactions when ordering medications in an electronic medical record. In this prospective, randomized crossover study, providers were randomized into cohorts that required a reason for overriding a medication alert from a customized or non-customized list of override reasons and/or by free-text entry. The primary outcome was to compare override responses that appropriately correlate with the alert type between the customized and non-customized configurations. The appropriateness of a subset of free-text responses that represented an affirmative and active acknowledgement of the alert without further explanation was classified as "indeterminate." Results were analyzed in three different ways by classifying indeterminate answers as either appropriate, inappropriate, or excluded entirely. Secondary outcomes included the appropriateness of override reasons when comparing cohorts and individual providers, reason selection based on order within the override list, and the determination of the frequency of free-text use, nonsensical responses, and multiple selection responses. Twenty-two clinicians were randomized into 2 cohorts and a total of 1829 alerts with a required response were generated during the study period. The customized configuration had a higher rate of appropriateness when compared to the non-customized configuration regardless of how indeterminate responses were classified (p<0.001). When comparing cohorts, appropriateness was significantly higher in the customized configuration regardless of the classification of indeterminate responses (p<0.001) with one exception: when indeterminate responses were considered inappropriate for the cohort of providers that were first exposed to the non-customized list (p=0.103). Free-text use was higher in the customized configuration overall (p<0.001), and there was no difference in nonsensical response between configurations (p=0.39). There is a benefit realized by using a customized list for medication override reasons. Poor application design or configuration can negatively affect provider behavior when responding to important medication alerts. Copyright © 2015. Published by Elsevier Ireland Ltd.

Adaptation of the Fresenius PD+ Cycler for a hearing-impaired patient.

PubMed

Kushner, A

2000-01-01

Continuous cycling peritoneal dialysis (CCPD) uses a cycler to perform dialysis exchanges and requires the patient to respond to an audible alarm signifying an interruption in the therapy. Consequently, an unassisted hearing-impaired patient could not use the system. By converting the standard alarm to a vibrating signal, the cycler was successfully adapted to accommodate the special needs of our hearing-impaired patient. The items required for the modification were the Sonic Alert Wake Up Alarm (Model SA-WA300: Sonic Alert, Troy, MI, U.S.A.) and the Sonic Alert Super Shaker Bed Vibrator (Model SA-SS120V: Sonic Alert). The patient can place the vibrator under either the pillow or the mattress. When the cycler alarm is activated, vibration wakens the patient. The equipment was purchased from Harris Communications (Eden Prairie, MN, U.S.A.) through a referral by the Easter Seal Society. Three days were needed to complete training compared to an average of one or two days for patients previously trained for continuous ambulatory peritoneal dialysis (CAPD). The patient remained on cycler therapy for approximately four months when the unrelated development of an abdominal hernia required termination of peritoneal dialysis and subsequent transfer to hemodialysis. In conclusion, a modified cycler can provide a safe and efficient renal replacement therapy option for a hearing-impaired patient.

The COMESEP Alert System

NASA Astrophysics Data System (ADS)

Crosby, Norma; Veronig, Astrid; Rodriguez, Luciano; Vrsnak, Bojan; Vennerstrom, Susanne; Malandraki, Olga; Dalla, Silvia; Srivastava, Nandita; Hesse, Michael; Odstrcil, Dusan; Robbrecht, Eva

2014-05-01

Tools for forecasting geomagnetic storms and solar energetic particle (SEP) radiation storms have been developed under the three-year EU FP7 COMESEP (COronal Mass Ejections and Solar Energetic Particles) collaborative project. To enhance our understanding of the 3D kinematics and interplanetary propagation of coronal mass ejections (CMEs), the structure, propagation and evolution of CMEs have been investigated. In parallel, the sources and propagation of SEPs have been examined and modeled. During the third year of the COMESEP project the produced tools have been validated and implemented into an operational space weather alert system. The COMESEP Alert System provides notifications for the space weather community. To achieve this the system relies on both models and data, the latter including near real-time data as well as historical data. Geomagnetic and SEP radiation storm alerts are based on the COMESEP definition of risk. The COMESEP Alert System has recently been launched. Receiving COMESEP alerts are free of charge, but registration is required. For more information see the project website (http://www.comesep.eu/). This work has received funding from the European Commission FP7 Project COMESEP (263252).

Mental Effort in Binary Categorization Aided by Binary Cues

ERIC Educational Resources Information Center

Botzer, Assaf; Meyer, Joachim; Parmet, Yisrael

2013-01-01

Binary cueing systems assist in many tasks, often alerting people about potential hazards (such as alarms and alerts). We investigate whether cues, besides possibly improving decision accuracy, also affect the effort users invest in tasks and whether the required effort in tasks affects the responses to cues. We developed a novel experimental tool…

Aircraft Alerting Systems Standardization Study. Phase IV. Accident Implications on Systems Design.

DTIC Science & Technology

1982-06-01

computing and processing to assimilate and process status informa- 5 tion using...provided with capabilities in computing and processing , sensing, interfacing, and controlling and displaying. 17 o Computing and Processing - Algorithms...alerting system to perform a flight status monitor function would require additional sensinq, computing and processing , interfacing, and controlling

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Advanced Collision Avoidance System for UAS (ACAS Xu) Interoperability White Paper Presentation

NASA Technical Reports Server (NTRS)

Fern, Lisa

2017-01-01

The Phase 1 DAA Minimum Operational Performance Standards (MOPS) provided requirements for two classes of DAA equipment: equipment Class 1 contains the basic DAA equipment required to assist a pilot in remaining well clear, while equipment Class 2 integrates the Traffic Alert and Collision Avoidance (TCAS) II system. Thus, the Class 1 system provides RWC functionality only, while the Class 2 system is intended to provide both RWC and Collision Avoidance (CA) functionality, in compliance with the Minimum Aviation System Performance (MASPS) for the Interoperability of Airborne Collision Avoidance Systems. The FAAs TCAS Program Office is currently developing Airborne Collision Avoidance System X (ACAS X) to support the objectives of the Federal Aviation Administrations (FAA) Next Generation Air Transportation System Program (NextGen). ACAS X has a suite of variants with a common underlying design that are intended to be optimized for their intended airframes and operations. ACAS Xu being is designed for UAS and allows for new surveillance technologies and tailored logic for platforms with different performance characteristics. In addition to Collision Avoidance (CA) alerting and guidance, ACAS Xu is being tuned to provide RWC alerting and guidance in compliance with the SC 228 DAA MOPS. With a single logic performing both RWC and CA functions, ACAS Xu will provide industry with an integrated DAA solution that addresses many of the interoperability shortcomings of Phase I systems. While the MOPS for ACAS Xu will specify an integrated DAA system, it will need to show compliance with the RWC alerting thresholds and alerting requirements defined in the DAA Phase 2 MOPS. Further, some functional components of the ACAS Xu system such as the remote pilots displayed guidance might be mostly references to the corresponding requirements in the DAA MOPS. To provide a seamless, integrated, RWC-CA system to assist the pilot in remaining well clear and avoiding collisions, several issues need to be addressed within the Phase 2 SC-228 DAA efforts. Interoperability of the RWC and CA alerting and guidance, and ensuring pilot comprehension, compliance and performance, will be a primary research area.

Natural hazard communication : effectiveness and quality

NASA Astrophysics Data System (ADS)

Presta, A.; Sole, A.; de Luca, G.

2009-04-01

Scientific, technological and methodological knowledge regarding the risks caused by natural events are in continuous evolution. A careful analysis of the communication and information, practiced by administrations and institutions involved in the decision-making processes, show a peculiar difference between the quality of the theoretical-operating level and the effectiveness of communication systems of the risk obtained. This is the level which involves directly citizens and institutions and needs, therefore, an efficacious and shared system whose aim is to inform the whole community, in a simple and clear way, during the different phases correlated to the environmental risk. The hypotesis is, in fact, to create a distinct typology of message, corresponding to each phase: • prevention of the risk > sensitization > information. If the potential risk is imminent or changes into real emergency, it is necessary to plan a communication aimed at supporting a very fast alarm to the community. • anticipation of the risk > pre-alert > information • imminence of the risk > alert > alarm • post-event /risk > information > precept and rules. The lack of a uniform and coerent planning process, both on the linguistic field (the typology of the message, iconic and verbal) and technical (the typology of supports) it is clear analysing the reference scenario in Italy. This involves the creation of deeply discordant systems which don't communicate the different typologies of risk efficaciously during distinct moments. To come to a systemic vision of the problem we proceed to collect and to obtain documentation about the "alarm" and communication systems existing in Italy nowadays. So we will have a classification of the different typologies about natural risk and communication systems related to them. The aim of this research is to propose a rationalization and a standard coding of signals. The logical conclusion of this course can be the creation of a national/international "catalogue system" which has the function of convalidating and guaranteeing the conformity of the communication in the ambit of the environmental risk. To continue the project, that has been proposed in the last year, is necessary to create a working group - with interdisciplinary expertise - to address the various issues related to the project and the definition of content spread: experts disciplinary course, but also the psychologists of perception , designers of communication, typedesigner, leading to the establishment of a system of signs (iconic and visual) that can carry useful and unambiguous messages.

Finite-Fault and Other New Capabilities of CISN ShakeAlert

NASA Astrophysics Data System (ADS)

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

2013-12-01

Over the past 6 years, scientists at Caltech, UC Berkeley, the Univ. of Southern California, the Univ. of Washington, the US Geological Survey, and ETH Zurich (Switzerland) have developed the 'ShakeAlert' earthquake early warning demonstration system for California and the Pacific Northwest. We have now started to transform this system into a stable end-to-end production system that will be integrated into the daily routine operations of the CISN and PNSN networks. To quickly determine the earthquake magnitude and location, ShakeAlert currently processes and interprets real-time data-streams from several hundred seismic stations within the California Integrated Seismic Network (CISN) and the Pacific Northwest Seismic Network (PNSN). Based on these parameters, the 'UserDisplay' software predicts and displays the arrival and intensity of shaking at a given user site. Real-time ShakeAlert feeds are currently being shared with around 160 individuals, companies, and emergency response organizations to gather feedback about the system performance, to educate potential users about EEW, and to identify needs and applications of EEW in a future operational warning system. To improve the performance during large earthquakes (M>6.5), we have started to develop, implement, and test a number of new algorithms for the ShakeAlert system: the 'FinDer' (Finite Fault Rupture Detector) algorithm provides real-time estimates of locations and extents of finite-fault ruptures from high-frequency seismic data. The 'GPSlip' algorithm estimates the fault slip along these ruptures using high-rate real-time GPS data. And, third, a new type of ground-motion prediction models derived from over 415,000 rupture simulations along active faults in southern California improves MMI intensity predictions for large earthquakes with consideration of finite-fault, rupture directivity, and basin response effects. FinDer and GPSlip are currently being real-time and offline tested in a separate internal ShakeAlert installation at Caltech. Real-time position and displacement time series from around 100 GPS sensors are obtained in JSON format from RTK/PPP(AR) solutions using the RTNet software at USGS Pasadena. However, we have also started to investigate the usage of onsite (in-receiver) processing using NetR9 with RTX and tracebuf2 output format. A number of changes to the ShakeAlert processing, xml message format, and the usage of this information in the UserDisplay software were necessary to handle the new finite-fault and slip information from the FinDer and GPSlip algorithms. In addition, we have developed a framework for end-to-end off-line testing with archived and simulated waveform data using the Earthworm tankplayer. Detailed background information about the algorithms, processing, and results from these test runs will be presented.

Critical laboratory values in hemostasis: toward consensus.

PubMed

Lippi, Giuseppe; Adcock, Dorothy; Simundic, Ana-Maria; Tripodi, Armando; Favaloro, Emmanuel J

2017-09-01

The term "critical values" can be defined to entail laboratory test results that significantly lie outside the normal (reference) range and necessitate immediate reporting to safeguard patient health, as well as those displaying a highly and clinically significant variation compared to previous data. The identification and effective communication of "highly pathological" values has engaged the minds of many clinicians, health care and laboratory professionals for decades, since these activities are vital to good laboratory practice. This is especially true in hemostasis, where a timely and efficient communication of critical values strongly impacts patient management. Due to the heterogeneity of available data, this paper is hence aimed to analyze the state of the art and provide an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis, thus providing a basic document for future consultation that assists laboratory professionals and clinicians alike. KEY MESSAGES Critical values are laboratory test results significantly lying outside the normal (reference) range and necessitating immediate reporting to safeguard patient health. A broad heterogeneity exists about critical values in hemostasis worldwide. We provide here an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis.

Validation of Test Performance and Clinical Time Zero for an Electronic Health Record Embedded Severe Sepsis Alert

PubMed Central

Downing, N. Lance; Shepard, John; Chu, Weihan; Tam, Julia; Wessels, Alexander; Li, Ron; Dietrich, Brian; Rudy, Michael; Castaneda, Leon; Shieh, Lisa

2016-01-01

Summary Bachground Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management. Objective To develop, evaluate, and validate an accurate and timely severe sepsis alert embedded in a commercial EHR. Methods The sepsis alert was developed by identifying the most common severe sepsis criteria among a cohort of patients with ICD 9 codes indicating a diagnosis of sepsis. This alert requires criteria in three categories: indicators of a systemic inflammatory response, evidence of suspected infection from physician orders, and markers of organ dysfunction. Chart review was used to evaluate test performance and the ability to detect clinical time zero, the point in time when a patient develops severe sepsis. Results Two physicians reviewed 100 positive cases and 75 negative cases. Based on this review, sensitivity was 74.5%, specificity was 86.0%, the positive predictive value was 50.3%, and the negative predictive value was 94.7%. The most common source of end-organ dysfunction was MAP less than 70 mm/Hg (59%). The alert was triggered at clinical time zero in 41% of cases and within three hours in 53.6% of cases. 96% of alerts triggered before a manual nurse screen. Conclusion We are the first to report the time between a sepsis alert and physician chart-review clinical time zero. Incorporating physician orders in the alert criteria improves specificity while maintaining sensitivity, which is important to reduce alert fatigue. By leveraging standard EHR functionality, this alert could be implemented by other healthcare systems. PMID:27437061

Validation of Test Performance and Clinical Time Zero for an Electronic Health Record Embedded Severe Sepsis Alert.

PubMed

Rolnick, Joshua; Downing, N Lance; Shepard, John; Chu, Weihan; Tam, Julia; Wessels, Alexander; Li, Ron; Dietrich, Brian; Rudy, Michael; Castaneda, Leon; Shieh, Lisa

2016-01-01

Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management. To develop, evaluate, and validate an accurate and timely severe sepsis alert embedded in a commercial EHR. The sepsis alert was developed by identifying the most common severe sepsis criteria among a cohort of patients with ICD 9 codes indicating a diagnosis of sepsis. This alert requires criteria in three categories: indicators of a systemic inflammatory response, evidence of suspected infection from physician orders, and markers of organ dysfunction. Chart review was used to evaluate test performance and the ability to detect clinical time zero, the point in time when a patient develops severe sepsis. Two physicians reviewed 100 positive cases and 75 negative cases. Based on this review, sensitivity was 74.5%, specificity was 86.0%, the positive predictive value was 50.3%, and the negative predictive value was 94.7%. The most common source of end-organ dysfunction was MAP less than 70 mm/Hg (59%). The alert was triggered at clinical time zero in 41% of cases and within three hours in 53.6% of cases. 96% of alerts triggered before a manual nurse screen. We are the first to report the time between a sepsis alert and physician chart-review clinical time zero. Incorporating physician orders in the alert criteria improves specificity while maintaining sensitivity, which is important to reduce alert fatigue. By leveraging standard EHR functionality, this alert could be implemented by other healthcare systems.

Efficient decentralized consensus protocols

NASA Technical Reports Server (NTRS)

Lakshman, T. V.; Agrawala, A. K.

1986-01-01

Decentralized consensus protocols are characterized by successive rounds of message interchanges. Protocols which achieve a consensus in one round of message interchange require O(N-squared) messages, where N is the number of participants. In this paper, a communication scheme, based on finite projective planes, which requires only O(N sq rt N) messages for each round is presented. Using this communication scheme, decentralized consensus protocols which achieve a consensus within two rounds of message interchange are developed. The protocols are symmetric, and the communication scheme does not impose any hierarchical structure. The scheme is illustrated using blocking and nonblocking commit protocols, decentralized extrema finding, and computation of the sum function.

Evaluating Alerting and Guidance Performance of a UAS Detect-And-Avoid System

NASA Technical Reports Server (NTRS)

Lee, Seung Man; Park, Chunki; Thipphavong, David P.; Isaacson, Douglas R.; Santiago, Confesor

2016-01-01

A key challenge to the routine, safe operation of unmanned aircraft systems (UAS) is the development of detect-and-avoid (DAA) systems to aid the UAS pilot in remaining "well clear" of nearby aircraft. The goal of this study is to investigate the effect of alerting criteria and pilot response delay on the safety and performance of UAS DAA systems in the context of routine civil UAS operations in the National Airspace System (NAS). A NAS-wide fast-time simulation study was conducted to assess UAS DAA system performance with a large number of encounters and a broad set of DAA alerting and guidance system parameters. Three attributes of the DAA system were controlled as independent variables in the study to conduct trade-off analyses: UAS trajectory prediction method (dead-reckoning vs. intent-based), alerting time threshold (related to predicted time to LoWC), and alerting distance threshold (related to predicted Horizontal Miss Distance, or HMD). A set of metrics, such as the percentage of true positive, false positive, and missed alerts, based on signal detection theory and analysis methods utilizing the Receiver Operating Characteristic (ROC) curves were proposed to evaluate the safety and performance of DAA alerting and guidance systems and aid development of DAA system performance standards. The effect of pilot response delay on the performance of DAA systems was evaluated using a DAA alerting and guidance model and a pilot model developed to support this study. A total of 18 fast-time simulations were conducted with nine different DAA alerting threshold settings and two different trajectory prediction methods, using recorded radar traffic from current Visual Flight Rules (VFR) operations, and supplemented with DAA-equipped UAS traffic based on mission profiles modeling future UAS operations. Results indicate DAA alerting distance threshold has a greater effect on DAA system performance than DAA alerting time threshold or ownship trajectory prediction method. Further analysis on the alert lead time (time in advance of predicted loss of well clear at which a DAA alert is first issued) indicated a strong positive correlation between alert lead time and DAA system performance (i.e. the ability of the UAS pilot to maneuver the unmanned aircraft to remain well clear). While bigger distance thresholds had beneficial effects on alert lead time and missed alert rate, it also generated a higher rate of false alerts. In the design and development of DAA alerting and guidance systems, therefore, the positive and negative effects of false alerts and missed alerts should be carefully considered to achieve acceptable alerting system performance by balancing false and missed alerts. The results and methodology presented in this study are expected to help stakeholders, policymakers and standards committees define the appropriate setting of DAA system parameter thresholds for UAS that ensure safety while minimizing operational impacts to the NAS and equipage requirements for its users before DAA operational performance standards can be finalized.

Airport Traffic Conflict Detection and Resolution Algorithm Evaluation

NASA Technical Reports Server (NTRS)

Jones, Denise R.; Chartrand, Ryan C.; Wilson, Sara R.; Commo, Sean A.; Ballard, Kathryn M.; Otero, Sharon D.; Barker, Glover D.

2016-01-01

Two conflict detection and resolution (CD&R) algorithms for the terminal maneuvering area (TMA) were evaluated in a fast-time batch simulation study at the National Aeronautics and Space Administration (NASA) Langley Research Center. One CD&R algorithm, developed at NASA, was designed to enhance surface situation awareness and provide cockpit alerts of potential conflicts during runway, taxi, and low altitude air-to-air operations. The second algorithm, Enhanced Traffic Situation Awareness on the Airport Surface with Indications and Alerts (SURF IA), was designed to increase flight crew awareness of the runway environment and facilitate an appropriate and timely response to potential conflict situations. The purpose of the study was to evaluate the performance of the aircraft-based CD&R algorithms during various runway, taxiway, and low altitude scenarios, multiple levels of CD&R system equipage, and various levels of horizontal position accuracy. Algorithm performance was assessed through various metrics including the collision rate, nuisance and missed alert rate, and alert toggling rate. The data suggests that, in general, alert toggling, nuisance and missed alerts, and unnecessary maneuvering occurred more frequently as the position accuracy was reduced. Collision avoidance was more effective when all of the aircraft were equipped with CD&R and maneuvered to avoid a collision after an alert was issued. In order to reduce the number of unwanted (nuisance) alerts when taxiing across a runway, a buffer is needed between the hold line and the alerting zone so alerts are not generated when an aircraft is behind the hold line. All of the results support RTCA horizontal position accuracy requirements for performing a CD&R function to reduce the likelihood and severity of runway incursions and collisions.

GMSEC Interface Specification Document 2016 March

NASA Technical Reports Server (NTRS)

Handy, Matthew

2016-01-01

The GMSEC Interface Specification Document contains the standard set of defined messages. Each GMSEC standard message contains a GMSEC Information Bus Header section and a Message Contents section. Each message section identifies required fields, optional fields, data type and recommended use of the fields. Additionally, this document includes the message subjects associated with the standard messages. The system design of the operations center should ensure the components that are selected use both the API and the defined standard messages in order to achieve full interoperability from component to component.

Risk management, or just a different risk?

PubMed

Freer, Y; Lyon, A

2006-09-01

National reporting of adverse incidents has resulted in a number of clinical alerts being issued. Despite a lack of evidence, these alerts are often accompanied by a mandatory requirement to alter practice. There is likely to be clinician resistance to such a method of change management, particularly where evidence of safety is missing. To determine the level of implementation within neonatal units of an alert requiring the change from litmus to pH paper to test nasogastric tube position. A questionnaire sent to all neonatal units in the United Kingdom with more than 12 cots. From the 207 questionnaires sent, there were 165 (80%) responses. Fifty five percent of units were still using litmus. All continued to use supplementary tests not recommended in best practice statements issued at the time of the alert. There was considerable variation in the pH value at which it was considered safe to feed. Nine months after the alert, more than half the units had not changed to pH paper, and supplementary methods of testing were still being used. The wide range of pH values highlights the uncertainty about the "normal" gastric pH in the newborn. The evidence that, in neonatal units, changing to pH paper is safer than the long established use of litmus is lacking. Recommendations for change in practice must be based on good information and not seen just as a "knee jerk" response to adverse incidents.

76 FR 35810 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

... Plan that provides for delivery of such alerts. 3. The Third FNPRM builds on that effort by seeking...)(3) of the Commission's rules should be modified to include a requirement for a single Ethernet port... distribution should be delineated in terms of how the EAN is distributed from the PEP/NP to the PN/NN stations...

Management of Patient-Reported Outcome (PRO) Alerts in Clinical Trials: A Cross Sectional Survey.

PubMed

Kyte, Derek; Ives, Jonathan; Draper, Heather; Calvert, Melanie

2016-01-01

Assessment of patient-reported outcomes (PROs) provides valuable information to inform patient-centered care, but may also reveal 'PRO alerts': psychological distress or physical symptoms that may require an immediate response. Ad-hoc management of PRO alerts in clinical trials may result in suboptimal patient care or potentially bias trial results. To gain greater understanding of current practice in PRO alert management we conducted a national survey of personnel involved in clinical trials with a PRO endpoint. We conducted a national cross-sectional survey of 767 UK-based research nurses, data managers/coordinators, trial managers and chief/principal investigators involved in clinical trials using PROs. Respondents were self-selected volunteers from a non-randomised sample of eligible individuals recruited via 55 UK Clinical Research Collaboration Registered Clinical Trials Units and 19 Comprehensive Local Research Networks. Questions centred on the proportion of trial personnel encountering alerts, how staff responded to PRO alerts and whether current guidance was deemed sufficient to support research personnel. We undertook descriptive analyses of the quantitative data and directed thematic analysis of free-text comments. 20% of research nurses did not view completed PRO questionnaires and were not in a position to discover alerts, 39-50% of the remaining respondent group participants reported encountering PRO alerts. Of these, 83% of research nurses and 54% of data managers/trial coordinators reported taking action to assist the trial participant, but less than half were able to record the intervention in the trial documentation. Research personnel reported current PRO alert guidance/training was insufficient. Research personnel are intermittently exposed to PRO alerts. Some intervene to help trial participants, but are not able to record this intervention in the trial documentation, risking co-intervention bias. Other staff do not check PRO information during the trial, meaning alerts may remain undiscovered, or do not respond to alerts if they are inadvertently encountered; both of which may impact on patient safety. Guidance is needed to support PRO alert management that protects the interests of trial participants whilst avoiding potential bias.

Improving Recognition of Pediatric Severe Sepsis in the Emergency Department: Contributions of a Vital Sign-Based Electronic Alert and Bedside Clinician Identification.

PubMed

Balamuth, Fran; Alpern, Elizabeth R; Abbadessa, Mary Kate; Hayes, Katie; Schast, Aileen; Lavelle, Jane; Fitzgerald, Julie C; Weiss, Scott L; Zorc, Joseph J

2017-12-01

Recognition of pediatric sepsis is a key clinical challenge. We evaluate the performance of a sepsis recognition process including an electronic sepsis alert and bedside assessment in a pediatric emergency department (ED). This was a cohort study with quality improvement intervention in a pediatric ED. Exposure was a positive electronic sepsis alert, defined as elevated pulse rate or hypotension, concern for infection, and at least one of the following: abnormal capillary refill, abnormal mental status, or high-risk condition. A positive electronic sepsis alert prompted team assessment or huddle to determine need for sepsis protocol. Clinicians could initiate team assessment or huddle according to clinical concern without positive electronic sepsis alert. Severe sepsis outcome defined as activation of the sepsis protocol in the ED or development of severe sepsis requiring ICU admission within 24 hours. There were 182,509 ED visits during the study period, with 86,037 before electronic sepsis alert implementation and 96,472 afterward, and 1,112 (1.2%) positive electronic sepsis alerts. Overall, 326 patients (0.3%) were treated for severe sepsis within 24 hours. Test characteristics of the electronic sepsis alert alone to detect severe sepsis were sensitivity 86.2% (95% confidence interval [CI] 82.0% to 89.5%), specificity 99.1% (95% CI 99.0% to 99.2%), positive predictive value 25.4% (95% CI 22.8% to 28.0%), and negative predictive value 100% (95% CI 99.9% to 100%). Inclusion of the clinician screen identified 43 additional electronic sepsis alert-negative children, with severe sepsis sensitivity 99.4% (95% CI 97.8% to 99.8%) and specificity 99.1% (95% CI 99.1% to 99.2%). Electronic sepsis alert implementation increased ED sepsis detection from 83% to 96%. Electronic sepsis alert for severe sepsis demonstrated good sensitivity and high specificity. Addition of clinician identification of electronic sepsis alert-negative patients further improved sensitivity. Implementation of the electronic sepsis alert was associated with improved recognition of severe sepsis. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Preventing intentional food contamination: a survey to assess restaurant preparedness.

PubMed

Xirasagar, Sudha; Kanwat, C P; Qu, Haiyan; Smith, Lillian U; Patterson, Nathaniel J; Shewchuk, Richard M

2010-01-01

In the age of preparedness, public health agencies are concerned with intentional acts of food contamination in restaurants, in addition to food safety. Food safety consists of applying standard norms of practice and infrastructure, which, if violated, cause food-borne illness. In contrast, food defense requires an institutionalized mindset of informed alertness to unusual variations from the norms, combined with preemptive practices best suited to each restaurant. Therefore, while food safety lends itself to regulation to ensure standard practices, food defense is best served by advisory guidelines for autonomous application, preserving the restaurant industry's core values of hospitality and customer service. To address this challenge, public health agencies need survey tools that can yield action-relevant data on the knowledge and practice gaps in food defense preparedness and on educational messages and support services to be developed for maximum impact potential. This article presents a mail survey instrument, developed using qualitative research to ensure content and face validity. Instrument development involved drafting the survey on the basis of expert consultations, validating its content by using focus groups (representing all restaurant categories and geographic regions), and ensuring face validity through cognitive interviews. The resulting survey remains sensitive to the hospitality industry while encompassing all vulnerable points.

Incorporating Data Link Features into a Multi-Function Display to Support Self-Separation and Spacing Tasks for General Aviation Pilots

NASA Technical Reports Server (NTRS)

Adams, Catherine A.; Murdoch, Jennifer L.; Consiglio, Maria C.; WIlliams, Daniel M.

2005-01-01

One objective of the Small Aircraft Transportation System (SATS) Higher Volume Operations (HVO) project is to increase the capacity and utilization of small non-towered, non-radar equipped airports by transferring traffic management activities to an automated Airport Management Module (AMM) and separation responsibilities to general aviation (GA) pilots. Implementation of this concept required the development of a research Multi-Function Display (MFD) to support the interactive communications between pilots and the AMM. The interface also had to accommodate traffic awareness, self-separation, and spacing tasks through dynamic messaging and symbology for flight path conformance and conflict detection and alerting (CDA). The display served as the mechanism to support the examination of the viability of executing instrument operations designed for SATS designated airports. Results of simulation and flight experiments conducted at the National Aeronautics and Space Administration's (NASA) Langley Research Center indicate that the concept, as facilitated by the research MFD, did not increase pilots subjective workload levels or reduce their situation awareness (SA). Post-test usability assessments revealed that pilots preferred using the enhanced MFD to execute flight procedures, reporting improved SA over conventional instrument flight rules (IFR) procedures.

Smart intimation and location of faults in distribution system

NASA Astrophysics Data System (ADS)

Hari Krishna, K.; Srinivasa Rao, B.

2018-04-01

Location of faults in the distribution system is one of the most complicated problems that we are facing today. Identification of fault location and severity of fault within a short time is required to provide continuous power supply but fault identification and information transfer to the operator is the biggest challenge in the distribution network. This paper proposes a fault location method in the distribution system based on Arduino nano and GSM module with flame sensor. The main idea is to locate the fault in the distribution transformer by sensing the arc coming out from the fuse element. The biggest challenge in the distribution network is to identify the location and the severity of faults under different conditions. Well operated transmission and distribution systems will play a key role for uninterrupted power supply. Whenever fault occurs in the distribution system the time taken to locate and eliminate the fault has to be reduced. The proposed design was achieved with flame sensor and GSM module. Under faulty condition, the system will automatically send an alert message to the operator in the distribution system, about the abnormal conditions near the transformer, site code and its exact location for possible power restoration.

Advanced power sources for space missions

NASA Technical Reports Server (NTRS)

Gavin, Joseph G., Jr.; Burkes, Tommy R.; English, Robert E.; Grant, Nicholas J.; Kulcinski, Gerald L.; Mullin, Jerome P.; Peddicord, K. Lee; Purvis, Carolyn K.; Sarjeant, W. James; Vandevender, J. Pace

1989-01-01

Approaches to satisfying the power requirements of space-based Strategic Defense Initiative (SDI) missions are studied. The power requirements for non-SDI military space missions and for civil space missions of the National Aeronautics and Space Administration (NASA) are also considered. The more demanding SDI power requirements appear to encompass many, if not all, of the power requirements for those missions. Study results indicate that practical fulfillment of SDI requirements will necessitate substantial advances in the state of the art of power technology. SDI goals include the capability to operate space-based beam weapons, sometimes referred to as directed-energy weapons. Such weapons pose unprecedented power requirements, both during preparation for battle and during battle conditions. The power regimes for these two sets of applications are referred to as alert mode and burst mode, respectively. Alert-mode power requirements are presently stated to range from about 100 kW to a few megawatts for cumulative durations of about a year or more. Burst-mode power requirements are roughly estimated to range from tens to hundreds of megawatts for durations of a few hundred to a few thousand seconds. There are two likely energy sources, chemical and nuclear, for powering SDI directed-energy weapons during the alert and burst modes. The choice between chemical and nuclear space power systems depends in large part on the total duration during which power must be provided. Complete study findings, conclusions, and eight recommendations are reported.

Required attention for synthesized speech perception for three levels of linguistic redundancy

NASA Technical Reports Server (NTRS)

Simpson, C. A.; Hart, S. G.

1977-01-01

The study evaluates the attention required for synthesized speech perception with reference to three levels of linguistic redundancy. Twelve commercial airline pilots were individually tested for 16 cockpit warning messages eight of which consisted of two monosyllabic key words and eight of which consisted of two polysyllabic key words. Three levels of linguistic redundancy were identified: monosyllabic words, polysyllabic words, and sentences. The experiment contained a message familiarization phase and a message recognition phase. It was found that: (1) when the messages are part of a previously learned and recently heard set, and the subject is familiar with the phrasing, the attention needed to recognize the message is not a function of the level of linguistic redundancy, and (2) there is a quantitative and qualitative difference between recognition and comprehension processes; only in the case of active comprehension does additional redundancy reduce attention requirements.

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

PubMed

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

2016-05-01

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

Airborne derivation of microburst alerts from ground-based Terminal Doppler Weather Radar information: A flight evaluation

NASA Technical Reports Server (NTRS)

Hinton, David A.

1993-01-01

An element of the NASA/FAA windshear program is the integration of ground-based microburst information on the flight deck, to support airborne windshear alerting and microburst avoidance. NASA conducted a windshear flight test program in the summer of 1991 during which airborne processing of Terminal Doppler Weather Radar (TDWR) data was used to derive microburst alerts. Microburst information was extracted from TDWR, transmitted to a NASA Boeing 737 in flight via data link, and processed to estimate the windshear hazard level (F-factor) that would be experienced by the aircraft in each microburst. The microburst location and F-factor were used to derive a situation display and alerts. The situation display was successfully used to maneuver the aircraft for microburst penetrations, during which atmospheric 'truth' measurements were made. A total of 19 penetrations were made of TDWR-reported microburst locations, resulting in 18 airborne microburst alerts from the TDWR data and two microburst alerts from the airborne reactive windshear detection system. The primary factors affecting alerting performance were spatial offset of the flight path from the region of strongest shear, differences in TDWR measurement altitude and airplane penetration altitude, and variations in microburst outflow profiles. Predicted and measured F-factors agreed well in penetrations near microburst cores. Although improvements in airborne and ground processing of the TDWR measurements would be required to support an airborne executive-level alerting protocol, the practicality of airborne utilization of TDWR data link data has been demonstrated.

Real-Time Computer-Mediated Communication: Email and Instant Messaging Simulation

ERIC Educational Resources Information Center

Newman, Amy

2007-01-01

As computer-mediated communication becomes increasingly prevalent in the workplace, students need to apply effective writing principles to today's technologies. Email, in particular, requires interns and new hires to manage incoming messages, use an appropriate tone, and craft clear, concise messages. In addition, with instant messaging (IM)…

47 CFR 10.540 - Attestation requirement. [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Attestation requirement. [Reserved] 10.540 Section 10.540 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Equipment Requirements § 10.540 Attestation requirement. [Reserved] ...

Education and Training Module in Alertness Management

NASA Technical Reports Server (NTRS)

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

2006-01-01

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

Photometric requirements for portable changeable message signs.

DOT National Transportation Integrated Search

2001-09-01

This project reviewed the performance of pchangeable message signs (PCMSs) and developed photometric standards to establish performance requirements. In addition, researchers developed photometric test methods and recommended them for use in evaluati...

Fatigue mitigation with SleepTrackTXT2 in air medical emergency care systems: study protocol for a randomized controlled trial.

PubMed

Patterson, P Daniel; Moore, Charity G; Guyette, Frank X; Doman, Jack M; Sequeira, Denisse; Werman, Howard A; Swanson, Doug; Hostler, David; Lynch, Joshua; Russo, Lindsey; Hines, Linda; Swecker, Karen; Runyon, Michael S; Buysse, Daniel J

2017-06-05

Most air medical Emergency Medical Services (EMS) clinicians work extended duration shifts, and more than 50% report inadequate sleep, poor sleep quality, and/or poor recovery between shifts. The SleepTrackTXT pilot trial (ClinicalTrials.gov, NCT02063737) showed that use of mobile phone text messages could impact EMS clinician self-reported fatigue and sleepiness during long duration shifts. The purpose of the SleepTrackTXT2 trial is to leverage lessons learned from the first SleepTrackTXT study and test an enhanced intervention targeting air medical EMS clinicians. We will conduct a multi-site randomized trial with a sample of adult EMS clinicians recruited from four air medical EMS systems located in the midwest, northeastern, and southern USA. Participants will be allocated to one of two possible arms for a 4-month (120-day) study period. The intervention arm will involve text-message assessments of sleepiness, fatigue, and difficulty concentrating at the beginning, every 4 hours during, and at the end of scheduled shifts. Participants reporting high levels of sleepiness, fatigue, or difficulty with concentration will receive one of nine randomly selected intervention messages to promote behavior change during shift work to improve alertness. Intervention participants will receive a text-message report on Friday of each week that shows their sleep debt over the previous 7 days followed by a text message to promote paying back sleep debt recovery when feasible. Participants in the control group receive text messages that only include assessments. Both arms will receive text-message assessments of perceived recovery since last shift, sleepiness, fatigue, or difficulty with concentration at noon (1200 hours) on days between scheduled shifts (off-duty days). We have two aims for this study: (1) to determine the short-term impact of the enhanced SleepTrackTXT2 intervention on air medical clinician fatigue reported in real time during and at the end of shift work, and (2) to determine the long-term impact of the SleepTrackTXT2 intervention on sleep quality and sleep health indicators including hours of sleep and recovery between shift work. The SleepTrackTXT2 trial may provide evidence of real-world effectiveness that would support widespread expansion of fatigue mitigation interventions in emergency care clinician shift workers. The trial may specifically support use of real-time assessments and interventions delivered via mobile technology such as text messaging. ClinicalTrials.gov, NCT02783027 . Registered on 23 May 2016.

The potential role of real-time geodetic observations in tsunami early warning

NASA Astrophysics Data System (ADS)

Tinti, Stefano; Armigliato, Alberto

2016-04-01

Tsunami warning systems (TWS) have the final goal to launch a reliable alert of an incoming dangerous tsunami to coastal population early enough to allow people to flee from the shore and coastal areas according to some evacuation plans. In the last decade, especially after the catastrophic 2004 Boxing Day tsunami in the Indian Ocean, much attention has been given to filling gaps in the existing TWSs (only covering the Pacific Ocean at that time) and to establishing new TWSs in ocean regions that were uncovered. Typically, TWSs operating today work only on earthquake-induced tsunamis. TWSs estimate quickly earthquake location and size by real-time processing seismic signals; on the basis of some pre-defined "static" procedures (either based on decision matrices or on pre-archived tsunami simulations), assess the tsunami alert level on a large regional scale and issue specific bulletins to a pre-selected recipients audience. Not unfrequently these procedures result in generic alert messages with little value. What usually operative TWSs do not do, is to compute earthquake focal mechanism, to calculate the co-seismic sea-floor displacement, to assess the initial tsunami conditions, to input these data into tsunami simulation models and to compute tsunami propagation up to the threatened coastal districts. This series of steps is considered nowadays too time consuming to provide the required timely alert. An equivalent series of steps could start from the same premises (earthquake focal parameters) and reach the same result (tsunami height at target coastal areas) by replacing the intermediate steps of real-time tsunami simulations with proper selection from a large archive of pre-computed tsunami scenarios. The advantage of real-time simulations and of archived scenarios selection is that estimates are tailored to the specific occurring tsunami and alert can be more detailed (less generic) and appropriate for local needs. Both these procedures are still at an experimental or testing stage and haven't been implemented yet in any standard TWS operations. Nonetheless, this is seen to be the future and the natural TWS evolving enhancement. In this context, improvement of the real-time estimates of tsunamigenic earthquake focal mechanism is of fundamental importance to trigger the appropriate computational chain. Quick discrimination between strike-slip and thrust-fault earthquakes, and equally relevant, quick assessment of co-seismic on-fault slip distribution, are exemplary cases to which a real-time geodetic monitoring system can contribute significantly. Robust inversion of geodetic data can help to reconstruct the sea floor deformation pattern especially if two conditions are met: the source is not too far from network stations and is well covered azimuthally. These two conditions are sometimes hard to satisfy fully, but in certain regions, like the Mediterranean and the Caribbean sea, this is quite possible due to the limited size of the ocean basins. Close cooperation between the Global Geodetic Observing System (GGOS) community, seismologists, tsunami scientists and TWS operators is highly recommended to obtain significant progresses in the quick determination of the earthquake source, which can trigger a timely estimation of the ensuing tsunami and a more reliable and detailed assessment of the tsunami size at the coast.

Douglas flight deck design philosophy

NASA Technical Reports Server (NTRS)

Oldale, Paul

1990-01-01

The systems experience gained from 17 years of DC-10 operation was used during the design of the MD-11 to automate system operation and reduce crew workload. All functions, from preflight to shutdown at the termination of flight, require little input from the crew. The MD-11 aircraft systems are monitored for proper operation by the Aircraft Systems Controllers (ASC). In most cases, system reconfiguration as a result of a malfunction is automated. Manual input is required for irreversible actions such as engine shutdown, fuel dump, fire agent discharge, or Integrated Drive Generator (IDG) disconnect. During normal operations, when the cockpit is configured for flight, all annunciators on the overhead panel will be extinguished. This Dark Cockpit immediately confirms to the crew that the panels are correctly configured and that no abnormalities are present. Primary systems annunciations are shown in text on the Alert Area of the Engine and Alert Display (EAD). This eliminates the need to scan the overhead. The MD-11 aircraft systems can be manually controlled from the overhead area of the cockpit. The center portion of the overhead panel is composed of the primary aircraft systems panels, which include FUEL, AIR, Electrical (ELEC) and Hydraulic (HYD) systems, which are easily accessible from both flight crew positions. Each Aircraft Systems Controller (ASC) has two automatic channels and a manual mode. All rectangular lights are annunciators. All square lights are combined switches and annunciators called switch/lights. Red switch/lights on the overhead (Level 3 alerts) are for conditions requiring immediate crew action. Amber (Level 2 or Level 1 alerts) indicates a fault or switch out of position requiring awareness or crew interaction. Overhead switches used in normal operating conditions will illuminate blue when in use (Level 0 alerts) such as WING ANTI-ICE - ON. An overhead switch/light with BLACK LETTERING on an amber or red background indicates a system failure and that crew interaction is required. A switch/light with blue or amber lettering and a BLACK BACKGROUND indicates a switch out of normal position and that crew action is necessary only if the system is in manual operation.

Prevalence and Risk Profile Of Unread Messages To Patients In A Patient Web Portal.

PubMed

Crotty, B H; Mostaghimi, A; O'Brien, J; Bajracharya, A; Safran, C; Landon, B E

2015-01-01

Excitement around the adoption of electronic communication between physicians and patients is tempered by the possibility of increased clinical and legal risk. If patients do not read messages in a timely fashion, duplicative communication efforts may be required and patient safety may be jeopardized. We sought to assess the prevalence and risk profile of unread messages in a mature patient portal. We analyzed six years of messages (2005-2010) from physicians to patients to determine the prevalence and associated characteristics of unread messages in a patient portal. We focused on clinical messages, and excluded announcements. Because some physicians sent clinical messages to groups of patients, we labeled messages sent to more than 5 patients as "outreach" messages and excluded them from general analyses. We performed a chart review of 75 clinical messages to assess for harm. We found that 3% of clinical messages were unread after 21 days. Messages arriving outside of business hours were slightly more likely to go unread (RR 1.15 95% CI 1.11-1.19). Patients who were male (OR 1.14 CI 1.04-1.26) African American (OR 1.69 CI 1.29-2.22) or Hispanic (OR 1.74 CI 1.17-2.59), or in the lowest income group (OR 1.72 CI 1.19-2.49) were more likely to have unread messages. Chart review showed no evidence of harm, but 13% of sampled unread messages were associated with potential delays in care. Incidentally, we found 50% of the physician-initiated outreach messages were unread. Overall, secure messaging appears a safe form of communication, but systems to notify senders when messages are unread may have value. While most clinical messages were read, many outreach messages were not, providing caution for relying on such systems for information dissemination. Similar to other studies, differences by race and income were observed and require further study.

Appraisal of work ability in relation to job-specific health requirements in ambulance workers.

PubMed

van Schaaijk, A; Boschman, J S; Frings-Dresen, M H W; Sluiter, J K

2017-01-01

To gain insight into which job-specific health requirements relate to work ability, the following two research questions were formulated: Which job-specific health requirements are associated with the appraisal of work ability in ambulance drivers and paramedics? How are appraisals of physical and mental work ability associated with the appraisal of overall work ability in ambulance drivers and paramedics? Workers Health Surveillance cross-sectional data of 506 ambulance workers (236 drivers and 270 paramedics) were used. The tests for specific job requirements were divided into six categories. Work ability was appraised as overall, physical and mental/emotional. Multiple linear stepwise regression analyses were used to model the associations. Outcomes in 'raised alertness and judgment ability' (R 2  = 0.09), 'job-specific physical abilities' (R 2  = 0.10) and 'emotional peak load' (R 2  = 0.07) significantly explained appraised overall, physical and mental/emotional work ability. Physical and mental/emotional work ability together explained 48.3% of the variance of overall work ability. The explained variance by physical and mental/emotional work ability was almost 4% higher in drivers than in paramedics. Overall work ability was significantly explained by outcomes in 'raised alertness and judgment ability' and 'emotional peak load.' Physical work ability was significantly explained by 'job-specific physical abilities' and 'raised alertness and judgment ability' outcomes, while 'emotional peak load' and 'raised alertness and judgment ability' outcomes significantly explained mental/emotional work ability. Physical and mental/emotional work ability explains the same proportion of variance in overall work ability.

Risk management, or just a different risk?

PubMed Central

Freer, Y; Lyon, A

2006-01-01

Background National reporting of adverse incidents has resulted in a number of clinical alerts being issued. Despite a lack of evidence, these alerts are often accompanied by a mandatory requirement to alter practice. There is likely to be clinician resistance to such a method of change management, particularly where evidence of safety is missing. Aim To determine the level of implementation within neonatal units of an alert requiring the change from litmus to pH paper to test nasogastric tube position. Method A questionnaire sent to all neonatal units in the United Kingdom with more than 12 cots. Results From the 207 questionnaires sent, there were 165 (80%) responses. Fifty five percent of units were still using litmus. All continued to use supplementary tests not recommended in best practice statements issued at the time of the alert. There was considerable variation in the pH value at which it was considered safe to feed. Conclusions Nine months after the alert, more than half the units had not changed to pH paper, and supplementary methods of testing were still being used. The wide range of pH values highlights the uncertainty about the “normal” gastric pH in the newborn. The evidence that, in neonatal units, changing to pH paper is safer than the long established use of litmus is lacking. Recommendations for change in practice must be based on good information and not seen just as a “knee jerk” response to adverse incidents. PMID:16464936

Effect of an obesity best practice alert on physician documentation and referral practices.

PubMed

Fitzpatrick, Stephanie L; Dickins, Kirsten; Avery, Elizabeth; Ventrelle, Jennifer; Shultz, Aaron; Kishen, Ekta; Rothschild, Steven

2017-12-01

The Centers for Medicare & Medicaid Services Electronic Health Record Meaningful Use Incentive Program requires physicians to document body mass index (BMI) and a follow-up treatment plan for adult patients with BMI ≥ 25. To examine the effect of a best practice alert on physician documentation of obesity-related care and referrals to weight management treatment, in a cluster-randomized design, 14 primary care clinics at an academic medical center were randomized to best practice alert intervention (n = 7) or comparator (n = 7). The alert was triggered when both height and weight were entered and BMI was ≥30. Both intervention and comparator clinics could document meaningful use by selecting a nutrition education handout within the alert. Intervention clinics could also select a referral option from the list of clinic and community-based weight management programs embedded in the alert. Main outcomes were proportion of eligible patients with (1) obesity-related documentation and (2) referral. There were 26,471 total primary care encounters with 12,981 unique adult patients with BMI ≥ 30 during the 6-month study period. Documentation doubled (17 to 33%) with implementation of the alert. However, intervention clinics were not significantly more likely to refer patients to weight management than comparator clinics (2.8 vs. 1.3%, p = 0.07). Although the alert was associated with increased physician meaningful use compliance, it was not an effective strategy for improving patient access to weight management services. Further research is needed to understand system-level characteristics that influence obesity management in primary care.

Impact of e-alert for detection of acute kidney injury on processes of care and outcomes: protocol for a systematic review and meta-analysis.

PubMed

Lachance, Philippe; Villeneuve, Pierre-Marc; Wilson, Francis P; Selby, Nicholas M; Featherstone, Robin; Rewa, Oleksa; Bagshaw, Sean M

2016-05-05

Acute kidney injury (AKI) is a common complication in hospitalised patients. It imposes significant risk for major morbidity and mortality. Moreover, patients suffering an episode of AKI consume considerable health resources. Recently, a number of studies have evaluated the implementation of automated electronic alerts (e-alerts) configured from electronic medical records (EMR) and clinical information systems (CIS) to warn healthcare providers of early or impending AKI in hospitalised patients. The impact of e-alerts on care processes, patient outcomes and health resource use, however, remains uncertain. We will perform a systematic review to describe and appraise e-alerts for AKI, and evaluate their impact on processes of care, clinical outcomes and health services use. In consultation with a research librarian, a search strategy will be developed and electronic databases (ie, MEDLINE, EMBASE, CINAHL, Cochrane Library and Inspec via Engineering Village) searched. Selected grey literature sources will also be searched. Search themes will focus on e-alerts and AKI. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. The primary analysis will be narrative; however, where feasible, pooled analysis will be performed. Each e-alert will be described according to trigger, type of alert, target recipient and degree of intrusiveness. Pooled effect estimates will be described, where applicable. Our systematic review will synthesise the literature on the value of e-alerts to detect AKI, and their impact on processes, patient-centred outcomes and resource use, and also identify key knowledge gaps and barriers to implementation. This is a fundamental step in a broader research programme aimed to understand the ideal structure of e-alerts, target population and methods for implementation, to derive benefit. Research ethics approval is not required for this review. CRD42016033033. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

An analysis of normative messages in signs at recreation settings

Treesearch

P.L. Winter; R.B. Cialdini; R.J. Bator; K. Rhoads; B.J. Sagarin

1998-01-01

The reliance on signs as a mode of agency communication with visitors requires an examination of message presentation and content in order to evaluate message impact and effectiveness. This paper reports on a system¬atic evaluation of signs and messages at 42 recreation areas in California and Arizona. A number of factors...

Motivating Parent Support for Physical Activity: The Role of Framed Persuasive Messages

ERIC Educational Resources Information Center

Bassett-Gunter, Rebecca; Stone, Rachael; Jarvis, Jocelyn; Latimer-Cheung, Amy

2017-01-01

Parent support for physical activity (PA) is a behavior unto itself that requires motivation. Persuasive messages may be one method for motivating parent support for their children's PA. Message framing is one strategy for optimizing the impact of messages. The current study examined the relative effectiveness of gain- versus loss-framed messages…

A rule-based smart automated fertilization and irrigation systems

NASA Astrophysics Data System (ADS)

Yousif, Musab El-Rashid; Ghafar, Khairuddin; Zahari, Rahimi; Lim, Tiong Hoo

2018-04-01

Smart automation in industries has become very important as it can improve the reliability and efficiency of the systems. The use of smart technologies in agriculture have increased over the year to ensure and control the production of crop and address food security. However, it is important to use proper irrigation systems avoid water wastage and overfeeding of the plant. In this paper, a Smart Rule-based Automated Fertilization and Irrigation System is proposed and evaluated. We propose a rule based decision making algorithm to monitor and control the food supply to the plant and the soil quality. A build-in alert system is also used to update the farmer using a text message. The system is developed and evaluated using a real hardware.

Design and implementation of a wearable healthcare monitoring system.

PubMed

Sagahyroon, Assim; Raddy, Hazem; Ghazy, Ali; Suleman, Umair

2009-01-01

A wearable healthcare monitoring unit that integrates various technologies was developed to provide patients with the option of leading a healthy and independent life without risks or confinement to medical facilities. The unit consists of various sensors integrated to a microcontroller and attached to the patient's body, reading vital signs and transmitting these readings via a Bluetooth link to the patient's mobile phone. Short-Messaging-Service (SMS) is incorporated in the design to alert a physician in emergency cases. Additionally, an application program running on the mobile phone uses the internet to update (at regular intervals) the patient records in a hospital database with the most recent readings. To reduce development costs, the components used were both off-the-shelf and affordable.

Communication between scientists and civil authorities, and the links with Knowledge and Responsibility

NASA Astrophysics Data System (ADS)

Papale, Paolo

2017-04-01

The issue of communicating volcanic hazard evaluations to civil authorities is becoming increasingly relevant, as the world itself is evolving towards more complex relationships in the process of understanding, anticipating, and reacting to natural disasters. Although different cultures and societies may largely differ in their perception of the roles of scientists, there is an increasing need for an international reference, or shared best practice, for communications by scientists to the society. I review the current methods adopted for volcanic hazard communications worldwide, and analyse them in terms of their informative contents, that I refer to as Knowledge, and the implicit Responsibility they involve. In general, volcano scientists' communications do not allow to discriminate between observations and inferences, providing messages that can be misleading; furthermore, the level of responsibility implicit in those communications appears unjustified given the scientific and technical competence of volcanologists. Discrete alert level systems, such as colour codes, bring about much of that criticism: they can be useful as a quick and synthetic means of communication when they refer to pure observations, but dramatically miss to communicate the large uncertainties which dominate scientists' forecasts, over which most alert levels are based; de facto giving to scientists, when they change level, the role of decision makers. I conclude that different means of communication should be established, fully accounting for the uncertain nature of volcanic hazard evaluations; and that decisions on current alert levels, especially when they significantly impact people and infrastructures, should be made by politicians, after they are fully and correctly informed by a variety of experts far exceeding just volcano scientists. One immediate consequence is that preparedness implies the set up of much more complex systems with respect to those put in place at most potentially dangerous volcanoes in the world.

Standard Anatomic Terminologies: Comparison for Use in a Health Information Exchange–Based Prior Computed Tomography (CT) Alerting System

PubMed Central

Lowry, Tina; Vreeman, Daniel J; Loo, George T; Delman, Bradley N; Thum, Frederick L; Slovis, Benjamin H; Shapiro, Jason S

2017-01-01

Background A health information exchange (HIE)–based prior computed tomography (CT) alerting system may reduce avoidable CT imaging by notifying ordering clinicians of prior relevant studies when a study is ordered. For maximal effectiveness, a system would alert not only for prior same CTs (exams mapped to the same code from an exam name terminology) but also for similar CTs (exams mapped to different exam name terminology codes but in the same anatomic region) and anatomically proximate CTs (exams in adjacent anatomic regions). Notification of previous same studies across an HIE requires mapping of local site CT codes to a standard terminology for exam names (such as Logical Observation Identifiers Names and Codes [LOINC]) to show that two studies with different local codes and descriptions are equivalent. Notifying of prior similar or proximate CTs requires an additional mapping of exam codes to anatomic regions, ideally coded by an anatomic terminology. Several anatomic terminologies exist, but no prior studies have evaluated how well they would support an alerting use case. Objective The aim of this study was to evaluate the fitness of five existing standard anatomic terminologies to support similar or proximate alerts of an HIE-based prior CT alerting system. Methods We compared five standard anatomic terminologies (Foundational Model of Anatomy, Systematized Nomenclature of Medicine Clinical Terms, RadLex, LOINC, and LOINC/Radiological Society of North America [RSNA] Radiology Playbook) to an anatomic framework created specifically for our use case (Simple ANatomic Ontology for Proximity or Similarity [SANOPS]), to determine whether the existing terminologies could support our use case without modification. On the basis of an assessment of optimal terminology features for our purpose, we developed an ordinal anatomic terminology utility classification. We mapped samples of 100 random and the 100 most frequent LOINC CT codes to anatomic regions in each terminology, assigned utility classes for each mapping, and statistically compared each terminology’s utility class rankings. We also constructed seven hypothetical alerting scenarios to illustrate the terminologies’ differences. Results Both RadLex and the LOINC/RSNA Radiology Playbook anatomic terminologies ranked significantly better (P<.001) than the other standard terminologies for the 100 most frequent CTs, but no terminology ranked significantly better than any other for 100 random CTs. Hypothetical scenarios illustrated instances where no standard terminology would support appropriate proximate or similar alerts, without modification. Conclusions LOINC/RSNA Radiology Playbook and RadLex’s anatomic terminologies appear well suited to support proximate or similar alerts for commonly ordered CTs, but for less commonly ordered tests, modification of the existing terminologies with concepts and relations from SANOPS would likely be required. Our findings suggest SANOPS may serve as a framework for enhancing anatomic terminologies in support of other similar use cases. PMID:29242174

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

PubMed

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

2016-01-01

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

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

USGS Publications Warehouse

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

2012-01-01

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

Nonblocking and orphan free message logging protocols

NASA Technical Reports Server (NTRS)

Alvisi, Lorenzo; Hoppe, Bruce; Marzullo, Keith

1992-01-01

Currently existing message logging protocols demonstrate a classic pessimistic vs. optimistic tradeoff. We show that the optimistic-pessimistic tradeoff is not inherent to the problem of message logging. We construct a message-logging protocol that has the positive features of both optimistic and pessimistic protocol: our protocol prevents orphans and allows simple failure recovery; however, it requires no blocking in failure-free runs. Furthermore, this protocol does not introduce any additional message overhead as compared to one implemented for a system in which messages may be lost but processes do not crash.

Nonblocking and orphan free message logging protocols

NASA Astrophysics Data System (ADS)

Alvisi, Lorenzo; Hoppe, Bruce; Marzullo, Keith

1992-12-01

Currently existing message logging protocols demonstrate a classic pessimistic vs. optimistic tradeoff. We show that the optimistic-pessimistic tradeoff is not inherent to the problem of message logging. We construct a message-logging protocol that has the positive features of both optimistic and pessimistic protocol: our protocol prevents orphans and allows simple failure recovery; however, it requires no blocking in failure-free runs. Furthermore, this protocol does not introduce any additional message overhead as compared to one implemented for a system in which messages may be lost but processes do not crash.

Terminal - Tactical Separation Assured Flight Environment (T-TSafe)

NASA Technical Reports Server (NTRS)

Verma, Savita Arora; Tang, Huabin; Ballinger, Debbi

2011-01-01

The Tactical Separation Assured Flight Environment (TSAFE) has been previously tested as a conflict detection and resolution tool in the en-route phase of flight. Fast time simulations of a terminal version of this tool called Terminal TSAFE (T-TSAFE) have shown promise over the current conflict detection tools. It has shown to have fewer false alerts (as low as 2 per hour) and better prediction to conflict time than Conflict Alert. The tool will be tested in the simulated terminal area of Los Angeles International Airport, in a Human-in-the-loop experiment to identify controller procedures and information requirements. The simulation will include comparisons of T-TSAFE with NASA's version of Conflict Alert. Also, some other variables such as altitude entry by the controller, which improve T-TSAFE's predictions for conflict detection, will be tested. T-TSAFE integrates features of current conflict detection tools such as Automated Terminal Proximity Alert used to alleviate compression errors in the final approach phase. Based on fast-time simulation analysis, the anticipated benefits of T-TSAFE over Conflict Alert include reduced false/missed alerts and increased time to predicted loss of separation. Other metrics that will be used to evaluate the tool's impact on the controller include controller intervention, workload, and situation awareness.

TexiCare: an innovative embedded device for pressure ulcer prevention. Preliminary results with a paraplegic volunteer.

PubMed

Chenu, Olivier; Vuillerme, Nicolas; Bucki, Marek; Diot, Bruno; Cannard, Francis; Payan, Yohan

2013-08-01

This paper introduces the recently developed TexiCare device that aims at preventing pressure ulcers for people with spinal cord injury. This embedded device is aimed to be mounted on the user wheelchair. Its sensor is 100% textile and allows the measurement of pressures at the interface between the cushion and the buttocks. It is comfortable, washable and low cost. It is connected to a cigarette-box sized unit that (i) measures the pressures in real time, (ii) estimates the risk for internal over-strains, and (iii) alerts the wheelchair user whenever necessary. The alert method has been defined as a result of a utility/usability/acceptability study conducted with representative end users. It is based on a tactile-visual feedback (via a watch or a smartphone for example): the tactile modality is used to discreetly alarm the person while the visual modality conveys an informative message. In order to evaluate the usability of the TexiCare device, a paraplegic volunteer equipped his wheelchair at home during a six months period. Interestingly, the first results revealed bad habits such as an inadequate posture when watching TV, rare relief maneuvers, and the occurrence of abnormal high pressures. Copyright © 2013 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

An Interoperable System toward Cardiac Risk Stratification from ECG Monitoring

PubMed Central

Mora-Jiménez, Inmaculada; Ramos-López, Javier; Quintanilla Fernández, Teresa; García-García, Antonio; Díez-Mazuela, Daniel; García-Alberola, Arcadi

2018-01-01

Many indices have been proposed for cardiovascular risk stratification from electrocardiogram signal processing, still with limited use in clinical practice. We created a system integrating the clinical definition of cardiac risk subdomains from ECGs and the use of diverse signal processing techniques. Three subdomains were defined from the joint analysis of the technical and clinical viewpoints. One subdomain was devoted to demographic and clinical data. The other two subdomains were intended to obtain widely defined risk indices from ECG monitoring: a simple-domain (heart rate turbulence (HRT)), and a complex-domain (heart rate variability (HRV)). Data provided by the three subdomains allowed for the generation of alerts with different intensity and nature, as well as for the grouping and scrutinization of patients according to the established processing and risk-thresholding criteria. The implemented system was tested by connecting data from real-world in-hospital electronic health records and ECG monitoring by considering standards for syntactic (HL7 messages) and semantic interoperability (archetypes based on CEN/ISO EN13606 and SNOMED-CT). The system was able to provide risk indices and to generate alerts in the health records to support decision-making. Overall, the system allows for the agile interaction of research and clinical practice in the Holter-ECG-based cardiac risk domain. PMID:29494497

Understanding mSOS: A qualitative study examining the implementation of a text-messaging outbreak alert system in rural Kenya

PubMed Central

Toda, Mitsuru; O-Tipo, Shikanga; Mwau, Matilu; Morita, Kouichi

2017-01-01

Outbreaks of epidemic diseases pose serious public health risks. To overcome the hurdles of sub-optimal disease surveillance reporting from the health facilities to relevant authorities, the Ministry of Health in Kenya piloted mSOS (mobile SMS-based disease outbreak alert system) in 2013–2014. In this paper, we report the results of the qualitative study, which examined factors that influence the performances of mSOS implementation. In-depth interviews were conducted with 11 disease surveillance coordinators and 32 in-charges of rural health facilities that took part in the mSOS intervention. Drawing from the framework analysis, dominant themes that emerged from the interviews are presented. All participants voiced their excitement in using mSOS. The results showed that the technology was well accepted, easy to use, and both health workers and managers unanimously recommended the scale-up of the system despite challenges encountered in the implementation processes. The most challenging components were the context in which mSOS was implemented, including the lack of strong existing structure for continuous support supervision, feedback and response action related to disease surveillance. The study revealed broader health systems issues that should be addressed prior to and during the intervention scale-up. PMID:28628629

Air/ground wind shear information integration: Flight test results

NASA Technical Reports Server (NTRS)

Hinton, David A.

1992-01-01

An element of the NASA/FAA wind shear program is the integration of ground-based microburst information on the flight deck, to support airborne wind shear alerting and microburst avoidance. NASA conducted a wind shear flight test program in the summer of 1991 during which airborne processing of Terminal Doppler Weather Radar (TDWR) data was used to derive microburst alerts. High level microburst products were extracted from TDWR, transmitted to a NASA Boeing 737 in flight via data link, and processed to estimate the wind shear hazard level (F-factor) that would be experienced by the aircraft in the core of each microburst. The microburst location and F-factor were used to derive a situation display and alerts. The situation display was successfully used to maneuver the aircraft for microburst penetrations, during which in situ 'truth' measurements were made. A total of 19 penetrations were made of TDWR-reported microburst locations, resulting in 18 airborne microburst alerts from the TDWR data and two microburst alerts from the airborne in situ measurements. The primary factors affecting alerting performance were spatial offset of the flight path from the region of strongest shear, differences in TDWR measurement altitude and airplane penetration altitude, and variations in microburst outflow profiles. Predicted and measured F-factors agreed well in penetrations near microburst cores. Although improvements in airborne and ground processing of the TDWR measurement would be required to support an airborne executive-level alerting protocol, the feasibility of airborne utilization of TDWR data link data has been demonstrated.

Motivating parent support for physical activity: the role of framed persuasive messages.

PubMed

Bassett-Gunter, Rebecca; Stone, Rachael; Jarvis, Jocelyn; Latimer-Cheung, Amy

2017-10-01

Parent support for physical activity (PA) is a behavior unto itself that requires motivation. Persuasive messages may be one method for motivating parent support for their children's PA. Message framing is one strategy for optimizing the impact of messages. The current study examined the relative effectiveness of gain- versus loss-framed messages for encouraging parent support for children's PA. Regardless of message frame, parents had an increase in social cognitive antecedents (e.g. perceived behavioral control, intentions) and support for children's PA following message exposure. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

An Evaluation of Two Methods for Generating Synthetic HL7 Segments Reflecting Real-World Health Information Exchange Transactions

PubMed Central

Mwogi, Thomas S.; Biondich, Paul G.; Grannis, Shaun J.

2014-01-01

Motivated by the need for readily available data for testing an open-source health information exchange platform, we developed and evaluated two methods for generating synthetic messages. The methods used HL7 version 2 messages obtained from the Indiana Network for Patient Care. Data from both methods were analyzed to assess how effectively the output reflected original ‘real-world’ data. The Markov Chain method (MCM) used an algorithm based on transitional probability matrix while the Music Box model (MBM) randomly selected messages of particular trigger type from the original data to generate new messages. The MBM was faster, generated shorter messages and exhibited less variation in message length. The MCM required more computational power, generated longer messages with more message length variability. Both methods exhibited adequate coverage, producing a high proportion of messages consistent with original messages. Both methods yielded similar rates of valid messages. PMID:25954458

47 CFR 10.500 - General requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false General requirements. 10.500 Section 10.500 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Equipment Requirements § 10.500 General requirements. CMAS mobile device functionality is dependent on the capabilities of a...

Caregiver and Health Care Provider Perspectives on Cloud-Based Shared Care Plans for Children With Medical Complexity.

PubMed

Desai, Arti D; Jacob-Files, Elizabeth A; Wignall, Julia; Wang, Grace; Pratt, Wanda; Mangione-Smith, Rita; Britto, Maria T

2018-06-05

Shared care plans play an essential role in coordinating care across health care providers and settings for children with medical complexity (CMC). However, existing care plans often lack shared ownership, are out-of-date, and lack universal accessibility. In this study, we aimed to establish requirements for shared care plans to meet the information needs of caregivers and providers and to mitigate current information barriers when caring for CMC. We followed a user-centered design methodology and conducted in-depth semistructured interviews with caregivers and providers of CMC who receive care at a tertiary care children's hospital. We applied inductive, thematic analysis to identify salient themes. Analysis occurred concurrently with data collection; therefore, the interview guide was iteratively revised as new questions and themes emerged. Interviews were conducted with 17 caregivers and 22 providers. On the basis of participant perspectives, we identified 4 requirements for shared care plans that would help meet information needs and mitigate current information barriers when caring for CMC. These requirements included the following: (1) supporting the accessibility of care plans from multiple locations (eg, cloud-based) and from multiple devices, with alert and search features; (2) ensuring the organization is tailored to the specific user; (3) including collaborative functionality such as real-time, multiuser content management and secure messaging; and (4) storing care plans on a secure platform with caregiver-controlled permission settings. Although further studies are needed to understand the optimal design and implementation strategies, shared care plans that meet these specified requirements could mitigate perceived information barriers and improve care for CMC. Copyright © 2018 by the American Academy of Pediatrics.

Cockpit weather information needs

NASA Technical Reports Server (NTRS)

Scanlon, Charles H.

1992-01-01

The primary objective is to develop an advanced pilot weather interface for the flight deck and to measure its utilization and effectiveness in pilot reroute decision processes, weather situation awareness, and weather monitoring. Identical graphical weather displays for the dispatcher, air traffic control (ATC), and pilot crew should also enhance the dialogue capabilities for reroute decisions. By utilizing a broadcast data link for surface observations, forecasts, radar summaries, lightning strikes, and weather alerts, onboard weather computing facilities construct graphical displays, historical weather displays, color textual displays, and other tools to assist the pilot crew. Since the weather data is continually being received and stored by the airborne system, the pilot crew has instantaneous access to the latest information. This information is color coded to distinguish degrees of category for surface observations, ceiling and visibilities, and ground radar summaries. Automatic weather monitoring and pilot crew alerting is accomplished by the airborne computing facilities. When a new weather information is received, the displays are instantaneously changed to reflect the new information. Also, when a new surface or special observation for the intended destination is received, the pilot crew is informed so that information can be studied at the pilot's discretion. The pilot crew is also immediately alerted when a severe weather notice, AIRMET or SIGMET, is received. The cockpit weather display shares a multicolor eight inch cathode ray tube and overlaid touch panel with a pilot crew data link interface. Touch sensitive buttons and areas are used for pilot selection of graphical and data link displays. Time critical ATC messages are presented in a small window that overlays other displays so that immediate pilot alerting and action can be taken. Predeparture and reroute clearances are displayed on the graphical weather system so pilot review of weather along the route can be accomplished prior to pilot acceptance of the clearance. An ongoing multiphase test series is planned for testing and modifying the graphical weather system. Preliminary data shows that the nine test subjects considered the graphical presentation to be much better than their current weather information source for situation awareness, flight safety, and reroute decision making.

High performance interconnection between high data rate networks

NASA Technical Reports Server (NTRS)

Foudriat, E. C.; Maly, K.; Overstreet, C. M.; Zhang, L.; Sun, W.

1992-01-01

The bridge/gateway system needed to interconnect a wide range of computer networks to support a wide range of user quality-of-service requirements is discussed. The bridge/gateway must handle a wide range of message types including synchronous and asynchronous traffic, large, bursty messages, short, self-contained messages, time critical messages, etc. It is shown that messages can be classified into three basic classes, synchronous and large and small asynchronous messages. The first two require call setup so that packet identification, buffer handling, etc. can be supported in the bridge/gateway. Identification enables resequences in packet size. The third class is for messages which do not require call setup. Resequencing hardware based to handle two types of resequencing problems is presented. The first is for a virtual parallel circuit which can scramble channel bytes. The second system is effective in handling both synchronous and asynchronous traffic between networks with highly differing packet sizes and data rates. The two other major needs for the bridge/gateway are congestion and error control. A dynamic, lossless congestion control scheme which can easily support effective error correction is presented. Results indicate that the congestion control scheme provides close to optimal capacity under congested conditions. Under conditions where error may develop due to intervening networks which are not lossless, intermediate error recovery and correction takes 1/3 less time than equivalent end-to-end error correction under similar conditions.

47 CFR 10.330 - Provider infrastructure requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Provider infrastructure requirements. 10.330 Section 10.330 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.330 Provider infrastructure requirements. This section specifies the general...

47 CFR 10.330 - Provider infrastructure requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Provider infrastructure requirements. 10.330 Section 10.330 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.330 Provider infrastructure requirements. This section specifies the general...

47 CFR 10.330 - Provider infrastructure requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Provider infrastructure requirements. 10.330 Section 10.330 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.330 Provider infrastructure requirements. This section specifies the general...

47 CFR 10.330 - Provider infrastructure requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Provider infrastructure requirements. 10.330 Section 10.330 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.330 Provider infrastructure requirements. This section specifies the general...

47 CFR 10.330 - Provider infrastructure requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Provider infrastructure requirements. 10.330 Section 10.330 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.330 Provider infrastructure requirements. This section specifies the general...

Effectiveness of a real-time clinical decision support system for computerized physician order entry of plasma orders.

PubMed

Yazer, Mark H; Triulzi, Darrell J; Reddy, Vivek; Waters, Jonathan H

2013-12-01

We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria. In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4-month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5-month period. In the 4-month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5-month period thereafter the alert rate was significantly lower at 27.9% (p < 0.0001). The percentage of heeded alerts increased during the adaptive alert period (24.3% vs. 17.1%, respectively, p = 0.004). A significant percentage (45%) of other plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders. Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non-evidence-based ordering. © 2013 American Association of Blood Banks.

GPs' perceptions and experiences of public awareness campaigns for cancer: a qualitative enquiry.

PubMed

Green, Trish; Atkin, Karl; Macleod, Una

2016-04-01

Public awareness campaigns for cancer are used to alert the UK population to symptoms which, if experienced, should be discussed with their general practitioner (GP). More timely diagnosis of cancer is assumed possible if patients with the appropriate symptoms present to GPs and GPs recognise the need to act on these symptoms. To investigate GPs' perceptions and experiences of public awareness campaigns for cancer. Semi-structured interviews with 55 GPs from practices in the North and North East of England and Greater London. Interviews were recorded and transcribed verbatim. Repeated reading of GP transcripts engendered thematic analysis and co-coding ensured legitimacy of findings. Participants supported the underpinning ethos of public health campaigns and articulated a commitment to engaging with patients with respect to cancer warning signs and symptoms despite the common perception that public awareness campaigns increased numbers of consultations. Tensions were evident with regard to increased demands on GP time and primary care resources during a period of major upheaval within the NHS. Concern was raised that some patients remain outwith the reach of campaign messages. The complexity of addressing how public health messages compete with other issues in people's lives was identified as challenging. General practitioners provided insight into why some members of the general public do not engage with public health messages. Public health/primary care interaction that incorporates GPs' knowledge of their patient populations could advance the search for solutions to a more robust approach to earlier cancer recognition and referral in primary care. © 2015 John Wiley & Sons Ltd.

Impact of Substance Messages in Music Videos on Youth: Beware the Influence of Connectedness and Its Potential Prevention-Shielding Effect.

PubMed

Russell, Cristel Antonia; Régnier-Denois, Véronique; Chapoton, Boris; Buhrau, Denise

2017-09-01

Two studies were conducted to investigate the role of connectedness with music videos in affecting youths' beliefs about substances (alcohol and tobacco) embedded therein and the potential for a prevention message to limit the impact of these images. The first study used cross-sectional data from a national sample of 1,023 adolescents (54.3% male) to evaluate the relationship between youths' consumption of music videos and their beliefs about the consequences of consuming alcohol and tobacco. A controlled experiment with 151 participants (57% male) then tested whether exposure to smoking in a video affects youths' smoking beliefs and the preventive potential of a pre-video warning. Connectedness to music videos, not overall amount of viewing, is the main correlate of beliefs about the positive outcomes of consuming alcohol/tobacco. A single exposure to a music video with smoking images can increase beliefs that smoking leads to positive consequences, and connected viewers are especially receptive to these images. Alerting youths to the presence of substance messages in a video leads to differential results as a function of connectedness. Many youths spend hours every day watching music videos in which positive visuals about drinking and smoking abound. Rather than the quantity of viewing, it is the degree to which youths immerse themselves in these music videos that enhances their beliefs that smoking and drinking have positive consequences. Interventions that warn youths about the presence of substances in music videos can minimize their influence, but youths highly connected with the music video content are especially resistant to warnings.

Final Report: Computer-aided Human Centric Cyber Situation Awareness

DTIC Science & Technology

2016-03-20

logs, OS audit trails, vulnerability reports, and packet dumps ), weeding out the false positives, grouping the related indicators so that different...short time duration of each visual stimulus in an fMRI study, we have designed “network security analysis cards ” that require the subject to...determine whether alerts in the cards indicate malicious events. Two types of visual displays of alerts (i.e., tabular display and node-link display) are

Phone-Based Interventions in Adolescent Psychiatry: A Perspective and Proof of Concept Pilot Study With a Focus on Depression and Autism

PubMed Central

Feltes, Jordan Robert; Tzeng, William Shun; Lu, Zoe Yunzhu; Pan, Michael; Zhao, Nan; Talkin, Rebecca; Javaherian, Kavon; Glowinski, Anne; Ross, Will

2017-01-01

Background Telemedicine has emerged as an innovative platform to diagnose and treat psychiatric disorders in a cost-effective fashion. Previous studies have laid the functional framework for monitoring and treating child psychiatric disorders electronically using videoconferencing, mobile phones (smartphones), and Web-based apps. However, phone call and text message (short message service, SMS) interventions in adolescent psychiatry are less studied than other electronic platforms. Further investigations on the development of these interventions are needed. Objective The aim of this paper was to explore the utility of text message interventions in adolescent psychiatry and describe a user feedback-driven iterative design process for text message systems. Methods We developed automated text message interventions using a platform for both depression (EpxDepression) and autism spectrum disorder (ASD; EpxAutism) and conducted 2 pilot studies for each intervention (N=3 and N=6, respectively). The interventions were prescribed by and accessible to the patients’ healthcare providers. EpxDepression and EpxAutism utilized an automated system to triage patients into 1 of 3 risk categories based on their text responses and alerted providers directly via phone and an online interface when patients met provider-specified risk criteria. Rapid text-based feedback from participants and interviews with providers allowed for quick iterative cycles to improve interventions. Results Patients using EpxDepression had high weekly response rates (100% over 2 to 4 months), but exhibited message fatigue with daily prompts with mean (SD) overall response rates of 66.3% (21.6%) and 64.7% (8.2%) for mood and sleep questionnaires, respectively. In contrast, parents using EpxAutism displayed both high weekly and overall response rates (100% and 85%, respectively, over 1 to 4 months) that did not decay significantly with time. Monthly participant feedback surveys for EpxDepression (7 surveys) and EpxAutism (18 surveys) preliminarily indicated that for both interventions, daily messages constituted the “perfect amount” of contact and that EpxAutism, but not EpxDepression, improved patient communication with providers. Notably, EpxDepression detected thoughts of self-harm in patients before their case managers or caregivers were aware of such ideation. Conclusions Text-message interventions in adolescent psychiatry can provide a cost-effective and engaging method to track symptoms, behavior, and ideation over time. Following the collection of pilot data and feedback from providers and patients, larger studies are already underway to validate the clinical utility of EpxDepression and EpxAutism. Trial Registration Clinicaltrials.gov NCT03002311; https://clinicaltrials.gov/ct2/show/NCT03002311 (Archived by WebCite at http://www.webcitation.org/6qQtlCIS0) PMID:28623183

47 CFR 10.350 - WEA Testing requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false WEA Testing requirements. 10.350 Section 10.350 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.350 WEA Testing requirements. This section specifies the testing that will be required, no later than the...

47 CFR 10.350 - WEA Testing requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false WEA Testing requirements. 10.350 Section 10.350 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.350 WEA Testing requirements. This section specifies the testing that will be required, no later than the...

Behavioral frequency moderates the effects of message framing on HPV vaccine acceptability.

PubMed

Gerend, Mary A; Shepherd, Janet E; Monday, Kara A

2008-04-01

Research suggests that gain-framed messages are generally more effective than loss-framed messages at promoting preventive health behaviors. Virtually all previous studies, however, have examined prevention behaviors that require regular and repeated action to be effective. Little is known about the utility of message framing for promoting low-frequency prevention behaviors such as vaccination. Moreover, few studies have identified mediators of framing effects. We investigated whether behavioral frequency (operationalized as the number of shots required) moderated the effect of framed health messages on women's intentions to receive the human papillomavirus (HPV) vaccine. We also sought to identify mediators of framing effects. Undergraduate women (N = 237) were randomly assigned to read an HPV vaccination booklet that varied by message frame (gain vs. loss) and behavioral frequency (one shot vs. six shots). We observed a frame-by-frequency interaction such that the loss-framed message led to greater vaccination intentions than did the gain-framed message but only among participants in the one-shot condition. Perceived susceptibility to HPV infection mediated the observed framing effects. This study provides an important exception to the commonly observed gain-framed advantage for preventive health behaviors. Loss-framed appeals appear to be particularly effective in promoting interest in low-frequency prevention behaviors such as HPV vaccination.

Conditional Loss of Pten in Myogenic Progenitors Leads to Postnatal Skeletal Muscle Hypertrophy but Age-Dependent Exhaustion of Satellite Cells.

PubMed

Yue, Feng; Bi, Pengpeng; Wang, Chao; Li, Jie; Liu, Xiaoqi; Kuang, Shihuan

2016-11-22

Skeletal muscle stem cells (satellite cells [SCs]) are normally maintained in a quiescent (G 0 ) state. Muscle injury not only activates SCs locally, but also alerts SCs in distant uninjured muscles via circulating factors. The resulting G Alert SCs are adapted to regenerative cues and regenerate injured muscles more efficiently, but whether they provide any long-term benefits to SCs is unknown. Here, we report that embryonic myogenic progenitors lacking the phosphatase and tensin homolog (Pten) exhibit enhanced proliferation and differentiation, resulting in muscle hypertrophy but fewer SCs in adult muscles. Interestingly, Pten null SCs are predominantly in the G Alert state, even in the absence of an injury. The G Alert SCs are deficient in self-renewal and subjected to accelerated depletion during regeneration and aging and fail to repair muscle injury in old mice. Our findings demonstrate a key requirement of Pten in G 0 entry of SCs and provide functional evidence that prolonged G Alert leads to stem cell depletion and regenerative failure. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

Is anybody doing it? An experimental study of the effect of normative messages on intention to do physical activity.

PubMed

van Bavel, René; Esposito, Gabriele; Baranowski, Tom

2014-07-31

The study explores whether messages about the physical activity levels of the majority (i.e. normative messages) affect young adults' intention to engage in regular physical activity. An experimental survey among 16 to 24 year-olds in Bulgaria, Croatia and Romania (n = 1200) was conducted in March 2013. A control group received no message; one treatment group was told that the majority was physically active (positive message); and another treatment group was told that the majority was not physically active (negative message). Both the positive and (unexpectedly) the negative normative messages showed a significant and positive effect on intention to be physically active. There was no difference between the effects of the messages. Normative messages affect intention, which is encouraging for public health campaigns. The effect of the positive message confirms previous findings on conformity to the norm; the effect of the negative message is unexpected and requires further research to be understood.

A Model-based Approach to Controlling the ST-5 Constellation Lights-Out Using the GMSEC Message Bus and Simulink

NASA Technical Reports Server (NTRS)

Witt, Kenneth J.; Stanley, Jason; Shendock, Robert; Mandl, Daniel

2005-01-01

Space Technology 5 (ST-5) is a three-satellite constellation, technology validation mission under the New Millennium Program at NASA to be launched in March 2006. One of the key technologies to be validated is a lights-out, model-based operations approach to be used for one week to control the ST-5 constellation with no manual intervention. The ground architecture features the GSFC Mission Services Evolution Center (GMSEC) middleware, which allows easy plugging in of software components and a standardized messaging protocol over a software bus. A predictive modeling tool built on MatLab's Simulink software package makes use of the GMSEC standard messaging protocol to interface to the Advanced Mission Planning System (AMPS) Scenario Scheduler which controls all activities, resource allocation and real-time re-profiling of constellation resources when non-nominal events occur. The key features of this system, which we refer to as the ST-5 Simulink system, are as follows: Original daily plan is checked to make sure that predicted resources needed are available by comparing the plan against the model. As the plan is run in real-time, the system re-profiles future activities in real-time if planned activities do not occur in the predicted timeframe or fashion. Alert messages are sent out on the GMSEC bus by the system if future predicted problems are detected. This will allow the Scenario Scheduler to correct the situation before the problem happens. The predictive model is evolved automatically over time via telemetry updates thus reducing the cost of implementing and maintaining the models by an order of magnitude from previous efforts at GSFC such as the model-based system built for MAP in the mid-1990's. This paper will describe the key features, lessons learned and implications for future missions once this system is successfully validated on-orbit in 2006.

Privacy Sensitive Surveillance for Assisted Living - A Smart Camera Approach

NASA Astrophysics Data System (ADS)

Fleck, Sven; Straßer, Wolfgang

An elderly woman wanders about aimlessly in a home for assisted living. Suddenly, she collapses on the floor of a lonesome hallway. Usually it can take over two hours until a night nurse passes this spot on her next inspection round. But in this case she is already on site after two minutes, ready to help. She has received an alert message on her beeper: "Inhabitant fallen in hallway 2b". The source: the SmartSurv distributed network of smart cameras for automated and privacy respecting video analysis.Welcome to the future of smart surveillance Although this scenario is not yet daily practice, it shall make clear how such systems will impact the safety of the elderly without the privacy intrusion of traditional video surveillance systems.

Biomedical information @ the speed of light: implementing desktop access to publishers' resources at the Paterson Institute for Cancer Research.

PubMed

Glover, S W

2001-06-01

Shortly after midnight every Thursday morning, a list server in Massachusetts delivers an electronic table of contents message to the Kostoris Medical Library at the Paterson Institute for Cancer Research in Manchester, UK. The messageins details of the latest edition of the New England Journal of Medicine, complete with hyperlinks to the full text of the content online. Publishers' electronic current awareness services have been integrated into the dissemination process of the Library service to enhance the speed of communication and access to full text content. As a means of promoting electronic journal use, a system of e-mail delivery coupled with fast Internet access has allowed a migration from paper-based current awareness alerting to a seamless online product.

The Effects of Denial-of-Service Attacks on Secure Time-Critical Communications in the Smart Grid

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Fengli; Li, QInghua; Mantooth, Homer Alan

2016-04-02

According to IEC 61850, many smart grid communications require messages to be delivered in a very short time. –Trip messages and sample values applied to the transmission level: 3 ms –Interlocking messages applied to the distribution level: 10 ms •Time-critical communications are vulnerable to denial-of-service (DoS) attacks –Flooding attack: Attacker floods many messages to the target network/machine. We conducted systematic, experimental study about how DoS attacks affect message delivery delays.

47 CFR 11.51 - EAS code and Attention Signal Transmission requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false EAS code and Attention Signal Transmission... SYSTEM (EAS) Emergency Operations § 11.51 EAS code and Attention Signal Transmission requirements. (a... programming before EAS message transmission should not cause television receivers to mute EAS audio messages...

Hypertext: Improved Capability for Shipboard Naval Messages

DTIC Science & Technology

1989-09-01

message handling system; a complete working model of the system has not been developed . 3 D. ORGANIZATION OF STUDY 1. The "Paperless" Ship Initiative...work in tandem to improve afloat message handling procedures. The objective of the PCMT project is to develop a system that could be installed on...working group has identified a list of requirements to guide the DoD’s progress towards improving its message communication system. These

Design of decision support interventions for medication prescribing.

PubMed

Horsky, Jan; Phansalkar, Shobha; Desai, Amrita; Bell, Douglas; Middleton, Blackford

2013-06-01

Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety. Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort. Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks. Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

An Evaluation of One-Sided and Two-Sided Communication Paradigms on Relaxed-Ordering Interconnect

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ibrahim, Khaled Z.; Hargrove, Paul H.; Iancu, Costin

The Cray Gemini interconnect hardware provides multiple transfer mechanisms and out-of-order message delivery to improve communication throughput. In this paper we quantify the performance of one-sided and two-sided communication paradigms with respect to: 1) the optimal available hardware transfer mechanism, 2) message ordering constraints, 3) per node and per core message concurrency. In addition to using Cray native communication APIs, we use UPC and MPI micro-benchmarks to capture one- and two-sided semantics respectively. Our results indicate that relaxing the message delivery order can improve performance up to 4.6x when compared with strict ordering. When hardware allows it, high-level one-sided programmingmore » models can already take advantage of message reordering. Enforcing the ordering semantics of two-sided communication comes with a performance penalty. Furthermore, we argue that exposing out-of-order delivery at the application level is required for the next-generation programming models. Any ordering constraints in the language specifications reduce communication performance for small messages and increase the number of active cores required for peak throughput.« less

Verifying Safety Messages Using Relative-Time and Zone Priority in Vehicular Ad Hoc Networks.

PubMed

Banani, Sam; Gordon, Steven; Thiemjarus, Surapa; Kittipiyakul, Somsak

2018-04-13

In high-density road networks, with each vehicle broadcasting multiple messages per second, the arrival rate of safety messages can easily exceed the rate at which digital signatures can be verified. Since not all messages can be verified, algorithms for selecting which messages to verify are required to ensure that each vehicle receives appropriate awareness about neighbouring vehicles. This paper presents a novel scheme to select important safety messages for verification in vehicular ad hoc networks (VANETs). The proposed scheme uses location and direction of the sender, as well as proximity and relative-time between vehicles, to reduce the number of irrelevant messages verified (i.e., messages from vehicles that are unlikely to cause an accident). Compared with other existing schemes, the analysis results show that the proposed scheme can verify messages from nearby vehicles with lower inter-message delay and reduced packet loss and thus provides high level of awareness of the nearby vehicles.

Verifying Safety Messages Using Relative-Time and Zone Priority in Vehicular Ad Hoc Networks

PubMed Central

Banani, Sam; Thiemjarus, Surapa; Kittipiyakul, Somsak

2018-01-01

In high-density road networks, with each vehicle broadcasting multiple messages per second, the arrival rate of safety messages can easily exceed the rate at which digital signatures can be verified. Since not all messages can be verified, algorithms for selecting which messages to verify are required to ensure that each vehicle receives appropriate awareness about neighbouring vehicles. This paper presents a novel scheme to select important safety messages for verification in vehicular ad hoc networks (VANETs). The proposed scheme uses location and direction of the sender, as well as proximity and relative-time between vehicles, to reduce the number of irrelevant messages verified (i.e., messages from vehicles that are unlikely to cause an accident). Compared with other existing schemes, the analysis results show that the proposed scheme can verify messages from nearby vehicles with lower inter-message delay and reduced packet loss and thus provides high level of awareness of the nearby vehicles. PMID:29652840

Designing a Multi-Petabyte Database for LSST

DOE Office of Scientific and Technical Information (OSTI.GOV)

Becla, Jacek; Hanushevsky, Andrew; Nikolaev, Sergei

2007-01-10

The 3.2 giga-pixel LSST camera will produce approximately half a petabyte of archive images every month. These data need to be reduced in under a minute to produce real-time transient alerts, and then added to the cumulative catalog for further analysis. The catalog is expected to grow about three hundred terabytes per year. The data volume, the real-time transient alerting requirements of the LSST, and its spatio-temporal aspects require innovative techniques to build an efficient data access system at reasonable cost. As currently envisioned, the system will rely on a database for catalogs and metadata. Several database systems are beingmore » evaluated to understand how they perform at these data rates, data volumes, and access patterns. This paper describes the LSST requirements, the challenges they impose, the data access philosophy, results to date from evaluating available database technologies against LSST requirements, and the proposed database architecture to meet the data challenges.« less

SMSaúde: Design, Development, and Implementation of a Remote/Mobile Patient Management System to Improve Retention in Care for HIV/AIDS and Tuberculosis Patients.

PubMed

Nhavoto, José António; Grönlund, Åke; Chaquilla, Walter Ponce

2015-03-09

The widespread and low cost of mobile phones and the convenience of short message service (SMS) text messaging suggest potential suitability for use with alternative strategies for supporting retention in care and adherence to the treatment of various chronic diseases, such as HIV and tuberculosis (TB). Despite the growing body of literature reporting positive outcomes of SMS text message-based communication with patients, there is yet very little research about the integration of communication technologies and electronic medical records or electronic patient tracking systems. To design, develop, and implement an integrated mobile phone text messaging system used to follow up with patients with HIV and TB in treatment in Mozambique. Following the design science research methodology, we developed a Web-based system that provides support to patients. A case study involving three health care sites in Mozambique was a basis for discussing design issues for this kind of system. We used brainstorming techniques to solicit usability requirements, focus group meetings to discuss and define system architecture, and prototyping to test in real environments and to improve the system. We found six sets of system requirements that need to be addressed for success: data collection, telecommunication costs, privacy and data security, text message content, connectivity, and system scalability. A text messaging system was designed and implemented in three health facilities. These sites feed data into a central data repository, which can be used for analysis of operations and decision support. Based on the treatment schedule, the system automatically sent SMS text message appointment reminders, medication reminders, as well as motivational and educational messages to patients enrolled in antiretroviral therapy and TB treatment programs. We successfully defined the requirements for, designed, and implemented a mobile phone text messaging system to support HIV and TB treatments. Implementation of this system could improve patients' self-management skills and strengthen communication between patients and health care providers.

The Generic Resolution Advisor and Conflict Evaluator (GRACE) for Detect-And-Avoid (DAA) Systems

NASA Technical Reports Server (NTRS)

Abramson, Michael; Refai, Mohamad; Santiago, Confesor

2017-01-01

The paper describes the Generic Resolution Advisor and Conflict Evaluator (GRACE), a novel alerting and guidance algorithm that combines flexibility, robustness, and computational efficiency. GRACE is "generic" in that it makes no assumptions regarding temporal or spatial scales, aircraft performance, or its sensor and communication systems. Accordingly, GRACE is well suited to research applications where alerting and guidance is a central feature and requirements are fluid involving a wide range of aviation technologies. GRACE has been used at NASA in a number of real-time and fast-time experiments supporting evolving requirements of DAA research, including parametric studies, NAS-wide simulations, human-in-the-loop experiments, and live flight tests.

Improving the Health Forecasting Alert System for Cold Weather and Heat-Waves In England: A Proof-of-Concept Using Temperature-Mortality Relationships

PubMed Central

Masato, Giacomo; Bone, Angie; Charlton-Perez, Andrew; Cavany, Sean; Neal, Robert; Dankers, Rutger; Dacre, Helen; Carmichael, Katie; Murray, Virginia

2015-01-01

Objectives In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office’s (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. Method The prototype health forecasting alert system introduces an “impact vs likelihood matrix” for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. Conclusions The prototype shows some clear improvements over the current alert system. It allows for a much greater degree of flexibility, provides more detailed regional information about the health risks associated with periods of extreme temperatures, and is more coherent with other weather alerts which may make it easier for front line responders to use. It will require validation and engagement with stakeholders before it can be considered for use. PMID:26431427

Improving the Health Forecasting Alert System for Cold Weather and Heat-Waves In England: A Proof-of-Concept Using Temperature-Mortality Relationships.

PubMed

Masato, Giacomo; Bone, Angie; Charlton-Perez, Andrew; Cavany, Sean; Neal, Robert; Dankers, Rutger; Dacre, Helen; Carmichael, Katie; Murray, Virginia

2015-01-01

In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office's (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. The prototype health forecasting alert system introduces an "impact vs likelihood matrix" for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. The prototype shows some clear improvements over the current alert system. It allows for a much greater degree of flexibility, provides more detailed regional information about the health risks associated with periods of extreme temperatures, and is more coherent with other weather alerts which may make it easier for front line responders to use. It will require validation and engagement with stakeholders before it can be considered for use.

High-priority and low-priority drug-drug interactions in different international electronic health record systems: A comparative study.

PubMed

Cornu, Pieter; Phansalkar, Shobha; Seger, Diane L; Cho, Insook; Pontefract, Sarah; Robertson, Alexandra; Bates, David W; Slight, Sarah P

2018-03-01

To investigate whether alert warnings for high-priority and low-priority drug-drug interactions (DDIs) were present in five international electronic health record (EHR) systems, to compare and contrast the severity level assigned to them, and to establish the proportion of alerts that were overridden. We conducted a comparative, retrospective, multinational study using a convenience sample of 5 EHRs from the U.S., U.K., Republic of Korea and Belgium. Of the 15 previously defined, high-priority, class-based DDIs, alert warnings were found to exist for 11 in both the Korean and UK systems, 9 in the Belgian system, and all 15 in the two US systems. The specific combinations that were included in these class-based DDIs varied considerably in number, type and level of severity amongst systems. Alerts were only active for 8.4% (52/619) and 52.4% (111/212) of the specific drug-drug combinations contained in the Belgian and UK systems, respectively. Hard stops (not possible to override) existed in the US and UK systems only. The override rates for high-priority alerts requiring provider action ranged from 56.7% to 83.3%. Of the 33 previously defined low-priority DDIs, active alerts existed only in the US systems, for three class-based DDIs. The majority were non-interruptive. Alert warnings existed for most of the high-priority DDIs in the different EHRs but overriding them was easy in most of the systems. In addition to validating the high- and low-priority DDIs, this study reported a lack of standardization in DDI levels across different international knowledge bases. Copyright © 2017. Published by Elsevier B.V.

Timely response to secure messages from primary care patients.

PubMed

Rohrer, James E; North, Frederick; Angstman, Kurt B; Oberhelman, Sara S; Meunier, Matthew R

2013-01-01

To assess delays in response to patient secure e-mail messages in primary care. Secure electronic messages are initiated by primary care patients. Timely response is necessary for patient safety and quality. A database of secure messages. A random sample of 353 secure electronic messages initiated by primary care patients treated in 4 clinics. Message not opened after 12 hours or messages not responded to after 36 hours. A total of 8.5% of electronic messages were not opened within 12 hours, and 17.6% did not receive a response in 36 hours. Clinic location, being a clinic employee, and patient sex were not related to delays. Patients older than 50 years were more likely to receive a delayed response (25.7% delayed, P = .013). The risk of both kinds of delays was higher on weekends (P < .001 for both). The e-mail message system resulted in high rates of delayed response. Delays were concentrated on weekends (Friday-Sunday). Reducing delayed responses may require automatic rerouting of messages to message centers staffed 24-7 or other mechanisms to manage this after-hours work flow.

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

PubMed

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

2016-07-01

Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impact of ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports. The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (p<0.0001, Cochran-Armitage trend test). The proportion of provider-communicated reports with non-critical results remained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test). A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting the system did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prescription errors before and after introduction of electronic medication alert system in a pediatric emergency department.

PubMed

Sethuraman, Usha; Kannikeswaran, Nirupama; Murray, Kyle P; Zidan, Marwan A; Chamberlain, James M

2015-06-01

Prescription errors occur frequently in pediatric emergency departments (PEDs).The effect of computerized physician order entry (CPOE) with electronic medication alert system (EMAS) on these is unknown. The objective was to compare prescription errors rates before and after introduction of CPOE with EMAS in a PED. The hypothesis was that CPOE with EMAS would significantly reduce the rate and severity of prescription errors in the PED. A prospective comparison of a sample of outpatient, medication prescriptions 5 months before and after CPOE with EMAS implementation (7,268 before and 7,292 after) was performed. Error types and rates, alert types and significance, and physician response were noted. Medication errors were deemed significant if there was a potential to cause life-threatening injury, failure of therapy, or an adverse drug effect. There was a significant reduction in the errors per 100 prescriptions (10.4 before vs. 7.3 after; absolute risk reduction = 3.1, 95% confidence interval [CI] = 2.2 to 4.0). Drug dosing error rates decreased from 8 to 5.4 per 100 (absolute risk reduction = 2.6, 95% CI = 1.8 to 3.4). Alerts were generated for 29.6% of prescriptions, with 45% involving drug dose range checking. The sensitivity of CPOE with EMAS in identifying errors in prescriptions was 45.1% (95% CI = 40.8% to 49.6%), and the specificity was 57% (95% CI = 55.6% to 58.5%). Prescribers modified 20% of the dosing alerts, resulting in the error not reaching the patient. Conversely, 11% of true dosing alerts for medication errors were overridden by the prescribers: 88 (11.3%) resulted in medication errors, and 684 (88.6%) were false-positive alerts. A CPOE with EMAS was associated with a decrease in overall prescription errors in our PED. Further system refinements are required to reduce the high false-positive alert rates. © 2015 by the Society for Academic Emergency Medicine.

Response to Alert on Possible Infections with Mycobacterium chimaera From Contaminated Heater-Cooler Devices in Hospitals Participating in the Canadian Nosocomial Infection Surveillance Program (CNISP).

PubMed

Mertz, Dominik; Macri, Jennifer; Hota, Susy; Amaratunga, Kanchana; Davis, Ian; Johnston, Lynn; Lee, Bonita; Pelude, Linda; Science, Michelle; Smith, Stephanie; Wong, Alice

2018-04-01

Canadian hospitals were made aware of the risk of Mycobacterium chimaera infection associated with heater-cooler units (HCUs) through alerts issued by the US food and Drug Administration (FDA) and the US Centers for Disease Control and Prevention (CDC). In response, most hospitals conducted retrospective reviews for infections, informed exposed patients, and initiated a requirement for informed consent with HCU use. Infect Control Hosp Epidemiol 2018;39:482-484.

16 CFR 316.4 - Requirement to place warning labels on commercial electronic mail that contains sexually oriented...

Code of Federal Regulations, 2014 CFR

2014-01-01

... person who initiates, to a protected computer, the transmission of a commercial electronic mail message... electronic mail message or other form of Internet-based communication requesting not to receive future... received; and (B) Remains capable of receiving such messages or communications for no less than 30 days...

16 CFR 316.4 - Requirement to place warning labels on commercial electronic mail that contains sexually oriented...

Code of Federal Regulations, 2013 CFR

2013-01-01

... person who initiates, to a protected computer, the transmission of a commercial electronic mail message... electronic mail message or other form of Internet-based communication requesting not to receive future... received; and (B) Remains capable of receiving such messages or communications for no less than 30 days...

16 CFR 316.4 - Requirement to place warning labels on commercial electronic mail that contains sexually oriented...

Code of Federal Regulations, 2012 CFR

2012-01-01

... person who initiates, to a protected computer, the transmission of a commercial electronic mail message... electronic mail message or other form of Internet-based communication requesting not to receive future... received; and (B) Remains capable of receiving such messages or communications for no less than 30 days...

16 CFR 316.4 - Requirement to place warning labels on commercial electronic mail that contains sexually oriented...

Code of Federal Regulations, 2011 CFR

2011-01-01

... person who initiates, to a protected computer, the transmission of a commercial electronic mail message... electronic mail message or other form of Internet-based communication requesting not to receive future... received; and (B) Remains capable of receiving such messages or communications for no less than 30 days...

A concept for reducing oceanic separation minima through the use of a TCAS-derived CDTI

NASA Technical Reports Server (NTRS)

Love, W. D.; Mcfarland, A. L.; Ludwick, J. S.

1984-01-01

A concept for using a cockpit display of traffic information (CDTI), as derived from a modified version of the Traffic Alert and Collision Avoidance System 2 (TCAS 2), to support reductions in air traffic separation minima for an oceanic track system is presented. The concept, and the TCAS modifications required to support it, are described. The feasibility of the concept is examined from a number of standpoints, including expected benefits, maximum alert rates, and possible transition strategies. Various implementation issues are analyzed. Pilot procedures are suggested for dealing with alert situations. Possible variations of the concept are also examined. Finally, recommendations are presented for other studies and simulation experiments which can be used to further verify the feasibility of the concept.

SC-228 Inclusion of DAA Warning Alert for TCAS Interoperability

NASA Technical Reports Server (NTRS)

Fern, Lisa

2016-01-01

This white paper summarizes NASA research results that have informed Special Committee 228 (SC-228) discussions and decisions regarding the inclusion of a warning-level alert within the detect and avoid (DAA) alerting structure for unmanned aircraft systems (UAS). For UAS, the removal of the pilot from onboard the aircraft has eliminated the ability of the ground-based pilot in command (PIC) to use out-the-window visual information to make judgments about a potential threat of a loss of well clear with another aircraft. As a result, the DAA traffic display will be the primary source of information that the PIC can use to execute the three primary well clear functions: 1) detect a potential loss of well clear, 2) determine a resolution maneuver, and 3) upload that maneuver to the aircraft via the ground control station (GCS). In addition, pilots are required to coordinate with air traffic control (ATC) prior to maneuvering off of their approved flight plan. In determining an appropriate resolution maneuver to avoid a loss of well clear, the PIC must decide both when and how to maneuver, and both the timeliness and the accuracy (i.e., correctness) of the maneuver are critical to reducing the likelihood and/or severity of a loss of well clear. Alerting information is one of three critical components of the DAA display, along with traffic information elements (e.g., relative heading, speed and altitude) and maneuver guidance. Alerting information and maneuver guidance, in particular, have been found to have a significant impact, both statistically and practically, on pilots' ability to avoid and minimize the severity of losses of well clear While all three display components are key to pilots performing the traffic avoidance task of remaining well clear, in general, alerting information provides crucial information about when a resolution maneuver is required while maneuver guidance assists the pilot in determining how best to maneuver. A fundamental task of the DAA alerting system is to provide critical timing information to the pilot about the potential for a loss of well clear with another aircraft. This is done by employing both temporal and spatial thresholds that indicate to the pilot the likelihood and imminence of a loss of well clear. The design of the DAA alerting thresholds is a balancing act between eliciting the desired pilot response in real loss of well clear threat events and reducing excessive, unnecessary, and/or uncoordinated UAS maneuvering within the air traffic environment; larger thresholds, both spatially and temporally, may increase the likelihood of a pilot avoiding a loss of well clear, but it can also increase the frequency of maneuvering - especially in cases where a maneuver is not actually needed to maintain well clear. A series of human in the loop (HITL) simulations have been conducted as part of NASA's Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) project. The purpose of these HITLs has been to provide empirical results in order to inform development of the minimum human-machine interface requirements for the DAA system. This white paper will present those results which provide evidence of a human performance benefit (in terms of response times and ability to remain well clear of other aircraft) of the DAA warning alert both with and without a collision avoidance system on board the aircraft.

Automatic discovery of optimal classes

NASA Technical Reports Server (NTRS)

Cheeseman, Peter; Stutz, John; Freeman, Don; Self, Matthew

1986-01-01

A criterion, based on Bayes' theorem, is described that defines the optimal set of classes (a classification) for a given set of examples. This criterion is transformed into an equivalent minimum message length criterion with an intuitive information interpretation. This criterion does not require that the number of classes be specified in advance, this is determined by the data. The minimum message length criterion includes the message length required to describe the classes, so there is a built in bias against adding new classes unless they lead to a reduction in the message length required to describe the data. Unfortunately, the search space of possible classifications is too large to search exhaustively, so heuristic search methods, such as simulated annealing, are applied. Tutored learning and probabilistic prediction in particular cases are an important indirect result of optimal class discovery. Extensions to the basic class induction program include the ability to combine category and real value data, hierarchical classes, independent classifications and deciding for each class which attributes are relevant.

Key messages for communicating information about BRCA1 and BRCA2 to women with breast or ovarian cancer: Consensus across health professionals and service users.

PubMed

Jacobs, Chris; Pichert, Gabriella; Harris, Jackie; Tucker, Kathy; Michie, Susan

2017-11-01

Genetic testing of cancer predisposing genes will increasingly be needed in oncology clinics to target cancer treatment. This Delphi study aimed to identify areas of agreement and disagreement between genetics and oncology health professionals and service users about the key messages required by women with breast/ovarian cancer who undergo BRCA1/BRCA2 genetic testing and the optimal timing of communicating key messages. Participants were 16 expert health professionals specialising in oncology/genetics and 16 service users with breast/ovarian cancer and a pathogenic BRCA1/BRCA2 variant. Online questionnaires containing 53 inductively developed information messages were circulated to the groups separately. Participants rated each message as key/not key on a Likert scale and suggested additional messages. Questionnaires were modified according to the feedback and up to 3 rounds were circulated. Consensus was reached when there was ≥75% agreement. Thirty key messages were agreed by both groups with 7 of the key messages agreed by ≥95% of participants: dominant inheritance, the availability of predictive testing, the importance of pretest discussion, increased risk of breast and ovarian cancer, and the option of risk-reducing mastectomy and bilateral salpingo-oophorectomy. Both groups agreed that key messages should be communicated before genetic testing and once a pathogenic variant has been identified. There was a high level of agreement within and between the groups about the information requirements of women with breast/ovarian cancer about BRCA1/BRCA2. These key messages will be helpful in developing new approaches to the delivery of information as genetic testing becomes further integrated into mainstream oncology services. Copyright © 2017 John Wiley & Sons, Ltd.

Improving the health forecasting alert system for cold weather and heat-waves in England: a case-study approach using temperature-mortality relationships

NASA Astrophysics Data System (ADS)

Masato, Giacomo; Cavany, Sean; Charlton-Perez, Andrew; Dacre, Helen; Bone, Angie; Carmicheal, Katie; Murray, Virginia; Danker, Rutger; Neal, Rob; Sarran, Christophe

2015-04-01

The health forecasting alert system for cold weather and heatwaves currently in use in the Cold Weather and Heatwave plans for England is based on 5 alert levels, with levels 2 and 3 dependent on a forecast or actual single temperature action trigger. Epidemiological evidence indicates that for both heat and cold, the impact on human health is gradual, with worsening impact for more extreme temperatures. The 60% risk of heat and cold forecasts used by the alerts is a rather crude probabilistic measure, which could be substantially improved thanks to the state-of-the-art forecast techniques. In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office's (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. The prototype health forecasting alert system introduces an "impact vs likelihood matrix" for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. The prototype shows some clear improvements over the current alert system. It allows for a much greater degree of flexibility, provides more detailed regional information about the health risks associated with periods of extreme temperatures, and is more coherent with other weather alerts which may make it easier for front line responders to use. It will require validation and engagement with stakeholders before it can be considered for use.

Investigating the contribution of short wavelengths in the alerting effect of bright light.

PubMed

Sasseville, Alexandre; Martin, Jeanne Sophie; Houle, Jérôme; Hébert, Marc

2015-11-01

Short-wavelengths can have an acute impact on alertness, which is allegedly due to their action on intrinsically photosensitive retinal ganglion cells. Classical photoreceptors cannot, however, be excluded at this point in time as contributors to the alerting effect of light. The objective of this study was to compare the alerting effect at night of a white LED light source while wearing blue-blockers or not, in order to establish the contribution of short-wavelengths. 20 participants stayed awake under dim light (< 5 lx) from 23:00 h to 04:00 h on two consecutive nights. On the second night, participants were randomly assigned to one light condition for 30 min starting at 3:00 h. Group A (5M/5F) was exposed to 500 μW/cm(2) of unfiltered LED light, while group B (4M/6F) was required to wear blue-blocking glasses, while exposed to 1500 μW/cm(2) from the same light device in order to achieve 500 μW/cm(2) at eye level (as measured behind the glasses). Subjective alertness, energy, mood and anxiety were assessed for both nights at 23:30 h, 01:30 h and 03:30 h using a visual analog scale (VAS). Subjective sleepiness was assessed with the Stanford Sleepiness Scale (SSS). Subjects also performed the Conners' Continuous Performance Test II (CPT-II) in order to assess objective alertness. Mixed model analysis was used to compare VAS, SSS and CPT-II parameters. No difference between group A and group B was observed for subjective alertness, energy, mood, anxiety and sleepiness, as well as CPT-II parameters. Subjective alertness (p < 0.001), energy (p < 0.001) and sleepiness (p < 0.05) were, however improved after light exposure on the second night independently of the light condition. The current study shows that when sleepiness is high, the alerting effect of light can still be triggered at night in the absence of short-wavelengths with a 30 minute light pulse of 500 μW/cm(2). This suggests that the underlying mechanism by which a brief polychromatic light exposure improves alertness is not solely due to short-wavelengths through intrinsically photosensitive retinal ganglion cells.

Secure HL7 transactions using Internet mail (Internet draft).

PubMed

Schadow, Gunther; Tucker, Mark; Rishel, Wes

2002-01-01

The document describes the applicability of the Internet standardisation efforts on secure electronic data interchange (EDI) transactions for Health Level-7 (HL7), an EDI standard for Healthcare used world-wide. The document heavily relies on the work in progress by the IETF EDIINT working group. It is in most parts a restatement of the EDIINTs requirements document and application statement 1 (AS#1) tailored to the needs of the HL7 audience. The authors tried to make the document as self consistent as possible. The goal is to give to the reader who is not a security or Internet standards expert enough foundational and detail information to enable him to build communication software that complies to the Internet standards. Even though the authors rely on and promote the respective Internet standards and drafts, they did not withstand from commenting on and criticising the work where they see upcoming problems in use with HL7 or other EDI protocols that have not been in the initial focus of the EDIINT working group. The authors make suggestions to add parameters to the specification of the MIME type for EDI messages in RFC 1767 in order to enhance functionality. The authors give use cases for a larger subset of disposition types and modifiers of message disposition notifications. One key issue where the document goes beyond the current EDIINT drafts is the concept of non-repudiation of commitment to an EDI transaction. Secure EDI transactions should be regarded as "distributed contracts," i.e. not only the sending and receiving of single messages should be non-refutable but also the connection between messages interchanges. In anticipation of this requirement HL7 usually requires a response message to be sent to acknowledge every transaction. The authors therefore have the requirement to securely couple an EDI response message to its request message. Given the current shape of RFC 1767 this is generally possible only if a response message is coupled with an MDN receipt and the combination of both signed by the responder. The document describes a protocol to bundle MDN and response that uses the MIME multi-part/related content type in RFC 2112.

Requirements for the Military Message System (MMS) Family: Data Types and User Commands.

DTIC Science & Technology

1986-04-11

AD-A167 126 REQUIREMENTS FOR THE MILITARY MESSASE SYSTEM (NHS) i FRILY: DATA TYPES AND USER CONNNDS(U) NAVAL RESEARCH LAB WASHINGTON DC C L HEITHEVER... System (MMS) Family: Data Types and User Commands CONSTANCE L. HEITMEYER Computer Science and Systems Branch I Information Technology Division April 11...Security Classification) Requirements for the Military Message System (MMS) Family: Data Types and User Commands 12. PERSONAL AUTHOR(S) Heitmeer, Constance

Airline Transport Pilot Preferences for Predictive Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1996-01-01

This experiment assessed certain issues about the usefulness of predictive information: (1) the relative time criticality of failures, (2) the subjective utility of predictive information for different parameters or sensors, and (3) the preferred form and prediction time for displaying predictive information. To address these issues, three separate tasks were administered to 22 airline pilots. As shown by the data, these pilots preferred predictive information on parameters they considered vital to the safety of the flight. These parameters were related to the checklists performed first for alert messages. These pilots also preferred to know whether a parameter was changing abnormally and the time to a certain value being reached. Furthermore, they considered this information most useful during the cruise, the climb, and the descent phases of flight. Lastly, these pilots preferred the information to predict as far ahead as possible.

Tablet PC Enabled Body Sensor System for Rural Telehealth Applications

PubMed Central

Panicker, Nitha V.; Kumar, A. Sukesh

2016-01-01

Telehealth systems benefit from the rapid growth of mobile communication technology for measuring physiological signals. Development and validation of a tablet PC enabled noninvasive body sensor system for rural telehealth application are discussed in this paper. This system includes real time continuous collection of physiological parameters (blood pressure, pulse rate, and temperature) and fall detection of a patient with the help of a body sensor unit and wireless transmission of the acquired information to a tablet PC handled by the medical staff in a Primary Health Center (PHC). Abnormal conditions are automatically identified and alert messages are given to the medical officer in real time. Clinical validation is performed in a real environment and found to be successful. Bland-Altman analysis is carried out to validate the wrist blood pressure sensor used. The system works well for all measurements. PMID:26884757

The Possible Contribution of Social Grammar of Language Analysis to Inter-Cultural Communication and the Avoidance of Misunderstanding.

ERIC Educational Resources Information Center

Grayshon, Matthew C.

Different languages code messages in different ways and use different channels for sending messages; thus there are many places for misinterpreting and mishearing messages in an intercultural context. To move from one language to another requires a description of the total language communication system, one that has its universals in social and…

Healthcare-associated infection surveillance and bedside alerts.

PubMed

Adlassnig, Klaus-Peter; Berger, Angelika; Koller, Walter; Blacky, Alexander; Mandl, Harald; Unterasinger, Lukas; Rappelsberger, Andrea

2014-01-01

Expectations and requirements concerning the identification and surveillance of healthcare-associated infections (HAIs) are increasing, calling for differentiated automated approaches. In an attempt to bridge the "definition swamp" of these infections and serve the needs of different users, we improved the monitoring of nosocomial infections (MONI) software to create better surveillance reports according to consented national and international definitions, as well as produce infection overviews on complex clinical matters including alerts for the clinician's ward and bedside work. MONI contains and processes surveillance definitions for intensive-care-unit-acquired infections from the European Centre for Disease Prevention and Control, Sweden, as well as the Centers for Disease Control and Prevention, USA. The latest release of MONI also includes KISS criteria of the German National Reference Center for Surveillance of Nosocomial Infections. In addition to these "classic" surveillance criteria, clinical alert criteria--which are similar but not identical to the surveillance criteria--were established together with intensivists. This is an important step to support both infection control and clinical personnel; and--last but not least--to foster co-evolution of the two groups of definitions: surveillance and alerts.

Cooperative runtime monitoring

NASA Astrophysics Data System (ADS)

Hallé, Sylvain

2013-11-01

Requirements on message-based interactions can be formalised as an interface contract that specifies constraints on the sequence of possible messages that can be exchanged by multiple parties. At runtime, each peer can monitor incoming messages and check that the contract is correctly being followed by their respective senders. We introduce cooperative runtime monitoring, where a recipient 'delegates' its monitoring task to the sender, which is required to provide evidence that the message it sends complies with the contract. In turn, this evidence can be quickly checked by the recipient, which is then guaranteed of the sender's compliance to the contract without doing the monitoring computation by itself. A particular application of this concept is shown on web services, where service providers can monitor and enforce contract compliance of third-party clients at a small cost on the server side, while avoiding to certify or digitally sign them.

The DDN (Defense Data Network) Course,

DTIC Science & Technology

1986-04-01

devices will share the same node-to-node channels. * Simultaneous availability of source and destination is not required. * Speed and code conversion can...address multiple addresses simultaneously 3) Disadvantages of Message Switching Systems Not suited to real time or interactive use * Long and highly...transmission b) Unlike message switching, packet switching requires the -. simultaneous availability of source and destination. 64 -4 ) ..xa...e s

Analysis of acoustic data for hybrid and electric vehicles measured on hemi-anechoic chambers

DOT National Transportation Integrated Search

2015-04-01

The Pedestrian Safety Enhancement Act of 2010 requires the National Highway Traffic Safety : Administration to conduct a rulemaking to establish a Federal Motor Vehicle Safety Standard requiring an alert sound for pedestrians to be emitted by electri...

Flow Control and Routing in an Integrated Voice and Data Communication Network

DTIC Science & Technology

1981-08-01

require continuous and almost real - time delivery; they are very sensitive to delay. Data conversations, on the other hand, are generally intolerant of...packets arrive in time to be delivered to the sink. However, this is not the solution we seek. We have noted that voice conversations require almost real ...by long messages that require continuous real - time delivery; e.g. voice facsimile, video. Class II: characterized by short discrete messages that

Effects of redundancy in the comparison of speech and pictorial displays in the cockpit environment.

PubMed

Byblow, W D

1990-06-01

Synthesised speech and pictorial displays were compared in a spatially compatible simulated cockpit environment. Messages of high or low levels of redundancy were presented to subjects in both modality conditions. Subjects responded to warnings presented in a warning-only condition and in a dual-task condition, in which a simulated flight task was performed with visual and manual input/output modalities. Because the amount of information presented in most real-world applications and experimental paradigms is quantifiably large with respect to present guidelines for the use of synthesised speech warnings, the low-redundancy condition was hypothesised to allow for better performance. Results showed that subjects respond quicker to messages of low redundancy in both modalities. It is suggested that speech messages with low-redundancy levels were effective in minimising message length and ensuring that messages did not overload the short-term memory required to process and maintain speech in memory. Manipulation of phrase structure was used to optimise message redundancy and enhance the conceptual compatibility of the message without increasing message length or imposing a perceptual cost or memory overload. The results also suggest that system response times were quicker when synthesised speech warnings were used. This result is consistent with predictions from multiple resource theory which states that the resources required for the perception of verbal warnings are different from those for the flight task. It is also suggested that the perception of a pictorial display requires the same resources used for the perception of the primary flight task. An alternative explanation is that pictorial displays impose a visual scanning cost which is responsible for decreased performance. Based on the findings reported here, it is suggested that speech displays be incorporated in a spatially compatible cockpit environment because they allow equal or better performance when compared with pictorial displays. More importantly, the amount of time that the operator must direct his vision away from information vital to the flight task is decreased.

Automated detection of optical counterparts to GRBs with RAPTOR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wozniak, P. R.; Vestrand, W. T.; Evans, S.

2006-05-19

The RAPTOR system (RAPid Telescopes for Optical Response) is an array of several distributed robotic telescopes that automatically respond to GCN localization alerts. Raptor-S is a 0.4-m telescope with 24 arc min. field of view employing a 1k x 1k Marconi CCD detector, and has already detected prompt optical emission from several GRBs within the first minute of the explosion. We present a real-time data analysis and alert system for automated identification of optical transients in Raptor-S GRB response data down to the sensitivity limit of {approx} 19 mag. Our custom data processing pipeline is designed to minimize the timemore » required to reliably identify transients and extract actionable information. The system utilizes a networked PostgreSQL database server for catalog access and distributes email alerts with successful detections.« less

Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts

PubMed Central

McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras

2016-01-01

Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time—the time elapsed from when an interruptive alert is generated to when it is dismissed—could be calculated by using historical alert data from log files. Drug–drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1–4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < .001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < .001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. PMID:26499101

Message Framing, Perceived Susceptibility, and Intentions to Vaccinate Children against HPV among African American Parents

PubMed Central

Nan, Xiaoli; Madden, Kelly; Richards, Adam; Holt, Cheryl; Wang, Min Qi; Tracy, Kate

2017-01-01

This research examines the interaction effect of message framing (gain vs. loss) and perceived susceptibility (i.e., perceived likelihood that one’s child is at risk of contracting HPV) on African American parents’ intentions to vaccinate their children against HPV. Results of an experiment (N = 193), in which parents were exposed to either a gain-framed or loss-framed message about HPV vaccination, revealed a significant interaction between message framing and perceived susceptibility when parents were required to pay for the vaccine. The specific pattern of interaction suggested that parents who perceived their children to be at high risk of contracting HPV were more persuaded by the gain-framed message, whereas those who believed their children to be at low risk of contracting HPV were more persuaded by the loss-framed message. Implications of the findings for HPV vaccination messaging are discussed. PMID:26646190

High occupancy vehicle (HOV) lane management system : amendment A.

DOT National Transportation Integrated Search

2011-12-01

This report describes a system designed to provide Single Occupancy Hybrid Vehicles (SOHVs) restriction : messages dynamically to drivers through variable message signs. This system will allow California to : comply with federal requirements (that Si...

The Only Safe SMS Texting Is No SMS Texting.

PubMed

Toth, Cheryl; Sacopulos, Michael J

2015-01-01

Many physicians and practice staff use short messaging service (SMS) text messaging to communicate with patients. But SMS text messaging is unencrypted, insecure, and does not meet HIPAA requirements. In addition, the short and abbreviated nature of text messages creates opportunities for misinterpretation, and can negatively impact patient safety and care. Until recently, asking patients to sign a statement that they understand and accept these risks--as well as having policies, device encryption, and cyber insurance in place--would have been enough to mitigate the risk of using SMS text in a medical practice. But new trends and policies have made SMS text messaging unsafe under any circumstance. This article explains these trends and policies, as well as why only secure texting or secure messaging should be used for physician-patient communication.

Multiculturalism and AIDS: different communities mean different educational messages required

PubMed Central

Lechky, O

1997-01-01

Having a multitude of different ethnic communities forces Canada's AIDS educators to use many different methods to deliver their messages. These range from an AIDS bingo game that has been used to educate natives in northern Manitoba to attempts to take AIDS education to the streets of Toronto. With AIDS education, reports Olga Lechky, one message definitely does not fit all. PMID:9164407

Military Message Experiment. Volume II.

DTIC Science & Technology

1982-04-01

elements of the Department of Defense. This resulted in a memorandum from the Director, Telecomunications and Comand and Control, OSD, in June 1975...1978 to April 1979 and provides a discussion of the telecomunications inter- face aspects of the experiment. This Final Report covers the period of...arise in the telecomunication system which require A retransmission of an outgoing message. A "service" message may be created within the

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

PubMed

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

2018-05-15

Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P < 0.001). After disabling the least severe alerts, total DDI alert burden fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

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

PubMed

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

2017-01-01

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

A novel active heads-up display for driver assistance.

PubMed

Doshi, Anup; Cheng, Shinko Yuanhsien; Trivedi, Mohan Manubhai

2009-02-01

In this paper, we introduce a novel laser-based wide-area heads-up windshield display which is capable of actively interfacing with a human as part of a driver assistance system. The dynamic active display (DAD) is a unique prototype interface that presents safety-critical visual icons to the driver in a manner that minimizes the deviation of his or her gaze direction without adding to unnecessary visual clutter. As part of an automotive safety system, the DAD presents alerts in the field of view of the driver only if necessary, which is based upon the state and pose of the driver, vehicle, and environment. This paper examines the effectiveness of DAD through a comprehensive comparative experimental evaluation of a speed compliance driver assistance system, which is implemented on a vehicular test bed. Three different types of display protocols for assisting a driver to comply with speed limits are tested on actual roadways, and these are compared with a conventional dashboard display. Given the inclination, drivers who are given an overspeed warning alert reduced the time required to slow down to the speed limit by 38% (p < 0.01) as compared with the drivers not given the alert. Additionally, certain alerts decreased distraction levels by reducing the time spent looking away from the road by 63% (p < 0.01). Ultimately, these alerts demonstrate the utility and promise of the DAD system.

Acoustic Data for Hybrid and Electric Heavy-Duty Vehicles and Electric Motorcycles

DOT National Transportation Integrated Search

2015-12-01

The Pedestrian Safety Enhancement Act (PSEA) of 2010 requires NHTSA to conduct a rulemaking to establish a Federal Motor Vehicle Safety Standard requiring an alert sound for pedestrians to be emitted by all types of motor vehicles that are electric o...

{open_quotes}Media-On-Demand{close_quotes} multimedia electronic mail: A tool for collaboration on the web

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsoi, Kei Nam; Rahman, S.M.

1996-12-31

Undoubtedly, multimedia electronic mail has many advantages in exchanging information electronically in a collaborative work. The existing design of e-mail systems architecture is inefficient in exchanging multimedia message which has much larger volume, and requires more bandwidth and storage space than the text-only messages. This paper presents an innovative method for exchanging multimedia mail messages in a heterogeneous environment to support collaborative work over YAW on the Internet. We propose a {open_quotes}Parcel Collection{close_quotes} approach for exchanging multimedia electronic mail messages. This approach for exchanging multimedia electronic mail messages integrates the current WWW technologies with the existing electronic mail systems.

The influence of ATC message length and timing on pilot communication

NASA Technical Reports Server (NTRS)

Morrow, Daniel; Rodvold, Michelle

1993-01-01

Pilot-controller communication is critical to safe and efficient flight. It is often a challenging component of piloting, which is reflected in the number of incidents and accidents involving miscommunication. Our previous field study identified communication problems that disrupt routine communication between pilots and controllers. The present part-task simulation study followed up the field results with a more controlled investigation of communication problems. Pilots flew a simulation in which they were frequently vectored by Air Traffic Control (ATC), requiring intensive communication with the controller. While flying, pilots also performed a secondary visual monitoring task. We examined the influence of message length (one message with four commands vs. two messages with two commands each) and noncommunication workload on communication accuracy and length. Longer ATC messages appeared to overload pilot working memory, resulting in more incorrect or partial readbacks, as well as more requests to repeat the message. The timing between the two short messages also influenced communication. The second message interfered with memory for or response to the first short message when it was delivered too soon after the first message. Performing the secondary monitoring task did not influence communication. Instead, communication reduced monitoring accuracy.

Emergency Situation Prediction Mechanism: A Novel Approach for Intelligent Transportation System Using Vehicular Ad Hoc Networks

PubMed Central

Gokulakrishnan, P.

2015-01-01

In Indian four-lane express highway, millions of vehicles are travelling every day. Accidents are unfortunate and frequently occurring in these highways causing deaths, increase in death toll, and damage to infrastructure. A mechanism is required to avoid such road accidents at the maximum to reduce the death toll. An Emergency Situation Prediction Mechanism, a novel and proactive approach, is proposed in this paper for achieving the best of Intelligent Transportation System using Vehicular Ad Hoc Network. ESPM intends to predict the possibility of occurrence of an accident in an Indian four-lane express highway. In ESPM, the emergency situation prediction is done by the Road Side Unit based on (i) the Status Report sent by the vehicles in the range of RSU and (ii) the road traffic flow analysis done by the RSU. Once the emergency situation or accident is predicted in advance, an Emergency Warning Message is constructed and disseminated to all vehicles in the area of RSU to alert and prevent the vehicles from accidents. ESPM performs well in emergency situation prediction in advance to the occurrence of an accident. ESPM predicts the emergency situation within 0.20 seconds which is comparatively less than the statistical value. The prediction accuracy of ESPM against vehicle density is found better in different traffic scenarios. PMID:26065014

Testing of a long-term fall detection system incorporated into a custom vest for the elderly.

PubMed

Bourke, Alan K; van de Ven, Pepijn W J; Chaya, Amy E; OLaighin, Gearóid M; Nelson, John

2008-01-01

A fall detection system and algorithm, incorporated into a custom designed garment has been developed. The developed fall detection system uses a tri-axial accelerometer to detect impacts and monitor posture. This sensor is attached to a custom designed vest, designed to be worn by the elderly person under clothing. The fall detection algorithm was developed and incorporates both impact and posture detection capability. The vest and fall algorithm was tested by two teams of 5 elderly subjects who wore the sensor system in turn for 2 week each and were monitored for 8 hours a day. The system previously achieved sensitivity of >90% and a specificity of >99%, using young healthy subjects performing falls and normal activities of daily living (ADL). In this study, over 833 hours of monitoring was performed over the course of the four weeks from the elderly subjects, during normal daily activity. In this time no actual falls were recorded, however the system registered a total of the 42 fall-alerts however only 9 were received at the care taker site. A fall detection system incorporated into a custom designed garment has been developed which will help reduce the incidence of the long-lie, when falls occur in the elderly population. However further development is required to reduce the number of false-positives and improve the transmission of messages.

Intelligent Gateway design and development : final report

DOT National Transportation Integrated Search

1996-10-01

The U.S. Coast Guard (USCG) had communications requirements uncommon to other services. Currently, there were no Defense Message System (DMS) products that could be used to send messages to underway vessels with multiple modes of communications. The ...

SPECS: Secure and Privacy Enhancing Communications Schemes for VANETs

NASA Astrophysics Data System (ADS)

Chim, T. W.; Yiu, S. M.; Hui, L. C. K.; Jiang, Zoe L.; Li, Victor O. K.

Vehicular ad hoc network (VANET) is an emerging type of networks which facilitates vehicles on roads to communicate for driving safety. The basic idea is to allow arbitrary vehicles to broadcast ad hoc messages (e.g. traffic accidents) to other vehicles. However, this raises the concern of security and privacy. Messages should be signed and verified before they are trusted while the real identity of vehicles should not be revealed, but traceable by authorized party. Existing solutions either rely heavily on a tamper-proof hardware device, or cannot satisfy the privacy requirement and do not have an effective message verification scheme. In this paper, we provide a software-based solution which makes use of only two shared secrets to satisfy the privacy requirement and gives lower message overhead and at least 45% higher successful rate than previous solutions in the message verification phase using the bloom filter and the binary search techniques. We also provide the first group communication protocol to allow vehicles to authenticate and securely communicate with others in a group of known vehicles.

Are self-reported telemonitored blood pressure readings affected by end-digit preference: a prospective cohort study in Scotland.

PubMed

Parker, Richard A; Paterson, Mary; Padfield, Paul; Pinnock, Hilary; Hanley, Janet; Hammersley, Vicky S; Steventon, Adam; McKinstry, Brian

2018-01-31

Simple forms of blood pressure (BP) telemonitoring require patients to text readings to central servers creating an opportunity for both entry error and manipulation. We wished to determine if there was an apparent preference for particular end digits and entries which were just below target BPs which might suggest evidence of data manipulation. Prospective cohort study SETTING: 37 socioeconomically diverse primary care practices from South East Scotland. Patients were recruited with hypertension to a telemonitoring service in which patients submitted home BP readings by manually transcribing the measurements into text messages for transmission ('patient-texted system'). These readings were compared with those from primary care patients with uncontrolled hypertension using a system in which readings were automatically transmitted, eliminating the possibility of manipulation of values ('automatic-transmission system'). A generalised estimating equations method was used to compare BP readings between the patient-texted and automatic-transmission systems, while taking into account clustering of readings within patients. A total of 44 150 BP readings were analysed on 1068 patients using the patient-texted system compared with 20 705 readings on 199 patients using the automatic-transmission system. Compared with the automatic-transmission data, the patient-texted data showed a significantly higher proportion of occurrences of both systolic and diastolic BP having a zero end digit (OR 2.1, 95% CI 1.7 to 2.6) although incidence was <2% of readings. Similarly, there was a preference for systolic 134 and diastolic 84 (the threshold for alerts was 135/85) (134 systolic BP OR 1.5, 95% CI 1.3 to 1.8; 84 diastolic BP OR 1.5, 95% CI 1.3 to 1.9). End-digit preference for zero numbers and specific-value preference for readings just below the alert threshold exist among patients in self-reporting their BP using telemonitoring. However, the proportion of readings affected is small and unlikely to be clinically important. ISRCTN72614272; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Initial Evaluation of a Conflict Detection Tool in the Terminal Area

NASA Technical Reports Server (NTRS)

Verma Savita Arora; Tang, Huabin; Ballinger, Deborah S.; Kozon, Thomas E.; Farrahi, Amir Hossein

2012-01-01

Despite the recent economic recession and its adverse impact on air travel, the Federal Aviation Administration (FAA) continues to forecast an increase in air traffic demand that may see traffic double or triple by the year 2025. Increases in air traffic will burden the air traffic management system, and higher levels of safety and efficiency will be required. The air traffic controllers primary task is to ensure separation between aircraft in their airspace and keep the skies safe. As air traffic is forecasted to increase in volume and complexity [1], there is an increased likelihood of conflicts between aircraft, which adds risk and inefficiency to air traffic management and increases controller workload. To attenuate these factors, recent ATM research has shown that air and ground-based automation tools could reduce controller workload, especially if the automation is focused on conflict detection and resolution. Conflict Alert is a short time horizon conflict detection tool deployed in the Terminal Radar Approach Control (TRACON), which has limited utility due to the high number of false alerts generated and its use of dead reckoning to predict loss of separation between aircraft. Terminal Tactical Separation Assurance Flight Environment (T-TSAFE) is a short time horizon conflict detection tool that uses both flight intent and dead reckoning to detect conflicts. Results of a fast time simulation experiment indicated that TTSAFE provided a more effective alert lead-time and generated less false alerts than Conflict Alert [2]. TSAFE was previously tested in a Human-In-The-Loop (HITL) simulation study that focused on the en route phase of flight [3]. The current study tested the T-TSAFE tool in an HITL simulation study, focusing on the terminal environment with current day operations. The study identified procedures, roles, responsibilities, information requirements and usability, with the help of TRACON controllers who participated in the experiment. Metrics such as lead alert time, alert response time, workload, situation awareness and other measures were statistically analyzed. These metrics were examined from an overall perspective and comparisons between conditions (altitude resolutions via keyboard entry vs. ADS-B entry) and controller positions (two final approach sectors and two feeder sectors) were also examined. Results of these analyses and controller feedback provided evidence of T-TSAFE s potential promise as a useful air traffic controller tool. Heuristic analysis also provided information on ways in which the T-TSAFE tool can be improved. Details of analyses results will be presented in the full paper.

Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts.

PubMed

McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras; Hoffman, James M

2016-04-01

Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time-the time elapsed from when an interruptive alert is generated to when it is dismissed-could be calculated by using historical alert data from log files. Drug-drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1-4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < 001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < 001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Text messaging interventions for individuals with mental health disorders including substance use: A systematic review.

PubMed

Watson, Tyler; Simpson, Scot; Hughes, Christine

2016-09-30

We completed a systematic review of the literature to characterize the impact of text messaging interventions on medication adherence or mental health related outcomes in people with mental health disorders including substance use. Four electronic databases were searched from January 1999 to October 2015. Seven studies met our inclusion criteria: three studies evaluated text messaging in patients with schizophrenia or schizoaffective disorder diagnosis, two studies evaluated text messaging in patients with chronic alcohol dependence, and two studies reviewed text messaging in patients with mood disorders. Six studies were randomized controlled trials and one was a prospective pilot study with pre-post intervention design. Text messaging frequency ranged from once weekly to twelve per day. The effect of text messaging on medication adherence was measured in five studies; one study reporting significant improvements in the text messaging intervention group. The effect of text messaging on mental health related outcomes was measured in all seven studies, with five studies showing significant improvements in a variety of psychiatric and social functioning assessments. Collectively, these studies suggest text messaging is a promising tool to support management of patients with mental illness. Further research examining theory-based text messaging interventions in larger samples of patients is required. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Effect of Automated Alerts on Provider Ordering Behavior in an Outpatient Setting

PubMed Central

Steele, Andrew W; Eisert, Sheri; Witter, Joel; Lyons, Pat; Jones, Michael A; Gabow, Patricia; Ortiz, Eduardo

2005-01-01

Background Computerized order entry systems have the potential to prevent medication errors and decrease adverse drug events with the use of clinical-decision support systems presenting alerts to providers. Despite the large volume of medications prescribed in the outpatient setting, few studies have assessed the impact of automated alerts on medication errors related to drug–laboratory interactions in an outpatient primary-care setting. Methods and Findings A primary-care clinic in an integrated safety net institution was the setting for the study. In collaboration with commercial information technology vendors, rules were developed to address a set of drug–laboratory interactions. All patients seen in the clinic during the study period were eligible for the intervention. As providers ordered medications on a computer, an alert was displayed if a relevant drug–laboratory interaction existed. Comparisons were made between baseline and postintervention time periods. Provider ordering behavior was monitored focusing on the number of medication orders not completed and the number of rule-associated laboratory test orders initiated after alert display. Adverse drug events were assessed by doing a random sample of chart reviews using the Naranjo scoring scale. The rule processed 16,291 times during the study period on all possible medication orders: 7,017 during the pre-intervention period and 9,274 during the postintervention period. During the postintervention period, an alert was displayed for 11.8% (1,093 out of 9,274) of the times the rule processed, with 5.6% for only “missing laboratory values,” 6.0% for only “abnormal laboratory values,” and 0.2% for both types of alerts. Focusing on 18 high-volume and high-risk medications revealed a significant increase in the percentage of time the provider stopped the ordering process and did not complete the medication order when an alert for an abnormal rule-associated laboratory result was displayed (5.6% vs. 10.9%, p = 0.03, Generalized Estimating Equations test). The provider also increased ordering of the rule-associated laboratory test when an alert was displayed (39% at baseline vs. 51% during post intervention, p < 0.001). There was a non-statistically significant difference towards less “definite” or “probable” adverse drug events defined by Naranjo scoring (10.3% at baseline vs. 4.3% during postintervention, p = 0.23). Conclusion Providers will adhere to alerts and will use this information to improve patient care. Specifically, in response to drug–laboratory interaction alerts, providers will significantly increase the ordering of appropriate laboratory tests. There may be a concomitant change in adverse drug events that would require a larger study to confirm. Implementation of rules technology to prevent medication errors could be an effective tool for reducing medication errors in an outpatient setting. PMID:16128621

Informational masking of speech in children: Effects of ipsilateral and contralateral distracters

NASA Astrophysics Data System (ADS)

Wightman, Frederic L.; Kistler, Doris J.

2005-11-01

Using a closed-set speech recognition paradigm thought to be heavily influenced by informational masking, auditory selective attention was measured in 38 children (ages 4-16 years) and 8 adults (ages 20-30 years). The task required attention to a monaural target speech message that was presented with a time-synchronized distracter message in the same ear. In some conditions a second distracter message or a speech-shaped noise was presented to the other ear. Compared to adults, children required higher target/distracter ratios to reach comparable performance levels, reflecting more informational masking in these listeners. Informational masking in most conditions was confirmed by the fact that a large proportion of the errors made by the listeners were contained in the distracter message(s). There was a monotonic age effect, such that even the children in the oldest age group (13.6-16 years) demonstrated poorer performance than adults. For both children and adults, presentation of an additional distracter in the contralateral ear significantly reduced performance, even when the distracter messages were produced by a talker of different sex than the target talker. The results are consistent with earlier reports from pure-tone masking studies that informational masking effects are much larger in children than in adults.

Faster clinical response to the onset of adverse events: A wearable metacognitive attention aid for nurse triage of clinical alarms.

PubMed

McFarlane, Daniel C; Doig, Alexa K; Agutter, James A; Brewer, Lara M; Syroid, Noah D; Mittu, Ranjeev

2018-01-01

This study evaluates the potential for improving patient safety by introducing a metacognitive attention aid that enables clinicians to more easily access and use existing alarm/alert information. It is hypothesized that this introduction will enable clinicians to easily triage alarm/alert events and quickly recognize emergent opportunities to adapt care delivery. The resulting faster response to clinically important alarms/alerts has the potential to prevent adverse events and reduce healthcare costs. A randomized within-subjects single-factor clinical experiment was conducted in a high-fidelity 20-bed simulated acute care hospital unit. Sixteen registered nurses, four at a time, cared for five simulated patients each. A two-part highly realistic clinical scenario was used that included representative: tasking; information; and alarms/alerts. The treatment condition introduced an integrated wearable attention aid that leveraged metacognition methods from proven military systems. The primary metric was time for nurses to respond to important alarms/alerts. Use of the wearable attention aid resulted in a median relative within-subject improvement for individual nurses of 118% (W = 183, p = 0.006). The top quarter of relative improvement was 3,303% faster (mean; 17.76 minutes reduced to 1.33). For all unit sessions, there was an overall 148% median faster response time to important alarms (8.12 minutes reduced to 3.27; U = 2.401, p = 0.016), with 153% median improvement in consistency across nurses (F = 11.670, p = 0.001). Existing device-centric alarm/alert notification solutions can require too much time and effort for nurses to access and understand. As a result, nurses may ignore alarms/alerts as they focus on other important work. There has been extensive research on reducing alarm frequency in healthcare. However, alarm safety remains a top problem. Empirical observations reported here highlight the potential of improving patient safety by supporting the meta-work of checking alarms.

Faster clinical response to the onset of adverse events: A wearable metacognitive attention aid for nurse triage of clinical alarms

PubMed Central

Doig, Alexa K.; Agutter, James A.; Brewer, Lara M.; Syroid, Noah D.; Mittu, Ranjeev

2018-01-01

Objective This study evaluates the potential for improving patient safety by introducing a metacognitive attention aid that enables clinicians to more easily access and use existing alarm/alert information. It is hypothesized that this introduction will enable clinicians to easily triage alarm/alert events and quickly recognize emergent opportunities to adapt care delivery. The resulting faster response to clinically important alarms/alerts has the potential to prevent adverse events and reduce healthcare costs. Materials and methods A randomized within-subjects single-factor clinical experiment was conducted in a high-fidelity 20-bed simulated acute care hospital unit. Sixteen registered nurses, four at a time, cared for five simulated patients each. A two-part highly realistic clinical scenario was used that included representative: tasking; information; and alarms/alerts. The treatment condition introduced an integrated wearable attention aid that leveraged metacognition methods from proven military systems. The primary metric was time for nurses to respond to important alarms/alerts. Results Use of the wearable attention aid resulted in a median relative within-subject improvement for individual nurses of 118% (W = 183, p = 0.006). The top quarter of relative improvement was 3,303% faster (mean; 17.76 minutes reduced to 1.33). For all unit sessions, there was an overall 148% median faster response time to important alarms (8.12 minutes reduced to 3.27; U = 2.401, p = 0.016), with 153% median improvement in consistency across nurses (F = 11.670, p = 0.001). Discussion and conclusion Existing device-centric alarm/alert notification solutions can require too much time and effort for nurses to access and understand. As a result, nurses may ignore alarms/alerts as they focus on other important work. There has been extensive research on reducing alarm frequency in healthcare. However, alarm safety remains a top problem. Empirical observations reported here highlight the potential of improving patient safety by supporting the meta-work of checking alarms. PMID:29768477

Hypoglycemic Accuracy and Improved Low Glucose Alerts of the Latest Dexcom G4 Platinum Continuous Glucose Monitoring System.

PubMed

Peyser, Thomas A; Nakamura, Katherine; Price, David; Bohnett, Lucas C; Hirsch, Irl B; Balo, Andrew

2015-08-01

Accuracy of continuous glucose monitoring (CGM) devices in hypoglycemia has been a widely reported shortcoming of this technology. We report the accuracy in hypoglycemia of a new version of the Dexcom (San Diego, CA) G4 Platinum CGM system (software 505) and present results regarding the optimum setting of CGM hypoglycemic alerts. CGM values were compared with YSI analyzer (YSI Life Sciences, Yellow Springs, OH) measurements every 15 min. We reviewed the accuracy of the CGM system in the hypoglycemic range using standard metrics. We analyzed the time required for the CGM system to detect biochemical hypoglycemia (70 mg/dL) compared with the YSI with alert settings at 70 mg/dL and 80 mg/dL. We also analyzed the time between the YSI value crossing 55 mg/dL, defined as the threshold for cognitive impairment due to hypoglycemia, and when the CGM system alerted for hypoglycemia. The mean absolute difference for a glucose level of less than 70 mg/dL was 6 mg/dL. Ninety-six percent of CGM values were within 20 mg/dL of the YSI values between 40 and 80 mg/dL. When the CGM hypoglycemic alert was set at 80 mg/dL, the device provided an alert for biochemical hypoglycemia within 10 min in 95% of instances and at least a 10-min advance warning before the cognitive impairment threshold in 91% of instances in the study. Use of an 80 mg/dL threshold setting for hypoglycemic alerts on the G4 Platinum (software 505) may provide patients with timely warning of hypoglycemia before the onset of cognitive impairment, enabling them to treat themselves for hypoglycemia with fast-acting carbohydrates and prevent neuroglycopenia associated with very low glucose levels.

Traffic Alert and Collision Avoidance System (TCAS): Cockpit Display of Traffic Information (CDTI) investigation. Phase 1: Feasibility study

NASA Technical Reports Server (NTRS)

Burgess, Malcolm; Davis, Dean; Hollister, Walter; Sorensen, John A.

1991-01-01

The possibility of the Threat Alert and Collision Avoidance System (TCAS) traffic sensor and display being used for meaningful Cockpit Display of Traffic Information (CDTI) applications has resulted in the Federal Aviation Administration initiating a project to establish the technical and operational requirements to realize this potential. Phase 1 of the project is presented here. Phase 1 was organized to define specific CDTI applications for the terminal area, to determine what has already been learned about CDTI technology relevant to these applications, and to define the engineering required to supply the remaining TCAS-CDTI technology for capacity benefit realization. The CDTI applications examined have been limited to those appropriate to the final approach and departure phases of flight.

Frequency of Risk-Related News Media Messages in 2016 Coverage of Zika Virus.

PubMed

Sell, Tara Kirk; Watson, Crystal; Meyer, Diane; Kronk, Marissa; Ravi, Sanjana; Pechta, Laura E; Lubell, Keri M; Rose, Dale A

2018-01-03

News media plays a large role in the information the public receives during an infectious disease outbreak, and may influence public knowledge and perceptions of risk. This study analyzed and described the content of U.S. news media coverage of Zika virus and Zika response during 2016. A random selection of 800 Zika-related news stories from 25 print and television news sources was analyzed. The study examined 24 different messages that appeared in news media articles and characterized them using theories of risk perception as messages with characteristics that could increase perception of risk (risk-elevating messages; n = 14), messages that could decrease perception of risk (risk-minimizing messages; n = 8), or messages about travel or testing guidance (n = 2). Overall, 96% of news stories in the study sample contained at least one or more risk-elevating message(s) and 61% contained risk-minimizing message(s). The frequency of many messages changed after local transmission was confirmed in Florida, and differed between sources in locations with or without local transmission in 2016. Forty percent of news stories included messages about negative potential outcomes of Zika virus infection without mentioning ways to reduce risk. Findings from this study may help inform current federal, state, and local Zika responses by offering a detailed analysis of how news media are covering the outbreak and response activities as well as identifying specific messages appearing more or less frequently than intended. Findings identifying the types of messages that require greater emphasis may also assist public health communicators in responding more effectively to future outbreaks. © 2017 Society for Risk Analysis.

Sleep, alertness and alertness management among commercial airline pilots on short-haul and long-haul flights.

PubMed

Sallinen, Mikael; Sihvola, Maria; Puttonen, Sampsa; Ketola, Kimmo; Tuori, Antti; Härmä, Mikko; Kecklund, Göran; Åkerstedt, Torbjörn

2017-01-01

Airline pilots' sleep and on-duty alertness are important focus areas in commercial aviation. Until now, studies pertaining to this topic have mainly focused on specific characteristics of flights and thus a comprehensive picture of the matter is not well established. In addition, research knowledge of what airline pilots actually do to maintain their alertness while being on duty is scarce. To address these gaps in research knowledge, we conducted a field study on a representative sample of the airline pilots of a medium-sized airline. The sample consisted of 90 pilots, of whom 30 flew long-haul (LH) routes, 30 short-haul (SH) routes, and 30 flew both. A total of 86 pilots completed the measurements that lasted for almost two months per pilot. The measurements resulted in a total of 965 flight duty periods (FDPs) including SH flights and 627 FDPs including LH flights. During the measurement periods, sleep was measured by a diary and actigraphs, on-duty alertness by the Karolinska Sleepiness Scale (KSS) in all flight phases, and on-duty alertness management strategies by the diary. Results showed that SH and LH FDPs covering the whole domicile night (00:00-06:00 at home base) were most consistently associated with reduced sleep-wake ratio and subjective alertness. Approximately every 3rd FDP falling into this category involved a reduced sleep-wake ratio (1:3 or lower) and every 2nd a reduced level of subjective alertness (KSS rating 8-9 in at least one flight phase). The corresponding frequencies for the SH and LH FDPs that partly covered the domicile night were every 10th and every 5th FDP and for the pure non-night FDPs every 30th and every 36th FDP, respectively. The results also showed that the pilots tended to increase the use of effective on-duty alertness management strategies (consuming alertness-promoting products and taking strategic naps) in connection with the FDPs that overlapped the domicile night. Finally, the results showed that the frequency of flights involving reduced subjective alertness depended on how alertness was assessed. If it was assessed solely in the flight phase just before starting the landing procedures (top of descent) the phenomenon was less frequent than if the preceding cruise phase was also taken into account. Our results suggest that FDPs covering the whole domicile night should be prioritised over the other FDPs in fatigue management, regardless of whether an FDP is a short-haul or a long-haul. In addition, the identification of fatigue in flight operations requires one to assess pilots' alertness across all flight phases, not only at ToD. Due to limitations in our data, these conclusions can, however, be generalise to only LH FDPs during which pilots can be expected to be well acclimatised to the local time at their home base and SH night FDPs that include at least 3h of flying in the cruise phase. Copyright © 2016 Elsevier Ltd. All rights reserved.

Measles, social media and surveillance in Baltimore City.

PubMed

Warren, Katherine E; Wen, Leana S

2017-09-01

Baltimore City was faced with two potential measles outbreaks in 2015. Both cases occurred in the wake of national media attention paid to the Disneyland outbreaks of the same year. A comparative case study approach was used applying qualitative data to elicit best practices in infectious disease protocols in the age of social media. The research also used search engine data from Google Trends to track constituent engagement over time. Across the two case studies, the Baltimore City Health Department identified a number of best practices to inform the public via social media and minimize levels of misinformation and panic. These practices included clarity in messaging across platforms and public health jurisdictions; pre-emptor alerts of potential measles cases to control and shape the media messaging; and targeted, in-person outreach to engage groups in a culturally competent manner. The Baltimore City Health Department's response drew out a critical need for re-examining infectious disease protocols in the age of social media (e.g. contact notification, quarantine, media sensitivity) and anti-vaccination movements that pose new obstacles to government intervention. The benefits and challenges of greater connectivity between providers, patients, and public health officers are discussed. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mobile phone use patterns and preferences in safety net office-based buprenorphine patients.

PubMed

Tofighi, Babak; Grossman, Ellie; Buirkle, Emily; McNeely, Jennifer; Gourevitch, Marc; Lee, Joshua D

2015-01-01

Integrating mobile phone technologies in addiction treatment is of increasing importance and may optimize patient engagement with their care and enhance the delivery of existing treatment strategies. Few studies have evaluated mobile phone and text message (TM) use patterns in persons enrolled in addiction treatment, and none have assessed the use in safety net, office-based buprenorphine practices. A 28-item, quantitative and qualitative semistructured survey was administered to opiate-dependent adults in an urban, publicly funded, office-based buprenorphine program. Survey domains included demographic characteristics, mobile phone and TM use patterns, and preferences pertaining to their recovery. Surveyors approached 73 of the 155 eligible subjects (47%); 71 respondents completed the survey. Nearly all participants reported mobile phone ownership (93%) and TM use (93%), and most reported "very much" or "somewhat" comfort sending TM (79%). Text message contact with 12-step group sponsors, friends, family members, and counselors was also described (32%). Nearly all preferred having their providers' mobile phone number (94%), and alerting the clinic via TM in the event of a potential relapse to receive both supportive TM and a phone call from their buprenorphine provider was also well received (62%). Mobile phone and TM use patterns and preferences among this sample of office-based buprenorphine participants highlight the potential of adopting patient-centered mobile phone-based interventions in this treatment setting.

Centralized Alert-Processing and Asset Planning for Sensorwebs

NASA Technical Reports Server (NTRS)

Castano, Rebecca; Chien, Steve A.; Rabideau, Gregg R.; Tang, Benyang

2010-01-01

A software program provides a Sensorweb architecture for alert-processing, event detection, asset allocation and planning, and visualization. It automatically tasks and re-tasks various types of assets such as satellites and robotic vehicles in response to alerts (fire, weather) extracted from various data sources, including low-level Webcam data. JPL has adapted cons iderable Sensorweb infrastructure that had been previously applied to NASA Earth Science applications. This NASA Earth Science Sensorweb has been in operational use since 2003, and has proven reliability of the Sensorweb technologies for robust event detection and autonomous response using space and ground assets. Unique features of the software include flexibility to a range of detection and tasking methods including those that require aggregation of data over spatial and temporal ranges, generality of the response structure to represent and implement a range of response campaigns, and the ability to respond rapidly.

Temporal Precedence Checking for Switched Models and its Application to a Parallel Landing Protocol

NASA Technical Reports Server (NTRS)

Duggirala, Parasara Sridhar; Wang, Le; Mitra, Sayan; Viswanathan, Mahesh; Munoz, Cesar A.

2014-01-01

This paper presents an algorithm for checking temporal precedence properties of nonlinear switched systems. This class of properties subsume bounded safety and capture requirements about visiting a sequence of predicates within given time intervals. The algorithm handles nonlinear predicates that arise from dynamics-based predictions used in alerting protocols for state-of-the-art transportation systems. It is sound and complete for nonlinear switch systems that robustly satisfy the given property. The algorithm is implemented in the Compare Execute Check Engine (C2E2) using validated simulations. As a case study, a simplified model of an alerting system for closely spaced parallel runways is considered. The proposed approach is applied to this model to check safety properties of the alerting logic for different operating conditions such as initial velocities, bank angles, aircraft longitudinal separation, and runway separation.

Data Mining and the Twitter Platform for Prescribed Burn and Wildfire Incident Reporting with Geospatial Applications

NASA Astrophysics Data System (ADS)

Endsley, K.; McCarty, J. L.

2012-12-01

Data mining techniques have been applied to social media in a variety of contexts, from mapping the evolution of the Tahrir Square protests in Egypt to predicting influenza outbreaks. The Twitter platform is a particular favorite due to its robust application programming interface (API) and high throughput. Twitter, Inc. estimated in 2011 that over 2,200 messages or "tweets" are generated every second. Also helpful is Twitter's semblance in operation to the short message service (SMS), better known as "texting," available on cellular phones and the most popular means of wide telecommunications in many developing countries. In the United States, Twitter has been used by a number of federal, state and local officials as well as motivated individuals to report prescribed burns in advance (sometimes as part of a reporting obligation) or to communicate the emergence, response to, and containment of wildfires. These reports are unstructured and, like all Twitter messages, limited to 140 UTF-8 characters. Through internal research and development at the Michigan Tech Research Institute, the authors have developed a data mining routine that gathers potential tweets of interest using the Twitter API, eliminates duplicates ("retweets"), and extracts relevant information such as the approximate size and condition of the fire. Most importantly, the message is geocoded and/or contains approximate locational information, allowing for prescribed and wildland fires to be mapped. Natural language processing techniques, adapted to improve computational performance, are used to tokenize and tag these elements for each tweet. The entire routine is implemented in the Python programming language, using open-source libraries. As such, it is demonstrated in a web-based framework where prescribed burns and/or wildfires are mapped in real time, visualized through a JavaScript-based mapping client in any web browser. The practices demonstrated here generalize to an SMS platform (or any short text-based platform) and thus provide exciting opportunities for the cultivation of fire or other disaster alerts and response here in the U.S. and in the developing world.

A data platform to improve rabies prevention, Sri Lanka.

PubMed

De Silva, A Pubudu; Harischandra, Pa Lionel; Beane, Abi; Rathnayaka, Shriyananda; Pimburage, Ruwini; Wijesiriwardana, Wageesha; Gamage, Dilanthi; Jayasinghe, Desika; Sigera, Chathurani; Gunasekara, Amila; Cadre, Mizaya; Amunugama, Sarath; Athapattu, Priyantha L; Jayasinghe, K Saroj A; Dondorp, Arjen M; Haniffa, Rashan

2017-09-01

In Sri Lanka, rabies prevention initiatives are hindered by fragmented and delayed information-sharing that limits clinicians' ability to follow patients and impedes public health surveillance. In a project led by the health ministry, we adapted existing technologies to create an electronic platform for rabies surveillance. Information is entered by trained clinical staff, and both aggregate and individual patient data are visualized in real time. An automated short message system (SMS) alerts patients for vaccination follow-up appointments and informs public health inspectors about incidents of animal bites. The platform was rolled out in June 2016 in four districts of Sri Lanka, linking six rabies clinics, three laboratories and the public health inspectorate. Over a 9-month period, 12 121 animal bites were reported to clinics and entered in the registry. Via secure portals, clinicians and public health teams accessed live information on treatment and outcomes of patients started on post-exposure prophylaxis (9507) or receiving deferred treatment (2614). Laboratories rapidly communicated the results of rabies virus tests on dead mammals (328/907 positive). In two pilot districts SMS reminders were sent to 1376 (71.2%) of 1933 patients whose contact details were available. Daily SMS reports alerted 17 public health inspectors to bite incidents in their area for investigation. Existing technologies in low-resource countries can be harnessed to improve public health surveillance. Investment is needed in platform development and training and support for front-line staff. Greater public engagement is needed to improve completeness of surveillance and treatment.

Reducing warfarin medication interactions: an interrupted time series evaluation.

PubMed

Feldstein, Adrianne C; Smith, David H; Perrin, Nancy; Yang, Xiuhai; Simon, Steven R; Krall, Michael; Sittig, Dean F; Ditmer, Diane; Platt, Richard; Soumerai, Stephen B

2006-05-08

Computerized decision support reduces medication errors in inpatients, but limited evidence supports its effectiveness in reducing the coprescribing of interacting medications, especially in the outpatient setting. The usefulness of academic detailing to enhance the effectiveness of medication interaction alerts also is uncertain. This study used an interrupted time series design. In a health maintenance organization with an electronic medical record, we evaluated the effectiveness of electronic medical record alerts and group academic detailing to reduce the coprescribing of warfarin and interacting medications. Participants were 239 primary care providers at 15 primary care clinics and 9910 patients taking warfarin. All 15 clinics received electronic medical record alerts for the coprescription of warfarin and 5 interacting medications: acetaminophen, nonsteroidal anti-inflammatory medications, fluconazole, metronidazole, and sulfamethoxazole. Seven clinics were randomly assigned to receive group academic detailing. The primary outcome, the interacting prescription rate (ie, the number of coprescriptions of warfarin-interacting medications per 10 000 warfarin users per month), was analyzed with segmented regression models, controlling for preintervention trends. At baseline, nearly a third of patients had an interacting prescription. Coinciding with the alerts, there was an immediate and continued reduction in the warfarin-interacting medication prescription rate (from 3294.0 to 2804.2), resulting in a 14.9% relative reduction (95% confidence interval, -19.5 to -10.2) at 12 months. Group academic detailing did not enhance alert effectiveness. This study, using a strong and quasi-experimental design in ambulatory care, found that medication interaction alerts modestly reduced the frequency of coprescribing of interacting medications. Additional efforts will be required to further reduce rates of inappropriate prescribing of warfarin with interacting drugs.

A Comparison of Blue Light and Caffeine Effects on Cognitive Function and Alertness in Humans

PubMed Central

Beaven, C. Martyn; Ekström, Johan

2013-01-01

The alerting effects of both caffeine and short wavelength (blue) light have been consistently reported. The ability of blue light to enhance alertness and cognitive function via non-image forming neuropathways have been suggested as a non-pharmacological countermeasure for drowsiness across a range of occupational settings. Here we compare and contrast the alerting and psychomotor effects of 240 mg of caffeine and a 1-h dose of ~40 lx blue light in a non-athletic population. Twenty-one healthy subjects performed a computer-based psychomotor vigilance test before and after each of four randomly assigned trial conditions performed on different days: white light/placebo; white light/240 mg caffeine; blue light/placebo; blue light/240 mg caffeine. The Karolinska Sleepiness Scale was used to assess subjective measures of alertness. Both the caffeine only and blue light only conditions enhanced accuracy in a visual reaction test requiring a decision and an additive effect was observed with respect to the fastest reaction times. However, in a test of executive function, where a distraction was included, caffeine exerted a negative effect on accuracy. Furthermore, the blue light only condition consistently outperformed caffeine when both congruent and incongruent distractions were presented. The visual reactions in the absence of a decision or distraction were also enhanced in the blue light only condition and this effect was most prominent in the blue-eyed participants. Overall, blue light and caffeine demonstrated distinct effects on aspects of psychomotor function and have the potential to positively influence a range of settings where cognitive function and alertness are important. Specifically, despite the widespread use of caffeine in competitive sporting environments, the possible impact of blue light has received no research attention. PMID:24282477

FT4 Data Analysis Summary (SSI-ARC)

NASA Technical Reports Server (NTRS)

Isaacson, Douglas R.; Gong, Chester; Reardon, Scott Edward; Santiago, Confesor

2016-01-01

Standards for Unmanned Aircraft System (UAS) Detect-and-Avoid (DAA) systems are currently being developed under the auspices of the RTCA Special Committee 228 (SC-228). To support the development of these standards, a series of flight tests has been conducted at NASAs Armstrong Flight Research Center (NASA-AFRC). The fourth in this series of flight test activities (Flight Test 4, or simply FT4) was conducted during the Spring and Summer of 2016. FT4 supported the objectives of numerous organizations working toward UAS DAA Minimum Operational Performance Standards (MOPS) and UAS DAA Radar MOPS. The summary provided herein is limited to the objectives, analysis and conclusions of the NASA Ames Research Center (NASA-ARC) SSI team toward the refinement of UAS DAA MOPS. This document provides a high-level overview of FT4 and the SSI-ARC objectives, a summary of the data analysis methodology and recommendations for UAS DAA MOPS refinements based on the data analysis results. A total of 72 encounters were flown to support SSI-ARC objectives. Test results were generally consistent with acceptable UAS DAA system performance and will be considered in broader SC-228 requirements validation efforts. Observed alert lead times indicated acceptable UAS DAA alerting performance. Effective interoperability between the UAS DAA system and the Traffic Alert and Collision Avoidance System (TCAS) was observed with one notable exception: TCAS Resolutions Advisories (RA) were observed in the absence of any DAA alert on two occasions, indicating the need for alert parameter refinement. Findings further indicated the need for continued work in the areas of DAA Well Clear Recovery logic and alert stability for Mode-C-only intruders. Finally, results demonstrated a high level of compliance with a set of evaluation criteria designed to provide anecdotal evidence of acceptable UAS DAA system performance.

Optical aurora detectors: using natural optics to motivate education and outreach

NASA Astrophysics Data System (ADS)

Shaw, Joseph A.; Way, Jesse M.; Pust, Nathan J.; Nugent, Paul W.; Coate, Hans; Balster, Daniel

2009-06-01

Natural optical phenomena enjoy a level of interest sufficiently high among a wide array of people to provide ideal education and outreach opportunities. The aurora promotes particularly high interest, perhaps because of its relative rarity in the areas of the world where most people live. A project is being conducted at Montana State University to use common interest and curiosity about auroras to motivate learning and outreach through the design and deployment of optical sensor systems that detect the presence of an auroral display and send cell phone messages to alert interested people. Project participants learn about the physics and optics of the aurora, basic principles of optical system design, radiometric calculations and calibrations, electro-optical detectors, electronics, embedded computer systems, and computer software. The project is moving into a stage where it will provide greatly expanded outreach and education opportunities as optical aurora detector kits are created and disbursed to colleges around our region.

Analysing trends and forecasting malaria epidemics in Madagascar using a sentinel surveillance network: a web-based application.

PubMed

Girond, Florian; Randrianasolo, Laurence; Randriamampionona, Lea; Rakotomanana, Fanjasoa; Randrianarivelojosia, Milijaona; Ratsitorahina, Maherisoa; Brou, Télesphore Yao; Herbreteau, Vincent; Mangeas, Morgan; Zigiumugabe, Sixte; Hedje, Judith; Rogier, Christophe; Piola, Patrice

2017-02-13

The use of a malaria early warning system (MEWS) to trigger prompt public health interventions is a key step in adding value to the epidemiological data routinely collected by sentinel surveillance systems. This study describes a system using various epidemic thresholds and a forecasting component with the support of new technologies to improve the performance of a sentinel MEWS. Malaria-related data from 21 sentinel sites collected by Short Message Service are automatically analysed to detect malaria trends and malaria outbreak alerts with automated feedback reports. Roll Back Malaria partners can, through a user-friendly web-based tool, visualize potential outbreaks and generate a forecasting model. The system already demonstrated its ability to detect malaria outbreaks in Madagascar in 2014. This approach aims to maximize the usefulness of a sentinel surveillance system to predict and detect epidemics in limited-resource environments.

Viable investigations and real-time recitation of enhanced ECG-based cardiac telemonitoring system for homecare applications: a systematic evaluation.

PubMed

Rajan, S Palanivel; Rajamony, Sukanesh

2013-04-01

A light and portable wireless biosignal retrieving system has always been a medical dream. This proposed wireless-type biosignal alerting system aims at designing and developing a module that detects the abnormal interpretations in the PQRST complex (electrocardiography) and heart rate of a patient in advance, gives a self-warning ring to the patient, and also sends a short message service warning to the doctor's mobile phone through the Global System for Mobile Communication. This system is a solution to supplement the limitations in conventional clinic examination such as the difficulty in capturing rare events, out-of-hospital monitoring of patients' heart status, and the immediate dissemination of the physician's instruction to the patient. These study results have immense consequence in researching, finding, and preventing epidemics in the cardiovascular system for the entire world.

Space Weather Services and Products of RWC Russia in 2007

NASA Astrophysics Data System (ADS)

Burov, Viatcheslav; Avdyushin, Sergei; Denisova, Valentina

RWC Russia (Institute of Applied Geophysics) - forecasting center unites activity of the National Heliogeophysic Service of Russia and Regional Warning Center ISES. The Center has been operating since 1974. There are several services that carry out gathering, processing and spreading of the total information data flow, (including both Russian and foreign-exchange data), and forecasts. Forecasting activities results are issued in the form of special messages, the major part of which corresponds to standard codes. Our Web page: www.geospace.ru are represented the current data and the forecasts. At present both a weekly 7-day geomagnetic forecast and the actual disturbance activity information for the previous week are available on the Web page. And, the data of some ionosphere and magnetic stations are available on this page too. Various types of our forecast alert and routine observations are considered in the report

Cooperation not confrontation: the imperative of a nuclear age. The message from Budapest.

PubMed

Lown, B; Chazov, E

1985-08-02

Reprinted here is the text of a speech to the Fifth Congress of the International Physicians for the Prevention of Nuclear War (IPPNW), delivered in Budapest on 29 June 1985 by the group's co-founders, Dr. Bernard Lown from the United States and Dr. Eugene Chazov from the U.S.S.R. After reminding the delegates that 1985 marked the 40th anniversary of the bombings of Hiroshima and Nagasaki and the founding of the United Nations, the two physicians review the work of the IPPNW in alerting the world to the dangers of nuclear warfare. They warn that the chances of nuclear confrontation have increased, and urge their colleagues to foster cooperation between East and West. Lown and Chazov identify nuclear war as the greatest public health threat of all, and call for a moratorium on all nuclear explosions.

Application of a Tsunami Warning Message Metric to refine NOAA NWS Tsunami Warning Messages

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D.; Sorensen, J.; Whitmore, P.

2013-12-01

In 2010, the U.S. National Weather Service (NWS) funded a three year project to integrate social science into their Tsunami Program. One of three primary requirements of the grant was to make improvements to tsunami warning messages of the NWS' two Tsunami Warning Centers- the West Coast/Alaska Tsunami Warning Center (WCATWC) in Palmer, Alaska and the Pacific Tsunami Warning Center (PTWC) in Ewa Beach, Hawaii. We conducted focus group meetings with a purposive sample of local, state and Federal stakeholders and emergency managers in six states (AK, WA, OR, CA, HI and NC) and two US Territories (US Virgin Islands and American Samoa) to qualitatively asses information needs in tsunami warning messages using WCATWC tsunami messages for the March 2011 Tohoku earthquake and tsunami event. We also reviewed research literature on behavioral response to warnings to develop a tsunami warning message metric that could be used to guide revisions to tsunami warning messages of both warning centers. The message metric is divided into categories of Message Content, Style, Order and Formatting and Receiver Characteristics. A message is evaluated by cross-referencing the message with the operational definitions of metric factors. Findings are then used to guide revisions of the message until the characteristics of each factor are met. Using findings from this project and findings from a parallel NWS Warning Tiger Team study led by T. Nicolini, the WCATWC implemented the first of two phases of revisions to their warning messages in November 2012. A second phase of additional changes, which will fully implement the redesign of messages based on the metric, is in progress. The resulting messages will reflect current state-of-the-art knowledge on warning message effectiveness. Here we present the message metric; evidence-based rational for message factors; and examples of previous, existing and proposed messages.

Advanced alerting features: displaying new relevant data and retracting alerts.

PubMed Central

Kuperman, G. J.; Hiltz, F. L.; Teich, J. M.

1997-01-01

We added two advanced features to our automated alerting system. The first feature identifies and displays, at the time an alert is reviewed, relevant data filed between the login time of a specimen leading to an alerting result and the time the alert is reviewed. Relevant data is defined as data of the same kind as generated the alert. The other feature retracts alerts when the alerting value is edited and no longer satisfies the alerting criteria. We evaluated the two features for a 14-week period (new relevant data) and a 6-week period (retraction). Of a total of 1104 alerts in the 14-week evaluation, 286 (25.9%) had new relevant data displayed at alert review time. Of the 286, 75.2% were due to additions of comments to the original piece of alerting data; 24.1% were due to new or pending laboratory results of the same type that generated the alert. Two alerts (out of 490) were retracted in a 6 week period. We conclude that in our system, new clinically relevant data is often added between the time of specimen login and the time that an alerting result from that specimen is reviewed. Retractions occur rarely but are important to detect and communicate. PMID:9357625

Comparison and Analysis of ISO/IEEE 11073, IHE PCD-01, and HL7 FHIR Messages for Personal Health Devices

PubMed Central

Do, Hyoungho

2018-01-01

Objectives Increasing use of medical devices outside of healthcare facilities inevitably requires connectivity and interoperability between medical devices and healthcare information systems. To this end, standards have been developed and used to provide interoperability between personal health devices (PHDs) and external systems. ISO/IEEE 11073 standards and IHE PCD-01 standard messages have been used the most in the exchange of observation data of health devices. Recently, transmitting observation data using the HL7 FHIR standard has been devised in the name of DoF (Devices on FHIR) and adopted very fast. We compare and analyze these standards and suggest that which standard will work best at the different environments of device usage. Methods We generated each message/resource of the three standards for observed vital signs from blood pressure monitor and thermometer. Then, the size, the contents, and the exchange processes of these messages are compared and analyzed. Results ISO/IEEE 11073 standard message has the smallest data size, but it has no ability to contain the key information, patient information. On the other hand, PCD-01 messages and FHIR standards have the fields for patient information. HL7 DoF standards provide reusing of information unit known as resource, and it is relatively easy to parse DoF messages since it uses widely known XML and JSON. Conclusions ISO/IEEE 11073 standards are suitable for devices having very small computing power. IHE PCD-01 and HL7 DoF messages can be used for the devices that need to be connected to hospital information systems that require patient information. When information reuse is frequent, DoF is advantageous over PCD-01. PMID:29503752

Comparison and Analysis of ISO/IEEE 11073, IHE PCD-01, and HL7 FHIR Messages for Personal Health Devices.

PubMed

Lee, Sungkee; Do, Hyoungho

2018-01-01

Increasing use of medical devices outside of healthcare facilities inevitably requires connectivity and interoperability between medical devices and healthcare information systems. To this end, standards have been developed and used to provide interoperability between personal health devices (PHDs) and external systems. ISO/IEEE 11073 standards and IHE PCD-01 standard messages have been used the most in the exchange of observation data of health devices. Recently, transmitting observation data using the HL7 FHIR standard has been devised in the name of DoF (Devices on FHIR) and adopted very fast. We compare and analyze these standards and suggest that which standard will work best at the different environments of device usage. We generated each message/resource of the three standards for observed vital signs from blood pressure monitor and thermometer. Then, the size, the contents, and the exchange processes of these messages are compared and analyzed. ISO/IEEE 11073 standard message has the smallest data size, but it has no ability to contain the key information, patient information. On the other hand, PCD-01 messages and FHIR standards have the fields for patient information. HL7 DoF standards provide reusing of information unit known as resource, and it is relatively easy to parse DoF messages since it uses widely known XML and JSON. ISO/IEEE 11073 standards are suitable for devices having very small computing power. IHE PCD-01 and HL7 DoF messages can be used for the devices that need to be connected to hospital information systems that require patient information. When information reuse is frequent, DoF is advantageous over PCD-01.

Design of a clinical notification system.

PubMed

Wagner, M M; Tsui, F C; Pike, J; Pike, L

1999-01-01

We describe the requirements and design of an enterprise-wide notification system. From published descriptions of notification schemes, our own experience, and use cases provided by diverse users in our institution, we developed a set of functional requirements. The resulting design supports multiple communication channels, third party mappings (algorithms) from message to recipient and/or channel of delivery, and escalation algorithms. A requirement for multiple message formats is addressed by a document specification. We implemented this system in Java as a CORBA object. This paper describes the design and current implementation of our notification system.

Technologic Distractions (Part 1): Summary of Approaches to Manage Alert Quantity With Intent to Reduce Alert Fatigue and Suggestions for Alert Fatigue Metrics.

PubMed

Kane-Gill, Sandra L; O'Connor, Michael F; Rothschild, Jeffrey M; Selby, Nicholas M; McLean, Barbara; Bonafide, Christopher P; Cvach, Maria M; Hu, Xiao; Konkani, Avinash; Pelter, Michele M; Winters, Bradford D

2017-09-01

To provide ICU clinicians with evidence-based guidance on tested interventions that reduce or prevent alert fatigue within clinical decision support systems. Systematic review of PubMed, Embase, SCOPUS, and CINAHL for relevant literature from 1966 to February 2017. Focus on critically ill patients and included evaluations in other patient care settings, as well. Identified interventions designed to reduce or prevent alert fatigue within clinical decision support systems. Study selection was based on one primary key question to identify effective interventions that attempted to reduce alert fatigue and three secondary key questions that covered the negative effects of alert fatigue, potential unintended consequences of efforts to reduce alert fatigue, and ideal alert quantity. Data were abstracted by two reviewers independently using a standardized abstraction tool. Surveys, meeting abstracts, "gray" literature, studies not available in English, and studies with non-original data were excluded. For the primary key question, articles were excluded if they did not provide a comparator as key question 1 was designed as a problem, intervention, comparison, and outcome question. We anticipated that reduction in alert fatigue, including the concept of desensitization may not be directly measured and thus considered interventions that reduced alert quantity as a surrogate marker for alert fatigue. Twenty-six articles met the inclusion criteria. Approaches for managing alert fatigue in the ICU are provided as a result of reviewing tested interventions that reduced alert quantity with the anticipated effect of reducing fatigue. Suggested alert management strategies include prioritizing alerts, developing sophisticated alerts, customizing commercially available alerts, and including end user opinion in alert selection. Alert fatigue itself is studied less frequently, as an outcome, and there is a need for more precise evaluation. Standardized metrics for alert fatigue is needed to advance the field. Suggestions for standardized metrics are provided in this document.

Innovative methods for calculation of freeway travel time using limited data : executive summary report.

DOT National Transportation Integrated Search

2008-08-01

ODOTs policy for Dynamic Message Sign : utilization requires travel time(s) to be displayed as : a default message. The current method of : calculating travel time involves a workstation : operator estimating the travel time based upon : observati...

Cigarette pack messages about toxic chemicals: a randomised clinical trial.

PubMed

Brewer, Noel T; Jeong, Michelle; Mendel, Jennifer R; Hall, Marissa G; Zhang, Dongyu; Parada, Humberto; Boynton, Marcella H; Noar, Seth M; Baig, Sabeeh A; Morgan, Jennifer C; Ribisl, Kurt M

2018-04-13

The USA can require tobacco companies to disclose information about harmful and potentially harmful chemicals in cigarette smoke, but the impact of these messages is uncertain. We sought to assess the effect of placing messages about toxic chemicals on smokers' cigarette packs. Participants were 719 adult cigarette smokers from California, USA, recruited from September 2016 through March 2017. We randomly assigned smokers to receive either factual messages about chemicals in cigarette smoke and their health harms (intervention) or messages about not littering cigarette butts (control) on the side of their cigarette packs for 3 weeks. The primary trial outcome was intention to quit smoking. In intent-to-treat analyses, smokers whose packs had chemical messages did not have higher intentions to quit smoking at the end of the trial than those whose packs had control messages (P=0.56). Compared with control messages, chemical messages led to higher awareness of the chemicals (28% vs 15%, P<0.001) and health harms (60% vs 52%, P=0.02) featured in the messages. In addition, chemical messages led to greater negative affect, thinking about the chemicals in cigarettes and the harms of smoking, conversations about the messages and forgoing a cigarette (all P<0.05). Chemical messages on cigarette packs did not lead to higher intentions to quit among smokers in our trial. However, chemical messages informed smokers of chemicals in cigarettes and harms of smoking, which directly supports their implementation and would be critical to defending the messages against cigarette company legal challenges. NCT02785484. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

IR panoramic alerting sensor concepts and applications

NASA Astrophysics Data System (ADS)

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

2003-09-01

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

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

PubMed Central

Zhuravlev, Maksim O.; Makarov, Vladimir V.; Nedayvozov, Vladimir; Grubov, Vadim V.; Pchelintceva, Svetlana V.; Hramov, Alexander E.

2017-01-01

The influence of motivation and alertness on brain activity associated with visual perception was studied experimentally using the Necker cube, which ambiguity was controlled by the contrast of its ribs. The wavelet analysis of recorded multichannel electroencephalograms (EEG) allowed us to distinguish two different scenarios while the brain processed the ambiguous stimulus. The first scenario is characterized by a particular destruction of alpha rhythm (8–12 Hz) with a simultaneous increase in beta-wave activity (20–30 Hz), whereas in the second scenario, the beta rhythm is not well pronounced while the alpha-wave energy remains unchanged. The experiments were carried out with a group of financially motivated subjects and another group of unpaid volunteers. It was found that the first scenario occurred mainly in the motivated group. This can be explained by the increased alertness of the motivated subjects. The prevalence of the first scenario was also observed in a group of subjects to whom images with higher ambiguity were presented. We believe that the revealed scenarios can occur not only during the perception of bistable images, but also in other perceptual tasks requiring decision making. The obtained results may have important applications for monitoring and controlling human alertness in situations which need substantial attention. On the base of the obtained results we built a brain-computer interface to estimate and control the degree of alertness in real time. PMID:29267295

Postural control system influences intrinsic alerting state.

PubMed

Barra, Julien; Auclair, Laurent; Charvillat, Agnès; Vidal, Manuel; Pérennou, Dominic

2015-03-01

Numerous studies using dual-task paradigms (postural and cognitive) have shown that postural control requires cognitive resources. However, the influence of postural control on attention components has never been directly addressed. Using the attention network test (ANT), which assesses specifically each of the 3 components of attention-alertness, orientation, and executive control-within a single paradigm, we investigated the effect of postural balance demand on these 3 components. Forty-two participants completed the ANT in 3 postural conditions: (a) supine, a very stable position; (b) sitting on a chair, an intermediate position; and (c) standing with feet lined up heel to toe, a very instable position known as the Romberg position. Our results revealed that the difficulty of postural control does modulate alerting in such a way that it improves with the level of instability of the position. Regarding the orienting and executive control components of attention, performance was not different when participants were standing upright or seated, whereas in the supine position, performance dropped. The strong and specific interaction between postural control and the alerting system suggests that these mechanisms may share parts of the underlying neural circuits. We discuss the possible implication of the locus coeruleus, known to be involved in both postural balance and alerting. Also, our findings concerning orienting and executive control systems suggest that supine posture could have a specific effect on cognitive activities. These effects are discussed in terms of particularities resulting from the supine position. PsycINFO Database Record (c) 2015 APA, all rights reserved.

The data acquisition system for the Anglo-Australian Observatory 2-degree field project

NASA Technical Reports Server (NTRS)

Shortridge, K.; Farrell, T. J.; Bailey, J.

1992-01-01

The Anglo-Australian Observatory (AAO) is building a system that will provide a two-degree field of view at prime focus. A robot positioner will be used to locate up to 400 optical fibers at pre-determined positions in this field. While observations are being made using one set of 400 fibers, the robot will be positioning a second set of fibers in a background field that can be moved in to replace the first when the telescope is moved to a new position. The fibers feed two spectrographs each with a 1024 square CCD detector. The software system being produced to control this involves Vaxes for overall control and data recording, UNIX workstations for fiber configuration calculations and on-line data reduction, and VME systems running VxWorks for real-time control of critical parts such as the positioner robot. The system has to be able to interact with the observatory's present data acquisition systems, which use the ADAM system. As yet, the real-time parts of ADAM have not been ported to Unix, and so we are having to produce a smaller-scale system that is similar but inherently distributed (which ADAM is not). We are using this system as a testbed for ideas that we hope may eventually influence an ADAM II system. The system we are producing is based on a message system that is designed to be able to handle inter-process and inter-processor messages of any length, efficiently, and without ever requiring a task to block (i.e., be unresponsive to 'cancel' messages, enquiry messages), other than when deliberately waiting for external input - all of which will be through such messages. The essential requirement is that a message 'send' operation should never be able to block. The messages will be hierarchical, self-defining, machine-independent data structures. This allows us to provide very simple monitoring of messages for diagnostic purposes, and allows general purpose interface programs to be written without needing to share precise byte by byte message format definitions. Programs in this system have interfaces defined simply in terms of named actions and their parameters. Real-time control programs are required to be able to handle a number of such actions concurrently; data reduction programs will normally only need to handle one action at a time ('process an image', 'display a spectrum', etc).

47 CFR 64.2201 - Ringing indication requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... party is being alerted and provides an audio tone or announcement, originating providers must cease any... any audio tone or announcement provided by the terminating provider. (3) In this section, the term...

Role of the Physician Anesthesiologist

MedlinePlus

... thought much about the physician anesthesiologist or the importance of his or her medical expertise in your ... be awake and alert but require effective pain management. They also help patients who have serious pain ...

A framework for evaluating the appropriateness of clinical decision support alerts and responses

PubMed Central

Waitman, Lemuel R; Lewis, Julia B; Wright, Julie A; Choma, David P; Miller, Randolph A; Peterson, Josh F

2011-01-01

Objective Alerting systems, a type of clinical decision support, are increasingly prevalent in healthcare, yet few studies have concurrently measured the appropriateness of alerts with provider responses to alerts. Recent reports of suboptimal alert system design and implementation highlight the need for better evaluation to inform future designs. The authors present a comprehensive framework for evaluating the clinical appropriateness of synchronous, interruptive medication safety alerts. Methods Through literature review and iterative testing, metrics were developed that describe successes, justifiable overrides, provider non-adherence, and unintended adverse consequences of clinical decision support alerts. The framework was validated by applying it to a medication alerting system for patients with acute kidney injury (AKI). Results Through expert review, the framework assesses each alert episode for appropriateness of the alert display and the necessity and urgency of a clinical response. Primary outcomes of the framework include the false positive alert rate, alert override rate, provider non-adherence rate, and rate of provider response appropriateness. Application of the framework to evaluate an existing AKI medication alerting system provided a more complete understanding of the process outcomes measured in the AKI medication alerting system. The authors confirmed that previous alerts and provider responses were most often appropriate. Conclusion The new evaluation model offers a potentially effective method for assessing the clinical appropriateness of synchronous interruptive medication alerts prior to evaluating patient outcomes in a comparative trial. More work can determine the generalizability of the framework for use in other settings and other alert types. PMID:21849334

Medication-related clinical decision support alert overrides in inpatients.

PubMed

Nanji, Karen C; Seger, Diane L; Slight, Sarah P; Amato, Mary G; Beeler, Patrick E; Her, Qoua L; Dalleur, Olivia; Eguale, Tewodros; Wong, Adrian; Silvers, Elizabeth R; Swerdloff, Michael; Hussain, Salman T; Maniam, Nivethietha; Fiskio, Julie M; Dykes, Patricia C; Bates, David W

2018-05-01

To define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers' reasons for overriding them and the appropriateness of those reasons. We conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons. Overall, 73.3% of patient allergy, drug-drug interaction, and duplicate drug alerts were overridden, though the rate of overrides varied by alert type (P < .0001). About 60% of overrides were appropriate, and that proportion also varied by alert type (P < .0001). Few overrides of renal- (2.2%) or age-based (26.4%) medication substitutions were appropriate, while most duplicate drug (98%), patient allergy (96.5%), and formulary substitution (82.5%) alerts were appropriate. Despite warnings of potential significant harm, certain categories of alert overrides were inappropriate >75% of the time. The vast majority of duplicate drug, patient allergy, and formulary substitution alerts were appropriate, suggesting that these categories of alerts might be good targets for refinement to reduce alert fatigue. Almost three-quarters of alerts were overridden, and 40% of the overrides were not appropriate. Future research should optimize alert types and frequencies to increase their clinical relevance, reducing alert fatigue so that important alerts are not inappropriately overridden.

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

PubMed Central

Harrison, Andrew M.; Thongprayoon, Charat; Aakre, Christopher A.; Jeng, Jack Y.; Dziadzko, Mikhail A.; Gajic, Ognjen; Pickering, Brian W.

2017-01-01

Background Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148) and 51% (N = 156) from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5) and median 2 min (N = 80) from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting. PMID:28316887

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

PubMed

Harrison, Andrew M; Thongprayoon, Charat; Aakre, Christopher A; Jeng, Jack Y; Dziadzko, Mikhail A; Gajic, Ognjen; Pickering, Brian W; Herasevich, Vitaly

2017-01-01

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

Physicians’ response to computerised alerts for psychotropic drugs in older persons: a multilevel analysis of the associated alert, patient and physician characteristics

PubMed Central

Tamblyn, Robyn; Reidel, Kristen; Patel, Vaishali

2012-01-01

Objective Computerised drug alerts are expected to reduce patients’ risk of adverse drug events. However, physicians over-ride most drug alerts, because they believe that the benefit exceeds the risk. The purpose of this study was to determine the drug alert, patient and physician characteristics associated with the: (1) occurrence of psychotropic drug alerts for elderly patients and the (2) response to these alerts by their primary care physicians. Setting Primary care, Quebec, Canada. Design Prospective cohort study. Participants Sixty-one physicians using an electronic prescribing and drug alert decision-support system in their practice, and 3413 elderly patients using psychotropic drugs. Primary and secondary measures Psychotropic drug class, alert severity, patient risk for fall injuries and physician experience, practice volume and computer use were evaluated in relationship to the likelihood of having: (1) a psychotropic drug alert, (2) the prescription revised in response to an alert. Cluster-adjusted alternating logistic regression was used to assess multilevel predictors of alert occurrence and response. Results In total 13 080 psychotropic drug alerts were generated in 8931 visits. Alerts were more likely to be generated for male patients at higher risk of fall-related injury and for physicians who established the highest alert threshold. In 9.9% of alerts seen, the prescription was revised. The highest revision rate was for antipsychotic alerts (22.6%). Physicians were more likely to revise prescriptions for severe alerts (OR 2.03; 95%CI 1.39 to 2.98), if patients had cognitive impairment (OR 1.95; 95%CI 1.13 to 3.36), and if they made more visits to their physician (OR 1.05 per 5 visits; 95%CI 1 to 1.09). Conclusions Physicians view and respond to a small proportion of alerts, mainly for higher-risk patients. To reduce the risk of psychotropic drug-related fall injuries, a new generation of evidence-based drug alerts should be developed. PMID:23024254

Differential effects of phasic and tonic alerting on the efficiency of executive attention.

PubMed

Asanowicz, Dariusz; Marzecová, Anna

2017-05-01

The study examined how alerting and executive attention interact in a task involving conflict resolution. We proposed a tentative scenario in which an initial exogenous phasic alerting phase is followed by an endogenous tonic alerting phase, and hypothesized that these two processes may have distinct effects on conflict resolution. Phasic alerting was expected to increase the conflict, whereas tonic alerting was expected to decrease the conflict. Three experiments were conducted using different variants of the flanker task with visual alerting cues and varied cue-target intervals (SOA), to differentiate between effects of phasic alerting (short SOA) and tonic alerting (long SOA). The results showed that phasic alerting consistently decreased the efficiency of conflict resolution indexed by response time and accuracy, whereas tonic alerting increased the accuracy of conflict resolution, but at a cost in the speed of processing the conflict. The third experiment additionally showed that the effects of phasic alerting may be modulated by the psychophysical strength of alerting cues. Discussed are possible mechanisms that could account for the observed interactions between alerting and conflict resolution, as well as some discrepancies between the current and previous studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Message Processing Research from Psychology to Communication.

ERIC Educational Resources Information Center

Basil, Michael D.

Information processing theories have been very useful in psychology. The application of information processing literature to communication, however, requires definitions of audiences and definitions of messages relevant to information-processing theories. In order to establish the relevant aspect of audiences, a multiple-stage model of audiences…

Slope Failure Prediction and Early Warning Awareness Education for Reducing Landslides Casualty in Malaysia

NASA Astrophysics Data System (ADS)

Koay, S. P.; Tay, L. T.; Fukuoka, H.; Koyama, T.; Sakai, N.; Jamaludin, S. B.; Lateh, H.

2015-12-01

Northeast monsoon causes heavy rain in east coast of Peninsular Malaysia from November to March, every year. During this monsoon period, besides the happening of flood along east coast, landslides also causes millions of Malaysian Ringgit economical losses. Hence, it is essential to study the prediction of slope failure to prevent the casualty of landslides happening. In our study, we introduce prediction method of the accumulated rainfall affecting the stability of the slope. If the curve, in the graph, which is presented by rainfall intensity versus accumulated rainfall, crosses over the critical line, the condition of the slope is considered in high risk where the data are calculated and sent from rain gauge in the site via internet. If the possibility of slope failure is going high, the alert message will be sent out to the authorities for decision making on road block or setting the warning light at the road side. Besides road block and warning light, we propose to disseminate short message, to pre-registered mobile phone user, to notify the public for easing the traffic jam and avoiding unnecessary public panic. Prediction is not enough to prevent the casualty. Early warning awareness of the public is very important to reduce the casualty of landslides happening. IT technology does not only play a main role in disseminating information, early warning awareness education, by using IT technology, should be conducted, in schools, to give early warning awareness on natural hazard since childhood. Knowing the pass history on landslides occurrence will gain experience on the landslides happening. Landslides historical events with coordinate information are stored in database. The public can browse these historical events via internet. By referring to such historical landslides events, the public may know where did landslides happen before and the possibility of slope failure occurrence again is considered high. Simulation of rainfall induced slope failure mechanism and educational video on symptom before the occurrence of landslide may alert the public awareness, especially in the hilly area. The hazard map for the public provides information on where to take shelter, before, when and after natural disaster happened. A simple hazard map is recommended for the community in the aborigines villages in Malaysia.

Optimizing the real-time ground level enhancement alert system based on neutron monitor measurements: Introducing GLE Alert Plus

NASA Astrophysics Data System (ADS)

Souvatzoglou, G.; Papaioannou, A.; Mavromichalaki, H.; Dimitroulakos, J.; Sarlanis, C.

2014-11-01

Whenever a significant intensity increase is being recorded by at least three neutron monitor stations in real-time mode, a ground level enhancement (GLE) event is marked and an automated alert is issued. Although, the physical concept of the algorithm is solid and has efficiently worked in a number of cases, the availability of real-time data is still an open issue and makes timely GLE alerts quite challenging. In this work we present the optimization of the GLE alert that has been set into operation since 2006 at the Athens Neutron Monitor Station. This upgrade has led to GLE Alert Plus, which is currently based upon the Neutron Monitor Database (NMDB). We have determined the critical values per station allowing us to issue reliable GLE alerts close to the initiation of the event while at the same time we keep the false alert rate at low levels. Furthermore, we have managed to treat the problem of data availability, introducing the Go-Back-N algorithm. A total of 13 GLE events have been marked from January 2000 to December 2012. GLE Alert Plus issued an alert for 12 events. These alert times are compared to the alert times of GOES Space Weather Prediction Center and Solar Energetic Particle forecaster of the University of Málaga (UMASEP). In all cases GLE Alert Plus precedes the GOES alert by ≈8-52 min. The comparison with UMASEP demonstrated a remarkably good agreement. Real-time GLE alerts by GLE Alert Plus may be retrieved by http://cosray.phys.uoa.gr/gle_alert_plus.html, http://www.nmdb.eu, and http://swe.ssa.esa.int/web/guest/space-radiation. An automated GLE alert email notification system is also available to interested users.

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

PubMed

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

2013-06-01

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

THE TSUNAMI SERVICE BUS, AN INTEGRATION PLATFORM FOR HETEROGENEOUS SENSOR SYSTEMS

NASA Astrophysics Data System (ADS)

Fleischer, J.; Häner, R.; Herrnkind, S.; Kriegel, U.; Schwarting, H.; Wächter, J.

2009-12-01

The Tsunami Service Bus (TSB) is the sensor integration platform of the German Indonesian Tsunami Early Warning System (GITEWS) [1]. The primary goal of GITEWS is to deliver reliable tsunami warnings as fast as possible. This is achieved on basis of various sensor systems like seismometers, ocean instrumentation, and GPS stations, all providing fundamental data to support prediction of tsunami wave propagation by the GITEWS warning center. However, all these sensors come with their own proprietary data formats and specific behavior. Also new sensor types might be added, old sensors will be replaced. To keep GITEWS flexible the TSB was developed in order to access and control sensors in a uniform way. To meet these requirements the TSB follows the architectural blueprint of a Service Oriented Architecture (SOA). The integration platform implements dedicated services communicating via a service infrastructure. The functionality required for early warnings is provided by loosely coupled services replacing the "hard-wired" coupling at data level. Changes in the sensor specification are confined to the data level without affecting the warning center. Great emphasis was laid on following the Sensor Web Enablement (SWE) standard [2], specified by the Open Geospatial Consortium (OGC) [3]. As a result the full functionality needed in GITEWS could be achieved by implementing the four SWE services: The Sensor Observation Service for retrieving sensor measurements, the Sensor Alert Service in order to deliver sensor alerts, the Sensor Planning Service for tasking sensors, and the Web Notification Service for conduction messages to various media channels. Beyond these services the TSB also follows SWE Observation & Measurements specifications (O&M) for data encoding and Sensor Model Language (SensorML) for meta information. Moreover, accessing sensors via the TSB is not restricted to GITEWS. Multiple instances of the TSB can be composed to realize federate warning system. Beside the already operating TSB at the BMKG warning center [4], two other organizations in Indonesia ([5], [6]) consider using the TSB, making their data centers available to GITEWS. The presentation takes a look at the concepts and implementation and reflects the usefulness of the mentioned standards. REFERENCES [1] GITEWS is a project of the German Federal Government to aid the recon¬struction of the tsunami-prone region of the Indian Ocean, http://www.gitews.org/ [2] SWE, www.opengeospatial.org/projects/groups/sensorweb [3] OGC, www.opengeospatial.org [4] Meteorological and Geophysical Agency of Indonesia (BMKG), www.bmg.go.id [5] National Coordinating Agency for Surveys and Mapping (BAKOSURTANAL), www.bakosurtanal.go.id [6] Agency for the Assessment & Application of Technology (BPPT), www.bppt.go.id