Software Reviews Since Acquisition Reform - The Artifact Perspective

DTIC Science & Technology

2004-01-01

Risk Management OLD NEW Slide 13Acquisition of Software Intensive Systems 2004 – Peter Hantos Single, basic software paradigm Single processor Low...software risk mitigation related trade-offs must be done together Integral Software Engineering Activities Process Maturity and Quality Frameworks Quality

[Medical safety management in the setting of a clinical reference laboratory--risk management efforts in clinical testing].

PubMed

Seki, Akira; Miya, Tetsumasa

2011-03-01

As a result of recurring medical accidents, risk management in the medical setting has been given much attention. The announcement in August, 2000 by the Ministry of Health committee for formulating a standard manual for risk management, of a "Risk management manual formulation guideline" has since been accompanied by the efforts of numerous medical testing facilities to develop such documents. In 2008, ISO/TS 22367:2008 on "Medical laboratories-Reduction of error through risk management and continual improvement" was published. However, at present, risk management within a medical testing facility stresses the implementation of provisional actions in response to a problem after it has occurred. Risk management is basically a planned process and includes "corrective actions" as well as "preventive actions." A corrective action is defined as identifying the root cause of the problem and removing it, and is conducted to prevent the problem from recurring. A preventive action is defined as identifying of the any potential problem and removing it, and is conducted to prevent a problem before it occurs. Presently, I shall report on the experiences of our laboratory regarding corrective and preventive actions taken in response to accidents and incidents, respectively.

Risk assessment and management of radiofrequency radiation exposure

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

Dabala, Dana; Surducan, Emanoil; Surducan, Vasile

2013-11-13

Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

Risk assessment and management of radiofrequency radiation exposure

NASA Astrophysics Data System (ADS)

Dabala, Dana; Surducan, Emanoil; Surducan, Vasile; Neamtu, Camelia

2013-11-01

Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

A review of basic patient rights in psychiatric care.

PubMed

Cady, Rebecca F

2010-01-01

Although patient rights is a concept that all nurse managers need to be aware of, this concept often becomes confusing when applied to patients undergoing psychiatric treatment. It is important for the nurse manager to understand the basic rights that psychiatric patients are entitled to, to best be able to help staff nurses under his/her supervision to protect these rights. The nurse manager on a psychiatric unit often serves as a reference for staff nurses, and even for physicians, when questions regarding patient rights present themselves. The nurse manager should be certain to discuss these issues with the facility's legal and risk management team to be aware of particulars of the law of the state in which the facility is located, as state laws may differ somewhat in their treatment of psychiatric patients.

Low Dose Risk, Decisions, and Risk Communication

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

Flynn, James

The overall research objective was to establish new levels of information about how people, groups, and communities respond to low dose radiation exposure. This is basic research into the social psychology of individual, group, and community responses to radiation exposures. The results of this research are directed to improving risk communication and public participation in management of environmental problems resulting from low dose radiation.

PSP, TSP, XP, CMMI...Eating the Alphabet Soup!

DTIC Science & Technology

2011-05-19

Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other...4 Q tit t Continuous process improvement Organizational Performance Management Causal Analysis and Resolution Level Focus Process Areas Requirements...Project Management process standardization Risk management Decision Analysis and Resolution Product Integration 2 M d R i t t anage Basic Project

Enhancing U.S. Army Aircrew Coordination Training

DTIC Science & Technology

2003-05-01

while decreasing the errors that lead to accidents. ACT and Crew/Cockpit Resource Management ( CRM ) programs were instituted in the 1980’s, first in...Both courses contain a fully integrated Data Management System that tracks student demographics, provides graphic feedback displays during evaluation...2 1 Appendix A Objectives, Basic Qualities, and Risk Management ...................... A-1 Appendix B Performance Evaluation Checklist

Using risk assessment in periodontics.

PubMed

Woodman, Alan J

2014-08-01

Risk assessment has become a regular feature in both dental practice and society as a whole, and principles used to assess risk in society are similar to those used in a clinical setting. Although the concept of risk assessment as a prognostic indicator for periodontal disease incidence and activity is well established in the management of periodontitis, the use of risk assessment to manage the practical treatment of periodontitis and its sequelae appears to have less foundation. A simple system of initial risk assessment - building on the use of the Basic Periodontal Examination (BPE), clinical, medical and social factors - is described, linked to protocols for delivering care suited to general dental practice and stressing the role of long-term supportive care. The risks of not treating the patient are considered, together with the possible causes of failure, and the problems of successful treatment are illustrated by the practical management of post-treatment recession.

[Quality Management for Surgeons: The Knowledge of Basic Contexts and Innovative Strategies Promotes the Competitiveness of Clinical Department].

PubMed

Hellmann, Wolfgang

2017-12-01

Efficient quality management aiming to achieve high quality in patient care is crucial to the success of a surgery department. This requires the knowledge of relevant terms und contexts of quality management. Implementation remains difficult in the light of demographic change and skills shortage. If a hospital has an efficient internal quality management in place, this should be used as a supplementary instrument. Otherwise it is the (sole) task of a specialist department to ensure quality for patients, employees, and cooperative partners. This paper provides basic knowledge on quality management, risk management, and quality assurance in the context of relevant medical terms. It demonstrates new ways for implementation on the level of a surgery department, and introduces a new model of quality. Georg Thieme Verlag KG Stuttgart · New York.

[Interview study on autonomous chemical management system and the contribution of occupational health specialists in companies].

PubMed

Mori, Koji; Takebayashi, Toru

2004-09-01

Under the circumstance that autonomous risk management for chemicals is required in Japan, it is necessary to define fundamental steps for developing chemical management system that are applicable in various types of companies and to understand the effective contribution of chemical or occupational health specialists to the system. For the purposes, we conducted interviews with companies which have an advanced chemical management system in Japan. As the result, each company had a certain policy about detailedness level of collected hazard and exposure information, and also had an efficient risk management system to ensure workers' health in depending on the business type and situations. Moreover, it was commonly observed that the specialists played major roles in developing tools for risk assessment and control, and then business lines led execution of the risk management with their supports. Based on the interviews, we showed a hypothesis of basic steps in introducing autonomous chemical risk management system at the workplaces. It is necessary to verify the hypothesis and to develop a simple system that is applicable to middle or small size companies as the next step.

An Integrated Risk Management Model for Source Water Protection Areas

PubMed Central

Chiueh, Pei-Te; Shang, Wei-Ting; Lo, Shang-Lien

2012-01-01

Watersheds are recognized as the most effective management unit for the protection of water resources. For surface water supplies that use water from upstream watersheds, evaluating threats to water quality and implementing a watershed management plan are crucial for the maintenance of drinking water safe for humans. The aim of this article is to establish a risk assessment model that provides basic information for identifying critical pollutants and areas at high risk for degraded water quality. In this study, a quantitative risk model that uses hazard quotients for each water quality parameter was combined with a qualitative risk model that uses the relative risk level of potential pollution events in order to characterize the current condition and potential risk of watersheds providing drinking water. In a case study of Taipei Source Water Area in northern Taiwan, total coliforms and total phosphorus were the top two pollutants of concern. Intensive tea-growing and recreational activities around the riparian zone may contribute the greatest pollution to the watershed. Our risk assessment tool may be enhanced by developing, recording, and updating information on pollution sources in the water supply watersheds. Moreover, management authorities could use the resultant information to create watershed risk management plans. PMID:23202770

Stress management training for military trainees returned to duty after a mental health evaluation: effect on graduation rates.

PubMed

Cigrang, J A; Todd, S L; Carbone, E G

2000-01-01

A significant proportion of people entering the military are discharged within the first 6 months of enlistment. Mental health related problems are often cited as the cause of discharge. This study evaluated the utility of stress inoculation training in helping reduce the attrition of a sample of Air Force trainees at risk for discharge from basic military training. Participants were 178 trainees referred for a psychological evaluation from basic training. Participants were randomly assigned to a 2-session stress management group or a usual-care control condition. Compared with past studies that used less rigorous methodology, this study did not find that exposure to stress management information increased the probability of graduating basic military training. Results are discussed in terms of possible reasons for the lack of treatment effects and directions for future research.

The Art World's Concept of Negative Space Applied to System Safety Management

NASA Technical Reports Server (NTRS)

Goodin, James Ronald (Ronnie)

2005-01-01

Tools from several different disciplines can improve system safety management. This paper relates the Art World with our system safety world, showing useful art schools of thought applied to system safety management, developing an art theory-system safety bridge. This bridge is then used to demonstrate relations with risk management, the legal system, personnel management and basic management (establishing priorities). One goal of this presentation/paper is simply to be a fun diversion from the many technical topics presented during the conference.

Quality, risk management and patient safety: the challenge of effective integration.

PubMed

França, Margarida

2008-01-01

Nowadays we observe the development of three waves of intervention and change within healthcare services: quality management, risk management and patient safety. The Patient Safety movement has been launched at international level as a consequence of the Institute of Medicine's report--To Err is Human, and today patient safety constitutes one basic dimension of health quality subjected to the direct intervention of supranational entities (WHO, EU) and Member States' Governments. The objective of this paper is to raise awareness about the value of quality improvement (QI) methodologies and tools to sustainable healthcare quality outcomes.

Basic Information for the Review of New Chemicals

EPA Pesticide Factsheets

Mandated by section 5 of the Toxic Substances Control Act (TSCA), EPA's New Chemicals program helps manage the potential risk to human health and the environment from chemicals new to the marketplace.

Small Group Activities for Introductory Business Classes.

ERIC Educational Resources Information Center

Mundrake, George

1999-01-01

Describes numerous small-group activities for the following areas of basic business education: consumer credit, marketing, business organization, entrepreneurship, insurance, risk management, economics, personal finance, business careers, global markets, and government regulation. (SK)

Occupational hazards to hospital personnel

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

Patterson, W.B.; Craven, D.E.; Schwartz, D.A.

1985-05-01

Hospital personnel are subject to various occupational hazards. Awareness of these risks, compliance with basic preventive measures, and adequate resources for interventions are essential components of an occupational health program. Physical, chemical, and radiation hazards; important infectious risks; and psychosocial problems prevalent in hospital workers are reviewed. A rational approach to managing and preventing these problems is offered. 370 references.

Evaluation of volcanic risk management in Merapi and Bromo Volcanoes

NASA Astrophysics Data System (ADS)

Bachri, S.; Stöetter, J.; Sartohadi, J.; Setiawan, M. A.

2012-04-01

Merapi (Central Java Province) and Bromo (East Java Province) volcanoes have human-environmental systems with unique characteristics, thus causing specific consequences on their risk management. Various efforts have been carried out by many parties (institutional government, scientists, and non-governmental organizations) to reduce the risk in these areas. However, it is likely that most of the actions have been done for temporary and partial purposes, leading to overlapping work and finally to a non-integrated scheme of volcanic risk management. This study, therefore, aims to identify and evaluate actions of risk and disaster reduction in Merapi and Bromo Volcanoes. To achieve this aims, a thorough literature review was carried out to identify earlier studies in both areas. Afterward, the basic concept of risk management cycle, consisting of risk assessment, risk reduction, event management and regeneration, is used to map those earlier studies and already implemented risk management actions in Merapi and Bromo. The results show that risk studies in Merapi have been developed predominantly on physical aspects of volcanic eruptions, i.e. models of lahar flows, hazard maps as well as other geophysical modeling. Furthermore, after the 2006 eruption of Merapi, research such on risk communication, social vulnerability, cultural vulnerability have appeared on the social side of risk management research. Apart from that, disaster risk management activities in the Bromo area were emphasizing on physical process and historical religious aspects. This overview of both study areas provides information on how risk studies have been used for managing the volcano disaster. This result confirms that most of earlier studies emphasize on the risk assessment and only few of them consider the risk reduction phase. Further investigation in this field work in the near future will accomplish the findings and contribute to formulate integrated volcanic risk management cycles for both Merapi and Bromo. Keywords: Risk management, volcanoes hazard, Merapi and Bromo Volcano Indonesia

Risk evaluation of highway engineering project based on the fuzzy-AHP

NASA Astrophysics Data System (ADS)

Yang, Qian; Wei, Yajun

2011-10-01

Engineering projects are social activities, which integrate with technology, economy, management and organization. There are uncertainties in each respect of engineering projects, and it needs to strengthen risk management urgently. Based on the analysis of the characteristics of highway engineering, and the study of the basic theory on risk evaluation, the paper built an index system of highway project risk evaluation. Besides based on fuzzy mathematics principle, analytical hierarchy process was used and as a result, the model of the comprehensive appraisal method of fuzzy and AHP was set up for the risk evaluation of express way concessionary project. The validity and the practicability of the risk evaluation of expressway concessionary project were verified after the model was applied to the practice of a project.

Agroclimate.Org: Tools and Information for a Climate Resilient Agriculture in the Southeast USA

NASA Astrophysics Data System (ADS)

Fraisse, C.

2014-12-01

AgroClimate (http://agroclimate.org) is a web-based system developed to help the agricultural industry in the southeastern USA reduce risks associated with climate variability and change. It includes climate related information and dynamic application tools that interact with a climate and crop database system. Information available includes climate monitoring and forecasts combined with information about crop management practices that help increase the resiliency of the agricultural industry in the region. Recently we have included smartphone apps in the AgroClimate suite of tools, including irrigation management and crop disease alert systems. Decision support tools available in AgroClimate include: (a) Climate risk: expected (probabilistic) and historical climate information and freeze risk; (b) Crop yield risk: expected yield based on soil type, planting date, and basic management practices for selected commodities and historical county yield databases; (c) Crop diseases: disease risk monitoring and forecasting for strawberry and citrus; (d) Crop development: monitoring and forecasting of growing degree-days and chill accumulation; (e) Drought: monitoring and forecasting of selected drought indices, (f) Footprints: Carbon and water footprint calculators. The system also provides background information about the main drivers of climate variability and basic information about climate change in the Southeast USA. AgroClimate has been widely used as an educational tool by the Cooperative Extension Services in the region and also by producers. It is now being replicated internationally with version implemented in Mozambique and Paraguay.

Surgical errors and risks – the head and neck cancer patient

PubMed Central

Harréus, Ulrich

2013-01-01

Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

A Study of Program Manager Effectiveness and Risk Taking Propensity

DTIC Science & Technology

1988-09-01

Kelly Sherwin, my section leader , has been a great source of leadership and inspiration . Next, I would like to thank Lieutenant Colonel Fred Westfall...managers peiZ.rm ten basic tasks which can be broken into three categories. The categories and tasks are: Interpersonal Roles 1. Figurehead 2. Leader 3...17:59). When-a program manager is successful, he is not necessarily effective (10:10). Luthans studied this phenomenon by examining the managerial

General RMP Guidance - Chapter 4: Offsite Consequence Analysis

EPA Pesticide Factsheets

This chapter provides basic compliance information, not modeling methodologies, for people who plan to do their own air dispersion modeling. OCA is a required part of the risk management program, and involves worst-case and alternative release scenarios.

A Method for Dynamic Risk Assessment and Management of Rockbursts in Drill and Blast Tunnels

NASA Astrophysics Data System (ADS)

Liu, Guo-Feng; Feng, Xia-Ting; Feng, Guang-Liang; Chen, Bing-Rui; Chen, Dong-Fang; Duan, Shu-Qian

2016-08-01

Focusing on the problems caused by rockburst hazards in deep tunnels, such as casualties, damage to construction equipment and facilities, construction schedule delays, and project cost increase, this research attempts to present a methodology for dynamic risk assessment and management of rockbursts in D&B tunnels. The basic idea of dynamic risk assessment and management of rockbursts is determined, and methods associated with each step in the rockburst risk assessment and management process are given, respectively. Among them, the main parts include a microseismic method for early warning the occurrence probability of rockburst risk, an estimation method that aims to assess potential consequences of rockburst risk, an evaluation method that utilizes a new quantitative index considering both occurrence probability and consequences for determining the level of rockburst risk, and the dynamic updating. Specifically, this research briefly describes the referenced microseismic method of warning rockburst, but focuses on the analysis of consequences and associated risk assessment and management of rockburst. Using the proposed method of risk assessment and management of rockburst, the occurrence probability, potential consequences, and the level of rockburst risk can be obtained in real-time during tunnel excavation, which contributes to the dynamic optimisation of risk mitigation measures and their application. The applicability of the proposed method has been verified by those cases from the Jinping II deep headrace and water drainage tunnels at depths of 1900-2525 m (with a length of 11.6 km in total for D&B tunnels).

78 FR 38483 - Area Risk Protection Insurance Regulations and Area Risk Protection Insurance Crop Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

...The Federal Crop Insurance Corporation (FCIC) finalizes the Area Risk Protection Insurance (ARPI) Basic Provisions, ARPI Barley Crop Insurance Provisions, ARPI Corn Crop Insurance Provisions, ARPI Cotton Crop Insurance Provisions, ARPI Forage Crop Insurance Provisions, ARPI Grain Sorghum Crop Insurance Provisions, ARPI Peanut Crop Insurance Provisions, ARPI Soybean Crop Insurance Provisions, and ARPI Wheat Crop Insurance Provisions to provide area yield protection and area revenue protection. These provisions will replace the Group Risk Plan (GRP) provisions in 7 CFR part 407, which includes the: GRP Basic Provisions, GRP Barley Crop Provisions, GRP Corn Crop Provisions, GRP Cotton Crop Provisions, GRP Forage Crop Provisions, GRP Peanut Crop Provisions, GRP Sorghum Crop Provisions, GRP Soybean Crop Provisions, and GRP Wheat Crop Provisions. The ARPI provisions will also replace the Group Risk Income Protection (GRIP) Basic Provisions, the GRIP Crop Provisions, and the GRIP-Harvest Revenue Option (GRIP-HRO). The GRP and GRIP plans of insurance will no longer be available. The intended effect of this action is to offer producers a choice of Area Revenue Protection, Area Revenue Protection with the Harvest Price Exclusion, or Area Yield Protection, all within one Basic Provision and the applicable Crop Provisions. This will reduce the amount of information producers must read to determine the best risk management tool for their operation and will improve the provisions to better meet the needs of insureds. The changes will apply for the 2014 and succeeding crop years.

Derivation of Failure Rates and Probability of Failures for the International Space Station Probabilistic Risk Assessment Study

NASA Technical Reports Server (NTRS)

Vitali, Roberto; Lutomski, Michael G.

2004-01-01

National Aeronautics and Space Administration s (NASA) International Space Station (ISS) Program uses Probabilistic Risk Assessment (PRA) as part of its Continuous Risk Management Process. It is used as a decision and management support tool to not only quantify risk for specific conditions, but more importantly comparing different operational and management options to determine the lowest risk option and provide rationale for management decisions. This paper presents the derivation of the probability distributions used to quantify the failure rates and the probability of failures of the basic events employed in the PRA model of the ISS. The paper will show how a Bayesian approach was used with different sources of data including the actual ISS on orbit failures to enhance the confidence in results of the PRA. As time progresses and more meaningful data is gathered from on orbit failures, an increasingly accurate failure rate probability distribution for the basic events of the ISS PRA model can be obtained. The ISS PRA has been developed by mapping the ISS critical systems such as propulsion, thermal control, or power generation into event sequences diagrams and fault trees. The lowest level of indenture of the fault trees was the orbital replacement units (ORU). The ORU level was chosen consistently with the level of statistically meaningful data that could be obtained from the aerospace industry and from the experts in the field. For example, data was gathered for the solenoid valves present in the propulsion system of the ISS. However valves themselves are composed of parts and the individual failure of these parts was not accounted for in the PRA model. In other words the failure of a spring within a valve was considered a failure of the valve itself.

Mismatch repair defects and Lynch syndrome: The role of the basic scientist in the battle against cancer.

PubMed

Heinen, Christopher D

2016-02-01

We have currently entered a genomic era of cancer research which may soon lead to a genomic era of cancer treatment. Patient DNA sequencing information may lead to a personalized approach to managing an individual's cancer as well as future cancer risk. The success of this approach, however, begins not necessarily in the clinician's office, but rather at the laboratory bench of the basic scientist. The basic scientist plays a critical role since the DNA sequencing information is of limited use unless one knows the function of the gene that is altered and the manner by which a sequence alteration affects that function. The role of basic science research in aiding the clinical management of a disease is perhaps best exemplified by considering the case of Lynch syndrome, a hereditary disease that predisposes patients to colorectal and other cancers. This review will examine how the diagnosis, treatment and even prevention of Lynch syndrome-associated cancers has benefitted from extensive basic science research on the DNA mismatch repair genes whose alteration underlies this condition. Copyright © 2015 Elsevier B.V. All rights reserved.

[Forensic psychiatry. Its relations to clinical psychiatry and criminology].

PubMed

Kröber, H-L

2005-11-01

A basic task of psychiatry is to identify and treat mentally disordered persons at risk of committing crimes. Psychiatry has an important function in preserving social peace, law, and order. How the psychiatric world handles this duty has changed with time. There have been very important changes from asylums to mental hospitals and from voluntary or involuntary inpatient treatment to outpatient care; but clinical psychiatry cannot give up forensic psychiatry. As a result of developments, inpatient care in mental hospitals often concentrates on crisis management, risk assessment, and risk management. On the other hand, forensic psychiatry has made great efforts in recent decades with special therapies for mentally disturbed criminals and collaborated closely with criminologists in developing instruments for risk assessment and prognosis of repeat offenses.

PRIORITY EXPERT PANEL (PEP) REPORTS

EPA Science Inventory

The National Institute of Nursing Research supports clinical and basic research to establish a scientific basis for the care of individuals across the life span-from management of patients during illness and recovery to the reduction of risks for disease and disability, the promo...

Northwest Latinos' health promotion lifestyle profiles according to diabetes risk status.

PubMed

Sutherland, Leonie L; Weiler, Dawn M; Bond, Laura; Simonson, Shawn; Reis, Janet

2012-12-01

A sample of 225 low income and low education, middle aged Latinos with concern about diabetes and living in a mid-size Idaho city volunteered for a physical assessment for risk status for the disease. The health promoting lifestyles of Latino congregants were measured using the Health Promoting Lifestyle Profile II. Diabetes risk was measured by clinically standard glycated hemoglobin readings. From no risk for the disease to full blown diabetes as determined by glycated hemoglobin levels, the respondents reported engaging in basically the same levels of physical activity, monitoring of nutrition and use of health care services thus evidencing no apparent understanding of the role of lifestyle in disease management. The findings point to the imperative of a broad, comprehensive and especially culturally attuned educational campaign on basic disease pathophysiology, the value of prevention for individual health, and the necessity of day-to-day self-care should diabetes be diagnosed.

Estimation of risk management effects on revenue and purchased feed costs on US dairy farms.

PubMed

Hadrich, Joleen C; Johnson, Kamina K

2015-09-01

Variations in milk and feed prices directly affect dairy farm risk management decisions. This research used data from the 2010 US Department of Agriculture-Agricultural Resource Management Surveys phase III dairy survey to examine how risk management tools affected revenues and expenses across US dairy farms. The survey was sent to 26 states and collected information on costs and returns to individual dairy farms. This research used the information from milk sales, crops sales, feed expenses, and farm and operator characteristics, as well as the use of risk management tools. Matching methodology was used to evaluate the effect of 5 independent risk management tools on revenues and expenses: selling milk to a cooperative, using a commodity contract to sell grain, feeding homegrown forage at a basic and intensive level, and use of a nutritionist. Results showed that dairy farms located in the Midwest and East benefit from selling milk to a cooperative and using commodity contracts to sell grain. Across the United States, using a nutritionist increased total feed costs, whereas a feeding program that included more than 65% homegrown forages decreased total feed costs. Results point to benefits from educational programming on risk management tools that are region specific rather than a broad generalization to all US dairy farmers. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Linking Climate Risk, Policy Networks and Adaptation Planning in Public Lands

NASA Astrophysics Data System (ADS)

Lubell, M.; Schwartz, M.; Peters, C.

2014-12-01

Federal public land management agencies in the United States have engaged a variety of planning efforts to address climate adaptation. A major goal of these efforts is to build policy networks that enable land managers to access information and expertise needed for responding to local climate risks. This paper investigates whether the perceived and modeled climate risk faced by different land managers is leading to larger networks or more participating in climate adaptation. In theory, the benefits of climate planning networks are larger when land managers are facing more potential changes. The basic hypothesis is tested with a survey of public land managers from hundreds of local and regional public lands management units in the Southwestern United States, as well as other stakeholders involved with climate adaptation planning. All survey respondents report their perceptions of climate risk along a variety of dimensions, as well as their participation in climate adaptation planning and information sharing networks. For a subset of respondents, we have spatially explicity GIS data about their location, which will be linked with downscaled climate model data. With the focus on climate change, the analysis is a subset of the overall idea of linking social and ecological systems.

Essentials of finance for occupational physicians.

PubMed

Miller, K; Fallon, L F

2001-01-01

Comprehending the principles of finance is paramount to understanding the way an organization chooses to generate and use its financial resources. Financial principles may be employed in the same way a physician reviews fundamental systems to gauge a person s health. Just as basic anatomical and physiological components are used to assess the health of an individual, basic financial elements exist to ascertain the health of an organization. This chapter explains risk assessment, accounts receivable management, inventory, depreciation, capital formation, ratio analysis, and more.

The United South and Eastern Tribe (USET) Proper Functioning Condition (PFC) and Tribal Focused Environmental Risk and Sustainability Tool (Tribal-FERST) Train the Trainers Workshop.October 6-9, 2014, in Nashville, Tennessee: PFC Assessment for Management and Monitoring

EPA Science Inventory

The maintenance of wildlife and aquatic habitat is dependent on the development of a riparian area management strategy, which considers and adapts to certain basic ecological and economic relationships. These relationships are functions of riparian and terrestrial ecosystems, gro...

A Framework for the Next Generation of Risk Science

PubMed Central

Krewski, Daniel; Andersen, Melvin E.; Paoli, Gregory M.; Chiu, Weihsueh A.; Al-Zoughool, Mustafa; Croteau, Maxine C.; Burgoon, Lyle D.; Cote, Ila

2014-01-01

Objectives: In 2011, the U.S. Environmental Protection Agency initiated the NexGen project to develop a new paradigm for the next generation of risk science. Methods: The NexGen framework was built on three cornerstones: the availability of new data on toxicity pathways made possible by fundamental advances in basic biology and toxicological science, the incorporation of a population health perspective that recognizes that most adverse health outcomes involve multiple determinants, and a renewed focus on new risk assessment methodologies designed to better inform risk management decision making. Results: The NexGen framework has three phases. Phase I (objectives) focuses on problem formulation and scoping, taking into account the risk context and the range of available risk management decision-making options. Phase II (risk assessment) seeks to identify critical toxicity pathway perturbations using new toxicity testing tools and technologies, and to better characterize risks and uncertainties using advanced risk assessment methodologies. Phase III (risk management) involves the development of evidence-based population health risk management strategies of a regulatory, economic, advisory, community-based, or technological nature, using sound principles of risk management decision making. Conclusions: Analysis of a series of case study prototypes indicated that many aspects of the NexGen framework are already beginning to be adopted in practice. Citation: Krewski D, Westphal M, Andersen ME, Paoli GM, Chiu WA, Al-Zoughool M, Croteau MC, Burgoon LD, Cote I. 2014. A framework for the next generation of risk science. Environ Health Perspect 122:796–805; http://dx.doi.org/10.1289/ehp.1307260 PMID:24727499

Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study.

PubMed

Simonsen, Bjoerg O; Daehlin, Gro K; Johansson, Inger; Farup, Per G

2014-11-21

Nurses experience insufficient medication knowledge; particularly in drug dose calculations, but also in drug management and pharmacology. The weak knowledge could be a result of deficiencies in the basic nursing education, or lack of continuing maintenance training during working years. The aim of this study was to compare the medication knowledge, certainty and risk of error between graduating bachelor students in nursing and experienced registered nurses. Bachelor students in closing term and registered nurses with at least one year job experience underwent a multiple choice test in pharmacology, drug management and drug dose calculations: 3x14 questions with 3-4 alternative answers (score 0-42). Certainty of each answer was recorded with score 0-3, 0-1 indicating need for assistance. Risk of error was scored 1-3, where 3 expressed high risk: being certain that a wrong answer was correct. The results are presented as mean and (SD). Participants were 243 graduating students (including 29 men), aged 28.2 (7.6) years, and 203 registered nurses (including 16 men), aged 42.0 (9.3) years and with a working experience of 12.4 years (9.2). The knowledge among the nurses was found to be superior to that of the students: 68.9%(8.0) and 61.5%(7.8) correct answers, respectively, (p < 0.001). The difference was largest in drug management and dose calculations. The improvement occurred during the first working year. The nurses expressed higher degree of certainty and the risk of error was lower, both overall and for each topic (p < 0.01). Low risk of error was associated with high knowledge and high sense of coping (p < 0.001). The medication knowledge among experienced nurses was superior to bachelor students in nursing, but nevertheless insufficient. As much as 25% of the answers to the drug management questions would lead to high risk of error. More emphasis should be put into the basic nursing education and in the introduction to medication procedures in clinical practice to improve the nurses' medication knowledge and reduce the risk of error.

Safety in Riding Programs: A Director's Guide.

ERIC Educational Resources Information Center

Kpachavi, Teresa

1996-01-01

Camp riding programs should be examined regularly for liability and risk management issues. Elements of a basic safety assessment include requiring proper safety apparel, removing obstructions from riding rings, ensuring doors and gates are closed, requiring use of lead ropes, securing equine medications, banning smoking, posting written…

Understanding What Is in Your Insurance Policies.

ERIC Educational Resources Information Center

Kahn, Steven P.

This document outlines the various types of insurance policies and their functions to help school administrators improve their management of risk. Eight exhibits highlight information on the following topics: the five basic sections of all insurance policies; key property insurance clauses; general liability; school board legal liability; the…

Investment Policy for Community College Foundations: Are Commodity Futures Prudent?

ERIC Educational Resources Information Center

Riggs, Robert O.; Helweg, Otto J.

1996-01-01

Reviews several basic risk-reward techniques to assist community college fund managers in reassessing sources of private funding for nongovernmental, not-for-profit foundations. Describes several tools for formulating an investment strategy. Indicates that administrators of foundation funds should consider the tradeoff between more risky…

Software reliability through fault-avoidance and fault-tolerance

NASA Technical Reports Server (NTRS)

Vouk, Mladen A.; Mcallister, David F.

1993-01-01

Strategies and tools for the testing, risk assessment and risk control of dependable software-based systems were developed. Part of this project consists of studies to enable the transfer of technology to industry, for example the risk management techniques for safety-concious systems. Theoretical investigations of Boolean and Relational Operator (BRO) testing strategy were conducted for condition-based testing. The Basic Graph Generation and Analysis tool (BGG) was extended to fully incorporate several variants of the BRO metric. Single- and multi-phase risk, coverage and time-based models are being developed to provide additional theoretical and empirical basis for estimation of the reliability and availability of large, highly dependable software. A model for software process and risk management was developed. The use of cause-effect graphing for software specification and validation was investigated. Lastly, advanced software fault-tolerance models were studied to provide alternatives and improvements in situations where simple software fault-tolerance strategies break down.

Strategies for basic laboratory diagnostics of the hemoglobinopathies in multi-ethnic societies: interpretation of results and pitfalls.

PubMed

Giordano, P C

2013-10-01

The consistent multi-ethnic migrations of the last decades have considerably changed the epidemiology of the hemoglobinopathies. Healthy carriers of these conditions are present today in many nonendemic parts of the world, and severely affected children are now born where these diseases were previously rare or unknown. Improving the competence in carrier diagnostics at the laboratory level is one of the first concerns when introducing management and primary prevention of the severe conditions in nonendemic areas. This review describes how and when carriers should be correctly diagnosed and informed. The essential technologies needed for basic carrier diagnostics in different situations are summarized in some detail, and interpretation of the results and a number of related problems are discussed. The role of the hematology laboratory is essential, particularly in nonendemic areas where the first line of health care is often insufficiently aware of hemoglobinopathy management. Carriers living in nonendemic areas can be appropriately diagnosed and informed regarding genetic risk and prevention by well-organized laboratories. Both basic and specialized diagnostics are needed for the correct treatment for the anemic carriers, for primary prevention in couples at risk and for state-of-the art care of severely affected patients. © 2012 John Wiley & Sons Ltd.

Iodinated contrast media and their adverse reactions.

PubMed

Singh, Jagdish; Daftary, Aditya

2008-06-01

Cross-use of technology between nuclear medicine and radiology technologists is expanding. The growth of PET/CT and the increasing use of intravenous contrast agents during these procedures bring the nuclear medicine technologist into direct contact with these agents and their associated complications. A basic understanding of the occurrence, risk factors, clinical features, and management of these procedures is of increasing importance to the nuclear medicine technologist. After reading this article, the technologist will be able to list the factors that increase the risk of contrast reactions; understand ways to minimize the occurrence of contrast reactions; and develop a plan to identify, treat, and manage the reactions effectively.

Using derivatives to hedge against the unexpected.

PubMed

Aderholt, J M; Rasmussen, R H

1996-02-01

Derivatives--financial instruments with a rate of return derived from an underlying asset--have been used as investment instruments for decades. Many derivative products originally were created explicitly for the purpose of reducing financial risks and have become more widely used and more complex in recent years. Healthcare financial managers should have a basic understanding of derivatives as well as the ability to apply general guidelines for their appropriate use in healthcare financial management.

Shift in performance of food safety management systems in supply chains: case of green bean chain in Kenya versus hot pepper chain in Uganda.

PubMed

Nanyunja, Jessica; Jacxsens, Liesbeth; Kirezieva, Klementina; Kaaya, Archileo N; Uyttendaele, Mieke; Luning, Pieternel A

2016-08-01

This study investigates the level of design and operation of food safety management systems (FSMS) of farmers and export traders in Kenya and Uganda. FSMS diagnostic tools developed for the fresh produce chain were used to assess the levels of context riskiness, FSMS activities and system output in primary production (n = 60) and trade (n = 60). High-risk context characteristics combined with basic FSMS are expected to increase the risk on unsafe produce. In Uganda both farmers and export traders of hot peppers operate in a high- to moderate-risk context but have basic FSMS and low systems output. In Kenya, both farmers and export traders of green beans operate in a low- to moderate-risk context. The farmers have average performing FSMS, whereas export trade companies showed more advanced FSMS and system output scores ranging from satisfactory to good. Large retailers supplying the EU premium market play a crucial role in demanding compliance with strict voluntary food safety standards, which was reflected in the more advanced FSMS and good system output in Kenya, especially traders. In Kenya, a clear shift in more fit-for-purpose FSMS and higher system output was noticed between farms and trade companies. In the case of Uganda, traders commonly supply to the less demanding EU wholesale markets such as ethnic specialty shops. They only have to comply with the legal phytosanitary and pesticide residue requirements for export activities, which apparently resulted in basic FSMS and low system output present with both farmers and traders. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

Therapy with Law Enforcement Couples: Clinical Management of the "High-Risk Lifestyle."

ERIC Educational Resources Information Center

Borum, Randy; Philpot, Carol

1993-01-01

Reviews three primary ways in which law enforcement can affect relationships (organizational influences, peer/socialization influences, and police role influences). Identifies some common difficulties encountered by law enforcement couples and provides some basic goals and strategies for engaging them in treatment and addressing these issues in…

Equity Access Plans: A Regulatory and Educational State Response Model.

ERIC Educational Resources Information Center

DeLisle, James

1984-01-01

Introduces the basic notion of equity access plans as property-based solutions to the cash flow needs of elderly homeowners and then proposes a normative response model that states can adopt to help manage the risk exposures. The recommended model incorporates regulatory, information dissemination, and educational elements. (BH)

Burn injury care for Special Forces and far-forward deployed troops.

PubMed

Brown, Tim La H; Skinner, Adrian M

2005-11-01

Special Forces are at risk of serious burn injury. We have suggested standard operating procedures for burn injury management in a constrained environment, with novel uses of operational kit components for trauma care. In addition, we propose instruction in basic skills of escharotomy for forward troops.

Understanding and Managing Student Hostility

ERIC Educational Resources Information Center

Keener, Sally; Leaman, David R.

2007-01-01

Conscientious educators grapple with the challenge of teaching all students, including emotionally troubled, high risk students. The general expectation is that teachers should know how to reach and teach every student--even the most irritating and obstinate child. To do that, teachers must be able to identify basic psychological factors of…

Analytic concepts for assessing risk as applied to human space flight

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

Garrick, B J

Quantitative risk assessment (QRA) principles provide an effective framework for quantifying individual elements of risk, including the risk to astronauts and spacecraft of the radiation environment of space flight. The concept of QRA is based on a structured set of scenarios that could lead to different damage states initiated by either hardware failure, human error, or external events. In the context of a spacecraft risk assessment, radiation may be considered as an external event and analyzed in the same basic way as any other contributor to risk. It is possible to turn up the microscope on any particular contributor tomore » risk and ask more detailed questions than might be necessary to simply assess safety. The methods of QRA allow for as much fine structure in the analysis as is desired. For the purpose of developing a basis for comprehensive risk management and considering the tendency to {open_quotes}fear anything nuclear,{close_quotes} radiation risk is a prime candidate for examination beyond that necessary to answer the basic question of risk. Thus, rather than considering only the customary damage states of fatalities or loss of a spacecraft, it is suggested that the full range of damage be analyzed to quantify radiation risk. Radiation dose levels in the form of a risk curve accomplish such a result. If the risk curve is the complementary cumulative distribution function, then it answers the extended question of what is the likelihood of receiving a specific dose of radiation or greater. Such results can be converted to specific health effects as desired. Knowing the full range of the radiation risk of a space mission and the contributors to that risk provides the information necessary to take risk management actions [operational, design, scheduling of missions around solar particle events (SPE), etc.] that clearly control radiation exposure.« less

Does uterine gauze packing increase the risk of puerperal morbidity in the management of postpartum hemorrhage during caesarean section: a retrospective cohort study

PubMed Central

Guo, Yu-Na; Ma, Jue; Wang, Xiao-Jin; Wang, Bing-Shun

2015-01-01

Background: To compare the outcomes especially the puerperal morbidity of uterine gauze packing (UGP) with those of uterine balloon tamponade (UBT) in the management of postpartum hemorrhage (PPH) during caesarean section (c-section). Methods: It was considered success as no requirement for either a further therapy or hysterectomy for PPH. The postpartum infection risk was pragmatically measured as puerperal morbidity. Results: The identified PPH subjects were subdivided into two groups for comparison, in which UGP or UBT was used as second-line therapy for women undergoing c-sections between January 2010 and September 2014. Of the 318 c-section subjects initially treated by basic managements for expected PPH, 99 cases underwent UGP and 66 UBT as the second-line therapies to stop persistent bleeding. The success rates of the UGP and UBT groups were 90.91 and 87.88%, respectively. Only one patient in UBT group resorted to hysterectomy. The respective rates of puerperal morbidity were 10.10 and 13.64%, with risk ratio of 0.74 (95% CI: 0.32, 1.72). There were no significant differences between the two groups even after the adjustment for potential confounding factors. Conclusion: UGP appears to be effective in treating PPH during c-section without an observed increase in the risk of potential postpartum infection when compared with UBT. UGP could be recommended as routine for patients who are not responding to conventional basic therapies in addressing PPH, along with the provision of appropriate training. PMID:26550320

Expert Views on Regulatory Preparedness for Managing the Risks of Nanotechnologies

PubMed Central

Beaudrie, Christian E. H.; Satterfield, Terre; Kandlikar, Milind; Harthorn, Barbara H.

2013-01-01

The potential and promise of nanotechnologies depends in large part on the ability for regulatory systems to assess and manage their benefits and risks. However, considerable uncertainty persists regarding the health and environmental implications of nanomaterials, hence the capacity for existing regulations to meet this challenge has been widely questioned. Here we draw from a survey (N=254) of US-based nano-scientists and engineers, environmental health and safety scientists, and regulatory scientists and decision-makers, to ask whether nano experts regard regulatory agencies as prepared for managing nanomaterial risks. We find that all three expert groups view regulatory agencies as unprepared. The effect is strongest for regulators themselves, and less so for scientists conducting basic, applied, or health and safety work on nanomaterials. Those who see nanotechnology risks as novel, uncertain, and difficult to assess are particularly likely to see agencies as unprepared. Trust in regulatory agencies, views of stakeholder responsibility regarding the management of risks, and socio-political values were also found to be small but significant drivers of perceived agency preparedness. These results underscore the need for new tools and methods to enable the assessment of nanomaterial risks, and to renew confidence in regulatory agencies’ ability to oversee their growing use and application in society. PMID:24244662

Nurse case management for pregnant women experiencing or at risk for abuse.

PubMed

Curry, Mary Ann; Durham, Laurel; Bullock, Linda; Bloom, Tina; Davis, Jan

2006-01-01

To determine whether individualized nursing case management can decrease stress among pregnant women at risk for or in abusive relationships. A multisite randomized controlled trial. Two prenatal clinics in the Pacific Northwest and rural Midwest. 1,000 women who spoke English and were 13 to 23 weeks pregnant at time of recruitment. All intervention group women (N = 499) were offered an abuse video and had access to a nurse case manager 24/7. Additionally, participants at risk for or in abusive relationships received individualized nursing care management throughout the pregnancy. The most frequent nursing care management activities were providing support (38%) and assessing needs (32%). The nursing care management group received an average of 22 contacts, most (80%) by telephone and had a significant reduction in stress scores as measured by the Prenatal Psychosocial Profile. Compared to the control group, the differences were in the predicted direction, but not statistically different. A major finding was the choice by abused women to focus on basic needs and their pregnancies rather than the abuse, although all received safety planning. Pregnant women at risk for or in abusive relationships experience very stressful and complex lives. Nurses need to focus on the needs they identify, which may not be the abusive relationship.

The re-identification risk of Canadians from longitudinal demographics

PubMed Central

2011-01-01

Background The public is less willing to allow their personal health information to be disclosed for research purposes if they do not trust researchers and how researchers manage their data. However, the public is more comfortable with their data being used for research if the risk of re-identification is low. There are few studies on the risk of re-identification of Canadians from their basic demographics, and no studies on their risk from their longitudinal data. Our objective was to estimate the risk of re-identification from the basic cross-sectional and longitudinal demographics of Canadians. Methods Uniqueness is a common measure of re-identification risk. Demographic data on a 25% random sample of the population of Montreal were analyzed to estimate population uniqueness on postal code, date of birth, and gender as well as their generalizations, for periods ranging from 1 year to 11 years. Results Almost 98% of the population was unique on full postal code, date of birth and gender: these three variables are effectively a unique identifier for Montrealers. Uniqueness increased for longitudinal data. Considerable generalization was required to reach acceptably low uniqueness levels, especially for longitudinal data. Detailed guidelines and disclosure policies on how to ensure that the re-identification risk is low are provided. Conclusions A large percentage of Montreal residents are unique on basic demographics. For non-longitudinal data sets, the three character postal code, gender, and month/year of birth represent sufficiently low re-identification risk. Data custodians need to generalize their demographic information further for longitudinal data sets. PMID:21696636

The physics of MRI safety.

PubMed

Panych, Lawrence P; Madore, Bruno

2018-01-01

The main risks associated with magnetic resonance imaging (MRI) have been extensively reported and studied; for example, everyday objects may turn into projectiles, energy deposition can cause burns, varying fields can induce nerve stimulation, and loud noises can lead to auditory loss. The present review article is geared toward providing intuition about the physical mechanisms that give rise to these risks. On the one hand, excellent literature already exists on the practical aspect of risk management, with clinical workflow and recommendations. On the other hand, excellent technical articles also exist that explain these risks from basic principles of electromagnetism. We felt that an underserved niche might be found between the two, ie, somewhere between basic science and practical advice, to help develop intuition about electromagnetism that might prove of practical value when working around MR scanners. Following a wide-ranging introduction, risks originating from the main magnetic field, the excitation RF electromagnetic field, and switching of the imaging gradients will be presented in turn. 5 Technical Efficacy: 1 J. Magn. Reson. Imaging 2018;47:28-43. © 2017 International Society for Magnetic Resonance in Medicine.

The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management.

PubMed

Reuben, David B; Gazarian, Priscilla; Alexander, Neil; Araujo, Katy; Baker, Dorothy; Bean, Jonathan F; Boult, Chad; Charpentier, Peter; Duncan, Pamela; Latham, Nancy; Leipzig, Rosanne M; Quintiliani, Lisa M; Storer, Thomas; McMahon, Siobhan

2017-12-01

In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs). The components include a standardized assessment of eight modifiable risk factors (medications; postural hypotension; feet and footwear; vision; vitamin D; osteoporosis; home safety; strength, gait, and balance impairment) and the use of protocols and algorithms to generate recommended management of risk factors; explanation of assessment results to the patient (and caregiver when appropriate) using basic motivational interviewing techniques to elicit patient priorities, preferences, and readiness to participate in treatments; co-creation of individualized falls care plans that patients' PCPs review, modify, and approve; implementation of the falls care plan; and ongoing monitoring of response, regularly scheduled re-assessments of fall risk, and revisions of the falls care plan. Custom-designed falls care management software facilitates risk factor assessment, the identification of recommended interventions, clinic note generation, and longitudinal care management. The trial testing the effectiveness of the STRIDE intervention is in progress, with results expected in late 2019. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Suicide risk of your client: initial identification and management for the allied health professional.

PubMed

Donley, Euan

2013-01-01

Allied health professionals treat clients in varying degrees of distress with complex needs in a wide range of services. A client could be experiencing a chronic or life-changing illness, have a trauma from a critical event, have preexisting mental illness, be dealing with significant health or personal loss, be using substances, or experiencing a depression. At some point an allied health professional will treat a client who may have a diagnosed depression, appear depressed, or have thoughts of suicide. Mental health of clients is everyone's responsibility, especially those working in health. This article aims to increase allied health professionals' understanding of some risk factors and clinical features a client at risk may have and will discuss some initial options of management. It is recommended the allied health professional and organisation be aware of risk factors for suicide but not rely too heavily on risk screening. The worker should have basic skills in recognising poor mood and have a list of useful questions to ask in a crisis. Know your local crisis and supportive mental health services, create links with them, have ongoing professional education and protocols for managing clients at-risk, and be acutely aware of your role and limitations.

[The management of arteriovenous fistula for dialysis patients].

PubMed

Lopez, Teodoro; Casino, Francesco

2014-01-01

A well-functioning vascular access is a basic requirement for a good dialysis treatment. Among the vascular accesses, the Artero-venous fistula (FAV) with native vessels is preferred for increasing survival rate, reducing risk of infection and with fewer complications. This review examines some aspects concerning the preparation and the surveillance of AVF.

Special Education at the Crossroad: An Identity Crisis and the Need for a Scientific Reconstruction

ERIC Educational Resources Information Center

Kauffman, James M.; Anastasiou, Dimitris; Maag, John W.

2017-01-01

Special education is losing its identity--its visibility, distinctiveness, budget, and basic functions are all at risk. Special education functions include (a) sorting, categorizing, and labeling students who need it; (b) making the right comparisons; (c) honoring diversity but changing "particular" differences; (d) managing stigma; (e)…

Modeling the main fungal diseases of winter wheat: constraints and possible solutions

USDA-ARS?s Scientific Manuscript database

The first step in the formulation of disease management strategy for any cropping system is to identify the most important risk factors among those on the long list of possible candidates. This is facilitated by basic epidemiological studies of pathogen life cycles, and an understanding of the way i...

Guidelines for personal exposure monitoring of chemicals: Part V.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-05-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part IV.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-03-27

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part III.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-01-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part I.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2017-09-28

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided later in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part II.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2017-11-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

The principle of safety evaluation in medicinal drug - how can toxicology contribute to drug discovery and development as a multidisciplinary science?

PubMed

Horii, Ikuo

2016-01-01

Pharmaceutical (drug) safety assessment covers a diverse science-field in the drug discovery and development including the post-approval and post-marketing phases in order to evaluate safety and risk management. The principle in toxicological science is to be placed on both of pure and applied sciences that are derived from past/present scientific knowledge and coming new science and technology. In general, adverse drug reactions are presented as "biological responses to foreign substances." This is the basic concept of thinking about the manifestation of adverse drug reactions. Whether or not toxic expressions are extensions of the pharmacological effect, adverse drug reactions as seen from molecular targets are captured in the category of "on-target" or "off-target", and are normally expressed as a biological defense reaction. Accordingly, reactions induced by pharmaceuticals can be broadly said to be defensive reactions. Recent molecular biological conception is in line with the new, remarkable scientific and technological developments in the medical and pharmaceutical areas, and the viewpoints in the field of toxicology have shown that they are approaching toward the same direction as well. This paper refers to the basic concept of pharmaceutical toxicology, the differences for safety assessment in each stage of drug discovery and development, regulatory submission, and the concept of scientific considerations for risk assessment and management from the viewpoint of "how can multidisciplinary toxicology contribute to innovative drug discovery and development?" And also realistic translational research from preclinical to clinical application is required to have a significant risk management in post market by utilizing whole scientific data derived from basic and applied scientific research works. In addition, the significance for employing the systems toxicology based on AOP (Adverse Outcome Pathway) analysis is introduced, and coming challenges on precision medicine are to be addressed for the new aspect of efficacy and safety evaluation.

Pressure ulcers: Back to the basics

PubMed Central

Agrawal, Karoon; Chauhan, Neha

2012-01-01

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of “prevention is better than cure” suits this condition the most. PMID:23162223

Risk Management in Complex Construction Projects that Apply Renewable Energy Sources: A Case Study of the Realization Phase of the Energis Educational and Research Intelligent Building

NASA Astrophysics Data System (ADS)

Krechowicz, Maria

2017-10-01

Nowadays, one of the characteristic features of construction industry is an increased complexity of a growing number of projects. Almost each construction project is unique, has its project-specific purpose, its own project structural complexity, owner’s expectations, ground conditions unique to a certain location, and its own dynamics. Failure costs and costs resulting from unforeseen problems in complex construction projects are very high. Project complexity drivers pose many vulnerabilities to a successful completion of a number of projects. This paper discusses the process of effective risk management in complex construction projects in which renewable energy sources were used, on the example of the realization phase of the ENERGIS teaching-laboratory building, from the point of view of DORBUD S.A., its general contractor. This paper suggests a new approach to risk management for complex construction projects in which renewable energy sources were applied. The risk management process was divided into six stages: gathering information, identification of the top, critical project risks resulting from the project complexity, construction of the fault tree for each top, critical risks, logical analysis of the fault tree, quantitative risk assessment applying fuzzy logic and development of risk response strategy. A new methodology for the qualitative and quantitative risk assessment for top, critical risks in complex construction projects was developed. Risk assessment was carried out applying Fuzzy Fault Tree analysis on the example of one top critical risk. Application of the Fuzzy sets theory to the proposed model allowed to decrease uncertainty and eliminate problems with gaining the crisp values of the basic events probability, common during expert risk assessment with the objective to give the exact risk score of each unwanted event probability.

Pain Management in CKD: A Guide for Nephrology Providers.

PubMed

Koncicki, Holly M; Unruh, Mark; Schell, Jane O

2017-03-01

Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis. Management of pain begins with the development of a shared treatment plan, identification of appropriate medications, and continual follow-up and assessment of efficacy and adverse effects. Through adequate pain management, providers can positively affect the health of individual patients and the performance of health care systems. Copyright © 2016 National Kidney Foundation, Inc. All rights reserved.

Electrical, Electronic and Electromechanical (EEE) Parts in the New Space Paradigm: When is Better the Enemy of Good Enough?

NASA Technical Reports Server (NTRS)

La Bel, Kenneth A.; Sampson, Michael J.

2016-01-01

As the space business rapidly evolves to accommodate a lower cost model of development and operation via concepts such as commercial space and small spacecraft (aka, CubeSats), traditional EEE parts screening and qualification methods are being scrutinized under a risk-reward trade space. In this presentation, two basic concepts will be the overarching theme: 1) The movement from complete risk aversion EEE parts methods to managing and/or accepting risk via alternate approaches; and, 2) A discussion of over-design focusing on both electrical design performance and bounding margins.

Electrical, Electronic and Electromechanical (EEE) Parts in the New Space Paradigm: When is Better the Enemy of Good Enough?

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Sampson, Michael J.

2016-01-01

As the space business rapidly evolves to accommodate a lower cost model of development and operation via concepts such as commercial space and small spacecraft (aka, CubeSats), traditional EEE parts screening and qualification methods are being scrutinized under a risk-reward trade space. In this presentation, two basic concepts will be the overarching theme: 1) The movement from complete risk aversion EEE parts methods to managing and or accepting risk via alternate approaches; and, 2) A discussion of over-design focusing on both electrical design performance and bounding margins.

Intracranial aneurysms: Review of current science and management.

PubMed

Toth, Gabor; Cerejo, Russell

2018-06-01

Unruptured intracranial aneurysms often have a relatively benign clinical course. Frequently, they are found incidentally during workup for an underlying, possibly related or unrelated, symptom or condition. Overall, brain aneurysms are considered to have a relatively low annual risk of rupture. However, should it occur, aneurysmal subarachnoid hemorrhage can lead to significant morbidity and mortality. Our understanding of the natural history and treatment outcomes of cerebral aneurysms has significantly increased over the last few decades, but choosing the optimal management for each patient requires the careful consideration of numerous medical, clinical and anatomic factors. The purpose of this review is to help physicians and caregivers, who may participate in the diagnosis, counseling and triage of patients with brain aneurysms, understand the basic elements of decision making. We discuss natural history, risk factors, screening, presentation, diagnosis, and their implications on aneurysm management and long-term follow-up. We also provide an overview of the risks and benefits of currently available treatment options.

Conservation and management of eastern big-eared bats: a symposium

Treesearch

Susan C. Loeb; Michael J. Lacki; Darren A. Miller

2011-01-01

Big-eared bats (genus Corynorhinus) in the Eastern United States are species of special conservation concern. These species are at risk due to many factors, including lack of knowledge about their basic biology, population numbers or trends, and distribution. This volume contains five synthesis papers on the status, ecology, and conservation of eastern big-eared bats...

Crisis Intervention with Older Persons: State of the Art and Clinical Applications.

ERIC Educational Resources Information Center

Duffy, Michael

A basic tenet of this paper is that the concept of crisis and crisis management has developed as a central issue within the fields of community psychiatry, psychology, and mental health, but that little systematic attention has been devoted to a particular subgroup at risk, i.e., older persons. Both theoretical background and clinical implications…

Community College Alumni as Customers: A Discussion of the Benefits and Risks of a Common Student Data Repository.

ERIC Educational Resources Information Center

Hamlin, W. Thomas

This white paper provides an overview of the present state of community college evaluation processes and procedures, discusses possible enhancements, and outlines the basic design concepts for a unified system to collect, organize and manage student data. The intended audience is community college administrators, researchers, and others who…

Basic principles of forest fuel reduction treatments

Treesearch

James K. Agee; Carl N. Skinner

2005-01-01

Successful fire exclusion in the 20th century has created severe fire problems across the West. Not every forest is at risk of uncharacteristically severe wildfire, but drier forests are in need of active management to mitigate fire hazard. We summarize a set of simple principles important to address in fuel reduction treatments: reduction of surface fuels, increasing...

School Law for the Principal: A Handbook for Practitioners.

ERIC Educational Resources Information Center

Shoop, Robert J.; Dunklee, Dennis R.

The relationship between the principal and the law has never been easy to define. This book provides basic information on the current status of law, risk, and site-based management as they relate to the legal rights and responsibilities of principals. Twenty-one chapters are included in five sections. The first section discusses the school and the…

Risk factors for fatigue and stress among Korean police officers

PubMed Central

Seok, Jong-Min; Cho, Jae-Hwan; Jeon, Woo-Jin; Ahn, Jae-Ouk

2015-01-01

[Purpose] This study investigated factors that affect the health of police officers by analyzing job stress, psychosocial stress, and fatigue faced by police officers in order to provide basic data for the efficient management of police officers and future comparative research. [Subjects and Methods] Police officers admitted to the National Police Hospital from March to May 2013 were surveyed to investigate their degree of stress. The questionnaire consisted of 4 areas related to patient characteristics: general and demographic characteristics factors, job stress, psychosocial stress, and fatigue. [Results] The analysis of the relationships among job stress, psychosocial health, and fatigue showed the 0%, 44.7%, and 82% of those with healthy, potential, and high risks of stress had high job stress, respectively. Meanwhile, 40.8% and 77.9% of subjects with normal and high risks of fatigue had high job stress. [Conclusion] The studies can be used as basic and comparative data for the prevention and early control of job-related diseases for police officers. PMID:26157229

Environmental Management Science Program Workshop. Proceedings

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

None

1998-07-01

The Department of Energy Office of Environmental Management (EM), in partnership with the Office of Energy Research (ER), designed, developed, and implemented the Environmental Management Science Program as a basic research effort to fund the scientific and engineering understanding required to solve the most challenging technical problems facing the government's largest, most complex environmental cleanup program. The intent of the Environmental Management Science Program is to: (1) Provide scientific knowledge that will revolutionize technologies and cleanup approaches to significantly reduce future costs, schedules, and risks. (2) Bridge the gap between broad fundamental research that has wide-ranging applications such as thatmore » performed in the Department's Office of Energy Research and needs-driven applied technology development that is conducted in Environmental Management's Office of Science and Technology. (3) Focus the nation's science infrastructure on critical Department of Energy environmental problems. In an effort to share information regarding basic research efforts being funded by the Environmental Management Science Program and the Environmental Management/Energy Research Pilot Collaborative Research Program (Wolf-Broido Program), this CD includes summaries for each project. These project summaries, available in portable document format (PDF), were prepared in the spring of 1998 by the principal investigators and provide information about their most recent project activities and accomplishments.« less

Total Probability of Collision as a Metric for Finite Conjunction Assessment and Collision Risk Management

NASA Astrophysics Data System (ADS)

Frigm, R.; Johnson, L.

The Probability of Collision (Pc) has become a universal metric and statement of on-orbit collision risk. Although several flavors of the computation exist and are well-documented in the literature, the basic calculation requires the same input: estimates for the position, position uncertainty, and sizes of the two objects involved. The Pc is used operationally to make decisions on whether a given conjunction poses significant collision risk to the primary object (or space asset of concern). It is also used to determine necessity and degree of mitigative action (typically in the form of an orbital maneuver) to be performed. The predicted post-maneuver Pc also informs the maneuver planning process into regarding the timing, direction, and magnitude of the maneuver needed to mitigate the collision risk. Although the data sources, techniques, decision calculus, and workflows vary for different agencies and organizations, they all have a common thread. The standard conjunction assessment and collision risk concept of operations (CONOPS) predicts conjunctions, assesses the collision risk (typically, via the Pc), and plans and executes avoidance activities for conjunctions as a discrete events. As the space debris environment continues to increase and improvements are made to remote sensing capabilities and sensitivities to detect, track, and predict smaller debris objects, the number of conjunctions will in turn continue to increase. The expected order-of-magnitude increase in the number of predicted conjunctions will challenge the paradigm of treating each conjunction as a discrete event. The challenge will not be limited to workload issues, such as manpower and computing performance, but also the ability for satellite owner/operators to successfully execute their mission while also managing on-orbit collision risk. Executing a propulsive maneuver occasionally can easily be absorbed into the mission planning and operations tempo; whereas, continuously planning evasive maneuvers for multiple conjunction events is time-consuming and would disrupt mission and science operations beyond what is tolerable. At the point when the number of conjunctions is so large that it is no longer possible to consider each individually, some sort of an amalgamation of events and risk must be considered. This shift is to one where each conjunction cannot be treated individually and the effects of all conjunctions within a given period of time must be considered together. This new paradigm is called finite Conjunction Assessment (CA) risk management. This paper considers the use of the Total Probability of Collision (TPc) as an analogous collision risk metric in the finite CA paradigm. TPc is expressed by the equation below and provides an aggregate probability of colliding with any one of the predicted conjunctions under consideration. TPc=1-?(1-Pc,i) While the TPc computation is straightforward and its physical meaning is understandable, the implications of its usage operationally requires a change in mindset and approach to collision risk management. This paper explores the necessary changes to evolve the basic CA and collision risk management CONOPS from discrete to finite CA, including aspects of collision risk assessment and collision risk mitigation. It proposes numerical and graphical decision aids to understand both the “risk outlook” for a given primary as well as mitigation options for the total collision risk. Both concepts make use of the TPc as a metric for finite collision risk management. Several operational scenarios are used to demonstrate the proposed concepts in practice.

What deserves our respect? Reexamination of respect for autonomy in the context of the management of chronic conditions.

PubMed

Enzo, Aya; Okita, Taketoshi; Asai, Atsushi

2018-05-29

The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient's decisions, behaviors, emotions, or life-style regardless of his or her "autonomous" capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities.

An Online Risk Monitor System (ORMS) to Increase Safety and Security Levels in Industry

NASA Astrophysics Data System (ADS)

Zubair, M.; Rahman, Khalil Ur; Hassan, Mehmood Ul

2013-12-01

The main idea of this research is to develop an Online Risk Monitor System (ORMS) based on Living Probabilistic Safety Assessment (LPSA). The article highlights the essential features and functions of ORMS. The basic models and modules such as, Reliability Data Update Model (RDUM), running time update, redundant system unavailability update, Engineered Safety Features (ESF) unavailability update and general system update have been described in this study. ORMS not only provides quantitative analysis but also highlights qualitative aspects of risk measures. ORMS is capable of automatically updating the online risk models and reliability parameters of equipment. ORMS can support in the decision making process of operators and managers in Nuclear Power Plants.

Basic Microbiologic and Infection Control Information to Reduce the Potential Transmission of Pathogens to Patients via Computer Hardware

PubMed Central

Neely, Alice N.; Sittig, Dean F.

2002-01-01

Computer technology from the management of individual patient medical records to the tracking of epidemiologic trends has become an essential part of all aspects of modern medicine. Consequently, computers, including bedside components, point-of-care testing equipment, and handheld computer devices, are increasingly present in patients’ rooms. Recent articles have indicated that computer hardware, just as other medical equipment, may act as a reservoir for microorganisms and contribute to the transfer of pathogens to patients. This article presents basic microbiological concepts relative to infection, reviews the present literature concerning possible links between computer contamination and nosocomial colonizations and infections, discusses basic principles for the control of contamination, and provides guidelines for reducing the risk of transfer of microorganisms to susceptible patient populations. PMID:12223502

Risk perception and communication: lessons for the food and food packaging industry.

PubMed

Renn, O

2005-10-01

Health risks are front-page news. Be it bovine spongiform encephalitis (BSE), surface ozone, or radiation from transmitter stations or mobile phones, the popular press puts out a constant stream of risk warnings and sensational reports about potential health threats. This paper examines how the general public perceives and assesses such information when it comes to food and food packaging risks. In the first part, the basic components of food risks are discussed and then compared with the perceptions of these risks. The main emphasis is on the risks from food packaging. The term 'perception' as used in cognitive psychology applies to the mental processes through which a person takes in, deals with and assesses information from the environment (physical and communicative) via the senses. The last part of the paper deals with the consequences of risk assessment and risk perception for risk management and risk communication.

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

PubMed

Yamashita, Shunichi

2014-06-01

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

NASA Safety Manual. Volume 3: System Safety

NASA Technical Reports Server (NTRS)

1970-01-01

This Volume 3 of the NASA Safety Manual sets forth the basic elements and techniques for managing a system safety program and the technical methods recommended for use in developing a risk evaluation program that is oriented to the identification of hazards in aerospace hardware systems and the development of residual risk management information for the program manager that is based on the hazards identified. The methods and techniques described in this volume are in consonance with the requirements set forth in NHB 1700.1 (VI), Chapter 3. This volume and future volumes of the NASA Safety Manual shall not be rewritten, reprinted, or reproduced in any manner. Installation implementing procedures, if necessary, shall be inserted as page supplements in accordance with the provisions of Appendix A. No portion of this volume or future volumes of the NASA Safety Manual shall be invoked in contracts.

An Integrated Web-based Decision Support System in Disaster Risk Management

NASA Astrophysics Data System (ADS)

Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

2012-04-01

Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact-probability matrix in terms of socio-economic dimension.

[Strategic approaches to risk management to reduce human vulnerability due to water factor changes].

PubMed

Rakhmanin, Iu A; Doronina, O D

2010-01-01

The current globalization tendencies give rise to serious human health risks associated with the problems in providing the safety of water resources, with their intense microbiological contamination due to sewage disposal, with the loss of capacity of water ecosystems for self-repair. To guarantee access to safe drinking water and basic sanitary services is considered to be one of the most priority tasks of the international community, which are embodied in the Plan of Implementation of the World Summit on Sustainable Development approved by the United Nations Organization.

Failure Modes and Effects Analysis (FMEA): A Bibliography

NASA Technical Reports Server (NTRS)

2000-01-01

Failure modes and effects analysis (FMEA) is a bottom-up analytical process that identifies process hazards, which helps managers understand vulnerabilities of systems, as well as assess and mitigate risk. It is one of several engineering tools and techniques available to program and project managers aimed at increasing the likelihood of safe and successful NASA programs and missions. This bibliography references 465 documents in the NASA STI Database that contain the major concepts, failure modes or failure analysis, in either the basic index of the major subject terms.

Medical and legal considerations in managing patients with musculoskeletal tumors.

PubMed

Morris, Carol D; Bal, B Sonny; D'Elia, Elizabeth M; Benevenia, Joseph

2014-01-01

At some point in their careers, many orthopaedic surgeons will have to navigate the legal system as it pertains to medical malpractice. An orthopaedic surgeon will find it helpful to review information on the basic legal elements of medical malpractice law along with suggestions on how he or she can assist the legal defense team if a lawsuit is filed. Surgeons who face litigation within the context of managing patients with musculoskeletal tumors should be aware of the common pitfalls in managing these patients. Knowledge of complementary strategies can provide good patient care and reduce legal risks when caring for patients with musculoskeletal neoplasms.

Management of Major Vascular Injury During Endoscopic Endonasal Skull Base Surgery.

PubMed

Gardner, Paul A; Snyderman, Carl H; Fernandez-Miranda, Juan C; Jankowitz, Brian T

2016-06-01

A major vascular injury is the most feared complication of endoscopic sinus and skull base surgery. Risk factors for vascular injury are discussed, and an algorithm for management of a major vascular injury is presented. A team of surgeons (otolaryngology and neurosurgery) is important for identification and control of a major vascular injury applying basic principles of vascular control. A variety of techniques can be used to control a major injury, including coagulation, a muscle patch, sacrifice of the artery, and angiographic stenting. Immediate and close angiographic follow-up is critical to prevent and manage subsequent complications of vascular injury. Copyright © 2016 Elsevier Inc. All rights reserved.

Natural hazard management high education: laboratory of hydrologic and hydraulic risk management and applied geomorphology

NASA Astrophysics Data System (ADS)

Giosa, L.; Margiotta, M. R.; Sdao, F.; Sole, A.; Albano, R.; Cappa, G.; Giammatteo, C.; Pagliuca, R.; Piccolo, G.; Statuto, D.

2009-04-01

The Environmental Engineering Faculty of University of Basilicata have higher-level course for students in the field of natural hazard. The curriculum provides expertise in the field of prediction, prevention and management of earthquake risk, hydrologic-hydraulic risk, and geomorphological risk. These skills will contribute to the training of specialists, as well as having a thorough knowledge of the genesis and the phenomenology of natural risks, know how to interpret, evaluate and monitor the dynamic of environment and of territory. In addition to basic training in the fields of mathematics and physics, the course of study provides specific lessons relating to seismic and structural dynamics of land, environmental and computational hydraulics, hydrology and applied hydrogeology. In particular in this course there are organized two connected examination arguments: Laboratory of hydrologic and hydraulic risk management and Applied geomorphology. These course foresee the development and resolution of natural hazard problems through the study of a real natural disaster. In the last year, the work project has regarded the collapse of two decantation basins of fluorspar, extracted from some mines in Stava Valley, 19 July 1985, northern Italy. During the development of the course, data and event information has been collected, a guided tour to the places of the disaster has been organized, and finally the application of mathematical models to simulate the disaster and analysis of the results has been carried out. The student work has been presented in a public workshop.

In Vitro-In Vivo Extrapolation of Metabolism- and Transporter-Mediated Drug-Drug Interactions-Overview of Basic Prediction Methods.

PubMed

Yoshida, Kenta; Zhao, Ping; Zhang, Lei; Abernethy, Darrell R; Rekić, Dinko; Reynolds, Kellie S; Galetin, Aleksandra; Huang, Shiew-Mei

2017-09-01

Evaluation of drug-drug interaction (DDI) risk is vital to establish benefit-risk profiles of investigational new drugs during drug development. In vitro experiments are routinely conducted as an important first step to assess metabolism- and transporter-mediated DDI potential of investigational new drugs. Results from these experiments are interpreted, often with the aid of in vitro-in vivo extrapolation methods, to determine whether and how DDI should be evaluated clinically to provide the basis for proper DDI management strategies, including dosing recommendations, alternative therapies, or contraindications under various DDI scenarios and in different patient population. This article provides an overview of currently available in vitro experimental systems and basic in vitro-in vivo extrapolation methodologies for metabolism- and transporter-mediated DDIs. Published by Elsevier Inc.

Coordination of short-term and long-term mitigation measures of hydro-meteorological risks: the importance of establishing a link between emergency management and spatial planning

NASA Astrophysics Data System (ADS)

Prenger-Berninghoff, Kathrin; Cortes, V. Juliette; Aye, Zar Chi; Sprague, Teresa

2013-04-01

The management of natural hazards involves, as generally known, the four stages of the risk management cycle: Prevention, preparedness, response and recovery. Accordingly, the mitigation of disasters can be performed in terms of short-term and long-term purposes. Whereas emergency management or civil protection helps to strengthen a community's capacity to be better prepared for natural hazards and to better respond in case a disaster strikes, thus addressing the short-term perspective, spatial planning serves long-term planning goals and can therefore implement long-term prevention measures. A purposefully applied risk mitigation strategy requires coordination of short-term and long-term mitigation measures and thus an effective coordination of emergency management and spatial planning. Several actors are involved in risk management and should consequently be linked throughout the whole risk management cycle. However, these actors, partly because of a historically fragmented administrative system, are hardly connected to each other, with spatial planning only having a negligible role compared to other actors1, a problem to which Young (2002) referred to as the "problem of interplay". In contrast, information transfer and decision-taking happen at the same time and are not coordinated among different actors. This applies to the prevention and preparedness phase as well as to the recovery phase, which basically constitutes the prevention phase for the next disaster2. Since investments in both risk prevention and emergency preparedness and response are considered necessary, a better coordination of the two approaches is required. In this regard, Decision Support Systems (DSS) can be useful in order to provide support in the decision-making aspect of risk management. The research work currently undertaken examines the problem of interplay in the four case study areas of the Marie Curie ITN, CHANGES3. The link between different risk management actors will be explored by means of exploratory questionnaires and interviews with government agencies, local administrations, community and research organizations on each study site. First results provided will address the general role of spatial planning in risk management. Additionally, preliminary observations are made in regard to the coordination of emergency preparedness and long-term spatial planning activities. The observations consider that integration facilitates proactive strategies that aim at preventing disaster occurrence and promote interaction between involved parties. Finally, consideration is given to the potential use of a DSS tool to cover both aspects of spatial planning and emergency management in the risk management cycle.

IFKIS - a basis for managing avalanche risk in settlements and on roads in Switzerland

NASA Astrophysics Data System (ADS)

Bründl, M.; Etter, H.-J.; Steiniger, M.; Klingler, Ch.; Rhyner, J.; Ammann, W. J.

2004-04-01

After the avalanche winter of 1999 in Switzerland, which caused 17 deaths and damage of over CHF 600 mill. in buildings and on roads, the project IFKIS, aimed at improving the basics of organizational measures (closure of roads, evacuation etc.) in avalanche risk management, was initiated. The three main parts of the project were the development of a compulsory checklist for avalanche safety services, a modular education and training course program and an information system for safety services. The information system was developed in order to improve both the information flux between the national centre for avalanche forecasting, the Swiss Federal Institute for Snow and Avalanche Research SLF, and the local safety services on the one hand and the communication between avalanche safety services in the communities on the other hand. The results of this project make a valuable contribution to strengthening organizational measures in avalanche risk management and to closing the gaps, which became apparent during the avalanche winter of 1999. They are not restricted to snow avalanches but can also be adapted for dealing with other natural hazard processes and catastrophes.

Towards AN Inventory for Archaeological Heritage Management in Israel

NASA Astrophysics Data System (ADS)

Alef, Y.

2017-08-01

The vast amount of archaeological data and information that is systematically accumulated in the Israel Antiquities Authority database, has not yet been transformed into a tool for heritage management, i.e. accessible knowledge of the sites' cultural significance and risk assessment that is needed to support wise decision making regarding its future. As a response, a pilot project for developing an inventory for the archaeological heritage management was launched. A basic ESRI ArcGIS Online system was developed as a prototype, following the categories recommended in international standards for documentation. Five field surveys implementing the GIS system were conducted to examine different aspects and workflows: ancient synagogues in the Galilee, sites at risk, mosaics in Tel Shiqmona, the ancient settlement of Huqoq and sites included in The National Master Plan for Forests and Afforestation. The pilot project revealed the main gaps in knowledge and the critical faults in the working procedures. In spite of the systems' technological limitations, the results were convincing enough to promote a multidisciplinary discussion about the need for integration of significance and risk assessment in the working processes of the organization.

Risk assessment and management of Chlamydia psittaci in poultry processing plants.

PubMed

Deschuyffeleer, Thomas P G; Tyberghien, Laurens F V; Dickx, Veerle L C; Geens, Tom; Saelen, Jacques M M M; Vanrompay, Daisy C G; Braeckman, Lutgard A C M

2012-04-01

Chlamydia psittaci causes respiratory disease in poultry and can be transmitted to humans. Historical outbreaks of psittacosis in poultry workers indicated the need for higher awareness and an efficient risk assessment and management. This group reviewed relevant previous research, practical guidelines, and European directives. Subsequently, basic suggestions were made on how to assess and manage the risk of psittacosis in poultry processing plants based on a classical four-step approach. Collective and personal protective measures as well as the role of occupational medicine are described. Despite the finding that exposure is found in every branch, abattoir workstations seem to be associated with the highest prevalence of psittacosis. Complete eradication is difficult to achieve. Ventilation, cleaning, hand hygiene, and personal protective equipment are the most important protective measures to limit and control exposure to C. psittaci. Adequate information, communication, and health surveillance belong to the responsibilities of the occupational physician. Future challenges lay in the rigorous reporting of infections in both poultry and poultry workers and in the development of an avian and human vaccine.

On the historical account of disastrous landslides in Mexico: the challenge of risk management and disaster prevention

NASA Astrophysics Data System (ADS)

Alcántara-Ayala, I.

2008-01-01

Landslides disasters in Mexico caused more than 3500 deaths between 1935 and 2006. Such disasters have been mainly associated to intense precipitation events derived from hurricanes, tropical storms and their interactions with cold fronts, although earthquake triggered landslides have also occurred to a lesser extent. The impact of landsliding in Mexico is basically determined by the geomorphic features of mountain ranges and dissected plateaus inhabited by vulnerable communities. The present contribution provides a comprehensive temporal assessment of historical landslide disasters in Mexico. Moreover, it aims at exploring the future directions of risk management and disaster prevention, in order to reduce the impact of landslides on populations as a result of climatic change, urban sprawl, land use change and social vulnerability.

Case complexity scores in congenital heart surgery: a comparative study of the Aristotle Basic Complexity score and the Risk Adjustment in Congenital Heart Surgery (RACHS-1) system.

PubMed

Al-Radi, Osman O; Harrell, Frank E; Caldarone, Christopher A; McCrindle, Brian W; Jacobs, Jeffrey P; Williams, M Gail; Van Arsdell, Glen S; Williams, William G

2007-04-01

The Aristotle Basic Complexity score and the Risk Adjustment in Congenital Heart Surgery system were developed by consensus to compare outcomes of congenital cardiac surgery. We compared the predictive value of the 2 systems. Of all index congenital cardiac operations at our institution from 1982 to 2004 (n = 13,675), we were able to assign an Aristotle Basic Complexity score, a Risk Adjustment in Congenital Heart Surgery score, and both scores to 13,138 (96%), 11,533 (84%), and 11,438 (84%) operations, respectively. Models of in-hospital mortality and length of stay were generated for Aristotle Basic Complexity and Risk Adjustment in Congenital Heart Surgery using an identical data set in which both Aristotle Basic Complexity and Risk Adjustment in Congenital Heart Surgery scores were assigned. The likelihood ratio test for nested models and paired concordance statistics were used. After adjustment for year of operation, the odds ratios for Aristotle Basic Complexity score 3 versus 6, 9 versus 6, 12 versus 6, and 15 versus 6 were 0.29, 2.22, 7.62, and 26.54 (P < .0001). Similarly, odds ratios for Risk Adjustment in Congenital Heart Surgery categories 1 versus 2, 3 versus 2, 4 versus 2, and 5/6 versus 2 were 0.23, 1.98, 5.80, and 20.71 (P < .0001). Risk Adjustment in Congenital Heart Surgery added significant predictive value over Aristotle Basic Complexity (likelihood ratio chi2 = 162, P < .0001), whereas Aristotle Basic Complexity contributed much less predictive value over Risk Adjustment in Congenital Heart Surgery (likelihood ratio chi2 = 13.4, P = .009). Neither system fully adjusted for the child's age. The Risk Adjustment in Congenital Heart Surgery scores were more concordant with length of stay compared with Aristotle Basic Complexity scores (P < .0001). The predictive value of Risk Adjustment in Congenital Heart Surgery is higher than that of Aristotle Basic Complexity. The use of Aristotle Basic Complexity or Risk Adjustment in Congenital Heart Surgery as risk stratification and trending tools to monitor outcomes over time and to guide risk-adjusted comparisons may be valuable.

Using trading zones and life cycle analysis to understand nanotechnology regulation.

PubMed

Wardak, Ahson; Gorman, Michael E

2006-01-01

This article reviews the public health and environmental regulations applicable to nanotechnology using a life cycle model from basic research through end-of-life for products. Given nanotechnology's immense promise and public investment, regulations are important, balancing risk with the public good. Trading zones and earth systems engineering management assist in explaining potential solutions to gaps in an otherwise complex, overlapping regulatory system.

Road Infrastructure Safety Management in Poland

NASA Astrophysics Data System (ADS)

Budzynski, Marcin; Jamroz, Kazimierz; Kustra, Wojciech; Michalski, Lech; Gaca, Stanislaw

2017-10-01

The objective of road safety infrastructure management is to ensure that when roads are planned, designed, built and used road risks can be identified, assessed and mitigated. Road transport safety is significantly less developed than that of rail, water and air transport. The average individual risk of being a fatality in relation to the distance covered is thirty times higher in road transport that in the other modes. This is mainly because the different modes have a different approach to safety management and to the use of risk management methods and tools. In recent years Poland has had one of the European Union’s highest road death numbers. In 2016 there were 3026 fatalities on Polish roads with 40,766 injuries. Protecting road users from the risk of injury and death should be given top priority. While Poland’s national and regional road safety programmes address this problem and are instrumental in systematically reducing the number of casualties, the effects are far from the expectations. Modern approaches to safety focus on three integrated elements: infrastructure measures, safety management and safety culture. Due to its complexity, the process of road safety management requires modern tools to help with identifying road user risks, assess and evaluate the safety of road infrastructure and select effective measures to improve road safety. One possible tool for tackling this problem is the risk-based method for road infrastructure safety management. European Union Directive 2008/96/EC regulates and proposes a list of tools for managing road infrastructure safety. Road safety tools look at two criteria: the life cycle of a road structure and the process of risk management. Risk can be minimized through the application of the proposed interventions during design process as reasonable. The proposed methods of risk management bring together two stages: risk assessment and risk response occurring within the analyzed road structure (road network, road stretch, road section, junction, etc.). The objective of the methods is to help road authorities to take rational decisions in the area of road safety and road infrastructure safety and understand the consequences occurring in the particular phases of road life cycle. To help with assessing the impact of a road project on the safety of related roads, a method was developed for long-term forecasts of accidents and accident cost estimation as well as a risk classification to identify risks that are not acceptable risks. With regard to road safety audits and road safety inspection, a set of principles was developed to identify risks and the basic classification of mistakes and omissions. This work has added to the Polish experience of preparing and implementing such tools within the competent road authorities.

Extractive waste management: A risk analysis approach.

PubMed

Mehta, Neha; Dino, Giovanna Antonella; Ajmone-Marsan, Franco; Lasagna, Manuela; Romè, Chiara; De Luca, Domenico Antonio

2018-05-01

Abandoned mine sites continue to present serious environmental hazards because the heavy metals associated with extractive waste are continuously released into the environment, where they threaten human life and the environment. Remediating and securing extractive waste are complex, lengthy and costly processes. Thus, in most European countries, a site is considered for intervention when it poses a risk to human health and the surrounding environment. As a consequence, risk analysis presents a viable decisional approach towards the management of extractive waste. To evaluate the effects posed by extractive waste to human health and groundwater, a risk analysis approach was used for an abandoned nickel extraction site in Campello Monti in North Italy. This site is located in the Southern Italian Alps. The area consists of large and voluminous mafic rocks intruded by mantle peridotite. The mining activities in this area have generated extractive waste. A risk analysis of the site was performed using Risk Based Corrective Action (RBCA) guidelines, considering the properties of extractive waste and water for the properties of environmental matrices. The results showed the presence of carcinogenic risk due to arsenic and risks to groundwater due to nickel. The results of the risk analysis form a basic understanding of the current situation at the site, which is affected by extractive waste. Copyright © 2017 Elsevier B.V. All rights reserved.

41 CFR 102-80.10 - What are the basic safety and environmental management policies for real property?

Code of Federal Regulations, 2010 CFR

2010-07-01

... safety and environmental management policies for real property? 102-80.10 Section 102-80.10 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT General Provisions § 102-80.10 What are the basic safety and environmental management policies for real property? The basic safety and...

Managing IT service management implementation complexity: from the perspective of the Warfield Version of systems science

NASA Astrophysics Data System (ADS)

Wan, Jiangping; Jones, James D.

2013-11-01

The Warfield version of systems science supports a wide variety of application areas, and is useful to practitioners who use the work program of complexity (WPOC) tool. In this article, WPOC is applied to information technology service management (ITSM) for managing the complexity of projects. In discussing the application of WPOC to ITSM, we discuss several steps of WPOC. The discovery step of WPOC consists of a description process and a diagnosis process. During the description process, 52 risk factors are identified, which are then narrowed to 20 key risk factors. All of this is done by interviews and surveys. Root risk factors (the most basic risk factors) consist of 11 kinds of common 'mindbugs' which are selected from an interpretive structural model. This is achieved by empirical analysis of 25 kinds of mindbugs. (A lesser aim of this research is to affirm that these mindbugs developed from a Western mindset have corresponding relevance in a completely different culture: the Peoples Republic of China.) During the diagnosis process, the relationships among the root risk factors in the implementation of the ITSM project are identified. The resolution step of WPOC consists of a design process and an implementation process. During the design process, issues related to the ITSM application are compared to both e-Government operation and maintenance, and software process improvement. The ITSM knowledge support structure is also designed at this time. During the implementation process, 10 keys to the successful implementation of ITSM projects are identified.

Multi-criteria decision assessments using Subjective Logic: Methodology and the case of urban water strategies

NASA Astrophysics Data System (ADS)

Moglia, Magnus; Sharma, Ashok K.; Maheepala, Shiroma

2012-07-01

SummaryPlanning of regional and urban water resources, and in particular with Integrated Urban Water Management approaches, often considers inter-relationships between human uses of water, the health of the natural environment as well as the cost of various management strategies. Decision makers hence typically need to consider a combination of social, environmental and economic goals. The types of strategies employed can include water efficiency measures, water sensitive urban design, stormwater management, or catchment management. Therefore, decision makers need to choose between different scenarios and to evaluate them against a number of criteria. This type of problem has a discipline devoted to it, i.e. Multi-Criteria Decision Analysis, which has often been applied in water management contexts. This paper describes the application of Subjective Logic in a basic Bayesian Network to a Multi-Criteria Decision Analysis problem. By doing this, it outlines a novel methodology that explicitly incorporates uncertainty and information reliability. The application of the methodology to a known case study context allows for exploration. By making uncertainty and reliability of assessments explicit, it allows for assessing risks of various options, and this may help in alleviating cognitive biases and move towards a well formulated risk management policy.

Management of extravasation injuries: a focused evaluation of noncytotoxic medications.

PubMed

Reynolds, Paul M; MacLaren, Robert; Mueller, Scott W; Fish, Douglas N; Kiser, Tyree H

2014-06-01

Extravasations are common manifestations of iatrogenic injury that occur in patients requiring intravenous delivery of known vesicants. These injuries can contribute substantially to patient morbidity, cost of therapy, and length of stay. Many different mechanisms are behind the tissue damage during extravasation injuries. In general, extravasations consist of four different subtypes of tissue injury: vasoconstriction, osmotic, pH related, and cytotoxic. Recognition of high-risk patients, appropriate cannulation technique, and monitoring of higher risk materials remain the standard of care for the prevention of extravasation injury. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. The best therapeutic agent for treatment of vasopressor extravasation is intradermal phentolamine. Topical vasodilators and intradermal terbutaline may provide relief. Intradermal hyaluronidase has been effective for hyperosmotic extravasations, although its use largely depends on the risk of tissue injury and the severity of extravasation. Among the hyperosmotic agents, calcium extravasation is distinctive because it may present as an acute tissue injury or may possess delayed clinical manifestations. Extravasation of acidic or basic materials can produce significant tissue damage. Phenytoin is the prototypical basic drug that causes a clinical manifestation known as purple glove syndrome (PGS). This syndrome is largely managed through preventive and conservative treatment measures. Promethazine is acidic and can cause a devastating extravasation, particularly if administered inadvertently through the arteriolar route. Systemic heparin therapy remains the accepted treatment option for intraarteriolar administration of promethazine. Overall, the evidence for managing extravasations due to noncytotoxic medications is nonexistent or limited to case reports. More research is needed to improve knowledge of patient risk, prompt recognition of the extravasation, and time course for tissue injury, and to develop prevention and treatment strategies for extravasation injuries. © 2014 Pharmacotherapy Publications, Inc.

What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa.

PubMed

Olu, Olushayo; Usman, Abdulmumini; Kalambay, Kalula; Anyangwe, Stella; Voyi, Kuku; Orach, Christopher Garimoi; Azazh, Aklilu; Mapatano, Mala Ali; Nsenga, Ngoy; Manga, Lucien; Woldetsadik, Solomon; Nguessan, Francois; Benson, Angela

2018-04-02

As part of efforts to implement the human resources capacity building component of the African Regional Strategy on Disaster Risk Management (DRM) for the health sector, the African Regional Office of the World Health Organization, in collaboration with selected African public health training institutions, followed a multistage process to develop core competencies and curricula for training the African health workforce in public health DRM. In this article, we describe the methods used to develop the competencies, present the identified competencies and training curricula, and propose recommendations for their integration into the public health education curricula of African member states. We conducted a pilot research using mixed methods approaches to develop and test the applicability and feasibility of a public health disaster risk management curriculum for training the African health workforce. We identified 14 core competencies and 45 sub-competencies/training units grouped into six thematic areas: 1) introduction to DRM; 2) operational effectiveness; 3) effective leadership; 4) preparedness and risk reduction; 5) emergency response and 6) post-disaster health system recovery. These were defined as the skills and knowledge that African health care workers should possess to effectively participate in health DRM activities. To suit the needs of various categories of African health care workers, three levels of training courses are proposed: basic, intermediate, and advanced. The pilot test of the basic course among a cohort of public health practitioners in South Africa demonstrated their relevance. These competencies compare favourably to the findings of other studies that have assessed public health DRM competencies. They could provide a framework for scaling up the capacity development of African healthcare workers in the area of public health DRM; however further validation of the competencies is required through additional pilot courses and follow up of the trainees to demonstrate outcome and impact of the competencies and curriculum.

A look at statin cost-effectiveness in view of the 2013 ACC/AHA cholesterol management guidelines.

PubMed

Deaño, Roderick C; Pandya, Ankur; Jones, Erica C; Borden, William B

2014-09-01

The 2013 cholesterol management guidelines presented a major shift in recommendations on which patients at risk of cardiovascular disease should be treated and how to treat them. Implementation of the guidelines is estimated to increase substantially the number of people who would be eligible for statin therapy. As the medical community considers the broad population impact of the new cholesterol guidelines, the issue of cost-effectiveness plays a role. This review covers the basic fundamentals of cost-effectiveness analysis and summarizes the key cost-effectiveness studies that relate to the new cholesterol guidelines.

[The role of a specialised risk analysis group in the Veterinary Services of a developing country].

PubMed

Urbina-Amarís, M E

2003-08-01

Since the World Trade Organization (WTO) Agreement on the Application of Sanitary and Phytosanitary Measures was established, risk analysis in trade, and ultimately in Veterinary and Animal Health Services, has become strategically important. Irrespective of their concept (discipline, approach, method, process), all types of risk analysis in trade involve four periods or phases:--risk identification-- risk assessment--risk management--risk information or communication. All veterinarians involved in a risk analysis unit must have in-depth knowledge of statistics and the epidemiology of transmissible diseases, as well as a basic knowledge of veterinary science, economics, mathematics, data processing and social communication, to enable them to work with professionals in these disciplines. Many developing countries do not have enough well-qualified professionnals in these areas to support a risk analysis unit. This will need to be rectified by seeking strategic alliances with other public or private sectors that will provide the required support to run the unit properly. Due to the special nature of its risk analysis functions, its role in supporting decision-making, and the criteria of independence and transparency that are so crucial to its operations, the hierarchical position of the risk analysis unit should be close to the top management of the Veterinary Service. Due to the shortage of personnel in developing countries with the required training and scientific and technical qualifications, countries with organisations responsible for both animal and plant health protection would be advised to set up integrated plant and animal risk analysis units. In addition, these units could take charge of all activities relating to WTO agreements and regional agreements on animal and plant health management.

Risk Assessment Overview

NASA Technical Reports Server (NTRS)

Prassinos, Peter G.; Lyver, John W., IV; Bui, Chinh T.

2011-01-01

Risk assessment is used in many industries to identify and manage risks. Initially developed for use on aeronautical and nuclear systems, risk assessment has been applied to transportation, chemical, computer, financial, and security systems among others. It is used to gain an understanding of the weaknesses or vulnerabilities in a system so modification can be made to increase operability, efficiency, and safety and to reduce failure and down-time. Risk assessment results are primary inputs to risk-informed decision making; where risk information including uncertainty is used along with other pertinent information to assist management in the decision-making process. Therefore, to be useful, a risk assessment must be directed at specific objectives. As the world embraces the globalization of trade and manufacturing, understanding the associated risk become important to decision making. Applying risk assessment techniques to a global system of development, manufacturing, and transportation can provide insight into how the system can fail, the likelihood of system failure and the consequences of system failure. The risk assessment can identify those elements that contribute most to risk and identify measures to prevent and mitigate failures, disruptions, and damaging outcomes. In addition, risk associated with public and environment impact can be identified. The risk insights gained can be applied to making decisions concerning suitable development and manufacturing locations, supply chains, and transportation strategies. While risk assessment has been mostly applied to mechanical and electrical systems, the concepts and techniques can be applied across other systems and activities. This paper provides a basic overview of the development of a risk assessment.

Identifying and treating agitated behaviors in the long-term care setting.

PubMed

Hastings, S N; Thompson-Heisterman, A; Farrell, S P

1999-01-01

This article provides information on identification, assessment, and intervention techniques for agitated behaviors in the long-term care setting. Although the emphasis is on prevention and management of agitation, the article offers suggestions to assist health care providers in differentiating between delirium, psychosis, depression, anxiety, and dementia, which may place a resident at risk for agitation. Basic treatment approaches for each of these disorders is also reviewed.

Post-traumatic diaphragmatic hernias - importance of basic radiographic investigations.

PubMed

Mansoor, E

2013-05-03

This case presentation highlights important principles in the management of post-traumatic diaphragmatic hernia. A suggestive history should prompt early diagnosis even if the patient appears well. The chest radiograph, although not pathognomonic, is extremely useful in the detection of diaphragmatic hernia if accurately interpreted. Herniated bowel is at high risk of strangulation, especially in the presence of a 'ribbon sign'. Delayed operative intervention can prove fatal.

A Value Measure for Public-Sector Enterprise Risk Management: A TSA Case Study.

PubMed

Fletcher, Kenneth C; Abbas, Ali E

2018-05-01

This article presents a public value measure that can be used to aid executives in the public sector to better assess policy decisions and maximize value to the American people. Using Transportation Security Administration (TSA) programs as an example, we first identify the basic components of public value. We then propose a public value account to quantify the outcomes of various risk scenarios, and we determine the certain equivalent of several important TSA programs. We illustrate how this proposed measure can quantify the effects of two main challenges that government organizations face when conducting enterprise risk management: (1) short-term versus long-term incentives and (2) avoiding potential negative consequences even if they occur with low probability. Finally, we illustrate how this measure enables the use of various tools from decision analysis to be applied in government settings, such as stochastic dominance arguments and certain equivalent calculations. Regarding the TSA case study, our analysis demonstrates the value of continued expansion of the TSA trusted traveler initiative and increasing the background vetting for passengers who are afforded expedited security screening. © 2017 Society for Risk Analysis.

Identification of ballast water discharge profiles of a port to enable effective ballast water management and environmental studies

NASA Astrophysics Data System (ADS)

David, Matej; Gollasch, Stephan; Penko, Ludvik

2018-03-01

Information about the profile of ballast water discharges in a port is one of the basic elements of the decision making process in ballast water risk assessment and management, and supports the evaluation of dimensions and processes of aquatic species invasions with vessels ballast water. In the lack of ballast water reporting, ballast water discharge assessments need to be conducted. In this study we have assessed and compared ballast water discharge profiles of two ports with different maritime traffic and cargo profiles, the Port of Hamburg (Germany) and the Muuga Harbour, Port of Tallinn (Estonia). This study shows methods and approaches which can be used to assess volumes and donor ports of ballast water discharges for a port at the level of each vessel call. These methods and approaches can be applied to any port to support the implementation of feasible and efficient ballast water management measures and to enable environmental studies including long-term accumulation risks of disinfection by-products from ballast water management systems making use of active substances, as well as for discharges of other chemical compounds.

Regulatory risk assessment approaches for synthetic mineral fibres.

PubMed

Harrison, Paul; Holmes, Philip; Bevan, Ruth; Kamps, Klaus; Levy, Leonard; Greim, Helmut

2015-10-01

Exposure to synthetic mineral fibres (SMF) may occur in a number of workplace scenarios. To protect worker health, a number of different organisations worldwide have assessed the health risk of these materials and established workplace exposure limits. This paper outlines the basic principles of risk assessment and the scientific methods used to derive valid (justifiable) occupational exposure limits (OELs) and goes on to show how, for SMF, and particularly for refractory ceramic fibre (otherwise known as aluminosilicate wool, RCF/ASW), the methods used and the associated outcomes differ widely. It is argued that the resulting differences in established OELs prevent consistent and appropriate risk management of SMF worldwide, and that development of a transparent and harmonised approach to fibre risk assessment and limit-setting is required. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Basic statistics (the fundamental concepts).

PubMed

Lim, Eric

2014-12-01

An appreciation and understanding of statistics is import to all practising clinicians, not simply researchers. This is because mathematics is the fundamental basis to which we base clinical decisions, usually with reference to the benefit in relation to risk. Unless a clinician has a basic understanding of statistics, he or she will never be in a position to question healthcare management decisions that have been handed down from generation to generation, will not be able to conduct research effectively nor evaluate the validity of published evidence (usually making an assumption that most published work is either all good or all bad). This article provides a brief introduction to basic statistical methods and illustrates its use in common clinical scenarios. In addition, pitfalls of incorrect usage have been highlighted. However, it is not meant to be a substitute for formal training or consultation with a qualified and experienced medical statistician prior to starting any research project.

Fukushima Nuclear Power Plant Accident and Comprehensive Health Risk Management—Global Radiocontamination and Information Disaster

PubMed Central

2014-01-01

The Great East Japan Earthquake on March 11, 2011, besides further studying the appropriateness of the initial response and post-countermeasures against the severe Fukushima nuclear accident, has now increased the importance of the epidemiological study in comprehensive health risk management and radiation protection; lessons learnt from the Chernobyl accident should be also implemented. Therefore, since May 2011, Fukushima Prefecture has started the “Fukushima Health Management Survey Project” for the purpose of long-term health care administration and early diagnosis/treatment for the prefectural residents. Basic survey is under investigation on a retrospective estimation of external exposure of the first four months. As one of the four detailed surveys, the thyroid ultrasound examination has clarified the increased detection rate of childhood thyroid cancers as a screening effect in the past three years and so thyroid cancer occurrence by Fukushima nuclear power plant accident, especially due to radioactive iodine will be discussed despite of difficult challenge of accurate estimation of low dose and low-dose rate radiation exposures. Through the on-site valuable experience and a difficult challenge for recovery, we should learn the lessons from this severe and large-scale nuclear accident, especially how to countermeasure against public health emergency at the standpoint of health risk and also social risk management. PMID:25425958

The precautionary principle in fisheries management under climate change: How the international legal framework formulate it?

NASA Astrophysics Data System (ADS)

Latifah, E.; Imanullah, M. N.

2018-03-01

One of the objectives of fisheries management is to reach long-term sustainable benefits of the fish stocks while reducing the risk of severe or irreversible damage to the marine ecosystem. Achieving this objective needs, the good scientific knowledge and understanding on fisheries management including scientific data and information on the fish stock, fishing catch, distribution, migration, the proportion of mature fish, the mortality rate, reproduction as well as the knowledge on the impact of fishing on dependent and associated species and other species belonging to the same ecosystem, and further the impact of climate change and climate variability on the fish stocks and marine ecosystem. Lack of this scientific knowledge may lead to high levels of uncertainty. The precautionary principle is one of the basic environmental principles needed in overcoming this problem. An essence of this principle is that, in facing the serious risk as a result of the limited scientific knowledge or the absence of complete evidence of harm, it should not prevent the precautionary measures in minimizing risks and protecting the fish stocks and ecosystem. This study aims to examine how the precautionary principle in fisheries management be formulated into the international legal framework, especially under the climate change framework.

Understanding stakeholders' attitudes toward water management interventions: Role of place meanings

NASA Astrophysics Data System (ADS)

Jacobs, Maarten H.; Buijs, Arjen E.

2011-01-01

Water resource managers increasingly need to take the opinions of stakeholders into account when planning interventions. We studied stakeholders' concerns in two water management planning contexts, focusing on the meanings assigned to places and on attitudes toward proposed interventions. Semistructured interviews were held, and public meetings were observed in order to collect data. Five categories of place meanings emerged from the analysis: beauty (esthetic judgments), functionality (ways of use), attachment (feelings of belonging), biodiversity (meanings pertaining to nature), and risk (worries about current or future events). These categories reflect the basic dimensions of sense of place. Our results suggest that stakeholders' attitudes toward proposed interventions are, to a great extent, derived from their place meanings. Discussing place meanings during participatory planning processes could contribute substantially to successful water management.

Uncertainty analysis in vulnerability estimations for elements at risk- a review of concepts and some examples on landslides

NASA Astrophysics Data System (ADS)

Ciurean, R. L.; Glade, T.

2012-04-01

Decision under uncertainty is a constant of everyday life and an important component of risk management and governance. Recently, experts have emphasized the importance of quantifying uncertainty in all phases of landslide risk analysis. Due to its multi-dimensional and dynamic nature, (physical) vulnerability is inherently complex and the "degree of loss" estimates imprecise and to some extent even subjective. Uncertainty analysis introduces quantitative modeling approaches that allow for a more explicitly objective output, improving the risk management process as well as enhancing communication between various stakeholders for better risk governance. This study presents a review of concepts for uncertainty analysis in vulnerability of elements at risk to landslides. Different semi-quantitative and quantitative methods are compared based on their feasibility in real-world situations, hazard dependency, process stage in vulnerability assessment (i.e. input data, model, output), and applicability within an integrated landslide hazard and risk framework. The resulted observations will help to identify current gaps and future needs in vulnerability assessment, including estimation of uncertainty propagation, transferability of the methods, development of visualization tools, but also address basic questions like what is uncertainty and how uncertainty can be quantified or treated in a reliable and reproducible way.

The NASA Continuous Risk Management Process

NASA Technical Reports Server (NTRS)

Pokorny, Frank M.

2004-01-01

As an intern this summer in the GRC Risk Management Office, I have become familiar with the NASA Continuous Risk Management Process. In this process, risk is considered in terms of the probability that an undesired event will occur and the impact of the event, should it occur (ref., NASA-NPG: 7120.5). Risk management belongs in every part of every project and should be ongoing from start to finish. Another key point is that a risk is not a problem until it has happened. With that in mind, there is a six step cycle for continuous risk management that prevents risks from becoming problems. The steps are: identify, analyze, plan, track, control, and communicate & document. Incorporated in the first step are several methods to identify risks such as brainstorming and using lessons learned. Once a risk is identified, a risk statement is made on a risk information sheet consisting of a single condition and one or more consequences. There can also be a context section where the risk is explained in more detail. Additionally there are three main goals of analyzing a risk, which are evaluate, classify, and prioritize. Here is where a value is given to the attributes of a risk &e., probability, impact, and timeframe) based on a multi-level classification system (e.g., low, medium, high). It is important to keep in mind that the definitions of these levels are probably different for each project. Furthermore the risks can be combined into groups. Then, the risks are prioritized to see what risk is necessary to mitigate first. After the risks are analyzed, a plan is made to mitigate as many risks as feasible. Each risk should be assigned to someone in the project with knowledge in the area of the risk. Then the possible approaches to choose from are: research, accept, watch, or mitigate. Next, all risks, mitigated or not, are tracked either individually or in groups. As the plan is executed, risks are re-evaluated, and the attribute values are adjusted as necessary. Metrics are established and monitored as tools for risk tracking. Also a trigger or threshold should be set on the metric data that indicates when an action is needed. Results of this tracking are usually evaluated and reported in a relevant format at weekly or monthly meetings. Choosing controls is the subsequent step, which involves the effects of the tracking. The three basic controls are: close, continue tracking, and re- plan. Finally communicate & document is the last step, but occurs throughout the process. It is vital that main risks, plans, changes, and progress are known by everyone in the project. A good way to keep everyone updated and inform other projects of common issues is by thoroughly documenting project risks. NASA sees value in risk management and believes that projects have greater probability or success by using the NASA Continuous Risk Management Process.

Assessment of printed patient-educational materials for chronic kidney disease

PubMed Central

Tuot, Delphine S; Davis, Elizabeth; Velasquez, Alexandra; Banerjee, Tanushree; Powe, Neil R

2013-01-01

Background Awareness of chronic kidney disease (CKD) is suboptimal among patients with CKD, perhaps due to poor readability of patient education materials (PEMs). We reviewed the suitability and readability of common PEMs that focused on 5 content areas: basics of CKD, risk factors for CKD development, risk factors for CKD progression, complications of CKD and self-management strategies to improve kidney health. Methods Three reviewers (nephrologist, primary care physician, patient) used the Suitability Assessment of Materials to rate PEMs on message content/stimulation of learning, typography, visuals and layout and determined literacy level. Mean ratings were calculated for each PEM by content area and overall (Superior=70–100; Adequate=40–69; Inadequate=<40). Linear regression was used to determine the impact of literacy level on mean rating. Results We reviewed 69 PEMs from 19 organizations, divided into 113 content area sections. Most (79%) PEM sections were “Adequate” (mean rating, 58.3%). Inclusion of patient-centered content and opportunities for patient interaction were associated with “Superior” ratings. Mean ratings (SD) were similar across content areas: basics of CKD, 58.9% [9.1]; risk factors for CKD development, 57.0% [12.3]; risk factors for CKD progression, 58.5% [12.0]; CKD complications, 62.3% [15.7] and self-management strategies, 62.2% [12.3]. ≤ 6th grade literacy level (vs >6th grade) was associated with an 11.7 point higher mean rating. Conclusion Most PEMs for kidney disease were adequate. Outstanding PEMs shared characteristics of patient centeredness, a low literacy level, and patient interaction. Providers should be aware of strengths and limitations of PEMs when educating their patients about CKD. PMID:23970127

Assessment of printed patient-educational materials for chronic kidney disease.

PubMed

Tuot, Delphine S; Davis, Elizabeth; Velasquez, Alexandra; Banerjee, Tanushree; Powe, Neil R

2013-01-01

Awareness of chronic kidney disease (CKD) is suboptimal among patients with CKD, perhaps due to poor readability of patient education materials (PEMs). We reviewed the suitability and readability of common PEMs that focused on 5 content areas: basics of CKD, risk factors for CKD development, risk factors for CKD progression, complications of CKD and self-management strategies to improve kidney health. Three reviewers (nephrologist, primary care physician, patient) used the Suitability Assessment of Materials to rate PEMs on message content/stimulation of learning, typography, visuals and layout and determined literacy level. Mean ratings were calculated for each PEM by content area and overall (superior = 70-100; adequate = 40-69; inadequate = <40). Linear regression was used to determine the impact of literacy level on mean rating. We reviewed 69 PEMs from 19 organizations, divided into 113 content area sections. Most (79%) PEM sections were 'adequate' (mean rating, 58.3%). Inclusion of patient-centered content and opportunities for patient interaction were associated with 'superior' ratings. Mean ratings (SD) were similar across content areas: basics of CKD, 58.9% (9.1); risk factors for CKD development, 57.0% (12.3); risk factors for CKD progression, 58.5% (12.0); CKD complications, 62.3% (15.7), and self-management strategies, 62.2% (12.3). ≤6th grade literacy level (vs. >6th grade) was associated with an 11.7 point higher mean rating. Most PEMs for kidney disease were adequate. Outstanding PEMs shared characteristics of patient centeredness, a low literacy level, and patient interaction. Providers should be aware of strengths and limitations of PEMs when educating their patients about CKD. Copyright © 2013 S. Karger AG, Basel.

Assessing return on investment of defined-population disease management interventions.

PubMed

Wilson, Thomas W; Gruen, Jeff; William, Thar; Fetterolf, Donald; Minalkumar, Patel; Popiel, Richard G; Lewis, Al; Nash, David B

2004-11-01

Strategies to reduce health expenditures through the improvement of health and quality of care are in high demand. A group of experts formed a nonpartisan, independent work group, under the sponsorship of the National Managed Health Care Congress. Its goal was to establish a list of easy-to-understand, actionable, and usable recommendations to enable disease management program advocates to conduct basic-level evaluations. The work group made recommendations concerning identification of reference and intervention population, population definitions, quantitative methods and data quality, confounding and bias, and stakeholder agreements/contracting. A case study was created to quantitatively illustrate some of the major issues raised by the work group. Five typical errors were simulated by applying different rules to the intervention population than to the reference population: differential inclusion (high versus low risk), differential exclusion (high versus low risk) and differential claims run-out. Compared with the true impact, four of the five errors resulted in a bias toward "intervention effect," while one (differential inclusion of high-risk patients) was biased against the "intervention effect." The direction and magnitude of the bias in natural settings will not necessarily follow this pattern.

A Review of Cyanobacterial Odorous and Bioactive Metabolites: Impacts and Management Alternatives in Aquaculture

DTIC Science & Technology

2008-05-06

concentrations (i.e., basic conditions). Cyanobacteria are also well adapted to high-light and low-light conditions. Cyanobacteria benefit from photosynthetic...including the foot, gonads, or whole body of gastropods , the foot or whole body of Table 2 Maximum accumulation of cyanobacterial toxins in the tissues...Evidence suggests that gastropods , bivalves and crayfish provide a greater risk than fish to human consumers as they accumulate higher concentrations

Electrical, Electronic and Electromechanical (EEE) Parts in the New Space Paradigm: When is Better the Enemy of Good Enough?

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Sampson, Michael J.

2017-01-01

As the space business rapidly evolves to accommodate a lower cost model of development and operation via concepts such as commercial space and small spacecraft (aka, CubeSats and swarms), traditional EEE parts screening and qualification methods are being scrutinized under a risk-reward trade space. In this presentation, two basic concepts will be discussed: (1) The movement from complete risk aversion EEE parts methods to managing and/or accepting risk via alternate approaches; and, (2) A discussion of emerging assurance methods to reduce overdesign as well emerging model based mission assurance (MBMA) concepts. center dot Example scenarios will be described as well as consideration for trading traditional versus alternate methods.

Affective science perspectives on cancer control: Strategically crafting a mutually beneficial research agenda

PubMed Central

Ferrer, Rebecca A.; McDonald, Paige Green; Barrett, Lisa Feldman

2015-01-01

Cancer control research involves the conduct of basic and applied behavioral and social sciences to reduce cancer incidence, morbidity, and mortality, and improve quality of life. Given the importance of behavior in cancer control, fundamental research is necessary to identify psychological mechanisms underlying cancer risk, prevention, and management behaviors. Cancer prevention, diagnosis, and treatment are often emotionally-laden. As such, affective science research to elucidate questions related to basic phenomenological nature of emotion, stress, and mood is necessary to understand how cancer control can be hindered or facilitated by emotional experiences. To date, the intersection of basic affective science research and cancer control remains largely unexplored. The goal of this paper is to outline key questions in the cancer control research domain that provide an ecologically valid context for new affective science discoveries. We also provide examples of ways in which basic affective discoveries could inform future cancer prevention and control research. These examples are not meant to be exhaustive or prescriptive, but instead are offered to generate creative thought about the promise of a cancer research context for answering basic affective science questions. Together, these examples provide a compelling argument for fostering collaborations between affective and cancer control scientists. PMID:25987511

Referring Physicians' Tendency to Collaborate With Radiologists in Managing Contrast Media-Related Risk Factors.

PubMed

İmamoğlu, Hakan; Doğan, Serap; Erdoğan, Nuri

2018-02-01

The aim of this study was to investigate the tendency of referring physicians to collaborate with radiologists in managing contrast media (CM)-related risk factors. The study was conducted at a single academic hospital. Among 150 referring physicians from various specialties, 51 referring physicians (34%) responded to the invitation letter asking for an interview with a radiologist. During the interview, a modified form of the Control Preferences Scale was administered, in which there were five preferences (each displayed on a separate card) that ranged from the fully active to fully passive involvement of referring physicians in managing CM-related risk factors. A descriptive analysis was performed through categorization of the results depending on the respondents' two most preferred roles. Thirty-six referring physicians (70.5%) preferred a collaborative role, and 15 (29.4%) preferred a noncollaborative role (i.e., remained on either the fully active or fully passive side). Among the referring physicians who preferred a collaborative role, the most common response (n = 15 [29.4%]) was collaborative-active. Referring physicians at the authors' institution have basic cognitive and motivational-affective tone toward collaboration in future teamwork aimed at the management of CM-related risk factors. A modified form of the Control Preferences Scale, as in this study, can be used to investigate the tendency of referring physicians to collaborate with radiologists. The results are discussed from ethical and legal perspectives. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

41 CFR 301-73.106 - What are the basic services that should be covered by a TMS?

Code of Federal Regulations, 2010 CFR

2010-07-01

..., confirmation of reservations, etc.). (b) Provide basic management information, such as— (1) Number of... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What are the basic... Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 73...

The diabetes educator as an entrepreneur: starting your business.

PubMed

Moore, Patricia S; Dayhoff, Nancy E

2002-01-01

If you determine that you have many of the attributes of an entrepreneur (including being a risk taker), if you have a passion for your products and services, and if you are willing to risk an uncertain income, then you are ready to be an entrepreneur. The steps outlined in this article provide a basic overview of how to set up a business. If you decide to become an entrepreneur, there are numerous books and Web sites to guide you through the steps of establishing and managing a business. Although the challenges of becoming an entrepreneur may seem intimidating, becoming an entrepreneur can be very rewarding.

Cognitively-Related Basic Activities of Daily Living Impairment Greatly Increases the Risk of Death in Alzheimers Disease.

PubMed

Liang, Fu-Wen; Chan, Wenyaw; Chen, Ping-Jen; Zimmerman, Carissa; Waring, Stephen; Doody, Rachelle

2016-01-01

Some Alzheimer's disease (AD) patients die without ever developing cognitively impaired basic activities of daily living (basic ADL), which may reflect slower disease progression or better compensatory mechanisms. Although impaired basic ADL is related to disease severity, it may exert an independent risk for death. This study examined the association between impaired basic ADL and survival of AD patients, and proposed a multistate approach for modeling the time to death for patients who demonstrate different patterns of progression of AD that do or do not include basic ADL impairment. 1029 patients with probable AD at the Baylor College of Medicine Alzheimer's Disease and Memory Disorders Center met the criteria for this study. Two complementary definitions were used to define development of basic ADL impairment using the Physical Self-Maintenance Scale score. A weighted Cox regression model, including a time-dependent covariate (development of basic ADL impairment), and a multistate survival model were applied to examine the effect of basic ADL impairment on survival. As expected decreased ability to perform basic ADL at baseline, age at initial visit, years of education, and sex were all associated with significantly higher mortality risk. In those unimpaired at baseline, the development of basic ADL impairment was also associated with a much greater risk of death (hazard ratios 1.77-4.06) over and above the risk conferred by loss of MMSE points. A multi-state Cox model, controlling for those other variables quantified the substantive increase in hazard ratios for death conferred by the development of basic ADL impairment by two definitions and can be applied to calculate the short term risk of mortality in individual patients. The current study demonstrates that the presence of basic ADL impairment or the development of such impairments are important predictors of death in AD patients, regardless of severity.

Making parks make a difference: poor alignment of policy, planning and management with protected-area impact, and ways forward

PubMed Central

Pressey, Robert L.; Visconti, Piero; Ferraro, Paul J.

2015-01-01

Policy and practice around protected areas are poorly aligned with the basic purpose of protection, which is to make a difference. The difference made by protected areas is their impact, defined in program evaluation as the outcomes arising from protection relative to the counterfactual of no protection or a different form of protection. Although impact evaluation of programs is well established in fields such as medicine, education and development aid, it is rare in nature conservation. We show that the present weak alignment with impact of policy targets and operational objectives for protected areas involves a great risk: targets and objectives can be achieved while making little difference to the conservation of biodiversity. We also review potential ways of increasing the difference made by protected areas, finding a poor evidence base for the use of planning and management ‘levers’ to better achieve impact. We propose a dual strategy for making protected areas more effective in their basic role of saving nature, outlining ways of developing targets and objectives focused on impact while also improving the evidence for effective planning and management. PMID:26460132

Use of Probabilistic Risk Assessment in Shuttle Decision Making Process

NASA Technical Reports Server (NTRS)

Boyer, Roger L.; Hamlin, Teri, L.

2011-01-01

This slide presentation reviews the use of Probabilistic Risk Assessment (PRA) to assist in the decision making for the shuttle design and operation. Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and disciplined approach to identifying and analyzing risk in complex systems and/or processes that seeks answers to three basic questions: (i.e., what can go wrong? what is the likelihood of these occurring? and what are the consequences that could result if these occur?) The purpose of the Shuttle PRA (SPRA) is to provide a useful risk management tool for the Space Shuttle Program (SSP) to identify strengths and possible weaknesses in the Shuttle design and operation. SPRA was initially developed to support upgrade decisions, but has evolved into a tool that supports Flight Readiness Reviews (FRR) and near real-time flight decisions. Examples of the use of PRA for the shuttle are reviewed.

[National health fund and morbidity-based risk structure equalization with focus on haemophilia].

PubMed

König, T

2010-11-01

The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbidity-based risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying levels of contributory income of the members of a health insurance (basic wage totals) and expenditure differences due to varying distribution of morbidity risks across different health insurances, as well as the varying numbers of non-contributing insured family members. Additionally, insured persons are allocated to morbidity groups according to a classification model based upon diagnoses and prescriptions anticipating medical expenses in the subsequent year. Haemophilia falls, among 80 disease entities, in the morbidity group which generates the highest risk supplement. Matching of prescribed drugs with disease entities facilitates disease grading and improves the accuracy of risk supplements.

Diabetic emergencies including hypoglycemia during Ramadan

PubMed Central

Ahmad, Jamal; Pathan, Md Faruque; Jaleel, Mohammed Abdul; Fathima, Farah Naaz; Raza, Syed Abbas; Khan, A. K. Azad; Ishtiaq, Osama; Sheikh, Aisha

2012-01-01

Majority of physicians are of the opinion that Ramadan fasting is acceptable for well-balanced type 2 patients conscious of their disease and compliant with their diet and drug intake. Fasting during Ramadan for patients with diabetes carries a risk of an assortment of complications. Islamic rules allow patients not to fast. However, if patient with diabetes wish to fast, it is necessary to advice them to undertake regular monitoring of blood glucose levels several times a day, to reduce the risk of hypoglycemia during day time fasting or hyperglycemia during the night. Patient with type 1 diabetes who fast during Ramadan may be better managed with fast-acting insulin. They should have basic knowledge of carbohydrate metabolism, the standard principles of diabetes care, and pharmacology of various antidiabetic drugs. This Consensus Statement describes the management of the various diabetic emergencies that may occur during Ramadan. PMID:22837906

Safe teleradiology: information assurance as project planning methodology.

PubMed

Collmann, Jeff; Alaoui, Adil; Nguyen, Dan; Lindisch, David

2005-01-01

The Georgetown University Medical Center Department of Radiology used a tailored version of OCTAVE, a self-directed information security risk assessment method, to design a teleradiology system that complied with the regulation implementing the security provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The system addressed threats to and vulnerabilities in the privacy and security of protected health information. By using OCTAVE, Georgetown identified the teleradiology program's critical assets, described threats to the assurance of those assets, developed and ran vulnerability scans of a system pilot, evaluated the consequences of security breaches, and developed a risk management plan to mitigate threats to program assets, thereby implementing good information assurance practices. This case study illustrates the basic point that prospective, comprehensive planning to protect the privacy and security of an information system strategically benefits program management as well as system security.

Estimating the NIH efficient frontier.

PubMed

Bisias, Dimitrios; Lo, Andrew W; Watkins, James F

2012-01-01

The National Institutes of Health (NIH) is among the world's largest investors in biomedical research, with a mandate to: "…lengthen life, and reduce the burdens of illness and disability." Its funding decisions have been criticized as insufficiently focused on disease burden. We hypothesize that modern portfolio theory can create a closer link between basic research and outcome, and offer insight into basic-science related improvements in public health. We propose portfolio theory as a systematic framework for making biomedical funding allocation decisions-one that is directly tied to the risk/reward trade-off of burden-of-disease outcomes. Using data from 1965 to 2007, we provide estimates of the NIH "efficient frontier", the set of funding allocations across 7 groups of disease-oriented NIH institutes that yield the greatest expected return on investment for a given level of risk, where return on investment is measured by subsequent impact on U.S. years of life lost (YLL). The results suggest that NIH may be actively managing its research risk, given that the volatility of its current allocation is 17% less than that of an equal-allocation portfolio with similar expected returns. The estimated efficient frontier suggests that further improvements in expected return (89% to 119% vs. current) or reduction in risk (22% to 35% vs. current) are available holding risk or expected return, respectively, constant, and that 28% to 89% greater decrease in average years-of-life-lost per unit risk may be achievable. However, these results also reflect the imprecision of YLL as a measure of disease burden, the noisy statistical link between basic research and YLL, and other known limitations of portfolio theory itself. Our analysis is intended to serve as a proof-of-concept and starting point for applying quantitative methods to allocating biomedical research funding that are objective, systematic, transparent, repeatable, and expressly designed to reduce the burden of disease. By approaching funding decisions in a more analytical fashion, it may be possible to improve their ultimate outcomes while reducing unintended consequences.

Managing problematic severe asthma: beyond the guidelines.

PubMed

Pike, Katharine C; Levy, Mark L; Moreiras, John; Fleming, Louise

2018-04-01

This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management. Basic asthma management requires optimisation of inhaler technique and treatment adherence, avoidance of environmental triggers and self-management education. It is also important that clinicians recognise risk factors that predispose patients to asthma exacerbations and potentially life-threatening attacks. These correctable issues need to be tackled in partnership with children and young people and their families. This requires a coordinated approach between professionals across healthcare settings. Establishing appropriate infrastructure for coordinated asthma care benefits not only those with problematic severe asthma, but also the wider asthma population as similar correctable issues exist for children with asthma of all severities. Investigation and management of genuine severe asthma requires specialist multidisciplinary expertise and a systematic approach to characterising patients' asthma phenotypes and delivering individualised care. While inhaled corticosteroids continue to play a leading role in asthma therapy, new treatments on the horizon might further support phenotype-specific therapy. © 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.

An agent based architecture for high-risk neonate management at neonatal intensive care unit.

PubMed

Malak, Jaleh Shoshtarian; Safdari, Reza; Zeraati, Hojjat; Nayeri, Fatemeh Sadat; Mohammadzadeh, Niloofar; Farajollah, Seide Sedighe Seied

2018-01-01

In recent years, the use of new tools and technologies has decreased the neonatal mortality rate. Despite the positive effect of using these technologies, the decisions are complex and uncertain in critical conditions when the neonate is preterm or has a low birth weight or malformations. There is a need to automate the high-risk neonate management process by creating real-time and more precise decision support tools. To create a collaborative and real-time environment to manage neonates with critical conditions at the NICU (Neonatal Intensive Care Unit) and to overcome high-risk neonate management weaknesses by applying a multi agent based analysis and design methodology as a new solution for NICU management. This study was a basic research for medical informatics method development that was carried out in 2017. The requirement analysis was done by reviewing articles on NICU Decision Support Systems. PubMed, Science Direct, and IEEE databases were searched. Only English articles published after 1990 were included; also, a needs assessment was done by reviewing the extracted features and current processes at the NICU environment where the research was conducted. We analyzed the requirements and identified the main system roles (agents) and interactions by a comparative study of existing NICU decision support systems. The Universal Multi Agent Platform (UMAP) was applied to implement a prototype of our multi agent based high-risk neonate management architecture. Local environment agents interacted inside a container and each container interacted with external resources, including other NICU systems and consultation centers. In the NICU container, the main identified agents were reception, monitoring, NICU registry, and outcome prediction, which interacted with human agents including nurses and physicians. Managing patients at the NICU units requires online data collection, real-time collaboration, and management of many components. Multi agent systems are applied as a well-known solution for management, coordination, modeling, and control of NICU processes. We are currently working on an outcome prediction module using artificial intelligence techniques for neonatal mortality risk prediction. The full implementation of the proposed architecture and evaluation is considered the future work.

41 CFR 102-74.10 - What is the basic facility management policy?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the basic facility management policy? 102-74.10 Section 102-74.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY...

Econometric analysis of the impact of the relationship of GDP and the pension capital

NASA Astrophysics Data System (ADS)

Nepp, A. N.; Amiryan, A. A.

2016-12-01

The article demonstrates the impact of institutional risks on indicators of compulsory pension insurance and describes the results of a comparative analysis of investment risks faced by the pension systems of the Russian Federation and OECD countries. Efficiency of private companies managing pension funds in Russia and OECD countries is compared and analyzed to show the necessity to liberalize requirements placed on investments of pension savings funds. On the basis of the available statistical data, the article puts forward and discusses the hypothesis that increasing of the basic indicators of the pension system is possible by reducing its institutional risks. It is concluded that if the institutional risks are reduced and the level of trust increases, there will be enhance growth in the pension system key indicators, such as pension payments and the replacement rate.

Application of Risk-Based Inspection method for gas compressor station

NASA Astrophysics Data System (ADS)

Zhang, Meng; Liang, Wei; Qiu, Zeyang; Lin, Yang

2017-05-01

According to the complex process and lots of equipment, there are risks in gas compressor station. At present, research on integrity management of gas compressor station is insufficient. In this paper, the basic principle of Risk Based Inspection (RBI) and the RBI methodology are studied; the process of RBI in the gas compressor station is developed. The corrosion loop and logistics loop of the gas compressor station are determined through the study of corrosion mechanism and process of the gas compressor station. The probability of failure is calculated by using the modified coefficient, and the consequence of failure is calculated by the quantitative method. In particular, we addressed the application of a RBI methodology in a gas compressor station. The risk ranking is helpful to find the best preventive plan for inspection in the case study.

Injury during U.S. Army basic combat training: a systematic review of risk factor studies.

PubMed

Bulzacchelli, Maria T; Sulsky, Sandra I; Rodriguez-Monguio, Rosa; Karlsson, Lee H; Hill, Maj Owen T

2014-12-01

Approximately one quarter of men and half of women in U.S. Army basic combat training experience an injury. Preventing basic combat training-related injuries would reduce associated human and economic costs and discharges from the Army. Identification of risk factors for such injuries is a crucial step toward their prevention. Although some research has begun to address this need, prior studies of risk factors for training-related injury have not been reviewed systematically. This study systematically reviews the literature on risk factors for injury during U.S. Army basic combat training. Original studies of risk factors for injury during U.S. Army basic combat training published since 1990 in peer-reviewed journals were identified using PubMed and manual searches of reference lists. This search was last performed in May 2013. Nineteen studies met the inclusion criteria. Methodologic quality and potential for bias were assessed. The findings of 11 studies deemed to be of high or medium quality were synthesized to determine the level of evidence supporting the association between each risk factor studied and risk of injury during basic combat training. Quality assessment and evidence synthesis were performed from June to September 2013. There is strong or moderate evidence supporting association of older age, history of smoking, and self-rated low physical activity level prior to basic combat training with increased risk of training-related injury among male trainees. There is limited, mixed, or insufficient evidence to identify risk factors for injury among female trainees. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Rutgers Young Horse Teaching and Research Program: sustainability of taking a risk with "at risk" horses.

PubMed

Ralston, Sarah L; Molnar, Anne

2012-12-01

In 1999, the Young Horse Teaching and Research Program (YHTRP) was initiated at Rutgers University. The unique aspect of the program was using horses generally considered "at risk" and in need of rescue, but of relatively low value. The risks of using horses from pregnant mare urine (PMU) ranches and Bureau of Land Management (BLM) mustangs were high, but, ultimately, unrealized. No students or staff members were seriously injured over the course of the next 12 yr, and the horses were sold annually as highly desirable potential athletes or pleasure horses, usually at a profit. The use of "at risk" horses generated a significant amount of positive media attention and attracted substantial funding in the form of donations and sponsorships, averaging over $60,000 (USD)per year. Despite economic downturns, public and industry support provided sustainability for the program with only basic University infrastructural support. Taking the risk of using "at risk" horses paid off, with positive outcomes for all.

Clinical review: Medication errors in critical care

PubMed Central

Moyen, Eric; Camiré, Eric; Stelfox, Henry Thomas

2008-01-01

Medication errors in critical care are frequent, serious, and predictable. Critically ill patients are prescribed twice as many medications as patients outside of the intensive care unit (ICU) and nearly all will suffer a potentially life-threatening error at some point during their stay. The aim of this article is to provide a basic review of medication errors in the ICU, identify risk factors for medication errors, and suggest strategies to prevent errors and manage their consequences. PMID:18373883

Time Safety Margin: Theory and Practice

DTIC Science & Technology

2016-09-01

Basic Dive Recovery Terminology The Simplest Definition of TSM: Time Safety Margin is the time to directly travel from the worst-case vector to an...Safety Margin (TSM). TSM is defined as the time in seconds to directly travel from the worst case vector (i.e. worst case combination of parameters...invoked by this AFI, base recovery planning and risk management upon the calculated TSM. TSM is the time in seconds to di- rectly travel from the worst case

Improving traffic signal management and operations : a basic service model.

DOT National Transportation Integrated Search

2009-12-01

This report provides a guide for achieving a basic service model for traffic signal management and : operations. The basic service model is based on simply stated and defensible operational objectives : that consider the staffing level, expertise and...

Profile of Knowledge Management, Basic Sanitation and Attitudes towards Clean and Health Community in Kupang City

ERIC Educational Resources Information Center

Nikmah; Ardi, Muhammad; Yahya, Mohamad; Upa, Muhamad D. Pua; Dirawan, Gufran Darma

2017-01-01

The objective of research is to describe the knowledge and attitude of basic sanitation management community in Kupang City. This type of research is a survey research using quantitative approach. Data were collected by using the instrument in the form of test knowledge of basic sanitation management and attitude questionnaire. The data was then…

Covariance Manipulation for Conjunction Assessment

NASA Technical Reports Server (NTRS)

Hejduk, M. D.

2016-01-01

The manipulation of space object covariances to try to provide additional or improved information to conjunction risk assessment is not an uncommon practice. Types of manipulation include fabricating a covariance when it is missing or unreliable to force the probability of collision (Pc) to a maximum value ('PcMax'), scaling a covariance to try to improve its realism or see the effect of covariance volatility on the calculated Pc, and constructing the equivalent of an epoch covariance at a convenient future point in the event ('covariance forecasting'). In bringing these methods to bear for Conjunction Assessment (CA) operations, however, some do not remain fully consistent with best practices for conducting risk management, some seem to be of relatively low utility, and some require additional information before they can contribute fully to risk analysis. This study describes some basic principles of modern risk management (following the Kaplan construct) and then examines the PcMax and covariance forecasting paradigms for alignment with these principles; it then further examines the expected utility of these methods in the modern CA framework. Both paradigms are found to be not without utility, but only in situations that are somewhat carefully circumscribed.

Improved Financial Capability Can Reduce Material Hardship among Mothers.

PubMed

Huang, Jin; Nam, Yunju; Sherraden, Michael; Clancy, Margaret M

2016-10-01

This study draws on the theoretical framework of financial capability in investigating whether financial access (that is, availability of financial products and services) and financial knowledge (that is, understanding of basic financial concepts) can influence the risk of material hardship. Authors examine the possibility of direct associations as well as of indirect ones in which financial management (that is, individual financial behaviors) serves as a mediator. The probability sample of mothers with young children born in Oklahoma during 2007 (N = 2,529) was selected from Oklahoma birth certificates. Results from structural equation modeling analyses show that financial access is positively associated with financial management (p < 0.001) but that financial knowledge is not; both financial access (p < 0.001) and financial management (p < 0.001) are negatively correlated with material hardship. Similar results are obtained from analyses with a subsample of low-income mothers. Findings suggest that financial capability, particularly the financial access component, is critical for improving financial management and reducing the risk of material hardship among mothers with young children, including low-income mothers. Efforts to promote financial capability offer social workers an important strategy for improving their clients’ economic well-being.

Factor Analysis of Traffic Safety in Urban Roads Based on FTA-LEC

NASA Astrophysics Data System (ADS)

Shuicheng, TIAN; Xingbo, YANG; Xiaoqing, SHEN; Detao, ZHANG

2018-05-01

In order to reduce the number and the loss of urban road traffic accidents in our country, improve the safety of road traffic, a statistical analysis of the research report on major road traffic accidents in 2016 was conducted. The risk factors affecting urban road traffic in China were analyzed by using FTA to find the basic hidden events. Secondly, the risk value of the identified hidden danger events were calculated and classified into four levels I, II, III and IV through the LEC evaluation method. Finally, the graded results of risk factors are verified through a case of specific accidents in Beijing. The results show that: the case verified the scientificalness and effectiveness of hazard classification and provided guidance for urban road traffic management.

Rigid bronchoscopy and silicone stents in the management of central airway obstruction

PubMed Central

Yarmus, Lonny

2015-01-01

The field of interventional pulmonology has grown significantly over the past several decades now including the diagnosis and therapeutic treatment of complex airway disease. Rigid bronchoscopy is an invaluable tool in the diagnosis and management of several malignant and non-malignant causes of central airway obstruction (CAO) and has become integral after the inception of airway stenting. The management of CAO can be a complicated endeavor with significant risks making the understanding of basic rigid bronchoscopy techniques, ablative technologies, anesthetic care and stenting of utmost importance in the care of these complex patients. This review article will focus on the history of rigid bronchoscopy, the technical aspects of performing a rigid bronchoscopy as well as the use of silicone stents their indications, complications and placement techniques. PMID:26807283

Chronic Mountain Sickness: Clinical Aspects, Etiology, Management, and Treatment

PubMed Central

Corante, Noemí

2016-01-01

Abstract Villafuerte, Francisco C., and Noemí Corante. Chronic mountain sickness: clinical aspects, etiology, management, and treatment. High Alt Med Biol. 17:61–69, 2016.—Millions of people worldwide live at a high altitude, and a significant number are at risk of developing Chronic Mountain Sickness (CMS), a progressive incapacitating syndrome caused by lifelong exposure to hypoxia. CMS is characterized by severe symptomatic excessive erythrocytosis (EE; Hb ≥19 g/dL for women and Hb ≥21 g/dL for men) and accentuated hypoxemia, which are frequently associated with pulmonary hypertension. In advanced cases, the condition may evolve to cor pulmonale and congestive heart failure. Current knowledge indicates a genetic predisposition to develop CMS. However, there are important risk factors and comorbidities that may trigger and aggravate the condition. Thus, appropriate medical information on CMS is necessary to provide adequate diagnosis and healthcare to high-altitude inhabitants. After reviewing basic clinical aspects of CMS, including its definition, diagnosis, and common clinical findings, we discuss aspects of its etiology, and address its epidemiology, risk factors, and treatment. PMID:27218284

Managing stress in a crisis.

PubMed

Wright-Reid, Alison

2018-01-01

Crisis situations are inherently uncertain and threatening. Although the primal stress reactions they provoke deliver some advantages, they so severely restrict intellect and behaviour that consultants observe crisis teams making the same mistakes over and again. Stress risks can be managed before, during and after a crisis. Crisis planning can select the right people, control the crisis team environment, and mitigate fatigue risks and memory demands. Because stress reactions are primitive, stress can be manipulated at a remarkably primitive level and teams can increase their resilience through such basics as sleep and breathing skills. Teams can learn to manipulate perceptions of danger, to tolerate uncertainty and to become comfortable making decisions which were reasonable at the time. Crisis leaders can frame the crisis as a challenge and options as gains, and can ensure the team avoids groupthink and challenges the paradigm. Where individuals are trained to apply critical thinking processes, intuitive decision-making is not only fast, but also accurate, and helps to challenge assumptions, predictions and groupthink. Crises are more easily recognised and managed where training has covered critical decision methods.

Data Analysis

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

Powell, Danny H; Elwood Jr, Robert H

2011-01-01

Analysis of the material protection, control, and accountability (MPC&A) system is necessary to understand the limits and vulnerabilities of the system to internal threats. A self-appraisal helps the facility be prepared to respond to internal threats and reduce the risk of theft or diversion of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) fault tree was developed to depict the failure of the MPC&A system as a result of poor practices and random failures in the MC&A system. It can also be employed as a basis for assessing deliberate threats against a facility. MSET uses faultmore » tree analysis, which is a top-down approach to examining system failure. The analysis starts with identifying a potential undesirable event called a 'top event' and then determining the ways it can occur (e.g., 'Fail To Maintain Nuclear Materials Under The Purview Of The MC&A System'). The analysis proceeds by determining how the top event can be caused by individual or combined lower level faults or failures. These faults, which are the causes of the top event, are 'connected' through logic gates. The MSET model uses AND-gates and OR-gates and propagates the effect of event failure using Boolean algebra. To enable the fault tree analysis calculations, the basic events in the fault tree are populated with probability risk values derived by conversion of questionnaire data to numeric values. The basic events are treated as independent variables. This assumption affects the Boolean algebraic calculations used to calculate results. All the necessary calculations are built into the fault tree codes, but it is often useful to estimate the probabilities manually as a check on code functioning. The probability of failure of a given basic event is the probability that the basic event primary question fails to meet the performance metric for that question. The failure probability is related to how well the facility performs the task identified in that basic event over time (not just one performance or exercise). Fault tree calculations provide a failure probability for the top event in the fault tree. The basic fault tree calculations establish a baseline relative risk value for the system. This probability depicts relative risk, not absolute risk. Subsequent calculations are made to evaluate the change in relative risk that would occur if system performance is improved or degraded. During the development effort of MSET, the fault tree analysis program used was SAPHIRE. SAPHIRE is an acronym for 'Systems Analysis Programs for Hands-on Integrated Reliability Evaluations.' Version 1 of the SAPHIRE code was sponsored by the Nuclear Regulatory Commission in 1987 as an innovative way to draw, edit, and analyze graphical fault trees primarily for safe operation of nuclear power reactors. When the fault tree calculations are performed, the fault tree analysis program will produce several reports that can be used to analyze the MPC&A system. SAPHIRE produces reports showing risk importance factors for all basic events in the operational MC&A system. The risk importance information is used to examine the potential impacts when performance of certain basic events increases or decreases. The initial results produced by the SAPHIRE program are considered relative risk values. None of the results can be interpreted as absolute risk values since the basic event probability values represent estimates of risk associated with the performance of MPC&A tasks throughout the material balance area (MBA). The RRR for a basic event represents the decrease in total system risk that would result from improvement of that one event to a perfect performance level. Improvement of the basic event with the greatest RRR value produces a greater decrease in total system risk than improvement of any other basic event. Basic events with the greatest potential for system risk reduction are assigned performance improvement values, and new fault tree calculations show the improvement in total system risk. The operational impact or cost-effectiveness from implementing the performance improvements can then be evaluated. The improvements being evaluated can be system performance improvements, or they can be potential, or actual, upgrades to the system. The RIR for a basic event represents the increase in total system risk that would result from failure of that one event. Failure of the basic event with the greatest RIR value produces a greater increase in total system risk than failure of any other basic event. Basic events with the greatest potential for system risk increase are assigned failure performance values, and new fault tree calculations show the increase in total system risk. This evaluation shows the importance of preventing performance degradation of the basic events. SAPHIRE identifies combinations of basic events where concurrent failure of the events results in failure of the top event.« less

The hexagon hypothesis: Six disruptive scenarios.

PubMed

Burtles, Jim

2015-01-01

This paper aims to bring a simple but effective and comprehensive approach to the development, delivery and monitoring of business continuity solutions. To ensure that the arguments and principles apply across the board, the paper sticks to basic underlying concepts rather than sophisticated interpretations. First, the paper explores what exactly people are defending themselves against. Secondly, the paper looks at how defences should be set up. Disruptive events tend to unfold in phases, each of which invites a particular style of protection, ranging from risk management through to business continuity to insurance cover. Their impact upon any business operation will fall into one of six basic scenarios. The hexagon hypothesis suggests that everyone should be prepared to deal with each of these six disruptive scenarios and it provides them with a useful benchmark for business continuity.

41 CFR 102-80.10 - What are the basic safety and environmental management policies for real property?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What are the basic safety and environmental management policies for real property? 102-80.10 Section 102-80.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL...

Resilient Practices in Maintaining Safety of Health Information Technologies

PubMed Central

Ash, Joan S.; Sittig, Dean F.; Singh, Hardeep

2014-01-01

Electronic health record systems (EHRs) can improve safety and reliability of health care, but they can also introduce new vulnerabilities by failing to accommodate changes within a dynamic EHR-enabled health care system. Continuous assessment and improvement is thus essential for achieving resilience in EHR-enabled health care systems. Given the rapid adoption of EHRs by many organizations that are still early in their experiences with EHR safety, it is important to understand practices for maintaining resilience used by organizations with a track record of success in EHR use. We conducted interviews about safety practices with 56 key informants (including information technology managers, chief medical information officers, physicians, and patient safety officers) at two large health care systems recognized as leaders in EHR use. We identified 156 references to resilience-related practices from 41 informants. Framework analysis generated five categories of resilient practices: (a) sensitivity to dynamics and interdependencies affecting risks, (b) basic monitoring and responding practices, (c) management of practices and resources for monitoring and responding, (d) sensitivity to risks beyond the horizon, and (e) reflecting on risks with the safety and quality control process itself. The categories reflect three functions that facilitate resilience: reflection, transcending boundaries, and involving sharp-end practitioners in safety management. PMID:25866492

Foot care education in patients with diabetes at low risk of complications: a consensus statement

PubMed Central

McInnes, A; Jeffcoate, W; Vileikyte, L; Game, F; Lucas, K; Higson, N; Stuart, L; Church, A; Scanlan, J; Anders, J

2011-01-01

Aims To define and agree a practical educational framework for delivery by all healthcare professionals managing patients with diabetes, particularly those at low risk of developing foot complications. Methods A consensus meeting of a multidisciplinary expert panel. Prior to the meeting, relevant clinical papers were disseminated to the panel for review. The consensus was largely based upon the experts’ clinical experience and judgement. Results Four main health behaviours were identified for those at low risk of developing foot complications, namely:, control of blood glucose levels; attendance at annual foot screening examination; reporting of any changes in foot health immediately; and the engagement in a simple daily foot care routine. Conclusion There is currently little evidence-based literature to support specific foot care practices. Patients with diabetes at low risk of developing complications should be encouraged to undertake a basic foot care regimen to reduce their likelihood of developing complications. PMID:21219423

Cardiovascular risk after androgen deprivation therapy for prostate cancer: an Asian perspective.

PubMed

Teoh, Jeremy Yuen Chun; Ng, Chi-Fai

2016-09-01

Androgen deprivation therapy (ADT) plays an important role in managing prostate cancer. However, ADT may result in major cardiovascular events and potentially lead to fatal consequences. Cardiovascular disease is the leading cause of mortality and it is a very important health condition to look into. Asians and Caucasians differ both physiologically and genetically, and they may have display different cardiovascular profiles. In this article, we reviewed the literature focusing on the cardiovascular risk after ADT for prostate cancer in the Asian population. We would discuss about the pathogenesis of ADT leading to cardiovascular events, summarize the findings concerning cardiac and stroke risks after ADT, compare between the different modalities of ADT and also provide genetic basics which are unique to Asians. We hope this article would provide more insights into the cardiovascular risk after ADT for prostate cancer in an Asian perspective.

Biological and communication skills needed for introduced fish biologists

USGS Publications Warehouse

Bonar, Scott A.

2016-01-01

What skills and knowledge will a new graduate seeking employment need to work with introduced fishes? Clearly, success in introduced species management—similar to other disciplines in fisheries—requires a mixture of scientific and communication skills. However, specific abilities especially important to a biologist who manages introduced fishes should be highlighted. Unlike most other management strategies, stocking an introduced species can result in unintended and irreversible impacts, so particular care must be employed when stocking is considered. Furthermore, fish populations in areas outside of the introduced species management area might also be affected, usually negatively, if the introduced fish escapes. Therefore, rock-solid knowledge of basic aquatic ecology, including risk management; fish taxonomy (so the wrong fish species is not mistakenly stocked!); familiarity with human values of both the time and the place (which requires communication skills); and a strong understanding of human history are all important.

Comparative risk analysis of technological hazards (a review).

PubMed Central

Kates, R W; Kasperson, J X

1983-01-01

Hazards are threats to people and what they value and risks are measures of hazards. Comparative analyses of the risks and hazards of technology can be dated to Starr's 1969 paper [Starr, C. (1969) Science 165, 1232-1238] but are rooted in recent trends in the evolution of technology, the identification of hazard, the perception of risk, and the activities of society. These trends have spawned an interdisciplinary quasi profession with new terminology, methodology, and literature. A review of 54 English-language monographs and book-length collections, published between 1970 and 1983, identified seven recurring themes: (i) overviews of the field of risk assessment, (ii) efforts to estimate and quantify risk, (iii) discussions of risk acceptability, (iv) perception, (v) analyses of regulation, (vi) case studies of specific technological hazards, and (vii) agenda for research. Within this field, science occupies a unique niche, for many technological hazards transcend the realm of ordinary experience and require expert study. Scientists can make unique contributions to each area of hazard management but their primary contribution is the practice of basic science. Beyond that, science needs to further risk assessment by understanding the more subtle processes of hazard creation and by establishing conventions for estimating risk and for presenting and handling uncertainty. Scientists can enlighten the discussion of tolerable risk by setting risks into comparative contexts, by studying the process of evaluation, and by participating as knowledgeable individuals, but they cannot decide the issue. Science can inform the hazard management process by broadening the range of alternative control actions and modes of implementation and by devising methods to evaluate their effectiveness. PMID:6580625

Sustainment in the Army 2020: Using the Army’s Sustainment Principles to Identify and Mitigate Risks Associated with Organizational Change

DTIC Science & Technology

2015-06-12

redesign itself to be better suited to a post Cold War world . In 2008, the Army established the brigade combat team as the primary basic unit of...important to understand models established for the business world and not just those used by the military. Historically, the term logistics as we know...involves every possible phase of the product support process.12 Peter Drucker, a renowned management consultant, argued that logistics is

A Study on the Priority Selection of Sediment-related Desaster Evacuation Using Debris Flow Combination Degree of Risk

NASA Astrophysics Data System (ADS)

Woo, C.; Kang, M.; Seo, J.; Kim, D.; Lee, C.

2017-12-01

As the mountainous urbanization has increased the concern about landslides in the living area, it is essential to develop the technology to minimize the damage through quick identification and sharing of the disaster occurrence information. In this study, to establish an effective system of alert evacuation that has influence on the residents, we used the debris flow combination degree of risk to predict the risk of the disaster and the level of damage and to select evacuation priorities. Based on the GIS information, the physical strength and social vulnerability were determined by following the debris flow combination of the risk formula. The results classify the physical strength hazard rating of the debris flow combination of the through the normalization process. Debris flow the estimated residential population included in the damage range of the damage prediction map is based on the area and the unit size data. Prediction of occupant formula was calculated by applying different weighting to the resident population and users, and the result was classified into 5 classes as the debris flow physical strength. The debris flow occurrence physical strength and social and psychological vulnerability were classified into the classifications to be reflected in the debris flow integrated risk map using the matrix technique. In addition, to supplement the risk of incorporation of debris flow, we added weight to disaster vulnerable facilities that require a lot of time and manpower to evacuate. The basic model of welfare facilities was supplemented by using basic data, population density, employment density and GDP. First, evacuate areas with high integrated degree of risk level, and evacuate with consideration of physical class differences if classification difficult because of the same or similar grade among the management areas. When the physical hazard class difference is similar, the population difference of the area including the welfare facility is considered first, and the priority is decided in order of age distribution, population density by period, and class difference of residential facility. The results of this study are expected be used as basic data for establishing a safety net for landslide by evacuation systems for disasters. Keyword: Landslide, Debris flow, Early warning system, evacuation

Utilization of accident databases and fuzzy sets to estimate frequency of HazMat transport accidents.

PubMed

Qiao, Yuanhua; Keren, Nir; Mannan, M Sam

2009-08-15

Risk assessment and management of transportation of hazardous materials (HazMat) require the estimation of accident frequency. This paper presents a methodology to estimate hazardous materials transportation accident frequency by utilizing publicly available databases and expert knowledge. The estimation process addresses route-dependent and route-independent variables. Negative binomial regression is applied to an analysis of the Department of Public Safety (DPS) accident database to derive basic accident frequency as a function of route-dependent variables, while the effects of route-independent variables are modeled by fuzzy logic. The integrated methodology provides the basis for an overall transportation risk analysis, which can be used later to develop a decision support system.

Chest Trauma in Athletic Medicine.

PubMed

Phillips, Nicholas R; Kunz, Derek E

2018-03-01

While overall sports participation continues at high rates, chest injuries occur relatively infrequently. Many conditions of chest injury are benign, related to simple contusions and strains, but the more rare, severe injuries carry a much higher risk of morbidity and mortality than the typical issues encountered in athletic medicine. Missed or delayed diagnosis can prove to be catastrophic. Sports medicine providers must be prepared to encounter a wide range of traumatic conditions relating to the torso, varying from the benign chest wall contusion to the life-threatening tension pneumothorax. Basic field-side management should be rapid and focused, using the standardized approach of Advanced Traumatic Life Support protocol. Early and appropriate diagnosis and management can help allow safe and enjoyable sports participation.

Substance Abuse Prevention, Assessment, and Treatment for Lesbian, Gay, Bisexual, and Transgender Youth.

PubMed

Aromin, Romulo Alcalde

2016-12-01

Knowing how to manage substance abuse in all youth is an important aspect of pediatric care, including providing clinically appropriate anticipatory guidance, monitoring, assessment, and treatment. Although most lesbian, gay, bisexual, and transgender (LGBT) youth do not abuse substances, as a group they experience unique challenges in self-identity development that put them at an increased risk for substance abuse. This article addresses prevention and management of substance use in LGBT youth relevant to pediatrics and allied professions as an aspect of their overall health care. It reviews basic information about substance abuse in youth and special considerations for LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

Affective science perspectives on cancer control: strategically crafting a mutually beneficial research agenda.

PubMed

Ferrer, Rebecca A; Green, Paige A; Barrett, Lisa Feldman

2015-05-01

Cancer control research involves the conduct of basic and applied behavioral and social sciences to reduce cancer incidence, morbidity, and mortality and improve quality of life. Given the importance of behavior in cancer control, fundamental research is necessary to identify psychological mechanisms underlying cancer risk, prevention, and management behaviors. Cancer prevention, diagnosis, and treatment are often emotionally laden. As such, affective science research to elucidate questions related to the basic phenomenological nature of emotion, stress, and mood is necessary to understand how cancer control can be hindered or facilitated by emotional experiences. To date, the intersection of basic affective science research and cancer control remains largely unexplored. The goal of this article is to outline key questions in the cancer control research domain that provide an ecologically valid context for new affective science discoveries. We also provide examples of ways in which basic affective discoveries could inform future cancer prevention and control research. These examples are not meant to be exhaustive or prescriptive but instead are offered to generate creative thought about the promise of a cancer research context for answering basic affective science questions. Together, these examples provide a compelling argument for fostering collaborations between affective and cancer control scientists. © The Author(s) 2015.

Proactive and Early Aggressive Wound Management: A Shift in Strategy Developed by a Consensus Panel Examining the Current Science, Prevention, and Management of Acute and Chronic Wounds.

PubMed

Bohn, Gregory A; Schultz, Gregory S; Liden, Brock A; Desvigne, Michael N; Lullove, Eric J; Zilberman, Igor; Regan, Mary B; Ostler, Marta; Edwards, Karen; Arvanitis, Georgia M; Hartman, Jodi F

2017-11-01

Normal wound healing is accomplished through a series of well-coordinated, progressive events with overlapping phases. Chronic wounds are described as not progressing to healing or not being responsive to management in a timely manner. A consensus panel of multidisciplinary wound care professionals was assembled to (1) educate wound care practitioners by identifying key principles of the basic science of chronic wound pathophysiology, highlighting the impact of metalloproteinases and biofilms, as well as the role of the extracellular matrix; and (2) equip practitioners with a systematic strategy for the prevention and healing of acute injuries and chronic wounds based upon scientific evidence and the panel members' expertise. An algorithm is presented that represents a shift in strategy to proactive and early aggressive wound management. With proactive management, adjunct therapies are applied preemptively to acute injuries to reduce wound duration and risk of chronicity. For existing chronic wounds, early aggressive wound management is employed to break the pathophysiology cycle and drive wounds toward healing. Reducing bioburden through debridement and bioburden management and using collagen dressings to balance protease activity prior to the use of advanced modalities may enhance their effectiveness. This early aggressive wound management strategy is recommended for patients at high risk for chronic wound development at a minimum. In their own practices, the panel members apply this systematic strategy for all patients presenting with acute injuries or chronic wounds.

Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America

PubMed Central

Perfect, John R.; Dismukes, William E.; Dromer, Francoise; Goldman, David L.; Graybill, John R.; Hamill, Richard J.; Harrison, Thomas S.; Larsen, Robert A.; Lortholary, Olivier; Nguyen, Minh-Hong; Pappas, Peter G.; Powderly, William G.; Singh, Nina; Sobel, Jack D.; Sorrell, Tania C.

2018-01-01

Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. These guidelines for its management have been built on the previous Infectious Diseases Society of America guidelines from 2000 and include new sections. There is a discussion of the management of cryptococcal meningoencephalitis in 3 risk groups: (1) human immunodeficiency virus (HIV)–infected individuals, (2) organ transplant recipients, and (3) non–HIV-infected and nontransplant hosts. There are specific recommendations for other unique risk populations, such as children, pregnant women, persons in resource-limited environments, and those with Cryptococcus gattii infection. Recommendations for management also include other sites of infection, including strategies for pulmonary crypto-coccosis. Emphasis has been placed on potential complications in management of cryptococcal infection, including increased intracranial pressure, immune reconstitution inflammatory syndrome (IRIS), drug resistance, and crypto-coccomas. Three key management principles have been articulated: (1) induction therapy for meningoencephalitis using fungicidal regimens, such as a polyene and flucytosine, followed by suppressive regimens using fluconazole; (2) importance of early recognition and treatment of increased intracranial pressure and/or IRIS; and (3) the use of lipid formulations of amphotericin B regimens in patients with renal impairment. Cryptococcosis remains a challenging management issue, with little new drug development or recent definitive studies. However, if the diagnosis is made early, if clinicians adhere to the basic principles of these guidelines, and if the underlying disease is controlled, then cryptococcosis can be managed successfully in the vast majority of patients. PMID:20047480

ASTARTE: Assessment Strategy and Risk Reduction for Tsunamis in Europe

NASA Astrophysics Data System (ADS)

Baptista, M. A.; Yalciner, A. C.; Canals, M.

2014-12-01

Tsunamis are low frequency but high impact natural disasters. In 2004, the Boxing Day tsunami killed hundreds of thousands of people from many nations along the coastlines of the Indian Ocean. Tsunami run-up exceeded 35 m. Seven years later, and in spite of some of the best warning technologies and levels of preparedness in the world, the Tohoku-Oki tsunami in Japan dramatically showed the limitations of scientific knowledge on tsunami sources, coastal impacts and mitigation measures. The experience from Japan raised serious questions on how to improve the resilience of coastal communities, to upgrade the performance of coastal defenses, to adopt a better risk management, and also on the strategies and priorities for the reconstruction of damaged coastal areas. Societal resilience requires the reinforcement of capabilities to manage and reduce risk at national and local scales.ASTARTE (Assessment STrategy And Risk for Tsunami in Europe), a 36-month FP7 project, aims to develop a comprehensive strategy to mitigate tsunami impact in this region. To achieve this goal, an interdisciplinary consortium has been assembled. It includes all CTWPs of NEAM and expert institutions across Europe and worldwide. ASTARTE will improve i) basic knowledge of tsunami generation and recurrence going beyond simple catalogues, with novel empirical data and new statistical analyses for assessing long-term recurrence and hazards of large events in sensitive areas of NEAM, ii) numerical techniques for tsunami simulation, with focus on real-time codes and novel statistical emulation approaches, and iii) methods for assessment of hazard, vulnerability, and risk. ASTARTE will also provide i) guidelines for tsunami Eurocodes, ii) better tools for forecast and warning for CTWPs and NTWCs, and iii) guidelines for decision makers to increase sustainability and resilience of coastal communities. In summary, ASTARTE will develop basic scientific and technical elements allowing for a significant enhancement of the Tsunami Warning System in the NEAM region in terms of monitoring, early warning and forecast, governance and resilience. This work is funded by project ASTARTE - Assessment, STrategy And Risk Reduction for Tsunamis in Europe. Grant 603839, 7th FP (ENV.2013.6.4-3 ENV.2013.6.4-3)

41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What basic design and construction policy governs Federal agencies? 102-76.10 Section 102-76.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL...

41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What basic design and... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL... must be timely, efficient, and cost effective. (b) Use a distinguished architectural style and form in...

Waterborne disease-related risk perceptions in the Sonora River basin, Mexico.

PubMed

Morua, Agustin Robles; Halvorsen, Kathleen E; Mayer, Alex S

2011-05-01

Waterborne disease is estimated to cause about 10% of all diseases worldwide. However, related risk perceptions are not well understood, particularly in the developing world where waterborne disease is an enormous problem. We focus on understanding risk perceptions related to these issues in a region within northern Mexico. Our findings show how waterborne disease problems and solutions are understood in eight small communities along a highly contaminated river system. We found major differences in risk perceptions between health professionals, government officials, and lay citizens. Health professionals believed that a high level of human-waste-related risk existed within the region. Few officials and lay citizens shared this belief. In addition, few officials and lay citizens were aware of poor wastewater-management-related disease outbreaks and water contamination. Finally, aside from health professionals, a few interviewees understood the importance of basic hygiene and water treatment measures that could help to prevent disease. Our results add to the literature on environmentally-related risk perceptions in the developing world. We discuss recommendations for improving future human-wastewater-related risk communication within the region. © 2011 Society for Risk Analysis.

Baseline and pre-operative 1-year mortality risk factors in a cohort of 509 hip fracture patients consecutively admitted to a co-managed orthogeriatric unit (FONDA Cohort).

PubMed

Menéndez-Colino, Rocío; Alarcon, Teresa; Gotor, Pilar; Queipo, Rocío; Ramírez-Martín, Raquel; Otero, Angel; González-Montalvo, Juan I

2018-03-01

The aim of this study was to determine the patient characteristics that predict 1-year mortality after a hip fracture (HF). All patients admitted consecutively with fragility HF during 1 year in a co-managed orthogeriatric unit of a university hospital (FONDA cohort) were assesed. Baseline and admission demographic, clinical, functional, analytical and body-composition variables were collected in the first 72 h after admission. A protocol designed to minimize the consequences of the HF was applied. One year after the fracture patients or their carers were contacted by telephone to ascertain their vital status. A total of 509 patients with a mean age of 85.6 years were included. One-year mortality was 23.2%. The final multivariate model included 8 independent mortality risk factors: age >85 years, baseline functional impairment in basic activities of daily living, low body mass index, cognitive impairment, heart disease, low hand-grip strength, anaemia at admission, and secondary hyperparathyroidism associated with vitamin D deficiency. The association of several of these factors greatly increased mortality risk, with an OR (95% confidence interval [CI]) of 5.372 (3.227-8.806) in patients with 4 to 5 factors, and an OR (95% CI) of 11.097 (6.432-19.144) in those with 6 or more factors. In addition to previously known factors (such as age, impairment in basic activities of daily living, cognitive impairment, malnutrition and anaemia at admission), other factors, such as muscle strength and hyperparathyroidism associated with vitamin D deficiency, are associated with greater 1-year mortality after a HF. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed

Yamashita, S

2016-04-01

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

Medication knowledge, certainty, and risk of errors in health care: a cross-sectional study

PubMed Central

2011-01-01

Background Medication errors are often involved in reported adverse events. Drug therapy, prescribed by physicians, is mostly carried out by nurses, who are expected to master all aspects of medication. Research has revealed the need for improved knowledge in drug dose calculation, and medication knowledge as a whole is poorly investigated. The purpose of this survey was to study registered nurses' medication knowledge, certainty and estimated risk of errors, and to explore factors associated with good results. Methods Nurses from hospitals and primary health care establishments were invited to carry out a multiple-choice test in pharmacology, drug management and drug dose calculations (score range 0-14). Self-estimated certainty in each answer was recorded, graded from 0 = very uncertain to 3 = very certain. Background characteristics and sense of coping were recorded. Risk of error was estimated by combining knowledge and certainty scores. The results are presented as mean (±SD). Results Two-hundred and three registered nurses participated (including 16 males), aged 42.0 (9.3) years with a working experience of 12.4 (9.2) years. Knowledge scores in pharmacology, drug management and drug dose calculations were 10.3 (1.6), 7.5 (1.6), and 11.2 (2.0), respectively, and certainty scores were 1.8 (0.4), 1.9 (0.5), and 2.0 (0.6), respectively. Fifteen percent of the total answers showed a high risk of error, with 25% in drug management. Independent factors associated with high medication knowledge were working in hospitals (p < 0.001), postgraduate specialization (p = 0.01) and completion of courses in drug management (p < 0.01). Conclusions Medication knowledge was found to be unsatisfactory among practicing nurses, with a significant risk for medication errors. The study revealed a need to improve the nurses' basic knowledge, especially when referring to drug management. PMID:21791106

Chronic Chagas disease: from basics to laboratory medicine.

PubMed

Haberland, Annekathrin; Saravia, Silvia Gilka Munoz; Wallukat, Gerd; Ziebig, Reinhard; Schimke, Ingolf

2013-02-01

Chagas disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America and has huge potential to become a worldwide problem, due to increasing migration, and international tourism, as well as infectant transfer by blood contact and transfusion, intrauterine transfer, and organ transplantation. Nearly 30% of chronically-infected patients become symptomatic, often with a latency of 10-30 years, developing life-threatening complications. Of those, nearly 90% develop Chagas heart disease, while the others manifest gastrointestinal disease and neuronal disorders. Besides interrupting the infection cycle and chemo therapeutic infectant elimination, starting therapy early in symptomatic patients is important for counteracting the disease. This would be essentially supported by optimized patient management, involving risk assessment, early diagnosis and monitoring of the disease and its treatment. From economic and logistic viewpoints, the tools of laboratory medicine should be especially able to guarantee this. After summarizing the basics of chronic Chagas disease, such as the epidemiological data, the pathogenetic mechanisms thought to drive symptomatic Chagas disease and also treatment options, we present tools of laboratory medicine that address patient diagnosis, risk assessment for becoming symptomatic and guidance, focusing on autoantibody estimation for risk assessment and heart marker measurement for patient guidance. In addition, increases in levels of inflammation and oxidative stress markers in chronic Chagas disease are discussed.

[Three decades of the hepatitis C virus from the discovery to the potential global elimination: the success of translational researches].

PubMed

Pár, Alajos; Pár, Gabriella

2018-03-01

More than 25 years after the discovery of hepatitis C virus, the development of the direct acting antivirals can lead to the regional or long-term global elimination of the virus with over 90% efficacy. This is the success of basic and clinical translational research. Yet, some unsolved challanges remain, such as the great number of unidentified patients who are not aware of their condition, the limited access to the therapy due to the high prices of the drugs, and the treatment of resistance-associated variants. In addition, the lack of vaccine is also an obstacle. In 2016, the World Health Organization (WHO) developed the first global health sector strategy for the elimination of viral hepatitis by 2030. Its evidence-based guidelines are primarily targeted at the national hepatitis programme managers who are responsible for the national testing and treatment plans. According to these recommendations, it is of basic importance to perform focused risk-based testing in higher-risk populations and after diagnosis to start treatment as "cure as prevention", furthermore, to limit the risk of reinfection. We review the events of the HCV story from the discovery to these days, including virology, epidemiology, pathogenesis, diagnosis and therapy. Orv Hetil. 2018; 159(12): 455-465.

Finding Basic Writing's Place.

ERIC Educational Resources Information Center

Sheridan-Rabideau, Mary P.; Brossell, Gordon

1995-01-01

Posits that basic writing serves a vital function by providing writing support for at-risk students and serves the needs of a growing student population that universities accept yet feel needs additional writing instruction. Concludes that the basic writing classroom is the most effective educational support for at-risk students and their writing.…

Using a Novel Spatial Tool to Inform Invasive Species Early Detection and Rapid Response Efforts

NASA Astrophysics Data System (ADS)

Davidson, Alisha D.; Fusaro, Abigail J.; Kashian, Donna R.

2015-07-01

Management of invasive species has increasingly emphasized the importance of early detection and rapid response (EDRR) programs in limiting introductions, establishment, and impacts. These programs require an understanding of vector and species spatial dynamics to prioritize monitoring sites and efficiently allocate resources. Yet managers often lack the empirical data necessary to make these decisions. We developed an empirical mapping tool that can facilitate development of EDRR programs through identifying high-risk locations, particularly within the recreational boating vector. We demonstrated the utility of this tool in the Great Lakes watershed. We surveyed boaters to identify trips among water bodies and to quantify behaviors associated with high likelihood of species transfer (e.g., not removing organic materials from boat trailers) during that trip. We mapped water bodies with high-risk inbound and outbound boater movements using ArcGIS. We also tested for differences in high-risk behaviors based on demographic variables to understand risk differences among boater groups. Incorporation of boater behavior led to identification of additional high-risk water bodies compared to using the number of trips alone. Therefore, the number of trips itself may not fully reflect the likelihood of invasion. This tool can be broadly applied in other geographic contexts and with different taxa, and can be adjusted according to varying levels of information concerning the vector or species of interest. The methodology is straightforward and can be followed after a basic introduction to ArcGIS software. The visual nature of the mapping tool will facilitate site prioritization by managers and stakeholders from diverse backgrounds.

Report to Congress on the U.S. Department of Energy`s Environmental Management Science Program: Research funded and its linkages to environmental cleanup problems, and high out-year cost environmental management project descriptions. Volume 3 of 3 -- Appendix C

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

NONE

1998-04-01

The Department of Energy`s Environmental Management Science Program (EMSP) serves as a catalyst for the application of scientific discoveries to the development and deployment of technologies that will lead to reduction of the costs and risks associated with cleaning up the nation`s nuclear complex. Appendix C provides details about each of the Department`s 82 high cost projects and lists the EMSP research awards with potential to impact each of these projects. The high cost projects listed are those having costs greater than $50 million in constant 1998 dollars from the year 2007 and beyond, based on the March 1998 Acceleratingmore » Cleanup: Paths to Closure Draft data, and having costs of quantities of material associated with an environmental management problem area. The high cost project information is grouped by operations office and organized by site and project code. Each operations office section begins with a list of research needs associated with that operations office. Potentially related research awards are listed by problem area in the Index of Research Awards by Environmental Management Problem Area, which can be found at the end of appendices B and C. For projects that address high risks to the public, workers, or the environment, refer also the Health/Ecology/Risk problem area awards. Research needs are programmatic or technical challenges that may benefit from knowledge gained through basic research.« less

Management of hereditary antithrombin deficiency in pregnancy.

PubMed

James, Andra H; Bates, Shannon M; Bauer, Kenneth A; Branch, Ware; Mann, Kenneth; Paidas, Michael; Silverman, Neil; Konkle, Barbara A

2017-09-01

Antithrombin (AT) deficiency is a high-risk thrombophilia and a rare condition. Despite full anticoagulation during pregnancy and the postpartum period, women with AT deficiency may still be vulnerable to developing venous thromboembolism (VTE), including fatal events. There is limited guidance on the management of AT deficiency in pregnancy, including the role of AT concentrates. Following a comprehensive review of the state of the art with respect to recommendations and guidelines, our expert panel in maternal-fetal medicine, hematology and basic science reached consensus on key issues in the recognition and management of AT deficiency in pregnancy. This paper summarizes the state of the art and summarizes what we believe are best practices with special emphasis on a multidisciplinary approach involving obstetrics and hematology in the care of women with AT deficiency. Copyright © 2017 Elsevier Ltd. All rights reserved.

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, Implementation Strategy for a Distribution Management System

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

Singh, Ravindra; Reilly, James T.; Wang, Jianhui

Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to commonmore » barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.« less

Reducing risk from lahar hazards: concepts, case studies, and roles for scientists

USGS Publications Warehouse

Pierson, Thomas C.; Wood, Nathan J.; Driedger, Carolyn L.

2014-01-01

Lahars are rapid flows of mud-rock slurries that can occur without warning and catastrophically impact areas more than 100 km downstream of source volcanoes. Strategies to mitigate the potential for damage or loss from lahars fall into four basic categories: (1) avoidance of lahar hazards through land-use planning; (2) modification of lahar hazards through engineered protection structures; (3) lahar warning systems to enable evacuations; and (4) effective response to and recovery from lahars when they do occur. Successful application of any of these strategies requires an accurate understanding and assessment of the hazard, an understanding of the applicability and limitations of the strategy, and thorough planning. The human and institutional components leading to successful application can be even more important: engagement of all stakeholders in hazard education and risk-reduction planning; good communication of hazard and risk information among scientists, emergency managers, elected officials, and the at-risk public during crisis and non-crisis periods; sustained response training; and adequate funding for risk-reduction efforts. This paper reviews a number of methods for lahar-hazard risk reduction, examines the limitations and tradeoffs, and provides real-world examples of their application in the U.S. Pacific Northwest and in other volcanic regions of the world. An overriding theme is that lahar-hazard risk reduction cannot be effectively accomplished without the active, impartial involvement of volcano scientists, who are willing to assume educational, interpretive, and advisory roles to work in partnership with elected officials, emergency managers, and vulnerable communities.

Pharmacovigilance practice and risk control of Traditional Chinese Medicine drugs in China: current status and future perspective.

PubMed

Zhang, Li; Yan, Jingbo; Liu, Xinmin; Ye, Zuguang; Yang, Xiaohui; Meyboom, Ronald; Chan, Kelvin; Shaw, Debbie; Duez, Pierre

2012-04-10

Traditional Chinese Medicine (TCM), including Traditional Chinese Medicine drugs (TCM drugs), has been playing a very important role in health protection and disease control for thousands of years in China. Relying on natural products, mainly of herbal origin, used either as raw materials for decoction, as prepared herbal medicines or as formulated traditional medicines, TCM is still widely accepted by Chinese people, especially for chronic diseases treatment. This extensive use warrants safety measures and so TCM drug safety monitoring and risk management are becoming increasingly important tasks for the Chinese State Food and Drug Administration (SFDA). The Adverse Drug Reaction (ADR) monitoring system in China was established both for western and TCM drugs in 1989 as a voluntary reporting system with a National Center collecting and compiling reports. Serious or multi-case reports on individual TCM drug or formulated products are detailed in the Chinese ADR Information Bulletin to inform the public and Drug Administrative authorities for risk management. About 10-15% of the ADR reports received by the National Center are related to TCM drugs and mainly pertaining to the formulated products. In certain cases, the suspension of a particular TCM preparation is decided by SFDA China. The model of safety monitoring and risk management of TCM drugs is still under exploration. Indeed, the characteristics and risk factors associated with these drugs require both proper understanding and control of the risk by strengthening standardization of clinical applications, basic science research, quality control in manufacturing, exploration of the actives monitoring methodology and enhancement of international communication and cooperation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Trust and risk: a model for medical education.

PubMed

Damodaran, Arvin; Shulruf, Boaz; Jones, Philip

2017-09-01

Health care delivery, and therefore medical education, is an inherently risky business. Although control mechanisms, such as external audit and accreditation, are designed to manage risk in clinical settings, another approach is 'trust'. The use of entrustable professional activities (EPAs) represents a deliberate way in which this is operationalised as a workplace-based assessment. Once engaged with the concept, clinical teachers and medical educators may have further questions about trust. This narrative overview of the trust literature explores how risk, trust and control intersect with current thinking in medical education, and makes suggestions for potential directions of enquiry. Beyond EPAs, the importance of trust in health care and medical education is reviewed, followed by a brief history of trust research in the wider literature. Interpersonal and organisational levels of trust and a model of trust from the management literature are used to provide the framework with which to decipher trust decisions in health care and medical education, in which risk and vulnerability are inherent. In workplace learning and assessment, the language of 'trust' may offer a more authentic and practical vocabulary than that of 'competency' because clinical and professional risks are explicitly considered. There are many other trust relationships in health care and medical education. At the most basic level, it is helpful to clearly delineate who is the trustor, the trustee, and for what task. Each relationship has interpersonal and organisational elements. Understanding and considered utilisation of trust and control mechanisms in health care and medical education may lead to systems that maturely manage risk while actively encouraging trust and empowerment. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Management of intracerebral hemorrhage.

PubMed

Thabet, A M; Kottapally, M; Hemphill, J Claude

2017-01-01

Intracerebral hemorrhage (ICH) is a potentially devastating neurologic injury representing 10-15% of stroke cases in the USA each year. Numerous risk factors, including age, hypertension, male gender, coagulopathy, genetic susceptibility, and ethnic descent, have been identified. Timely identification, workup, and management of this condition remain a challenge for clinicians as numerous factors can present obstacles to achieving good functional outcomes. Several large clinical trials have been conducted over the prior decade regarding medical and surgical interventions. However, no specific treatment has shown a major impact on clinical outcome. Current management guidelines do exist based on medical evidence and consensus and these provide a framework for care. While management of hypertension and coagulopathy are generally considered basic tenets of ICH management, a variety of measures for surgical hematoma evacuation, intracranial pressure control, and intraventricular hemorrhage can be further pursued in the emergent setting for selected patients. The complexity of management in parenchymal cerebral hemorrhage remains challenging and offers many areas for further investigation. A systematic approach to the background, pathology, and early management of spontaneous parenchymal hemorrhage is provided. © 2017 Elsevier B.V. All rights reserved.

Ecological Networks in Stored Grain: Key Postharvest Nodes for Emerging Pests, Pathogens, and Mycotoxins.

PubMed

Hernandez Nopsa, John F; Daglish, Gregory J; Hagstrum, David W; Leslie, John F; Phillips, Thomas W; Scoglio, Caterina; Thomas-Sharma, Sara; Walter, Gimme H; Garrett, Karen A

2015-10-01

Wheat is at peak quality soon after harvest. Subsequently, diverse biota use wheat as a resource in storage, including insects and mycotoxin-producing fungi. Transportation networks for stored grain are crucial to food security and provide a model system for an analysis of the population structure, evolution, and dispersal of biota in networks. We evaluated the structure of rail networks for grain transport in the United States and Eastern Australia to identify the shortest paths for the anthropogenic dispersal of pests and mycotoxins, as well as the major sources, sinks, and bridges for movement. We found important differences in the risk profile in these two countries and identified priority control points for sampling, detection, and management. An understanding of these key locations and roles within the network is a new type of basic research result in postharvest science and will provide insights for the integrated pest management of high-risk subpopulations, such as pesticide-resistant insect pests.

Ecological Networks in Stored Grain: Key Postharvest Nodes for Emerging Pests, Pathogens, and Mycotoxins

PubMed Central

Hernandez Nopsa, John F.; Daglish, Gregory J.; Hagstrum, David W.; Leslie, John F.; Phillips, Thomas W.; Scoglio, Caterina; Thomas-Sharma, Sara; Walter, Gimme H.; Garrett, Karen A.

2015-01-01

Wheat is at peak quality soon after harvest. Subsequently, diverse biota use wheat as a resource in storage, including insects and mycotoxin-producing fungi. Transportation networks for stored grain are crucial to food security and provide a model system for an analysis of the population structure, evolution, and dispersal of biota in networks. We evaluated the structure of rail networks for grain transport in the United States and Eastern Australia to identify the shortest paths for the anthropogenic dispersal of pests and mycotoxins, as well as the major sources, sinks, and bridges for movement. We found important differences in the risk profile in these two countries and identified priority control points for sampling, detection, and management. An understanding of these key locations and roles within the network is a new type of basic research result in postharvest science and will provide insights for the integrated pest management of high-risk subpopulations, such as pesticide-resistant insect pests. PMID:26955074

Teaching Basic Probability in Undergraduate Statistics or Management Science Courses

ERIC Educational Resources Information Center

Naidu, Jaideep T.; Sanford, John F.

2017-01-01

Standard textbooks in core Statistics and Management Science classes present various examples to introduce basic probability concepts to undergraduate business students. These include tossing of a coin, throwing a die, and examples of that nature. While these are good examples to introduce basic probability, we use improvised versions of Russian…

Estimating the NIH Efficient Frontier

PubMed Central

2012-01-01

Background The National Institutes of Health (NIH) is among the world’s largest investors in biomedical research, with a mandate to: “…lengthen life, and reduce the burdens of illness and disability.” Its funding decisions have been criticized as insufficiently focused on disease burden. We hypothesize that modern portfolio theory can create a closer link between basic research and outcome, and offer insight into basic-science related improvements in public health. We propose portfolio theory as a systematic framework for making biomedical funding allocation decisions–one that is directly tied to the risk/reward trade-off of burden-of-disease outcomes. Methods and Findings Using data from 1965 to 2007, we provide estimates of the NIH “efficient frontier”, the set of funding allocations across 7 groups of disease-oriented NIH institutes that yield the greatest expected return on investment for a given level of risk, where return on investment is measured by subsequent impact on U.S. years of life lost (YLL). The results suggest that NIH may be actively managing its research risk, given that the volatility of its current allocation is 17% less than that of an equal-allocation portfolio with similar expected returns. The estimated efficient frontier suggests that further improvements in expected return (89% to 119% vs. current) or reduction in risk (22% to 35% vs. current) are available holding risk or expected return, respectively, constant, and that 28% to 89% greater decrease in average years-of-life-lost per unit risk may be achievable. However, these results also reflect the imprecision of YLL as a measure of disease burden, the noisy statistical link between basic research and YLL, and other known limitations of portfolio theory itself. Conclusions Our analysis is intended to serve as a proof-of-concept and starting point for applying quantitative methods to allocating biomedical research funding that are objective, systematic, transparent, repeatable, and expressly designed to reduce the burden of disease. By approaching funding decisions in a more analytical fashion, it may be possible to improve their ultimate outcomes while reducing unintended consequences. PMID:22567087

Risk based inspection for atmospheric storage tank

NASA Astrophysics Data System (ADS)

Nugroho, Agus; Haryadi, Gunawan Dwi; Ismail, Rifky; Kim, Seon Jin

2016-04-01

Corrosion is an attack that occurs on a metallic material as a result of environment's reaction.Thus, it causes atmospheric storage tank's leakage, material loss, environmental pollution, equipment failure and affects the age of process equipment then finally financial damage. Corrosion risk measurement becomesa vital part of Asset Management at the plant for operating any aging asset.This paper provides six case studies dealing with high speed diesel atmospheric storage tank parts at a power plant. A summary of the basic principles and procedures of corrosion risk analysis and RBI applicable to the Process Industries were discussed prior to the study. Semi quantitative method based onAPI 58I Base-Resource Document was employed. The risk associated with corrosion on the equipment in terms of its likelihood and its consequences were discussed. The corrosion risk analysis outcome used to formulate Risk Based Inspection (RBI) method that should be a part of the atmospheric storage tank operation at the plant. RBI gives more concern to inspection resources which are mostly on `High Risk' and `Medium Risk' criteria and less on `Low Risk' shell. Risk categories of the evaluated equipment were illustrated through case study analysis outcome.

Stratum Electricity Markets: Toward Multi-temporal Distributed Risk Management for Sustainable Electricity Provision

NASA Astrophysics Data System (ADS)

Wu, Zhiyong (Richard)

Motivated by the overall challenge of ensuring long-term sustainable electricity service, we view this challenge as a long-term decision making problem under uncertainties. We start by recognizing that, independent of the industry organization, the uncertainties are enormous and often exogenous to the energy service providers. They are multi-dimensional and are result of fundamental drivers, ranging from the supply side, through the demand side, to the regulatory and policy sides. The basic contribution of this thesis comes from the recognition that long-term investments for ensuring reliable and stable electricity service critically depend on how these uncertainties are perceived, valued and managed by the different stakeholders within the complex industry organization such as the electric power industry. We explain several reasons why price signals obtained from current short-term electricity markets alone are not sufficient enough for long-term sustainable provision. Some enhancements are presented in the thesis to improve the short-term electricity market price signals to reflect the true cost of operation. New market mechanisms and instruments are needed to facilitate the stakeholders to better deal with long-term risks. The problems of ensuring long-term stable reliable service in the sense of the traditional resource adequacy requirements are revisited in both the restructuring industry and regulated industry. We introduce a so-called Stratum Electricity Market (SEM) design as the basic market mechanism for solving the problem of long-term reliable electricity service through a series of interactive multi-lateral market exchange platforms for risks communication, management and evaluations over various time horizons and by the different groups of stakeholders. In other words, our proposed SEM is a basic IT-enabled framework for the decision making processes by various parties over different time. Because of the uniqueness of electricity as a commodity, the values for the same amount of energy during different time and at different location can vary dramatically. Moreover, for the same hour, the values for the same amount of power at base load level or at peak load level are different due to the different generation technologies and other non-convex constraints like unit commitment. The multiple market products at zonal/nodal levels with different time horizon and time of use categories are designed to reflect more realistic demand and supply conditions at various temporal and spatial granularities. Detailed market rules, rights and regulations (3Rs) concerning the sub-markets interactions, product hierarchy and financial settlements are also examined.

Integrating basic research and long-term management: a case study using avian research at the Savannah River Site

Treesearch

John B. Dunning; John C. Kilgo

2000-01-01

In this introduction to Avian Research at the Savannah River Site: A Model for Integrating Basic Research and Long-term Management, editors Dunning and Kilgo discuss the interrelationship between research and management at the Savannah River Site. They emphasize the increasing need for collaboration between scientists and land managers....

Return on Scientific Investment - RoSI: a PMO dynamical index proposal for scientific projects performance evaluation and management.

PubMed

Caous, Cristofer André; Machado, Birajara; Hors, Cora; Zeh, Andrea Kaufmann; Dias, Cleber Gustavo; Amaro Junior, Edson

2012-01-01

To propose a measure (index) of expected risks to evaluate and follow up the performance analysis of research projects involving financial and adequate structure parameters for its development. A ranking of acceptable results regarding research projects with complex variables was used as an index to gauge a project performance. In order to implement this method the ulcer index as the basic model to accommodate the following variables was applied: costs, high impact publication, fund raising, and patent registry. The proposed structured analysis, named here as RoSI (Return on Scientific Investment) comprises a pipeline of analysis to characterize the risk based on a modeling tool that comprises multiple variables interacting in semi-quantitatively environments. This method was tested with data from three different projects in our Institution (projects A, B and C). Different curves reflected the ulcer indexes identifying the project that may have a minor risk (project C) related to development and expected results according to initial or full investment. The results showed that this model contributes significantly to the analysis of risk and planning as well as to the definition of necessary investments that consider contingency actions with benefits to the different stakeholders: the investor or donor, the project manager and the researchers.

Testing REACH draft technical guidance notes for conducting chemical safety assessments-the experience of a downstream user of a preparation.

PubMed

Gade, Anne Lill; Ovrebø, Steinar; Hylland, Ketil

2008-07-01

The goal of REACH is the safe use of chemicals. This study examines the efficiency and usefulness of two draft technical guidance notes in the REACH Interim Project 3.2-2 for the development of the chemical safety report and exposure scenarios. A case study was carried out for a paint system for protection of structural steel. The focuses of the study were risk assessment of preparations based on Derived No Effect Level (DNEL) and Predicted No Effect Concentrations (PNEC) and on effective and accurate communication in the supply chain. Exposure scenarios and generic descriptions of uses, risk management measures, and exposure determinants were developed. The study showed that communication formats, software tools, and guidelines for chemical risk assessment need further adjustment to preparations and real-life situations. Web platforms may simplify such communication. The downstream formulator needs basic substance data from the substance manufacturer during the pre-registration phase to develop exposure scenarios for preparations. Default values need to be communicated in the supply chain because these were critical for the derivation of applicable risk management demands. The current guidelines which rely on the available toxicological knowledge are insufficient to advise downstream users on how to develop exposure scenarios for preparations.

Business Process Reengineering in the Inventory Management to Improve Aircraft Maintenance Operations in the Indonesian Air Force

DTIC Science & Technology

2006-06-01

research will cover an overview of business process engineering (BPR) and operation management . The focus will be on the basic process of BPR, inventory...management and improvement of the process of business operation management to appropriately provide a basic model for the Indonesian Air Force in...discuss the operation management aspects of inventory management and process improvement, including Economic Order Quantity, Material Requirement

Basic symptoms and the prediction of first-episode psychosis.

PubMed

Schultze-Lutter, Frauke; Ruhrmann, Stephan; Fusar-Poli, Paolo; Bechdolf, Andreas; Schimmelmann, Benno G; Klosterkötter, Joachim

2012-01-01

Recent focus on early detection and intervention in psychosis has renewed interest in subtle psychopathology beyond positive and negative symptoms. Such self-experienced sub-clinical disturbances are described in detail by the basic symptom concept. This review will give an introduction into the concept of basic symptoms and describe the development of the current instruments for their assessment, the Schizophrenia Proneness Instrument, Adult (SPI-A) and Child and Youth version (SPI-CY), as well as of the two at-risk criteria: the at-risk criterion Cognitive-Perceptive Basic Symptoms (COPER) and the high-risk criterion Cognitive Disturbances (COGDIS). Further, an overview of prospective studies using both or either basic symptom criteria and transition rates related to these will be given, and the potential benefit of combining ultra-high risk criteria, particularly attenuated psychotic symptoms, and basic symptom criteria will be discussed. Finally, their prevalence in psychosis patients, i.e. the sensitivity, as well as in general population samples will be described. It is concluded that both COPER and COGDIS are able to identify subjects at a high risk of developing psychosis. Further, they appear to be sufficiently frequent prior to onset of the first psychotic episode as well as sufficiently rare in persons of general population to be considered as valuable for an early detection of psychosis.

Predicting the Future: Delivery Room Planning of Congenital Heart Disease Diagnosed by Fetal Echocardiography.

PubMed

Donofrio, Mary T

2018-05-01

Advances in prenatal imaging have improved the examination of the fetal cardiovascular system. Fetal echocardiography facilitates the prenatal diagnosis of congenital heart disease (CHD) and through sequential examination, allows assessment of fetal cardiac hemodynamics, predicting the evolution of anatomical and functional cardiovascular abnormalities in utero and during the transition to a postnatal circulation at delivery. This approach allows detailed diagnosis with prenatal counseling and enables planning to define perinatal management, selecting the fetuses at a risk of postnatal hemodynamic instability who are likely to require a specialized delivery plan. The prenatal diagnosis and management of critical neonatal CHD has been shown to play an important role in improving the outcome of newborns with these conditions, allowing timely stabilization of the circulation prior to cardiac intervention or surgery, thus reducing the risk of perioperative morbidity and mortality. Diagnostic protocols aimed at risk-stratifying severity and potential postnatal compromise in fetuses with CHD have been developed to identify those who may require special intervention at birth or within the first days of life. In addition, new methodologies are being studied to improve the accuracy of prediction of disease severity. Perinatal management of neonates with a prenatal diagnosis of CHD requires a close collaboration between obstetric, neonatal, and cardiology services. In this article, the management of fetuses with CHD will be discussed, along with summarizing the in utero and fetal echocardiographic findings used for risk stratification of newborns with CHD and reviewing the basic principles used for planning for neonatal resuscitation and initial transitional care of these complex newborns. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

49 CFR 633.21 - Basic requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.21 Basic requirement. (a) If a project meets the definition of major capital project, the recipient shall submit a project management plan prepared in accordance with § 633.25 of this part, as a condition of Federal financial...

Linking Theory with Practice in Basic Management

ERIC Educational Resources Information Center

Carroll, Archie B.

1974-01-01

Instructors of management in higher education have not been cautious in explaining the relation between practice and theory in their basic courses. The author distinguished between the two in suggesting that management theory is based on observed practices and may or may not have broader application. (AG)

49 CFR 633.21 - Basic requirement.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.21 Basic requirement. (a) If a project meets the definition of major capital project, the recipient shall submit a project management plan prepared in accordance with § 633.25 of this part, as a condition of Federal financial...

49 CFR 633.21 - Basic requirement.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.21 Basic requirement. (a) If a project meets the definition of major capital project, the recipient shall submit a project management plan prepared in accordance with § 633.25 of this part, as a condition of Federal financial...

49 CFR 633.21 - Basic requirement.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.21 Basic requirement. (a) If a project meets the definition of major capital project, the recipient shall submit a project management plan prepared in accordance with § 633.25 of this part, as a condition of Federal financial...

49 CFR 633.21 - Basic requirement.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.21 Basic requirement. (a) If a project meets the definition of major capital project, the recipient shall submit a project management plan prepared in accordance with § 633.25 of this part, as a condition of Federal financial...

College Financial Management: Basics for Administrators.

ERIC Educational Resources Information Center

Carter, E. Eugene

Basic economic concepts applicable for college financial management are considered, along with the characteristics of financial instruments available to universities that have money to invest for short-term or long-term purposes. A discussion of various financial securities provides information for the endowment manager who has to select among…

Basic symptoms in the general population and in psychotic and non-psychotic psychiatric adolescents.

PubMed

Meng, Heiner; Schimmelmann, Benno Graf; Koch, Eginhard; Bailey, Barbara; Parzer, Peter; Günter, Michael; Mohler, Beat; Kunz, Natalia; Schulte-Markwort, Michael; Felder, Wilhelm; Zollinger, Rudolf; Bürgin, Dieter; Resch, Franz

2009-06-01

Cognitive-perceptive 'basic symptoms' are used complementary to ultra-high-risk criteria in order to predict onset of psychosis in the pre-psychotic phase. The aim was to investigate the prevalence of a broad selection of 'basic symptoms' in a representative general adolescent population sample (GPS; N=96) and to compare it with adolescents first admitted for early onset psychosis (EOP; N=87) or non-psychotic psychiatric disorders (NP; N=137). Subjects were assessed with the Bonn Scale for the Assessment of Basic Symptoms (BSABS). Prevalence of at least one 'basic symptom' and mean numbers were compared across the three groups. Logistic regression was used to predict group membership by BSABS subscales; risk ratios were calculated to identify 'basic symptoms' which best discriminated between groups. The prevalence of at least any one 'basic symptom' was 30.2% in GPS compared to 81% in NP and 96.5% in EOP. Correct classification of EOP when compared to GPS was high (94.0%) and lower when compared to NP (78.6%). Cognitive symptoms discriminated best between EOP and NP. Alike other prodromal- and psychotic-like experiences, 'basic symptoms' are prevalent in the general adolescent population, yet at a lower rate compared to EOP and NP. The usage of 'at least one basic symptom' as a screening criterion for youth at risk of developing a psychotic disorder is not recommended in the general population or in unselected psychiatrically ill adolescents. However, particularly cognitive 'basic symptoms' may be a valuable criteria to be included in future 'at risk' studies in adolescents.

Tipping the scales: educating surgeons about medical malpractice.

PubMed

Raper, Steven E; Joseph, Johncy; Seymour, Wilda G; Sullivan, Patricia G

2016-11-01

In Pennsylvania, medical malpractice premiums are a major cost to surgeons. Yet surgeons often have little if any education in the basics of tort litigation or how to manage their risk. This work describes one approach for educating academic faculty surgeons on current concepts of medical malpractice and provide some guidance on how to "tip the scales of justice"; or minimize the risks of being named in a malpractice claim. The course had five parts: the basics of medical malpractice, the cost of malpractice insurance, current departmental claims experience, strategies for decreasing the risk of being named in a claim, and an overview of malpractice reforms. An anonymous seven question survey was cast in a five-point Likert scale format. A weighted average of 4.5 or above was considered satisfactory. Two free text questions asked about positive and negative aspects of the course. Eighty of 95 (84%) faculty attended either in person or by reviewing a web-based video. Quantitatively, five of seven questions had a weighted average of more than 4.5 (n = 48, response rate = 60%). Qualitatively, the course was reviewed very favorably. The high percentage of participation and overall survey results suggest that the course was successful. This course was one facet of an approach to decrease the risk of malpractice claims. Unique aspects of this course include an emphasis on state law, department-specific data, and strategies to minimize risk of future claims. Given the state-specific nature of malpractice claims and litigation, individual departments must particularize similar presentations. Copyright © 2016 Elsevier Inc. All rights reserved.

Competency-Based Adult Education Classroom Management Guide for Adult Basic Education Curriculum (Level II, 5-8).

ERIC Educational Resources Information Center

Singer, Elizabeth

This Competency-Based Adult Basic Education (CBABE) Classroom Management Guide was developed to aid the Adult Basic Education (ABE) facilitator in implementing a model CBABE Level 5-8 curriculum. First, introductory material provides background on the CBABE project at Brevard Community College (Florida) and the rationale for the development of the…

Basic Training: A 1-Day Education Module for New Clientele in the Turf Industry

ERIC Educational Resources Information Center

Patton, Aaron J.; Reicher, Zachary J.

2011-01-01

It is important that Extension education programs be directed at clientele new to the turfgrass industry. A 1-day Basic Training: Turf Management seminar was created in 2006 to provide education to those new to the turfgrass industry. The seminar covered the basics of turfgrass management including growth, physiology, fertilization, cultural…

Repeat prescribing of medications: A system‐centred risk management model for primary care organisations

PubMed Central

Price, Julie; Man, Shu Ling; Bartlett, Stephen; Taylor, Kate; Dinwoodie, Mark

2017-01-01

Abstract Rationale, aims and objectives Reducing preventable harm from repeat medication prescriptions is a patient safety priority worldwide. In the United Kingdom, repeat prescriptions items issued has doubled in the last 20 years from 5.8 to 13.3 items per patient per annum. This has significant resource implications and consequences for avoidable patient harms. Consequently, we aimed to test a risk management model to identify, measure, and reduce repeat prescribing system risks in primary care. Methods All 48 general medical practices in National Health Service (NHS) Lambeth Clinical Commissioning Group (an inner city area of south London in England) were recruited. Multiple interventions were implemented, including educational workshops, a web‐based risk monitoring system, and external reviews of repeat prescribing system risks by clinicians. Data were collected via documentation reviews and interviews and subject to basic thematic and descriptive statistical analyses. Results Across the 48 participating general practices, 62 unique repeat prescribing risks were identified on 505 occasions (eg, practices frequently experiencing difficulty interpreting medication changes on hospital discharge summaries), equating to a mean of 8.1 risks per practice (range: 1‐33; SD = 7.13). Seven hundred sixty‐seven system improvement actions were recommended across 96 categories (eg, alerting hospitals to illegible writing and delays with discharge summaries) with a mean of 15.6 actions per practice (range: 0‐34; SD = 8.0). Conclusions The risk management model tested uncovered important safety concerns and facilitated the development and communication of related improvement recommendations. System‐wide information on hazardous repeat prescribing and how this could be mitigated is very limited. The approach reported may have potential to close this gap and improve the reliability of general practice systems and patient safety, which should be of high interest to primary care organisations internationally. PMID:28370904

[Executive summary of the recommendations on the evaluation and management of renal disease in human immunodeficiency virus-infected patients].

PubMed

Gorriz, José L; Gutiérrez, Félix; Trullàs, Joan C; Arazo, Piedad; Arribas, Jose R; Barril, Guillermina; Cervero, Miguel; Cofán, Frederic; Domingo, Pere; Estrada, Vicente; Fulladosa, Xavier; Galindo, María J; Gràcia, Sílvia; Iribarren, José A; Knobel, Hernando; López-Aldeguer, José; Lozano, Fernando; Martínez-Castelao, Alberto; Martínez, Esteban; Mazuecos, Maria A; Miralles, Celia; Montañés, Rosario; Negredo, Eugenia; Palacios, Rosario; Pérez-Elías, María J; Portilla, Joaquín; Praga, Manuel; Quereda, Carlos; Rivero, Antonio; Santamaría, Juan M; Sanz, José; Sanz, Jesús; Miró, José M

2014-11-01

The aim of this article is to update the 2010 recommendations on the evaluation and management of renal disease in human immunodeficiency virus (HIV)-infected patients. Renal function should be monitored in all HIV-infected patients. The basic renal work-up should include measurements of serum creatinine, estimated glomerular filtration rate by CKD-EPI, urine protein-to-creatinine ratio, and urinary sediment. Tubular function tests should include determination of serum phosphate levels and urine dipstick for glycosuria. In the absence of abnormal values, renal screening should be performed annually. In patients treated with tenofovir, or with risk factors for chronic kidney disease (CKD), more frequent renal screening is recommended. In order to prevent disease progression, potentially nephrotoxic antiretroviral drugs are not recommended in patients with CKD or risk factors for CKD. The document provides indications for renal biopsy and advises on the optimal time for referral of a patient to the nephrologist. The indications for and evaluation and management of dialysis and renal transplantation are also addressed. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

AACRAO's Basic Guide to Enrollment Management

ERIC Educational Resources Information Center

Westman, Craig

2005-01-01

The sole purpose of this book is to provide a primer or "how-to" resource for new or seasoned enrollment managers. Its core chapters are practical applications of Strategic Enrollment Management (SEM) best practices. While incorporating some secondary source referencing, the dialogue primarily outlines how making some basic adjustments to business…

Equine Management and Production. Vocational Agriculture Education.

ERIC Educational Resources Information Center

Rudolph, James A.

This basic core of instruction for equine management and production is designed to assist instructors in preparing students for successful employment or management of a one- or two-horse operation. Contents include seven instructional areas totaling seventeen units of instruction: (1) Orientation (basic horse production; handling and grooming;…

Resilient Urban Infrastructures - Basics of Smart Sustainable Cities

NASA Astrophysics Data System (ADS)

Timashev, S. A.

2017-11-01

In this paper the notion of urban infrastructure resilience is formulated being expressed verbally and strictly in conditional probability terms. It is further used to formulate several most important features of a smart city. This multidisciplinary and multifaceted approach is used to explain the concept of quantitative resilience in urban design, operation, managing urban risk and mitigating of the consequences of a natural or industrial disaster. The extremely urgent problem is formulated on how to connect the physical and spatial (core) resiliencies with the functional, organizational, economic and social resiliencies.

A Clinician-Centered Evaluation of the Usability of AHLTA and Automated Clinical Practice Guidelines at TAMC

DTIC Science & Technology

2011-03-31

enclave and receives care at a civilian facility during the later months of her pregnancy. During that time she develops gestational diabetes . Upon... Diabetic ” collection as those patients with a HgA1c > 9. Once the basic collection is defined, it can be used to create a rule such as “if high-risk... diabetic = true, then order HgA1c very six months, else every 12 months”. Using patient Cohort allows rule authors to efficiently manage rule systems

Risk analysis and its link with standards of the World Organisation for Animal Health.

PubMed

Sugiura, K; Murray, N

2011-04-01

Among the agreements included in the treaty that created the World Trade Organization (WTO) in January 1995 is the Agreement on the Application of Sanitary and Phytosanitary Measures (SPS Agreement) that sets out the basic rules for food safety and animal and plant health standards. The SPS Agreement designates the World Organisation for Animal Health (OIE) as the organisation responsible for developing international standards for animal health and zoonoses. The SPS Agreement requires that the sanitary measures that WTO members apply should be based on science and encourages them to either apply measures based on the OIE standards or, if they choose to adopt a higher level of protection than that provided by these standards, apply measures based on a science-based risk assessment. The OIE also provides a procedural framework for risk analysis for its Member Countries to use. Despite the inevitable challenges that arise in carrying out a risk analysis of the international trade in animals and animal products, the OIE risk analysis framework provides a structured approach that facilitates the identification, assessment, management and communication of these risks.

Improving online risk assessment with equipment prognostics and health monitoring

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

Coble, Jamie B.; Liu, Xiaotong; Briere, Chris

The current approach to evaluating the risk of nuclear power plant (NPP) operation relies on static probabilities of component failure, which are based on industry experience with the existing fleet of nominally similar light water reactors (LWRs). As the nuclear industry looks to advanced reactor designs that feature non-light water coolants (e.g., liquid metal, high temperature gas, molten salt), this operating history is not available. Many advanced reactor designs use advanced components, such as electromagnetic pumps, that have not been used in the US commercial nuclear fleet. Given the lack of rich operating experience, we cannot accurately estimate the evolvingmore » probability of failure for basic components to populate the fault trees and event trees that typically comprise probabilistic risk assessment (PRA) models. Online equipment prognostics and health management (PHM) technologies can bridge this gap to estimate the failure probabilities for components under operation. The enhanced risk monitor (ERM) incorporates equipment condition assessment into the existing PRA and risk monitor framework to provide accurate and timely estimates of operational risk.« less

Framework for Risk Analysis in Multimedia Environmental Systems: Modeling Individual Steps of a Risk Assessment Process

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

Shah, Anuj; Castleton, Karl J.; Hoopes, Bonnie L.

2004-06-01

The study of the release and effects of chemicals in the environment and their associated risks to humans is central to public and private decision making. FRAMES 1.X, Framework for Risk Analysis in Multimedia Environmental Systems, is a systems modeling software platform, developed by PNNL, Pacific Northwest National Laboratory, that helps scientists study the release and effects of chemicals on a source to outcome basis, create environmental models for similar risk assessment and management problems. The unique aspect of FRAMES is to dynamically introduce software modules representing individual components of a risk assessment (e.g., source release of contaminants, fate andmore » transport in various environmental media, exposure, etc.) within a software framework, manipulate their attributes and run simulations to obtain results. This paper outlines the fundamental constituents of FRAMES 2.X, an enhanced version of FRAMES 1.X, that greatly improve the ability of the module developers to “plug” their self-developed software modules into the system. The basic design, the underlying principles and a discussion of the guidelines for module developers are presented.« less

Nurses' Educational Needs Assessment for Financial Management Education Using the Nominal Group Technique.

PubMed

Noh, Wonjung; Lim, Ji Young

2015-06-01

The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. After analyzing the results, nine key components were selected: corporate management and accounting, introduction to financial management in hospitals, basic structure of accounting, basics of hospital accounting, basics of financial statements, understanding the accounts of financial statements, advanced analysis of financial statements, application of financial management, and capital financing of hospitals. The present findings can be used to develop a financial management education program to strengthen the financial management competencies of nurses. Copyright © 2015. Published by Elsevier B.V.

Radiation risk and human space exploration.

PubMed

Schimmerling, W; Cucinotta, F A; Wilson, J W

2003-01-01

Radiation protection is essential to enable humans to live and work safely in space. Predictions about the nature and magnitude of the risks posed by space radiation are subject to very large uncertainties. Prudent use of worst-case scenarios may impose unacceptable constraints on shielding mass for spacecraft or habitats, tours of duty of crews on Space Station, and on the radius and duration of sorties on planetary surfaces. The NASA Space Radiation Health Program has been devised to develop the knowledge required to accurately predict and to efficiently manage radiation risk. The knowledge will be acquired by means of a peer-reviewed, largely ground-based and investigator-initiated, basic science research program. The NASA Strategic Plan to accomplish these objectives in a manner consistent with the high priority assigned to the protection and health maintenance of crews will be presented. Published by Elsevier Science Ltd on behalf of COSPAR.

Radiation risk and human space exploration

NASA Technical Reports Server (NTRS)

Schimmerling, W.; Cucinotta, F. A.; Wilson, J. W.

2003-01-01

Radiation protection is essential to enable humans to live and work safely in space. Predictions about the nature and magnitude of the risks posed by space radiation are subject to very large uncertainties. Prudent use of worst-case scenarios may impose unacceptable constraints on shielding mass for spacecraft or habitats, tours of duty of crews on Space Station, and on the radius and duration of sorties on planetary surfaces. The NASA Space Radiation Health Program has been devised to develop the knowledge required to accurately predict and to efficiently manage radiation risk. The knowledge will be acquired by means of a peer-reviewed, largely ground-based and investigator-initiated, basic science research program. The NASA Strategic Plan to accomplish these objectives in a manner consistent with the high priority assigned to the protection and health maintenance of crews will be presented. Published by Elsevier Science Ltd on behalf of COSPAR.

Evaluation of Microcomputer-Based Operation and Maintenance Management Systems for Army Water/Wastewater Treatment Plant Operation.

DTIC Science & Technology

1986-07-01

COMPUTER-AIDED OPERATION MANAGEMENT SYSTEM ................. 29 Functions of an Off-Line Computer-Aided Operation Management System Applications of...System Comparisons 85 DISTRIBUTION 5V J. • 0. FIGURES Number Page 1 Hardware Components 21 2 Basic Functions of a Computer-Aided Operation Management System...Plant Visits 26 4 Computer-Aided Operation Management Systems Reviewed for Analysis of Basic Functions 29 5 Progress of Software System Installation and

[Study on the overall implementation status of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Li, J J; Li, J L; Zhang, J; Jin, R R; Ma, S; Deng, G J; Su, X W; Bian, F; Qu, Y M; Hu, L L; Jiang, Y

2018-04-10

Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.

Barriers to management of cardiovascular risk in a low-resource setting using hypertension as an entry point.

PubMed

Mendis, Shanthi; Abegunde, Dele; Oladapo, Olulola; Celletti, Francesca; Nordet, Porfirio

2004-01-01

Assess capacity of health-care facilities in a low-resource setting to implement the absolute risk approach for assessment of cardiovascular risk in hypertensive patients and effective management of hypertension. A descriptive cross-sectional study in Egbeda and Oluyole local government areas of Oyo State in Nigeria in 56 randomly selected primary- (n = 42) and secondary-level (n = 2) health-care and private health-care (n = 12) facilities. One thousand consecutive, known hypertensives attending the selected facilities for follow-up, and health-care providers working in the above randomly selected facilities, were interviewed. About two-thirds of hypertensives utilized primary-care centers both for diagnosis and for follow-up. Laboratory and other investigations to exclude secondary hypertension or to assess target organ damage were not available in the majority of facilities, particularly in primary care. A considerable knowledge and awareness gap related to hypertension and its complications was found, both among patients and health-care providers. Blood pressure control rates were poor (28% with systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg] and drug prescription patterns were not evidence based and cost effective. The majority of patients (73%) in this low socio-economic group (mean monthly income 73 US dollars) had to pay fully, out of their own pocket, for consultations and medications. If the absolute risk approach for assessment of risk and effective management of hypertension is to be implemented in low-resource settings, appropriate policy measures need to be taken to improve the competency of health-care providers, to provide basic laboratory facilities and to develop affordable financing mechanisms.

Exploiting Science: Enhancing the Safety Training of Pilots to Reduce the Risk of Bird Strikes

NASA Astrophysics Data System (ADS)

Mendonca, Flavio A. C.

Analysis of bird strikes to aviation in the U.S. from 1990 to 2015 indicate that the successful mitigation efforts at airports, which must be sustained, have reduced incidents with damage and a negative effect-on-flight since 2000. However, such efforts have done little to reduce strikes outside the airport jurisdiction, such as occurred with US Airways Flight 1549 in 2009. There are basically three strategies to mitigate the risk of bird strikes: standards set by aviation authorities, technology, and actions by crewmembers. Pilots play an important role as stakeholders in the prevention of bird strikes, especially outside the airport environment. Thus, safety efforts require enhanced risk management and aeronautical decision-making training for flight crews. The purpose of this study was to determine if a safety training protocol could effectively enhance CFR Part 141 general aviation pilots' knowledge and skills to reduce the risk of bird strikes to aviation. Participants were recruited from the Purdue University professional flight program and from Purdue Aviation. The researcher of this study used a pretest posttest experimental design. Additionally, qualitative data were collected through open-ended questions in the pretest, posttest, and a follow-up survey questionnaire. The participants' pretest and posttest scores were analyzed using parametric and nonparametric tests. Results indicated a significant increase in the posttest scores of the experimental group. An investigation of qualitative data showed that the topic "safety management of bird hazards by pilots" is barely covered during the ground and flight training of pilots. Furthermore, qualitative data suggest a misperception of the safety culture tenets and a poor familiarity with the safety risk management process regarding bird hazards. Finally, the researcher presented recommendations for practice and future research.

Implementation of Risk Management Tools to improve Soil fertility in Ethiopian Agro Systems

NASA Astrophysics Data System (ADS)

García Moreno, Rosario; Ramos Fuentes, Natalia; Gameda, Samuel; Cruz Díaz Álvarez, M.; Selasie, Yihenew G.

2013-04-01

Agriculture is one of the activities with the highest degree of edaphoclimatic risk exposure in Ethiopia. The survival of 80The analysis showed that for most of the medium small farmers it is absolutely necessary the use of risk management tools to mitigate or prevent the consequences. A case that has been very interesting is the use of index insurance based on rain and temperature index as indicators of drought. But these projects have several limitations that make difficult its large-scale development. The main problem is to obtain meteorological data, both by the poor infrastructure and the lack of historical records in many parts of the country. The lack of a legal framework at a national level is also a great barrier for the development of these instruments. In addition, the need of further information on the knowledge and opinions of farmers is also fundamental, as well as the implementation of best soil management practices. The results of the project indicated the needs of obtaining information directed from producers, for that reason a questionnaire was developed according to universities working with the producers, introducing the need of doing a regular survey to get the basic information about the area where we plan to make management improvements. In any case, it was found that to get a better performance on the index insurance projects together with the introduction of best management practices at a large-scale, they must be accompanied by social protection programs. This project is financed by the Spanish Agency for International Development Cooperation (AECID), Ministry of Foreign Affairs and Cooperation, through the PCI funding AP/038205/11 and the economical support of the FES though the Program Angeles Alvariño 2013 of Xunta of Galicia

Effect of water resource development and management on lymphatic filariasis, and estimates of populations at risk.

PubMed

Erlanger, Tobias E; Keiser, Jennifer; Caldas De Castro, Marcia; Bos, Robert; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

2005-09-01

Lymphatic filariasis (LF) is a debilitating disease overwhelmingly caused by Wuchereria bancrofti, which is transmitted by various mosquito species. Here, we present a systematic literature review with the following objectives: (i) to establish global and regional estimates of populations at risk of LF with particular consideration of water resource development projects, and (ii) to assess the effects of water resource development and management on the frequency and transmission dynamics of the disease. We estimate that globally, 2 billion people are at risk of LF. Among them, there are 394.5 million urban dwellers without access to improved sanitation and 213 million rural dwellers living in close proximity to irrigation. Environmental changes due to water resource development and management consistently led to a shift in vector species composition and generally to a strong proliferation of vector populations. For example, in World Health Organization (WHO) subregions 1 and 2, mosquito densities of the Anopheles gambiae complex and Anopheles funestus were up to 25-fold higher in irrigated areas when compared with irrigation-free sites. Although the infection prevalence of LF often increased after the implementation of a water project, there was no clear association with clinical symptoms. Concluding, there is a need to assess and quantify changes of LF transmission parameters and clinical manifestations over the entire course of water resource developments. Where resources allow, integrated vector management should complement mass drug administration, and broad-based monitoring and surveillance of the disease should become an integral part of large-scale waste management and sanitation programs, whose basic rationale lies in a systemic approach to city, district, and regional level health services and disease prevention.

Risk analysis for biological hazards: What we need to know about invasive species

USGS Publications Warehouse

Stohlgren, T.J.; Schnase, J.L.

2006-01-01

Risk analysis for biological invasions is similar to other types of natural and human hazards. For example, risk analysis for chemical spills requires the evaluation of basic information on where a spill occurs; exposure level and toxicity of the chemical agent; knowledge of the physical processes involved in its rate and direction of spread; and potential impacts to the environment, economy, and human health relative to containment costs. Unlike typical chemical spills, biological invasions can have long lag times from introduction and establishment to successful invasion, they reproduce, and they can spread rapidly by physical and biological processes. We use a risk analysis framework to suggest a general strategy for risk analysis for invasive species and invaded habitats. It requires: (1) problem formation (scoping the problem, defining assessment endpoints); (2) analysis (information on species traits, matching species traits to suitable habitats, estimating exposure, surveys of current distribution and abundance); (3) risk characterization (understanding of data completeness, estimates of the “potential” distribution and abundance; estimates of the potential rate of spread; and probable risks, impacts, and costs); and (4) risk management (containment potential, costs, and opportunity costs; legal mandates and social considerations and information science and technology needs).

General medicine and surgery for dental practitioners: part 2. Medical emergencies in dental practice: the drug box, equipment and basic principles of management.

PubMed

Greenwood, M; Meechan, J G

2014-06-13

Dental practitioners need knowledge of the diagnosis and management of medical emergencies. This paper deals with the general aspects of emergency treatment including basic management principles which are applicable to all emergencies. The next paper in this series, part 3, deals with more specific aspects of medical emergency management.

Match of psychosocial risk and psychosocial care in families of a child with cancer.

PubMed

Sint Nicolaas, S M; Schepers, S A; van den Bergh, E M M; de Boer, Y; Streng, I; van Dijk-Lokkart, E M; Grootenhuis, M A; Verhaak, C M

2017-12-01

The Psychosocial Assessment Tool (PAT) was developed to screen for psychosocial risk, aimed to be supportive in directing psychosocial care to families of a child with cancer. This study aimed to determine (i) the match between PAT risk score and provided psychosocial care with healthcare professionals blind to outcome of PAT assessment, and (ii) the match between PAT risk score and team risk estimation. Eighty-three families of children with cancer from four pediatric oncology centers in the Netherlands participated (59% response rate). The PAT and team risk estimation was assessed at diagnosis (M = 40.2 days, SD = 14.1 days), and the content of provided psychosocial care in the 5-month period thereafter resulting in basic or specialized care. According to the PAT, 65% of families were defined as having low (universal), 30% medium (targeted), and 5% high (clinical) risk for developing psychosocial problems. Thirty percent of patients from universal group got basic psychosocial care, 63% got specialized care, and 7% did not get any care. Fourteen percent of the families at risk got basic care, 86% got specialized care. Team risk estimations and PAT risk scores matched with 58% of the families. This study showed that families at risk, based on standardized risk assessment with the PAT, received more specialized care than families without risk. However, still 14% of the families with high risks only received basic care, and 63% of the families with standard risk got specialized care. Standardized risk assessment can be used as part of comprehensive care delivery, complementing the team. © 2017 Wiley Periodicals, Inc.

Risk management of key issues of FPSO

NASA Astrophysics Data System (ADS)

Sun, Liping; Sun, Hai

2012-12-01

Risk analysis of key systems have become a growing topic late of because of the development of offshore structures. Equipment failures of offloading system and fire accidents were analyzed based on the floating production, storage and offloading (FPSO) features. Fault tree analysis (FTA), and failure modes and effects analysis (FMEA) methods were examined based on information already researched on modules of relex reliability studio (RRS). Equipment failures were also analyzed qualitatively by establishing a fault tree and Boolean structure function based on the shortage of failure cases, statistical data, and risk control measures examined. Failure modes of fire accident were classified according to the different areas of fire occurrences during the FMEA process, using risk priority number (RPN) methods to evaluate their severity rank. The qualitative analysis of FTA gave the basic insight of forming the failure modes of FPSO offloading, and the fire FMEA gave the priorities and suggested processes. The research has practical importance for the security analysis problems of FPSO.

Managing the care needs of low-income board-and-care home residents: a process of negotiating risks.

PubMed

Perkins, Molly M; Ball, Mary M; Whittington, Frank J; Combs, Bess L

2004-04-01

Small, low-income board-and-care homes play a critical role in the long-term care system, serving a variety of at-risk groups, including chronically mentally ill individuals, frail elders, and developmentally disabled adults. Unfortunately, the supply of homes available to serve these populations is decreasing. The purpose of this study, based on an in-depth ethnographic case study of one small (13-bed) African American-owned and -operated home in metropolitan Atlanta, was to understand how and why some homes continue to operate despite significant challenges. Grounded theory analysis showed that the survival of this home and residents' ability to remain in it involved a basic social process conceptualized as Negotiating Risks. This survival process often put participants at risk of losing their means of subsistence. Community support emerged as an important protective factor. Findings have implications for community interventions to increase these homes' survival and improve resident care.

Effect of blockage of the endocannabinoid system by CB(1) antagonism on cardiovascular risk.

PubMed

Mach, François; Montecucco, Fabrizio; Steffens, Sabine

2009-01-01

The endocannabinoid system is a crucial player in the inflammatory processes underlying atherosclerosis. Recently, basic research studies and animal models have strongly supported the role of the endocannabinoid system not only in the regulation of classical cardiovascular risk factors (including lipid profile and glucose homeostasis), but also in the activation of immune cells and inflammatory mediators. Clinical trials investigating treatment with rimonabant (a selective antagonist of the cannabinoid type 1 receptor) have suggested a beneficial effect of this drug in the management of obesity. Further studies are needed to explore a possible use for rimonabant in treating type 2 diabetes and acute and chronic cardiovascular disease. Despite the slight increase in adverse events (mainly psychiatric), which has led to the recent withdrawal of rimonabant from the market, CB(1) receptor antagonism might represent a very promising therapeutic strategy to reduce the cardiovascular risk. In the present review, we focused on the most important experimental investigations into the role of the endocannabinoid system in atherosclerosis and cardiovascular risk.

Certified records manager exam

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

Not Available

1990-01-01

The Institute of Certified Records Managers (ICRM) is a non-profit, certifying organization of professional records managers and administrators. ICRM members are experienced in information requirements, records and information systems, and the related office systems and technologies. All members have met certification requirements and have received the Certified Records Manager (CRM) designation. As the field of information and records management moves toward standardization, and as the application of new technologies and technicalities complicate the measurement and demonstration of professional competence, the need for a means of identifying persons who have basic competency increases. The ICRM is providing such a means bymore » testing and certifying basic knowledge. More and more job announcements are requiring this evidence of competency. Unfortunately, as an organization, NIRMA has a relatively small number of CRMs. The goal of the ICRM Development Group is two-fold; (1) to encourage NIRMA members to obtain their certification by providing basic information and support and; (2) to develop the Nuclear Specialist test module which will demonstrate that bearers have demonstrated expertise in nuclear records management as well as basic competencies. This report covers the examination process.« less

Management of pulmonary arterial hypertension.

PubMed

McLaughlin, Vallerie V; Shah, Sanjiv J; Souza, Rogerio; Humbert, Marc

2015-05-12

Pulmonary hypertension (PH) is common and may result from a number of disorders, including left heart disease, lung disease, and chronic thromboembolic disease. Pulmonary arterial hypertension (PAH) is an uncommon disease characterized by progressive remodeling of the distal pulmonary arteries, resulting in elevated pulmonary vascular resistance and, eventually, in right ventricular failure. Over the past decades, knowledge of the basic pathobiology of PAH and its natural history, prognostic indicators, and therapeutic options has exploded. A thorough evaluation of a patient is critical to correctly characterize the PH. Cardiac studies, including echocardiography and right heart catheterization, are key elements in the assessment. Given the multitude of treatment options currently available for PAH, assessment of risk and response to therapy is critical in long-term management. This review also underscores unique situations, including perioperative management, intensive care unit management, and pregnancy, and highlights the importance of collaborative care of the PAH patient through a multidisciplinary approach. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Agent-Based Simulations for Project Management

NASA Technical Reports Server (NTRS)

White, J. Chris; Sholtes, Robert M.

2011-01-01

Currently, the most common approach used in project planning tools is the Critical Path Method (CPM). While this method was a great improvement over the basic Gantt chart technique being used at the time, it now suffers from three primary flaws: (1) task duration is an input, (2) productivity impacts are not considered , and (3) management corrective actions are not included. Today, computers have exceptional computational power to handle complex simulations of task e)(eculion and project management activities (e.g ., dynamically changing the number of resources assigned to a task when it is behind schedule). Through research under a Department of Defense contract, the author and the ViaSim team have developed a project simulation tool that enables more realistic cost and schedule estimates by using a resource-based model that literally turns the current duration-based CPM approach "on its head." The approach represents a fundamental paradigm shift in estimating projects, managing schedules, and reducing risk through innovative predictive techniques.

Management of dyslipidemia and hyperglycemia with a fixed-dose combination of sitagliptin and simvastatin

PubMed Central

Steinberg, Helmut; Anderson, Matt S; Musliner, Thomas; Hanson, Mary E; Engel, Samuel S

2013-01-01

The risk of death due to heart disease and stroke is up to four times higher in individuals with diabetes compared to individuals without diabetes. Most guidelines that address treatment of dyslipidemia in patients with diabetes consider diabetes a cardiovascular disease (CVD) “risk equivalent” and recommend intensive treatment of dyslipidemia for the purpose of CVD prevention. Statins (3-hydroxy 3-methylglutaryl coenzyme A reductase [HMG-CoA reductase] inhibitors) are first-line agents in achieving lipid goals as an adjunct to diet and exercise and should be used in most patients. In addition to lipid management and blood pressure control, glycemic control is a basic component in the management of diabetes. Glycemic control is achieved by combining diabetes self-management education, diet and exercise, and, where required, antihyperglycemic agents (OHAs). Persistence and adherence to therapy are critical in achieving recommended treatment goals. However, overall compliance with concomitantly prescribed OHAs and statins is low in patients with type 2 diabetes. Fixed-dose combination (FDC) therapies have been shown to improve adherence by reducing pill burden, the complexity of treatment regimen, and, potentially, cost. Based on the available evidence regarding the pharmacokinetics and the efficacy and safety profiles of each component drug, the sitagliptin/simvastatin FDC may provide a rational and well-tolerated approach to achieving better adherence to multiple-drug therapy and improved lipid lowering and glycemic control, with consequent reduction in cardiovascular risk, diabetic microvascular disease, and mortality in diabetic patients for whom treatment with both compounds is appropriate. PMID:23761972

Telecommunications handbook for transportation professionals : the basics of telecommunications.

DOT National Transportation Integrated Search

2004-08-01

This handbook was created to provide individuals responsible for managing and implementing Traffic : Signal, and Freeway Management programs with an understand of the basic technologies of : telecommunications. The handbook provides a brief look at t...

Normal accidents: human error and medical equipment design.

PubMed

Dain, Steven

2002-01-01

High-risk systems, which are typical of our technologically complex era, include not just nuclear power plants but also hospitals, anesthesia systems, and the practice of medicine and perfusion. In high-risk systems, no matter how effective safety devices are, some types of accidents are inevitable because the system's complexity leads to multiple and unexpected interactions. It is important for healthcare providers to apply a risk assessment and management process to decisions involving new equipment and procedures or staffing matters in order to minimize the residual risks of latent errors, which are amenable to correction because of the large window of opportunity for their detection. This article provides an introduction to basic risk management and error theory principles and examines ways in which they can be applied to reduce and mitigate the inevitable human errors that accompany high-risk systems. The article also discusses "human factor engineering" (HFE), the process which is used to design equipment/ human interfaces in order to mitigate design errors. The HFE process involves interaction between designers and endusers to produce a series of continuous refinements that are incorporated into the final product. The article also examines common design problems encountered in the operating room that may predispose operators to commit errors resulting in harm to the patient. While recognizing that errors and accidents are unavoidable, organizations that function within a high-risk system must adopt a "safety culture" that anticipates problems and acts aggressively through an anonymous, "blameless" reporting mechanism to resolve them. We must continuously examine and improve the design of equipment and procedures, personnel, supplies and materials, and the environment in which we work to reduce error and minimize its effects. Healthcare providers must take a leading role in the day-to-day management of the "Perioperative System" and be a role model in promoting a culture of safety in their organizations.

Basic management of medical emergencies: recognizing a patient's distress.

PubMed

Reed, Kenneth L

2010-05-01

Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.

Mild Traumatic Brain Injury Pocket Guide (CONUS)

DTIC Science & Technology

2010-01-01

Cognitive Rehab Driving Following TBI Patient Education Clinical Tools and Resources Report Documentation Page Form ApprovedOMB No. 0704-0188 Public... Rehab Driving Following TBI Patient Education Clinical Tools and Resources 2 3 TBI Basics VA/DoD CPG Management of Headaches Management of Other...Symptoms ICD-9 Coding Cognitive Rehab Driving Following TBI Patient Education Clinical Tools and Resources TBI BASICS 4 5 TBI BASICS dod definition

Evaluation of wholesale electric power market rules and financial risk management by agent-based simulations

NASA Astrophysics Data System (ADS)

Yu, Nanpeng

As U.S. regional electricity markets continue to refine their market structures, designs and rules of operation in various ways, two critical issues are emerging. First, although much experience has been gained and costly and valuable lessons have been learned, there is still a lack of a systematic platform for evaluation of the impact of a new market design from both engineering and economic points of view. Second, the transition from a monopoly paradigm characterized by a guaranteed rate of return to a competitive market created various unfamiliar financial risks for various market participants, especially for the Investor Owned Utilities (IOUs) and Independent Power Producers (IPPs). This dissertation uses agent-based simulation methods to tackle the market rules evaluation and financial risk management problems. The California energy crisis in 2000-01 showed what could happen to an electricity market if it did not go through a comprehensive and rigorous testing before its implementation. Due to the complexity of the market structure, strategic interaction between the participants, and the underlying physics, it is difficult to fully evaluate the implications of potential changes to market rules. This dissertation presents a flexible and integrative method to assess market designs through agent-based simulations. Realistic simulation scenarios on a 225-bus system are constructed for evaluation of the proposed PJM-like market power mitigation rules of the California electricity market. Simulation results show that in the absence of market power mitigation, generation company (GenCo) agents facilitated by Q-learning are able to exploit the market flaws and make significantly higher profits relative to the competitive benchmark. The incorporation of PJM-like local market power mitigation rules is shown to be effective in suppressing the exercise of market power. The importance of financial risk management is exemplified by the recent financial crisis. In this dissertation, basic financial risk management concepts relevant for wholesale electric power markets are carefully explained and illustrated. In addition, the financial risk management problem in wholesale electric power markets is generalized as a four-stage process. Within the proposed financial risk management framework, the critical problem of financial bilateral contract negotiation is addressed. This dissertation analyzes a financial bilateral contract negotiation process between a generating company and a load-serving entity in a wholesale electric power market with congestion managed by locational marginal pricing. Nash bargaining theory is used to model a Pareto-efficient settlement point. The model predicts negotiation results under varied conditions and identifies circumstances in which the two parties might fail to reach an agreement. Both analysis and agent-based simulation are used to gain insight regarding how relative risk aversion and biased price estimates influence negotiated outcomes. These results should provide useful guidance to market participants in their bilateral contract negotiation processes.

Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management.

PubMed

Malamed, Stanley F

2015-12-01

Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

Assessment of disaster preparedness among emergency departments in Italian hospitals: a cautious warning for disaster risk reduction and management capacity.

PubMed

Paganini, Matteo; Borrelli, Francesco; Cattani, Jonathan; Ragazzoni, Luca; Djalali, Ahmadreza; Carenzo, Luca; Della Corte, Francesco; Burkle, Frederick M Jr; Ingrassia, Pier Luigi

2016-08-15

Since the 1990s, Italian hospitals are required to comply with emergency disaster plans known as Emergency Plan for Massive Influx of Casualties. While various studies reveal that hospitals overall suffer from an insufficient preparedness level, the aim of this study was to better determine the preparedness level of Emergency Departments of Italian hospitals by assessing the knowledge-base of emergency physicians regarding basic disaster planning and procedures. A prospective observational study utilized a convenience sample of Italian Emergency Departments identified from the Italian Ministry of Health website. Anonymous telephone interviews were conducted of medical consultants in charge at the time in the respective Emergency Departments, and were structured in 3 parts: (1) general data and demographics, (2) the current disaster plan and (3) protocols and actions of the disaster plan. Eighty-five Emergency Departments met inclusion criteria, and 69 (81 %) agreed to undergo the interview. Only 45 % of participants declared to know what an Emergency Plan for Massive Influx of Casualties is, 41 % believed to know who has the authority to activate the plan, 38 % knew who is in charge of intra-hospital operations. In Part 3 physicians revealed a worrisome inconsistency in critical content knowledge of their answers. Results demonstrate a poor knowledge-base of basic hospital disaster planning concepts by Italian Emergency Department physicians-on-duty. These findings should alert authorities to enhance staff disaster preparedness education, training and follow-up to ensure that these plans are known to all who have responsibility for disaster risk reduction and management capacity.

Warning Signals: Basic Criteria for Tracking At-Risk Infants and Toddlers.

ERIC Educational Resources Information Center

Blackman, James

Developed by a multidisciplinary group (convened by Project Zero to Three) of 17 experts in the identification and evaluation of high risk infants and young children, this manual presents basic criteria for tracking at risk infants and toddlers. The first section answers such questions about the criteria as the following: What is a tracking system…

Emergency medicine: beyond the basics.

PubMed

Malamed, S F

1997-07-01

Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

Needs Assessment for the Construction Industry in B.C. & the Yukon. Skill Plan.

ERIC Educational Resources Information Center

Lewe, Glenda

A basic skills needs assessment developed a picture of the basic skills levels and needs of the construction industry in British Columbia and the Yukon. The three parts of the assessment were interviews with business managers and managers of other programs provided through joint labor/management initiatives, a questionnaire administered to…

Emerging technologies in healthcare: navigating risks, evaluating rewards.

PubMed

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

2010-01-01

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

The 14th Hoyt Lecture: Ischemic Optic Neuropathy: The Evolving Profile, 1966-2015.

PubMed

Arnold, Anthony C

2016-06-01

Since the first English language description by Miller and Smith in 1966 of ischemic optic neuropathy as a distinct ophthalmic syndrome, a long series of studies has refined the clinical profile to what we consider to be accurate today. From the specifics of pathogenesis to the clinical appearance to the effect of therapy, the basic tenets of diagnosis and management have evolved over 5 decades. What we thought we knew about the following topics has changed: location of vasculopathy; incidence; age at onset; optic disc appearance; risk factors for development; natural history; rate of fellow eye involvement; ischemia as an all-or-none phenomenon; and treatment. A look back at these discoveries shows both how far we have come and how far we have to go in managing this disorder.

Lipoprotein (a) Management: Lifestyle and Hormones.

PubMed

Garcia-Rios, Antonio; Leon-Acuna, Ana; Lopez-Miranda, Jose; Perez-Martinez, Pablo

2017-01-01

Cardiovascular disease (CVD) continues to be the first cause of mortality in developed countries. Moreover, far from diminishing, the cardiovascular risk factors leading towards the development of CVD are on the rise. Therefore, the preventive and therapeutic management which is currently in place is clearly not enough to stop this pandemic. In this context, a major resurgence in interest in lipoprotein (a) [Lp(a)] has occurred in light of its association with CVD. This series aims to review the basic and clinical aspects of Lp(a) biology. Specifically, the present review considers the current situation regarding the influence of lifestyle, hormones and other physiological or pathological conditions on Lp(a) plasma concentrations which might mitigate the harmful effects of this lipoprotein. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Risk Importance Measures in the Designand Operation of Nuclear Power Plants

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

Vrbanic I.; Samanta P.; Basic, I

This monograph presents and discusses risk importance measures as quantified by the probabilistic risk assessment (PRA) models of nuclear power plants (NPPs) developed according to the current standards and practices. Usually, PRA tools calculate risk importance measures related to a single ?basic event? representing particular failure mode. This is, then, reflected in many current PRA applications. The monograph focuses on the concept of ?component-level? importance measures that take into account different failure modes of the component including common-cause failures (CCFs). In opening sections the roleof risk assessment in safety analysis of an NPP is introduced and discussion given of ?traditional?,more » mainly deterministic, design principles which have been established to assign a level of importance to a particular system, structure or component. This is followed by an overview of main risk importance measures for risk increase and risk decrease from current PRAs. Basic relations which exist among the measures are shown. Some of the current practical applications of risk importancemeasures from the field of NPP design, operation and regulation are discussed. The core of the monograph provides a discussion on theoreticalbackground and practical aspects of main risk importance measures at the level of ?component? as modeled in a PRA, starting from the simplest case, single basic event, and going toward more complexcases with multiple basic events and involvements in CCF groups. The intent is to express the component-level importance measures via theimportance measures and probabilities of the underlying single basic events, which are the inputs readily available from a PRA model andits results. Formulas are derived and discussed for some typical cases. The formulas and their results are demonstrated through some practicalexamples, done by means of a simplified PRA model developed in and run by RiskSpectrum? tool, which are presented in the appendices. The monograph concludes with discussion of limitations of the use of risk importance measures and a summary of component-level importance cases evaluated.« less

A new web-based course: dealing with glaciers and permafrost hazards

NASA Astrophysics Data System (ADS)

Oswald, S.; Kaeaeb, A.; Haeberli, W.

2003-04-01

The intensive human use of high mountains intersects more and more with the hazard zones of such environments. Because of the complexity of such processes and impacts, dealing with such risks requires a broad education in many sub-domains of the earth sciences and the socio-economic field. Inter- and trans-disciplinary training and education of professionals is therefore essential. Thus the goal of the Swiss Virtual Campus project "Dealing with Natural Hazards" is to provide such a course program covering the basics of dealing with natural hazards, including technical, environmental and social aspects. In the field of natural hazards and risk management, education at the Swiss universities is mostly structured in narrow sectors. Using the advantages of the internet, the Virtual Campus provides teachers and students an interdisciplinary discussion platform on the integral approach and the handling with natural hazards. The course content is organised in 5 modules: 1 basic knowledge and tools, 2 hydrological / meteorological hazards, 3 geological hazards, 4 vulnerability of property and of socio-economic systems and 5 integral natural risk management. To ensure a national and international access the courses are designed in English and published on the internet. Within the scope of this project we are developing lessons in the subject area of natural hazards related to glaciers and permafrost. These are ice avalanches, glacier floods, glacier length variations and permafrost. The content is divided into chapters, which are consistent over the entire module: (1) processes: characterisation of the different processes, (2) triggering: initiating events, (3) data acquisition, mapping and monitoring: appropriate methods, (4) estimation models: application of the adequate model, (5) combinations and interactions: interrelation and impacts of different hazards, (6) long-term effects: global change effects, (7) integral hazard recognition and assessment: integral proceedings, (8) measures: appropriate protection measures, (9) examples: different cases from throughout the world. It is our goal to design the e-lessons in interactive way, to utilise the benefits of computer-based learning. The course will replace the classical way of "ex-cathedra" teaching by problem-based learning. After working out the basics individually the students shell have the opportunity to discuss and apply their acquired knowledge by editing case studies. It is also planned to use the course for capacity building in development countries.

Ethics and managed care.

PubMed

Perkel, R L

1996-03-01

Managed care presents physicians with potential ethical dilemmas different from dilemmas in traditional fee-for-service practice. The ethical assumptions of managed care are explored, with special attention to the evolving dual responsibilities of physicians as patient advocates and as entrepreneurs. A number of proposals are described that delineate issues in support of and in opposition to managed care. Through an understanding of how to apply basic ethics principles to managed care participation, physicians may yet hold on to the basic ethic of the fiduciary doctor-patient relationship.

[Alcohol intake and gamma -GTP observed from the viewpoint of an occupational physician].

PubMed

Oikawa, Takamitsu

2007-06-01

Alcohol is an important basic factor in health management at the workplace. The fact is, however, when alcohol is pervasive in a worker's daily life, effective measures are very difficult to carry out. We examined an intervention program based on serum y -GTP (IU/l) measurements at physical examination. Subjects were clients of the Keio Counseling Center in2005 (male, 5568: female, 1725). Among nondrinkers, gamma-GTP values were under 50 in 83% of men and 93% of women. Relative risk of lifestyle-related diseases (obesity, hypertension, hyperlipidemia, hyperuricemia, hyperglycemia and fatty liver) among male drinkers increased dramatically when gamma-GTP exceeded 50,with a further gradual increase for gamma-GTP over 100. Moreover, relative risk of over two concurrent diseases among obesity, hypertension, hyperlipidemia and hyperglycemia increased when gamma-GTP exceeded 25 and greatly increased beyond 50. While the findings suggest 25 or less as an ideal gamma-GTP values, a workplace program might more practically regard values over 50 as a threshold for management measures and values over 100 as indicating enforced management. At the workplace, management of other diseases including lifestyle-related diseases, alcoholism per se, and mental health issues needs to be carried out in a balanced, coordinated manner. Cooperation of related medical institutions and effective alcohol treatment program, and efforts to enlist the understanding and trust of all workers are needed.

Carbonyl compounds generated from electronic cigarettes.

PubMed

Bekki, Kanae; Uchiyama, Shigehisa; Ohta, Kazushi; Inaba, Yohei; Nakagome, Hideki; Kunugita, Naoki

2014-10-28

Electronic cigarettes (e-cigarettes) are advertised as being safer than tobacco cigarettes products as the chemical compounds inhaled from e-cigarettes are believed to be fewer and less toxic than those from tobacco cigarettes. Therefore, continuous careful monitoring and risk management of e-cigarettes should be implemented, with the aim of protecting and promoting public health worldwide. Moreover, basic scientific data are required for the regulation of e-cigarette. To date, there have been reports of many hazardous chemical compounds generated from e-cigarettes, particularly carbonyl compounds such as formaldehyde, acetaldehyde, acrolein, and glyoxal, which are often found in e-cigarette aerosols. These carbonyl compounds are incidentally generated by the oxidation of e-liquid (liquid in e-cigarette; glycerol and glycols) when the liquid comes in contact with the heated nichrome wire. The compositions and concentrations of these compounds vary depending on the type of e-liquid and the battery voltage. In some cases, extremely high concentrations of these carbonyl compounds are generated, and may contribute to various health effects. Suppliers, risk management organizations, and users of e-cigarettes should be aware of this phenomenon.

Literacy and motivation for the prevention and control of hypertension among female community health volunteers: a qualitative study from Nepal.

PubMed

Neupane, Dinesh; Mclachlan, Craig S; Gautam, Rupesh; Mishra, Shiva Raj; Thorlund, Michael; Schlütter, Mette; Kallestrup, Per

2015-01-01

The prevalence of hypertension is increasing in Nepal. Thus, there is a need for a programme to improve primary healthcare. One possibility is to assign prevention, diagnosis, and treatment of hypertension to female community health volunteers (FCHVs). To assess literacy and motivation to be involved in a hypertension prevention and control programme in Nepal among FCHVs. Five focus group discussions (FGDs) were conducted with a total of 69 FCHVs in Lekhnath municipality, Kaski district, Nepal. Seven themes were developed on the basis of data collection: 1) knowledge about hypertension; 2) risk factors of hypertension; 3) prevention and control of hypertension; 4) access to treatment for hypertension in the community; 5) learning about blood pressure measurement; 6) ability to raise blood pressure awareness in the community; 7) possible challenges for their future involvement. Data were analysed using the thematic analysis approach. FCHVs have some knowledge about diagnosis, risk factors, and complications of hypertension. General unanimity was observed in the understanding that hypertension and risk factors needed to be addressed. The willingness of FCHVs to contribute to prevention, control, and management was strong, and they were confident that with some basic training they could obtain skills in hypertension management. Despite limited knowledge about hypertension, FCHVs expressed willingness and readiness to be trained in hypertension management. This study supports the possibility of involving FCHVs in prevention and control of hypertension in Nepal.

Modeling seasonal behavior changes and disease transmission with application to chronic wasting disease.

PubMed

Oraby, Tamer; Vasilyeva, Olga; Krewski, Daniel; Lutscher, Frithjof

2014-01-07

Behavior and habitat of wildlife animals change seasonally according to environmental conditions. Mathematical models need to represent this seasonality to be able to make realistic predictions about the future of a population and the effectiveness of human interventions. Managing and modeling disease in wild animal populations requires particular care in that disease transmission dynamics is a critical consideration in the etiology of both human and animal diseases, with different transmission paradigms requiring different disease risk management strategies. Since transmission of infectious diseases among wildlife depends strongly on social behavior, mechanisms of disease transmission could also change seasonally. A specific consideration in this regard confronted by modellers is whether the contact rate between individuals is density-dependent or frequency-dependent. We argue that seasonal behavior changes could lead to a seasonal shift between density and frequency dependence. This hypothesis is explored in the case of chronic wasting disease (CWD), a fatal disease that affects deer, elk and moose in many areas of North America. Specifically, we introduce a strategic CWD risk model based on direct disease transmission that accounts for the seasonal change in the transmission dynamics and habitats occupied, guided by information derived from cervid ecology. The model is composed of summer and winter susceptible-infected (SI) equations, with frequency-dependent and density-dependent transmission dynamics, respectively. The model includes impulsive birth events with density-dependent birth rate. We determine the basic reproduction number as a weighted average of two seasonal reproduction numbers. We parameterize the model from data derived from the scientific literature on CWD and deer ecology, and conduct global and local sensitivity analyses of the basic reproduction number. We explore the effectiveness of different culling strategies for the management of CWD: although summer culling seems to be an effective disease eradication strategy, the total culling rate is limited by the requirement to preserve the herd. © 2013 Elsevier Ltd. All rights reserved.

The Definition of Basic Skills in Manufacturing Industries.

ERIC Educational Resources Information Center

Jones, Charles M.

1996-01-01

Survey responses from 186 of 250 trainers/human resource managers and a Delphi panel of 21 rated companies' basic skills training provisions and the importance of basic skills. Although most stated their companies provide basic skills training, results show most are reluctant to hire, train, or retain workers with low basic skills. (SK)

The biology of cancer: what do oncology nurses really need to know.

PubMed

Eggert, Julie

2011-02-01

To describe the impact of genetics and genomics on the biology of cancer and the implications for patient care. Pubmed; CINAHL. Cancer research in genetics/genomics has identified new mechanisms influencing personalized risk assessment/management, early detection, cancer treatment, and long-term screening/surveillance. Understanding the basics of genetics/genomics on the biology of cancer will facilitate patient education and care delivery, including the administration and monitoring of genetically targeted therapies whose toxicities may in part be mediated by the molecular pathways targeted by the specific agent. Copyright © 2011 Elsevier Inc. All rights reserved.

Caring capacity in the management of the nutrition crisis in infants, young children and women in Nigeria.

PubMed

Igbedioh, S O

1996-01-01

Nigeria's nutrition crisis has been shown to have a considerable negative impact on infants, young children and women. Available evidence suggests that 'caring capacity' when properly planned and targeted at the most-at-risk can help. Strategies that can achieve this care are increasing women's income and control over income, increasing investment in women's education and improving access to credit facilities. Others are the aggressive promotion of gender-biased labour saving technology, increasing women's access to basic health and family planning services and implementing reforms in land ownership while instituting social security for women.

Spatiotemporal patterns of population distribution as crucial element for risk management

NASA Astrophysics Data System (ADS)

Gokesch, Karin; Promper, Catrin; van Westen, Cees J.; Glade, Thomas

2014-05-01

The spatiotemporal distribution and presence of the population in a certain area is a crucial element within natural hazard risk management, especially in the case of rapid onset hazard events and emergency management. When fast onset hazards such as earthquakes, flash floods or industrial accidents occur, people may not have adequate time for evacuation and the emergency management requires a fast response and reaction. Therefore, information on detailed distribution of people affected by a certain hazard is important for a fast assessment of the situation including the number and the type of people (distinguishing between elderly or handicapped people, children, working population etc.) affected. This study thus aims at analyzing population distribution on an hourly basis for different days e.g. workday or holiday. The applied method combines the basic assessment of population distribution in a given area with specific location-related patterns of distribution-changes over time. The calculations are based on detailed information regarding the expected presence of certain groups of people, e.g. school children, working or elderly people, which all show different patterns of movement over certain time periods. The study area is the city of Waidhofen /Ybbs located in the Alpine foreland in the Southwest of Lower Austria. This city serves as a regional center providing basic infrastructure, shops and schools for the surrounding countryside. Therefore a lot of small and medium businesses are located in this area showing a rather high variation of population present at different times of the day. The available building footprint information was classified with respect to building type and occupancy type, which was used to estimate the expected residents within the buildings, based on the floorspace of the buildings and the average floorspace per person. Additional information on the distribution and the average duration of stay of the people in these buildings was assessed using general population statistics and specific information about selected buildings, such as schools, hospitals or homes for the elderly, to calculate the distribution patterns for each group of people over time.

The asset pricing model of musharakah factors

NASA Astrophysics Data System (ADS)

Simon, Shahril; Omar, Mohd; Lazam, Norazliani Md

2015-02-01

The existing three-factor model developed by Fama and French for conventional investment was formulated based on risk-free rates element in which contradict with Shariah principles. We note that the underlying principles that govern Shariah investment were mutual risk and profit sharing between parties, the assurance of fairness for all and that transactions were based on an underlying asset. In addition, the three-factor model did not exclude stock that was not permissible by Shariah such as financial services based on riba (interest), gambling operator, manufacture or sale of non-halal products or related products and other activities deemed non-permissible according to Shariah. Our approach to construct the factor model for Shariah investment was based on the basic tenets of musharakah in tabulating the factors. We start by noting that Islamic stocks with similar characteristics should have similar returns and risks. This similarity between Islamic stocks was defined by the similarity of musharakah attributes such as business, management, profitability and capital. These attributes define factor exposures (or betas) to factors. The main takeaways were that musharakah attributes we chose had explain stock returns well in cross section and were significant in different market environments. The management factor seemed to be responsible for the general dynamics of the explanatory power.

75 FR 27547 - Notice of Reestablishment of the Secretary of Energy Advisory Board

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... management, basic science, research, development and technology activities; energy and national security... basis of their broad competence in areas relating to quality management, basic science, renewable energy, energy policy, environmental science, economics, and broad public policy interests. Membership of the...

[Genetic counseling in cystic fibrosis].

PubMed

Julia, S; Bieth, E

2000-08-01

Genetic counseling is an important part of health care in patients with cystic fibrosis or respiratory diseases associated with the CFTR (cystic fibrosis transmembrane conductance regulator) gene, including certain types of allergic bronchopulmonary aspergilloses or bronchial diseases (diffuse bronchiectasia). The basic goal is to provide patients with information on the transmission of cystic fibrosis and to asses the risk of recurrence. This risk is determined from molecular biology analyses examining the CFTR gene. Genotyping is the only means of screening for the heterozygous state, frequent in the French population (about 1/30). Because of the large number of mutated alleles not covered entirely by the genetic tests, there remains a question of probability expressed as a residual risk of a heterozygous state. A prenatal genotype diagnosis should be proposed to heterozygous couples who have a 25% risk of having a diseased child. Technically, this is almost always possible and the results are highly reliable. Nevertheless, there remains the risks related to sample taking and the ethical issue about which the patients must be informed. Management of these at risk couples who desire a child must be based on a multidisciplinary approach, particularly important when one of the parents has overt cystic fibrosis.

[Suicide Risk Assessment in the Clinical Practice Guidelines for the Diagnosis and Management of Depression in Colombia].

PubMed

Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Gil Lemus, Laura Marcela; Jaramillo, Luis Eduardo; García Valencia, Jenny; Bravo Narváez, Eliana; de la Hoz Bradford, Ana María; Palacio, Carlos

2013-01-01

Suicide is the most serious complications of depression. It has high associated health costs and causes millions of deaths worldwide per year. Given its implications, it is important to know the factors that increase the risk of its occurrence and the most useful tools for addressing it. To identify the signs and symptoms that indicate an increased risk of suicide, and factors that increase the risk in patients diagnosed with depression. To establish the tools best fitted to identify suicide risk in people with depression. Clinical practice guidelines were developed, following those of the methodmethodological guidelines of the Ministry of Social Protection, to collect evidence and to adjust recommendations. Recommendations from the NICE90 and CANMAT guidelines were adopted and updated for questions found in these guidelines, while new recommendations were developed for questions not found in them. Basic points and recommendations are presented from a chapter of the clinical practice guidelines on depressive episodes and recurrent depressive disorder related to suicide risk assessment. Their corresponding recommendation levels are included. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

ELICITED EXPERT PERCEPTIONS FOR CLIMATE CHANGE RISKS AND ADAPTATION IN AGRICULTURE AND FOOD PRODUCTION THROUGH MENTAL MODELS APPROACH

NASA Astrophysics Data System (ADS)

Suda, Eiko; Kubota, Hiromi; Baba, Kenshi; Hijioka, Yasuaki; Takahashi, Kiyoshi; Hanasaki, Naota

Impacts of climate change have become obvious in agriculture and food production in Japan these days, and researches to adapt to their risks have been conducted as a key effort to cope with the climate change. Numerous scientific findings on climate change impacts have been presented so far; however, prospective risks to be adapted to and their management in the context of individual on-site situations have not been investigated in detail. The structure of climate change risks and their management vary depending on geographical and social features in the regions where the adaptation options should be applied; therefore, a practical adaptation strategy should consider actual on-site situations. This study intended to clarify climate change risks to be adapted to in the Japanese agricultural sector, and factors to be considered in adaptation options, for encouragement of decision-making on adaptation implementation in the field. Semi-structured individual interviews have been conducted with 9 multidisciplinary experts engaging in climate change impacts research in agricultural production, economics, engineering, policy, and so on. Based on the results of the interviews, and the latest literatures available for risk assessment and adaptation, an expert mental model including their perceptions which cover the process from climate change impacts assessment to adaptation has been developed. The prospective risks, adaptation options, and issues to be examined to progress the development of practical and effective adaptation options and to support individual or social decision-making, have been shown on the developed expert mental model. It is the basic information for developing social communication and stakeholders cooperations in climate change adaptation strategies in agriculture and food production in Japan.

Hazards and occupational risk in hard coal mines - a critical analysis of legal requirements

NASA Astrophysics Data System (ADS)

Krause, Marcin

2017-11-01

This publication concerns the problems of occupational safety and health in hard coal mines, the basic elements of which are the mining hazards and the occupational risk. The work includes a comparative analysis of selected provisions of general and industry-specific law regarding the analysis of hazards and occupational risk assessment. Based on a critical analysis of legal requirements, basic assumptions regarding the practical guidelines for occupational risk assessment in underground coal mines have been proposed.

5 CFR 831.1203 - Basic requirements for disability retirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Basic requirements for disability retirement. 831.1203 Section 831.1203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... service, or with the former employing agency or the Office of Personnel Management (OPM) within 1 year...

5 CFR 831.1203 - Basic requirements for disability retirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Basic requirements for disability retirement. 831.1203 Section 831.1203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... service, or with the former employing agency or the Office of Personnel Management (OPM) within 1 year...

Primary Health Care as a guide for assistance to infants at risk of neurodevelopmental disorders.

PubMed

Molini-Avejonas, Daniela Regina; Rondon-Melo, Silmara; Batista, Estela Ramos; Souza, Amanda Calsolari de; Dias, Daniela Cardilli; Samelli, Alessandra Gianella

2018-01-01

Purpose Characterize infants at risk of neurodevelopmental disorders according to sociodemographic and health profiles and describe their monitoring in Basic Health Units (UBS) under different management models. Methods Data were collected from medical records of infants at risk of neurodevelopmental disorders in the west region of the city of Sao Paulo from August 2013 to February 2014 (phase 1 - characterization; phase 2 - monitoring). Results Of the 225 individuals assessed in the first phase of the study, 51.1% were female and 7.11% were twins. Adolescent (45.2%), brown (50.56%), single (46.09%), complete primary education (47.60%) mothers were predominant. The mean number of prenatal visits was 7.12. Most mothers had vaginal delivery (62.22%) at mean gestational age of 37.05 weeks. Mean Apgar scores at the 1st and 5th minutes were 7.13 and 8.80, respectively. Mean weight at birth was 2597.21g., with 50.22% of newborns weighting ≤2500g. In its second phase, the study describes and compares the follow-up of 55 infants according to the UBS management model: 28 in UBS/"Estratégia Saúde da Família" (UBS/ESF) and 27 in traditional UBS (UBS/T). UBS/ESF presented higher mean of consultations (p=0.006). Longer interval between consultations was observed at UBS/T. No records of development milestones were found in 56% of the sample. Growth measures were better registered at UBS/ESF. In both management models, the number of consultations was smaller and the interval between them was shorter than those recommended by the Brazilian Ministry of Health. Conclusion According to the recommended guidelines of the "Rede Cegonha" public policy, gaps in the monitoring of infants at risk of neurodevelopmental disorders are still observed.

Concerns related to Safety Management of Engineered Nanomaterials in research environment

NASA Astrophysics Data System (ADS)

Groso, A.; Meyer, Th

2013-04-01

Since the rise of occupational safety and health research on nanomaterials a lot of progress has been made in generating health effects and exposure data. However, when detailed quantitative risk analysis is in question, more research is needed, especially quantitative measures of workers exposure and standards to categorize toxicity/hazardousness data. In the absence of dose-response relationships and quantitative exposure measurements, control banding (CB) has been widely adopted by OHS community as a pragmatic tool in implementing a risk management strategy based on a precautionary approach. Being in charge of health and safety in a Swiss university, where nanomaterials are largely used and produced, we are also faced with the challenge related to nanomaterials' occupational safety. In this work, we discuss the field application of an in-house risk management methodology similar to CB as well as some other methodologies. The challenges and issues related to the process will be discussed. Since exact data on nanomaterials hazardousness are missing for most of the situations, we deduce that the outcome of the analysis for a particular process is essentially the same with a simple methodology that determines only exposure potential and the one taking into account the hazardousness of ENPs. It is evident that when reliable data on hazardousness factors (as surface chemistry, solubility, carcinogenicity, toxicity etc.) will be available, more differentiation will be possible in determining the risk for different materials. On the protective measures side, all CB methodologies are inclined to overprotection side, only that some of them suggest comprehensive protective/preventive measures and others remain with basic advices. The implementation and control of protective measures in research environment will also be discussed.

Municipal solid waste management in Rasht City, Iran.

PubMed

Alavi Moghadam, M R; Mokhtarani, N; Mokhtarani, B

2009-01-01

Pollution and health risks generated by improper solid waste management are important issues concerning environmental management in developing countries. In most cities, the use of open dumps is common for the disposal of wastes, resulting in soil and water resource contamination by leachate in addition to odors and fires. Solid waste management infrastructure and services in developing countries are far from achieving basic standards in terms of hygiene and efficient collection and disposal. This paper presents an overview of current municipal solid waste management in Rasht city, Gilan Province, Iran, and provides recommendations for system improvement. The collected data of different MSW functional elements were based on data from questionnaires, visual observations of the authors, available reports and several interviews and meetings with responsible persons. Due to an increase in population and changes in lifestyle, the quantity and quality of MSW in Rasht city has changed. Lack of resources, infrastructure, suitable planning, leadership, and public awareness are the main challenges of MSW management of Rasht city. However, the present situation of solid waste management in this city, which generates more than 400tons/d, has been improved since the establishment of an organization responsible only for solid waste management. Source separation of wastes and construction of a composting plant are the two main activities of the Rasht Municipality in recent years.

Use of EPA collaborative problem-solving model to obtain environmental justice in North Carolina.

PubMed

Wilson, Sacoby M; Wilson, Omega R; Heaney, Christopher D; Cooper, John

2007-01-01

The West End Revitalization Association (WERA), a community-based organization (CBO) in Mebane, North Carolina, was awarded a Collaborative Problem-Solving (CPS) grant from the U.S. Environmental Protection Agency's Office of Environmental Justice (EPA OEJ). The purpose of this paper is to highlight WERA's efforts to bring stakeholders in three low-income African-American communities where environmental hazards created public health risks together for collaboration rather than litigation. WERA's board and staff organized nine working groups with specific areas of expertise that would facilitate research, identify lack of basic amenities, and encourage funding for corrective action and participation in progress reporting workshops. WERA used consensus building, dispute resolution, and resource mobilization as part of the CPS model to address noncompliance with environmental laws, including the Clean Air Act, Clean Water Act, Safe Drinking Water Act, Toxic Substances Control Act, and Solid Waste Disposal Act. WERA's CPS "Right to Basic Amenities" project produced a framework for (1) grassroots management and ownership of a collaborative problem-solving process; (2) bringing stakeholders together with diverse and conflicting viewpoints; (3) implementation of an innovative community-owned and managed (COMR) research model; and (4) leveraging millions of dollars to fund installation of first-time municipal water/sewer services, street paving, and relocation of the 119-bypass to advance environmental health solutions. The structure and successes of WERA's Right to Basic Amenities project have been discussed at demonstration and training sessions to help others replicate the model in comparable low-income communities of color in North Carolina and across the United States.

Pain Management: Part 1: Managing Acute and Postoperative Dental Pain

PubMed Central

Becker, Daniel E.

2010-01-01

Abstract Safe and effective management of acute dental pain can be accomplished with nonopioid and opioid analgesics. To formulate regimens properly, it is essential to appreciate basic pharmacological principles and appropriate dosage strategies for each of the available analgesic classes. This article will review the basic pharmacology of analgesic drug classes, including their relative efficacy for dental pain, and will suggest appropriate regimens based on pain intensity. Management of chronic pain will be addressed in the second part of this series. PMID:20553137

Is risk associated with drinking water in Australia of significant concern to justify mandatory regulation?

PubMed

McKay, J; Moeller, A

2001-10-01

Presently in Australia there are no mandatory drinking water standards. Here we argue that the risk associated with drinking water in Australia is of a dimension discernible to warrant mandatory regulations. The catchments that supply the major metropolitan areas of Sydney and Adelaide, and the groundwater for the city of Perth have been seriously compromised by the encroachment of development and activities. Melbourne in the past has generally relied on a closed catchment reservoir system; however, population growth in the near future will sequester the full online operation of additional reservoirs, which have multiple land use catchments. In addition to the current landscape circumstances, the management of a water system in itself proposes significant issues of risk. Two critical assumptions that are unique to a mass medium substance like water and dramatically alter the appraisal of risk are: (1) very large numbers of people are potentially exposed, and (2) small changes in contaminant levels may have adverse population outcomes. It is also known that water reticulation systems frequently suffer from contamination problems caused solely by the distribution system, and optimal management of these facilities would best be served by statutory protected transparency and dedicated water quality programs. In 1979, an Australian parliamentary committee stated that an "uncontaminated water supply is" a "basic requirement for the obtainment of good health"; however, recent surveys of Australian water systems show many are not meeting basic water quality criteria, and many communities are not receiving regular monitoring or testing as required by government authorized Australian drinking water guidelines. Exacerbating this situation is the lack of reporting and statutory endorsed standardized procedures to ensure information is properly and promptly recorded and that data are centralized for maximum benefit. The evaluation of risk associated with drinking water in Australia is often hampered by inadequate or incomplete data. Lastly, regional and rural water supplies face a vast array of contemporary problems and experiences that include widespread usage of pesticides and agricultural chemicals. In recent years, the Darling River has experienced the worst algal bloom known to man, and this river system not only supplies a number of regional and rural towns with water, but eventually connects with the River Murray, which supplies the State of South Australia with approximately 50% of its water requirements.

A critical assessment of regulatory triggers for products of biotechnology: Product vs. process

PubMed Central

McHughen, Alan

2016-01-01

ABSTRACT Regulatory policies governing the safety of genetic engineering (rDNA) and the resulting products (GMOs) have been contentious and divisive, especially in agricultural applications of the technologies. These tensions led to vastly different approaches to safety regulation in different jurisdictions, even though the intent of regulations—to assure public and environmental safety—are common worldwide, and even though the international scientific communities agree on the basic principles of risk assessment and risk management. So great are the political divisions that jurisdictions cannot even agree on the appropriate triggers for regulatory capture, whether product or process. This paper reviews the historical policy and scientific implications of agricultural biotechnology regulatory approaches taken by the European Union, USA and Canada, using their respective statutes and regulations, and then critically assesses the scientific underpinnings of each. PMID:27813691

A critical assessment of regulatory triggers for products of biotechnology: Product vs. process.

PubMed

McHughen, Alan

2016-10-01

Regulatory policies governing the safety of genetic engineering (rDNA) and the resulting products (GMOs) have been contentious and divisive, especially in agricultural applications of the technologies. These tensions led to vastly different approaches to safety regulation in different jurisdictions, even though the intent of regulations-to assure public and environmental safety-are common worldwide, and even though the international scientific communities agree on the basic principles of risk assessment and risk management. So great are the political divisions that jurisdictions cannot even agree on the appropriate triggers for regulatory capture, whether product or process. This paper reviews the historical policy and scientific implications of agricultural biotechnology regulatory approaches taken by the European Union, USA and Canada, using their respective statutes and regulations, and then critically assesses the scientific underpinnings of each.

Terrorism-related risk management for health care facilities.

PubMed

Reid, Daniel J; Reid, William H

2005-01-01

Clinicians should have a basic understanding of the physical and financial risk to mental health facilities related to external threat, such as (but not necessarily limited to) terrorism. Patient care and accessibility to mental health services rest not only on clinical skills, but on a place to practice them and an organized system supported by staff, physical facilities and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or serving at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state, and national standards for hospital safety, or insurance providers' individual facility requirements.

Department of Defense Basic Research Program.

DTIC Science & Technology

1983-01-01

25 Environmental Sciences oceanography ........................................................................... 27...budget category and increased emphasis on high- risk , high-payoff, and named Basic Research, most of the effort funded under long-term research was...proximity fue, °.tchooie-o examplsi, radar, theus prxiit fuzenan asrsk purchasing power because of inflation and was risking nuclear weapons, homing

Space shuttle low cost/risk avionics study

NASA Technical Reports Server (NTRS)

1971-01-01

All work breakdown structure elements containing any avionics related effort were examined for pricing the life cycle costs. The analytical, testing, and integration efforts are included for the basic onboard avionics and electrical power systems. The design and procurement of special test equipment and maintenance and repair equipment are considered. Program management associated with these efforts is described. Flight test spares and labor and materials associated with the operations and maintenance of the avionics systems throughout the horizontal flight test are examined. It was determined that cost savings can be achieved by using existing hardware, maximizing orbiter-booster commonality, specifying new equipments to MIL quality standards, basing redundancy on cost effective analysis, minimizing software complexity and reducing cross strapping and computer-managed functions, utilizing compilers and floating point computers, and evolving the design as dictated by the horizontal flight test schedules.

Robust optimization-based DC optimal power flow for managing wind generation uncertainty

NASA Astrophysics Data System (ADS)

Boonchuay, Chanwit; Tomsovic, Kevin; Li, Fangxing; Ongsakul, Weerakorn

2012-11-01

Integrating wind generation into the wider grid causes a number of challenges to traditional power system operation. Given the relatively large wind forecast errors, congestion management tools based on optimal power flow (OPF) need to be improved. In this paper, a robust optimization (RO)-based DCOPF is proposed to determine the optimal generation dispatch and locational marginal prices (LMPs) for a day-ahead competitive electricity market considering the risk of dispatch cost variation. The basic concept is to use the dispatch to hedge against the possibility of reduced or increased wind generation. The proposed RO-based DCOPF is compared with a stochastic non-linear programming (SNP) approach on a modified PJM 5-bus system. Primary test results show that the proposed DCOPF model can provide lower dispatch cost than the SNP approach.

24 CFR 55.1 - Purpose and basic responsibility.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Urban Development FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS General § 55.1 Purpose and basic... alternative.” (2) The purpose of Executive Order 11990, Protection of Wetlands, is “to avoid to the extent... Management, and Executive Order 11990, Protection of Wetlands, and employs the principles of the Unified...

Life Management Skills, 8230. Home Economics Education.

ERIC Educational Resources Information Center

Loudoun County Public Schools, Leesburg, VA.

The middle school home economics curriculum on Life Management Skills I (eighth grade) meets the needs of the early adolescent. It is based upon three major concepts: (1) basic skills; (2) self-knowledge/understanding/decision making; and (3) independence/interdependence. Emphasis on the basic skills of reading, writing, communicating, using…

Management Basics for Minority Women. Facilitator's Manual.

ERIC Educational Resources Information Center

Jackson, Stanlie M., Ed.

This facilitator's manual consists of guidelines and materials for use in conducting a workshop dealing with three management basics for minority women--communication, decision making, and interpersonal skills. Covered in the first half of the manual are the following aspects of implementing the workshop: background on the need for and development…

Farm Business Management. Volume I. Vocational Agriculture Education.

ERIC Educational Resources Information Center

Hodgens, Jim; Meyers, Leland

This curriculum guide provides a basic core of instruction for the first year of a three-year adult program in farm business management. It contains 12 units of instruction. Each unit consists of seven basic components: performance objectives, teacher activities, information sheets (content essential for meeting the cognitive objectives),…

The RSZ BASIC programming language manual

NASA Technical Reports Server (NTRS)

Stattel, R. J.; Niswander, J. K.; Kochhar, A. K.

1980-01-01

The RSZ BASIC interactive language is described. The RSZ BASIC interpreter is resident in the Telemetry Data Processor, a system dedicated to the processing and displaying of PCM telemetry data. A series of working examples teaches the fundamentals of RSZ BASIC and shows how to construct, edit, and manage storage of programs.

Back to Basics: Preventing Surgical Fires.

PubMed

Spruce, Lisa

2016-09-01

When fires occur in the OR, they are devastating and potentially fatal to both patients and health care workers. Fires can be prevented by understanding the fire triangle and methods of reducing fire risk, conducting fire risk assessments, and knowing how to respond if a fire occurs. This Back to Basics article addresses the basics of fire prevention and the steps that can be taken to prevent fires from occurring. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Effect of the Army Oral Health Maintenance Program on the Dental Health Status of Army Personnel (AOHMP Evaluation) Executive Summary

DTIC Science & Technology

1979-06-01

dental care requirements and the amount of dental care received by US Army active duty populations according to rank group, basic career management...investigators there was no disruption of care during this phase of the study effort. c. Data Collection Procedures. (1) Initial Examination. The basic ...SN. C. .(I) Pst D. Unit (2) Dental Clinic where record ftiled COLUMN E. Rank (see code sheet) ŔO F. Basic Branch/Career Management Field/Type of

Dysphagia in the elderly: management and nutritional considerations

PubMed Central

Sura, Livia; Madhavan, Aarthi; Carnaby, Giselle; Crary, Michael A

2012-01-01

Dysphagia is a prevalent difficulty among aging adults. Though increasing age facilitates subtle physiologic changes in swallow function, age-related diseases are significant factors in the presence and severity of dysphagia. Among elderly diseases and health complications, stroke and dementia reflect high rates of dysphagia. In both conditions, dysphagia is associated with nutritional deficits and increased risk of pneumonia. Recent efforts have suggested that elderly community dwellers are also at risk for dysphagia and associated deficits in nutritional status and increased pneumonia risk. Swallowing rehabilitation is an effective approach to increase safe oral intake in these populations and recent research has demonstrated extended benefits related to improved nutritional status and reduced pneumonia rates. In this manuscript, we review data describing age related changes in swallowing and discuss the relationship of dysphagia in patients following stroke, those with dementia, and in community dwelling elderly. Subsequently, we review basic approaches to dysphagia intervention including both compensatory and rehabilitative approaches. We conclude with a discussion on the positive impact of swallowing rehabilitation on malnutrition and pneumonia in elderly who either present with dysphagia or are at risk for dysphagia. PMID:22956864

The study on stage financing model of IT project investment.

PubMed

Chen, Si-hua; Xu, Sheng-hua; Lee, Changhoon; Xiong, Neal N; He, Wei

2014-01-01

Stage financing is the basic operation of venture capital investment. In investment, usually venture capitalists use different strategies to obtain the maximum returns. Due to its advantages to reduce the information asymmetry and agency cost, stage financing is widely used by venture capitalists. Although considerable attentions are devoted to stage financing, very little is known about the risk aversion strategies of IT projects. This paper mainly addresses the problem of risk aversion of venture capital investment in IT projects. Based on the analysis of characteristics of venture capital investment of IT projects, this paper introduces a real option pricing model to measure the value brought by the stage financing strategy and design a risk aversion model for IT projects. Because real option pricing method regards investment activity as contingent decision, it helps to make judgment on the management flexibility of IT projects and then make a more reasonable evaluation about the IT programs. Lastly by being applied to a real case, it further illustrates the effectiveness and feasibility of the model.

The Study on Stage Financing Model of IT Project Investment

PubMed Central

Xu, Sheng-hua; Xiong, Neal N.

2014-01-01

Stage financing is the basic operation of venture capital investment. In investment, usually venture capitalists use different strategies to obtain the maximum returns. Due to its advantages to reduce the information asymmetry and agency cost, stage financing is widely used by venture capitalists. Although considerable attentions are devoted to stage financing, very little is known about the risk aversion strategies of IT projects. This paper mainly addresses the problem of risk aversion of venture capital investment in IT projects. Based on the analysis of characteristics of venture capital investment of IT projects, this paper introduces a real option pricing model to measure the value brought by the stage financing strategy and design a risk aversion model for IT projects. Because real option pricing method regards investment activity as contingent decision, it helps to make judgment on the management flexibility of IT projects and then make a more reasonable evaluation about the IT programs. Lastly by being applied to a real case, it further illustrates the effectiveness and feasibility of the model. PMID:25147845

The Zero-vision: potential side effects of communicating health perfection and zero risk.

PubMed

Fugelli, Per

2006-03-01

Public health education may have harmful side effects: generate fear, give rise to healthism and contribute to a medical sorting society. To prevent these adverse reactions a new deal for public health communication is presented. It is commended to move public health from omnipotence to moderation, from life style to living conditions, from risk to the bright sides of health, from statistical clone to the holy individual. Furthermore public health communication ought to include uncertainty as authoritarian truth mongering erodes trust. The public health educator must convey compassion and dedication. Rational techno-info is not sufficient. The last golden rule for a new public health is to respect the people. The people are not an inferior mass subjected to basic instincts and irrational fears. Common sense and lay experiences may contribute to the wise management of risk. Therefore public health should develop a people-centered method, recognizing people's own values, perceptions and potentials for preventing disease and promoting health.

Ligand binding assays in the 21st century laboratory: recommendations for characterization and supply of critical reagents.

PubMed

O'Hara, Denise M; Theobald, Valerie; Egan, Adrienne Clements; Usansky, Joel; Krishna, Murli; TerWee, Julie; Maia, Mauricio; Spriggs, Frank P; Kenney, John; Safavi, Afshin; Keefe, Jeannine

2012-06-01

Critical reagents are essential components of ligand binding assays (LBAs) and are utilized throughout the process of drug discovery, development, and post-marketing monitoring. Successful lifecycle management of LBA critical reagents minimizes assay performance problems caused by declining reagent activity and can mitigate the risk of delays during preclinical and clinical studies. Proactive reagent management assures adequate supply. It also assures that the quality of critical reagents is appropriate and consistent for the intended LBA use throughout all stages of the drug development process. This manuscript summarizes the key considerations for the generation, production, characterization, qualification, documentation, and management of critical reagents in LBAs, with recommendations for antibodies (monoclonal and polyclonal), engineered proteins, peptides, and their conjugates. Recommendations are given for each reagent type on basic and optional characterization profiles, expiration dates and storage temperatures, and investment in a knowledge database system. These recommendations represent a consensus among the authors and should be used to assist bioanalytical laboratories in the implementation of a best practices program for critical reagent life cycle management.

Assessments of levels, potential ecological risk, and human health risk of heavy metals in the soils from a typical county in Shanxi Province, China.

PubMed

Pan, Libo; Ma, Jin; Hu, Yu; Su, Benying; Fang, Guangling; Wang, Yue; Wang, Zhanshan; Wang, Lei; Xiang, Bao

2016-10-01

A total of 128 surface soil samples were collected, and eight heavy metals, including As, Cd, Cr, Cu, Pb, Ni, Zn, and Hg, were analyzed for their concentrations, potential ecological risks, and human health risks. The mean concentrations of these eight metals were lower than the soil environmental quality standards in China, while they were slightly higher than the background values in Shanxi Province. The enrichment factor, coefficient variation, and potential ecological risk index were used to assess the pollution and eco-risk level of heavy metals, among which, Cd and Hg showed higher pollution levels and potential risks than the others in the studied area. Moreover, multivariate geostatistical analysis suggested that Hg originated mainly from point sources such as industrial emissions, while agricultural activity is the predominant factor for Cd. The human health risk assessment indicated that non-carcinogenic values were below the threshold values. The total carcinogenic risks due to As, Cr, and Ni were within the acceptable range for adults, while for children, they were higher than the threshold value (1.0E-04), indicating that children are facing higher threat to heavy metals in soils. These results provide basic information on heavy metal pollution control and human health risk assessment management in the study regions.

Simulation of Mission Phases

NASA Technical Reports Server (NTRS)

Carlstrom, Nicholas Mercury

2016-01-01

This position with the Simulation and Graphics Branch (ER7) at Johnson Space Center (JSC) provided an introduction to vehicle hardware, mission planning, and simulation design. ER7 supports engineering analysis and flight crew training by providing high-fidelity, real-time graphical simulations in the Systems Engineering Simulator (SES) lab. The primary project assigned by NASA mentor and SES lab manager, Meghan Daley, was to develop a graphical simulation of the rendezvous, proximity operations, and docking (RPOD) phases of flight. The simulation is to include a generic crew/cargo transportation vehicle and a target object in low-Earth orbit (LEO). Various capsule, winged, and lifting body vehicles as well as historical RPOD methods were evaluated during the project analysis phase. JSC core mission to support the International Space Station (ISS), Commercial Crew Program (CCP), and Human Space Flight (HSF) influenced the project specifications. The simulation is characterized as a 30 meter +V Bar and/or -R Bar approach to the target object's docking station. The ISS was selected as the target object and the international Low Impact Docking System (iLIDS) was selected as the docking mechanism. The location of the target object's docking station corresponds with the RPOD methods identified. The simulation design focuses on Guidance, Navigation, and Control (GNC) system architecture models with station keeping and telemetry data processing capabilities. The optical and inertial sensors, reaction control system thrusters, and the docking mechanism selected were based on CCP vehicle manufacturer's current and proposed technologies. A significant amount of independent study and tutorial completion was required for this project. Multiple primary source materials were accessed using the NASA Technical Report Server (NTRS) and reference textbooks were borrowed from the JSC Main Library and International Space Station Library. The Trick Simulation Environment and User Training Materials version 2013.0 release was used to complete the Trick tutorial. Multiple network privilege and repository permission requests were required in order to access previous simulation models. The project was also an introduction to computer programming and the Linux operating system. Basic C++ and Python syntax was used during the completion of the Trick tutorial. Trick's engineering analysis and Monte Carlo simulation capabilities were observed and basic space mission planning procedures were applied in the conceptual design phase. Multiple professional development opportunities were completed in addition to project duties during this internship through the System for Administration, Training, and Education Resources for NASA (SATERN). Topics include: JSC Risk Management Workshop, CCP Risk Management, Basic Radiation Safety Training, X-Ray Radiation Safety, Basic Laser Safety, JSC Export Control, ISS RISE Ambassador, Basic SharePoint 2013, Space Nutrition and Biochemistry, and JSC Personal Protective Equipment. Additionally, this internship afforded the opportunity for formal project presentation and public speaking practice. This was my first experience at a NASA center. After completing this internship I have a much clearer understanding of certain aspects of the agency's processes and procedures, as well as a deeper appreciation from spaceflight simulation design and testing. I will continue to improve my technical skills so that I may have another opportunity to return to NASA and Johnson Space Center.

Fall risk and function in older women after gynecologic surgery.

PubMed

Miller, Karen L; Richter, Holly E; Graybill, Charles S; Neumayer, Leigh A

2017-11-01

To examine change in balance-related fall risk and daily functional abilities in the first 2 post-operative weeks and up to 6 weeks after gynecologic surgery. Prospective cohort study in gynecologic surgery patients age 65 and older. Balance confidence (Activities-specific Balance Confidence Scale) and functional status (basic and instrumental activities of daily living) were recorded pre- and post-operatively daily for 1 week and twice the second week. Physical performance balance and functional mobility were measured pre- and 1 week post-operatively using the Tinetti Fall Risk Scale, Timed Up and Go, and 6-Minute Walk test. Measures were repeated 6 weeks after surgery. Non-parametric tests for paired data were used comparing scores baseline to post-operative (POD) 7 and to POD 42. Median age was 72 years (range 65-88). Fall risk was elevated during the first 2 post-operative weeks, greatest on the median discharge day, POD 2 (p<0.01). Balance performance and functional mobility at 1 week were significantly lower than baseline (p<0.01). Functional abilities declined, including new dependence in medication management at home in 22% of these independent and cognitively intact women. After gynecologic surgery, older women's fall risk is highest on POD 2 and remains elevated from baseline for 2 weeks. Functional limitations in the early home recovery period include the anticipated (bathing, cooking, etc.) and some unanticipated (medication management) ones. This information may help with post-operative discharge planning. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Managing the natural disasters from space technology inputs

NASA Astrophysics Data System (ADS)

Jayaraman, V.; Chandrasekhar, M. G.; Rao, U. R.

1997-01-01

Natural disasters, whether of meteorological origin such as Cyclones, Floods, Tornadoes and Droughts or of having geological nature such as earthquakes and volcanoes, are well known for their devastating impacts on human life, economy and environment. With tropical climate and unstable land forms, coupled with high population density, poverty, illiteracy and lack of infrastructure development, developing countries are more vulnerable to suffer from the damaging potential of such disasters. Though it is almost impossible to completely neutralise the damage due to these disasters, it is, however possible to (i) minimise the potential risks by developing disaster early warning strategies (ii) prepare developmental plans to provide resilience to such disasters, (iii) mobilize resources including communication and telemedicinal services and (iv) to help in rehabilitation and post-disaster reconstruction. Space borne platforms have demonstrated their capability in efficient disaster management. While communication satellites help in disaster warning, relief mobilisation and telemedicinal support, Earth observation satellites provide the basic support in pre-disaster preparedness programmes, in-disaster response and monitoring activities, and post-disaster reconstruction. The paper examines the information requirements for disaster risk management, assess developing country capabilities for building the necessary decision support systems, and evaluate the role of satellite remote sensing. It describes several examples of initiatives from developing countries in their attempt to evolve a suitable strategy for disaster preparedness and operational framework for the disaster management Using remote sensing data in conjunction with other collateral information. It concludes with suggestions and recommendations to establish a worldwide network of necessary space and ground segments towards strengthening the technological capabilities for disaster management and mitigation.

Household safe water management in Kisii County, Kenya.

PubMed

Misati, A G

2016-11-01

Contaminated drinking water can lead to the risk of intestinal and other infectious diseases that lead to high morbidity. Therefore, determining household safe water management practices will benefit billions of people by ensuring there is no recontamination. A cross-sectional study design was used and a sample of 346 households was selected through systematic random sampling. A questionnaire was then used which was based on the core questions on drinking water and sanitation for household surveys and descriptive analyses were performed for the collected data using SPSS. Springs were predominantly used as the main source of water (97 %). Approximately, over half (58 %) of the sampled households never treated their drinking water to ensure that it was safe for drinking. Mostly (56 %), the households used jerricans for the storage of water with a majority of the households (95 %) covering their containers which were elevated from the reach of children in 52 % of the households. The risks included lack of water treatment, not covering the water container, risk of permitting dipping for those containers, lacking narrow neck and the risk of container being accessible to children. Basic treatment of the water at the household level by use of chemicals, filtration and boiling may have a great impact on the drinking water quality and health of the inhabitants of Kisii County. Also, creation of awareness on the possibilities of spring water being contaminated should be carried because of the assumption that spring water is safe and does not need to be treated.

High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

PubMed Central

Taylor, Andrew T.

2011-01-01

High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS) which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler. PMID:23908794

Cost-effectiveness of preventive case management for parents with a mental illness: a randomized controlled trial from three economic perspectives.

PubMed

Wansink, Henny J; Drost, Ruben M W A; Paulus, Aggie T G; Ruwaard, Dirk; Hosman, Clemens M H; Janssens, Jan M A M; Evers, Silvia M A A

2016-07-07

The children of parents with a mental illness (COPMI) are at increased risk for developing costly psychiatric disorders because of multiple risk factors which threaten parenting quality and thereby child development. Preventive basic care management (PBCM) is an intervention aimed at reducing risk factors and addressing the needs of COPMI-families in different domains. The intervention may lead to financial consequences in the healthcare sector and in other sectors, also known as inter-sectoral costs and benefits (ICBs). The objective of this study was to assess the cost-effectiveness of PBCM from three perspectives: a narrow healthcare perspective, a social care perspective (including childcare costs) and a broad societal perspective (including all ICBs). Effects on parenting quality (as measured by the HOME) and costs during an 18-month period were studied in in a randomized controlled trial. Families received PBCM (n = 49) or care as usual (CAU) (n = 50). For all three perspectives, incremental cost-effectiveness ratios (ICERs) were calculated. Stochastic uncertainty in the data was dealt with using non-parametric bootstraps. Sensitivity analyses included calculating ICERs excluding cost outliers, and making an adjustment for baseline cost differences. Parenting quality improved in the PBCM group and declined in the CAU group, and PBCM was shown to be more costly than CAU. ICERs differ from 461 Euros (healthcare perspective) to 215 Euros (social care perspective) to 175 Euros (societal perspective) per one point improvement on the HOME T-score. The results of the sensitivity analyses, based on complete cases and excluding cost outliers, support the finding that the ICER is lower when adopting a broader perspective. The subgroup analysis and the analysis with baseline adjustments resulted in higher ICERs. This study is the first economic evaluation of family-focused preventive basic care management for COPMI in psychiatric and family services. The effects of the chosen perspective on determining the cost-effectiveness of PBCM underscore the importance of economic studies of interdepartmental policies. Future studies focusing on the cost-effectiveness of programs like PBCM in other sites and studies with more power are encouraged as this may improve the quality of information used in supporting decision making. NTR2569 , date of registration 2010-10-12.

[The Basic-Symptom Concept and its Influence on Current International Research on the Prediction of Psychoses].

PubMed

Schultze-Lutter, F

2016-12-01

The early detection of psychoses has become increasingly relevant in research and clinic. Next to the ultra-high risk (UHR) approach that targets an immediate risk of developing frank psychosis, the basic symptom approach that targets the earliest possible detection of the developing disorder is being increasingly used worldwide. The present review gives an introduction to the development and basic assumptions of the basic symptom concept, summarizes the results of studies on the specificity of basic symptoms for psychoses in different age groups as well as on studies of their psychosis-predictive value, and gives an outlook on future results. Moreover, a brief introduction to first recent imaging studies is given that supports one of the main assumptions of the basic symptom concept, i. e., that basic symptoms are the most immediate phenomenological expression of the cerebral aberrations underlying the development of psychosis. From this, it is concluded that basic symptoms might be able to provide important information on future neurobiological research on the etiopathology of psychoses. © Georg Thieme Verlag KG Stuttgart · New York.

Left ventricular mass, blood pressure, and lowered cognitive performance in the Framingham offspring.

PubMed

Elias, Merrill F; Sullivan, Lisa M; Elias, Penelope K; D'Agostino, Ralph B; Wolf, Philip A; Seshadri, Sudha; Au, Rhoda; Benjamin, Emelia J; Vasan, Ramachandran S

2007-03-01

The purpose of this study was to determine whether echocardiographic left ventricular mass is related to cognitive performance beyond casual blood pressure adjusting for the influence of other vascular risk factors. We used multivariable regression analyses to relate left ventricular mass assessed at a routine examination (1995-1998) to measures of cognitive ability obtained routinely (1998-2001) in 1673 Framingham Offspring Study participants (56% women; mean age: 57 years) free from stroke, transient ischemic attack, and dementia. We adjusted for the following covariates hierarchically: (1) age, education, sex, body weight, height, interval between left ventricular mass measurement and neuropsychological testing (basic model); (2) basic model+blood pressure+treatment for hypertension; and (3) basic model+blood pressure+treatment for hypertension+vascular risk factors and prevalent cardiovascular disease. For the basic model, left ventricular mass was inversely associated with abstract reasoning (similarities), visual-spatial memory and organization, and verbal memory. For the basic model+blood pressure+treatment for hypertension, left ventricular mass was inversely associated with similarities and visual-spatial memory and organization. For the basic+blood pressure+treatment for hypertension+risk factors+cardiovascular disease model, no significant associations were observed. Echocardiographic left ventricular mass is associated with cognitive performance beyond casual and time-averaged systolic blood pressure, but this association is attenuated and rendered nonsignificant with additional adjustment for cardiovascular risk factors and cardiovascular disease, thus suggesting that these variables play an important role in mediating the association between left ventricular mass and cognition.

32 CFR Appendix A to Part 272 - Principles for the Conduct and Support of Basic Research

Code of Federal Regulations, 2010 CFR

2010-07-01

... Research A Appendix A to Part 272 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMINISTRATION AND SUPPORT OF BASIC RESEARCH BY THE... Research 1. Basic research is an investment. The DoD Components are to view and manage basic research...

The Indispensable Teachers' Guide to Computer Skills. Second Edition.

ERIC Educational Resources Information Center

Johnson, Doug

This book provides a framework of technology skills that can be used for staff development. Part One presents critical components of effective staff development. Part Two describes the basic CODE 77 skills, including basic computer operation, file management, time management, word processing, network and Internet use, graphics and digital images,…

Management of Universal Basic Education Scheme (U.B.E.) for Qualitative Education in Nigeria

ERIC Educational Resources Information Center

Omotayo, Dare Michael; Ihebereme, Chioma; Maduewesi, Sir B. U.

2008-01-01

Since independence, Nigeria has been searching diligently for a viable educational system capable of enhancing the socio-economic and political values inherent in the country. This paper discusses concepts such as management, qualitative education and Universal Basic Education. In addition to the above, the paper also examines the National…

Language Management Theory as One Approach in Language Policy and Planning

ERIC Educational Resources Information Center

Nekvapil, Jirí

2016-01-01

Language Policy and Planning is currently a significantly diversified research area and thus it is not easy to find common denominators that help to define basic approaches within it. Richard B. Baldauf attempted to do so by differentiating between four basic approaches: (1) the classical approach, (2) the language management approach (Language…

Is basic self-disturbance in ultra-high risk for psychosis ('prodromal') patients associated with borderline personality pathology?

PubMed

Nelson, Barnaby; Thompson, Andrew; Chanen, Andrew M; Amminger, Günther Paul; Yung, Alison R

2013-08-01

Research in the phenomenological tradition suggests that the schizophrenia spectrum is characterized by disturbance of the 'basic' self, whereas borderline personality disorder involves disturbance of the 'narrative' self. The current study investigated this proposal in an ultra-high risk for psychosis sample. The sample consisted of 42 ultra-high-risk participants with a mean age of 19.22 years. Basic self-disturbance was measured using the Examination of Anomalous Self-Experience. Borderline personality pathology was measured using the borderline personality disorder items from the structured clinical interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis II Personality Questionnaire. No correlation was found between the measures of basic self-disturbance and borderline personality pathology. The finding is consistent with the proposal that different (although not mutually exclusive) types of self-disturbance characterize the schizophrenia spectrum and borderline personality disorder. Further research should further examine the question of basic self-disturbance in patients with established borderline personality disorder. © 2013 Wiley Publishing Asia Pty Ltd.

Evaluation of the Eological Management and Enhancement Alernative for Remediation of the K1007-P1 Pond

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

Peterson, M.J.

2005-10-31

An evaluation of the human and ecological risks associated with the P1 Pond and surrounding environs was conducted as part of the ETTP Site-Wide Remedial Investigation. The RI provides the basis for the focus on PCBs as the most important unacceptable risk to human and ecological health in the pond. Other P1 contaminants, media, or pathways of risk to receptors are identified in the RI, but are not addressed as a major risk reduction goal for the ETTP Site-Wide Feasibility Study. Therefore, the goal of the Ecological Management alternative is to reduce unacceptable risks associated with PCBs in fish. Manymore » of the actions proposed for this alternative, however, are likely to reduce risks associated with other contaminants and their pathways. The high PCB concentrations in fish from the P1 Pond are most certainly due in part to the current ecological condition of the pond that maximizes PCB biomagnification. This basic assumption and the factors contributing to it were evaluated by conducting an intensive field study of the P1 Pond in the summer of 2004 (for a thorough presentation of current P1 Pond biological conditions, see Peterson et al. 2005). Major hypotheses regarding the P1 Pond's current fish community, PCB fate and transport processes, pond vegetation, and limnological conditions that contribute to the high PCB levels in fish were validated by the study (Appendix A), The results of the 2004 ecological assessment, in concert with long-term datasets obtained as part of the ETTP Biological Monitoring and Abatement Program (BMAP) and recent abiotic sampling for the RI, provide the basis for the assessment of current conditions.« less

Precision medicine and drug development in Alzheimer's disease: The importance of sexual dimorphism and patient stratification.

PubMed

Hampel, Harald; Vergallo, Andrea; Giorgi, Filippo Sean; Kim, Seung Hyun; Depypere, Herman; Graziani, Manuela; Saidi, Amira; Nisticò, Robert; Lista, Simone

2018-06-12

Neurodegenerative diseases (ND) are among the leading causes of disability and mortality. Considerable sex differences exist in the occurrence of the various manifestations leading to cognitive decline. Alzheimer's disease (AD) exhibits substantial sexual dimorphisms and disproportionately affects women. Women have a higher life expectancy compared to men and, consequently, have more lifespan to develop AD. The emerging precision medicine and pharmacology concepts - taking into account the individual genetic and biological variability relevant for disease risk, prevention, detection, diagnosis, and treatment - are expected to substantially enhance our knowledge and management of AD. Stratifying the affected individuals by sex and gender is an important basic step towards personalization of scientific research, drug development, and care. We hypothesize that sex and gender differences, extending from genetic to psychosocial domains, are highly relevant for the understanding of AD pathophysiology, and for the conceptualization of basic/translational research and for clinical therapy trial design. Copyright © 2018 Elsevier Inc. All rights reserved.

Integrated Management of Residential Indoor Air Quality: A Call for Stakeholders in a Changing Climate.

PubMed

Levasseur, Marie-Eve; Poulin, Patrick; Campagna, Céline; Leclerc, Jean-Marc

2017-11-25

A paradigm change in the management of environmental health issues has been observed in recent years: instead of managing specific risks individually, a holistic vision of environmental problems would assure sustainable solutions. However, concrete actions that could help translate these recommendations into interventions are lacking. This review presents the relevance of using an integrated indoor air quality management approach to ensure occupant health and comfort. At the nexus of three basic concepts (reducing contaminants at the source, improving ventilation, and, when relevant, purifying the indoor air), this approach can help maintain and improve indoor air quality and limit exposure to several contaminants. Its application is particularly relevant in a climate change context since the evolving outdoor conditions have to be taken into account during building construction and renovation. The measures presented through this approach target public health players, building managers, owners, occupants, and professionals involved in building design, construction, renovation, and maintenance. The findings of this review will help the various stakeholders initiate a strategic reflection on the importance of indoor air quality and climate change issues for existing and future buildings. Several new avenues and recommendations are presented to set the path for future research activities.

Integrated Management of Residential Indoor Air Quality: A Call for Stakeholders in a Changing Climate

PubMed Central

Levasseur, Marie-Eve; Poulin, Patrick; Campagna, Céline; Leclerc, Jean-Marc

2017-01-01

A paradigm change in the management of environmental health issues has been observed in recent years: instead of managing specific risks individually, a holistic vision of environmental problems would assure sustainable solutions. However, concrete actions that could help translate these recommendations into interventions are lacking. This review presents the relevance of using an integrated indoor air quality management approach to ensure occupant health and comfort. At the nexus of three basic concepts (reducing contaminants at the source, improving ventilation, and, when relevant, purifying the indoor air), this approach can help maintain and improve indoor air quality and limit exposure to several contaminants. Its application is particularly relevant in a climate change context since the evolving outdoor conditions have to be taken into account during building construction and renovation. The measures presented through this approach target public health players, building managers, owners, occupants, and professionals involved in building design, construction, renovation, and maintenance. The findings of this review will help the various stakeholders initiate a strategic reflection on the importance of indoor air quality and climate change issues for existing and future buildings. Several new avenues and recommendations are presented to set the path for future research activities. PMID:29186831

Using principles from emergency management to improve emergency response plans for research animals.

PubMed

Vogelweid, Catherine M

2013-10-01

Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

Knowledge, awareness, and preparedness unlinked in layperson

NASA Astrophysics Data System (ADS)

Oki, S.; Nakayachi, K.

2012-12-01

Risk assessment is of importance for the reduction of natural disasters. By utilizing the risk information such as producing shake maps or tsunami hazard maps, people can learn what kind of natural hazards they have to deal with. Japanese government takes it as an effective strategy in mitigating earthquake disaster to transfer the basic knowledge of the tectonic background of Japan and of the latest research results. In fact, the Headquarters for Earthquake Research Promotion describes in their webpage that their basic concept is: to transfer the knowledge of research results such as long-term evaluation of large earthquake occurrence to the public, so that people will be aware and conscious of the existing risks, and then they take action to mitigate earthquake disaster. On the other hand, it goes without saying that there always exists a constant risk of earthquake disaster in Japan and every single person living in this earthquake prone country knows that. Moreover, residents know what will happen when a big earthquake occurs such as collapse of houses or tsunamis unlike cases for unknown infectious diseases. Thus they do not have to wait for the government's releasing latest research results of long-term evaluation and possibility of large earthquake occurrence to take action to mitigate disaster. Yet, people die from earthquakes of magnitude-7 class almost every year in Japan, and the causes of death are very common ones such as collapse of houses, falloff of furniture, fire or tsunamis. This fact tells us that the knowledge itself will not give serious awareness of earthquake risks or not motivate people to take action for disaster prevention. We have to have another look at the personnel risk management of earthquake disaster, for the concept of 3-steps; giving knowledge, giving awareness, and taking action would not work as expected. To examine this, we conducted experiments to see if knowledge of earthquake science helps people to be aware the risks or to take action for disaster prevention. Examinees are 200 high school and undergraduate students who do not major in Earth science. We first gave them information of basic knowledge such as tectonic backgrounds of Japan and the latest research outcomes such as long-term evaluation of large earthquake occurrence or the strong ground motion, and then asked what they felt. The results show that neither the basic knowledge nor the latest research outcomes motivate examinees to take action for the disaster prevention or even to give awareness. We then showed them the movies of the past earthquake disasters and some episodes who had lost their loved ones from the recent earthquakes, and asked the same question. As psychology implies, this information made examinees feel dread and they became aware of the risks lie ahead. But still, they did not mention what to do to prevent the tragedy. In the presentation, we would like to show the difficulty to make people take action to protect their lives from earthquake disasters. We also show peoples' preparedness/unpreparedness with the information released by a Japanese research group in the late January saying the possibility of metropolitan Tokyo earthquake being 70% in this coming 4-year.

RiskScape: a new tool for comparing risk from natural hazards (Invited)

NASA Astrophysics Data System (ADS)

Stirling, M. W.; King, A.

2010-12-01

The Regional RiskScape is New Zealand’s joint venture between GNS Science & NIWA, and represents a comprehensive and easy-to-use tool for multi-hazard-based risk and impact analysis. It has basic GIS functionality, in that it has Import/Export functions to use with GIS software. Five natural hazards have been implemented in Riskscape to date: Flood (river), earthquake, volcano (ash), tsunami and wind storm. The software converts hazard exposure information into the likely impacts for a region, for example, damage and replacement costs, casualties, economic losses, disruption, and number of people affected. It therefore can be used to assist with risk management, land use planning, building codes and design, risk identification, prioritization of risk-reduction/mitigation, determination of “best use” risk-reduction investment, evacuation and contingency planning, awareness raising, public information, realistic scenarios for exercises, and hazard event response. Three geographically disparate pilot regions have been used to develop and triall Riskscape in New Zealand, and each region is exposed to a different mix of natural hazards. Future (phase II) development of Riskscape will include the following hazards: Landslides (both rainfall and earthquake triggered), storm surges, pyroclastic flows and lahars, and climate change effects. While Riskscape developments have thus far focussed on scenario-based risk, future developments will advance the software into providing probabilistic-based solutions.

Educating Emergency Managers About Weather -Related Hazards

NASA Astrophysics Data System (ADS)

Spangler, T. C.; Johnson, V.

2006-12-01

The most common crises that emergency managers face are those related to hazardous weather - snowstorms, floods, hurricanes, heat waves, tornadoes, etc. However, man-made disasters, such as accidental releases of hazardous substances or terrorist acts, also often have a weather component. For example, after the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, emergency managers were concerned that thunderstorms in the area might cause the building to collapse, putting rescuers in further danger. Training emergency managers to recognize the importance of weather in disaster planning and response has been a small but important focus of the COMET Program's educational development effort. Topics addressed in COMET training modules that are pertinent to emergency management include fire weather, hurricanes, flood events, and air contaminant dispersion. Additionally, the module entitled Anticipating Hazardous Weather and Community Risk provides an overview of basic meteorological processes, describes a broad range of weather phenomenon, and then addresses what forecast products are available to emergency managers to assess a threat to their community. In many of the modules, learners are presented with scenarios that give them the opportunity to practice decision-making in hazardous weather situations. We will demonstrate some of those scenarios and discuss how training can be used to model good emergency management skills. We will discuss ways to communicate with the emergency management community and provide examples of how distance learning can be used to educate and train emergency managers.

Managed Behavioral Health Care: An Instrument to Characterize Critical Elements of Public Sector Programs

PubMed Central

Ridgely, M Susan; Giard, Julienne; Shern, David; Mulkern, Virginia; Burnam, M Audrey

2002-01-01

Objective To develop an instrument to characterize public sector managed behavioral health care arrangements to capture key differences between managed and “unmanaged” care and among managed care arrangements. Study Design The instrument was developed by a multi-institutional group of collaborators with participation of an expert panel. Included are six domains predicted to have an impact on access, service utilization, costs, and quality. The domains are: characteristics of the managed care plan, enrolled population, benefit design, payment and risk arrangements, composition of provider networks, and accountability. Data are collected at three levels: managed care organization, subcontractor, and network of service providers. Data Collection Methods Data are collected through contract abstraction and key informant interviews. A multilevel coding scheme is used to organize the data into a matrix along key domains, which is then reviewed and verified by the key informants. Principal Findings This instrument can usefully differentiate between and among Medicaid fee-for-service programs and Medicaid managed care plans along key domains of interest. Beyond documenting basic features of the plans and providing contextual information, these data will support the refinement and testing of hypotheses about the impact of public sector managed care on access, quality, costs, and outcomes of care. Conclusions If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary. PMID:12236386

Enhancing the resilience of local communities threated by natural disaster: the experience of the Project "Shkoder", (Albania)

NASA Astrophysics Data System (ADS)

Pazzi, Veronica; Morelli, Stefano; Fidolini, Francesco; Fanti, Riccardo; Vannocci, Pietro; Krymbi, Ervis; Centoducati, Carlo; Ghini, Alessandro

2013-04-01

The vulnerability of Albanian population to natural disasters is due to poverty, inadequate infrastructures (e.g. communication network, basic public facilities and works of soil protection), an uncontrollable building boom and a range of environmental factors, both geomorphological and geological. The greatest disaster threats in Albania are those related to severe earthquakes and large-scale riverine floods. Geohazards assessment is a crucial point for Albania, which has been subject to a rapid development after the recent political changes, resulting in a general land degradation. Also the rate of migration from rural areas to the most urbanized areas currently represents a major problem for the National Civil Protection, since the urban sprawl in the suburbs are often located in high-risk areas, particularly vulnerable to natural hazards. The National Civil Protection system, in terms of subsidiary institutional and volunteer components, is relatively young in Albania. The progressive decentralization of the administrative competences triggered by the recent political changes is accompanied by the acquisition of new territorial information and the development of specific protocols for the emergency management, as well as the risk reduction. The management of natural disasters demands not only an early response to the criticalities, but also a correct mapping of the damage and the development of emergency plans for future events in order to protect lives, properties and the environment and moreover to spread the risk awareness in the population and to prepare it for such circumstances. The main purposes of the Pilot Project "Shkoder" is to enhance the resilience of a little community, located 9 kilometers south-west of Shkodra (Northern Albania), to flooding and earthquakes and to promote the subsidiarity principle by means of: a) demonstrating how basic information for the disaster planning (collected with a real demonstrative field survey) and the risk scenarios can be obtained using relatively simple and low-cost technologies and methods, whose easy accessibility is fundamental for government and academic institutions of poorly developed countries; b) training of the local community (public administrations and volunteers) on the themes of natural risk, disaster prevention and emergency management; c) creating an efficient Civil Protection volunteer system, able to cooperate with the local governmental and scientific institutions in case of natural disasters. The evaluation of the flooding risk in the study area has been carried out by means of HEC-RAS software, while the seismic vulnerability of strategic buildings has been estimated by microtremors analysis. A two-days course has been performed to expose the main results of the field survey and to train the beneficiaries on local vulnerabilities, emergency behaviours and roles. Finally the local authorities and the volunteers, by working together under the supervision of the Italian institutions (National Civil Protection Department and University of Firenze), promoted and realized the first national civil protection relief drill in Albania.

[From complexity to simplification: contribution of the EPM Research Unit to producing a toolkit for risk assessment and management of biomechanical overload and WMSDs prevention].

PubMed

Occhipinti, E; Colombini, Daniela

2011-01-01

When studying musculoskeletal disorders and their connection with working conditions (WMSDs), several factors of different nature (mechanical, organizational, psychophysical, individual) and their interrelationship have been considered important in general models for epidemiologic surveys and risk assessment and management. Hence the necessity of a "holistic" (that is to say complex, global, multifactorial and interdisciplinary) approach to MSD prevention, especially when establishing technical norms, guidelines and strategic plans of action at national or international level. On the other hand, considering the widespread presence of these factors and WMSDs in many working contexts, there is a great demand by OSH agencies and operators to develop "simple" tools for risk assessment and management, usable also by non-experts in both developed and developing countries. Both these needs are perfectly justified but are also to a certain extent in conflict. How can we address the problem, i.e., simplify complexity? METHODS AND CRITERIA: The proposals are based on two essential criteria: 1) Act on a step-by-step approach using basic tools first and more complex tools only when necessary. 2) Take into account the complexity and the presence of multiple influencing factors at every step (even if with different degrees of in-depth analysis). The proposals are mainly developed within the framework of an IEA-WHO collaboration initiative for a "Toolkit for MSD prevention" but they are also derived from other converging issues (i.e. ISO application document of LSO series 11228 on manual handling). The proposals consider: 1) A Basic Step devoted to preliminary occupational hazard identification and priority check by operative "key enter" questions (at this step all potential hazards--including those influencing WMSDs--should be considered). This step also can be carried out by non-experts with limited training. 2) First Step, focused on WMSDs risk factors, consisting of a "quick assessment" and mainly addressed to identifying 3 possible conditions: acceptable/no consequences; high risk present/redesign urgently needed; a more detailed analysis (via tools proposed in second step) is necessary. This step can also be carried out by non-experts with only limited training. 3) Second Step, where recognized tools (i.e. from international standards or guidelines) for risk (of WMSDs) estimation are used as a consequence of the first step outcome. Examples of such tools are "adaptations" of the Revised NIOSH Lifting Equation, Liberty Mutual Psychophysical Tables, OCRA Checklist, etc. These tools should be able to adequately take account of most of the influencing factors. For some particular working sectors (i.e. agriculture) these tools need to be specifically adapted. For particular working sectors a database could be envisaged where the most common tasks (with their "variants") are "intrinsically" evaluated by experts and could provide non-experts with the relevant knowledge to be applied to the specific work context. This step can be carried out only by persons with some sort of specific training.

Target assessment for antiparasitic drug discovery

PubMed Central

Frearson, Julie A.; Wyatt, Paul G.; Gilbert, Ian H.; Fairlamb, Alan H.

2010-01-01

Drug discovery is a high-risk, expensive and lengthy process taking at least 12 years and costing upwards of US$500 million per drug to reach the clinic. For neglected diseases, the drug discovery process is driven by medical need and guided by pre-defined target product profiles. Assessment and prioritisation of the most promising targets for entry into screening programmes is crucial for maximising chances of success. Here we describe criteria used in our drug discovery unit for target assessment and introduce the ‘traffic light’ system as a prioritisation and management tool. We hope this brief review will stimulate basic scientists to acquire additional information necessary for drug discovery. PMID:17962072

[The frequency of risk factors for atherosclerosis in youth aged 16 and 18 years--students of upper-secondary schools in Poland].

PubMed

Jodkowska, Maria; Oblacińska, Anna; Mikiel-Kostyra, Krystyna; Tabak, Izabela

2012-01-01

1. To examine the prevalence of selected risk factors for atherosclerosis: overweight, tobacco smoking, low physical activity, psychological distress and type A personality (characterized by tenseness, impatience, competitiveness, and aggressiveness) in adolescents and to assess the frequency the coexistence of risk factors (≥3) in relation to gender, age and school type. A cross-sectional study was carried out in a representative sample of youth aged 16 and 18 years (N=2983) in 8 voivodeships in Poland. The frequency of five atherosclerosis risk factors and their coexistence (≥3) was examined using self-reported questionnaires, in relation to gender, age and school type. Logistic regression analyses were used to assess the influence of the variables (gender, age and school type) on odds ratios of risk factor coexistence. Low physical activity was the most common risk factor, statistically more frequent in students from Basic Vocational Schools than in other school types (p<0.05). In Basic Vocational Schools there was also the highest percentage of cigarette smokers (p<0.001). Psychological distress and type A behaviour were observed most frequently in students from General Upper Secondary Schools. The highest risk factor accumulation (≥3) was observed among students from Basic Vocational Schools (40%), significantly more frequent in girls than boys (47.5% and 37.5% respectively). Multivariable analyses show that students from Basic Vocational Schools had twice the odds (OR=2.25, p<0.001) to have the coexistence of risk factors for atherosclerosis as compared with students from General Upper Secondary Schools, girls had almost twice as many occurrences (OR=1.83, p<0.001) as boys and 18-year-olds 1.5 more than 16-year-olds (OR=1.46, p<0.001). 1. A significant difference in the prevalence of risk factors for atherosclerosis in youth from different school types requires precise definition of priority health promotion activities depending on school type. 2. Students from Basic Vocational Schools should be the target group for intervention aimed at reducing atherosclerosis risk factors.

Integrated Curriculum Design Reform of Civil Engineering Management Discipline Based on Inter-disciplinary Professional Training

NASA Astrophysics Data System (ADS)

Yidong, Xu; Ping, Wu; Jian, Chen; Jiansheng, Shen

2018-05-01

In view of the shortcomings of the current civil engineering management discipline, this paper investigates the necessity of the course design reform. Based on the analysis of basic occupation requirements of civil engineering management discipline, the basic ideas and implementation strategies of the integrated reform of curriculum design system are proposed, which can not only improve the students’ overall understanding of knowledge and skills, but also enhance the system of student learning.

Total Quality Management in a Knowledge Management Perspective.

ERIC Educational Resources Information Center

Johannsen, Carl Gustav

2000-01-01

Presents theoretical considerations on both similarities and differences between information management and knowledge management and presents a conceptual model of basic knowledge management processes. Discusses total quality management and quality control in the context of information management. (Author/LRW)

Results for Learning Report 2014-15: Basic Education at Risk

ERIC Educational Resources Information Center

Bernard, Jean-Marc; Amelewonou, Kokou; Bonnet, Gabrielle; Rubiano-Matulevich, Eliana; Soman, Kouassi; Sonnenberg, Krystyna

2014-01-01

The 2014/2015 Results for Learning Report: Basic Education at Risk examines the progress achieved by Global Partnership for Education (GPE) partner developing countries over the period 2008-2012. Universal primary education has never been so close, yet there are still 58 million children of primary school age who do not go to school around the…

Internet Technology on Spacecraft

NASA Technical Reports Server (NTRS)

Rash, James; Parise, Ron; Hogie, Keith; Criscuolo, Ed; Langston, Jim; Powers, Edward I. (Technical Monitor)

2000-01-01

The Operating Missions as Nodes on the Internet (OMNI) project has shown that Internet technology works in space missions through a demonstration using the UoSAT-12 spacecraft. An Internet Protocol (IP) stack was installed on the orbiting UoSAT-12 spacecraft and tests were run to demonstrate Internet connectivity and measure performance. This also forms the basis for demonstrating subsequent scenarios. This approach provides capabilities heretofore either too expensive or simply not feasible such as reconfiguration on orbit. The OMNI project recognized the need to reduce the risk perceived by mission managers and did this with a multi-phase strategy. In the initial phase, the concepts were implemented in a prototype system that includes space similar components communicating over the TDRS (space network) and the terrestrial Internet. The demonstration system includes a simulated spacecraft with sample instruments. Over 25 demonstrations have been given to mission and project managers, National Aeronautics and Space Administration (NASA), Department of Defense (DoD), contractor technologists and other decisions makers, This initial phase reached a high point with an OMNI demonstration given from a booth at the Johnson Space Center (JSC) Inspection Day 99 exhibition. The proof to mission managers is provided during this second phase with year 2000 accomplishments: testing the use of Internet technologies onboard an actual spacecraft. This was done with a series of tests performed using the UoSAT-12 spacecraft. This spacecraft was reconfigured on orbit at very low cost. The total period between concept and the first tests was only 6 months! On board software was modified to add an IP stack to support basic IP communications. Also added was support for ping, traceroute and network timing protocol (NTP) tests. These tests show that basic Internet functionality can be used onboard spacecraft. The performance of data was measured to show no degradation from current approaches. The cost to implement is much less than current approaches due to the availability of highly reliable and standard Internet tools. Use of standard Internet applications onboard reduces the risk of obsolescence inherent in custom protocols due to extremely wide use across all domains. These basic building blocks provide the framework for building onboard software to support direct user communication with payloads including payload control. Other benefits are payload to payload communication from dissimilar spacecraft, constellations of spacecraft, and reconfigurability on orbit. This work is funded through contract with the National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC).

Comparative studies of groundwater vulnerability assessment

NASA Astrophysics Data System (ADS)

Maria, Rizka

2018-02-01

Pollution of groundwater is a primary issue because aquifers are susceptible to contamination from land use and anthropogenic impacts. Groundwater susceptibility is intrinsic and specific. Intrinsic vulnerability refers to an aquifer that is susceptible to pollution and to the geological and hydrogeological features. Vulnerability assessment is an essential step in assessing groundwater contamination. This approach provides a visual analysis for helping planners and decision makers to achieve the sustainable management of water resources. Comparative studies are applying different methodologies to result in the basic evaluation of the groundwater vulnerability. Based on the comparison of methods, there are several advantages and disadvantages. SI can be overlaid on DRASTIC and Pesticide DRASTIC to extract the divergence in sensitivity. DRASTIC identifies low susceptibility and underestimates the pollution risk while Pesticide DRASTIC and SI represents better risk and is recommended for the future. SINTACS method generates very high vulnerability zones with surface waters and aquifer interactions. GOD method could be adequate for vulnerability mapping in karstified carbonate aquifers at small-moderate scales, and EPIK method can be used for large scale. GOD method is suitable for designing large area such as land management while DRASTIC has good accuracy and more real use in geoenvironmental detailed studies.

Aflatoxin control--how a regulatory agency managed risk from an unavoidable natural toxicant in food and feed.

PubMed

Park, D L; Stoloff, L

1989-04-01

The control by the Food and Drug Administration (FDA) of aflatoxin, a relatively recently discovered, unavoidable natural contaminant produced by specific molds that invade a number of basic food and feedstuffs, provides an example of the varying forces that affect risk assessment and management by a regulatory Agency. This is the story of how the FDA responded to the initial discovery of a potential carcinogenic hazard to humans in a domestic commodity, to the developing information concerning the nature of the hazard, to the economic and political pressures that are created by the impact of natural forces on regulatory controls, and to the restraints of laws within which the Agency must work. This story covers four periods: the years of discovery and action decisions on the basis of meager knowledge and the fear of cancer; the years of tinkering on paper with the regulatory process, the years of digestion of the accumulating knowledge, and the application of that knowledge to actions forced by natural events; and an audit of the current status of knowledge about the hazard from aflatoxin, and proposals for regulatory control based on that knowledge.

Management of pregnancy-related emergencies: what do Polish anesthesiologists know?

PubMed

Grzeskowiak, M; Kuczkowski, K M; Drobnik, L

2013-02-01

Emergencies can occur at any time during pregnancy. In addition to obstetricians and midwives, anesthesiologists should also be familiar with pregnancy-related emergencies. The aim of this study was to assess the basic and advanced knowledge regarding the management of pregnancy-related emergencies of anesthesiologists. An anonymous questionnaire was distributed to anesthesiologists at two conferences (S1, n = 87; S2, n = 35), and to other groups comprising doctors during specialization (DS, n = 28) and postgraduate doctors (PD, n = 130). Ultimately, 280 doctors were included in the survey. The first part of the questionnaire collected demographics, and a second one evaluated both their basic and advanced knowledge by taxonomy. Basic knowledge regarding the management of pregnancy-related emergencies of the tested group was poorer compared with advanced knowledge. The DS group had better basic management skills than anesthesiology specialists and the PD group. Significantly worse results of the tested group were obtained on the questions about maneuvers for choking pregnant women and time to cesarean section during cardiopulmonary resuscitation. The specialists and the DS group had results on advanced level questions better than the PD group. Older specialists in anesthesiology did not know how to properly manage pregnancy-related emergencies at the basic level; however, anesthesiologists were familiar with advanced management. No relationship between recalling and using such knowledge in difficult situations was observed. The teaching process of acute obstetric emergencies must be improved through implementation of compulsory nationwide courses and verification of knowledge every few years. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España, S.L. All rights reserved.

Guidelines for Carcinogen Risk Assessment

EPA Pesticide Factsheets

The Guidelines for Carcinogen Risk Assessment provide EPA staff with guidance for developing and using risk assessments. They also provide basic information to the public about the Agency's risk assessment methods.

Gas Migration Project: Risk Assessment Tool and Computational Analyses to Investigate Wellbore/Mine Interactions, Secretary's Potash Area, Southeastern New Mexico

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

Sobolik, Steven R.; Hadgu, Teklu; Rechard, Robert P.

The Bureau of Land Management (BLM), US Department of the Interior has asked Sandia National Laboratories (SNL) to perform scientific studies relevant to technical issues that arise in the development of co-located resources of potash and petroleum in southeastern New Mexico in the Secretary’s Potash Area. The BLM manages resource development, issues permits and interacts with the State of New Mexico in the process of developing regulations, in an environment where many issues are disputed by industry stakeholders. The present report is a deliverable of the study of the potential for gas migration from a wellbore to a mine openingmore » in the event of wellbore leakage, a risk scenario about which there is disagreement among stakeholders and little previous site specific analysis. One goal of this study was to develop a framework that required collaboratively developed inputs and analytical approaches in order to encourage stakeholder participation and to employ ranges of data values and scenarios. SNL presents here a description of a basic risk assessment (RA) framework that will fulfill the initial steps of meeting that goal. SNL used the gas migration problem to set up example conceptual models, parameter sets and computer models and as a foundation for future development of RA to support BLM resource development.« less

Basic infertility including polycystic ovary syndrome.

PubMed

Brassard, Maryse; AinMelk, Youssef; Baillargeon, Jean-Patrice

2008-09-01

Infertility in women has many possible causes and must be approached systematically. The most common cause of medically treatable infertility is the polycystic ovary syndrome (PCOS). This syndrome is common in young women and is the cause of anovulatory infertility in 70% of cases. It is therefore an important condition to screen and manage in primary care medical settings. In the past 10 years, insulin sensitization with weight loss or metformin has been shown to be a safe and effective treatment for PCOS infertility that eliminates the risk of multiple pregnancy and may reduce the risk of early pregnancy loss as compared with ovulation-inductor drugs. The authors believe metformin should be considered as first-line therapy because it has the advantage to allow for normal single ovulation, for reduced early pregnancy loss, and, most importantly, lifestyle modifications and weight loss before pregnancy. Losing weight not only improves fertility but also reduces adverse pregnancy outcomes associated with obesity.

Kidney Disease in Disadvantaged Populations

PubMed Central

Martins, David; Agodoa, Lawrence; Norris, Keith

2012-01-01

Disadvantaged populations across the globe exhibit a disproportionate burden of chronic kidney disease (CKD) because of differences in CKD occurrence and outcomes. Although many CKD risk factors can be managed and modified to optimize clinical outcomes, the prevailing socioeconomic and cultural factors in disadvantaged populations, more often than not, militate against optimum clinical outcomes. In addition, disadvantaged populations exhibit a broader spectrum of CKD risk factors and may be genetically predisposed to an earlier onset and a more rapid progression of chronic kidney disease. A basic understanding of the vulnerabilities of the disadvantaged populations will facilitate the adaptation and adoption of the kidney disease treatment and prevention guidelines for these vulnerable populations. The purpose of this paper is to examine recent discoveries and data on CKD occurrence and outcomes in disadvantaged populations and explore strategies for the prevention and treatment of CKD in these populations based on the established guidelines. PMID:22567281

Determinants of corporate dividend policy in Indonesia

NASA Astrophysics Data System (ADS)

Lestari, H. S.

2018-01-01

This study aims to investigate the determinants factors that effect the dividend policy. The sample used in this research is manufacture companies listed in Indonesia Stock Exchange (IDX) and the period 2011 - 2015. There are independent variables such as earning, cash flow, free cash flow, debt, growth opportunities, investment opportunities, firm size, largest shareholder, firm risk, lagged dividend and dividend policy used as dependent variable. The study examines a total of 32 manufacture companies. After analyzing the data using the program software Eviews 9.0 by multiples regression analysis reveal that earning, cash flow, free cash flow, firm size, and lagged dividend have significant effect on dividend policy, whereas debt, growth opportunities, investment opportunities, largest shareholder, and firm risk have no significant effect on dividend policy. The results of this study are expected to be implemented by the financial managers in improving corporate profits and basic information as return on investment decisions.

[Rules and regulations applying to incidents in radiotherapy].

PubMed

Lohr, F; Baus, W; Vorwerk, H; Schlömp, B; André, L; Georg, D; Hodapp, N

2012-07-01

Radiotherapy is an essential and reliable element of the treatment armamentarium in oncology. Numerous rules, regulations, and protocols minimize the associated risks. It can, however, never be excluded that errors in the treatment delivery chain result in inadequate tumor doses or unnecessary damage to organs at risk. A legal framework governs the management of such incidents. The most important European and North American regulations are reported. Various directives issued by the European Union are differently implemented nationally. This applies particularly to the characterization of incidents that must be reported to authorities. Reporting thresholds, audit systems, and the extent of the integration of voluntary reporting systems vary. Radiotherapy incidents are dealt with differently on an international level. Changes are to be expected based on the European Basic Safety Standards Directive that is currently being prepared and will have to be implemented nationally in due course.

Hyperthyroidism and cardiovascular complications: a narrative review on the basis of pathophysiology

PubMed Central

Cicero, Arrigo F.

2013-01-01

Cardiovascular complications are important in hyperthyroidism because of their high frequency in clinical presentation and increased mortality and morbidity risk. The cause of hyperthyroidism, factors related to the patient, and the genetic basis for complications are associated with risk and the basic underlying mechanisms are important for treatment and management of the disease. Besides cellular effects, hyperthyroidism also causes hemodynamic changes, such as increased preload and contractility and decreased systemic vascular resistance causes increased cardiac output. Besides tachyarrythmias, impaired systolic ventricular dysfunction and diastolic dysfunction may cause thyrotoxic cardiomyopathy in a small percentage of the patients, as another high mortality complication. Although the medical literature has some conflicting data about benefits of treatment of subclinical hyperthyroidism, even high-normal thyroid function may cause cardiovascular problems and it should be treated. This review summarizes the cardiovascular consequences of hyperthyroidism with underlying mechanisms. PMID:24273583

Assessment and management of dental erosion.

PubMed

Wang, Xiaojie; Lussi, Adrian

2010-07-01

Studies have shown a growing trend toward increasing prevalence of dental erosion, associated with the declining prevalence of caries disease in industrialized countries. Erosion is an irreversible chemical process that results in tooth substance loss and leaves teeth susceptible to damage as a result of wear over the course of an individual's lifetime. Therefore, early diagnosis and adequate prevention are essential to minimize the risk of tooth erosion. Clinical appearance is the most important sign to be used to diagnose erosion. The Basic Erosive Wear Examination (BEWE) is a simple method to fulfill this task. The determination of a variety of risk and protective factors (patient-dependent and nutrition-dependent factors) as well as their interplay are necessary to initiate preventive measures tailored to the individual. When tooth loss caused by erosive wear reaches a certain level, oral rehabilitation becomes necessary. Copyright 2010 Elsevier Inc. All rights reserved.

[Application of classified protection of information security in the information system of air pollution and health impact monitoring].

PubMed

Hao, Shuxin; Lü, Yiran; Liu, Jie; Liu, Yue; Xu, Dongqun

2018-01-01

To study the application of classified protection of information security in the information system of air pollution and health impact monitoring, so as to solve the possible safety risk of the information system. According to the relevant national standards and requirements for the information system security classified protection, and the professional characteristics of the information system, to design and implement the security architecture of information system, also to determine the protection level of information system. Basic security measures for the information system were developed in the technical safety and management safety aspects according to the protection levels, which effectively prevented the security risk of the information system. The information system established relatively complete information security protection measures, to enhanced the security of professional information and system service, and to ensure the safety of air pollution and health impact monitoring project carried out smoothly.

T.I.M.S: TaqMan Information Management System, tools to organize data flow in a genotyping laboratory

PubMed Central

Monnier, Stéphanie; Cox, David G; Albion, Tim; Canzian, Federico

2005-01-01

Background Single Nucleotide Polymorphism (SNP) genotyping is a major activity in biomedical research. The Taqman technology is one of the most commonly used approaches. It produces large amounts of data that are difficult to process by hand. Laboratories not equipped with a Laboratory Information Management System (LIMS) need tools to organize the data flow. Results We propose a package of Visual Basic programs focused on sample management and on the parsing of input and output TaqMan files. The code is written in Visual Basic, embedded in the Microsoft Office package, and it allows anyone to have access to those tools, without any programming skills and with basic computer requirements. Conclusion We have created useful tools focused on management of TaqMan genotyping data, a critical issue in genotyping laboratories whithout a more sophisticated and expensive system, such as a LIMS. PMID:16221298

Pediatric Cerebral Palsy in Africa: Where Are We?

PubMed

Donald, Kirsten A; Kakooza, Angelina M; Wammanda, Robinson D; Mallewa, Macpherson; Samia, Pauline; Babakir, Haydar; Bearden, David; Majnemer, Annette; Fehlings, Darcy; Shevell, Michael; Chugani, Harry; Wilmshurst, Jo M

2015-07-01

Cerebral palsy is the most common cause of physical disability in children worldwide. However, little is reported on this condition in the African context. Doctors from 22 countries in Africa, and representatives from a further 5 countries outside Africa, met to discuss the challenges in the evaluation and management of children with cerebral palsy in Africa and to propose service needs and further research. Basic care is limited by the poor availability of diagnostic facilities or medical personnel with experience and expertise in managing cerebral palsy, exacerbated by lack of available interventions such as medications, surgical procedures, or even regular therapy input. Relevant guidelines are lacking. In order to guide services for children with existing disabilities, to effectively target the main etiologies and to develop preventive strategies for the continent, research priorities must include multicenter collaborative studies looking at the prevalence, risk factors, and treatment of cerebral palsy. © The Author(s) 2014.

The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination.

PubMed

Park, In Sook; Suh, Yeon Ok; Park, Hae Sook; Ahn, Soo Yeon; Kang, So Young; Ko, Il Sun

2016-01-01

This study aimed at characterizing Korean nurses' occupational responsibilities to apply the results for improvement of the Korean Nursing Licensing Examination. First, the contents of nursing job were defined based on a focus group interview of 15 nurses. Developing a Curriculum (DACOM) method was used to examine those results and produce the questionnaire by 13 experts. After that, the questionnaire survey to 5,065 hospital nurses was done. The occupational responsibilities of nurses were characterized as involving 8 duties, 49 tasks, and 303 task elements. Those 8 duties are nursing management and professional development, safety and infection control, the management of potential risk factors, basic nursing and caring, the maintenance of physiological integrity, medication and parenteral treatments, socio-psychological integrity, and the maintenance and improvement of health. The content of Korean Nursing Licensing Examination should be improved based on 8 duties and 49 tasks of the occupational responsibilities of Korean nurses.

Food hygiene training in small to medium-sized care settings.

PubMed

Seaman, Phillip; Eves, Anita

2008-10-01

Adoption of safe food handling practices is essential to effectively manage food safety. This study explores the impact of basic or foundation level food hygiene training on the attitudes and intentions of food handlers in care settings, using questionnaires based on the Theory of Planned Behaviour. Interviews were also conducted with food handlers and their managers to ascertain beliefs about the efficacy of, perceived barriers to, and relevance of food hygiene training. Most food handlers had undertaken formal food hygiene training; however, many who had not yet received training were preparing food, including high risk foods. Appropriate pre-training support and on-going supervision appeared to be lacking, thus limiting the effectiveness of training. Findings showed Subjective Norm to be the most significant influence on food handlers' intention to perform safe food handling practices, irrespective of training status, emphasising the role of important others in determining desirable behaviours.

Major depression in primary care: making the diagnosis

PubMed Central

Ng, Chung Wai Mark; How, Choon How; Ng, Yin Ping

2016-01-01

Major depression is a common condition seen in the primary care setting, often presenting with somatic symptoms. It is potentially a chronic illness with considerable morbidity, and a high rate of relapse and recurrence. Major depression has a bidirectional relationship with chronic diseases, and a strong association with increased age and coexisting mental illnesses (e.g. anxiety disorders). Screening can be performed using clinical tools for major depression, such as the Patient Health Questionaire-2, Patient Health Questionaire-9 and Beck Depression Inventory, so that timely treatment can be initiated. An accurate diagnosis of major depression and its severity is essential for prompt treatment to reduce morbidity and mortality. This is the first of a series of articles that illustrates the approach to the management of major depression in primary care. Our next articles will cover suicide risk assessment in a depressed patient and outline the basic principles of management and treatment modalities. PMID:27872937

Clinical governance and infection control in the United Kingdom.

PubMed

Masterson, R G; Teare, E L

2001-01-01

The recent organizational changes in the NHS have at their core the concept of clinical governance. Although initially poorly defined and understood this term has now taken on a clear identity, placing quality alongside fiscal probity and corporate governance at the top of NHS priorities. Integral to clinical governance are the basic elements of clear national standards for services and treatments that are to be locally delivered through assured, monitored, high quality healthcare. It is within this framework that workers in infection control must develop their own methods of applying clinical governance. This review explores the implications that the strategy of clinical governance holds for the speciality of infection control, emphasizing the benefits its active adoption can bring and highlighting the key relevance of clinical risk management in this setting. It illustrates clinical governance as a tool to engage colleagues on a multi-disciplinary front, most particularly the crucial link to senior Trust management.

Sewage sludge disposal strategies for sustainable development.

PubMed

Kacprzak, Małgorzata; Neczaj, Ewa; Fijałkowski, Krzysztof; Grobelak, Anna; Grosser, Anna; Worwag, Małgorzata; Rorat, Agnieszka; Brattebo, Helge; Almås, Åsgeir; Singh, Bal Ram

2017-07-01

The main objective of the present review is to compare the existing sewage sludge management solutions in terms of their environmental sustainability. The most commonly used strategies, that include treatment and disposal has been favored within the present state-of-art, considering existing legislation (at European and national level), characterization, ecotoxicology, waste management and actual routs used currently in particular European countries. Selected decision making tools, namely End-of-waste criteria and Life Cycle Assessment has been proposed in order to appropriately assess the possible environmental, economic and technical evaluation of different systems. Therefore, some basic criteria for the best suitable option selection has been described, in the circular economy "from waste to resources" sense. The importance of sewage sludge as a valuable source of matter and energy has been appreciated, as well as a potential risk related to the application of those strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

Probabilistic Evaluation of Ecological and Economic Objectives of River Basin Management Reveals a Potential Flaw in the Goal Setting of the EU Water Framework Directive

NASA Astrophysics Data System (ADS)

Hjerppe, Turo; Taskinen, Antti; Kotamäki, Niina; Malve, Olli; Kettunen, Juhani

2017-04-01

The biological status of European lakes has not improved as expected despite up-to-date legislation and ecological standards. As a result, the realism of objectives and the attainment of related ecological standards are under doubt. This paper gets to the bottom of a river basin management plan of a eutrophic lake in Finland and presents the ecological and economic impacts of environmental and societal drivers and planned management measures. For these purposes, we performed a Monte Carlo simulation of a diffuse nutrient load, lake water quality and cost-benefit models. Simulations were integrated into a Bayesian influence diagram that revealed the basic uncertainties. It turned out that the attainment of good ecological status as qualified in the Water Framework Directive of the European Union is unlikely within given socio-economic constraints. Therefore, management objectives and ecological and economic standards need to be reassessed and reset to provide a realistic goal setting for management. More effort should be put into the evaluation of the total monetary benefits and on the monitoring of lake phosphorus balances to reduce the uncertainties, and the resulting margin of safety and costs and risks of planned management measures.

Probabilistic Evaluation of Ecological and Economic Objectives of River Basin Management Reveals a Potential Flaw in the Goal Setting of the EU Water Framework Directive.

PubMed

Hjerppe, Turo; Taskinen, Antti; Kotamäki, Niina; Malve, Olli; Kettunen, Juhani

2017-04-01

The biological status of European lakes has not improved as expected despite up-to-date legislation and ecological standards. As a result, the realism of objectives and the attainment of related ecological standards are under doubt. This paper gets to the bottom of a river basin management plan of a eutrophic lake in Finland and presents the ecological and economic impacts of environmental and societal drivers and planned management measures. For these purposes, we performed a Monte Carlo simulation of a diffuse nutrient load, lake water quality and cost-benefit models. Simulations were integrated into a Bayesian influence diagram that revealed the basic uncertainties. It turned out that the attainment of good ecological status as qualified in the Water Framework Directive of the European Union is unlikely within given socio-economic constraints. Therefore, management objectives and ecological and economic standards need to be reassessed and reset to provide a realistic goal setting for management. More effort should be put into the evaluation of the total monetary benefits and on the monitoring of lake phosphorus balances to reduce the uncertainties, and the resulting margin of safety and costs and risks of planned management measures.

Surviving the first hours in sepsis: getting the basics right (an intensivist's perspective).

PubMed

Daniels, Ron

2011-04-01

Severe sepsis is a major cause of morbidity and mortality, claiming between 36 000 and 64 000 lives annually in the UK, with a mortality rate of 35%. International guidelines for the management of severe sepsis were published in 2004 by the Surviving Sepsis Campaign and condensed into two Care Bundles. In 2010, the Campaign published results from its improvement programme showing that, although an absolute mortality reduction of 5.4% was seen over a 2 year period in line with increasing compliance with the Bundles, reliability was not achieved and Bundle compliance reached only 31%. This article explores current challenges in sepsis care and opportunities for further improvements. Basic care tasks [microbiological sampling and antibiotic delivery within 1 h, fluid resuscitation, and risk stratification using serum lactate (or alternative)] are likely to benefit patients most, yet are unreliably performed. Barriers include lack of awareness and robust process, the lack of supporting controlled trials, and complex diagnostic criteria leading to recognition delays. Reliable, timely delivery of more complex life-saving tasks (such as early goal-directed therapy) demands greater awareness, faster recognition and initiation of basic care, and more effective collaboration between clinicians and nurses on the front line, in critical care and in specialist support services, such as microbiology and infectious diseases. Organizations such as Survive Sepsis, the Surviving Sepsis Campaign and the Global Sepsis Alliance are working to raise awareness and promote further improvement initiatives. Future developments will focus on sepsis biomarkers and microarray techniques to rapidly screen for pathogens, risk stratification using genetic profiling, and the development of novel therapeutic agents targeting immunomodulation.

Simple Myths and Basic Maths about Greening Irrigation

NASA Astrophysics Data System (ADS)

Dionisio Pérez-Blanco, C.; Gómez, C. Mario

2014-05-01

Managing water is a very complex societal issue that needs to involve legal, environmental, technological, financial and political considerations that are difficult to co-ordinate in an effective manner. This complexity and the lack of an agreed assessment framework have often implied that political decisions, largely driven by transaction costs (especially the bargaining costs required to come to an acceptable agreement with all the parties involved), have overshadowed and prevailed over other considerations. As a result, (financially) expensive solutions such as irrigation modernization programmes have been preferred to their inexpensive alternatives to save water, such as quotas or pricing policies. However, greening the economy is mostly about improving water governance and not only about putting the existing resource saving technical alternatives into practice. Focusing on the second and forgetting the first risks finishing with a highly efficient use of water services at the level of each individual user but with an unsustainable amount of water use for the entire economy. This might be happening already in many places with the modernization of irrigated agriculture, the world's largest water user and the one offering the most promising water saving opportunities. In spite of high expectations, costly modern irrigation techniques seem not to be contributing to reduce water scarcity and increase drought resiliency. In fact, according to the little evidence available, in some areas they are resulting in higher water use. Building on basic economic principles this study aims to show the conditions under which this apparently paradoxical outcome, known as the Jevons' Paradox, might appear. This basic model is expected to serve as guidance for assessing the actual outcomes of increasing irrigation efficiency and to discuss the changes in water governance that would be required for this to make a real contribution to sustainable water management.

The habitus of hygiene: discourses of cleanliness and infection control in nursing work.

PubMed

Brown, Brian; Crawford, Paul; Nerlich, Brigitte; Koteyko, Nelya

2008-10-01

This paper reports upon a qualitative interview study of 22 matrons, infection control staff and operating theatre staff who were questioned about their working lives and the role they played in the control of healthcare acquired infections such as MRSA virus in the UK. A theoretical framework drawing upon the work of Bourdieu is deployed as his notion of habitus captures the combination of practical work, physical disposition and ways of looking at the world which are displayed in the interview accounts of labour in the healthcare field. Three themes emerged from the analysis: first, the 'securitization' of healthcare work, concerned with control, supervision, 'making sure' and the management of risk through inspection, audit and the exercise of responsibility; second, the sense of struggle against doctors who were seen to represent a threat to the carefully organized boundaries, through such alleged violations as not washing their hands, wandering between theatre and canteen areas in soiled clothing and thinking the rules did not apply to them; third, in a 'back to basics' theme participants emphasised the fundamentals of what they saw to be nursing work and were concerned with cleanliness and practically based training -- the habitus of hygiene itself. This was formulated in nostalgic terms with reminiscences about basic training earlier in the participants' careers. The preoccupation with hygiene and its 'basic' processes can be seen as a way of managing uncertainty, accumulating a certain kind of symbolic capital and constructing and maintaining boundaries in the healthcare field. It also makes for self-governing, self-exploiting individuals who accrue responsibility to themselves for implementing the 'habitus of hygiene'.

Municipal solid waste management in Rasht City, Iran

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

Alavi Moghadam, M.R.; Mokhtarani, N.; Mokhtarani, B.

2009-01-15

Pollution and health risks generated by improper solid waste management are important issues concerning environmental management in developing countries. In most cities, the use of open dumps is common for the disposal of wastes, resulting in soil and water resource contamination by leachate in addition to odors and fires. Solid waste management infrastructure and services in developing countries are far from achieving basic standards in terms of hygiene and efficient collection and disposal. This paper presents an overview of current municipal solid waste management in Rasht city, Gilan Province, Iran, and provides recommendations for system improvement. The collected data ofmore » different MSW functional elements were based on data from questionnaires, visual observations of the authors, available reports and several interviews and meetings with responsible persons. Due to an increase in population and changes in lifestyle, the quantity and quality of MSW in Rasht city has changed. Lack of resources, infrastructure, suitable planning, leadership, and public awareness are the main challenges of MSW management of Rasht city. However, the present situation of solid waste management in this city, which generates more than 400 tons/d, has been improved since the establishment of an organization responsible only for solid waste management. Source separation of wastes and construction of a composting plant are the two main activities of the Rasht Municipality in recent years.« less

Incorporating Social Determinants into a Groundwater Risk Framework

NASA Astrophysics Data System (ADS)

Simpson, M.; Allen, D. M.; Journeay, M.; Korteling, B.

2009-12-01

The remediation of polluted groundwater is often very costly, therefore water managers utilize various proactive measures, such as wellhead protection planning, to prevent contamination events. With limited available resources, it is essential to prioritize where these measures are introduced; systematic and integrated methodologies of assessing risk to groundwater can be utilized for this prioritization. To quantify the resistance of the physical system to pollution, Aquifer Vulnerability is commonly mapped for the area of interest. This information is useful for focusing monitoring efforts and identifying data gaps, but is a relative measure of contaminant risk. To more accurately assess the probability of contamination, an inventory of hazards can be integrated with intrinsic vulnerability of the physical system. This Threat indicator links land-use with chemicals and quantifies the risk based on the toxicity and environmental fate of these substances. Local knowledge of the quantity stored and likelihood of release can be utilized to further assess these threats. Both of these steps form part of an existing frameworks for assessing risk to groundwater. In this study, a groundwater risk framework is developed and tested in two study areas; Pender Island and the Lower Fraser Valley in British Columbia, Canada. Enhancements of a basic groundwater risk framework include not only incorporating points sources such as septic systems, landfills and fuel storage, but also various social determinants of risk. These social determinants include the Resistance of a community, which represents the planning and protection initiatives designed to safeguard the resource. These include items such as land-use planning that consider groundwater vulnerability and best management practices enforced by local governments. The ability to recover following an event is the Capacity of a community; indicators include the presence or absence of spill response plans, treatment systems or an alternative supply of water. The determinant of Loss quantifies the financial impact of this work. This indicator may be altered in future applications to include loss associated with human health and/or that stemming from a reduction in ecosystem health.

42 CFR 438.802 - Basic requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...

42 CFR 438.802 - Basic requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...

42 CFR 438.802 - Basic requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...

42 CFR 438.802 - Basic requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...

42 CFR 438.802 - Basic requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Basic requirements. 438.802 Section 438.802 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Conditions for Federal Financial Participation § 438.802 Basic...

5 CFR 772.101 - Basic authority.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Basic authority. 772.101 Section 772.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) INTERIM RELIEF General § 772.101 Basic authority. This part establishes a mechanism for agencies to provide...

5 CFR 772.101 - Basic authority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Basic authority. 772.101 Section 772.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) INTERIM RELIEF General § 772.101 Basic authority. This part establishes a mechanism for agencies to provide...

48 CFR 970.2201 - Basic labor policies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Basic labor policies. 970.2201 Section 970.2201 Federal Acquisition Regulations System DEPARTMENT OF ENERGY AGENCY SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Application of Labor Policies 970.2201 Basic labor policies. ...

Hydrogen fluoride (HF) substance flow analysis for safe and sustainable chemical industry.

PubMed

Kim, Junbeum; Hwang, Yongwoo; Yoo, Mijin; Chen, Sha; Lee, Ik-Mo

2017-11-01

In this study, the chemical substance flow of hydrogen fluoride (hydrofluoric acid, HF) in domestic chemical industries in 2014 was analyzed in order to provide a basic material and information for the establishment of organized management system to ensure safety during HF applications. A total of 44,751 tons of HF was made by four domestic companies (in 2014); import amount was 95,984 tons in 2014 while 21,579 tons of HF was imported in 2005. The export amount of HF was 2180 tons, of which 2074 ton (China, 1422 tons, U.S. 524 tons, and Malaysia, 128 tons) was exported for the manufacturing of semiconductors. Based on the export and import amounts, it can be inferred that HF was used for manufacturing semiconductors. The industries applications of 161,123 tons of HF were as follows: manufacturing of basic inorganic chemical substance (27,937 tons), manufacturing of other chemical products such as detergents (28,208 tons), manufacturing of flat display (24,896 tons), and manufacturing of glass container package (22,002 tons). In this study, an analysis of the chemical substance flow showed that HF was mainly used in the semiconductor industry as well as glass container manufacturing. Combined with other risk management tools and approaches in the chemical industry, the chemical substance flow analysis (CSFA) can be a useful tool and method for assessment and management. The current CSFA results provide useful information for policy making in the chemical industry and national systems. Graphical abstract Hydrogen fluoride chemical substance flows in 2014 in South Korea.

Planning & Priority Setting for Basic Research

DTIC Science & Technology

2010-05-05

Integrated into numerous commercial codes in aerospace, automotive , semiconductor, and chemical industries Fast Multipole Methods (ONR 31) Applications... Use knowledge (even failures) to reduce risk in acquisition Provide the basis for future Navy and arine Corps syste s Ensure research...relevancy to Naval S&T strategy Transition pro ising Basic Research to applications Use kno ledge (even failures) to reduce risk in acquisition Maintain

[Functional deterioration of basic daily living activities after an emergency service consultation].

PubMed

Gutiérrez Rodríguez, J; Varela Suárez, C; Alonso Alvarez, M; Solano Jaurrieta, J J

2000-05-01

To determine the incidence of functional decline of elderly patients discharged from an emergency department and to analized functional impairment as a risk of readmission. A prospective cohort aged 75 or older were followed up after discharge from an emergency department between 01-02-95 and 01-04-95. The study protocol included sociodemografics, clinicals, functionals and mentalsoutcomes. We studied the incidence of functional decline in basic activities of daily living, with Barthel Index, and association with the risk of readmission. The sample was composed by 125 elders (mean aged 81.9 +/- 4.6 years and 60.8% were women). The incidence of functional decline in basic activities of daily living at the visit to emergency department was 20.8% and one moth after discharge was 18.4%. Both activities with more functional impairment were bathing, dressing and movility activities. Functional decline was associated with the risk of readmission at emergency department (Odds Ratio = 4.1 [1.4-11.8]) 20% of patients who are discharged of emergency department present a new functional impairment in basics activities of daily living. Functional decline is associated with the risk of readmission one moth after discharged.

Fault and event tree analyses for process systems risk analysis: uncertainty handling formulations.

PubMed

Ferdous, Refaul; Khan, Faisal; Sadiq, Rehan; Amyotte, Paul; Veitch, Brian

2011-01-01

Quantitative risk analysis (QRA) is a systematic approach for evaluating likelihood, consequences, and risk of adverse events. QRA based on event (ETA) and fault tree analyses (FTA) employs two basic assumptions. The first assumption is related to likelihood values of input events, and the second assumption is regarding interdependence among the events (for ETA) or basic events (for FTA). Traditionally, FTA and ETA both use crisp probabilities; however, to deal with uncertainties, the probability distributions of input event likelihoods are assumed. These probability distributions are often hard to come by and even if available, they are subject to incompleteness (partial ignorance) and imprecision. Furthermore, both FTA and ETA assume that events (or basic events) are independent. In practice, these two assumptions are often unrealistic. This article focuses on handling uncertainty in a QRA framework of a process system. Fuzzy set theory and evidence theory are used to describe the uncertainties in the input event likelihoods. A method based on a dependency coefficient is used to express interdependencies of events (or basic events) in ETA and FTA. To demonstrate the approach, two case studies are discussed. © 2010 Society for Risk Analysis.

The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adults.

PubMed

Yamada, Minoru; Aoyama, Tomoki; Nakamura, Masatoshi; Tanaka, Buichi; Nagai, Koutatsu; Tatematsu, Noriatsu; Uemura, Kazuki; Nakamura, Takashi; Tsuboyama, Tadao; Ichihashi, Noriaki

2011-01-01

The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P < .001) and a nonsignificant difference in the Ski Slalom (P = .453). The discriminating criterion between the 2 groups was a score of 111 points on the Basic Step (P < .001). The Basic Step showed statistically significant, moderate correlations between the dual-task lag of walking (r = -.547) and the dual-task lag of the Timed Up and Go test (r = -.688). These results suggest that game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults. Copyright © 2011 Mosby, Inc. All rights reserved.

ABE Outreach: Teacher, Recruiter, Counselor. A Handbook for Adult Basic Education Teacher/Recruiter/Counselors. A Guide for Program Managers. Revised.

ERIC Educational Resources Information Center

Singer, Elizabeth W.

Designed for program managers and teacher/recruiter/counselors (TRC's), this handbook provides information on Brevard Community College's Adult Basic Education (ABE) Outreach program. First, background information on the ABE/TRC concept is presented, identifying the major functions of the TRC as counseling through door-to-door contact, conducting…

Management Training, Yes! Excellence?

ERIC Educational Resources Information Center

Davis, Gary E.

1990-01-01

Management training programs are a necessity for transportation supervisors. Basic and advanced training programs are available through associations for business officials and university fleet management training programs. (MLF)

Perception of Climate Risk among Rural Farmers in Vietnam: Consistency within Households and with the Empirical Record.

PubMed

Cullen, Alison C; Anderson, C Leigh

2017-03-01

Rural farmers in Vietnamese communes perceive climate risk and potential impacts on livelihood within a complex context that may influence individual and household decisions. In a primary survey of 1,145 residents of the Thach Ha district of Ha Tinh province, we gathered data regarding perception about stability in climate, potential risks to livelihood, demographic characteristics, orientation toward risk, and interest in expanding economic activity. Temporal analysis of meteorological and economic indicator data forms an empirical basis for comparison with human perception. We ask the basic question: Are rural farmers' perceptions of climate consistent with the historical record and reproducible within households? We find that respondents do perceive climate anomalies, with some anchoring on recent extreme events as revealed by climate observational data, and further that spouses disproportionately share perceptions relative to randomly simulated pairings. To put climate-related risk perception in a larger context, we examine patterns across a range of risks to livelihood faced by farmers (livestock disease, pests, markets, health), using dimension reduction techniques. We find that our respondents distinguish among potential causes of low economic productivity, with substantial emphasis on climate-related impacts. They do not express uniform concern across risks, but rather average patterns reveal common modes and distinguish climate concern. Still, among those expressing concern about climate-related risks to livelihood we do not find an association with expressed intention to pursue changes in economic activity as a risk management response. © 2016 Society for Risk Analysis.

5 CFR 300.103 - Basic requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic requirements. 300.103 Section 300.103 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYMENT (GENERAL) Employment Practices § 300.103 Basic requirements. (a) Job analysis. Each employment practice of the Federal Government generally, and of...

5 CFR 551.401 - Basic principles.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic principles. 551.401 Section 551.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All time...

Distribution and ecological risk assessment of cadmium in water and sediment in Longjiang River, China: Implication on water quality management after pollution accident.

PubMed

Zhao, Xue-Min; Yao, Ling-Ai; Ma, Qian-Li; Zhou, Guang-Jie; Wang, Li; Fang, Qiao-Li; Xu, Zhen-Cheng

2018-03-01

In early January 2012, the Longjiang River was subjected to a serious cadmium (Cd) pollution accident, which led to negatively environmental and social impacts. A series of measures of emergency treatment were subsequently taken to reduce water Cd level. However, little information was available about the change of Cd level in environmental matrices and long-term effect of this pollution accident to aquatic ecosystem. Thus, this study investigated the distribution of Cd in water and sediment of this river for two years since pollution accident, as well as assessed its ecological risk to aquatic ecosystem of Longjiang River. The results showed that it was efficient for taking emergency treatment measures to decrease water Cd concentration to below the threshold value of national drinking water quality standard of China. There was high risk (HQ > 1) to aquatic ecosystem in some of reaches between February and July 2012, but low or no risk (HQ < 1) between December 2012 to December 2013. Cd concentration in sediment in polluted reaches increased after pollution accident and emergency treatments in 2012, but decreased in 2013. During flood period, the sediment containing high concentration of Cd in Longjiang River was migrated to downstream Liujiang River. Cd content in sediment was reduced to background level after two years of the pollution accident occurrence. The study provides basic information about Cd levels in different media after pollution accident, which is helpful in evaluating the effectiveness of emergency treatments and the variation of ecological risk, as well as in conducting water management and conservation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association.

PubMed

Amsterdam, Ezra A; Kirk, J Douglas; Bluemke, David A; Diercks, Deborah; Farkouh, Michael E; Garvey, J Lee; Kontos, Michael C; McCord, James; Miller, Todd D; Morise, Anthony; Newby, L Kristin; Ruberg, Frederick L; Scordo, Kristine Anne; Thompson, Paul D

2010-10-26

The management of low-risk patients presenting to emergency departments is a common and challenging clinical problem entailing 8 million emergency department visits annually. Although a majority of these patients do not have a life-threatening condition, the clinician must distinguish between those who require urgent treatment of a serious problem and those with more benign entities who do not require admission. Inadvertent discharge of patients with acute coronary syndrome from the emergency department is associated with increased mortality and liability, whereas inappropriate admission of patients without serious disease is neither indicated nor cost-effective. Clinical judgment and basic clinical tools (history, physical examination, and electrocardiogram) remain primary in meeting this challenge and affording early identification of low-risk patients with chest pain. Additionally, established and newer diagnostic methods have extended clinicians' diagnostic capacity in this setting. Low-risk patients presenting with chest pain are increasingly managed in chest pain units in which accelerated diagnostic protocols are performed, comprising serial electrocardiograms and cardiac injury markers to exclude acute coronary syndrome. Patients with negative findings usually complete the accelerated diagnostic protocol with a confirmatory test to exclude ischemia. This is typically an exercise treadmill test or a cardiac imaging study if the exercise treadmill test is not applicable. Rest myocardial perfusion imaging has assumed an important role in this setting. Computed tomography coronary angiography has also shown promise in this setting. A negative accelerated diagnostic protocol evaluation allows discharge, whereas patients with positive findings are admitted. This approach has been found to be safe, accurate, and cost-effective in low-risk patients presenting with chest pain.

The use of failure mode and effects analysis to construct an effective disposal and prevention mechanism for infectious hospital waste

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

Ho, Chao Chung, E-mail: ho919@pchome.com.tw; Liao, Ching-Jong

Highlights: > This study is based on a real case in a regional teaching hospital in Taiwan. > We use Failure mode and effects analysis (FMEA) as the evaluation method. > We successfully identify the risk factors of infectious waste disposal. > We propose plans for the detection of exceptional cases of infectious waste. - Abstract: In recent times, the quality of medical care has been continuously improving in medical institutions wherein patient-centred care has been emphasized. Failure mode and effects analysis (FMEA) has also been promoted as a method of basic risk management and as part of total qualitymore » management (TQM) for improving the quality of medical care and preventing mistakes. Therefore, a study was conducted using FMEA to evaluate the potential risk causes in the process of infectious medical waste disposal, devise standard procedures concerning the waste, and propose feasible plans for facilitating the detection of exceptional cases of infectious waste. The analysis revealed the following results regarding medical institutions: (a) FMEA can be used to identify the risk factors of infectious waste disposal. (b) During the infectious waste disposal process, six items were scored over 100 in the assessment of uncontrolled risks: erroneous discarding of infectious waste by patients and their families, erroneous discarding by nursing staff, erroneous discarding by medical staff, cleaning drivers pierced by sharp articles, cleaning staff pierced by sharp articles, and unmarked output units. Therefore, the study concluded that it was necessary to (1) provide education and training about waste classification to the medical staff, patients and their families, nursing staff, and cleaning staff; (2) clarify the signs of caution; and (3) evaluate the failure mode and strengthen the effects.« less

Enumerating lepidopteran species associated with maize as a first step in risk assessment in the USA.

PubMed

Losey, John E; Hufbauer, Ruth A; Hartzler, Robert G

2003-01-01

Pest management can have substantial impacts on non-target species both within and outside the units being managed. Assessment of these impacts is hampered by the lack of even the most basic checklist of the species present in most systems. The maize agroecosytem is of particular interest because of the large area covered and the intensity of widely varying forms of pest management. In this study a database of lepidopteran species that occur within the maize agroecosystem in the United States was compiled. The process was initiated by developing a list of plants present in maize using published sources and the first-hand knowledge of "weed" experts. This list of plant species associated with maize was then cross-listed with lepidopteran host feeding records using published sources. Finally, phenological profiles and conservation rankings were added. Although our list is not exhaustive, we found 132 plant species in 33 families associated with maize, and 229 lepidopteran species in 21 families that feed on these plants. The database of plants and lepidopteran species can be a starting point for assessment of risk to non-target Lepidoptera in maize from chemical control, biological control, and the use of transgenic Bt maize. The lepidopteran species associated with maize were found to be significantly less imperiled, as measured by their conservation rankings, than lepidopteran species as a whole in all habitats. This finding suggests that rare or endangered lepidopteran species are unlikely to be impacted by pest management in maize. Based on the likely lack of impact of pest management in maize on individual species, future studies should focus on potential impacts on the ecological services that lepidopteran species provide.

Management Techniques for Librarians.

ERIC Educational Resources Information Center

Evans, G. Edward

This textbook on library management techniques is concerned with basic management problems. Examples of problems in planning, organization, and coordination are drawn from situations in libraries or information centers. After an introduction to library management, the history of management is covered. Several styles of management and organization…

NASA's Risk Management System

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2011-01-01

Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

Risk Management Issues - An Aerospace Perspective

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2011-01-01

Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks--risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements.. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner, Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

Quantitative risk assessment for skin sensitization: Success or failure?

PubMed

Kimber, Ian; Gerberick, G Frank; Basketter, David A

2017-02-01

Skin sensitization is unique in the world of toxicology. There is a combination of reliable, validated predictive test methods for identification of skin sensitizing chemicals, a clearly documented and transparent approach to risk assessment, and effective feedback from dermatology clinics around the world delivering evidence of the success or failure of the hazard identification/risk assessment/management process. Recent epidemics of contact allergy, particularly to preservatives, have raised questions of whether the safety/risk assessment process is working in an optimal manner (or indeed is working at all!). This review has as its focus skin sensitization quantitative risk assessment (QRA). The core toxicological principles of QRA are reviewed, and evidence of use and misuse examined. What becomes clear is that skin sensitization QRA will only function adequately if two essential criteria are met. The first is that QRA is applied rigourously, and the second is that potential exposure to the sensitizing substance is assessed adequately. This conclusion will come as no surprise to any toxicologist who appreciates the basic premise that "risk = hazard x exposure". Accordingly, use of skin sensitization QRA is encouraged, not least because the essential feedback from dermatology clinics can be used as a tool to refine QRA in situations where this risk assessment tool has not been properly used. Copyright © 2016 Elsevier Inc. All rights reserved.

Air Quality and Heart Health: Managing an Emerging ...

EPA Pesticide Factsheets

Dr. Cascio will share with a broad range of federal agencies current understanding of the links between air quality and cardiovascular health. The key facts include that air pollution contributes a high attributable health burden. That certain well-defined vulnerable subpopulations are at higher risk. At-risk populations include those with heart disease, lung disease and diabetes, older adults, children and individuals living in low socioeconomic neighborhoods. There is no established threshold level for safe long-term exposure to air particle pollution, and some of the basic biological mechanisms that account for adverse health effects are now known. This knowledge is giving us insight into how we might mitigate the effects apart from the regulatory efforts to improve overall air quality. Moreover, the work that each State has done to improve air quality has resulted in improved health outcomes including cardiovascular outcomes, and longer lives. The presentation will address: 1) What do we know? 2) Who are the at-risk populations? 3) What can communities do to reduce risk? 4) What can healthcare professionals do to reduce risk of the at-risk population? And 5) What tools are available to help healthcare professionals and their patients reduce exposure and risk from air pollutants? The talk will feature a description of the Air Quality Index and associated EPA tools and health information that can be used by health care providers to educate their at-ris

Basic Science Training Program.

ERIC Educational Resources Information Center

Brummel, Clete

These six learning modules were developed for Lake Michigan College's Basic Science Training Program, a workshop to develop good study skills while reviewing basic science. The first module, which was designed to provide students with the necessary skills to study efficiently, covers the following topics: time management; an overview of a study…

5 CFR 534.603 - Rates of basic pay.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Rates of basic pay. 534.603 Section 534.603 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.603 Rates of basic pay. (a) The...

Anticipatory Enrollment Management: Another Level of Enrollment Management

ERIC Educational Resources Information Center

Dennis, Marguerite J.

2012-01-01

Building on the principles of Enrollment Management (EM) and Strategic Enrollment Management (SEM), Anticipatory Enrollment Management (AEM) offers another level of managing enrollment: anticipating future enrollment. AEM is grounded in the basic principles of Customer Relationship Management (CRM) and includes strategic out-reach to parents and…

Habitat evaluation for outbreak of Yangtze voles (Microtus fortis) and management implications.

PubMed

Xu, Zhenggang; Zhao, Yunlin; Li, Bo; Zhang, Meiwen; Shen, Guo; Wang, Yong

2015-05-01

Rodent pests severely damage agricultural crops. Outbreak risk models of rodent pests often do not include sufficient information regarding geographic variation. Habitat plays an important role in rodent-pest outbreak risk, and more information about the relationship between habitat and crop protection is urgently needed. The goal of the present study was to provide an outbreak risk map for the Dongting Lake region and to understand the relationship between rodent-pest outbreak variation and habitat distribution. The main rodent pests in the Dongting Lake region are Yangtze voles (Microtus fortis). These pests cause massive damage in outbreak years, most notably in 2007. Habitat evaluation and ecological details were obtained by analyzing the correlation between habitat suitability and outbreak risk, as indicated by population density and historical events. For the source-sink population, 96.18% of Yangtze vole disaster regions were covered by a 10-km buffer zone of suitable habitat in 2007. Historical outbreak frequency and peak population density were significantly correlated with the proportion of land covered by suitable habitat (r = 0.68, P = 0.04 and r = 0.76, P = 0.03, respectively). The Yangtze vole population tends to migrate approximately 10 km in outbreak years. Here, we propose a practical method for habitat evaluation that can be used to create integrated pest management plans for rodent pests when combined with basic information on the biology, ecology and behavior of the target species. © 2014 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

Obesity, type 2 diabetes mellitus and cardiovascular disease risk: an uptodate in the management of polycystic ovary syndrome.

PubMed

Orio, Francesco; Muscogiuri, Giovanna; Nese, Cinar; Palomba, Stefano; Savastano, Silvia; Tafuri, Domenico; Colarieti, Giorgio; La Sala, Giovanbattista; Colao, Annamaria; Yildiz, Bulent O

2016-12-01

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women and is characterized by two of the following three features: oligoovulation or anovulation, clinical and/or biochemical signs of hyperandrogenism, or polycystic ovaries. It has been demonstrated that PCOS includes a complex number of systemic symptoms in addition to symptoms related to the reproductive apparatus. It has been associated with obesity, metabolic syndrome, type 2 diabetes and an increased risk of cardiovascular disease. Several clinical and basic studies have investigated the link between PCOS and the cardiovascular disease risk, which seems to be due to blunted lipid/glucose metabolism, hypertension, and systemic inflammatory and coagulation disorders. Therefore, the current manuscript aims to review the main findings on PCOS and obesity/obesity-related disease (glucose derangements and cardiovascular disease risk factors). Although there are no long-term data on the morbidity and mortality for cardiovascular disease in PCOS, it is advisable to perform a careful metabolic and cardiovascular assessment in women with PCOS in order to tailor the most suitable strategy to prevent cardiovascular disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Travel medicine

PubMed Central

Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

2014-01-01

Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

[Methodological and operational notes for the assessment and management of the risk of work-related stress].

PubMed

De Ambrogi, Francesco; Ratti, Elisabetta Ceppi

2011-01-01

Today the Italian national debate over the Work-Related Stress Risk Assessment methodology is rather heated. Several methodological proposals and guidelines have been published in recent months, not least those by the "Commissione Consultiva". But despite this wide range of proposals, it appears that there is still a lack of attention to some of the basic methodological issues that must be taken into account in order to correctly implement the above-mentioned guidelines. The aim of this paper is to outline these methodological issues. In order to achieve this, the most authoritative methodological proposals and guidelines have been reviewed. The study focuses in particular on the methodological issues that could lead to important biases if not considered properly. The study leads to some considerations about the methodological validity of a Work-Related Stress Risk Assessment based exclusively on the literal interpretation of the considered proposals. Furthermore, the study provides some hints and working hypotheses on how to overcome these methodological limits. This study should be considered as a starting point for further investigations and debate on the Work-Related Stress Risk Assessment methodology on a national level.

A Real-World Community Health Worker Care Coordination Model for High-Risk Children.

PubMed

Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W

2018-04-01

Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.

[Study on incorporation of "management and guidance of home-visiting by a pharmacist" into a care plan -observation based on a survey of care managers-].

PubMed

Nanaumi, Yoko; Onda, Mitsuko; Sakurai, Hidehiko; Tanaka, Rie; Tsubota, Kenichi; Matoba, Shunya; Mukai, Yusuke; Arakawa, Yukio; Hayase, Yukitoshi

2010-11-01

A survey of care managers ("CMs") was conducted to identify top priority issues in promoting the management and guidance of home-visiting by a pharmacist ("management and guidance") by focusing on the experience in incorporating the management and guidance into a care plan and its relevant factors. Major survey items included (1) number of years working as a CM, (2) basic occupation, (3) experience in incorporating the management and guidance into care plans, (4) understanding the management and guidance content, and (5) an awareness of the need for pharmacists' involvement in care plans. A χ² test was conducted to determine if the experience in incorporating the management and guidance into care plans caused a difference in the distribution of the number of years as a CM, the basic occupation, understanding of the management and guidance content, and an awareness of the need for pharmacists' involvement in care plans. A regression analysis was conducted to determine the degree of association between the incorporation experience and each item. The numbers of years working as a CM, the basic occupation, understanding of the management and guidance content, and an awareness of the need for pharmacists' involvement in care plans, were found to be associated with the experience in incorporating the management and guidance into care plans. Understanding of the management and guidance content was most closely associated. To promote pharmacists' management and guidance for home-based care, CMs need to deepen their understanding of this service.

A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Health impact and management.

PubMed

Farrag, Nesrine S; Cheskin, Lawrence J; Farag, Mohamed K

2017-01-01

Childhood obesity has serious consequences both immediately and in adulthood. The rates of obesity in children and adolescents are rising rapidly in the Middle East and North Africa (MENA) region. We systematically searched the literature to explore adverse effects associated with childhood obesity in this region and the management efforts for dealing with it. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies that examined adverse effects of childhood obesity gave fairly consistent results, revealing associations with higher blood pressure, pre-diabetes, metabolic abnormalities, and cardiovascular risk. Little or no overall effect on rates of childhood obesity has yet been demonstrated by interventions used to manage the problem. Obesity has a considerable impact on the health of children and adolescents, and the countries of the MENA region should endorse strategies and programs to prevent and manage this problem in an effective way.

Cardio-Facio-Cutaneous Syndrome: Clinical Features, Diagnosis, and Management Guidelines

PubMed Central

Magoulas, Pilar L.; Adi, Saleh; Kavamura, Maria Ines; Neri, Giovanni; Noonan, Jacqueline; Pierpont, Elizabeth I.; Reinker, Kent; Roberts, Amy E.; Shankar, Suma; Sullivan, Joseph; Wolford, Melinda; Conger, Brenda; Santa Cruz, Molly; Rauen, Katherine A.

2014-01-01

Cardio-facio-cutaneous syndrome (CFC) is one of the RASopathies that bears many clinical features in common with the other syndromes in this group, most notably Noonan syndrome and Costello syndrome. CFC is genetically heterogeneous and caused by gene mutations in the Ras/mitogen-activated protein kinase pathway. The major features of CFC include characteristic craniofacial dysmorphology, congenital heart disease, dermatologic abnormalities, growth retardation, and intellectual disability. It is essential that this condition be differentiated from other RASopathies, as a correct diagnosis is important for appropriate medical management and determining recurrence risk. Children and adults with CFC require multidisciplinary care from specialists, and the need for comprehensive management has been apparent to families and health care professionals caring for affected individuals. To address this need, CFC International, a nonprofit family support organization that provides a forum for information, support, and facilitation of research in basic medical and social issues affecting individuals with CFC, organized a consensus conference. Experts in multiple medical specialties provided clinical management guidelines for pediatricians and other care providers. These guidelines will assist in an accurate diagnosis of individuals with CFC, provide best practice recommendations, and facilitate long-term medical care. PMID:25180280

Still at Risk: What Students Don't Know, Even Now--A Report from Common Core

ERIC Educational Resources Information Center

Hess, Frederick M.

2009-01-01

A report from Common Core finds that many of America's high school students do not possess the basic knowledge they need to succeed in the world. The report shows that, twenty-five years after the publication of the landmark study, "A Nation at Risk," America's children continue to demonstrate a stunning ignorance about basic facts of America's…

Risk communication basics

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

Corrado, P.G.

In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information.

NASA's Risk Management System

NASA Technical Reports Server (NTRS)

Perera, Jeevan S.

2013-01-01

Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

A Methodology to Support Decision Making in Flood Plan Mitigation

NASA Astrophysics Data System (ADS)

Biscarini, C.; di Francesco, S.; Manciola, P.

2009-04-01

The focus of the present document is on specific decision-making aspects of flood risk analysis. A flood is the result of runoff from rainfall in quantities too great to be confined in the low-water channels of streams. Little can be done to prevent a major flood, but we may be able to minimize damage within the flood plain of the river. This broad definition encompasses many possible mitigation measures. Floodplain management considers the integrated view of all engineering, nonstructural, and administrative measures for managing (minimizing) losses due to flooding on a comprehensive scale. The structural measures are the flood-control facilities designed according to flood characteristics and they include reservoirs, diversions, levees or dikes, and channel modifications. Flood-control measures that modify the damage susceptibility of floodplains are usually referred to as nonstructural measures and may require minor engineering works. On the other hand, those measures designed to modify the damage potential of permanent facilities are called non-structural and allow reducing potential damage during a flood event. Technical information is required to support the tasks of problem definition, plan formulation, and plan evaluation. The specific information needed and the related level of detail are dependent on the nature of the problem, the potential solutions, and the sensitivity of the findings to the basic information. Actions performed to set up and lay out the study are preliminary to the detailed analysis. They include: defining the study scope and detail, the field data collection, a review of previous studies and reports, and the assembly of needed maps and surveys. Risk analysis can be viewed as having many components: risk assessment, risk communication and risk management. Risk assessment comprises an analysis of the technical aspects of the problem, risk communication deals with conveying the information and risk management involves the decision process. In the present paper we propose a novel methodology for supporting the priority setting in the assessment of such issues, beyond the typical "expected value" approach. Scientific contribution and management aspects are merged to create a simplified method for plan basin implementation, based on risk and economic analyses. However, the economic evaluation is not the sole criterion for flood-damage reduction plan selection. Among the different criteria that are relevant to the decision process, safety and quality of human life, economic damage, expenses related with the chosen measures and environmental issues should play a fundamental role on the decisions made by the authorities. Some numerical indices, taking in account administrative, technical, economical and risk aspects, are defined and are combined together in a mathematical formula that defines a Priority Index (PI). In particular, the priority index defines a ranking of priority interventions, thus allowing the formulation of the investment plan. The research is mainly focused on the technical factors of risk assessment, providing quantitative and qualitative estimates of possible alternatives, containing measures of the risk associated with those alternatives. Moreover, the issues of risk management are analyzed, in particular with respect to the role of decision making in the presence of risk information. However, a great effort is devoted to make this index easy to be formulated and effective to allow a clear and transparent comparison between the alternatives. Summarizing this document describes a major- steps for incorporation of risk analysis into the decision making process: framing of the problem in terms of risk analysis, application of appropriate tools and techniques to obtain quantified results, use of the quantified results in the choice of structural and non-structural measures. In order to prove the reliability of the proposed methodology and to show how risk-based information can be incorporated into a flood analysis process, its application to some middle italy river basins is presented. The methodology assessment is performed by comparing different scenarios and showing that the optimal decision stems from a feasibility evaluation.

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

ERIC Educational Resources Information Center

Puma, Michael J.; And Others

The third phase of SISFAP (Study on the Impact of Student Financial Aid Programs), the primary purpose of this study is to evaluate federal and institutional management policies and practices for Basic Educational Opportunity Grant (BEOG) and campus-based programs as they impact on the extent to which the programs are meeting their legislative…

Research on the Countermeasures Based on TTPM Theory for the Improvement of the Basic Education Teachers Training Performance

ERIC Educational Resources Information Center

Huabai, Bu; Dengyu, Zhang; Xiuying, Shen; Hao, Tu

2012-01-01

Many elements of the basic education teachers' training performance are embedded in the training interaction and sharing, so the enhancement of the training performance needs a whole process management and control. Based on TTPM theory, this paper has put forward four measures that must be pay attention to during the management of the basic…

Basic principles of management for cervical spine trauma.

PubMed

O'Dowd, J K

2010-03-01

This article reviews the basic principles of management of cervical trauma. The technique and critical importance of careful assessment is described. Instability is defined, and the incidence of a second injury is highlighted. The concept of spinal clearance is discussed. Early reduction and stabilisation techniques are described, and the indications, and approach for surgery reviewed. The importance of the role of post-injury rehabilitation is identified.

Guidance documents: Continued support to improve operations of fish hatcheries and field sites to reduce the impact or prevent establishment of New Zealand Mudsnails and other invasive mollusks

USGS Publications Warehouse

Moffitt, Christine M.

2017-01-01

This project tested and revised a risk assessment/management tool authored by Moffitt and Stockton designed to provide hatchery biologists and others a structure to measure risk and provide tools to control, prevent or eliminate invasive New Zealand mudsnails (NZMS) and other invasive mollusks in fish hatcheries and hatchery operations. The document has two parts: the risk assessment tool, and an appendix that summarizes options for control or management.The framework of the guidance document for risk assessment/hatchery tool combines approaches used by the Hazard Analysis and Critical Control Points (HACCP) process with those developed by the Commission for Environmental Cooperation (CEC), of Canada, Mexico, and the United States, in the Tri-National Risk Assessment Guidelines for Aquatic Alien Invasive Species. The framework approach for this attached first document assesses risk potential with two activities: probability of infestation and consequences of infestation. Each activity is treated equally to determine the risk potential. These two activities are divided into seven basic elements that utilize scientific, technical, and other relevant information in the process of the risk assessment. To determine the probability of infestation four steps are used that have scores reported or determined and averaged. This assessment follows a familiar HACCP process to assess pathways of entry, entry potential, colonization potential, spread potential. The economic, environmental and social consequences are considered as economic impact, environmental impact, and social and cultural influences.To test this document, the Principal Investigator worked to identify interested hatchery managers through contacts at regional aquaculture meetings, fish health meetings, and through the network of invasive species managers and scientists participating in the Western Regional Panel on Aquatic Nuisance Species and the 100th Meridian Initiative's Columbia River Basin Team, and the Western New Zealand Mudsnail Conference in Seattle. Targeted hatchery workshops were conducted with staff at Dworshak National Fish Hatchery Complex (ID), Similkameen Pond, Oroville WA, and Ringold Springs State Hatchery (WA).As a result of communications with hatchery staff, invasive species managers, and on site assessments of hatchery facilities, the document was modified and enhanced. Additional resources were added to keep it up to date. The result is a more simplified tool that can lead hatchery or management personnel through the process of risk assessment and provide an introduction to the risk management and communication process.In addition to the typical HACCP processes, this tool adds steps to rate and consider uncertainty and the weight of evidence regarding options and monitoring results . Uncertainty of outcome exists in most tools that can be used to control or prevent NZMS or other invasive mollusks from infesting an area. In additional this document emphasizes that specific control tools and plans must be tailored to each specific setting to consider the economic, environmental and social influences. From the testing and evaluation process, there was a strong recognition that a number of control and prevention tools previously suggested and reported in the literature from laboratory and small scale trials may not be compatible with regional and national regulations, economic constraints, social or cultural constraints, engineering or water chemistry characteristics of each facility.The options for control are summarized in the second document, Review of Control Measures for Hatcheries Infested with NZMS (Appendix A) that provides sources for additional resources and specific tools, and guidance regarding the feasibility and success of each approach. This tool also emphasizes that management plans need to be adaptive and incorporate oversight from professionals familiar with measuring risks of fish diseases, and treatments (e.g. the fish health practitioners and water quality and effluent management teams). Finally, with such a team, the adaptive management approach must be ongoing, and become a regular component of hatchery operations.Although it was the intent that this two part document would be included as part of the revised National Management and Control Plan for the NZMS proposed by the U.S. Fish and Wildlife Service (USFWS) and others, it is provided as a stand-alone document.

Basic need satisfaction and suicidal ideation: a self-determination perspective on interpersonal suicide risk and suicidal thinking.

PubMed

Tucker, Raymond P; Wingate, LaRicka R

2014-01-01

This study investigated the relationship between the basic psychological needs, as outlined by self-determination theory, and the interpersonal predictors of suicidal desire, as outlined by the interpersonal-psychological theory of suicidal behavior. It was hypothesized that basic need satisfaction (collective feeling of autonomy, relatedness, and competence) would be related to suicidal ideation through thwarted belongingness and perceived burdensomeness. Mediation analyses demonstrated that thwarted belongingness and perceived burdensomeness both individually mediated the relationship between basic need satisfaction and suicidal ideation. Relatedness also predicted variance of the interaction of thwarted belongingness by perceived burdensomeness while controlling for depression. The clinical utility of assessing need satisfaction as an indication of suicide risk is discussed. Future research to investigate the temporal relationship of the study variables is recommended.

The Project Manager Who Saved His Country

NASA Technical Reports Server (NTRS)

Baniszewski, John

2008-01-01

George Meade defeated Robert E. Lee, one of the greatest military leaders of all time. How did he do it? By using the skills he had learned as a project manager and outperforming Lee in all aspects of project management. Most project managers are familiar with the Project Management Institute's "Guide to the Project Management Body of Knowledge" (PMBOK), which identifies the skills and knowledge crucial to successful project management. Project managers need to make sure that all the elements of a project work together. They must develop and execute plans and coordinate changes to those plans. A project manager must define the scope of the work, break it into manageable pieces, verify and control what work is being done, and make sure that the work being done is essential to the project. Every project manager knows the challenges of schedule and the value of schedule slack. Project managers must get the resources they need and use them effectively. Project managers get the people they need and use their talents to achieve mission success. Projects generate huge amounts of information. A key to project success is getting sufficient and accurate information to the people who need it when they need it. Project managers must identify and quantify the risks that jeopardize project success and make plans for dealing with them. Studying Meade and Lee's performances at Gettysburg can help modern project managers appreciate, develop, and use the skills they need to be good project managers. The circumstances may be different, but the basic principles are the same. This dramatic event in American history shows how the skills of project management can be used in almost any situation. Former project manager George Meade used those skills to change the tide of the Civil War.

Nurse case management: negotiating care together within a developing relationship.

PubMed

Yamashita, Mineko; Forchuk, Cheryl; Mound, Bronwyn

2005-01-01

TOPIC/PROBLEM: The purpose of this study was to explicate the process of nurse case management involving clients afflicted with chronic mental illness. Grounded theory was the method of choice. Interviews were conducted with nurses in inpatient, transitional, and community settings in four cities in southern Ontario, Canada. Negotiating care together within a developing relationship emerged as the basic social process. "Building a trusting relationship" was identified as the foundation of case management. Salient differences were found between the three settings, yet the basic social process was consistent across settings. This underscores the therapeutic relationship as the basis for nurse psychiatric case management.

Induced seismicity and carbon storage: Risk assessment and mitigation strategies

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

White, Joshua A.; Foxall, William; Bachmann, Corinne

Geologic carbon storage (GCS) is widely recognized as an important strategy to reduce atmospheric carbon dioxide (CO 2) emissions. Like all technologies, however, sequestration projects create a number of potential environmental and safety hazards that must be addressed. These include earthquakes—from microseismicity to large, damaging events—that can be triggered by altering pore-pressure conditions in the subsurface. To date, measured seismicity due to CO 2 injection has been limited to a few modest events, but the hazard exists and must be considered. There are important similarities between CO 2 injection and fluid injection from other applications that have induced significant events—e.g.more » geothermal systems, waste-fluid injection, hydrocarbon extraction, and others. There are also important distinctions among these technologies that should be considered in a discussion of seismic hazard. This report focuses on strategies for assessing and mitigating risk during each phase of a CO 2 storage project. Four key risks related to fault reactivation and induced seismicity were considered. Induced slip on faults could potentially lead to: (1) infrastructure damage, (2) a public nuisance, (3) brine-contaminated drinking water, and (4) CO 2-contaminated drinking water. These scenarios lead to different types of damage—to property, to drinking water quality, or to the public welfare. Given these four risks, this report focuses on strategies for assessing (and altering) their likelihoods of occurrence and the damage that may result. This report begins with an overview of the basic physical mechanisms behind induced seismicity. This science basis—and its gaps—is crucial because it forms the foundation for risk assessment and mitigation. Available techniques for characterizing and monitoring seismic behavior are also described. Again, this technical basis—and its limitations—must be factored into the risk assessment and mitigation approach. A phased approach to risk management is then introduced. The basic goal of the phased approach is to constantly adapt site operations to current conditions and available characterization data. The remainder of the report then focuses in detail on different components of the monitoring, risk assessment, and mitigation strategies. Issues in current seismic risk assessment methods that must be modified to address induce seismicity are highlighted. The report then concludes with several specific recommendations for operators and regulatory authorities to consider when selecting, permitting, and operating a storage project.« less

Environmental Regulations as Drivers of Materials Obsolescence

NASA Technical Reports Server (NTRS)

Scroggins, Sharon

2010-01-01

This slide presentation reviews the operations of the Principal Center for Regulatory Risk Analysis and Communication (RRAC-PC) and the impact of environmental regulations in making some materials obsolete. The center is NASA's resource for identifying and managing risks associated with changing environmental regulations. To this end the center acts as an regulatory early warning system, to review track and analyze emerging regulations, collaborate with the technical community on regulatory risk analysis and interpretation and to represent NASA's interests to the regulatory agencies. Regulations frequently result in making some materials unavailable forcing a change to another material. Processes may also be changed due to environmental regulations. For example some items that were sprayed with a chemical may now have to be painted or dipped with the chemical. Sometimes a regulation changes the use of a certain product, which does not affect the usage on Earth, but has significant implications in space. An example of this is the use of lead-free solders of basically tin, which don't appear to have any problem on Earth, but in space applications tin whiskers have resulted in several confirmed satellite failures.

Time perspective, optimistic bias, and self-control among different statuses of university smokers in China: a cross-sectional study.

PubMed

Xu, Ying; Yang, Yang; Ma, Xiao

2018-01-09

Risk behavior often seems 'self-defeating' to the observers. Most people understand the basic health-related knowledge, but some of them still choose to continue risk behaviors, especially for the young. This study aimed to examine time perspective, optimism bias and self control correlated with smoking behavior in Chinese college students. A cross-sectional survey enrolling 3016 university students in Chengdu City, Sichuan Province, China. Influence Factors were identified using multiple logistic regression analyses. Prevalence of current smoking was 20.92% (631 smokers), including 272 daily smokers (9.02%) and 359 non-daily smokers (11.90%). Future-oriented time perspective, general capacity for self-discipline, reliability and ethnicity were protective factors of smoking behavior. Possibility of self-suffering diseases and gender were risk factors of smoking behavior. Smoking in University of Chengdu, China is a severe problem. Results in this research have suggested that irrespective of the smoking level, improving health-related knowledge, time management awareness and self-control ability may contribute to reducing the prevalence of smoking behavior.

Health, Environment and Social Management in Enterprises programme in the Republic of Macedonia.

PubMed

Karadzinska-Bislimovska, Jovanka; Baranski, Boguslaw; Risteska-Kuc, Snezana

2004-01-01

Macedonia is the first country in the region to launch implementation of the WHO Health, Environment and Social Management in Enterprises (HESME) Programme, following the WHO Ministerial Conference on Environment and Health held in London in 1999. The aim of this paper is to describe the efforts made to implement this programme. Methods are based on integrated management with joint involvement of crucial partners at all levels of activities suggested by the WHO. Commitment to inter-sectorial and interagency collaboration at national level, adoption of a final version of a National HESME Plan, with basic principles, criteria and concrete activities, establishment of a National coordination center for the HESME Project, development of training curricula and specific educational tools for occupational health personnel, preparation of questionnaires and procedures for a national survey to detect high occupational risks, specific occupational hazards and health promotion needs of the working population, and finally setting up quantitative and qualitative indicators for national or provincial workplace health profiles. Building up the concept of cooperation, partnership and common work in HESME activities is a challenge for the new public health view in Europe.

Transfusion risks and transfusion-related pro-inflammatory responses.

PubMed

Despotis, George John; Zhang, Lini; Lublin, Douglas M

2007-02-01

Despite improvements in blood screening and administration techniques, serious adverse events related to transfusion continue to occur, albeit at a much lower incidence. In addition to the development and implementation of new screening and blood purification/modification techniques and implementation of an optimal blood management program, the incidence and consequences of transfusion reactions can be reduced by a basic understanding of transfusion-related complications. Although acute hemolytic transfusion reactions, transfusion-associated anaphylaxis and sepsis, and transfusion-associated acute lung injury occur infrequently, diligence in administration of blood and monitoring for development of respective signs/symptoms can minimize the severity of these potentially life-threatening complications. In addition, emerging blood-banking techniques such as psoralen-UV inactivation of pathogens and use of patient identification systems may attenuate the incidence of adverse events related to transfusion. With respect to optimizing blood management by means of an effective blood management program involving pharmacologic and nonpharmacologic strategies, the ability to reduce use of blood products and to decrease operative time or re-exploration rates has important implications for disease prevention, blood inventory and costs, and overall health care costs.

Insulin Basics

MedlinePlus

... Risk? Home Prevention Diagnosing Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk ... Chat Closed engagement en -- So…Do You Have Prediabetes? - 2017-01-ad-council.html So…Do You ...

Bluetongue Disease Risk Assessment Based on Observed and Projected Culicoides obsoletus spp. Vector Densities

PubMed Central

Brugger, Katharina; Rubel, Franz

2013-01-01

Bluetongue is an arboviral disease of ruminants causing significant economic losses. Our risk assessment is based on the epidemiological key parameter, the basic reproduction number. It is defined as the number of secondary cases caused by one primary case in a fully susceptible host population, in which values greater than one indicate the possibility, i.e., the risk, for a major disease outbreak. In the course of the Bluetongue virus serotype 8 (BTV-8) outbreak in Europe in 2006 we developed such a risk assessment for the University of Veterinary Medicine Vienna, Austria. Basic reproduction numbers were calculated using a well-known formula for vector-borne diseases considering the population densities of hosts (cattle and small ruminants) and vectors (biting midges of the Culicoides obsoletus spp.) as well as temperature dependent rates. The latter comprise the biting and mortality rate of midges as well as the reciprocal of the extrinsic incubation period. Most important, but generally unknown, is the spatio-temporal distribution of the vector density. Therefore, we established a continuously operating daily monitoring to quantify the seasonal cycle of the vector population by a statistical model. We used cross-correlation maps and Poisson regression to describe vector densities by environmental temperature and precipitation. Our results comprise time series of observed and simulated Culicoides obsoletus spp. counts as well as basic reproduction numbers for the period 2009–2011. For a spatio-temporal risk assessment we projected our results from the location of Vienna to the entire region of Austria. We compiled both daily maps of vector densities and the basic reproduction numbers, respectively. Basic reproduction numbers above one were generally found between June and August except in the mountainous regions of the Alps. The highest values coincide with the locations of confirmed BTV cases. PMID:23560090

[C-section rate in low-risk women: a useful indicator to compare hospitals attending deliveries with different risks].

PubMed

Librero, Julián; Peiró, Salvador; Belda, Ana; Calabuig, Julia

2014-01-01

the C-section rate has been criticized as a performance indicator for not considering that different hospitals manage deliveries with diverse risks. In this work we explore the characteristics of a new indicator restricted to low C-section risk deliveries. retrospective cohort of all births (n=214,611) in all public hospitals during 2005-2010 in the Valencia Region, Spain (source: minimum basic dataset). A low-risk subpopulation consisting of women under-35, no history of c-section, between 37 and 41 gestational weeks, and with a single fetus, with cephalic presentation and normal weight (2500-3999 g) was constructed. We analyzed variability in the new indicator, its correlation with the crude indicator and, using multilevel logistic regression models, the presence of residual risks. a total of 117 589 births (58.4% of the whole deliveries) were identified as low C-section risk. The c-section rate in these women was 11.9% (24.4% for all deliveries) ranging between hospitals from 7.0% to 28.9%. The c-section rate in low-risk and total deliveries correlated strongly (r=0.88). The remaining risks in the population of low risk did not alter the hospital effect on the c-section rate. the percentage of C-section in low risk women include a high volume of deliveries, correlated with the crude indicator and residual risks are not differentially influenced by hospitals, being a useful indicator for monitoring the quality of obstetric care in the National Health System.

Vancomycin-Resistant Enterococci: Epidemiology, Infection Prevention, and Control.

PubMed

Reyes, Katherine; Bardossy, Ana Cecilia; Zervos, Marcus

2016-12-01

Vancomycin-resistant enterococci (VRE) infections have acquired prominence as a leading cause of health care-associated infections. Understanding VRE epidemiology, transmission modes in health care settings, risk factors for colonization, and infection is essential to prevention and control of VRE infections. Infection control strategies are pivotal in management of VRE infections and should be based on patient characteristics, hospital needs, and available resources. Hand hygiene is basic to decrease acquisition of VRE. The effectiveness of surveillance and contact precautions is variable and controversial in endemic settings, but important during VRE outbreak investigations and control. Environmental cleaning, chlorhexidine bathing, and antimicrobial stewardship are vital in VRE prevention and control. Copyright © 2016 Elsevier Inc. All rights reserved.

Achieving glycemic control in special populations in hospital: perspectives in practice.

PubMed

Cheng, Alice Y Y

2014-04-01

Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Flea control failure? Myths and realities.

PubMed

Halos, Lénaïg; Beugnet, Frédéric; Cardoso, Luís; Farkas, Robert; Franc, Michel; Guillot, Jacques; Pfister, Kurt; Wall, Richard

2014-05-01

Why is it that, despite the proliferation of research on their biology and control, fleas remain such a burden for companion animals and their owners? This review highlights a range of reasons for persistence and apparent treatment failures. It argues that a sustainable approach will require integrated pest management based upon a detailed understanding of the flea life cycle, targeting not only adult fleas but also the immature stages in the environment, combining several modes of control and limiting the risk of chemoresistance. Individual characteristics of the pet and its environment need to be considered. Control of fleas can be achieved, over a timescale of several months, if basic rules are respected. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implementing AORN recommended practices for medication safety.

PubMed

Hicks, Rodney W; Wanzer, Linda J; Denholm, Bonnie

2012-12-01

Medication errors in the perioperative setting can result in patient morbidity and mortality. The AORN "Recommended practices for medication safety" provide guidance to perioperative nurses in developing, implementing, and evaluating safe medication use practices. These practices include recognizing risk points in the medication use process, collaborating with pharmacy staff members, conducting preoperative assessments and postoperative evaluations (eg, medication reconciliation), and handling hazardous medications and pharmaceutical waste. Strategies for successful implementation of the recommended practices include promoting a basic understanding of the nurse's role in the medication use process and developing a medication management plan as well as policies and procedures that support medication safety and activities to measure compliance with safe practices. Published by Elsevier Inc.

Predicting the onset of psychosis in patients at clinical high risk: practical guide to probabilistic prognostic reasoning.

PubMed

Fusar-Poli, P; Schultze-Lutter, F

2016-02-01

Prediction of psychosis in patients at clinical high risk (CHR) has become a mainstream focus of clinical and research interest worldwide. When using CHR instruments for clinical purposes, the predicted outcome is but only a probability; and, consequently, any therapeutic action following the assessment is based on probabilistic prognostic reasoning. Yet, probabilistic reasoning makes considerable demands on the clinicians. We provide here a scholarly practical guide summarising the key concepts to support clinicians with probabilistic prognostic reasoning in the CHR state. We review risk or cumulative incidence of psychosis in, person-time rate of psychosis, Kaplan-Meier estimates of psychosis risk, measures of prognostic accuracy, sensitivity and specificity in receiver operator characteristic curves, positive and negative predictive values, Bayes' theorem, likelihood ratios, potentials and limits of real-life applications of prognostic probabilistic reasoning in the CHR state. Understanding basic measures used for prognostic probabilistic reasoning is a prerequisite for successfully implementing the early detection and prevention of psychosis in clinical practice. Future refinement of these measures for CHR patients may actually influence risk management, especially as regards initiating or withholding treatment. 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/

Analysis of good practice of public health Emergency Operations Centers.

PubMed

Xu, Min; Li, Shi-Xue

2015-08-01

To study the public health Emergency Operations Centers (EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Literature review was conducted to explore the EOCs of selected countries. The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

space technology and nigerian national challenges in disaster management

NASA Astrophysics Data System (ADS)

O. Akinyede, J., , Dr.; Abdullahi, R.

One of the sustainable development challenges of any nation is the nation s capacity and capabilities to manage its environment and disaster According to Abiodun 2002 the fundamental life support systems are air clean water and food or agricultural resources It also includes wholesome environment shelter and access to energy health and education All of these constitute the basic necessities of life whose provision and preservation should be a pre-occupation of the visionary leaders executive legislative and judiciary of any nation and its people in order to completely eradicate ignorance unemployment poverty and disease and also increase life expectancy Accordingly many societies around the globe including Nigeria are embarking on initiatives and developing agenda that could address redress the threats to the life supporting systems Disaster prevention management and reduction therefore present major challenges that require prompt attention locally nationally regionally and globally Responses to disasters vary from the application of space-derived data for disaster management to the disbursement of relief to the victims and the emplacement of recovery measures The role of space technology in particular in all the phases of disaster management planning against disaster disaster early warning risk reduction preparedness crises and damage assessment response and relief disbursement and recovery and reconstruction cannot be overemphasized Akinyede 2005 Therefore this paper seeks to focus on space

Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis "prodromal" population.

PubMed

Nelson, Barnaby; Thompson, Andrew; Yung, Alison R

2012-11-01

Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to a disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. In this study, we investigated the presence of basic self-disturbance in an "ultra high risk" (UHR) for psychosis sample compared with a healthy control sample and whether it predicted transition to psychotic disorder. Forty-nine UHR patients and 52 matched healthy control participants were recruited to the study. Participants were assessed for basic self-disturbance using the Examination of Anomalous Self-Experience (EASE) instrument. UHR participants were followed for a mean of 569 days. Levels of self-disturbance were significantly higher in the UHR sample compared with the healthy control sample (P < .001). Cox regression indicated that total EASE score significantly predicted time to transition (P < .05) when other significant predictors were controlled for. Exploratory analyses indicated that basic self-disturbance scores were higher in schizophrenia spectrum cases, irrespective of transition to psychosis, than nonschizophrenia spectrum cases. The results indicate that identifying basic self-disturbance in the UHR population may provide a means of further "closing in" on individuals truly at high risk of psychotic disorder, particularly of schizophrenia spectrum disorders. This may be of practical value by reducing inclusion of "false positive" cases in UHR samples and of theoretical value by shedding light on core phenotypic features of schizophrenia spectrum pathology.

Calculating cost savings in utilization management.

PubMed

MacMillan, Donna

2014-01-01

A major motivation for managing the utilization of laboratory testing is to reduce the cost of medical care. For this reason it is important to understand the basic principles of cost accounting in the clinical laboratory. The process of laboratory testing includes three distinct components termed the pre-analytic, analytic and post-analytic phases. Utilization management efforts may impact the cost structure of these three phases in different ways depending on the specific details of the initiative. Estimates of cost savings resulting from utilization management programs reported in the literature have often been fundamentally flawed due to a failure to understand basic concepts such as the difference between laboratory costs versus charges and the impact of reducing laboratory test volumes on the average versus marginal cost structure in the laboratory. This article will provide an overview of basic cost accounting principles in the clinical laboratory including both job order and process cost accounting. Specific examples will be presented to illustrate these concepts in various different scenarios. © 2013.

Issues in energy finance

NASA Astrophysics Data System (ADS)

Khokher, Zeigham Islam

As opposed to the well developed and understood equity markets, the energy markets are still in their infancy. The explosion of contracts, of both the primary and derivative types, are testament both to the existing size and the untapped growth potential of this exciting industry. However, because of its relative youth many basic issues in the energy markets remain unresolved. This thesis introduces some interesting questions and provides insights into these issues. Thematically, the chapters of this thesis are linked by an emphasis on valuation and risk management decisions. A contribution of this thesis is to show that subtle differences between the endogenous price process in our general equilibrium setting and the exogenous processes considered in earlier papers can generate significant differences in both financial and real option values. In addition to these valuation concerns there has been much debate about the corporate risk management function. Finance theory suggests that a value maximizing corporation should either be indifferent to hedging or, in the presence of certain imperfections, it should completely hedge all exposures. Both these extremes contradict empirical evidence. We show that existing corporate hedging behaviour is best explained in light of both physical market imperfections and directional predictions on future prices. While these speculative motives may arise from corporate hubris or genuine informational advantages, we argue that it would be difficult to implement private information in the absence of noise traders. Related to the risk management decision is the existence of futures risk premia. These premia have been thought to be cause by covariance with priced factors or due to the hedging demands of consumers and producers. This thesis argues that inventories serve as a signal of available quantity, which coupled with consumers fears regarding stockouts can induce a positive relationship between premia and inventories. In conclusion, we test this relationship using natural gas storage and futures price data and show empirical support for our hypothesis.

Water systems, sanitation, and public health risks in remote communities: Inuit resident perspectives from the Canadian Arctic.

PubMed

Daley, Kiley; Castleden, Heather; Jamieson, Rob; Furgal, Chris; Ell, Lorna

2015-06-01

Safe drinking water and wastewater sanitation are universally recognized as critical components of public health. It is well documented that a lack of access to these basic services results in millions of preventable deaths each year among vulnerable populations. Water and wastewater technologies and management practices are frequently tailored to local environmental conditions. Also important, but often overlooked in water management planning, are the social, cultural and economic contexts in which services are provided. The purpose of this qualitative case study was to identify and understand residents' perceptions of the functionality of current water and wastewater sanitation systems in one vulnerable context, that of a remote Arctic Aboriginal community (Coral Harbour, Nunavut), and to identify potential future water related health risks. Semi-structured interviews were conducted with 28 Inuit residents and 9 key informants in 2011 and 2012. Findings indicate that the population's rapid transition from a semi-nomadic hunting and gathering lifestyle to permanent settlements with municipally provided utilities is influencing present-day water usage patterns, public health perceptions, and the level of priority decision-makers place on water and wastewater management issues. Simultaneously environmental, social and cultural conditions conducive to increased human exposure to waterborne health risks were also found to exist and may be increasing in the settlements. While water and wastewater system design decisions are often based on best practices proven suitable in similar environmental conditions, this study reinforces the argument for inclusion of social, cultural, and economic variables in such decisions, particularly in remote and economically challenged contexts in Canada or elsewhere around the world. The results also indicate that the addition of qualitative data about water and wastewater systems users' behaviours to technical knowledge of systems and operations can enhance the understanding of human-water interactions and be valuable in risk assessments and intervention development. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Nurse's concept in the managerial conception of a basic health unit].

PubMed

Passos, Joanir Pereira; Ciosak, Suely Itsuko

2006-12-01

This study is part of a larger survey called "Use of indicators in nurses' managerial practice in Basic Health Care Units in the city of Rio de Janeiro", which was carried out in the Basic Health Care Units of the Planning Area 5.3 and whose objectives were to identify nurses' conception regarding the tools required for management in those units and to discuss the role of management in organizing health services. The study is descriptive and data were collected in interviews with seven nurse managers. The results show that health services actions are organized and directed to the purpose of the working process through the relationship established between the object, the instruments and the final product, and that for those nurses the end result to be achieved is client's satisfaction and the quality of medical and nursing care.

Linking Theory with Practice: Undergraduate Project Management with School-Age Children.

ERIC Educational Resources Information Center

Falkenberg, Loren; Russell, Randy; Ricker, Lynne

2000-01-01

Management students taught basic business concepts to sixth graders and managed business projects with them. The management students applied knowledge of marketing, human resources, and operations management and developed reflective learning skills through project reports and coaching sessions. (SK)

ECOSYSTEM MANAGEMENT: DESPERATELY SEEKING A PARADIGM

EPA Science Inventory

Two competing views of ecosystem management have emerged. One is that ecosystem management is another stage in the continual evolution of the basic management paradigm - one that natural resource managers have followed in North America for a century. The other view is that ecosys...

Teacher Effectiveness as Correlate of Students' Cognitive Achievement at Upper Basic Education in Basic Technology

ERIC Educational Resources Information Center

Owoh, Titus M.

2016-01-01

This study sought to find out the relationship between students perception of their teacher effectiveness and academic achievement in Basic Technology. Teacher's personality, teaching techniques/classroom management strategy and appearance, all integrate to make for teacher effectiveness. To carry out this research, two research questions and one…

5 CFR 531.406 - Creditable service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... pay is equal to or greater than the rate of basic pay for step 4 of the applicable grade and less than... period for an employee whose rate of basic pay is equal to or greater than the rate of basic pay for step....406 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER THE...

Evaluation Research in Basic Skills with Incarcerated Adults. Technical Report No. 303.

ERIC Educational Resources Information Center

Meyer, Linda A.; And Others

To evaluate the relative effectiveness of traditional versus computer managed instruction (CMI) basic skills programs for incarcerated adults, 359 male inmates from three traditional self-paced and three PLATO/CMI programs were given pretests in the Test of Adult Basic Education (TABE) and the Tennessee Self-Concept Scale (TSCS). Following three…

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2012 CFR

2012-01-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2014 CFR

2014-01-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2011 CFR

2011-01-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What is the basic real...

The Cost to Industry. Basic Skills and the UK Workforce.

ERIC Educational Resources Information Center

Adult Literacy and Basic Skills Unit, London (England).

In Fall 1992, 400 telephone interviews established levels of basic skills difficulties among the work force as encountered or perceived by employers in the United Kingdom. Costs to employers of poor basic skills and the effect of these on their operation were quantified and described. Respondents were mainly personnel/training managers or…

A Simulation for Teaching the Basic and Clinical Science of Fluid Therapy

ERIC Educational Resources Information Center

Rawson, Richard E.; Dispensa, Marilyn E.; Goldstein, Richard E.; Nicholson, Kimberley W.; Vidal, Noni Korf

2009-01-01

The course "Management of Fluid and Electrolyte Disorders" is an applied physiology course taught using lectures and paper-based cases. The course approaches fluid therapy from both basic science and clinical perspectives. While paper cases provide a basis for application of basic science concepts, they lack key components of genuine clinical…

Teaching About Economics.

ERIC Educational Resources Information Center

Paine, Carolyn; Arnold, Anne Jurmu

1983-01-01

A teaching unit on economics discusses basic background information, suggests classroom activities, and lists sources of instructional resources. Reproducible masters for two instructional levels are included and introduce economics law and basic financial management. (FG)

A trial-based economic evaluation of 2 nurse-led disease management programs in heart failure.

PubMed

Postmus, Douwe; Pari, Anees A Abdul; Jaarsma, Tiny; Luttik, Marie Louise; van Veldhuisen, Dirk J; Hillege, Hans L; Buskens, Erik

2011-12-01

Although previously conducted meta-analyses suggest that nurse-led disease management programs in heart failure (HF) can improve patient outcomes, uncertainty regarding the cost-effectiveness of such programs remains. To compare the relative merits of 2 variants of a nurse-led disease management program (basic or intensive support by a nurse specialized in the management of patients with HF) against care as usual (routine follow-up by a cardiologist), a trial-based economic evaluation was conducted alongside the COACH study. In terms of costs per life-year, basic support was found to dominate care as usual, whereas the incremental cost-effectiveness ratio between intensive support and basic support was found to be equal to €532,762 per life-year; in terms of costs per quality-adjusted life-year (QALY), basic support was found to dominate both care as usual and intensive support. An assessment of the uncertainty surrounding these findings showed that, at a threshold value of €20,000 per life-year/€20,000 per QALY, basic support was found to have a probability of 69/62% of being optimal against 17/30% and 14/8% for care as usual and intensive support, respectively. The results of our subgroup analysis suggest that a stratified approach based on offering basic support to patients with mild to moderate HF and intensive support to patients with severe HF would be optimal if the willingness-to-pay threshold exceeds €45,345 per life-year/€59,289 per QALY. Although the differences in costs and effects among the 3 study groups were not statistically significant, from a decision-making perspective, basic support still had a relatively large probability of generating the highest health outcomes at the lowest costs. Our results also substantiated that a stratified approach based on offering basic support to patients with mild to moderate HF and intensive support to patients with severe HF could further improve health outcomes at slightly higher costs. Copyright © 2011 Mosby, Inc. All rights reserved.

A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students.

PubMed

Turrisi, Rob; Larimer, Mary E; Mallett, Kimberly A; Kilmer, Jason R; Ray, Anne E; Mastroleo, Nadine R; Geisner, Irene Markman; Grossbard, Joel; Tollison, Sean; Lostutter, Ty W; Montoya, Heidi

2009-07-01

The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.

A Randomized Clinical Trial Evaluating a Combined Alcohol Intervention for High-Risk College Students*

PubMed Central

Turrisi, Rob; Larimer, Mary E.; Mallett, Kimberly A.; Kilmer, Jason R.; Ray, Anne E.; Mastroleo, Nadine R.; Geisner, Irene Markman; Grossbard, Joel; Tollison, Sean; Lostutter, Ty W.; Montoya, Heidi

2009-01-01

Objective: The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Method: Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. Results: The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. Conclusions: The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session. PMID:19515296

Do Something, Even if It's Wrong! An Approach to Better Management and Planning in Public Schools through a Systematic Approach to Improvement of Basic Skills.

ERIC Educational Resources Information Center

Noggle, Vernon R.

Maintaining that lack of action is one of the biggest errors school managers make, this author describes development of competency based education (CBE) programs as one example of how action can be taken by identifying a problem area and systematically approaching it. He defines CBE programs as those involving identification of basic skills, a…

Basic principles of management for cervical spine trauma

PubMed Central

2009-01-01

This article reviews the basic principles of management of cervical trauma. The technique and critical importance of careful assessment is described. Instability is defined, and the incidence of a second injury is highlighted. The concept of spinal clearance is discussed. Early reduction and stabilisation techniques are described, and the indications, and approach for surgery reviewed. The importance of the role of post-injury rehabilitation is identified. PMID:19701655

Manage Stress

MedlinePlus

... Manage Stress Print This Topic En español Manage Stress Browse Sections The Basics Overview Signs and Health ... and Health Effects What are the signs of stress? When people are under stress, they may feel: ...

"Since I have my case manager, I am back to life" case management in Croatia.

PubMed

Gruber, Ema N; Ivezić-Strkalj, Sladana; Agius, Mark; Martić-Biocina, Sanja

2008-03-01

The authors present a case report of a patient who was treated by a case manager, a member of a Croatian Community Mental Health (CMH) Team, following the recommendations of WHO 2004 as well as the IRIS guidelines and the Basic Standards for Management of Patients with Serious Mental Illness in the Community (Agius 2005) and using the elements of Clinical case management (Muser 1998), Assertive community treatment model (Burns 1995, Scott 1995, Wolfsan 1990), the personal strength model (Rapp 1988) and Rehabilitation model (Anthony 1993). In order to emphasize the importance of the therapist-patient relationship in the treatment of chronic schizophrenic patients (Ivezic 2001) and creating the group atmosphere a Croatian model of case management is created where the patient's needs and risks are assessed by a multidisciplinary team which also conducts the recommended psychosocial interventions plan. The majority of interventions are conducted in groups. The case manager develops a confident relationship with a patient, nourishes the positive transference and aids the delivery of the treatment. The main goals of the interventions are empowerment of the patient, improvement of his abilities and decreasing of disabilities. The case manager also carries out a full assessment of the needs of the patient's family so that the family or carers are also included in the treatment or support if necessary (Gruber 2006). A case report of a patient and the work of her case manager as well as the case manager's diary (Gruber 2007) and the Croatian model of case management is presented in this article.

[Clinical Management: Basics and organization].

PubMed

Torres, Juan; Mingo, Carlos

2015-01-01

Many strategies have been proposed over the last years to ensure the Health Care System sustainability, mainly after the recent global economic crisis. One of the most attractive approaches is clinical management, which is a way of organizing health care units based on active participation of professionals who receive the transference of responsibilities dispoto achieve the objectives with the mission of ensuring a proper patient centered care, taking into consideration the rational use of resources (Efficiency) For the start up of Health Care structures based on clinical management, it is necessary a previous management culture within the departments involved and the center's executive board. Furthermore, to achieve the objectives proposed various tools must be used, such as evidence based medicine, clinical practice variability analysis, process management, in addition of quality and safety strategies. The units involved have to propose a management plan that will result in a management contract with the center's executive board. This agreement will establish some activity, expense and quality objectives that will be quantifiable through various indicators. Risk transference to the unit must include certain budget allocation and incentive decision capacity. Clinical management must not be employed as a savings tool from the part of macro and meso management. There is not a health care structure based on clinical management that have a general character for all health care organizations, existing a great variability in the adoption of various organizational formulas, so that every center must perform its own analysis and decide the most adequate model. In our country there are many clinical management experiences, although there is a long way to go.

Isolating social influences on vulnerability to earthquake shaking: identifying cost-effective mitigation strategies.

NASA Astrophysics Data System (ADS)

Bhloscaidh, Mairead Nic; McCloskey, John; Pelling, Mark; Naylor, Mark

2013-04-01

Until expensive engineering solutions become more universally available, the objective targeting of resources at demonstrably effective, low-cost interventions might help reverse the trend of increasing mortality in earthquakes. Death tolls in earthquakes are the result of complex interactions between physical effects, such as the exposure of the population to strong shaking, and the resilience of the exposed population along with supporting critical infrastructures and institutions. The identification of socio-economic factors that contribute to earthquake mortality is crucial to identifying and developing successful risk management strategies. Here we develop a quantitative methodology more objectively to assess the ability of communities to withstand earthquake shaking, focusing on, in particular, those cases where risk management performance appears to exceed or fall below expectations based on economic status. Using only published estimates of the shaking intensity and population exposure for each earthquake, data that is available for earthquakes in countries irrespective of their level of economic development, we develop a model for mortality based on the contribution of population exposure to shaking only. This represents an attempt to remove, as far as possible, the physical causes of mortality from our analysis (where we consider earthquake engineering to reduce building collapse among the socio-economic influences). The systematic part of the variance with respect to this model can therefore be expected to be dominated by socio-economic factors. We find, as expected, that this purely physical analysis partitions countries in terms of basic socio-economic measures, for example GDP, focusing analytical attention on the power of economic measures to explain variance in observed distributions of earthquake risk. The model allows the definition of a vulnerability index which, although broadly it demonstrates the expected income-dependence of vulnerability to strong shaking, also identifies both anomalously resilient and anomalously vulnerable countries. We argue that this approach has the potential to direct sociological investigations to expose the underlying causes of the observed non-economic differentiation of vulnerability. At one level, closer study of the earthquakes represented by these data points might expose local or national interventions which are increasing resilience of communities to strong shaking in the absence of major national investment. Ultimately it may contribute to the development of a quantitative evaluation of risk management effectiveness at the national level that can be used better to target and track risk management investments.

Cellular and molecular mechanisms regulating vascular tone. Part 1: basic mechanisms controlling cytosolic Ca2+ concentration and the Ca2+-dependent regulation of vascular tone.

PubMed

Akata, Takashi

2007-01-01

General anesthetics cause hemodynamic instability and alter blood flow to various organs. There is mounting evidence that most general anesthetics, at clinical concentrations, influence a wide variety of cellular and molecular mechanisms regulating the contractile state of vascular smooth muscle cells (i.e., vascular tone). In addition, in current anesthetic practice, various types of vasoactive agents are often used to control vascular reactivity and to sustain tissue blood flow in high-risk surgical patients with impaired vital organ function and/or hemodynamic instability. Understanding the physiological mechanisms involved in the regulation of vascular tone thus would be beneficial for anesthesiologists. This review, in two parts, provides an overview of current knowledge about the cellular and molecular mechanisms regulating vascular tone-i.e., targets for general anesthetics, as well as for vasoactive drugs that are used in intraoperative circulatory management. This first part of the two-part review focuses on basic mechanisms regulating cytosolic Ca2+ concentration and the Ca2+-dependent regulation of vascular tone.

Animal contact as a source of human non-typhoidal salmonellosis

PubMed Central

2011-01-01

Non-typhoidal Salmonella represents an important human and animal pathogen world-wide. Most human salmonellosis cases are foodborne, but each year infections are also acquired through direct or indirect animal contact in homes, veterinary clinics, zoological gardens, farm environments or other public, professional or private settings. Clinically affected animals may exhibit a higher prevalence of shedding than apparently healthy animals, but both can shed Salmonella over long periods of time. In addition, environmental contamination and indirect transmission through contaminated food and water may complicate control efforts. The public health risk varies by animal species, age group, husbandry practice and health status, and certain human subpopulations are at a heightened risk of infection due to biological or behavioral risk factors. Some serotypes such as Salmonella Dublin are adapted to individual host species, while others, for instance Salmonella Typhimurium, readily infect a broad range of host species, but the potential implications for human health are currently unclear. Basic hygiene practices and the implementation of scientifically based management strategies can efficiently mitigate the risks associated with animal contacts. However, the general public is frequently unaware of the specific disease risks involved, and high-risk behaviors are common. Here we describe the epidemiology and serotype distribution of Salmonella in a variety of host species. In addition, we review our current understanding of the public health risks associated with different types of contacts between humans and animals in public, professional or private settings, and, where appropriate, discuss potential risk mitigation strategies. PMID:21324103

Analysis of risk factors for post-operative complications and prognostic predictors of disease recurrence following definitive treatment of patients with esophageal cancer from two medical centers in Northwest China

PubMed Central

Wang, Jichang; Zhang, Boxiang; Meng, Jinying; Xiao, Guodong; Li, Xiang; Li, Gang; Qin, Sida; Du, Ning; Zhang, Jia; Zhang, Jing; Xu, Chongwen; Tang, Shou-Ching; Liang, Rui; Ren, Hong; Sun, Xin

2017-01-01

Evaluating the clinicopathological features of patients receiving definitive treatment for esophageal cancer may facilitate the identification of patterns and factors associated with post-operative complications, and enable the development of a surveillance strategy for surviving patients at a higher risk of disease recurrence. In the present study, clinical data from 579 patients with esophageal cancer that underwent radical resection of esophagus were collected. These patients were admitted to two medical centers in Northwest China, and information regarding the presence or absence of basic chronic diseases and post-operative results were retrospectively analyzed. The level of selected stem cell markers, including aldehyde dehydrogenase 1, CD133, integrin subunit α 6, integrin subunit β 4 and T-cell factor-4, were determined in esophageal cancer tissue samples in order to determine whether these markers may be useful predictors of disease prognosis and recurrence. Post-operative complications in patients receiving radical resection of the esophagus included respiratory system complications, cardiovascular abnormalities and esophageal anastomotic fistulae. Diabetes, basic respiratory disease and lower pre-surgical serum albumin levels were observed to be individual risk factors associated with post-operative complications, including respiratory system complications of acute respiratory failure and pulmonary infection, cardiovascular abnormalities of atrial fibrillation and arrhythmia, as well as the development of esophageal anastomotic fistulae. Diagnosis of esophageal cancer at later stage was significantly correlated with anastomotic fistula. Molecular detection of stem cell markers for prognosis prediction was achieved by immunohistochemical and immunofluorescence staining assays. The results demonstrated that the presence of stem-like cells in cancer tissues was associated with poor disease prognosis and a high recurrence ratio. In conclusion, the results of the current study suggested that post-operative complications were more likely to occur in patients with diabetes, basic respiratory disease or lower serum albumin levels prior to surgery. Therefore, sufficient intensive peri-operative care, rigorous operative risk assessments, and the selection of the patients with early or mid-stage esophageal cancer, may decrease the risk of post-surgical complications in patients receiving radical resection of the esophagus. In addition, a high ratio of esophageal cancer stem-like cells was associated with cancer recurrence. These results suggest that an intensive surveillance strategy should be implemented in order to facilitate early detection of disease recurrence and improve the clinical management of these patients post-surgery. PMID:28962198

Who Is Spreading Avian Influenza in the Moving Duck Flock Farming Network of Indonesia?

PubMed

Henning, Joerg; Pfeiffer, Dirk U; Stevenson, Mark; Yulianto, Didik; Priyono, Walujo; Meers, Joanne

2016-01-01

Duck populations are considered to be a reservoir of Highly pathogenic avian influenza (HPAI) virus H5N1 in some agricultural production systems, as they are able to shed the virus for several days without clinical signs. Countries endemically affected with HPAI in Asia are characterised by production systems where ducks are fed on post-harvest spilled rice. During this scavenging process it is common for ducks to come into contact with other duck flocks or wild birds, thereby providing opportunities for virus spread. Effective risk management for HPAI has been significantly compromised by a limited understanding of management of moving duck flocks in these countries, despite of a small number of recent investigations. Here, for the first time, we described the management of moving duck flocks and the structure of the moving duck flock network in quantitative terms so that factors influencing the risk of HPAIV transmission can be identified. By following moving duck flock farmers over a period of 6 months in Java, Indonesia, we were able to describe the movement of flocks and to characterise the network of various types of actors associated with the production system. We used these data to estimate the basic reproductive number for HPAI virus spread. Our results suggest that focussing HPAI prevention measures on duck flocks alone will not be sufficient. Instead, the role of transporters of moving duck flocks, hatcheries and rice paddy owners, in the spread of the HPAI virus needs to be recognised.

Who Is Spreading Avian Influenza in the Moving Duck Flock Farming Network of Indonesia?

PubMed Central

Henning, Joerg; Pfeiffer, Dirk U.; Stevenson, Mark; Yulianto, Didik; Priyono, Walujo; Meers, Joanne

2016-01-01

Duck populations are considered to be a reservoir of Highly pathogenic avian influenza (HPAI) virus H5N1 in some agricultural production systems, as they are able to shed the virus for several days without clinical signs. Countries endemically affected with HPAI in Asia are characterised by production systems where ducks are fed on post-harvest spilled rice. During this scavenging process it is common for ducks to come into contact with other duck flocks or wild birds, thereby providing opportunities for virus spread. Effective risk management for HPAI has been significantly compromised by a limited understanding of management of moving duck flocks in these countries, despite of a small number of recent investigations. Here, for the first time, we described the management of moving duck flocks and the structure of the moving duck flock network in quantitative terms so that factors influencing the risk of HPAIV transmission can be identified. By following moving duck flock farmers over a period of 6 months in Java, Indonesia, we were able to describe the movement of flocks and to characterise the network of various types of actors associated with the production system. We used these data to estimate the basic reproductive number for HPAI virus spread. Our results suggest that focussing HPAI prevention measures on duck flocks alone will not be sufficient. Instead, the role of transporters of moving duck flocks, hatcheries and rice paddy owners, in the spread of the HPAI virus needs to be recognised. PMID:27019344

Using adaptive processes and adverse outcome pathways to develop meaningful, robust, and actionable environmental monitoring programs.

PubMed

Arciszewski, Tim J; Munkittrick, Kelly R; Scrimgeour, Garry J; Dubé, Monique G; Wrona, Fred J; Hazewinkel, Rod R

2017-09-01

The primary goals of environmental monitoring are to indicate whether unexpected changes related to development are occurring in the physical, chemical, and biological attributes of ecosystems and to inform meaningful management intervention. Although achieving these objectives is conceptually simple, varying scientific and social challenges often result in their breakdown. Conceptualizing, designing, and operating programs that better delineate monitoring, management, and risk assessment processes supported by hypothesis-driven approaches, strong inference, and adverse outcome pathways can overcome many of the challenges. Generally, a robust monitoring program is characterized by hypothesis-driven questions associated with potential adverse outcomes and feedback loops informed by data. Specifically, key and basic features are predictions of future observations (triggers) and mechanisms to respond to success or failure of those predictions (tiers). The adaptive processes accelerate or decelerate the effort to highlight and overcome ignorance while preventing the potentially unnecessary escalation of unguided monitoring and management. The deployment of the mutually reinforcing components can allow for more meaningful and actionable monitoring programs that better associate activities with consequences. Integr Environ Assess Manag 2017;13:877-891. © 2017 The Authors. Integrated Environmental Assessment and Management Published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management Published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

A whole process quality control system for energy measuring instruments inspection based on IOT technology

NASA Astrophysics Data System (ADS)

Yin, Bo; Liu, Li; Wang, Jiahan; Li, Xiran; Liu, Zhenbo; Li, Dewei; Wang, Jun; Liu, Lu; Wu, Jun; Xu, Tingting; Cui, He

2017-10-01

Electric energy measurement as a basic work, an accurate measurements play a vital role for the economic interests of both parties of power supply, the standardized management of the measurement laboratory at all levels is a direct factor that directly affects the fairness of measurement. Currently, the management of metering laboratories generally uses one-dimensional bar code as the recognition object, advances the testing process by manual management, most of the test data requires human input to generate reports. There are many problems and potential risks in this process: Data cannot be saved completely, cannot trace the status of inspection, the inspection process isn't completely controllable and so on. For the provincial metrology center's actual requirements of the whole process management for the performance test of the power measuring appliances, using of large-capacity RF tags as a process management information media, we developed a set of general measurement experiment management system, formulated a standardized full performance test process, improved the raw data recording mode of experimental process, developed a storehouse automatic inventory device, established a strict test sample transfer and storage system, ensured that all the raw data of the inspection can be traced back, achieved full life-cycle control of the sample, significantly improved the quality control level and the effectiveness of inspection work.

ePORT, NASA's Computer Database Program for System Safety Risk Management Oversight (Electronic Project Online Risk Tool)

NASA Technical Reports Server (NTRS)

Johnson, Paul W.

2008-01-01

ePORT (electronic Project Online Risk Tool) provides a systematic approach to using an electronic database program to manage a program/project risk management processes. This presentation will briefly cover the standard risk management procedures, then thoroughly cover NASA's Risk Management tool called ePORT. This electronic Project Online Risk Tool (ePORT) is a web-based risk management program that provides a common framework to capture and manage risks, independent of a programs/projects size and budget. It is used to thoroughly cover the risk management paradigm providing standardized evaluation criterion for common management reporting, ePORT improves Product Line, Center and Corporate Management insight, simplifies program/project manager reporting, and maintains an archive of data for historical reference.

Continuous Risk Management: An Overview

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hammer, Theodore F.

1999-01-01

Software risk management is important because it helps avoid disasters, rework, and overkill, but more importantly because it stimulates win-win situations. The objectives of software risk management are to identify, address, and eliminate software risk items before they become threats to success or major sources of rework. In general, good project managers are also good managers of risk. It makes good business sense for all software development projects to incorporate risk management as part of project management. The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to implement risk management. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This is an introductory tutorial to continuous risk management based on this course. The rational for continuous risk management and how it is incorporated into project management are discussed. The risk management structure of six functions is discussed in sufficient depth for managers to understand what is involved in risk management and how it is implemented. These functions include: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.

Probability concepts in quality risk management.

PubMed

Claycamp, H Gregg

2012-01-01

Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management.

Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets.

PubMed

Paolucci, Francesco; Schut, Erik; Beck, Konstantin; Gress, Stefan; Van de Voorde, Carine; Zmora, Irit

2007-04-01

As the share of supplementary health insurance (SI) in health care finance is likely to grow, SI may become an increasingly attractive tool for risk-selection in basic health insurance (BI). In this paper, we develop a conceptual framework to assess the probability that insurers will use SI for favourable risk-selection in BI. We apply our framework to five countries in which risk-selection via SI is feasible: Belgium, Germany, Israel, the Netherlands, and Switzerland. For each country, we review the available evidence of SI being used as selection device. We find that the probability that SI is and will be used for risk-selection substantially varies across countries. Finally, we discuss several strategies for policy makers to reduce the chance that SI will be used for risk-selection in BI markets.

Gender, Race, and Risk: Intersectional Risk Management in the Sale of Sex Online.

PubMed

Moorman, Jessica D; Harrison, Kristen

2016-09-01

Sex worker experience of risk (e.g., physical violence or rape) is shaped by race, gender, and context. For web-based sex workers, experience of risk is comparatively minimal; what is unclear is how web-based sex workers manage risk and if online advertising plays a role in risk management. Building on intersectionality theory and research exploring risk management in sex work, we content-analyzed 600 escort advertisements from Backpage.com ( http://www.backpage.com ) to explore risk management in web-based sex work. To guide our research we asked: Do advertisements contain risk management messages? Does the use of risk management messaging differ by sex worker race or gender? Which groups have the highest overall use of risk management messages? Through a multivariate analysis of covariance (MANCOVA) we found that advertisements contained risk management messages and that uses of these phrases varied by race and gender. Blacks, women, and transgender women drove the use of risk management messages. Black and White transgender women had the highest overall use of these phrases. We conclude that risk management is an intersectional practice and that the use of risk management messages is a venue-specific manifestation of broader risk management priorities found in all venues where sex is sold.

Chemical technology for the toxic gas flow control through process water system.

PubMed

Broussard, G; Bramanti, O; Salvatore, A; Marchese, F M

2001-01-01

The aim of this work is focused on the safety and toxicological aspects due to under-pressure industrial plant management, above all in the case which the gas is very dangerous for human health and environment. Here is illustrated the safe method of control of risks through specific choices of engineering devices and chemical process: in this way we have shown the mathematical calculation regarding the case of ammonia flow gas running in the piping and plant under-pressure. In this paper the Authors show the assessment of the technological solution for falling down of a toxic gas as NH3, which lets off from safety values facilities. The under pressure industrial plants with ammonia are protected through the safety valves, settled at 20 bar pressure. The out-let gas flow is capted by a tank of a water bulk of five time theoretical water amount necessary to the complete absorption of gas. In order to prevent any health risk and carry out a safety management, it needs to verify two basic aspects, with connected specific techniques: 1. The safety valves technology through the mathematical calculation of operating device; 2. The absorption process of the toxic agent for controlling of dangerous runaway of gas.

A national survey of clubs medical personnel, facilities and protocols in Irish Rugby Union.

PubMed

Coughlan, G F; Fullen, B M; McCarthy, C

2014-03-01

Rugby Union is one of the most popular sports in Ireland. Participation in all sports carries risk, and there is an onus on governing bodies and those involved in sport to minimise this risk using injury prevention and management programmes. The aim of this study was to evaluate the current status of medical personnel, facilities and equipment in Rugby Union clubs in Ireland. A nationwide cross sectional survey of affiliated clubs in Ireland was undertaken at the beginning of the 2011-2012. Clubs were surveyed on a range of variables including their medical personnel, facilities, equipment, policies and concussion. 47.7 % of those surveyed responded. The majority reported involvement of appropriate medically qualified personnel, having a dedicated medical area/room, a first aid kit and defibrillator, and a demand for first aid courses. This survey provided key information on the current medical status of clubs in Ireland to the governing body. Many clubs have adequate medical resources in place, however a large number do not have medical professionals working with them or own basic medical equipment. The results of this study have lead to the development and implementation of a rugby specific injury prevention and management programme for medical and non-medical personnel at all levels of the game in Ireland.

The United South and Eastern Tribe (USET) Proper ...

EPA Pesticide Factsheets

The maintenance of wildlife and aquatic habitat is dependent on the development of a riparian area management strategy, which considers and adapts to certain basic ecological and economic relationships. These relationships are functions of riparian and terrestrial ecosystems, growth and reproduction of woody and herbaceous plant communities, hydrologic and geomorphic conditions and processes, soils, sediment, water quality and quantity, recovery rates, upland conditions, cultural, recreation and domestic uses. The class participants determined functional ratings, using the Proper Functioning Condition protocol for each field site visited. The methods used in this Workshop were found to work equally well in both eastern and western ecosystems in the United States. One of the many goals of a Tribe’s environmental and natural resource department is to maintain and restore functionality of stream and wetland riparian and upland areas, which could protect Tribal beneficial uses and values for those water bodies. Disturbances occurring within a watershed, or adjacent to a stream corridor, typically cause effects that may temporarily or permanently alter environmental and ecological risk factors. Focusing on where and how water moves and vegetation/soil trends in the riparian system can often determine if important Tribal goals and objectives are being met. It can then be determined what management changes are needed to move the environmental and ecosystem risk facto

Principles of project management

NASA Technical Reports Server (NTRS)

1982-01-01

The basic principles of project management as practiced by NASA management personnel are presented. These principles are given as ground rules and guidelines to be used in the performance of research, development, construction or operational assignments.

Risk assessment and economic impact analysis of the implementation of new European legislation on radiopharmaceuticals in Italy: the case of the new monograph chapter Compounding of Radiopharmaceuticals (PHARMEUROPA, Vol. 23, No. 4, October 2011).

PubMed

Chitto, Giuseppe; Di Domenico, Elvira; Gandolfo, Patrizia; Ria, Francesco; Tafuri, Chiara; Papa, Sergio

2013-12-01

An assessment of the new monograph chapter Compounding of Radiopharmaceuticals has been conducted on the basis of the first period of implementation of Italian legislation on Good Radiopharmaceuticals Practice (NBP) in the preparation of radiopharmaceuticals, in keeping with Decree by the Italian Ministry of Health dated March 30, 2005. This approach is well grounded in the several points of similarity between the two sets of regulations. The impact on patient risk, on staff risk, and on healthcare organization risk, has been assessed. At the same time, the actual costs of coming into compliance with regulations have been estimated. A change risk analysis has been performed through the identification of healthcare-associated risks, the analysis and measurement of the likelihood of occurrence and of the potential impact in terms of patient harm and staff harm, and the determination of the healthcare organization's controlling capability. In order to evaluate the economic impact, the expenses directly related to the implementation of the activities as per ministerial decree have been estimated after calculating the overall costs unrelated to NBP implementation. The resulting costs have then been averaged over the total number of patient services delivered. NBP implementation shows an extremely positive impact on risk management for both patients receiving Nuclear Medicine services and the healthcare organization. With regard to healthcare workers, instead, the implementation of these regulations has a negative effect on the risk for greater exposure and a positive effect on the defense against litigation. The economic impact analysis of NBP implementation shows a 34% increase in the costs for a single patient service. The implementation of the ministerial decree allows for greater detectability of and control over a number of critical elements, paving the way for risk management and minimization. We, therefore, believe that the proposed tool can provide basic criteria for analysis that could be used by other organizations setting about completing the same process.

Cash Management.

ERIC Educational Resources Information Center

Fischer, Mary L.; Ostrom, John S.

1982-01-01

Elements of an effective management program for colleges and universities are examined. Five basic purposes of an effective program of cash management are identified: developing accurate cash projections, managing cash receipts, controlling cash disbursements, establishing sound banking relationships, and investing funds. It is suggested that all…

Time Management and the Woman Library Manager.

ERIC Educational Resources Information Center

Gothberg, Helen M.

1987-01-01

Discusses how women library managers can use efficient time management techniques to help them make the best of both career and home work environments. Nine basic steps to greater efficiency are presented, and external and internal time wasters are listed. (EM)

Downscaling catchment scale flood risk to contributing sub-catchments to determine the optimum location for flood management.

NASA Astrophysics Data System (ADS)

Pattison, Ian; Lane, Stuart; Hardy, Richard; Reaney, Sim

2010-05-01

The recent increase in flood frequency and magnitude has been hypothesised to have been caused by either climate change or land management. Field scale studies have found that changing land management practices does affect local runoff and streamflow, but upscaling these effects to the catchment scale continues to be problematic, both conceptually and more importantly methodologically. The impact on downstream flood risk is highly dependent upon where the changes are in the catchment, indicating that some areas of the catchment are more important in determining downstream flood risk than others. This is a major flaw in the traditional approach to studying the effect of land use on downstream flood risk: catchment scale hydrological models, which treat every cell in the model equally. We are proposing an alternative ideological approach for doing flood management research, which is underpinned by downscaling the downstream effect (problem i.e. flooding) to the upstream causes (contributing sub-catchments). It is hoped that this approach could have several benefits over the traditional upscaling approach. Firstly, it provides an efficient method to prioritise areas for land use management changes to be implemented to reduce downstream flood risk. Secondly, targets for sub-catchment hydrograph change can be determined which will deliver the required downstream effect. Thirdly, it may be possible to detect the effect of land use changes in upstream areas on downstream flood risk, by weighting the areas of most importance in hydrological models. Two methods for doing this downscaling are proposed; 1) data-based statistical analysis; and 2) hydraulic modelling-based downscaling. These will be outlined using the case study of the River Eden, Cumbria, NW England. The data-based methodology uses the timing and magnitude of floods for each sub-catchment. Principal components analysis (PCA) is used to simplify sub-catchment interactions and optimising stepwise regression is used to predict downstream flood magnitude from the significant principal components. Two particular sub-catchments, the Eamont and the Upper Eden were highlighted as explaining the highest proportion of downstream flood risk, with 21.0% and 19.6% respectively. This approach uses the concept of data mining, whereby commonly available discharge data is used in an innovative way to learn about catchment behaviour. An alternative downscaling approach is hydraulic modelling whereby the input hydrographs from each tributary are changed in turn, both in terms of the magnitudes and the timing of the flows. This basic scenario testing approach can be used to assess the sensitivity of downstream flood risk to upstream contributing tributaries. This approach also highlighted the Upper Eden and Eamont as the most sensitive sub-catchments. A 25% reduction in the flows from these sub-catchments resulted in a 33.1cm and 21.9cm stage reduction downstream respectively, while an 8 hour delay of the peak flow caused a 32.3cm and 27.4cm decrease in downstream stage respectively. This alternative flood management approach is not a replacement to traditional hydrological modelling (upscaling), but a pre-step which allows for more focussed and informed investigation of land management scenarios, in the area where they are most likely to have beneficial impacts on downstream flooding.

41 CFR 102-77.10 - What basic Art-in-Architecture policy governs Federal agencies?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What basic Art-in-Architecture policy governs Federal agencies? 102-77.10 Section 102-77.10 Public Contracts and Property... PROPERTY 77-ART-IN-ARCHITECTURE General Provisions § 102-77.10 What basic Art-in-Architecture policy...

41 CFR 102-77.10 - What basic Art-in-Architecture policy governs Federal agencies?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What basic Art-in-Architecture policy governs Federal agencies? 102-77.10 Section 102-77.10 Public Contracts and Property... PROPERTY 77-ART-IN-ARCHITECTURE General Provisions § 102-77.10 What basic Art-in-Architecture policy...

41 CFR 102-77.10 - What basic Art-in-Architecture policy governs Federal agencies?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What basic Art-in-Architecture policy governs Federal agencies? 102-77.10 Section 102-77.10 Public Contracts and Property... PROPERTY 77-ART-IN-ARCHITECTURE General Provisions § 102-77.10 What basic Art-in-Architecture policy...

41 CFR 102-77.10 - What basic Art-in-Architecture policy governs Federal agencies?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What basic Art-in... PROPERTY 77-ART-IN-ARCHITECTURE General Provisions § 102-77.10 What basic Art-in-Architecture policy governs Federal agencies? Federal agencies must incorporate fine arts as an integral part of the total...

Assessing the Universal Basic Education Primary and Koranic Schools' Synergy for "Almajiri" Street Boys in Nigeria

ERIC Educational Resources Information Center

Usman, Lantana M.

2008-01-01

Purpose: The purpose of this paper is to show how Nigeria's current Universal Basic Education on primary schooling targets Muslim "Almajiri" street boys for basic literacy acquisition. The paper examines the policy's management implementation practices and challenges, as well as provides policy options that may minimize discrepancies for…

41 CFR 102-85.25 - What is the basic principle governing OAs?

Code of Federal Regulations, 2010 CFR

2010-07-01

... principle governing OAs? 102-85.25 Section 102-85.25 Public Contracts and Property Management Federal... POLICY FOR OCCUPANCY IN GSA SPACE Pricing Policy-General § 102-85.25 What is the basic principle governing OAs? The basic principle governing OAs is to adopt the private sector practice of capturing in a...

Money Management and the Consumer, Basic Economic Skills: "Baffled, Bothered, Bewildered".

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.

This document, one in a series of six Project SCAT (Skills for Consumers Applied Today) units for senior high school students, provides an overview of basic economic skills and consumer practices. Project SCAT is designed to help students develop basic skills, solve problems, and apply consumer knowledge necessary for making wise choices in the…

41 CFR 102-77.10 - What basic Art-in-Architecture policy governs Federal agencies?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What basic Art-in... PROPERTY 77-ART-IN-ARCHITECTURE General Provisions § 102-77.10 What basic Art-in-Architecture policy governs Federal agencies? Federal agencies must incorporate fine arts as an integral part of the total...

The Alpha Mu Study: A Report on the Survey of Basic Business Survival Skills.

ERIC Educational Resources Information Center

Whitney, Eugene P.

A study was conducted to secure information relating to the following questions: (1) Are high school graduates leaving school with sufficient basic business skills to adequately manage their personal business affairs? and (2) what role is the business education department playing to provide all students with these basic business skills? A list of…

Project Risk Management

NASA Technical Reports Server (NTRS)

Jr., R. F. Miles

1995-01-01

Project risk management is primarily concerned with performance, reliability, cost, and schedule. Environmental risk management is primarily concerned with human health and ecological hazards and likelihoods. This paper discusses project risk management and compares it to environmental risk management, both with respect to goals and implementation. The approach of the Jet Propulsion Laboratory to risk management is presented as an example of a project risk management approach that is an extension to NASA NHB 7120.5: Management of Major System Programs and Projects.

Medical management of youth baseball and softball tournaments.

PubMed

Kanaan, Matthew; Ray, Tracy R

2013-01-01

The medical management of youth baseball and softball tournaments requires both proper planning and a basic awareness of commonly seen sport-specific injuries. While youth sporting events are designed to be a fun experience for all, injuries and emergencies will occur. With proper planning, and supplies, the impact of these issues can be minimized. This article will outline some basic principles for the medical personnel that may be involved in youth baseball and softball events.

Research on rebuilding the data information environment for aeronautical manufacturing enterprise

NASA Astrophysics Data System (ADS)

Feng, Xilan; Jiang, Zhiqiang; Zong, Xuewen; Shi, Jinfa

2005-12-01

The data environment on integrated information system and the basic standard on information resource management are the key effectively of the remote collaborative designing and manufacturing for complex product. A study project on rebuilding the data information environment for aeronautical manufacturing enterprise (Aero-ME) is put forwarded. Firstly, the data environment on integrated information system, the basic standard on information resource management, the basic establishment on corporation's information, the development on integrated information system, and the information education are discussed profoundly based on the practical requirement of information resource and technique for contemporary Aero-ME. Then, the idea and method with the data environment rebuilding based on I-CASE in the corporation is put forward, and the effective method and implement approach for manufacturing enterprise information is brought forwards. It will also the foundation and assurance that rebuilding the corporation data-environment and promoting standardizing information resource management for the development of Aero-ME information engineering.

The assessment of seismic hazard for Gori, (Georgia) and preliminary studies of seismic microzonation

NASA Astrophysics Data System (ADS)

Gogoladze, Z.; Moscatelli, M.; Giallini, S.; Avalle, A.; Gventsadze, A.; Kvavadze, N.; Tsereteli, N.

2016-12-01

Seismic risk is a crucial issue for South Caucasus, which is the main gateway between Asia and Europe. The goal of this work is to propose new methods and criteria for defining an overall approach aimed at assessing and mitigating seismic risk in Georgia. In this reguard seismic microzonation represents a highly useful tool for seismic risk assessmentin land management, for design of buildings or structures and for emergency planning.Seismic microzonation assessment of local seismic hazard,which is a component of seismicity resulting from specific local characteristics which cause local amplification and soil instability, through identification of zones with seismically homogeneous behavior. This paper presents the results of preliminary study of seismic microzonation of Gori, Georgia. Gori is and is located in the Shida Kartli region and on both sides of Liachvi and Mtkvari rivers, with area of about 135 km2around the Gori fortress. Gori is located in Achara-Trialeti fold-thrust belt, that is tectonically unstable. Half of all earthquakes in Gori area with magnitude M≥3.5 have happened along this fault zone and on basis of damage caused by previous earthquakes, this territory show the highest level of risk (the maximum value of direct losses) in central part of the town. The seismic microzonation map of level 1 for Gori was carried out using: 1) Already available data (i.e., topographic map and boreholes data), 2) Results of new geological surveys and 3) Geophysical measurements (i.e., MASW and noise measurements processed with HVSR technique). Our preliminary results highlight the presence of both stable zones susceptible to local amplifications and unstable zones susceptible to geological instability. Our results are directed to establish set of actions aimed at risk mitigation before initial onset of emergency, and to management of the emergency once the seismic event has occurred. The products obtained, will contain the basic elements of an integrated system aimed at reducing risk and improving over all safety of people and infrastructure in Georgia.

A 2D simulation model for urban flood management

NASA Astrophysics Data System (ADS)

Price, Roland; van der Wielen, Jonathan; Velickov, Slavco; Galvao, Diogo

2014-05-01

The European Floods Directive, which came into force on 26 November 2007, requires member states to assess all their water courses and coast lines for risk of flooding, to map flood extents and assets and humans at risk, and to take adequate and coordinated measures to reduce the flood risk in consultation with the public. Flood Risk Management Plans are to be in place by 2015. There are a number of reasons for the promotion of this Directive, not least because there has been much urban and other infrastructural development in flood plains, which puts many at risk of flooding along with vital societal assets. In addition there is growing awareness that the changing climate appears to be inducing more frequent extremes of rainfall with a consequent increases in the frequency of flooding. Thirdly, the growing urban populations in Europe, and especially in the developing countries, means that more people are being put at risk from a greater frequency of urban flooding in particular. There are urgent needs therefore to assess flood risk accurately and consistently, to reduce this risk where it is important to do so or where the benefit is greater than the damage cost, to improve flood forecasting and warning, to provide where necessary (and possible) flood insurance cover, and to involve all stakeholders in decision making affecting flood protection and flood risk management plans. Key data for assessing risk are water levels achieved or forecasted during a flood. Such levels should of course be monitored, but they also need to be predicted, whether for design or simulation. A 2D simulation model (PriceXD) solving the shallow water wave equations is presented specifically for determining flood risk, assessing flood defense schemes and generating flood forecasts and warnings. The simulation model is required to have a number of important properties: -Solve the full shallow water wave equations using a range of possible solutions; -Automatically adjust the time step and keep it as large as possible while maintaining the stability of the flow calculations; -Operate on a square grid at any resolution while retaining at least some details of the ground topography of the basic grid, the storage, and the form roughness and conveyance of the ground surface; -Account for the overall average ground slope for particular coarse cells; -Have the facility to refine the grid locally; -Have the facility to treat ponds or lakes as single, irregular cells; -Permit prescribed inflows and arbitrary outflows across the boundaries of the model domain or internally, and sources and sinks at any interior cell; -Simulate runoff for spatial rainfall while permitting infiltration; -Use ground surface cover and soil type indices to determine surface roughness, interception and infiltration parameters; -Present results at the basic cell level; -Have the facility to begin a model run with monitored soil moisture data; -Have the facility to hot-start a simulation using dumped data from a previous simulation; -Operate with a graphics cards for parallel processing; -Have the facility to link directly to the urban drainage simulation software such as SWMM through an Open Modelling Interface; -Be linked to the Netherlands national rainfall database for continuous simulation of rainfall-runoff for particular polders and urban areas; -Make the engine available as Open Source together with benchmark datasets; PriceXD forms a key modelling component of an integrated urban water management system consisting of an on-line database and a number of complementary modelling systems for urban hydrology, groundwater, potable water distribution, wastewater and stormwater drainage (separate and combined sewerage), wastewater treatment, and surface channel networks. This will be a 'plug and play' system. By linking the models together, confidence in the accuracy of the above-ground damage and construction costs is comparable to the below-ground costs. What is more, PriceXD can be used to examine additional physical phenomenon such as the interaction between flood flows and flows to and from inlets distributed along the pipes of the underground network, and to optimize the removal of blockages and improve asset management. Finally, PriceXD is already an integral component on a number of operational projects and platforms, including the MyWater distributed platform and the HydroNET web portal, where it is already applied to realistic case studies on the Netherlands (namely the Rijnland area), facilitating the access to both the model execution and results, by abstracting most of the complexity out of the model setup and configuration.

Effects of fire on fish populations: Landscape perspectives on persistance of native fishes and nonnative fish invasions

USGS Publications Warehouse

Dunham, J.B.; Young, M.; Gresswell, Robert E.; Rieman, B.

2003-01-01

Our limited understanding of the short and long-term effects of fire on fish contributes to considerable uncertainty in assessments of the risks and benefits of fire management alternatives. A primary concern among the many potential effects of fire is the effects of fire and fire management on persistence of native fish populations. Limited evidence suggests vulnerability of fish to fire is contingent upon the quality of affected habitats, the amount and distribution of habitat (habitat fragmentation), and habitat specificity of the species in question. Species with narrow habitat requirements in highly degraded and fragmented systems are likely to be most vulnerable to fire and fire-related disturbance. In addition to effects of fire on native fish, there are growing concerns about the effects of fire on nonnative fish invasions. The role of fire in facilitating invasions by nonnative fishes is unknown, but experience with other species suggests some forms of disturbance associated with fire may facilitate invasion. Management efforts to promote persistence of fishes in fire-prone landscapes can take the form of four basic alternatives: (1) pre-fire management; (2) post-fire management; (3) managing fire itself (e.g. fire fighting); and (4) monitoring and adaptive management. Among these alternatives, pre-fire management is likely to be most effective. Effective pre-fire management activities will address factors that may render fish populations more vulnerable to the effects of fire (e.g. habitat degradation, fragmentation, and nonnative species). Post-fire management is also potentially important, but suffers from being a reactive approach that may not address threats in time to avert them. Managing fire itself can be important in some contexts, but negative consequences for fish populations are possible (e.g. toxicity of fire fighting chemicals to fish). Monitoring and adaptive management can provide important new information for evaluating alternatives, but proper implementation is often hampered by inadequate study designs and inconsistent financial and institutional support. The challenge for providing better management guidelines will be to add solid empirical data and models to assess the relevance of emerging concepts and theories, and provide a sense of where and when fires pose significant risks and/or benefits to fishes.

ROLE OF CONTROLLABILITY FOR LONG TERM SUSTAINABILITY

EPA Science Inventory

Successful implementation of sustainability ideas in ecosystem management requires a basic understanding of the often nonlinear and nonintuitive relationships among different dimensions of sustainability, particularly the system-wide implications of human actions. This basic unde...

Does management really work?

PubMed

Bloom, Nicholas; Sadun, Raffaella; Van Reenen, John

2012-11-01

HBR's 90th anniversary is a sensible time to revisit a basic question: Are organizations more likely to succeed if they adopt good management practices? The answer may seem obvious to most HBR readers, but these three economists cast their net much wider than that. In a decadelong study of thousands of organizations in 20 countries, they and their interview teams assessed how well manufacturers, schools, and hospitals adhere to three management basics: targets, incentives, and monitoring. They found that huge numbers of companies follow none of those fundamentals, that adopting the basics yields big improvements in outcomes such as productivity and longevity, and that good nuts-and-bolts management at individual firms shapes national performance. At 14 textile manufacturers in India, for example, an intervention--involving free, high-quality advice from a consultant who was on-site half-time for five months--cut defects by half, reduced inventory by 20%, and raised output by 10%. A control group saw no such gains. The authors' global data set suggests that implementing good management at schools and hospitals yields change more slowly than at manufacturers--but it does come eventually. And the macroeconomic potential--for incomes, productivity, and delivery of critically needed services--is huge. A call for "better management" may sound prosaic, but given the global payoffs, it's actually quite radical.