Coal workers' pneumoconiosis in the United States: regional differences 40 years after implementation of the 1969 Federal Coal Mine Health and Safety Act.

PubMed

Suarthana, Eva; Laney, A Scott; Storey, Eileen; Hale, Janet M; Attfield, Michael D

2011-12-01

To assess whether the recent increases in the prevalence of coal workers' pneumoconiosis (CWP) in the USA reflect increased measured exposures over recent decades, and to identify other potential causative factors. The observed CWP prevalence was calculated for 12,408 underground coal miner participants in the Coal Workers' Health Surveillance Program for the period 2005-2009, stratified by the Mine Safety and Health Administration (MSHA) geographical districts. The predicted prevalence was estimated using a published exposure-response model from a large epidemiological study among U.S. coal miners using dust exposure, tenure, miner's age and coal rank as predictors. χ2 Testing was performed to compare the observed versus predicted CWP prevalence. Observed prevalence was significantly higher than predicted prevalence in MSHA districts 4-7 (central Appalachian region) (10.1% vs. 4.2%; prevalence ratio (PR) 2.4; p<0.001) and significantly lower than predicted in other regions (1.6% vs. 3.6%; PR 0.4; p<0.001). The central Appalachian region had a significantly older workforce with greater mining tenure, a lower proportion of mines with 200 or more employees, and lower seam heights. Significant lower average compliance dust concentrations were reported for this region. The observed CWP prevalence substantially exceeded predicted levels in central Appalachia. However, the increased prevalence was not explained by the measured levels of dust exposures. Likely contributing factors include mine size and low seam mining, which may be associated with higher exposure to silica. Further study is needed to characterise the responsible factors for the elevated CWP rates in central Appalachia.

A new approach to managing work-related road traffic injury: The development of a health investment framework.

PubMed

Warmerdam, Amanda; Newnam, Sharon; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark

2017-08-18

Statistics indicate that employees commuting or traveling as part of their work are overrepresented in workplace injury and death. Despite this, many organizations are unaware of the factors within their organizations that are likely to influence potential reductions in work-related road traffic injury. This article presents a multilevel conceptual framework that identifies health investment as the central feature in reducing work-related road traffic injury. Within this framework, we explore factors operating at the individual driver, workgroup supervisor, and organizational senior management levels that create a mutually reinforcing system of safety. The health investment framework identifies key factors at the senior manager, supervisor, and driver levels to cultivating a safe working environment. These factors are high-performance workplace systems, leader-member exchange and autonomy, trust and empowerment, respectively. The framework demonstrates the important interactions between these factors and how they create a self-sustaining organizational safety system. The framework aims to provide insight into the future development of interventions that are strategically aligned with the organization and target elements that facilitate and enhance driver safety and ultimately reduce work-related road traffic injury and death.

Improving patient safety: lessons from rock climbing.

PubMed

Robertson, Nic

2012-02-01

How to improve patient safety remains an intractable problem, despite large investment and some successes. Academics have argued that the root of the problem is a lack of a comprehensive 'safety culture' in hospitals. Other safety-critical industries such as commercial aviation invest heavily in staff training to develop such a culture, but comparable programmes are almost entirely absent from the health care sector. In rock climbing and many other dangerous activities, the 'buddy system' is used to ensure that safety systems are adhered to despite adverse circumstances. This system involves two or more people using simple checks and clear communication to prevent problems causing harm. Using this system as an example could provide a simple, original and entertaining way of introducing medical students to the idea that human factors are central to ensuring patient safety. Teaching the buddy system may improve understanding and acceptance of other patient safety initiatives, and could also be used by junior doctors as a tool to improve the safety of their practice. © Blackwell Publishing Ltd 2012.

Social Influence and Cognitive-Motivational Effects on Terrorism Preparedness: A Hurdle Model

ERIC Educational Resources Information Center

Wirtz, Philip W.; Rohrbeck, Cynthia A.

2017-01-01

Objectives: The identification of factors which influence peoples' preparation for health safety risks posed by natural and man-made disasters is a central concern in health education. Prior studies have generally approached this issue from either a cognitive or a social influence perspective, and have failed to recognise the increased importance…

Understanding nurses' and physicians' fear of repercussions for reporting errors: clinician characteristics, organization demographics, or leadership factors?

PubMed

Castel, Evan S; Ginsburg, Liane R; Zaheer, Shahram; Tamim, Hala

2015-08-14

Identifying and understanding factors influencing fear of repercussions for reporting and discussing medical errors in nurses and physicians remains an important area of inquiry. Work is needed to disentangle the role of clinician characteristics from those of the organization-level and unit-level safety environments in which these clinicians work and learn, as well as probing the differing reporting behaviours of nurses and physicians. This study examines the influence of clinician demographics (age, gender, and tenure), organization demographics (teaching status, location of care, and province) and leadership factors (organization and unit leadership support for safety) on fear of repercussions, and does so for nurses and physicians separately. A cross-sectional analysis of 2319 nurse and 386 physician responders from three Canadian provinces to the Modified Stanford patient safety climate survey (MSI-06). Data were analyzed using exploratory factor analysis, multiple linear regression, and hierarchical linear regression. Age, gender, tenure, teaching status, and province were not significantly associated with fear of repercussions for nurses or physicians. Mental health nurses had poorer fear responses than their peers outside of these areas, as did community physicians. Strong organization and unit leadership support for safety explained the most variance in fear for both nurses and physicians. The absence of associations between several plausible factors including age, tenure and teaching status suggests that fear is a complex construct requiring more study. Substantially differing fear responses across locations of care indicate areas where interventions may be needed. In addition, since factors affecting fear of repercussions appear to be different for nurses and physicians, tailoring patient safety initiatives to each group may, in some instances, be fruitful. Although further investigation is needed to examine these and other factors in detail, supportive safety leadership appears to be central to reducing fear of reporting errors for both nurses and physicians.

The attributes of successful de-escalation and restraint teams.

PubMed

Snorrason, Jón; Biering, Páll

2018-06-04

Inpatient violence is a widespread problem on psychiatric wards often with serious consequences, and psychiatric hospitals have set up teams to de-escalate and restrain patients with aggression (D-E&R teams) which are specially trained to respond to it in a safe manner. Successful de-escalation and restraining of patients with aggression depend not only on the methods learned in training but also on the confidence of the team. Therefore, it is of great importance to understand the factors that enhance D-E&R teams' competence in managing patients with aggression in a successful and safe manner. The aim of this hermeneutic study was to identify and understand those factors. Purposive-expert sampling was used and twelve D-E&R team members with significant experience participated in the study. The central theme found was a safe team. Ensuring the safety of the team and its members was found to be a prerequisite for successful teamwork in managing patients with aggression in a safe manner. This central theme falls into two interacting domains: the internal dynamics of the team and the team's interaction with patients. Several themes, such as mutual trust, flexibility, and knowing one's role, influence these domains and hence strengthen or weaken the confidence and safety of the team. The findings of the study will contribute to a better understanding of these factors; understanding which could be used to improve the training, supervision, and quality assessment of D-E&R teams and hence lead to more safety in psychiatric wards. © 2018 Australian College of Mental Health Nurses Inc.

Developing a disaster education program for community safety and resilience: The preliminary phase

NASA Astrophysics Data System (ADS)

Nifa, Faizatul Akmar Abdul; Abbas, Sharima Ruwaida; Lin, Chong Khai; Othman, Siti Norezam

2017-10-01

Resilience encompasses both the principles of preparedness and reaction within the dynamic systems and focuses responses on bridging the gap between pre-disaster activities and post-disaster intervention and among structural/non-structural mitigation. Central to this concept is the ability of the affected communities to recover their livelihood and inculcating necessary safety practices during the disaster and after the disaster strikes. While these ability and practices are important to improve the community safety and resilience, such factors will not be effective unless the awareness is present among the community. There have been studies conducted highlighting the role of education in providing awareness for disaster safety and resilience from a very young age. However for Malaysia, these area of research has not been fully explored and developed based on the specific situational and geographical factors of high-risk flood disaster locations. This paper explores the importance of disaster education program in Malaysia and develops into preliminary research project which primary aim is to design a flood disaster education pilot program in Kampung Karangan Primary School, Kelantan, Malaysia.

"Feeling unsafe": a photovoice analysis of factors influencing physical activity behavior among Malaysian adolescents.

PubMed

Saimon, Rosalia; Choo, Wan Yuen; Bulgiba, Awang

2015-03-01

Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents, n = 22, mean age = 14.27 ± 0.7 years, and parents, n = 8, mean age = 48 ± 6.8 years). Data analysis used constant comparison methods of a grounded theory. The Analysis Grid for Environments Linked to Obesity was used to categorize PA factors. Study findings were centered on the concept of safety, facilities, parental restriction, friends, cultural traits, media, community cohesiveness, and weather. The central theme was "feeling unsafe" when being outdoors. To promote PA behavior, provision of PA facilities needs to be supported by other programs that build on peer support, crime prevention, and traffic safety, together with other educational campaigns. © 2013 APJPH.

Labor unions and safety climate: perceived union safety values and retail employee safety outcomes.

PubMed

Sinclair, Robert R; Martin, James E; Sears, Lindsay E

2010-09-01

Although trade unions have long been recognized as a critical advocate for employee safety and health, safety climate research has not paid much attention to the role unions play in workplace safety. We proposed a multiple constituency model of workplace safety which focused on three central safety stakeholders: top management, ones' immediate supervisor, and the labor union. Safety climate research focuses on management and supervisors as key stakeholders, but has not considered whether employee perceptions about the priority their union places on safety contributes contribute to safety outcomes. We addressed this gap in the literature by investigating unionized retail employee (N=535) perceptions about the extent to which their top management, immediate supervisors, and union valued safety. Confirmatory factor analyses demonstrated that perceived union safety values could be distinguished from measures of safety training, workplace hazards, top management safety values, and supervisor values. Structural equation analyses indicated that union safety values influenced safety outcomes through its association with higher safety motivation, showing a similar effect as that of supervisor safety values. These findings highlight the need for further attention to union-focused measures related to workplace safety as well as further study of retail employees in general. We discuss the practical implications of our findings and identify several directions for future safety research. 2009 Elsevier Ltd. All rights reserved.

Transarterial Chemoembolization for Hepatocellular Carcinomas with Central Bile Duct Invasion: Safety, Prognosis, and Predictive Factors

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

Choi, Jin Woo; Chung, Jin Wook, E-mail: chungjw@snu.ac.kr; Cho, Yun Ku

PurposeTo assess the safety and effectiveness of transarterial chemoembolization (TACE) of patients who have hepatocellular carcinomas (HCCs) with central bile duct invasion.Materials and MethodsThe institutional review board approved this retrospective study and waived informed consent. Fifty-three patients, initially treated with TACE for HCCs with central bile duct invasion from January 1999 to September 2012, were included. Clinical, laboratory, and survival data were reviewed. Complications and hospitalization length were evaluated using the χ{sup 2} test, Fisher’s exact test, and logistic regression analysis. Survival was analyzed using the Kaplan–Meier method with log-rank test and Cox proportional hazard model.ResultsSeven patients experienced TACE-related major complications (severemore » post-embolization syndrome in 3, non-fatal sepsis in 3, and secondary bacterial peritonitis in 1). The overall major complication rate was 13.2 %, but there were no permanent adverse sequelae or deaths within 30 days. Serum total bilirubin ≥3.0 mg/dL was the only significant risk factor for long hospitalization [hazard ratio (HR) = 4.341, p = .022]. The median survival was 12.2 months. Extrahepatic metastasis (HR = 6.145, p < .001), international normalized ratio (PT-INR) ≥1.20 (HR = 4.564, p < .001), vascular invasion (HR = 3.484, p = .001), and intermediate tumor enhancement (HR = 2.417, p = .019) were significantly associated with shorter survival.ConclusionTACE can be a safe and effective treatment for patients who have HCCs with central bile duct invasion. In particular, long-term survival can be expected if patients have strongly enhancing tumors without poor prognostic factors such as extrahepatic metastasis, PT-INR prolongation, and vascular invasion.« less

The effects of driver identity on driving safety in a retrospective feedback system.

PubMed

Zhao, Guozhen; Wu, Changxu

2012-03-01

Retrospective feedback that provides detailed information on a driver's performance in critical driving situations at the end of a trip enhances his/her driving behaviors and safe driving habits. Although this has been demonstrated by a previous study, retrospective feedback can be further improved and applied to non-critical driving situations, which is needed for transportation safety. To propose a new retrospective feedback system that uses driver identity (i.e., a driver's name) and to experimentally study its effects on measures of driving performance and safety in a driving simulator. We conducted a behavioral experimental study with 30 participants. "Feedback type" was a between-subject variable with three conditions: no feedback (control group), feedback without driver identity, and feedback with driver identity. We measured multiple aspects of participants' driving behavior. To control for potential confounds, factors that were significantly correlated with driving behavior (e.g., age and driving experience) were all entered as covariates into a multivariate analysis of variance. To examine the effects of speeding on collision severity in driving simulation studies, we also developed a new index - momentum of potential collision - with a set of equations. Subjects who used a feedback system with driver identity had the fewest speeding violations and central-line crossings, spent the least amount of time speeding and crossing the central line, had the lowest speeding and central-line crossing magnitude, ran the fewest red lights, and had the smallest momentum of potential collision compared to the groups with feedback without driver identity and without feedback (control group). The new retrospective feedback system with driver identity has the potential to enhance a person's driving safety (e.g., speeding, central-line crossing, momentum of potential collision), which is an indication of the valence of one's name in a feedback system design. Copyright © 2011 Elsevier Ltd. All rights reserved.

Central line infections - hospitals

MedlinePlus

... infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired infection - central line infection; Patient safety - central ...

Effects of nursing unit spatial layout on nursing team communication patterns, quality of care, and patient safety.

PubMed

Hua, Ying; Becker, Franklin; Wurmser, Teri; Bliss-Holtz, Jane; Hedges, Christine

2012-01-01

Studies investigating factors contributing to improved quality of care have found that effective team member communication is among the most critical and influential aspects in the delivery of quality care. Relatively little research has examined the role of the physical design of nursing units on communication patterns among care providers. Although the concept of decentralized unit design is intended to increase patient safety, reduce nurse fatigue, and control the noisy, chaotic, and crowded space associated with centralized nursing stations, until recently little attention has been paid to how such nursing unit designs affected communication patterns or other medical and organizational outcomes. Using a pre/post research design comparing more centralized or decentralized unit designs with a new multi-hub design, the aim of this study was to describe the relationship between the clinical spatial environment and its effect on communication patterns, nurse satisfaction, distance walked, organizational outcomes, patient safety, and patient satisfaction. Hospital institutional data indicated that patient satisfaction increased substantially. Few significant changes were found in communication patterns; no significant changes were found in nurse job satisfaction, patient falls, pressure ulcers, or organizational outcomes such as average length of stay or patient census.

Factors Associated with the Adoption of Food Safety Controls by the Mexican Meat Industry

NASA Astrophysics Data System (ADS)

Maldonado-Simán, Ema; Martínez-Hernández, Pedro Arturo; García-Muñiz, José G.; Cadena-Meneses, José

Food marketing at international and domestic markets has focused on processing systems that improve food safety. The objective of this research is to determine the factors influencing the implementation of the HACCP system in the Mexican meat industry, and to identify the main marketing destination of their products. Only 18.5% of enterprises reports fully operational HACCP in their plants. The main destination of their production in the domestic market is supermarkets, suppliers and distributors and specific niches of the domestic market. Exports are to USA, Japan, Korea and Central America and some niches of the domestic market with requirements of higher quality. The four principal factors that motivate enterprises to adopt HACCP are associated with improvement of plant efficiency and profitability, adoption of good practices, improvement of product quality and waste reduction. It is concluded that Mexican enterprises adopt HACCP to successfully remain and face competition by foreign enterprises in the domestic market and to a lesser extent to compete in the international market.

75 FR 56548 - Joint Meeting of the Peripheral and Central Nervous System Drugs Advisory Committee and the Drug...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Joint Meeting of the Peripheral and Central Nervous System Drugs Advisory Committee and the Drug Safety... and Central Nervous System Drugs Advisory Committee and the Drug Safety and Risk Management Advisory...

Multi-level Bayesian safety analysis with unprocessed Automatic Vehicle Identification data for an urban expressway.

PubMed

Shi, Qi; Abdel-Aty, Mohamed; Yu, Rongjie

2016-03-01

In traffic safety studies, crash frequency modeling of total crashes is the cornerstone before proceeding to more detailed safety evaluation. The relationship between crash occurrence and factors such as traffic flow and roadway geometric characteristics has been extensively explored for a better understanding of crash mechanisms. In this study, a multi-level Bayesian framework has been developed in an effort to identify the crash contributing factors on an urban expressway in the Central Florida area. Two types of traffic data from the Automatic Vehicle Identification system, which are the processed data capped at speed limit and the unprocessed data retaining the original speed were incorporated in the analysis along with road geometric information. The model framework was proposed to account for the hierarchical data structure and the heterogeneity among the traffic and roadway geometric data. Multi-level and random parameters models were constructed and compared with the Negative Binomial model under the Bayesian inference framework. Results showed that the unprocessed traffic data was superior. Both multi-level models and random parameters models outperformed the Negative Binomial model and the models with random parameters achieved the best model fitting. The contributing factors identified imply that on the urban expressway lower speed and higher speed variation could significantly increase the crash likelihood. Other geometric factors were significant including auxiliary lanes and horizontal curvature. Copyright © 2015 Elsevier Ltd. All rights reserved.

Central safety factor and β N control on NSTX-U via beam power and plasma boundary shape modification, using TRANSP for closed loop simulations

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

Boyer, M. D.; Andre, R.; Gates, D. A.

The high-performance operational goals of NSTX-U will require development of advanced feedback control algorithms, including control of ßN and the safety factor profile. In this work, a novel approach to simultaneously controlling ßN and the value of the safety factor on the magnetic axis, q0, through manipulation of the plasma boundary shape and total beam power, is proposed. Simulations of the proposed scheme show promising results and motivate future experimental implementation and eventual integration into a more complex current profile control scheme planned to include actuation of individual beam powers, density, and loop voltage. As part of this work, amore » flexible framework for closed loop simulations within the high-fidelity code TRANSP was developed. The framework, used here to identify control-design-oriented models and to tune and test the proposed controller, exploits many of the predictive capabilities of TRANSP and provides a means for performing control calculations based on user-supplied data (controller matrices, target waveforms, etc.). The flexible framework should enable high-fidelity testing of a variety of control algorithms, thereby reducing the amount of expensive experimental time needed to implement new control algorithms on NSTX-U and other devices.« less

Central safety factor and βN control on NSTX-U via beam power and plasma boundary shape modification, using TRANSP for closed loop simulations

NASA Astrophysics Data System (ADS)

Boyer, M. D.; Andre, R.; Gates, D. A.; Gerhardt, S.; Goumiri, I. R.; Menard, J.

2015-05-01

The high-performance operational goals of NSTX-U will require development of advanced feedback control algorithms, including control of βN and the safety factor profile. In this work, a novel approach to simultaneously controlling βN and the value of the safety factor on the magnetic axis, q0, through manipulation of the plasma boundary shape and total beam power, is proposed. Simulations of the proposed scheme show promising results and motivate future experimental implementation and eventual integration into a more complex current profile control scheme planned to include actuation of individual beam powers, density, and loop voltage. As part of this work, a flexible framework for closed loop simulations within the high-fidelity code TRANSP was developed. The framework, used here to identify control-design-oriented models and to tune and test the proposed controller, exploits many of the predictive capabilities of TRANSP and provides a means for performing control calculations based on user-supplied data (controller matrices, target waveforms, etc). The flexible framework should enable high-fidelity testing of a variety of control algorithms, thereby reducing the amount of expensive experimental time needed to implement new control algorithms on NSTX-U and other devices.

Post-marketing surveillance of the safety and effectiveness of tacrolimus in 3,267 Japanese patients with rheumatoid arthritis.

PubMed

Takeuchi, Tsutomu; Kawai, Shinichi; Yamamoto, Kazuhiko; Harigai, Masayoshi; Ishida, Kota; Miyasaka, Nobuyuki

2014-01-01

A post-marketing surveillance (PMS) program was implemented to assess the safety and effectiveness of tacrolimus (TAC) in Japanese rheumatoid arthritis (RA) patients and to identify risk factors related to adverse drug reactions (ADRs). Patients were registered centrally and monitored for all adverse events (AEs) for 24 weeks. Effectiveness was evaluated using the Disease Activity Score 28-CRP (DAS28-CRP). Data from 3,172 patients (mean age 62.2 years) were evaluated in the safety analysis. Of the safety population, 78.5 %were female and 25.9 % were in Steinbrocker's functional class 3 or 4. TAC was prescribed as monotherapy in 52.5 % and the most common concomitant disease modifying antirheumatic drug (DMARD) was methotrexate, used in 28.9 % of the patients. The incidence of AEs, serious AEs (SAEs), ADRs and serious ADRs were 41.2, 6.4, 36.0, and 4.9 %, respectively. The most frequent serious ADR category was infections and infestations. Age ≥ 65 years, concurrent renal dysfunction, and concurrent diabetes mellitus were identified as significant risk factors for ADR. Based on EULAR response criteria, 65.4 % of the patients showed moderate or good response. The results demonstrate that TAC is well tolerated by Japanese patients with active RA, including those receiving concomitant methotrexate, in the real world.

Prophylaxis in congenital factor VII deficiency: indications, efficacy and safety. Results from the Seven Treatment Evaluation Registry (STER).

PubMed

Napolitano, Mariasanta; Giansily-Blaizot, Muriel; Dolce, Alberto; Schved, Jean F; Auerswald, Guenter; Ingerslev, Jørgen; Bjerre, Jens; Altisent, Carmen; Charoenkwan, Pimlak; Michaels, Lisa; Chuansumrit, Ampaiwan; Di Minno, Giovanni; Caliskan, Umran; Mariani, Guglielmo

2013-04-01

Because of the very short half-life of factor VII, prophylaxis in factor VII deficiency is considered a difficult endeavor. The clinical efficacy and safety of prophylactic regimens, and indications for their use, were evaluated in factor VII-deficient patients in the Seven Treatment Evaluation Registry. Prophylaxis data (38 courses) were analyzed from 34 patients with severe factor VII deficiency (<1-45 years of age, 21 female). Severest phenotypes (central nervous system, gastrointestinal, joint bleeding episodes) were highly prevalent. Twenty-one patients received recombinant activated factor VII (24 courses), four received plasma-derived factor VII, and ten received fresh frozen plasma. Prophylactic schedules clustered into "frequent" courses (three times weekly, n=23) and "infrequent" courses (≤ 2 times weekly, n=15). Excluding courses for menorrhagia, "frequent" and "infrequent" courses produced 18/23 (78%) and 5/12 (41%) "excellent" outcomes, respectively; relative risk, 1.88; 95% confidence interval, 0.93-3.79; P=0.079. Long term prophylaxis lasted from 1 to >10 years. No thrombosis or new inhibitors occurred. In conclusion, a subset of patients with factor VII deficiency needed prophylaxis because of severe bleeding. Recombinant activated factor VII schedules based on "frequent" administrations (three times weekly) and a 90 μg/kg total weekly dose were effective. These data provide a rationale for long-term, safe prophylaxis in factor VII deficiency.

A Clinical Tool for Reducing Central Nervous System Depression among Neonates Exposed to Codeine through Breast Milk

PubMed Central

Kelly, Lauren E.; Chaudhry, Shahnaz A.; Rieder, Michael J.; ‘t Jong, Geert; Moretti, Myla E.; Lausman, Andrea; Ross, Colin; Berger, Howard; Carleton, Bruce; Hayden, Michael R.; Madadi, Parvaz; Koren, Gideon

2013-01-01

Background Neonates are commonly exposed to maternal codeine through breast milk. Central Nervous System (CNS) depression has been reported in up to 24% of nurslings following codeine exposure. In 2009, we developed guidelines to improve the safety of codeine use during breastfeeding based on previously established pharmacogenetic and clinical risk factors. The primary objective of this study was to prospectively evaluate the effectiveness of these guidelines in ensuring neonatal safety. Methods and Findings Women taking codeine for pain following caesarean section were given safety guidelines, including advice to use the lowest codeine dose for no longer than four days and to switch to a non-opioid when possible. Mothers provided a saliva sample for analysis of genes involved in opioid disposition, metabolism and response. A total of 238 consenting women participated. Neonatal sedation was reported in 2.1% (5/238) of breastfeeding women taking codeine according to our safety guidelines. This rate was eight fold lower than that reported in previous prospective studies. Women reporting sedated infants were taking codeine for a significantly longer period of time (4.80±2.59 days vs. 2.52±1.58 days, p = 0.0018). While following the codeine safety guidelines, mothers were less likely to supplement with formula, reported lower rates of sedation in themselves and breastfed more frequently throughout the day when compared to previously reported rates. Genotyping analysis of cytochrome p450 2D6 (CYP2D6), uridine-diphosphate glucuronosyltransferase (UGT) 2B7, p-glycoprotein (ABCB1), the mu-opioid receptor (OPRM1) and catechol-o-demethyltransferase (COMT) did not predict codeine response in breastfeeding mother/infant pairs when following the safety guidelines. Conclusions The only cases of CNS depression occurred when the length of codeine use exceeded the guideline recommendations. Neonatal safety of codeine can be improved using evidence-based guidelines, even in those deemed by genetics to be at high risk for toxicity. PMID:23922910

THE REAL ESTATE OF MYOBLAST CARDIAC TRANSPLANTATION – NEGATIVE REMODELING IS ASSOCIATED WITH LOCATION

PubMed Central

McCue, Jonathan D.; Swingen, Cory; Feldberg, Tanya; Caron, Gabe; Kolb, Adam; Denucci, Christopher; Prabhu, Somnath; Motilall, Randy; Breviu, Brian; Taylor, Doris A.

2009-01-01

Background Skeletal myoblast (SKMB) transplantation has been proposed as a therapy for ischemic cardiomyopathy due to its possible role in myogenesis. The relative safety and efficacy based on location within scar is not known. We hypothesized that SKMB transplanted into peripheral scar (compared to central scar) would more effectively attenuate negative left ventricular (LV) remodeling but at the risk of arrhythmia. Methods 34 New Zealand White rabbits underwent mid-left anterior descending artery (LAD) ligation to produce a transmural LV infarction. One month after LAD ligation SKMBs were injected either in the scar center (n=13) or scar periphery (n=10) and compared to saline injection (n=11). Holter monitoring and MRI was performed pre-injection; Holter monitoring was continued until two weeks post injection, with follow-up MRI at one month. Results Centrally-treated animals demonstrated increased LV end systolic volume, end diastolic volume and mass that correlated with injected cell number. There was a trend toward attenuation of negative LV remodeling in peripherally-treated animals compared to vehicle. Significant late ectopy was seen in several centrally-injected animals with no late ectopy seen in peripherally-injected animals. Conclusions We noted untoward effects with respect to negative LV remodeling following central injection, suggesting that transplanted cell location with respect to scar may be a key factor in the safety and efficacy of SKMB cardiac transplantation. Administration of SKMBs into peripheral scar appears safe with a trend toward improved function in comparison to sham injection. PMID:18187097

Evaluation of radiation safety in 29 central Ohio veterinary practices

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

Moritz, S.A.; Wilkins, J.R. III; Hueston, W.D.

1989-07-01

A sample of 29 veterinary practices in Central Ohio were visited to assess radiation safety practices and observance of state regulations. Lead aprons and gloves were usually available, but gloves were not always worn. Protective thyroid collars and lead glasses were not available in any practice, lead shields in only five practices, and lead-lined walls and doors in only two practices. Eighteen practices had none of the required safety notices posted.

Congenital brain infections.

PubMed

Arbelaez, Andres; Restrepo, Feliza; Davila, Jorge; Castillo, Mauricio

2014-06-01

Pediatric congenital intracranial infections are a group of different and important entities that constitute a small percentage of all pediatric infections. The causal factors and clinical presentations are different in children compared with adults. They require early recognition because delay diagnosis and initiation of treatment may have catastrophic consequences. Despite improvements in prenatal screening, vaccine safety, and antibiotics, infections of the central nervous system remain an important cause of neurological disabilities worldwide. This article reviews the most common congenital infections and their imaging findings.

Longitudinal study of stress, self-care, and professional identity among nursing students.

PubMed

Hensel, Desiree; Laux, Marcia

2014-01-01

This longitudinal study describes the factors associated with the acquisition of a professional identity over the course of prelicensure education among 45 baccalaureate nursing students. At every time point, personal spiritual growth practices and the students' perceptions of their caring abilities predicted sense of fit with the profession. Even as there is a growing emphasis of quality and safety education, caring and spirituality remain central to nurses' professional identities on entry to practice.

Stability of DIII-D high-performance, negative central shear discharges

DOE PAGES

Hanson, Jeremy M.; Berkery, John W.; Bialek, James M.; ...

2017-03-20

Tokamak plasma experiments on the DIII-D device demonstrate high-performance, negative central shear (NCS) equilibria with enhanced stability when the minimum safety factor q min exceeds 2, qualitatively confirming theoretical predictions of favorable stability in the NCS regime. The discharges exhibit good confinement with an L-mode enhancement factor H 89 = 2.5, and are ultimately limited by the ideal-wall external kink stability boundary as predicted by ideal MHD theory, as long as tearing mode (TM) locking events, resistive wall modes (RWMs), and internal kink modes are properly avoided or controlled. Although the discharges exhibit rotating TMs, locking events are avoided asmore » long as a threshold minimum safety factor value q min > 2 is maintained. Fast timescale magnetic feedback control ameliorates RWM activity, expanding the stable operating space and allowing access to β N values approaching the ideal-wall limit. Quickly growing and rotating instabilities consistent with internal kink mode dynamics are encountered when the ideal-wall limit is reached. The RWM events largely occur between the no- and ideal-wall pressure limits predicted by ideal MHD. However, evaluating kinetic contributions to the RWM dispersion relation results in a prediction of passive stability in this regime due to high plasma rotation. In addition, the ideal MHD stability analysis predicts that the ideal-wall limit can be further increased to β N > 4 by broadening the current profile. Furthermore, this path toward improved stability has the potential advantage of being compatible with the bootstrap-dominated equilibria envisioned for advanced tokamak (AT) fusion reactors.« less

Stability of DIII-D high-performance, negative central shear discharges

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

Hanson, Jeremy M.; Berkery, John W.; Bialek, James M.

Tokamak plasma experiments on the DIII-D device demonstrate high-performance, negative central shear (NCS) equilibria with enhanced stability when the minimum safety factor q min exceeds 2, qualitatively confirming theoretical predictions of favorable stability in the NCS regime. The discharges exhibit good confinement with an L-mode enhancement factor H 89 = 2.5, and are ultimately limited by the ideal-wall external kink stability boundary as predicted by ideal MHD theory, as long as tearing mode (TM) locking events, resistive wall modes (RWMs), and internal kink modes are properly avoided or controlled. Although the discharges exhibit rotating TMs, locking events are avoided asmore » long as a threshold minimum safety factor value q min > 2 is maintained. Fast timescale magnetic feedback control ameliorates RWM activity, expanding the stable operating space and allowing access to β N values approaching the ideal-wall limit. Quickly growing and rotating instabilities consistent with internal kink mode dynamics are encountered when the ideal-wall limit is reached. The RWM events largely occur between the no- and ideal-wall pressure limits predicted by ideal MHD. However, evaluating kinetic contributions to the RWM dispersion relation results in a prediction of passive stability in this regime due to high plasma rotation. In addition, the ideal MHD stability analysis predicts that the ideal-wall limit can be further increased to β N > 4 by broadening the current profile. Furthermore, this path toward improved stability has the potential advantage of being compatible with the bootstrap-dominated equilibria envisioned for advanced tokamak (AT) fusion reactors.« less

How Design of Places Promotes or Inhibits Mobility of Older Adults: Realist Synthesis of 20 Years of Research

PubMed Central

Yen, Irene H.; Flood, Johnna Fandel; Thompson, Hannah; Anderson, Lynda A.; Wong, Geoff

2015-01-01

Objective The objective of this study was to determine the environmental features that best support aging in place. Method We conducted a realist synthesis, a theory-driven interpretive method of evidence synthesis, of 120+ articles (published 1991–2011) that attempts to explain how place may influence older adults’ decisions about mobility (e.g., physical activity). We developed an initial program theory, reviewed the literature, identified outcomes, analyzed and synthesized patterns, and created a final program theory. Results Safety was a central mechanism, serving as one of the bridges between environmental components (e.g., connectivity, aesthetics, retail and services) and decisions about mobility. Population density, sidewalk presence, and park proximity did not emerge as key factors. Discussion Safety considerations are one of the most prominent influences of older adults’ decisions about mobility. Street connectivity, pedestrian access and transit, and retail and services were also important. These factors are amenable to change and can help promote mobility for older adults. PMID:24788714

Diagnostic Yield and Safety of Brain Biopsy for Suspected Primary Central Nervous System Angiitis.

PubMed

Torres, Jose; Loomis, Caitlin; Cucchiara, Brett; Smith, Michelle; Messé, Steven

2016-08-01

The utility and safety of brain biopsy for suspected primary angiitis of the central nervous system (PACNS) are uncertain. Factors predictive of a positive biopsy have not been well described. Our aim was to evaluate the diagnostic yield and safety of brain biopsy in suspected PACNS and determine whether any prebiopsy variables are associated with a positive biopsy. This is a retrospective study of consecutive patients who underwent diagnostic brain biopsy for PACNS at a single institution. The relationship between biopsy yield and patient demographics, surgical technique, laboratory testing, neuroimaging, biopsy characteristics, and prebiopsy immunosuppressive therapy were examined. PACNS was confirmed in 9 of 79 patients (11%). Biopsy identified alternative diagnoses in 24 patients (30%), with cerebral amyloid angiopathy (8 patients), encephalitis (5 patients), demyelination (3 patients), and CNS lymphoma (3 patients) most commonly found. There was no correlation between a positive biopsy and cerebrospinal fluid results, neuroimaging, surgical technique, biopsy characteristics, or preoperative immunosuppressive therapy. Smaller biopsies (P=0.02) and closed procedures (P=0.013) were less likely to yield a diagnosis. Postoperative complications occurred in 13 patients (16%), 3 (4%) of which were serious. Brain biopsy leads to pathological confirmation of vasculitis in a minority of suspected PACNS cases but alternative diagnoses are often identified. Importantly, rare but meaningful complications may occur. © 2016 American Heart Association, Inc.

Safety monitoring of ophthalmic biologics: a systematic review of pre- and postmarketing safety data.

PubMed

Penedones, Ana; Mendes, Diogo; Alves, Carlos; Batel Marques, Francisco

2014-11-01

The present study evaluates the safety of the biologics approved for the treatment of ocular diseases. The European medicines agency Website was searched to identify biologics with approved ophthalmologic therapeutic indications. A systematic search was performed using MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL) and the International Clinical Trials Registry Platform up to December 2013. Pre-marketing, phase III randomized controlled trials (RCT), postmarketing clinical trials, observational longitudinal studies, and case reports involving adverse events (AE) were included. Methodological quality was assessed by Downs & Black checklist. All European spontaneous reports of AE included in the Eudravigilance up to December 2013 were also considered. AE were classified as ocular (related and non-related with the injection procedure) and non-ocular (related or non-related with vascular endothelial growth factor inhibition). Incidences of all reported AEs were estimated. Pegaptanib, ranibizumab, and aflibercept were identified as ophthalmic biologics. Fourteen premarketing RCT, 7 postmarketing clinical trials, 31 observational studies, along with 31 case reports and 7,720 spontaneous reports were identified and included in this study. Both in pre- and postmarketing settings, ocular AEs were more frequent than non-ocular AEs. Premarketing safety data inform the most common AEs. Postmarketing studies suggest an increased number of events such as retinal pigmented epithelium tears (0.6%-24%), thromboembolic events (0.8%-5%), and mortality (2.8%-4%). This study highlights the need to properly evaluate the risk for rare, serious, and long-term AEs, such as thromboembolic events, since they can lead to imbalances in the benefit-risk ratio of biologics in ophthalmology.

Health care-associated infection prevention in Japan: the role of safety culture.

PubMed

Sakamoto, Fumie; Sakihama, Tomoko; Saint, Sanjay; Greene, M Todd; Ratz, David; Tokuda, Yasuharu

2014-08-01

Limited data exist on the use of infection prevention practices in Japan. We conducted a nationwide survey to examine the use of recommended infection prevention strategies and factors affecting their use in Japanese hospitals. Between April 1, 2012, and January 31, 2013, we surveyed 971 hospitals in Japan. The survey instrument assessed general hospital and infection prevention program characteristics and use of infection prevention practices, including practices specific to preventing catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). Logistic regression models were used to examine multivariable associations between hospital characteristics and the use of the various prevention practices. A total of 685 hospitals (71%) responded to the survey. Maintaining aseptic technique during catheter insertion and maintenance, avoiding routine central line changes, and using maximum sterile barrier precautions and semirecumbent positioning were the only practices regularly used by more than one-half of the hospitals to prevent CAUTI, CLABSI, and VAP, respectively. Higher safety-centeredness was associated with regular use of prevention practices across all infection types. Although certain practices were used commonly, the rate of regular use of many evidence-based prevention practices was low in Japanese hospitals. Our findings highlight the importance of fostering an organization-wide atmosphere that prioritizes patient safety. Such a commitment to patient safety should in turn promote the use of effective measures to reduce health care-associated infections in Japan. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Perinatal staff perceptions of safety and quality in their service.

PubMed

Sinni, Suzanne V; Wallace, Euan M; Cross, Wendy M

2014-11-28

Ensuring safe and appropriate service delivery is central to a high quality maternity service. With this in mind, over recent years much attention has been given to the development of evidence-based clinical guidelines, staff education and risk reporting systems. Less attention has been given to assessing staff perceptions of a service's safety and quality and what factors may influence that. In this study we set out to assess staff perceptions of safety and quality of a maternity service and to explore potential influences on service safety. The study was undertaken within a new low risk metropolitan maternity service in Victoria, Australia with a staffing profile comprising midwives (including students), neonatal nurses, specialist obstetricians, junior medical staff and clerical staff. In depth open-ended interviews using a semi-structured questionnaire were conducted with 23 staff involved in the delivery of perinatal care, including doctors, midwives, nurses, nursing and midwifery students, and clerical staff. Data were analyzed using naturalistic interpretive inquiry to identify emergent themes. Staff unanimously reported that there were robust systems and processes in place to maintain safety and quality. Three major themes were apparent: (1) clinical governance, (2) dominance of midwives, (3) inter-professional relationships. Overall, there was a strong sense that, at least in this midwifery-led service, midwives had the greatest opportunity to be an influence, both positively and negatively, on the safe delivery of perinatal care. The importance of understanding team dynamics, particularly mutual respect, trust and staff cohesion, were identified as key issues for potential future service improvement. Senior staff, particularly midwives and neonatal nurses, play central roles in shaping team behaviors and attitudes that may affect the safety and quality of service delivery. We suggest that strategies targeting senior staff to enhance their performance in their roles, particularly in the training and teamwork role-modeling of the transitory junior workforce, are important for the development and maintenance of a high quality and safe maternity service.

Nothing is safe: Intolerance of uncertainty is associated with compromised fear extinction learning.

PubMed

Morriss, Jayne; Christakou, Anastasia; van Reekum, Carien M

2016-12-01

Extinction-resistant fear is considered to be a central feature of pathological anxiety. Here we sought to determine if individual differences in Intolerance of Uncertainty (IU), a potential risk factor for anxiety disorders, underlies compromised fear extinction. We tested this hypothesis by recording electrodermal activity in 38 healthy participants during fear acquisition and extinction. We assessed the temporality of fear extinction, by examining early and late extinction learning. During early extinction, low IU was associated with larger skin conductance responses to learned threat vs. safety cues, whereas high IU was associated with skin conductance responding to both threat and safety cues, but no cue discrimination. During late extinction, low IU showed no difference in skin conductance between learned threat and safety cues, whilst high IU predicted continued fear expression to learned threat, indexed by larger skin conductance to threat vs. safety cues. These findings suggest a critical role of uncertainty-based mechanisms in the maintenance of learned fear. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Microbiology and risk factors for central line-associated bloodstream infections among pediatric oncology outpatients: a single institution experience of 41 cases.

PubMed

Kelly, Matthew S; Conway, Margaret; Wirth, Kathleen E; Potter-Bynoe, Gail; Billett, Amy L; Sandora, Thomas J

2013-03-01

Risk factors for central line-associated bloodstream infections (CLABSI) among children with cancer in the outpatient setting remain poorly defined, and the microbiology may differ from hospital-onset CLABSI. We conducted a matched case-control study of oncology patients followed at the Dana Farber/Children's Hospital Cancer Center. Cases (N=41) were patients with CLABSI as per National Healthcare Safety Network criteria who had not been hospitalized in the preceding 48 hours. For each case we randomly selected 2 oncology outpatients with a central venous catheter and a clinic visit within 30 days of the case subject's CLABSI. Multivariate conditional logistic regression models were used to identify independent risk factors for CLABSI. We compared the microbiology to that of 54 hospital-onset CLABSI occurring at our institution during the study period. Independent predictors of community-onset CLABSI included neutropenia in the prior week (odds ratio 17.46; 95% confidence interval, 4.71-64.67) and tunneled externalized catheter (vs. implantable port; odds ratio 10.30; 95% confidence interval, 2.42-43.95). Nonenteric gram-negative bacteria were more frequently isolated from CLABSI occurring among outpatients. Pediatric oncology outpatients with recent neutropenia or tunneled externalized catheters are at increased risk of CLABSI. The microbiology of community-onset CLABSI differs from hospital-onset CLABSI.

The real estate of myoblast cardiac transplantation: negative remodeling is associated with location.

PubMed

McCue, Jonathan D; Swingen, Cory; Feldberg, Tanya; Caron, Gabe; Kolb, Adam; Denucci, Christopher; Prabhu, Somnath; Motilall, Randy; Breviu, Brian; Taylor, Doris A

2008-01-01

Skeletal myoblast transplantation has been proposed as a therapy for ischemic cardiomyopathy owing to its possible role in myogenesis. The relative safety and efficacy based on location within scar is not known. We hypothesized that skeletal myoblasts transplanted into peripheral scar (compared with central scar) would more effectively attenuate negative left ventricular (LV) remodeling but at the risk of arrhythmia. New Zealand White rabbits (n = 34) underwent mid-left anterior descending artery (LAD) ligation to produce a transmural LV infarction. One month after LAD ligation, skeletal myoblasts were injected either in the scar center (n = 13) or scar periphery (n = 10) and compared with saline injection (n = 11). Holter monitoring and magnetic resonance imaging (MRI) was performed pre-injection; Holter monitoring was continued until 2 weeks after injection, with follow-up MRI at 1 month. The centrally treated animals demonstrated increased LV end-systolic volume, end-diastolic volume, and mass that correlated with the number of injected cells. There was a trend toward attenuation of negative LV remodeling in peripherally treated animals compared with vehicle. Significant late ectopy was seen in several centrally injected animals, with no late ectopy seen in peripherally injected animals. We noted untoward effects with respect to negative LV remodeling after central injection, suggesting that transplanted cell location with respect to scar may be a key factor in the safety and efficacy of skeletal myoblast cardiac transplantation. Administration of skeletal myoblasts into peripheral scar appears safe, with a trend toward improved function in comparison with sham injection.

Hurricane Safety and Information - Central Pacific Hurricane Center -

Science.gov Websites

NOAA NWS United States Department of Commerce Central Pacific Hurricane Center National Oceanic and Distance Calculator Blank Tracking Maps ▾ Educational Resources Be Prepared! NWS Hurricane Prep Week Search For Go NWS All NOAA ▾ Hurricane Safety Hurricane Awareness Week Information from CPHC Red Cross

Safety and Efficacy of Catheter Direct Thrombolysis in Management of Acute Iliofemoral Deep Vein Thrombosis: A Systematic Review.

PubMed

Elbasty, Ahmed; Metcalf, James

2017-12-01

Catheter direct thrombolysis (CDT) has been shown to be an effective treatment for deep venous thrombosis. The objective of the review is to improve safety and efficacy of the CDT by using ward based protocol, better able to predict complications and treatment outcome through monitoring of haemostatic parameters and clinical observation during thrombolysis procedure. MEDLINE, EMBASE, CENTRAL and Web of Science were searched for all articles on deep venous thrombosis, thrombolysis and correlations of clinical events (bleeding, successful thrombolysis) during thrombolysis with hemostatic parameters to March 2016. The risk of bias in included studies was assessed by Cochrane Collaboration's tool and Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions. Twenty-four studies were included in the review and we found that improving safety and efficacy of CDT by using ward based protocol depending on eight factors; strict patient selection criteria, types of fibrinolytic drugs, mode of fibrinolytic drug injection, biochemical markers monitoring (fibrinogen, D-dimer, activated partial thromboplastin time, plasminogen activator inhibitor-1), timing of intervention, usage of intermittent pneumatic calf, ward monitoring and thrombolysis imaging assessment (intravascular ultrasound). These factors may help to improve safety and efficacy by reducing total thrombolytic drug dosage and at the same time ensure successful lysis. There is a marked lack of randomized controlled trials discussing the safety and efficacy of catheter direct thrombolysis. CDT can be performed safely and efficiently in clinical ward, providing that careful nursing, biochemical monitoring, proper selection and mode of infusion of fibrinolytic drugs, usage of Intermittent pneumatic calf and adequate thrombolysis imaging assessment are ensured.

Personalized medicine: theranostics (therapeutics diagnostics) essential for rational use of tumor necrosis factor-alpha antagonists.

PubMed

Bendtzen, Klaus

2013-04-01

With the discovery of the central pathogenic role of tumor necrosis factor (TNF)-alpha in many immunoinflammatory diseases, specific inhibition of this pleiotropic cytokine has revolutionized the treatment of patients with several non-infectious inflammatory disorders. As a result, genetically engineered anti-TNF-alpha antibody constructs now constitute one of the heaviest medicinal expenditures in many countries. All currently used TNF antagonists may dramatically lower disease activity and, in some patients, induce remission. Unfortunately, however, not all patients respond favorably, and safety can be severely impaired by immunogenicity, i.e., the ability of a drug to induce anti-drug antibodies (ADA). Assessment of ADA is therefore an important component of the evaluation of drug safety in both pre-clinical and clinical studies and in the process of developing less immunogenic and safer biopharmaceuticals. Therapeutics diagnostics, also called theranostics, i.e., monitoring functional drug levels and neutralizing ADA in the circulation, is central to more effective use of biopharmaceuticals. Hence, testing-based strategies rather than empirical dose-escalation may provide more cost-effective use of TNF antagonists as this allows therapies tailored according to individual requirements rather than the current universal approach to diagnosis. The objective of the present review is to discuss the reasons for recommending theranostics to implement an individualized use of TNF antagonists and to highlight some of the methodological obstacles that have obscured cost-effective ways of using these therapies.

Stability of DIII-D high-performance, negative central shear discharges

NASA Astrophysics Data System (ADS)

Hanson, J. M.; Berkery, J. W.; Bialek, J.; Clement, M.; Ferron, J. R.; Garofalo, A. M.; Holcomb, C. T.; La Haye, R. J.; Lanctot, M. J.; Luce, T. C.; Navratil, G. A.; Olofsson, K. E. J.; Strait, E. J.; Turco, F.; Turnbull, A. D.

2017-05-01

Tokamak plasma experiments on the DIII-D device (Luxon et al 2005 Fusion Sci. Tech. 48 807) demonstrate high-performance, negative central shear (NCS) equilibria with enhanced stability when the minimum safety factor {{q}\\text{min}} exceeds 2, qualitatively confirming theoretical predictions of favorable stability in the NCS regime. The discharges exhibit good confinement with an L-mode enhancement factor H 89  =  2.5, and are ultimately limited by the ideal-wall external kink stability boundary as predicted by ideal MHD theory, as long as tearing mode (TM) locking events, resistive wall modes (RWMs), and internal kink modes are properly avoided or controlled. Although the discharges exhibit rotating TMs, locking events are avoided as long as a threshold minimum safety factor value {{q}\\text{min}}>2 is maintained. Fast timescale magnetic feedback control ameliorates RWM activity, expanding the stable operating space and allowing access to {β\\text{N}} values approaching the ideal-wall limit. Quickly growing and rotating instabilities consistent with internal kink mode dynamics are encountered when the ideal-wall limit is reached. The RWM events largely occur between the no- and ideal-wall pressure limits predicted by ideal MHD. However, evaluating kinetic contributions to the RWM dispersion relation results in a prediction of passive stability in this regime due to high plasma rotation. In addition, the ideal MHD stability analysis predicts that the ideal-wall limit can be further increased to {β\\text{N}}>4 by broadening the current profile. This path toward improved stability has the potential advantage of being compatible with the bootstrap-dominated equilibria envisioned for advanced tokamak (AT) fusion reactors.

Tele-ICU and Patient Safety Considerations.

PubMed

Hassan, Erkan

The tele-ICU is designed to leverage, not replace, the need for bedside clinical expertise in the diagnosis, treatment, and assessment of various critical illnesses. Tele-ICUs are primarily decentralized or centralized models with differing advantages and disadvantages. The centralized model has sufficiently powered published data to be associated with improved mortality and ICU length of stay in a cost-effective manner. Factors associated with improved clinical outcomes include improved compliance with best practices; providing off-hours implementation of the bedside physician's care plan; and identification of and rapid response to physiological instability (initial clinical review within 1 hour) and rapid response to alerts, alarms, or direct notification by bedside clinicians. With improved communication and frequent review of patients between the tele-ICU and the bedside clinicians, the bedside clinician can provide the care that only they can provide. Although technology continues to evolve at a rapid pace, technology alone will most likely not improve clinical outcomes. Technology will enable us to process real or near real-time data into complex and powerful predictive algorithms. However, the remote and bedside teams must work collaboratively to develop care processes to better monitor, prioritize, standardize, and expedite care to drive greater efficiencies and improve patient safety.

Microscopic information processing and communication in crowd dynamics

NASA Astrophysics Data System (ADS)

Henein, Colin Marc; White, Tony

2010-11-01

Due, perhaps, to the historical division of crowd dynamics research into psychological and engineering approaches, microscopic crowd models have tended toward modelling simple interchangeable particles with an emphasis on the simulation of physical factors. Despite the fact that people have complex (non-panic) behaviours in crowd disasters, important human factors in crowd dynamics such as information discovery and processing, changing goals and communication have not yet been well integrated at the microscopic level. We use our Microscopic Human Factors methodology to fuse a microscopic simulation of these human factors with a popular microscopic crowd model. By tightly integrating human factors with the existing model we can study the effects on the physical domain (movement, force and crowd safety) when human behaviour (information processing and communication) is introduced. In a large-room egress scenario with ample exits, information discovery and processing yields a crowd of non-interchangeable individuals who, despite close proximity, have different goals due to their different beliefs. This crowd heterogeneity leads to complex inter-particle interactions such as jamming transitions in open space; at high crowd energies, we found a freezing by heating effect (reminiscent of the disaster at Central Lenin Stadium in 1982) in which a barrier formation of naïve individuals trying to reach blocked exits prevented knowledgeable ones from exiting. Communication, when introduced, reduced this barrier formation, increasing both exit rates and crowd safety.

78 FR 57463 - National Farm Safety and Health Week, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

... National Farm Safety and Health Week, 2013 By the President of the United States of America A Proclamation... to generation--is central to the American story. During National Farm Safety and Health Week, we... Safety and Health Week. I call upon the agencies, organizations, businesses, and extension services that...

Factors Associated With Major Bleeding Events

PubMed Central

Goodman, Shaun G.; Wojdyla, Daniel M.; Piccini, Jonathan P.; White, Harvey D.; Paolini, John F.; Nessel, Christopher C.; Berkowitz, Scott D.; Mahaffey, Kenneth W.; Patel, Manesh R.; Sherwood, Matthew W.; Becker, Richard C.; Halperin, Jonathan L.; Hacke, Werner; Singer, Daniel E.; Hankey, Graeme J.; Breithardt, Gunter; Fox, Keith A. A.; Califf, Robert M.

2014-01-01

Objectives This study sought to report additional safety results from the ROCKET AF (Rivaroxaban Once-daily oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation). Background The ROCKET AF trial demonstrated similar risks of stroke/systemic embolism and major/nonmajor clinically relevant bleeding (principal safety endpoint) with rivaroxaban and warfarin. Methods The risk of the principal safety and component bleeding endpoints with rivaroxaban versus warfarin were compared, and factors associated with major bleeding were examined in a multivariable model. Results The principal safety endpoint was similar in the rivaroxaban and warfarin groups (14.9 vs. 14.5 events/100 patient-years; hazard ratio: 1.03; 95% confidence interval: 0.96 to 1.11). Major bleeding risk increased with age, but there were no differences between treatments in each age category (<65, 65 to 74, ≥75 years; pinteraction = 0.59). Compared with those without (n = 13,455), patients with a major bleed (n = 781) were more likely to be older, current/prior smokers, have prior gastrointestinal (GI) bleeding, mild anemia, and a lower calculated creatinine clearance and less likely to be female or have a prior stroke/transient ischemic attack. Increasing age, baseline diastolic blood pressure (DBP) ≥90 mm Hg, history of chronic obstructive pulmonary disease or GI bleeding, prior acetylsalicylic acid use, and anemia were independently associated with major bleeding risk; female sex and DBP <90 mm Hg were associated with a decreased risk. Conclusions Rivaroxaban and warfarin had similar risk for major/nonmajor clinically relevant bleeding. Age, sex, DBP, prior GI bleeding, prior acetylsalicylic acid use, and anemia were associated with the risk of major bleeding. (An Efficacy and Safety Study of Rivaroxaban With Warfarin for the Prevention of Stroke and Non-Central Nervous System Systemic Embolism in Patients With Non-Valvular Atrial Fibrillation: NCT00403767) PMID:24315894

Evaluation of a standardized all-terrain vehicle safety education intervention for youth in rural Central Illinois.

PubMed

Novak, Joshua A; Hafner, John W; Aldag, Jean C; Getz, Marjorie A

2013-01-01

Although research investigating all-terrain vehicle (ATV) riders and ATV injury patterns has led to support for legislative and educational efforts to decrease injuries in users younger than 16 years, there is little published data regarding the utility of ATV safety education programs. This study investigates the effectiveness of a standardized adolescent ATV safety program in changing the safety knowledge and safe ATV riding practices reported by rural Central Illinois youths. A convenience sample of 260 rural Central Illinois middle and high school students received an ATV safety presentation with both didactic and interactive features during the 2009-2010 school year. Preintervention and postintervention surveys were distributed and collected by teachers. Survey questions consisted of multiple-choice questions pertaining to demographics, ATV safety knowledge, and ATV riding practices. More than 200 surveys were collected prior to the intervention and 165 surveys were collected 12 to 24 weeks after the intervention. Percentages are reported, with differences in nominal variables tested by χ(2) test and interval variables by t test. Following the intervention, there was a significant increase in the correct response rate for ATV safety knowledge questions (45.2% vs 56.2%, P < .001). For adolescents who reported riding ATVs, both safety gear use (11.8% to 21.2%, P = .05) and helmet use (25.4% to 29.0%, P = .56) increased; changes were not significant. Adolescent ATV riders reporting 2 or more accidents showed a slight nonsignificant decrease (25.2% vs 23.4%, P = .77) between the time of the pretest and posttest. This safety program was effective at increasing ATV safety knowledge but demonstrates limited effect on safe riding practices.

Factors associated with major bleeding events: insights from the ROCKET AF trial (rivaroxaban once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation).

PubMed

Goodman, Shaun G; Wojdyla, Daniel M; Piccini, Jonathan P; White, Harvey D; Paolini, John F; Nessel, Christopher C; Berkowitz, Scott D; Mahaffey, Kenneth W; Patel, Manesh R; Sherwood, Matthew W; Becker, Richard C; Halperin, Jonathan L; Hacke, Werner; Singer, Daniel E; Hankey, Graeme J; Breithardt, Gunter; Fox, Keith A A; Califf, Robert M

2014-03-11

This study sought to report additional safety results from the ROCKET AF (Rivaroxaban Once-daily oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation). The ROCKET AF trial demonstrated similar risks of stroke/systemic embolism and major/nonmajor clinically relevant bleeding (principal safety endpoint) with rivaroxaban and warfarin. The risk of the principal safety and component bleeding endpoints with rivaroxaban versus warfarin were compared, and factors associated with major bleeding were examined in a multivariable model. The principal safety endpoint was similar in the rivaroxaban and warfarin groups (14.9 vs. 14.5 events/100 patient-years; hazard ratio: 1.03; 95% confidence interval: 0.96 to 1.11). Major bleeding risk increased with age, but there were no differences between treatments in each age category (<65, 65 to 74, ≥75 years; pinteraction = 0.59). Compared with those without (n = 13,455), patients with a major bleed (n = 781) were more likely to be older, current/prior smokers, have prior gastrointestinal (GI) bleeding, mild anemia, and a lower calculated creatinine clearance and less likely to be female or have a prior stroke/transient ischemic attack. Increasing age, baseline diastolic blood pressure (DBP) ≥90 mm Hg, history of chronic obstructive pulmonary disease or GI bleeding, prior acetylsalicylic acid use, and anemia were independently associated with major bleeding risk; female sex and DBP <90 mm Hg were associated with a decreased risk. Rivaroxaban and warfarin had similar risk for major/nonmajor clinically relevant bleeding. Age, sex, DBP, prior GI bleeding, prior acetylsalicylic acid use, and anemia were associated with the risk of major bleeding. (An Efficacy and Safety Study of Rivaroxaban With Warfarin for the Prevention of Stroke and Non-Central Nervous System Systemic Embolism in Patients With Non-Valvular Atrial Fibrillation: NCT00403767). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Effective communication and teamwork promotes patient safety.

PubMed

Gluyas, Heather

2015-08-05

Teamwork requires co-operation, co-ordination and communication between members of a team to achieve desired outcomes. In industries with a high degree of risk, such as health care, effective teamwork has been shown to achieve team goals successfully and efficiently, with fewer errors. This article introduces behaviours that support communication, co-operation and co-ordination in teams. The central role of communication in enabling co-operation and co-ordination is explored. A human factors perspective is used to examine tools to improve communication and identify barriers to effective team communication in health care.

Poison or cure: meanings of medication in schizophrenia.

PubMed

Rosenfield, Paul J

2007-01-01

Antipsychotic medications provide tremendous relief to many individuals with schizophrenia, but can have significant costs, including adverse metabolic, neurological, and psychological effects. Prescribers and consumers of these medications often have different perceptions of the safety and utility of medications, ranging from "poison" to "cure." While much of the literature on the meaning of medication in schizophrenia discusses patients' negative perceptions of medication, poor insight, and other risk factors for nonadherence, a variety of additional factors should be considered, including both doctors' and patients' perspectives. Historical, cultural, and scientific, as well as individual factors, influence both the prescribing and taking of antipsychotic medications. The relationship between doctors and patients, as informed by these factors, plays a central role in the creation of the meanings of medications. An understanding of this relationship can help to establish more collaborative treatment relationships, beyond the dichotomy of poison or cure.

NAPS as an Alertness Management Strategy

NASA Technical Reports Server (NTRS)

Rosekind, Mark R.; Smith, Roy M.; Miller, Donna L.; Co, Elizabeth L.; Gregory, Kevin B.; Gander, Philippa H.; Lebacqz, J. Victor

2001-01-01

Today, 24-hour operations are necessary to meet the demands of our society and the requirements of our industrialized global economy. These around-the-clock demands pose unique physiological challenges for the humans who remain central to safe and productive operations. Optimal alertness and performance are critical factors that are increasingly challenged by unusual, extended, or changing work/rest schedules. Technological advancements and automated systems can exacerbate the challenges faced by the human factor in these environments. Shift work, transportation demands, and continuous operations engender sleep loss and circadian disruption. Both of these physiological factors can lead to increased sleepiness, decreased performance, and a reduced margin of safety. These factors can increase vulnerability to incidents and accidents in operational settings. The consequences can have both societal effects (e.g., major destructive accidents such as Three Mile Island, Exxon Valdez, Bhopal) and personal effects (e.g., an accident driving home after a night shift).

Multilevel Safety Climate and Safety Performance in the Construction Industry: Development and Validation of a Top-Down Mechanism

PubMed Central

Gao, Ran; Chan, Albert P.C.; Utama, Wahyudi P.; Zahoor, Hafiz

2016-01-01

The character of construction projects exposes front-line workers to dangers and accidents. Safety climate has been confirmed to be a predictor of safety performance in the construction industry. This study aims to explore the underlying mechanisms of the relationship between multilevel safety climate and safety performance. An integrated model was developed to study how particular safety climate factors of one level affect those of other levels, and then affect safety performance from the top down. A questionnaire survey was administered on six construction sites in Vietnam. A total of 1030 valid questionnaires were collected from this survey. Approximately half of the data were used to conduct exploratory factor analysis (EFA) and the remaining data were submitted to structural equation modeling (SEM). Top management commitment (TMC) and supervisors’ expectation (SE) were identified as factors to represent organizational safety climate (OSC) and supervisor safety climate (SSC), respectively, and coworkers’ caring and communication (CCC) and coworkers’ role models (CRM) were identified as factors to denote coworker safety climate (CSC). SEM results show that OSC factor is positively related to SSC factor and CSC factors significantly. SSC factor could partially mediate the relationship between OSC factor and CSC factors, as well as the relationship between OSC factor and safety performance. CSC factors partially mediate the relationship between OSC factor and safety performance, and the relationship between SSC factor and safety performance. The findings imply that a positive safety culture should be established both at the organizational level and the group level. Efforts from all top management, supervisors, and coworkers should be provided to improve safety performance in the construction industry. PMID:27834823

Multilevel Safety Climate and Safety Performance in the Construction Industry: Development and Validation of a Top-Down Mechanism.

PubMed

Gao, Ran; Chan, Albert P C; Utama, Wahyudi P; Zahoor, Hafiz

2016-11-08

The character of construction projects exposes front-line workers to dangers and accidents. Safety climate has been confirmed to be a predictor of safety performance in the construction industry. This study aims to explore the underlying mechanisms of the relationship between multilevel safety climate and safety performance. An integrated model was developed to study how particular safety climate factors of one level affect those of other levels, and then affect safety performance from the top down. A questionnaire survey was administered on six construction sites in Vietnam. A total of 1030 valid questionnaires were collected from this survey. Approximately half of the data were used to conduct exploratory factor analysis (EFA) and the remaining data were submitted to structural equation modeling (SEM). Top management commitment (TMC) and supervisors' expectation (SE) were identified as factors to represent organizational safety climate (OSC) and supervisor safety climate (SSC), respectively, and coworkers' caring and communication (CCC) and coworkers' role models (CRM) were identified as factors to denote coworker safety climate (CSC). SEM results show that OSC factor is positively related to SSC factor and CSC factors significantly. SSC factor could partially mediate the relationship between OSC factor and CSC factors, as well as the relationship between OSC factor and safety performance. CSC factors partially mediate the relationship between OSC factor and safety performance, and the relationship between SSC factor and safety performance. The findings imply that a positive safety culture should be established both at the organizational level and the group level. Efforts from all top management, supervisors, and coworkers should be provided to improve safety performance in the construction industry.

Two level approach to safety planning incorporating the Highway Safety Manual (HSM) network screening : [summary].

DOT National Transportation Integrated Search

2014-04-01

In this project, University of Central Florida researchers combined two types of safety analysis, microscopic and macroscopic, to overcome their limitations. Microscopic models focus on traffic flows and related parameters. Macroscopic models are bas...

A hierarchical factor analysis of a safety culture survey.

PubMed

Frazier, Christopher B; Ludwig, Timothy D; Whitaker, Brian; Roberts, D Steve

2013-06-01

Recent reviews of safety culture measures have revealed a host of potential factors that could make up a safety culture (Flin, Mearns, O'Connor, & Bryden, 2000; Guldenmund, 2000). However, there is still little consensus regarding what the core factors of safety culture are. The purpose of the current research was to determine the core factors, as well as the structure of those factors that make up a safety culture, and establish which factors add meaningful value by factor analyzing a widely used safety culture survey. A 92-item survey was constructed by subject matter experts and was administered to 25,574 workers across five multi-national organizations in five different industries. Exploratory and hierarchical confirmatory factor analyses were conducted revealing four second-order factors of a Safety Culture consisting of Management Concern, Personal Responsibility for Safety, Peer Support for Safety, and Safety Management Systems. Additionally, a total of 12 first-order factors were found: three on Management Concern, three on Personal Responsibility, two on Peer Support, and four on Safety Management Systems. The resulting safety culture model addresses gaps in the literature by indentifying the core constructs which make up a safety culture. This clarification of the major factors emerging in the measurement of safety cultures should impact the industry through a more accurate description, measurement, and tracking of safety cultures to reduce loss due to injury. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Systematic strategies for the third industrial accident prevention plan in Korea.

PubMed

Kang, Young-sig; Yang, Sung-hwan; Kim, Tae-gu; Kim, Day-sung

2012-01-01

To minimize industrial accidents, it's critical to evaluate a firm's priorities for prevention factors and strategies since such evaluation provides decisive information for preventing industrial accidents and maintaining safety management. Therefore, this paper proposes the evaluation of priorities through statistical testing of prevention factors with a cause analysis in a cause and effect model. A priority matrix criterion is proposed to apply the ranking and for the objectivity of questionnaire results. This paper used regression method (RA), exponential smoothing method (ESM), double exponential smoothing method (DESM), autoregressive integrated moving average (ARIMA) model and proposed analytical function method (PAFM) to analyze trends of accident data that will lead to an accurate prediction. This paper standardized the questionnaire results of workers and managers in manufacturing and construction companies with less than 300 employees, located in the central Korean metropolitan areas where fatal accidents have occurred. Finally, a strategy was provided to construct safety management for the third industrial accident prevention plan and a forecasting method for occupational accident rates and fatality rates for occupational accidents per 10,000 people.

Derivation of an occupational exposure limit (OEL) for methylene chloride based on acute CNS effects and relative potency analysis.

PubMed

Storm, J E; Rozman, K K

1998-06-01

The Occupational Safety and Health Administration (OSHA) methylene chloride Permissible Exposure Level (PEL) or 25 ppm is quantitatively derived from mouse tumor results observed in a high-exposure National Toxicology Program bioassay. Because this approach depends on controversial interspecies and low-dose extrapolations, the PEL itself has stimulated heated debate. Here, an alternative safety assessment for methylene chloride is presented. It is based on an acute human lowest-observed-adverse-effect level (LOAEL) of 200 ppm for subtle central nervous system (CNS) depression. Steep, parallel exposure-response curves for anesthetic and subanesthetic CNS effects associated with compounds mechanistically and structurally related to methylene chloride are shown to support a safety factor of two to account for inter-individual variability in response. LOAEL/no-observed-adverse-effect ratios for subtle CNS effects associated with structurally related solvents are shown to support a safety factor range of two to four to account for uncertainty in identifying a subthreshold exposure level. Anesthetic relative potencies and anesthetic/subanesthetic effect level ratios are shown to be constant for the compounds evaluated, demonstrating that subanesthetic relative potencies are also constant. Relative potencies among similarly derived occupational exposure limits (OELs) for solvents structurally related to methylene chloride are therefore used to validate the derived methylene chloride OEL range of 25-50 ppm. Because this safety assessment is based on human (rather than rodent) data and empirical (rather than theoretical) exposure-response relationships and is supported by relative potency analysis, it is a defensible alternative to to the OSHA risk assessment and should positively contribute to the debate regarding the appropriate basis and value for a methylene chloride PEL.

Safety and Efficacy of Catheter Direct Thrombolysis in Management of Acute Iliofemoral Deep Vein Thrombosis: A Systematic Review

PubMed Central

Elbasty, Ahmed; Metcalf, James

2017-01-01

Purpose Catheter direct thrombolysis (CDT) has been shown to be an effective treatment for deep venous thrombosis. The objective of the review is to improve safety and efficacy of the CDT by using ward based protocol, better able to predict complications and treatment outcome through monitoring of haemostatic parameters and clinical observation during thrombolysis procedure. Materials and Methods MEDLINE, EMBASE, CENTRAL and Web of Science were searched for all articles on deep venous thrombosis, thrombolysis and correlations of clinical events (bleeding, successful thrombolysis) during thrombolysis with hemostatic parameters to March 2016. The risk of bias in included studies was assessed by Cochrane Collaboration’s tool and Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions. Results Twenty-four studies were included in the review and we found that improving safety and efficacy of CDT by using ward based protocol depending on eight factors; strict patient selection criteria, types of fibrinolytic drugs, mode of fibrinolytic drug injection, biochemical markers monitoring (fibrinogen, D-dimer, activated partial thromboplastin time, plasminogen activator inhibitor-1), timing of intervention, usage of intermittent pneumatic calf, ward monitoring and thrombolysis imaging assessment (intravascular ultrasound). These factors may help to improve safety and efficacy by reducing total thrombolytic drug dosage and at the same time ensure successful lysis. There is a marked lack of randomized controlled trials discussing the safety and efficacy of catheter direct thrombolysis. Conclusion CDT can be performed safely and efficiently in clinical ward, providing that careful nursing, biochemical monitoring, proper selection and mode of infusion of fibrinolytic drugs, usage of Intermittent pneumatic calf and adequate thrombolysis imaging assessment are ensured. PMID:29354622

The School of Public Safety at Valencia College: Visioning and Implementation of a College-Wide Distributive and Collaborative Program Model for the Central Florida Community

ERIC Educational Resources Information Center

Goltz, Jeffrey W.

2016-01-01

The central Florida region, faced with record tourism, a large service population, and significant population growth over the next few decades, must rely on a community-based institution of higher education with lifelong learning offerings, a local community college, to create world class public safety education and training for the region.…

Human factors in command and control for the Los Angeles Fire Department.

PubMed

Harper, W R

1974-03-01

Ergonomics owes much of its operations and systems heritage to military research. Since public safety systems such as police, fire departments and civil defence organisations are quasi-military in nature, one may reasonably use the findings from military ergonomics research to extrapolate design data for use in a decision-making system. This article discusses a case study concerning Human Factors in command and control for the Los Angeles Fire Department. The case involved transfer from a manual dispatch system involving three geographic areas of metropolitan Los Angeles to one central computer-aided command and control system. Comments are made on console mock-ups, environmental factors in the Control Centre placement of the consoles. Because of extreme delays in procurement of the recommended hardware it is doubtful that empirical testing of the ergonomics aspect of the system will take place.

Analysis of routine pilot-controller communication

NASA Technical Reports Server (NTRS)

Morrow, Daniel G.; Lee, Alfred; Rodvold, Michelle

1990-01-01

Although pilot-controller communication is central to aviation safety, this area of aviation human factors has not been extensively researched. Most research has focused on what kinds of communication problems occur. A more complete picture of communication problems requires understanding how communication usually works in routine operations. A sample of routine pilot-controller communication in the TRACON environment is described. After describing several dimensions of routine communication, three kinds of communication problems are treated: inaccuracies such as incorrect readbacks, procedural deviations such as missing callsigns and readbacks, and nonroutine transactions where pilot and controller must deal with misunderstandings or other communication problems. Preliminary results suggest these problems are not frequent events in daily operations. However, analysis of the problems that do occur suggest some factors that may cause them.

Application of a process-based shallow landslide hazard model over a broad area in Central Italy

USGS Publications Warehouse

Gioia, Eleonora; Speranza, Gabriella; Ferretti, Maurizio; Godt, Jonathan W.; Baum, Rex L.; Marincioni, Fausto

2015-01-01

Process-based models are widely used for rainfall-induced shallow landslide forecasting. Previous studies have successfully applied the U.S. Geological Survey’s Transient Rainfall Infiltration and Grid-Based Regional Slope-Stability (TRIGRS) model (Baum et al. 2002) to compute infiltration-driven changes in the hillslopes’ factor of safety on small scales (i.e., tens of square kilometers). Soil data input for such models are difficult to obtain across larger regions. This work describes a novel methodology for the application of TRIGRS over broad areas with relatively uniform hydrogeological properties. The study area is a 550-km2 region in Central Italy covered by post-orogenic Quaternary sediments. Due to the lack of field data, we assigned mechanical and hydrological property values through a statistical analysis based on literature review of soils matching the local lithologies. We calibrated the model using rainfall data from 25 historical rainfall events that triggered landslides. We compared the variation of pressure head and factor of safety with the landslide occurrence to identify the best fitting input conditions. Using calibrated inputs and a soil depth model, we ran TRIGRS for the study area. Receiver operating characteristic (ROC) analysis, comparing the model’s output with a shallow landslide inventory, shows that TRIGRS effectively simulated the instability conditions in the post-orogenic complex during historical rainfall scenarios. The implication of this work is that rainfall-induced landslides over large regions may be predicted by a deterministic model, even where data on geotechnical and hydraulic properties as well as temporal changes in topography or subsurface conditions are not available.

Safety Extension Study Of Leuprolide Acetate (Lupron Depot) In The Treatment Of Central Precocious Puberty

ClinicalTrials.gov

2014-01-08

Precocious; Leuprolide Acetate; Luteinizing Hormone (LH); Gonadotrophin-releasing Hormone Agonist (GnRHa); Tanner Staging; Depot Formulation; Suppression of LH; Central Precocious Puberty (CPP); Gonadotrophin-releasing Hormone (GnRH); Lupron; GnRH Analog; Pediatrics Central Precocious Puberty

Transoral endoscopic thyroidectomy vestibular approach: a preliminary framework for assessment and safety.

PubMed

Russell, Jonathon; Anuwong, Angkoon; Dionigi, Gianlorenzo; Inabnet, William B; Kim, Hoon Yub; Randolph, Gregory W; Richmon, Jeremy D; Tufano, Ralph P

2018-05-23

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a new approach to the central neck that avoids an anterior cervical incision. This approach can be performed with endoscopic or robotic assistance and offers access to the bilateral central neck. It has been completed safely in both North American and, even more extensively, international populations. With any new technology or approach, complications during the learning curve, expense, instrument limitations, and overall safety may affect its ultimate adoption and utility. To ensure patient safety, it is imperative to define steps that should be considered by any surgeon or group before adoption of this new approach.

32 CFR 1903.4 - Vehicles and traffic safety.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Vehicles and traffic safety. 1903.4 Section 1903.4 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.4 Vehicles and traffic safety. (a) Open container of alcoholic...

32 CFR 1903.4 - Vehicles and traffic safety.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Vehicles and traffic safety. 1903.4 Section 1903.4 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.4 Vehicles and traffic safety. (a) Open container of alcoholic...

32 CFR 1903.4 - Vehicles and traffic safety.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Vehicles and traffic safety. 1903.4 Section 1903.4 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.4 Vehicles and traffic safety. (a) Open container of alcoholic...

32 CFR 1903.4 - Vehicles and traffic safety.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Vehicles and traffic safety. 1903.4 Section 1903.4 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.4 Vehicles and traffic safety. (a) Open container of alcoholic...

32 CFR 1903.4 - Vehicles and traffic safety.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Vehicles and traffic safety. 1903.4 Section 1903.4 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.4 Vehicles and traffic safety. (a) Open container of alcoholic...

The Occupy Central (Umbrella) movement and mental health distress in the Hong Kong general public: political movements and concerns as potential structural risk factors of population mental health.

PubMed

Lau, Joseph T F; Kim, Yoona; Wu, Anise M S; Wang, Zixin; Huang, Bishan; Mo, Phoenix K H

2017-05-01

Political tension, as expressed by mass movements such as the Occupy Central movement (2014) in Hong Kong, is a potential but understudied structural factor of population mental health. A random population-based telephone survey anonymously interviewed 344 Hong Kong Chinese adults aged 18-65 years during the 2 weeks since the termination date of the 2-month-long Occupy Central movement (15/12/2014). Linear regression models were fit using mental distress (depression, anxiety and negative mood) and self-perceived changes in mood/sleeping quality as dependent variables. Prevalence of participation in the movement was 10.5% (self), 17.7% (family members/relatives), and 34.0% (peers); 8.5% had participated for ≥2 days. Young age, but not participation, was associated with mental distress. In adjusted analysis, three types of responses to the movement (worry about safety, negative emotional responses to media reports, and conflicts with peers about the movement) and emotional responses to local political situations were significantly associated with all/some of the dependent variables related to mental distress. The variable on emotions toward local political situations was correlated with the three responses to the movement; it fully mediated the associations between such responses and mental distress. Many citizens participated in the movement, which was led by youths and might have increased the general public's mental distress. Negative personal responses to the movement and emotions toward political situations were potential risk factors. As the political tension would last and political pessimism is globally found, politics may have become a regular and persistent structural risk factor negatively affecting population mental health.

[Safety profile of zolpidem: two studies of 3805 patients by Swiss practitioners].

PubMed

Ganzoni, E; Gugger, M

1999-06-24

Evaluation and treatment of insomnia are frequent procedures in the physician's everyday practice, since many patients seek medical treatment for this condition. Knowledge of pharmacological therapeutical alternatives is therefore decisive, in order to identify the most efficaceous and safe therapy for the patient among the available hypnotics. The short-acting hypnotic zolpidem has been investigated in Switzerland in two multicenter safety studies in ambulatory practice. In the first study 8.9% (n = 125 of 1,972 treated patients), and in the second 7.2% of the patients (n = 175 of 1,833 treated patients) reported an adverse event. The most frequent events were related to the central nervous system (CNS) (somnolence, headache, confusion, vertigo); gastrointestinal and cutaneous symptoms were the most frequent non CNS-dependent effects. New, unknown or serious adverse events were not found and no specific risk factor or population at risk was identified. The safety profile of zolpidem is consistent with its known pharmacological properties, the results of previous clinical trials and the international experience obtained in large patients groups.

Knowledge, attitudes and opinions towards measles and the MMR vaccine across two NSW cohorts.

PubMed

Brieger, Daniel; Edwards, Matthew; Mudgil, Poonam; Whitehall, John

2017-12-01

Although the number of national measles cases has greatly decreased since 1980s, there has been resurgence in disease incidence in recent years. While parental knowledge and attitudes toward both disease and vaccinations are known to influence vaccine uptake, the contribution of these factors toward vaccination rates in NSW populations has not been studied. The aim of this study was to investigate the knowledge and opinions on measles and MMR vaccine in NSW Central and North Coast regions. Parents (n=201) of children <12 years were surveyed with a purpose design survey at public beaches at the Central Coast and community markets at the North Coast. Eight per cent of respondents reported not immunising their child with MMR vaccine. Most respondents recognised that measles is a highly contagious disease. Non-immunisers were found to be older, had a lower perceived severity of measles, were less likely to agree with the efficacy and safety of the vaccine, and were more likely to have encountered someone who had suffered side-effects of the vaccine. There is considerable concern over safety of MMR vaccine among non-immunisers. Implications for public health: Improving confidence in MMR vaccine should be a target of future public health interventions. © 2017 The Authors.

Non-technical skills of anaesthesia providers in Rwanda: an ethnography

PubMed Central

Livingston, Patricia; Zolpys, Lauren; Mukwesi, Christian; Twagirumugabe, Theogene; Whynot, Sara; MacLeod, Anna

2014-01-01

Introduction Patient safety depends on excellent practice of anaesthetists’ non-technical skills (ANTS). The ANTS framework has been validated in developed countries but there is no literature on the practice of ANTS in low-income countries. This study examines ANTS in this unexplored context. Methods This qualitative ethnographic study used observations of Rwandan anaesthesia providers and in-depth interviews with both North American and Rwandan anaesthesia providers to understand practice of ANTS in Rwanda. Results Communication is central to the practice of ANTS. Cultural factors in Rwanda, such as lack of assertiveness and discomfort taking leadership, and the strains of working in a resource-limited environment hinder the unfettered and focused communication needed for excellent anaesthesia practice. Conclusion Despite the challenges, anaesthesia providers are able to coordinate activities when good communication is actively encouraged. Future teaching interventions should address leadership and communication skills through encouraging both role definition and speaking up for patient safety. PMID:25722770

The practical application of mishap data in Army aircraft system safety programs

NASA Technical Reports Server (NTRS)

Darrah, J. T., Jr.

1971-01-01

The means are discussed by which the the United States Army Board for Aviation Accident Research (USABAAR) now utilizes the vast store of historical accident data in the application of the system safety concept for developmental aircraft. USABAAR serves as the central agency for the Army Accident Prevention Program which includes the receipt, processing, and analysis of all data and information related to Army aircraft accident experience. It is pointed out that methods which served the cause of accident prevention so well in the past are no longer adequate and that traditional parameters used to measure mishap experience have become obsolete. USABAAR has developed, and recently put into use, completely revised accident reporting forms which greatly expand the scope and detail of information provided as a result of investigation. This and other factors which have resulted in an improved data system are discussed in detail.

Muscles and their role in episodic tension-type headache: implications for treatment.

PubMed

Bendtsen, L; Ashina, S; Moore, A; Steiner, T J

2016-02-01

Tension-type headache (TTH) imposes a heavy burden on the global population but remains incompletely understood and poorly managed. Here, we review current knowledge of peripheral factors involved in the mechanism of TTH and make recommendations for the treatment of episodic TTH based on these. Peripheral activation or sensitization of myofascial nociceptors is most probably involved in the development of muscle pain and the acute episode of TTH. Repetitive episodes of muscle pain may sensitize the central nervous system resulting in progression of TTH to the chronic form. Thus, muscular factors may be responsible not only for the acute headache episode but also for chronification of the disorder. Simple analgesics and non-steroidal anti-inflammatory drugs are the mainstays of management of individual headache episodes. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice based on treatment effect, safety profile and costs. Non-pharmacological therapies include electromyographic biofeedback, physiotherapy and muscle relaxation therapy. Future studies should aim to identify the triggers of peripheral nociception and how to avoid peripheral and central sensitization. There is a need for more effective, faster acting drugs for acute TTH. Muscular factors play an important role in episodic TTH. Ibuprofen 400 mg and aspirin 1000 mg are recommended as drugs of first choice. © 2015 European Pain Federation - EFIC®

Health, safety, and environmental risk assessment of steel production complex in central Iran using TOPSIS.

PubMed

Jozi, S A; Majd, N Moradi

2014-10-01

This research was carried out with the aim of presenting an environmental management plan for steel production complex (SPC) in central Iran. Following precise identification of the plant activities as well as the study area, possible sources of environmental pollution and adverse impacts on the air quality, water, soil, biological environment, socioeconomic and cultural environment, and health and safety of the employees were determined considering the work processes of the steel complex. Afterwards, noise, wastewater, and air pollution sources were measured. Subsequently, factors polluting the steel complex were identified by TOPSIS and then prioritized using Excel Software. Based on the obtained results, the operation of the furnaces in hot rolling process with the score 1, effluent derived from hot rolling process with the score 0.565, nonprincipal disposal and dumping of waste at the plant enclosure with the score 0.335, walking beam process with the score 1.483 respectively allocated themselves the highest priority in terms of air, water, soil and noise pollution. In terms of habitats, land cover and socioeconomic and cultural environment, closeness to the forest area and the existence of four groups of wildlife with the score 1.106 and proximity of villages and residential areas to the plant with the score 3.771 respectively enjoyed the highest priorities while impressibility and occupational accidents with the score 2.725 and cutting and welding operations with score 2.134 had the highest priority among health and safety criteria. Finally, strategies for the control of pollution sources were identified and Training, Monitoring and environmental management plan of the SPC was prepared.

Multiple Sclerosis: Epidemiologic, Clinical, and Therapeutic Aspects.

PubMed

Vidal-Jordana, Angela; Montalban, Xavier

2017-05-01

Multiple sclerosis (MS) is a chronic autoimmune and degenerative disease of the central nervous system that affects young people. MS develops in genetically susceptible individuals exposed to different unknown triggering factors. Different phenotypes are described. About 15% of patients present with a primary progressive course and 85% with a relapsing-remitting course. An increasing number of disease-modifying treatments has emerged. Although encouraging, the number of drugs challenges the neurologist because each treatment has its own risk-benefit profile. Patients should be involved in the decision-making process to ensure good treatment and safety monitoring adherence. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of a satellite power system and six alternative technologies

NASA Technical Reports Server (NTRS)

Wolsko, T.; Whitfield, R.; Samsa, M.; Habegger, L. S.; Levine, E.; Tanzman, E.

1981-01-01

The satellite power system is assessed in comparison to six alternative technologies. The alternatives are: central-station terrestrial photovoltaic systems, conventional coal-fired power plants, coal-gasification/combined-cycle power plants, light water reactor power plants, liquid-metal fast-breeder reactors, and fusion. The comparison is made regarding issues of cost and performance, health and safety, environmental effects, resources, socio-economic factors, and institutional issues. The criteria for selecting the issues and the alternative technologies are given, and the methodology of the comparison is discussed. Brief descriptions of each of the technologies considered are included.

Human exposure standards in the frequency range 1 Hz To 100 kHz: the case for adoption of the IEEE standard.

PubMed

Patrick Reilly, J

2014-10-01

Differences between IEEE C95 Standards (C95.6-2002 and C95.1-2005) in the low-frequency (1 Hz-100 kHz) and the ICNIRP-2010 guidelines appear across the frequency spectrum. Factors accounting for lack of convergence include: differences between the IEEE standards and the ICNIRP guidelines with respect to biological induction models, stated objectives, data trail from experimentally derived thresholds through physical and biological principles, selection and justification of safety/reduction factors, use of probability models, compliance standards for the limbs as distinct from the whole body, defined population categories, strategies for central nervous system protection below 20 Hz, and correspondence of environmental electric field limits with contact currents. This paper discusses these factors and makes the case for adoption of the limits in the IEEE standards.

Cellular and molecular mechanisms of HIV-1 integration targeting.

PubMed

Engelman, Alan N; Singh, Parmit K

2018-07-01

Integration is central to HIV-1 replication and helps mold the reservoir of cells that persists in AIDS patients. HIV-1 interacts with specific cellular factors to target integration to interior regions of transcriptionally active genes within gene-dense regions of chromatin. The viral capsid interacts with several proteins that are additionally implicated in virus nuclear import, including cleavage and polyadenylation specificity factor 6, to suppress integration into heterochromatin. The viral integrase protein interacts with transcriptional co-activator lens epithelium-derived growth factor p75 to principally position integration within gene bodies. The integrase additionally senses target DNA distortion and nucleotide sequence to help fine-tune the specific phosphodiester bonds that are cleaved at integration sites. Research into virus-host interactions that underlie HIV-1 integration targeting has aided the development of a novel class of integrase inhibitors and may help to improve the safety of viral-based gene therapy vectors.

Estimating the effect of selected predictors on agricultural confined-space hazard perceptions of Utah farm owner/operators.

PubMed

Pate, M L; Dai, X

2014-04-01

The purpose of this study was to assess how selected variables affect the confined-space hazard perceptions of farmers in Utah. A confined space was defined as "any space found in an agricultural workplace that was not designed or intended as a regular workstation, has limited or restricted means of entry or exit, and contains potential physical and toxic hazards to workers who intentionally or unintentionally enter the space" (proposed by NCERA-197, 18 May 2011, draft copy). A total of 303 out of 327 farm owner/operators provided complete surveys that were used in the analysis. The state of Utah was grouped into five regions in this study: central, east, northeast, northwest, and southwest. Grain and dairy production comprised 48.7% of the operations responding to the survey. The general linear modeling (GLM) procedure in SAS 9.3 was used to select the models on hazard perception scores for the five studied regions. Interested predictors included response type, production type, safety planning, and injury concerns. Animal production operations had the highest average number of confined spaces (micro = 4, SD = 2.7). Regionally, the northwest region had the highest average number of confined spaces (micro = 4, SD = 2.5). The variables contributing most to confined-space hazard perceptions were injury and death concerns while working alone in confined spaces. Three factors were generated using principle factor analysis (PFA) with orthogonal varimax rotation. Results suggested that factors affect hazard perceptions differently by region. We conclude that outreach and educational efforts to change safety behaviors regarding confined-space hazards should be strategically targeted for each region based on predicting factors. The result can assist agricultural safety and health professionals in targeting agricultural producers' social networks to address human factors such as worker attitudes and/or lack of skills or knowledge that effect hazard perceptions of confined spaces in agriculture.

Consensus achievement of leadership, organisational and individual factors that influence safety climate: Implications for nursing management.

PubMed

Fischer, Shelly A; Jones, Jacqueline; Verran, Joyce A

2018-01-01

To validate a framework of factors that influence the relationship of transformational leadership and safety climate, and to enable testing of safety chain factors by generating hypotheses regarding their mediating and moderating effects. Understanding the patient safety chain and mechanisms by which leaders affect a strong climate of safety is essential to transformational leadership practice, education, and research. A systematic review of leadership and safety literature was used to develop an organising framework of factors proposed to influence the climate of safety. A panel of 25 international experts in leadership and safety engaged a three-round modified Delphi study with Likert-scored surveys. Eighty per cent of participating experts from six countries were retained to the final survey round. Consensus (>66% agreement) was achieved on 40 factors believed to influence safety climate in the acute care setting. Consensus regarding specific factors that play important roles in an organisation's climate of safety can be reached. Generally, the demonstration of leadership commitment to safety is key to cultivating a culture of patient safety. Transformational nurse leaders should consider and employ all three categories of factors in daily leadership activities and decision-making to drive a strong climate of patient safety. © 2017 John Wiley & Sons Ltd.

14 CFR 29.303 - Factor of safety.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Strength Requirements General § 29.303 Factor of safety. Unless otherwise provided, a factor of safety of 1.5 must be used. This factor applies to external and inertia... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Factor of safety. 29.303 Section 29.303...

14 CFR 27.303 - Factor of safety.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARDS: NORMAL CATEGORY ROTORCRAFT Strength Requirements General § 27.303 Factor of safety. Unless otherwise provided, a factor of safety of 1.5 must be used. This factor applies to external and inertia... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Factor of safety. 27.303 Section 27.303...

Analysis of factors influencing safety management for metro construction in China.

PubMed

Yu, Q Z; Ding, L Y; Zhou, C; Luo, H B

2014-07-01

With the rapid development of urbanization in China, the number and size of metro construction projects are increasing quickly. At the same time, and increasing number of accidents in metro construction make it a disturbing focus of social attention. In order to improve safety management in metro construction, an investigation of the participants' perspectives on safety factors in China metro construction has been conducted to identify the key safety factors, and their ranking consistency among the main participants, including clients, consultants, designers, contractors and supervisors. The result of factor analysis indicates that there are five key factors which influence the safety of metro construction including safety attitude, construction site safety, government supervision, market restrictions and task unpredictability. In addition, ANOVA and Spearman rank correlation coefficients were performed to test the consistency of the means rating and the ranking of safety factors. The results indicated that the main participants have significant disagreement about the importance of safety factors on more than half of the items. Suggestions and recommendations on practical countermeasures to improve metro construction safety management in China are proposed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Postmarketing Safety Study Tool: A Web Based, Dynamic, and Interoperable System for Postmarketing Drug Surveillance Studies

PubMed Central

Sinaci, A. Anil; Laleci Erturkmen, Gokce B.; Gonul, Suat; Yuksel, Mustafa; Invernizzi, Paolo; Thakrar, Bharat; Pacaci, Anil; Cinar, H. Alper; Cicekli, Nihan Kesim

2015-01-01

Postmarketing drug surveillance is a crucial aspect of the clinical research activities in pharmacovigilance and pharmacoepidemiology. Successful utilization of available Electronic Health Record (EHR) data can complement and strengthen postmarketing safety studies. In terms of the secondary use of EHRs, access and analysis of patient data across different domains are a critical factor; we address this data interoperability problem between EHR systems and clinical research systems in this paper. We demonstrate that this problem can be solved in an upper level with the use of common data elements in a standardized fashion so that clinical researchers can work with different EHR systems independently of the underlying information model. Postmarketing Safety Study Tool lets the clinical researchers extract data from different EHR systems by designing data collection set schemas through common data elements. The tool interacts with a semantic metadata registry through IHE data element exchange profile. Postmarketing Safety Study Tool and its supporting components have been implemented and deployed on the central data warehouse of the Lombardy region, Italy, which contains anonymized records of about 16 million patients with over 10-year longitudinal data on average. Clinical researchers in Roche validate the tool with real life use cases. PMID:26543873

Structural Deterministic Safety Factors Selection Criteria and Verification

NASA Technical Reports Server (NTRS)

Verderaime, V.

1992-01-01

Though current deterministic safety factors are arbitrarily and unaccountably specified, its ratio is rooted in resistive and applied stress probability distributions. This study approached the deterministic method from a probabilistic concept leading to a more systematic and coherent philosophy and criterion for designing more uniform and reliable high-performance structures. The deterministic method was noted to consist of three safety factors: a standard deviation multiplier of the applied stress distribution; a K-factor for the A- or B-basis material ultimate stress; and the conventional safety factor to ensure that the applied stress does not operate in the inelastic zone of metallic materials. The conventional safety factor is specifically defined as the ratio of ultimate-to-yield stresses. A deterministic safety index of the combined safety factors was derived from which the corresponding reliability proved the deterministic method is not reliability sensitive. The bases for selecting safety factors are presented and verification requirements are discussed. The suggested deterministic approach is applicable to all NASA, DOD, and commercial high-performance structures under static stresses.

Information system equality for food security--implementation of the food safety control system in Taiwan.

PubMed

Chen, Shaun C; Hsu, Guoo-Shyng Wang; Chiu, Chihwei P

2009-01-01

Food security plays a central role in governing agricultural policies in Taiwan. In addition to overuse or the illegal use of pesticide, meat leanness promoters, animal drugs and melamine in the food supply; as well as foodborne illness draws the greatest public concern due to incidents that occur every year in Taiwan. The present report demonstrates the implementation of a food safety control system in Taiwan. In order to control foodborne outbreaks effectively, the central government of the Department of Health of Taiwan launched the food safety control system which includes both the good hygienic practice (GHP) and the HACCP plan, in the last decade. From 1998 to the present, 302 food affiliations that implemented the system have been validated and accredited by a well-established audit system. The implementation of a food safety control system in compliance with international standards is of crucial importance to ensure complete safety and the high quality of foods, not only for domestic markets, but also for international trade.

The growth of partnerships to support patient safety practice adoption.

PubMed

Mendel, Peter; Damberg, Cheryl L; Sorbero, Melony E S; Varda, Danielle M; Farley, Donna O

2009-04-01

To document the numbers and types of interorganizational partnerships within the national patient safety domain, changes over time in these networks, and their potential for disseminating patient safety knowledge and practices. Self-reported information gathered from representatives of national-level organizations active in promoting patient safety. Social network analysis was used to examine the structure and composition of partnership networks and changes between 2004 and 2006. Two rounds of structured telephone interviews (n=35 organizations in 2004 and 55 in 2006). Patient safety partnerships expanded between 2004 and 2006. The average number of partnerships per interviewed organization increased 40 percent and activities per reported partnership increased over 50 percent. Partnerships increased in all activity domains, particularly dissemination and tools development. Fragmentation of the overall partnership network decreased and potential for information flow increased. Yet network centralization increased, suggesting vulnerability to partnership failure if key participants disengage. Growth in partnerships signifies growing strength in the capacity to disseminate and implement patient safety advancements in the U.S. health care system. The centrality of AHRQ in these networks of partnerships bodes well for its leadership role in disseminating information, tools, and practices generated by patient safety research projects.

Collapse Mechanisms Of Masonry Structures

NASA Astrophysics Data System (ADS)

Zuccaro, G.; Rauci, M.

2008-07-01

The paper outlines a possible approach to typology recognition, safety check analyses and/or damage measuring taking advantage by a multimedia tool (MEDEA), tracing a guided procedure useful for seismic safety check evaluation and post event macroseismic assessment. A list of the possible collapse mechanisms observed in the post event surveys on masonry structures and a complete abacus of the damages are provided in MEDEA. In this tool a possible combination between a set of damage typologies and each collapse mechanism is supplied in order to improve the homogeneity of the damages interpretation. On the other hand recent researches of one of the author have selected a number of possible typological vulnerability factors of masonry buildings, these are listed in the paper and combined with potential collapse mechanisms to be activated under seismic excitation. The procedure takes place from simple structural behavior models, derived from the Umbria-Marche earthquake observations, and tested after the San Giuliano di Puglia event; it provides the basis either for safety check analyses of the existing buildings or for post-event structural safety assessment and economic damage evaluation. In the paper taking advantage of MEDEA mechanisms analysis, mainly developed for the post event safety check surveyors training, a simple logic path is traced in order to approach the evaluation of the masonry building safety check. The procedure starts from the identification of the typological vulnerability factors to derive the potential collapse mechanisms and their collapse multipliers and finally addresses the simplest and cheapest strengthening techniques to reduce the original vulnerability. The procedure has been introduced in the Guide Lines of the Regione Campania for the professionals in charge of the safety check analyses and the buildings strengthening in application of the national mitigation campaign introduced by the Ordinance of the Central Government n. 3362/03. The main cases of out of plane mechanisms are analyzed and a possible innovative theory for masonry building vulnerability assessment, based on limit state analyses, is outlined. The paper report the first step of a research granted by the Department of the Civil Protection to Reluis within the research program of Line 10.

Collapse Mechanisms Of Masonry Structures

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

Zuccaro, G.; Rauci, M.

2008-07-08

The paper outlines a possible approach to typology recognition, safety check analyses and/or damage measuring taking advantage by a multimedia tool (MEDEA), tracing a guided procedure useful for seismic safety check evaluation and post event macroseismic assessment. A list of the possible collapse mechanisms observed in the post event surveys on masonry structures and a complete abacus of the damages are provided in MEDEA. In this tool a possible combination between a set of damage typologies and each collapse mechanism is supplied in order to improve the homogeneity of the damages interpretation. On the other hand recent researches of onemore » of the author have selected a number of possible typological vulnerability factors of masonry buildings, these are listed in the paper and combined with potential collapse mechanisms to be activated under seismic excitation. The procedure takes place from simple structural behavior models, derived from the Umbria-Marche earthquake observations, and tested after the San Giuliano di Puglia event; it provides the basis either for safety check analyses of the existing buildings or for post-event structural safety assessment and economic damage evaluation. In the paper taking advantage of MEDEA mechanisms analysis, mainly developed for the post event safety check surveyors training, a simple logic path is traced in order to approach the evaluation of the masonry building safety check. The procedure starts from the identification of the typological vulnerability factors to derive the potential collapse mechanisms and their collapse multipliers and finally addresses the simplest and cheapest strengthening techniques to reduce the original vulnerability. The procedure has been introduced in the Guide Lines of the Regione Campania for the professionals in charge of the safety check analyses and the buildings strengthening in application of the national mitigation campaign introduced by the Ordinance of the Central Government n. 3362/03. The main cases of out of plane mechanisms are analyzed and a possible innovative theory for masonry building vulnerability assessment, based on limit state analyses, is outlined. The paper report the first step of a research granted by the Department of the Civil Protection to Reluis within the research program of Line 10.« less

[Comparative study on four kinds of assessment methods of post-marketing safety of Danhong injection].

PubMed

Li, Xuelin; Tang, Jinfa; Meng, Fei; Li, Chunxiao; Xie, Yanming

2011-10-01

To study the adverse reaction of Danhong injection with four kinds of methods, central monitoring method, chart review method, literature study method and spontaneous reporting method, and to compare the differences between them, explore an appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection. Set down the adverse reactions' questionnaire of four kinds of methods, central monitoring method, chart review method, literature study method and collect the information on adverse reactions in a certain period. Danhong injection adverse reaction information from Henan Province spontaneous reporting system was collected with spontaneous reporting method. Carry on data summary and descriptive analysis. Study the adverse reaction of Danhong injection with four methods of central monitoring method, chart review method, literature study method and spontaneous reporting method, the rates of adverse events were 0.993%, 0.336%, 0.515%, 0.067%, respectively. Cyanosis, arrhythmia, hypotension, sweating, erythema, hemorrhage dermatitis, rash, irritability, bleeding gums, toothache, tinnitus, asthma, elevated aminotransferases, constipation, pain are new discovered adverse reactions. The central monitoring method is the appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection, which could objectively reflect the real world of clinical usage.

2009 Human Factors and Roadway Safety Workshop : Teen Driver Safety [SD .WMV (720x480/29fps/177.0 MB)

DOT National Transportation Integrated Search

2009-11-05

Iowa Department of Transportation Research and Technology Bureau video presentation from the 2009 human factors and roadway safety workshop session titled: Teen Driver Safety : Keynote Speaker Dan McGehee, director, Human Factors & Vehicle Safety Res...

Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia.

PubMed

Heiden, Siobhan M; Holden, Richard J; Alder, Catherine A; Bodke, Kunal; Boustani, Malaz

2017-10-01

Mental healthcare is a critical but largely unexplored application domain for human factors/ergonomics. This paper reports on a work system evaluation of a home-based dementia and depression care program for older adults, the Aging Brain Care program. The Workflow Elements Model was used to guide data collection and analysis of 59 h of observation, supplemented by key informant input. We identified four actors, 37 artifacts across seven types, ten action categories, and ten outcomes including improved health and safety. Five themes emerged regarding barriers and facilitators to care delivery in the program: the centrality of relationship building; the use of adaptive workarounds; performance of duplicate work; travel and scheduling challenges; and communication-related factors. Findings offer new insight into how mental healthcare services are delivered in a community-based program and key work-related factors shaping program outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of the major trauma case review tool.

PubMed

Curtis, Kate; Mitchell, Rebecca; McCarthy, Amy; Wilson, Kellie; Van, Connie; Kennedy, Belinda; Tall, Gary; Holland, Andrew; Foster, Kim; Dickinson, Stuart; Stelfox, Henry T

2017-02-28

As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review. The aim of this research was to develop and validate a trauma case review tool to facilitate clinical review of paediatric trauma patient care in extracting information to facilitate monitoring, inform change and enable loop closure. Development of the trauma case review tool was multi-faceted, beginning with a review of the trauma audit tool literature. Data were extracted from the literature to inform iterative tool development using a consensus approach. Inter-rater agreement was assessed for both the pilot and finalised versions of the tool. The final trauma case review tool contained ten sections, including patient factors (such as pre-existing conditions), presenting problem, a timeline of events, factors contributing to the care delivery problem (including equipment, work environment, staff action, organizational factors), positive aspects of care and the outcome of panel discussion. After refinement, the inter-rater reliability of the human factors and outcome components of the tool improved with an average 86% agreement between raters. This research developed an evidence-informed tool for use in paediatric trauma case review that considers both system safety and human factors to facilitate clinical review of trauma patient care. This tool can be used to identify opportunities for improvement in trauma care and guide quality assurance activities. Validation is required in the adult population.

A structural equation modelling approach examining the pathways between safety climate, behaviour performance and workplace slipping

PubMed Central

Swedler, David I; Verma, Santosh K; Huang, Yueng-Hsiang; Lombardi, David A; Chang, Wen-Ruey; Brennan, Melayne; Courtney, Theodore K

2015-01-01

Objective Safety climate has previously been associated with increasing safe workplace behaviours and decreasing occupational injuries. This study seeks to understand the structural relationship between employees’ perceptions of safety climate, performing a safety behaviour (ie, wearing slip-resistant shoes) and risk of slipping in the setting of limited-service restaurants. Methods At baseline, we surveyed 349 employees at 30 restaurants for their perceptions of their safety training and management commitment to safety as well as demographic data. Safety performance was identified as wearing slip-resistant shoes, as measured by direct observation by the study team. We then prospectively collected participants’ hours worked and number of slips weekly for the next 12 weeks. Using a confirmatory factor analysis, we modelled safety climate as a higher order factor composed of previously identified training and management commitment factors. Results The 349 study participants experienced 1075 slips during the 12-week follow-up. Confirmatory factor analysis supported modelling safety climate as a higher order factor composed of safety training and management commitment. In a structural equation model, safety climate indirectly affected prospective risk of slipping through safety performance, but no direct relationship between safety climate and slips was evident. Conclusions Results suggest that safety climate can reduce workplace slips through performance of a safety behaviour as well as suggesting a potential causal mechanism through which safety climate can reduce workplace injuries. Safety climate can be modelled as a higher order factor composed of safety training and management commitment. PMID:25710968

An Analysis of the Food Safety Educational Processes in the Cooperative Extension System of the North Central Region of the United States

ERIC Educational Resources Information Center

Koundinya, Vikram Swaroop Chandra

2010-01-01

Literature suggests that food safety is a serious concern all over the world, and lack of it has huge health and economic implications to different stakeholders. The situation in the U.S. is also no different with most of the American public not much knowledgeable about agriculture and food safety. Therefore, food safety education assumes…

14 CFR 23.303 - Factor of safety.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Factor of safety. 23.303 Section 23.303... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Structure General § 23.303 Factor of safety. Unless otherwise provided, a factor of safety of 1.5 must be used. ...

A qualitative exploration of the perceptions and information needs of public health inspectors responsible for food safety

PubMed Central

2010-01-01

Background In Ontario, local public health inspectors play an important frontline role in protecting the public from foodborne illness. This study was an in-depth exploration of public health inspectors' perceptions of the key food safety issues in public health, and their opinions and needs with regards to food safety information resources. Methods Four focus group discussions were conducted with public health inspectors from the Central West region of Ontario, Canada during June and July, 2008. A questioning route was used to standardize qualitative data collection. Audio recordings of sessions were transcribed verbatim and data-driven content analysis was performed. Results A total of 23 public health inspectors participated in four focus group discussions. Five themes emerged as key food safety issues: time-temperature abuse, inadequate handwashing, cross-contamination, the lack of food safety knowledge by food handlers and food premise operators, and the lack of food safety information and knowledge about specialty foods (i.e., foods from different cultures). In general, participants reported confidence with their current knowledge of food safety issues and foodborne pathogens. Participants highlighted the need for a central source for food safety information, access to up-to-date food safety information, resources in different languages, and additional food safety information on specialty foods. Conclusions The information gathered from these focus groups can provide a basis for the development of resources that will meet the specific needs of public health inspectors involved in protecting and promoting food safety. PMID:20553592

Patient safety initiatives in Central and Eastern Europe: A mixed methods approach by the LINNEAUS collaboration on patient safety in primary care

PubMed Central

Godycki-Cwirko, Maciek; Esmail, Aneez; Dovey, Susan; Wensing, Michel; Parker, Dianne; Kowalczyk, Anna; Błaszczyk, Honorata; Kosiek, Katarzyna

2015-01-01

ABSTRACT Background: Despite patient safety being recognized as an important healthcare issue in the European Union, there has been variable implementation of patient safety initiatives in Central and Eastern Europe (CEE). Objective: To assess the status of patient safety initiatives in countries in CEE; to describe a process of engagement in Poland, which can serve as a template for the implementation of patient safety initiatives in primary care. Methods: A mixed methods design was used. We conducted a review of literature focusing on publications from CEE, an inventory of patient safety initiatives in CEE countries, interviews with key informants, international survey, review of national reporting systems, and pilot demonstrator project in Poland with implementation of patient safety toolkits assessment. Results: There was no published patient safety research from Albania, Belarus, Greece, Latvia, Lithuania, Romania, or Russia. Nine papers were found from Bulgaria, Croatia, the Czech Republic, Poland, Serbia, and Slovenia. In most of the CEE countries, patient safety had been addressed at the policy level although the focus was mainly in hospital care. There was a dearth of activity in primary care. The use of patient improvement strategies was low. Conclusion: International cooperation as exemplified in the demonstrator project can help in the development and implementation of patient safety initiatives in primary care in changing the emphasis away from a blame culture to one where greater emphasis is placed on improvement and learning. PMID:26339839

Workplace injuries, safety climate and behaviors: application of an artificial neural network.

PubMed

Abubakar, A Mohammed; Karadal, Himmet; Bayighomog, Steven W; Merdan, Ethem

2018-05-09

This article proposes and tests a model for the interaction effect of the organizational safety climate and behaviors on workplace injuries. Using artificial neural network and survey data from 306 metal casting industry employees in central Anatolia, we found that an organizational safety climate mitigates workplace injuries, and safety behaviors enforce the strength of the negative impact of the safety climate on workplace injuries. The results suggest a complex relationship between the organizational safety climate, safety behavior and workplace injuries. Theoretical and practical implications are discussed in light of decreasing workplace injuries in the Anatolian metal casting industry.

Adaptive servo-ventilation: How does it fit into the treatment of central sleep apnoea syndrome? Expert opinions.

PubMed

Priou, P; d'Ortho, M-P; Damy, T; Davy, J-M; Gagnadoux, F; Gentina, T; Meurice, J-C; Pepin, J-L; Tamisier, R; Philippe, C

2015-12-01

The preliminary results of the SERVE-HF study have led to the release of safety information with subsequent contraindication to the use of adaptive servo-ventilation (ASV) for the treatment of central sleep apnoeas in patients with chronic symptomatic systolic heart failure with left ventricular ejection fraction (LVEF) ≤ 45%. The aim of this article is to review these results, and to provide more detailed arguments based on data from the literature advocating the continued use of ASV in different indications, including heart failure with preserved LVEF, complex sleep apnoea syndrome, opioid-induced central sleep apnea syndrome, idiopathic central SAS, and central SAS due to a stroke. Based on these findings, we propose to set up registers dedicated to patients in whom ASV has been stopped and in the context of the next setting up of ASV in these specific indications to ensure patient safety and allow reasoned decisions on the use of ASV. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

A cross-cultural study of organizational factors on safety: Japanese vs. Taiwanese oil refinery plants.

PubMed

Hsu, Shang Hwa; Lee, Chun-Chia; Wu, Muh-Cherng; Takano, Kenichi

2008-01-01

This study attempts to identify idiosyncrasies of organizational factors on safety and their influence mechanisms in Taiwan and Japan. Data were collected from employees of Taiwanese and Japanese oil refinery plants. Results show that organizational factors on safety differ in the two countries. Organizational characteristics in Taiwanese plants are highlighted as: higher level of management commitment to safety, harmonious interpersonal relationship, more emphasis on safety activities, higher devotion to supervision, and higher safety self-efficacy, as well as high quality of safety performance. Organizational characteristics in Japanese plants are highlighted as: higher level of employee empowerment and attitude towards continuous improvement, more emphasis on systematic safety management approach, efficient reporting system and teamwork, and high quality of safety performance. The casual relationships between organizational factors and workers' safety performance were investigated using structural equation modeling (SEM). Results indicate that the influence mechanisms of organizational factors in Taiwan and Japan are different. These findings provide insights into areas of safety improvement in emerging countries and developed countries respectively.

Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens

PubMed Central

Packer, Mark

2016-01-01

The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, PubMed.gov and Science.gov, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks. PMID:27354760

Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens.

PubMed

Packer, Mark

2016-01-01

The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, PubMed.gov and Science.gov, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks.

Organizational factors affecting safety implementation in food companies in Thailand.

PubMed

Chinda, Thanwadee

2014-01-01

Thai food industry employs a massive number of skilled and unskilled workers. This may result in an industry with high incidences and accident rates. To improve safety and reduce the accident figures, this paper investigates factors influencing safety implementation in small, medium, and large food companies in Thailand. Five factors, i.e., management commitment, stakeholders' role, safety information and communication, supportive environment, and risk, are found important in helping to improve safety implementation. The statistical analyses also reveal that small, medium, and large food companies hold similar opinions on the risk factor, but bear different perceptions on the other 4 factors. It is also found that to improve safety implementation, the perceptions of safety goals, communication, feedback, safety resources, and supervision should be aligned in small, medium, and large companies.

Neuroprotection as a Therapeutic Target for Diabetic Retinopathy.

PubMed

Hernández, Cristina; Dal Monte, Massimo; Simó, Rafael; Casini, Giovanni

2016-01-01

Diabetic retinopathy (DR) is a multifactorial progressive disease of the retina and a leading cause of vision loss. DR has long been regarded as a vascular disorder, although neuronal death and visual impairment appear before vascular lesions, suggesting an important role played by neurodegeneration in DR and the appropriateness of neuroprotective strategies. Upregulation of vascular endothelial growth factor (VEGF), the main target of current therapies, is likely to be one of the first responses to retinal hyperglycemic stress and VEGF may represent an important survival factor in early phases of DR. Of central importance for clinical trials is the detection of retinal neurodegeneration in the clinical setting, and spectral domain optical coherence tomography seems the most indicated technique. Many substances have been tested in animal studies for their neuroprotective properties and for possible use in humans. Perhaps, the most intriguing perspective is the use of endogenous neuroprotective substances or nutraceuticals. Together, the data point to the central role of neurodegeneration in the pathogenesis of DR and indicate neuroprotection as an effective strategy for treating this disease. However, clinical trials to determine not only the effectiveness and safety but also the compliance of a noninvasive route of drug administration are needed.

Neuroprotection as a Therapeutic Target for Diabetic Retinopathy

PubMed Central

Hernández, Cristina; Simó, Rafael

2016-01-01

Diabetic retinopathy (DR) is a multifactorial progressive disease of the retina and a leading cause of vision loss. DR has long been regarded as a vascular disorder, although neuronal death and visual impairment appear before vascular lesions, suggesting an important role played by neurodegeneration in DR and the appropriateness of neuroprotective strategies. Upregulation of vascular endothelial growth factor (VEGF), the main target of current therapies, is likely to be one of the first responses to retinal hyperglycemic stress and VEGF may represent an important survival factor in early phases of DR. Of central importance for clinical trials is the detection of retinal neurodegeneration in the clinical setting, and spectral domain optical coherence tomography seems the most indicated technique. Many substances have been tested in animal studies for their neuroprotective properties and for possible use in humans. Perhaps, the most intriguing perspective is the use of endogenous neuroprotective substances or nutraceuticals. Together, the data point to the central role of neurodegeneration in the pathogenesis of DR and indicate neuroprotection as an effective strategy for treating this disease. However, clinical trials to determine not only the effectiveness and safety but also the compliance of a noninvasive route of drug administration are needed. PMID:27123463

The advancement of a new human factors report--'The Unique Report'--facilitating flight crew auditing of performance/operations as part of an airline's safety management system.

PubMed

Leva, M C; Cahill, J; Kay, A M; Losa, G; McDonald, N

2010-02-01

This paper presents the findings of research relating to the specification of a new human factors report, conducted as part of the work requirements for the Human Integration into the Lifecycle of Aviation Systems project, sponsored by the European Commission. Specifically, it describes the proposed concept for a unique report, which will form the basis for all operational and safety reports completed by flight crew. This includes all mandatory and optional reports. Critically, this form is central to the advancement of improved processes and technology tools, supporting airline performance management, safety management, organisational learning and knowledge integration/information-sharing activities. Specifically, this paper describes the background to the development of this reporting form, the logic and contents of this form and how reporting data will be made use of by airline personnel. This includes a description of the proposed intelligent planning process and the associated intelligent flight plan concept, which makes use of airline operational and safety analyses information. Primarily, this new reporting form has been developed in collaboration with a major Spanish airline. In addition, it has involved research with five other airlines. Overall, this has involved extensive field research, collaborative prototyping and evaluation of new reports/flight plan concepts and a number of evaluation activities. Participants have included both operational and management personnel, across different airline flight operations processes. Statement of Relevance: This paper presents the development of a reporting concept outlined through field research and collaborative prototyping within an airline. The resulting reporting function, embedded in the journey log compiled at the end of each flight, aims at enabling employees to audit the operations of the company they work for.

Socio-environmental risk factors for medically-attended agricultural injuries in Wisconsin dairy farmers.

PubMed

VanWormer, Jeffrey J; Barnes, Kathrine L; Waring, Stephen C; Keifer, Matthew C

2017-07-01

Accidents are common in the agricultural industry, particularly among dairy farmers. How said farmers get hurt is well established, but far less is known about how distal, socio-environmental factors influence injuries. This study examined associations between medically-attended agricultural injuries and: (1) personal sociodemographic characteristics, and (2) farm environment features and general safety practices. A cross-sectional survey was implemented with linked data from electronic health records on prior agricultural injuries that occurred between 01/01/2002-12/31/2015. The sample included adult dairy producers who resided in north-central Wisconsin (USA) and were medically-homed to the Marshfield Clinic Health System. Multiple logistic regression was used to analyze associations between socio-environmental characteristics and agricultural injuries. There were 620 dairy farmers in the analytical sample, with 50 medically-attended agricultural injuries observed during the 14-year study time period (5.7 injuries per 1000 dairy farmers per year). In the multivariable model, the odds of agricultural injury were significantly greater among farmers who have private individually-purchased health insurance (OR=4.25; 95% CI: 1.31, 13.84), do not live at their dairy operation (OR=2.91; CI: 1.27, 6.67), and do not provide safety training to their workers (OR=4.27; CI: 1.00, 18.21). Dairy farmers in this analysis who did not live at their dairy operation, did not provide safety training to all their workers, or had individually-purchased health insurance were more apt to get injured, but more research is needed to confirm these findings in prospectively designed studies. How these factors can be directly addressed or otherwise used to better focus farm injury prevention initiatives should also be explored. Copyright © 2017 Elsevier Ltd. All rights reserved.

Investigation of structural factors of safety for the space shuttle

NASA Technical Reports Server (NTRS)

1972-01-01

A study was made of the factors governing the structural design of the fully reusable space shuttle booster to establish a rational approach to select optimum structural factors of safety. The study included trade studies of structural factors of safety versus booster service life, weight, cost, and reliability. Similar trade studies can be made on other vehicles using the procedures developed. The major structural components of a selected baseline booster were studied in depth, each being examined to determine the fatigue life, safe-life, and fail-safe capabilities of the baseline design. Each component was further examined to determine its reliability and safety requirements, and the change of structural weight with factors of safety. The apparent factors of safety resulting from fatigue, safe-life, proof test, and fail-safe requirements were identified. The feasibility of reduced factors of safety for design loads such as engine thrust, which are well defined, was examined.

14 CFR 31.25 - Factor of safety.

Code of Federal Regulations, 2010 CFR

2010-01-01

... envelope stress. (c) A factor of safety of at least five must be used in the design of all fibrous or non... any single failure will not jeopardize safety of flight. (d) In applying factors of safety, the effect...

14 CFR 25.303 - Factor of safety.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Factor of safety. 25.303 Section 25.303... STANDARDS: TRANSPORT CATEGORY AIRPLANES Structure General § 25.303 Factor of safety. Unless otherwise specified, a factor of safety of 1.5 must be applied to the prescribed limit load which are considered...

Impact of removing mucosal barrier injury laboratory-confirmed bloodstream infections from central line-associated bloodstream infection rates in the National Healthcare Safety Network, 2014.

PubMed

See, Isaac; Soe, Minn M; Epstein, Lauren; Edwards, Jonathan R; Magill, Shelley S; Thompson, Nicola D

2017-03-01

Central line-associated bloodstream infection (CLABSI) event data reported to the National Healthcare Safety Network from 2014, the first year of required use of the mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI) definition, were analyzed to assess the impact of removing MBI-LCBI events from CLABSI rates. CLABSI rates decreased significantly in some location types after removing MBI-LCBI events, and MBI-LCBI events will be removed from publicly reported CLABSI rates. Published by Elsevier Inc.

An examination of the impact of five grade crossing safety factors on driver decision making

DOT National Transportation Integrated Search

2014-04-01

The authors applied signal detection theory to model the impact : of five grade-crossing safety factors to understand their impact : on driver decision making. The safety factors were improving : commercial motor vehicle (CMV) driver safety through f...

Improving safety in high-speed work zones : a Super 70 study.

DOT National Transportation Integrated Search

2011-01-01

Super 70 was an urban reconstruction project (March-November 2007) along I-70 in the central part of Indianapolis. INDOT : applied in that project several innovative and traditional solutions. This study investigates the safety effect of the solution...

Oral Minocycline for the Treatment of Diabetic Macular Edema (DME): Results of a Phase I/II Clinical Study

PubMed Central

Cukras, Catherine A.; Petrou, Philip; Chew, Emily Y.; Meyerle, Catherine B.; Wong, Wai T.

2012-01-01

Purpose. Inflammation contributes significantly to the pathogenesis of diabetic macular edema (DME). In particular, retinal microglia demonstrate increased activation and aggregation in areas of DME. Study authors investigated the safety and potential efficacy of oral minocycline, a drug capable of inhibiting microglial activation, in the treatment of DME. Methods. A single-center, prospective, open-label phase I/II clinical trial enrolled five participants with fovea-involving DME who received oral minocycline 100 mg twice daily for 6 months. Main outcome measurements included best-corrected visual acuity (BCVA), central retinal subfield thickness (CST), and central macular volume using spectral domain optical coherence tomography (SD-OCT) and late leakage on fluorescein angiography (FA). Results. Findings indicated that the study drug was well tolerated and not associated with significant safety issues. In study eyes, mean BCVA improved continuously from baseline at 1, 2, 4, and 6 months by +1.0, +4.0, +4.0, and +5.8 letters, respectively, while mean retinal thickness (CST) on OCT decreased by −2.9%, −5.7%, −13.9, and −8.1% for the same time points. At month 6, mean area of late leakage on FA decreased by −34.4% in study eyes. Mean changes in contralateral fellow eyes also demonstrated similar trends. Improvements in outcome measures were not correlated with concurrent changes in systemic factors. Conclusions. In this pilot proof-of-concept study of DME, minocycline as primary treatment was associated with improved visual function, central macular edema, and vascular leakage, comparing favorably with historical controls from previous studies. Microglial inhibition with oral minocycline may be a promising therapeutic strategy targeting the inflammatory etiology of DME. (ClinicalTrials.gov number, NCT01120899.) PMID:22589436

Oral minocycline for the treatment of diabetic macular edema (DME): results of a phase I/II clinical study.

PubMed

Cukras, Catherine A; Petrou, Philip; Chew, Emily Y; Meyerle, Catherine B; Wong, Wai T

2012-06-22

Inflammation contributes significantly to the pathogenesis of diabetic macular edema (DME). In particular, retinal microglia demonstrate increased activation and aggregation in areas of DME. Study authors investigated the safety and potential efficacy of oral minocycline, a drug capable of inhibiting microglial activation, in the treatment of DME. A single-center, prospective, open-label phase I/II clinical trial enrolled five participants with fovea-involving DME who received oral minocycline 100 mg twice daily for 6 months. Main outcome measurements included best-corrected visual acuity (BCVA), central retinal subfield thickness (CST), and central macular volume using spectral domain optical coherence tomography (SD-OCT) and late leakage on fluorescein angiography (FA). Findings indicated that the study drug was well tolerated and not associated with significant safety issues. In study eyes, mean BCVA improved continuously from baseline at 1, 2, 4, and 6 months by +1.0, +4.0, +4.0, and +5.8 letters, respectively, while mean retinal thickness (CST) on OCT decreased by -2.9%, -5.7%, -13.9, and -8.1% for the same time points. At month 6, mean area of late leakage on FA decreased by -34.4% in study eyes. Mean changes in contralateral fellow eyes also demonstrated similar trends. Improvements in outcome measures were not correlated with concurrent changes in systemic factors. In this pilot proof-of-concept study of DME, minocycline as primary treatment was associated with improved visual function, central macular edema, and vascular leakage, comparing favorably with historical controls from previous studies. Microglial inhibition with oral minocycline may be a promising therapeutic strategy targeting the inflammatory etiology of DME. (ClinicalTrials.gov number, NCT01120899.).

Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

PubMed

Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

2008-01-01

To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p < .001). However, interdepartmental coordination for patient care was inversely related with antibiotic use in contrast to antimicrobial resistance spread prevention and control (p < .0001). Formalization and standardization may eliminate staff role conflict, whereas centralized authority may minimize ambiguity. Culture and communication likely promote internal trust, whereas information technology use helps integrate and support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

Modeling the factors affecting unsafe behavior in the construction industry from safety supervisors' perspective.

PubMed

Khosravi, Yahya; Asilian-Mahabadi, Hassan; Hajizadeh, Ebrahim; Hassanzadeh-Rangi, Narmin; Bastani, Hamid; Khavanin, Ali; Mortazavi, Seyed Bagher

2014-01-01

There can be little doubt that the construction is the most hazardous industry in the worldwide. This study was designed to modeling the factors affecting unsafe behavior from the perspective of safety supervisors. The qualitative research was conducted to extract a conceptual model. A structural model was then developed based on a questionnaire survey (n=266) by two stage Structural Equation Model (SEM) approach. An excellent confirmed 12-factors structure explained about 62% of variances unsafe behavior in the construction industry. A good fit structural model indicated that safety climate factors were positively correlated with safety individual factors (P<0.001) and workplace safety condition (P<0.001). The workplace safety condition was found to play a strong mediating role in linking the safety climate and construction workers' engagement in safe or unsafe behavior. In order to improve construction safety performance, more focus on the workplace condition is required.

Extension of the ECRH operational space with O2 and X3 heating schemes to control tungsten accumulation in ASDEX Upgrade

NASA Astrophysics Data System (ADS)

Höhnle, H.; Stober, J.; Herrmann, A.; Kasparek, W.; Leuterer, F.; Monaco, F.; Neu, R.; Schmid-Lorch, D.; Schütz, H.; Schweinzer, J.; Stroth, U.; Wagner, D.; Vorbrugg, S.; Wolfrum, E.; ASDEX Upgrade Team

2011-08-01

ASDEX Upgrade has been operated with tungsten-coated plasma-facing components for several years. H-mode operation with good confinement has been demonstrated. Nevertheless, purely neutral beam injection-heated H-modes with reduced gas puff, moderate heating power or/and increased triangularity tend to accumulate tungsten, followed by a radiative collapse. Under these conditions, central electron heating with electron cyclotron resonance heating (ECRH), usually in X2 polarization, changes the impurity transport in the plasma centre, reducing the central tungsten concentration and, in many cases, stabilizing the plasma. In order to extend the applicability of central ECRH to a wider range of magnetic field and plasma current additional ECRH schemes with reduced single-pass absorption have been implemented: X3 heating allows us to reduce the magnetic field by 30%, such that the first H-modes with an ITER-like value of the safety factor of q95 = 3 could be run in the tungsten-coated device. O2 heating increases the cutoff density by a factor of 2 allowing higher currents and triangularities to be addressed. For both schemes, scenarios have been developed to cope with the associated reduced absorption. In the case of central X3 heating, the X2 resonance lies close to the pedestal top at the high-field side of the plasma, serving as a beam dump. For O2, holographic mirrors have been developed which guarantee a second pass through the plasma centre. The beam position on these reflectors is controlled by fast thermocouples. Stray-radiation protection has been implemented using sniffer probes.

The Safety Argumentation Schools of Thought

NASA Technical Reports Server (NTRS)

Graydon, Patrick John

2017-01-01

Safety cases have been produced and researched for decades. Definitions of `safety case' agree on both the need to generate suitable evidence and the central role of argument. But the relevant literature seems to exhibit multiple schools of thought that are largely unrecognized and somewhat at odds with each other. This paper presents preliminary results from research to identify and characterize the safety case schools of thought so as to reduce confusion and discord in research and practice.

Interrelation Between Safety Factors and Reliability

NASA Technical Reports Server (NTRS)

Elishakoff, Isaac; Chamis, Christos C. (Technical Monitor)

2001-01-01

An evaluation was performed to establish relationships between safety factors and reliability relationships. Results obtained show that the use of the safety factor is not contradictory to the employment of the probabilistic methods. In many cases the safety factors can be directly expressed by the required reliability levels. However, there is a major difference that must be emphasized: whereas the safety factors are allocated in an ad hoc manner, the probabilistic approach offers a unified mathematical framework. The establishment of the interrelation between the concepts opens an avenue to specify safety factors based on reliability. In cases where there are several forms of failure, then the allocation of safety factors should he based on having the same reliability associated with each failure mode. This immediately suggests that by the probabilistic methods the existing over-design or under-design can be eliminated. The report includes three parts: Part 1-Random Actual Stress and Deterministic Yield Stress; Part 2-Deterministic Actual Stress and Random Yield Stress; Part 3-Both Actual Stress and Yield Stress Are Random.

Serving up food safety: who wants a piece of the pie?

PubMed

Schmidt, C W

2001-07-01

A total of 12 federal agencies, plus their state counterparts, contribute to the regulatory snarl that governs the safety of the American food supply. With so much federal oversight, one might expect U.S. foods to be virtually risk-free. But this is hardly the case; contaminated food is responsible for 75 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Recent reports from the General Accounting Office and the National Research Council claim that creation of a single agency with centralized authority is the best solution to U.S. food safety problems. Some experts agree that regulatory gaps in food safety highlight the need for centralized leadership, and that more money is necessary to fund the number of inspectors needed to adequately inspect the food supply before it reaches consumers. The single-agency concept has garnered congressional, industry, and scientific support, but the idea isn't without its skeptics, who believe that consolidating food safety under a single agency eliminates checks and balances offered by the current system and, more importantly, runs the risk of politicizing the agency.

Human aspects of mission safety

NASA Technical Reports Server (NTRS)

Connors, Mary M.

1989-01-01

Recent discussions of psychology's involvement in spaceflight have emphasized its role in enhancing space living conditions and incresing crew productivity. While these goals are central to space missions, behavioral scientists should not lose sight of a more basic flight requirement - that of crew safety. This paper examines some of the processes employed in the American space program in support of crew safety and suggests that behavioral scientists could contribute to flight safety, both through these formal processes and through less formal methods. Various safety areas of relevance to behavioral scientists are discussed.

Quantitative evolutionary design

PubMed Central

Diamond, Jared

2002-01-01

The field of quantitative evolutionary design uses evolutionary reasoning (in terms of natural selection and ultimate causation) to understand the magnitudes of biological reserve capacities, i.e. excesses of capacities over natural loads. Ratios of capacities to loads, defined as safety factors, fall in the range 1.2-10 for most engineered and biological components, even though engineered safety factors are specified intentionally by humans while biological safety factors arise through natural selection. Familiar examples of engineered safety factors include those of buildings, bridges and elevators (lifts), while biological examples include factors of bones and other structural elements, of enzymes and transporters, and of organ metabolic performances. Safety factors serve to minimize the overlap zone (resulting in performance failure) between the low tail of capacity distributions and the high tail of load distributions. Safety factors increase with coefficients of variation of load and capacity, with capacity deterioration with time, and with cost of failure, and decrease with costs of initial construction, maintenance, operation, and opportunity. Adaptive regulation of many biological systems involves capacity increases with increasing load; several quantitative examples suggest sublinear increases, such that safety factors decrease towards 1.0. Unsolved questions include safety factors of series systems, parallel or branched pathways, elements with multiple functions, enzyme reaction chains, and equilibrium enzymes. The modest sizes of safety factors imply the existence of costs that penalize excess capacities. Those costs are likely to involve wasted energy or space for large or expensive components, but opportunity costs of wasted space at the molecular level for minor components. PMID:12122135

Measuring safety climate in elderly homes.

PubMed

Yeung, Koon-Chuen; Chan, Charles C

2012-02-01

Provision of a valid and reliable safety climate dimension brings enormous benefits to the elderly home sector. The aim of the present study was to make use of the safety climate instrument developed by OSHC to measure the safety perceptions of employees in elderly homes such that the factor structure of the safety climate dimensions of elderly homes could be explored. In 2010, surveys by mustering on site method were administered in 27 elderly homes that had participated in the "Hong Kong Safe and Healthy Residential Care Home Accreditation Scheme" organized by the Occupational Safety and Health Council. Six hundred and fifty-one surveys were returned with a response rate of 54.3%. To examine the factor structure of safety climate dimensions in our study, an exploratory factor analysis (EFA) using principal components analysis method was conducted to identify the underlying factors. The results of the modified seven-factor's safety climate structure extracted from 35 items better reflected the safety climate dimensions of elderly homes. The Cronbach alpha range for this study (0.655 to 0.851) indicated good internal consistency among the seven-factor structure. Responses from managerial level, supervisory and professional level, and front-line staff were analyzed to come up with the suggestion on effective ways of improving the safety culture of elderly homes. The overall results showed that managers generally gave positive responses in the factors evaluated, such as "management commitment and concern to safety," "perception of work risks and some contributory influences," "safety communication and awareness," and "safe working attitude and participation." Supervisors / professionals, and frontline level staff on the other hand, have less positive responses. The result of the lowest score in the factors - "perception of safety rules and procedures" underlined the importance of the relevance and practicability of safety rules and procedures. The modified OSHC safety climate tool provided better evidence of structural validity and reliability for use by elderly homes' decision makers as an indicator of employee perception of safety in their institution. The findings and suggestions in the study provide useful information for the management, supervisors/professionals and frontline level staff to cultivate the safety culture in the elderly home sector. Most important, elderly homes can use the modified safety climate scale to identify problem areas in their safety culture and safety management practices and then target these for intervention. Copyright © 2012 Elsevier Ltd. All rights reserved.

Moving research to practice through partnership: a case study in Asphalt Paving.

PubMed

Chang, Charlotte; Nixon, Laura; Baker, Robin

2015-08-01

Multi-stakeholder partnerships play a critical role in dissemination and implementation in health and safety. To better document and understand construction partnerships that have successfully scaled up effective interventions to protect workers, this case study focused on the collaborative processes of the Asphalt Paving Partnership. In the 1990s, this partnership developed, evaluated, disseminated, and achieved near universal, voluntary adoption of paver engineering controls to reduce exposure to asphalt fumes. We used in-depth interviews (n = 15) and document review in the case study. We describe contextual factors that both facilitated and challenged the formation of the collaboration, central themes and group processes, and research to practice (r2p) outcomes. The Asphalt Paving Partnership offers insight into how multi-stakeholder partnerships in construction can draw upon the strengths of diverse members to improve the dissemination and adoption of health and safety innovations and build a collaborative infrastructure to sustain momentum over time. © 2015 Wiley Periodicals, Inc.

Emerging treatments for postmenopausal osteoporosis – focus on denosumab

PubMed Central

Geusens, Piet

2009-01-01

The pathway of the receptor activator of the nuclear factor κB ligand (RANKL), RANK and osteoprotegerin (OPG) plays a central role in coupling bone formation and resorption during normal bone turnover and in a wide spectrum of diseases characterized by disturbed bone remodeling, increased bone resorption and bone destruction (osteoporosis, Paget’s disease of bone, rheumatoid arthritis [RA], metastatic bone disease). Clinical trials indicate that denosumab, a RANKL-specific recombinant humanized monoclonal antibody, is effective in suppressing bone resorption, resulting in increase in bone mineral density (BMD) in post-menopausal women with low BMD, and has the potential to prevent progression of erosions in RA and of skeletal-related events in metastatic bone disease. The effects on fracture reduction in postmenopausal osteoporosis are awaited from the recently finished FREEDOM study. In clinical trials with denosumab, overall adverse events were similar to placebo or comparators, indicating a favorable safety profile in these diseases, which until now have been available up to 4 years, but data on long-term safety will be needed. PMID:19554095

Dimensions of Safety Climate among Iranian Nurses.

PubMed

Konjin, Z Naghavi; Shokoohi, Y; Zarei, F; Rahimzadeh, M; Sarsangi, V

2015-10-01

Workplace safety has been a concern of workers and managers for decades. Measuring safety climate is crucial in improving safety performance. It is also a method of benchmarking safety perception. To develop and validate a psychometrics scale for measuring nurses' safety climate. Literature review, subject matter experts and nurse's judgment were used in items developing. Content validity and reliability for new tool were tested by content validity index (CVI) and test-retest analysis, respectively. Exploratory factor analysis (EFA) with varimax rotation was used to improve the interpretation of latent factors. A 40-item scale in 6 factors was developed, which could explain 55% of the observed variance. The 6 factors included employees' involvement in safety and management support, compliance with safety rules, safety training and accessibility to personal protective equipment, hindrance to safe work, safety communication and job pressure, and individual risk perception. The proposed scale can be used in identifying the needed areas to implement interventions in safety climate of nurses.

Safety leadership in the teaching laboratories of electrical and electronic engineering departments at Taiwanese Universities.

PubMed

Wu, Tsung-Chih

2008-01-01

Safety has always been one of the principal goals in teaching laboratories. Laboratories cannot serve their educational purpose when accidents occur. The leadership of department heads has a major impact on laboratory safety, so this study discusses the factors affecting safety leadership in teaching laboratories. This study uses a mail survey to explore the perceived safety leadership in electrical and electronic engineering departments at Taiwanese universities. An exploratory factor analysis shows that there are three main components of safety leadership, as measured on a safety leadership scale: safety controlling, safety coaching, and safety caring. The descriptive statistics also reveals that among faculty, the perception of department heads' safety leadership is in general positive. A two-way MANOVA shows that there are interaction effects on safety leadership between university size and instructor age; there are also interaction effects between presence of a safety committee and faculty gender and faculty age. It is therefore necessary to assess organizational factors when determining whether individual factors are the cause of differing perceptions among faculty members. The author also presents advice on improving safety leadership for department heads at small universities and at universities without safety committees.

76 FR 35130 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors AGENCY: Pipeline and Hazardous Materials Safety Administration... safety standards, risk assessments, and safety policies for natural gas pipelines and for hazardous...

Documentation of hazards and safety perceptions for mechanized logging operations in east central Alabama

Treesearch

R. M. Bordas; G. A. Davis; B. L. Hopkins; R. E. Thornas; Robert B. Rummer

2001-01-01

The logging industry remains one of the most hazardous in the nation. Despite more stringent safety regulations and improvements in equipment safety features, the rate of logging fatalities has decreased at a much lower rate than the decrease in the rate of illnesses and injuries in the same occupation. The objective of this research was to identify and assess the...

Central Memory CD4+ T Cells Are Responsible for the Recombinant Bacillus Calmette-Guérin ΔureC::hly Vaccine's Superior Protection Against Tuberculosis

PubMed Central

Vogelzang, Alexis; Perdomo, Carolina; Zedler, Ulrike; Kuhlmann, Stefanie; Hurwitz, Robert; Gengenbacher, Martin; Kaufmann, Stefan H. E.

2014-01-01

Bacillus Calmette-Guérin (BCG) has been used for vaccination against tuberculosis for nearly a century. Here, we analyze immunity induced by a live tuberculosis vaccine candidate, recombinant BCG ΔureC::hly vaccine (rBCG), with proven preclinical and clinical safety and immunogenicity. We pursue in-depth analysis of the endogenous mycobacteria-specific CD4+ T-cell population, comparing the more efficacious rBCG with canonical BCG to determine which T-cell memory responses are prerequisites for superior protection against tuberculosis. rBCG induced higher numbers and proportions of antigen-specific memory CD4+ T cells than BCG, with a CXCR5+CCR7+ phenotype and low expression of the effector transcription factors T-bet and Bcl-6. We found that the superior protection of rBCG, compared with BCG, correlated with higher proportions and numbers of these central memory T cells and of T follicular helper cells associated with specific antibody responses. Adoptive transfer of mycobacteria-specific central memory T cells validated their critical role in protection against pulmonary tuberculosis. PMID:24943726

Proceedings, 10th Central Hardwood Forest Conference

Treesearch

Kurt W. Gottschalk; Sandra L.C., eds. Fosbroke

1995-01-01

Two invited papers, 57 volunteer papers, and 22 volunteer poster summaries presented at the 10th Central Hardwood Forest Conference. Presentation topics included economics, forest amenities, harvesting, logging safety, utilization, physiology, genetics, ecology, regeneration, silviculture, protection, management, hydrology, soils, nutrient cycling, and hardwood markets...

Determination of Slope Safety Factor with Analytical Solution and Searching Critical Slip Surface with Genetic-Traversal Random Method

PubMed Central

2014-01-01

In the current practice, to determine the safety factor of a slope with two-dimensional circular potential failure surface, one of the searching methods for the critical slip surface is Genetic Algorithm (GA), while the method to calculate the slope safety factor is Fellenius' slices method. However GA needs to be validated with more numeric tests, while Fellenius' slices method is just an approximate method like finite element method. This paper proposed a new method to determine the minimum slope safety factor which is the determination of slope safety factor with analytical solution and searching critical slip surface with Genetic-Traversal Random Method. The analytical solution is more accurate than Fellenius' slices method. The Genetic-Traversal Random Method uses random pick to utilize mutation. A computer automatic search program is developed for the Genetic-Traversal Random Method. After comparison with other methods like slope/w software, results indicate that the Genetic-Traversal Random Search Method can give very low safety factor which is about half of the other methods. However the obtained minimum safety factor with Genetic-Traversal Random Search Method is very close to the lower bound solutions of slope safety factor given by the Ansys software. PMID:24782679

Safety improvement from edge lines on rural two-lane highways : tech summary.

DOT National Transportation Integrated Search

2012-01-01

The previous study "Impact of Edge Lines on Safety of Rural Two-Lane Highways" completed in 2005 concluded that, : with edge lines, centralization of a vehicle's position is more apparent during nighttime, which reduces the risk of runoff : -road (RO...

Atmospheric Radiation Measurement Program facilities newsletter, July 2000.

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

Sisterson, D. L.; Holdridge, D. J., ed.

2000-08-03

For improved safety in and around the ARM SGP CART site, the ARM Program recently purchased and installed an aircraft detection radar system at the central facility near Lamont, Oklahoma. The new system will enhance safety measures already in place at the central facility. The SGP CART site, especially the central facility, houses several instruments employing laser technology. These instruments are designed to be eye-safe and are not a hazard to personnel at the site or pilots of low-flying aircraft over the site. However, some of the specialized equipment brought to the central facility by visiting scientists during scheduled intensivemore » observation periods (IOPs) might use higher-power laser beams that point skyward to make measurements of clouds or aerosols in the atmosphere. If these beams were to strike the eye of a person in an aircraft flying above the instrument, damage to the person's eyesight could result. During IOPs, CART site personnel have obtained Federal Aviation Administration (FAA) approval to temporarily close the airspace directly over the central facility and keep aircraft from flying into the path of the instrument's laser beam. Information about the blocked airspace is easily transmitted to commercial aircraft, but that does not guarantee that the airspace remains completely plane-free. For this reason, during IOPs in which non-eye-safe lasers were in use in the past, ARM technicians watched for low-flying aircraft in and around the airspace over the central facility. If the technicians spotted such an aircraft, they would manually trigger a safety shutter to block the laser beam's path skyward until the plane had cleared the area.« less

The Ultimate Factor of Safety for Aircraft and Spacecraft Its History, Applications and Misconceptions

NASA Technical Reports Server (NTRS)

Zipay, John J.; Modlin, C. Thomas, Jr.; Larsen, Curtis E.

2016-01-01

The ultimate factor of safety (FOSULT) concept used in aircraft and spacecraft has evolved over many decades. Currently an FOSULT 1.5 is the FAR-mandated value for aircraft while an FOSULT of 1.4 has been used in various spacecraft. This paper was motivated by the desire to concisely explain the origins, proper interpretation and application of the ultimate factor of safety concept, since the authors have seen throughout their careers many misconceptions and incorrect applications of this concept. The history of the ultimate factor of safety concept is briefly summarized, the proper application of the factor of safety in aircraft design, structural analysis and operations is covered in detail, examples of limit load exceedance in aircraft and spacecraft are discussed, the evolution of the 1.4 FOSULT for spacecraft is described and some misconceptions regarding the ultimate factor of safety concept are addressed. It is hoped that this paper can be a summary resource for engineers to understand the origin, purpose and proper application of the ultimate factor of safety.

Development and initial validation of an Aviation Safety Climate Scale.

PubMed

Evans, Bronwyn; Glendon, A Ian; Creed, Peter A

2007-01-01

A need was identified for a consistent set of safety climate factors to provide a basis for aviation industry benchmarking. Six broad safety climate themes were identified from the literature and consultations with industry safety experts. Items representing each of the themes were prepared and administered to 940 Australian commercial pilots. Data from half of the sample (N=468) were used in an exploratory factor analysis that produced a 3-factor model of Management commitment and communication, Safety training and equipment, and Maintenance. A confirmatory factor analysis on the remaining half of the sample showed the 3-factor model to be an adequate fit to the data. The results of this study have produced a scale of safety climate for aviation that is both reliable and valid. This study developed a tool to assess the level of perceived safety climate, specifically of pilots, but may also, with minor modifications, be used to assess other groups' perceptions of safety climate.

Safety assessment in the urban park environment in Alborz Province, Iran.

PubMed

Oostakhan, Morteza; Babaei, Aliakbar

2013-01-01

Urban parks, as one of the recreational and sports sectors, could cause serious injuries among different ages if the safety issues in their design are not considered. These injuries can result from the equipment in the park, including play and sports equipment, or even from environmental factors, too. Lack of safety benchmark in parks will impact on the development of future proposals. In this article, attempts are made to survey the important safety factors in the urban parks including playgrounds, fitness equipment, pedestrian surface and environmental factors into a risk assessment. Hence, a checklist of safety factors was used. A Yes or No descriptor was allocated to any factor for determining safety level. The study also suggests recommendations for future planning concerning existing failures for designers. It was found that the safety level of the regional and local parks differ from each other.

Sensitivity of magnetic field-line pitch angle measurements to sawtooth events in tokamaks

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

Ko, J., E-mail: jinseok@nfri.re.kr

2016-11-15

The sensitivity of the pitch angle profiles measured by the motional Stark effect (MSE) diagnostic to the evolution of the safety factor, q, profiles during the tokamak sawtooth events has been investigated for Korea Superconducting Tokamak Advanced Research (KSTAR). An analytic relation between the tokamak pitch angle, γ, and q estimates that Δγ ∼ 0.1° is required for detecting Δq ∼ 0.05 near the magnetic axis (not at the magnetic axis, though). The pitch angle becomes less sensitive to the same Δq for the middle and outer regions of the plasma (Δγ ∼ 0.5°). At the magnetic axis, it ismore » not straightforward to directly relate the γ sensitivity to Δq since the gradient of γ(R), where R is the major radius of the tokamak, is involved. Many of the MSE data obtained from the 2015 KSTAR campaign, when calibrated carefully, can meet these requirements with the time integration down to 10 ms. The analysis with the measured data shows that the pitch angle profiles and their gradients near the magnetic axis can resolve the change of the q profiles including the central safety factor, q{sub 0}, during the sawtooth events.« less

School and Community Factors Involved in Chilean Students' Perception of School Safety

ERIC Educational Resources Information Center

López, Verónica; Torres-Vallejos, Javier; Villalobos-Parada, Boris; Gilreath, Tamika D.; Ascorra, Paula; Bilbao, Marian; Morales, Macarena; Carrasco, Claudia

2017-01-01

Identifying and understanding predictors of school safety perceptions is important due to its consequences for students. However, it is not clear what school-related factors most contribute to explaining students' perception of school safety, and how they relate to community-related factors such as neighborhood safety. The purpose of this study…

2008 International Meeting on Simulation in Healthcare

DTIC Science & Technology

2008-05-01

procedural simulator to teach central venous catheterization (CVC). METHODS: Fourth year medical students (n 12) at the Medical College of Georgia...RESEARCH ABSTRACT 51 Use of A Variety of Simulation Modalities in a Graduate Medical Education Safety Initiative on Central Venous Catheterization Walter...events associated with central venous catheterization (CVC) procedures is well-established.1–2 The overall goal of this multidis- ciplinary project

Community gun safety in Central Pennsylvania.

PubMed

Wargo, Christina; Erdman, Deborah A; Smith, Jill Gray; Widom, Kenneth; Reardon, Judith

2013-01-01

Firearm-related injuries are a public health issue in the United States. In rural Pennsylvania, it is a familiar way of life to have a gun or guns in the home. Safety behaviors along with gun storage in the home, specifically where there are young children (aged 6 years and younger), are a concern for this level I regional resource center in rural Pennsylvania. Head Start families were surveyed regarding gun safety habits before and after safety educational activities. A noteworthy number of families reported changing behaviors regarding better safety habits for storing and use of firearms in the home postsurvey.

Use of a safety climate questionnaire in UK health care: factor structure, reliability and usability.

PubMed

Hutchinson, A; Cooper, K L; Dean, J E; McIntosh, A; Patterson, M; Stride, C B; Laurence, B E; Smith, C M

2006-10-01

To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care. Four acute hospital trusts and nine primary care trusts in England. The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then sent to 3650 staff within the 13 NHS trusts, seeking to achieve at least 600 responses as the basis for the factor analysis. 1307 questionnaires were returned (36% response). Factor analyses and reliability analyses were carried out on 897 responses from staff involved in direct patient care, to explore how consistently the questions measured the underlying constructs of safety climate and teamwork. Some questionnaire items related to multiple factors or did not relate strongly to any factor. Five items were discarded. Two teamwork factors were derived from the remaining 11 teamwork items and three safety climate factors were derived from the remaining 11 safety items. Internal consistency reliabilities were satisfactory to good (Cronbach's alpha > or =0.69 for all five factors). This is one of the few studies to undertake a detailed evaluation of a patient safety climate questionnaire in UK health care and possibly the first to do so in primary as well as secondary care. The results indicate that a 22 item version of this safety climate questionnaire is useable as a research instrument in both settings, but also demonstrates a more general need for thorough validation of safety climate questionnaires before widespread usage.

Profiling contextual factors which influence safety in heavy vehicle industries.

PubMed

Edwards, Jason R D; Davey, Jeremy; Armstrong, Kerry A

2014-12-01

A significant proportion of worker fatalities within Australia result from truck-related incidents. Truck drivers face a number of health and safety concerns. Safety culture, viewed here as the beliefs, attitudes and values shared by an organisation's workers, which interact with their surrounding context to influence behaviour, may provide a valuable lens for exploring safety-related behaviours in heavy vehicle operations. To date no major research has examined safety culture within heavy vehicle industries. As safety culture provides a means to interpret experiences and generate behaviour, safety culture research should be conducted with an awareness of the context surrounding safety. The current research sought to examine previous health and safety research regarding heavy vehicle operations to profile contextual factors which influence health and safety. A review of 104 peer-reviewed papers was conducted. Findings of these papers were then thematically analysed. A number of behaviours and scenarios linked with crashes and non-crash injuries were identified, along with a selection of health outcomes. Contextual factors which were found to influence these outcomes were explored. These factors were found to originate from government departments, transport organisations, customers and the road and work environment. The identified factors may provide points of interaction, whereby culture may influence health and safety outcomes. Copyright © 2014. Published by Elsevier Ltd.

The Core Values that Support Health, Safety, and Well-being at Work

PubMed Central

Zwetsloot, Gerard I.J.M.; Scheppingen, Arjella R. van; Bos, Evelien H.; Dijkman, Anja; Starren, Annick

2013-01-01

Background Health, safety, and well-being (HSW) at work represent important values in themselves. It seems, however, that other values can contribute to HSW. This is to some extent reflected in the scientific literature in the attention paid to values like trust or justice. However, an overview of what values are important for HSW was not available. Our central research question was: what organizational values are supportive of health, safety, and well-being at work? Methods The literature was explored via the snowball approach to identify values and value-laden factors that support HSW. Twenty-nine factors were identified as relevant, including synonyms. In the next step, these were clustered around seven core values. Finally, these core values were structured into three main clusters. Results The first value cluster is characterized by a positive attitude toward people and their “being”; it comprises the core values of interconnectedness, participation, and trust. The second value cluster is relevant for the organizational and individual “doing”, for actions planned or undertaken, and comprises justice and responsibility. The third value cluster is relevant for “becoming” and is characterized by the alignment of personal and organizational development; it comprises the values of growth and resilience. Conclusion The three clusters of core values identified can be regarded as “basic value assumptions” that underlie both organizational culture and prevention culture. The core values identified form a natural and perhaps necessary aspect of a prevention culture, complementary to the focus on rational and informed behavior when dealing with HSW risks. PMID:24422174

Conbercept for patients with age-related macular degeneration: a systematic review.

PubMed

Zhang, Jiaxing; Liang, Yi; Xie, Juan; Li, Dong; Hu, Qian; Li, Xiaosi; Zheng, Wenyi; He, Rui

2018-06-15

Conbercept is a novel vascular endothelial growth factor (VEGF) inhibitor for the treatment of wet age-related macular degeneration (AMD). This systematic review aims to assess the efficacy and safety of conbercept in the treatment of wet AMD. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP database, and Wanfang database were searched from their earliest records to June 2017. We included randomized controlled trials (RCTs) evaluating the efficacy and safety of conbercept in wet AMD patients. Outcomes included the mean changes from baseline in best-corrected visual acuity (BCVA) score (primary outcome), central retinal thickness (CRT), plasma level of vascular endothelial growth factor (VEGF) over time, and the incidence of adverse events (AEs). Eighteen RCTs (1285 participants) were included in this systematic review. Conbercept might improve BCVA compared to triamcinolone acetonide [MD = 0.11, 95% CI (0.08, 0.15)], and reduce CRT compared to the other four therapies (conservative treatment, ranibizumab, transpupillary thermotherapy, and triamcinolone acetonide). The incidence of AEs in patients receiving conbercept was significantly lower than those receiving triamcinolone acetonide [RR = 0.25, 95% CI (0.09-0.72)], but was similar to the other therapies. Conbercept seemed to be more effective than ranibizumab in lowering the plasma level of VEGF [MD = - 15.86, 95% CI (- 23.17, - 8.55)]. Current evidence shows that conbercept is a promising option for the treatment of wet AMD. Nevertheless, further studies are required to compare the efficacy, long-term safety and cost-effectiveness between conbercept and other anti-VEGF agents in different populations.

2009 Human Factors and Roadway Safety Workshop : Overviews of Safety Initiatives in Iowa [SD .WMV (720x480/29fps/80.2 MB)

DOT National Transportation Integrated Search

2009-11-05

Iowa Department of Transportation Research and Technology Bureau video presentation from the 2009 human factors and roadway safety workshop session titled: Overview of Safety Initiatives in Iowa : Tom Welch, Iowa DOT Highway Division Safety Engineer,...

Integrative Review of the Intersection of Green Space and Neighborhood Violence.

PubMed

Mancus, Gibran C; Campbell, Jacquelyn

2018-03-01

To systematically analyze evidence about the impact of green space on the perception and actual safety of residents of urban neighborhoods. Systematic review of green space and violence based on Broome review criteria. One landmark study prompted the initial hand search and identification of search terms. Twenty-three quantitative, five qualitative, and two mixed-methods studies were found in the urban planning, public health, medical, and psychological literature that met the following criteria: analyzed green space and violence as factors in the perception of safety as an outcome measure, including action taken by being outside for recreation, exercise, or self-report in the survey. Findings were inconsistent regarding the direct relationship between perception of safety and green space when using recreation and exercise as a proxy for perception of safety. Findings regarding perception of safety in surveys were limited but indicated a positive correlation with green space. There is sufficient evidence to conclude that the perception of safety is supported by quality, accessibility, and aesthetic dimensions of neighborhood green space, and the perception of safety is often unrelated to actual crime rates. The science for understanding mechanisms between green space and violence as part of environmental health has been insufficiently developed and requires further study. Environmental health, including green space, is central to health promotion, and understanding is key to preventing the epidemic of violence. This article provides a summary of research related to green space, violence in communities, perception of safety, and violent crime in those communities. It identifies gaps in our knowledge where future research is needed. Nurses have the opportunity to lead the development, implementation, and evaluation of evidence-based interventions and policies addressing the inequality of quality and quantity of green space in the built and natural environment and related co-benefits. © 2018 Sigma Theta Tau International.

Factors Influencing Implementation of OHSAS 18001 in Indian Construction Organizations: Interpretive Structural Modeling Approach

PubMed Central

Rajaprasad, Sunku Venkata Siva; Chalapathi, Pasupulati Venkata

2015-01-01

Background Construction activity has made considerable breakthroughs in the past two decades on the back of increases in development activities, government policies, and public demand. At the same time, occupational health and safety issues have become a major concern to construction organizations. The unsatisfactory safety performance of the construction industry has always been highlighted since the safety management system is neglected area and not implemented systematically in Indian construction organizations. Due to a lack of enforcement of the applicable legislation, most of the construction organizations are forced to opt for the implementation of Occupational Health Safety Assessment Series (OHSAS) 18001 to improve safety performance. Methods In order to better understand factors influencing the implementation of OHSAS 18001, an interpretive structural modeling approach has been applied and the factors have been classified using matrice d'impacts croises-multiplication appliqué a un classement (MICMAC) analysis. The study proposes the underlying theoretical framework to identify factors and to help management of Indian construction organizations to understand the interaction among factors influencing in implementation of OHSAS 18001. Results Safety culture, continual improvement, morale of employees, and safety training have been identified as dependent variables. Safety performance, sustainable construction, and conducive working environment have been identified as linkage variables. Management commitment and safety policy have been identified as the driver variables. Conclusion Management commitment has the maximum driving power and the most influential factor is safety policy, which states clearly the commitment of top management towards occupational safety and health. PMID:26929828

Effect of particle pinch on the fusion performance and profile features of an international thermonuclear experimental reactor-like fusion reactor

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

Wang, Shijia, E-mail: wangsg@mail.ustc.edu.cn; Wang, Shaojie

2015-04-15

The evolution of the plasma temperature and density in an international thermonuclear experimental reactor (ITER)-like fusion device has been studied by numerically solving the energy transport equation coupled with the particle transport equation. The effect of particle pinch, which depends on the magnetic curvature and the safety factor, has been taken into account. The plasma is primarily heated by the alpha particles which are produced by the deuterium-tritium fusion reactions. A semi-empirical method, which adopts the ITERH-98P(y,2) scaling law, has been used to evaluate the transport coefficients. The fusion performances (the fusion energy gain factor, Q) similar to the ITERmore » inductive scenario and non-inductive scenario (with reversed magnetic shear) are obtained. It is shown that the particle pinch has significant effects on the fusion performance and profiles of a fusion reactor. When the volume-averaged density is fixed, particle pinch can lower the pedestal density by ∼30%, with the Q value and the central pressure almost unchanged. When the particle source or the pedestal density is fixed, the particle pinch can significantly enhance the Q value by  60%, with the central pressure also significantly raised.« less

High-beta, steady-state hybrid scenario on DIII-D

DOE PAGES

Petty, C. C.; Kinsey, J. E.; Holcomb, C. T.; ...

2015-12-17

Here, the potential of the hybrid scenario (first developed as an advanced inductive scenario for high fluence) as a regime for high-beta, steady-state plasmas is demonstrated on the DIII-D tokamak. These experiments show that the beneficial characteristics of hybrids, namely safety factor ≥1 with low central magnetic shear, high stability limits and excellent confinement, are maintained when strong central current drive (electron cyclotron and neutral beam) is applied to increase the calculated non-inductive fraction to ≈100% (≈50% bootstrap current). The best discharges achieve normalized beta of 3.4, IPB98(y,2) confinement factor of 1.4, surface loop voltage of 0.01 V, and nearlymore » equal electron and ion temperatures at low collisionality. A zero-dimensional physics model shows that steady-state hybrid operation with Q fus ~ 5 is feasible in FDF and ITER. The advantage of the hybrid scenario as an Advanced Tokamak regime is that the external current drive can be deposited near the plasma axis where the efficiency is high; additionally, good alignment between the current drive and plasma current profiles is not necessary as the poloidal magnetic flux pumping self-organizes the current density profile in hybrids with an m/n=3/2 tearing mode.« less

Predictors of Hospital Nurses' Safety Practices: Work Environment, Workload, Job Satisfaction, and Error Reporting.

PubMed

Chiang, Hui-Ying; Hsiao, Ya-Chu; Lee, Huan-Fang

Nurses' safety practices of medication administration, prevention of falls and unplanned extubations, and handover are essentials to patient safety. This study explored the prediction between such safety practices and work environment factors, workload, job satisfaction, and error-reporting culture of 1429 Taiwanese nurses. Nurses' job satisfaction, error-reporting culture, and one environmental factor of nursing quality were found to be major predictors of safety practices. The other environment factors related to professional development and participation in hospital affairs and nurses' workload had limited predictive effects on the safety practices. Increasing nurses' attention to patient safety by improving these predictors is recommended.

A qualitative study identifying the cost categories associated with electronic health record implementation in the UK

PubMed Central

Slight, Sarah P; Quinn, Casey; Avery, Anthony J; Bates, David W; Sheikh, Aziz

2014-01-01

Objective We conducted a prospective evaluation of different forms of electronic health record (EHR) systems to better understand the costs incurred during implementation and the factors that can influence these costs. Methods We selected a range of diverse organizations across three different geographical areas in England that were at different stages of implementing three centrally procured applications, that is, iSOFT's Lorenzo Regional Care, Cerner's Millennium, and CSE's RiO. 41 semi-structured interviews were conducted with hospital staff, members of the implementation team, and those involved in the implementation at a national level. Results Four main overarching cost categories were identified: infrastructure (eg, hardware and software), personnel (eg, training team), estates/facilities (eg, space), and other (eg, training materials). Many factors were felt to impact on these costs, with different hospitals choosing varying amounts and types of infrastructure, diverse training approaches for staff, and different software applications to integrate with the new system. Conclusions Improving the quality and safety of patient care through EHR adoption is a priority area for UK and US governments and policy makers worldwide. With cost considered one of the most significant barriers, it is important for hospitals and governments to be clear from the outset of the major cost categories involved and the factors that may impact on these costs. Failure to adequately train staff or to follow key steps in implementation has preceded many of the failures in this domain, which can create new safety hazards. PMID:24523391

NCEP Central Operations

Science.gov Websites

Climate Climate Prediction Climate Archives Weather Safety Storm Ready NOAA Central Library Photo Library NCO's MISSION * Execute the NCEP operational model suite - Create climate, weather, ocean, space and ) NCO Organizational Chart NOAA's Weather and Climate Operational Supercomputing System is known as

75 FR 57437 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

... a Food Safety Education and Training Materials Database. The Database is a centralized gateway to... creating previously available education materials) (2) provide a central gateway to access the education materials (3) create a systematic and efficient method of collecting data from USDA grantees and (4) promote...

78 FR 69040 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-18

... a Food Safety Education and Training Materials Database. The Database is a centralized gateway to... creating previously available education materials), (2) provide a central gateway to access the education materials, (3) create a systematic and efficient method of collecting data from USDA grantees, and (4...

Validation of the group nuclear safety climate questionnaire.

PubMed

Navarro, M Felisa Latorre; Gracia Lerín, Francisco J; Tomás, Inés; Peiró Silla, José María

2013-09-01

Group safety climate is a leading indicator of safety performance in high reliability organizations. Zohar and Luria (2005) developed a Group Safety Climate scale (ZGSC) and found it to have a single factor. The ZGSC scale was used as a basis in this study with the researchers rewording almost half of the items on this scale, changing the referents from the leader to the group, and trying to validate a two-factor scale. The sample was composed of 566 employees in 50 groups from a Spanish nuclear power plant. Item analysis, reliability, correlations, aggregation indexes and CFA were performed. Results revealed that the construct was shared by each unit, and our reworded Group Safety Climate (GSC) scale showed a one-factor structure and correlated to organizational safety climate, formalized procedures, safety behavior, and time pressure. This validation of the one-factor structure of the Zohar and Luria (2005) scale could strengthen and spread this scale and measure group safety climate more effectively. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Navigating School Safety Law and Policy

ERIC Educational Resources Information Center

Vaillancourt, Kelly; Rossen, Eric

2012-01-01

Initiatives designed to improve school safety and conditions for learning have become central to education reform efforts at the local, state, and national levels. These efforts often target the reduction and prevention of bullying, discrimination, and harassment in schools. While most states currently have some form of law or policy designed to…

Safety review package for University of Central Florida flat-plate heat pipe experiment

NASA Technical Reports Server (NTRS)

Chow, Louis C.

1998-01-01

A flat-plate heat pipe (FPHP) experiment has been set up for micro-gravity tests on a NASA supplied aircraft. This report presents an analysis on various components of the experimental setup to certify that it will satisfy the flight safety and operation requirements.

Review of Post-Marketing Safety Data on Tapentadol, a Centrally Acting Analgesic.

PubMed

Stollenwerk, Ariane; Sohns, Melanie; Heisig, Fabian; Elling, Christian; von Zabern, Detlef

2018-01-01

Tapentadol is a centrally acting analgesic that has been available for the management of acute and chronic pain in routine clinical practice since 2009. This is the first integrated descriptive analysis of post-marketing safety data following the use of tapentadol in a broad range of pain conditions relating to the topics overall safety, dose administration above approved dosages, administration during pregnancy, serotonin syndrome, respiratory depression, and convulsion. The data analyzed pertain to spontaneous reports from healthcare and non-healthcare professionals and were put in the context of safety information known from interventional and non-interventional trials. The first years of routine clinical practice experience with tapentadol have confirmed the tolerability profile that emerged from the clinical trials. Moreover, the reporting of expected side effects such as respiratory depression and convulsion was low and no major risks were identified. The evaluation of available post-marketing data did not confirm the theoretical risk of serotonin syndrome nor did it reveal unexpected side effects with administration of higher than recommended doses. More than 8 years after its first introduction, the favorable overall safety profile of tapentadol in the treatment of various pain conditions is maintained in the general population. Grünenthal GmbH.

Safety considerations of anesthetic drugs in children.

PubMed

Brown, Raeford E

2017-04-01

Great strides have been made in the last twenty years in providing safe anesthesia care for infants and children. Despite a historical record of safety, recent findings have called to question the toxicities of many anesthetic agents. Observations concerning the inherent safety of these agents, their appropriate management in infants, and new findings which suggest overlooked toxicities will be discussed. Areas covered: A literature search using Pub Med identified journal articles relating to the safety of anesthetic agents in infants and children. From this group, representative classical articles, as well as more recent offerings, were chosen that were germane to the topic of anesthetic drug safety in children. Expert opinion: Anesthetic agents used in children in the US are generally safe in the short term and are administered to thousands of children daily without demonstrable harm. The question of a deleterious effect of anesthetics on the developing central nervous system when used for long periods and on multiple occasions continues to be open to debate. Conservative elective management of these agents in infants and young children is reasonable until such time as more is known about the toxicities on the central nervous system.

[Weighing use and safety of therapeutic agents and feed additives (author's transl)].

PubMed

van der Wal, P

1982-02-01

(1) The pros and cons of using feed additives and therapeutic agents may be successfully weighed in the light of carefully considered consumer requirements. (2) The socio-economic interests of the producer and the welfare of the animal will also determine the response of the production apparatus to consumer requirements. (3) Consumption of the current amounts of products of animal origin and maintenance of price and quality will only be feasible in the event of rational large-scale production in which constituents used in nutrition, prophylaxis and therapeutics are highly important factors. (4) Using these ingredients should be preceded by accurate evaluation of their use and safety. Testing facilities, conduct of studies and reporting should be such as to make the results nationally and internationally acceptable to all those concerned. (5) In deciding whether feed constituents are acceptable in view of the established use and safety, compliance will have to be sought with those standards which are accepted in other fields of society. Measures which result in raising the price of food without actually helping to reduce the risks to the safety of man, animals and environment, are likely to be rejected by any well-informed consumer who is aware of the facts. (6) For accurate weighing of use and safety at a national level, possibilities are hardly adequate in Europe. Decisions reached within the framework of the European Community, also tuned to U.S.A.- conditions are rightly encouraged. A centrally managed professionally staffed and equipped test system in the European Community would appear to be indispensable.

Sustained high βN plasmas on EAST tokamak

NASA Astrophysics Data System (ADS)

Gao, Xiang; the EAST team

2018-05-01

Sustained high normalized beta (βN ∼ 1.9) plasmas with an ITER-like tungsten divertor have been achieved on EAST tokamak recently. The high power NBI heating system of 4.8 MW and the 4.6 GHz lower hybrid wave of 1 MW were developed and applied to produce edge and internal transport barriers in high βN discharges. The central flat q profile with q (ρ) ∼ 1 at ρ < 0.3 region and edge safety factor q95 = 4.7 is identified by the multi-channel far-infrared laser polarimeter and the EFIT code. The fraction of non-inductive current is about 40%. The relation between fishbone activity and ITB formation is observed and discussed.

Observation of instability-induced current redistribution in a spherical-torus plasma.

PubMed

Menard, J E; Bell, R E; Gates, D A; Kaye, S M; LeBlanc, B P; Levinton, F M; Medley, S S; Sabbagh, S A; Stutman, D; Tritz, K; Yuh, H

2006-09-01

A motional Stark effect diagnostic has been utilized to reconstruct the parallel current density profile in a spherical-torus plasma for the first time. The measured current profile compares favorably with neoclassical theory when no large-scale magnetohydrodynamic instabilities are present in the plasma. However, a current profile anomaly is observed during saturated interchange-type instability activity. This apparent anomaly can be explained by redistribution of neutral beam injection current drive and represents the first observation of interchange-type instabilities causing such redistribution. The associated current profile modifications contribute to sustaining the central safety factor above unity for over five resistive diffusion times, and similar processes may contribute to improved operational scenarios proposed for ITER.

DETERMINING THE PHARMACOKINETICS AND LONG-TERM BIODISTRIBUTION OF SiO2 NANOPARTICLES IN VIVO USING ACCELERATOR MASS SPECTROMETRY

PubMed Central

Malfatti, Michael A.; Palko, Heather A.; Kuhn, Edward A.; Turteltaub, Kenneth W.

2012-01-01

Biodistribution is an important factor in better understanding silica dioxide nanoparticle (SiNP) safety. Currently, comprehensive studies on biodistribution are lacking, most likely due to the lack of suitable analytical methods. Accelerator mass spectrometry (AMS) was used to investigate the relationship between administered dose, PK, and long-term biodistribution of 14C-SiNPs in vivo. PK analysis showed that SiNPs were rapidly cleared from the central compartment, were distributed to tissues of the reticuloendothelial system, and persisted in the tissue over the 8-week time course, raising questions about the potential for bioaccumulation and associated long-term effects. PMID:23075393

Calibration of highway safety manual work zone crash modification factors.

DOT National Transportation Integrated Search

2014-06-01

The Highway Safety Manual is the national safety manual that provides quantitative methods for analyzing highway safety. The : HSM presents crash modification factors related to work zone characteristics such as work zone duration and length. These c...

[Investigation of work-related acute pesticide poisoning among farmers in Jiangsu Province and the risk factors].

PubMed

Cui, Meng-jing; Tu, Zhi-bin; Gu, Yue; Zhang, Xu-jun

2013-01-01

To determine the incidence of work-related acute pesticide poisoning among farmers in Jiangsu Province and to identify the risk factors. Multi-stage stratified sampling and cluster sampling methods were used to randomly select 1490 farmers from the south (Z village), centre (Y village) and north (X village) of Jiangsu Province. The database was established by EpiData 3.1. SPSS 17.0 and SAS 9.13 were used to do chi-square test, trend chi-square test, single factor and multi-factor logistic regression analysis. Among 1490 farmers, 121 people had work-related acute pesticide poisoning in the past year. The incidence rate in Jiangsu Province was 8.1%. 118 farmers (97.5%) were mild pesticide poisoning.3 farmers (2.5%) were moderate pesticide poisoning. The incidence rate of Work-related acute pesticide poisoning in X village of North Jiangsu Province (13.5%, 68/505) is obviously higher than that in Y village of Central Jiangsu Province (4.8%, 19/399) and Z village of South Jiangsu Province (5.8%, 34/586), and the difference is statistically significant (χ(2) = 29.60, P < 0.01). The incidence rate of Work-related acute pesticide poisoning in female (10.4%, 58/557) is obviously higher than that in male (6.8%, 63/933), and the difference is statistically significant (χ(2) = 6.26, P < 0.05). There are lack of safety guidance, unsafety application methods (without alternate row spraying, without backward application, without down-wind application) and risk behaviors in the spraying (without read labels, preparing pesticides without gloves, wiping sweat with hand (s), equipment leakage, body pollution by pesticide, working when feeling sick, without bath after work). If farmers have risk behaviors above, the incidence rate of Work-related acute pesticide poisoning will be obviously higher than farmers who receive safety guidance and have no such dangerous behaviors, and all the differences are statistically significant (P < 0.05). The group of 24 ∼ 34 years old has the highest risk of work-related acute pesticide poisoning (OR = 7.15). The incidence rate of work-related acute pesticide poisoning among farmers in Jiangsu Province was higher. Effective measures are needed to prevent and reduce the occurrence of work-related acute pesticide poisoning. We can teach the farmers who spray pesticides about safety guidance, safety application methods and avoiding risky behaviors.

Relationship between organizational justice and organizational safety climate: do fairness perceptions influence employee safety behaviour?

PubMed

Gyekye, Seth Ayim; Haybatollahi, Mohammad

2014-01-01

This study investigated the relationships between organizational justice, organizational safety climate, job satisfaction, safety compliance and accident frequency. Ghanaian industrial workers participated in the study (N = 320). Safety climate and justice perceptions were assessed with Hayes, Parender, Smecko, et al.'s (1998) and Blader and Tyler's (2003) scales respectively. A median split was performed to dichotomize participants into 2 categories: workers with positive and workers with negative justice perceptions. Confirmatory factors analysis confirmed the 5-factor structure of the safety scale. Regression analyses and t tests indicated that workers with positive fairness perceptions had constructive perspectives regarding workplace safety, expressed greater job satisfaction, were more compliant with safety policies and registered lower accident rates. These findings provide evidence that the perceived level of fairness in an organization is closely associated with workplace safety perception and other organizational factors which are important for safety. The implications for safety research are discussed.

Aviation occupant survival factors: an empirical study of the SQ006 accident.

PubMed

Chang, Yu-Hern; Yang, Hui-Hua

2010-03-01

We present an empirical study of Singapore Airline (SIA) flight SQ006 to illustrate the critical factors that influence airplane occupant survivability. The Fuzzy Delphi Method was used to identify and rank the survival factors that may reduce injury and fatality in potentially survivable accidents. This is the first attempt by a group from both the public and private sectors in Taiwan to focus on cabin-safety issues related to survival factors. We designed a comprehensive survey based on our discussions with aviation safety experts. We next designed an array of important cabin-safety dimensions and then investigated and selected the critical survival factors for each dimension. Our findings reveal important cabin safety and survivability information that should provide a valuable reference for developing and evaluating aviation safety programs. We also believe that the results will be practical for designing cabin-safety education material for air travelers. Finally, the major contribution of this research is that it has identified 47 critical factors that influence accident survivability; therefore, it may encourage improvements that will promote more successful cabin-safety management. Copyright 2009 Elsevier Ltd. All rights reserved.

Investigating ethnic minorities' perceptions of safety climate in the construction industry.

PubMed

Chan, Albert P C; Wong, Francis K W; Hon, Carol K H; Lyu, Sainan; Javed, Arshad Ali

2017-12-01

An increasing number of ethnic minorities (EMs) have been employed in the construction industry to alleviate severe labor shortages in many countries. Unfortunately, statistics show that EMs have higher fatal and non-fatal occupational injury rates than their local counterparts. However, EMs are often underrepresented in safety climate (SC) research as they are difficult to reach and gauge their perception. A positive relationship has been widely found between SC and safety performance. Understanding the safety perceptions of EMs helps to reduce injuries and improve their safety performance. Based on a sample of 320 EMs from 20 companies in the construction industry, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to identify the SC factors of EMs, and validate the extracted factors, respectively. Multivariate analysis of variance was undertaken to examine mean differences in perceptions of SC by personal characteristics. Three SC factors for EMs encapsulating 16 variables were identified through EFA. The hypothesized CFA model for a three-factor structure derived from EFA showed a satisfactory goodness-of-fit, composite reliability, and construct validity. Three SC factors were identified, namely: (a) safety management commitment, safety resources, and safety communication; (b) employee's involvement and workmate's influence; and (c) perception of safety rules, procedures and risks. The perceptions of SC differed significantly by nationality, marital status, the number of family members supported, and drinking habit. This study reveals the perception of EMs toward SC. The findings highlight the areas for safety improvement and provide leading indicators for safety performance of EMs. The findings are also enlightening for countries with a number of EMs, such as the United Sates, the United Kingdom, Australia, Singapore, and the Middle East. Copyright © 2017. Published by Elsevier Ltd.

16 CFR 1105.2 - Factors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Factors. 1105.2 Section 1105.2 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS CONTRIBUTIONS TO COSTS OF PARTICIPANTS IN DEVELOPMENT OF CONSUMER PRODUCT SAFETY STANDARDS § 1105.2 Factors. The Commission...

Evaluating the impact of grade crossing safety factors through signal detection theory

DOT National Transportation Integrated Search

2012-10-22

The purpose of this effort was to apply signal detection theory to descriptively model the impact : of five grade crossing safety factors to understand their effect on driver decision making. The : safety factors consisted of: improving commercial mo...

Patient safety in surgical environments: cross-countries comparison of psychometric properties and results of the Norwegian version of the Hospital Survey on Patient Safety.

PubMed

Haugen, Arvid S; Søfteland, Eirik; Eide, Geir E; Nortvedt, Monica W; Aase, Karina; Harthug, Stig

2010-09-22

How hospital health care personnel perceive safety climate has been assessed in several countries by using the Hospital Survey on Patient Safety (HSOPS). Few studies have examined safety climate factors in surgical departments per se. This study examined the psychometric properties of a Norwegian translation of the HSOPS and also compared safety climate factors from a surgical setting to hospitals in the United States, the Netherlands and Norway. This survey included 575 surgical personnel in Haukeland University Hospital in Bergen, an 1100-bed tertiary hospital in western Norway: surgeons, operating theatre nurses, anaesthesiologists, nurse anaesthetists and ancillary personnel. Of these, 358 returned the HSOPS, resulting in a 62% response rate. We used factor analysis to examine the applicability of the HSOPS factor structure in operating theatre settings. We also performed psychometric analysis for internal consistency and construct validity. In addition, we compared the percent of average positive responds of the patient safety climate factors with results of the US HSOPS 2010 comparative data base report. The professions differed in their perception of patient safety climate, with anaesthesia personnel having the highest mean scores. Factor analysis using the original 12-factor model of the HSOPS resulted in low reliability scores (r = 0.6) for two factors: "adequate staffing" and "organizational learning and continuous improvement". For the remaining factors, reliability was ≥ 0.7. Reliability scores improved to r = 0.8 by combining the factors "organizational learning and continuous improvement" and "feedback and communication about error" into one six-item factor, supporting an 11-factor model. The inter-item correlations were found satisfactory. The psychometric properties of the questionnaire need further investigations to be regarded as reliable in surgical environments. The operating theatre personnel perceived their hospital's patient safety climate far more negatively than the health care personnel in hospitals in the United States and with perceptions more comparable to those of health care personnel in hospitals in the Netherlands. In fact, the surgical personnel in our hospital may perceive that patient safety climate is less focused in our hospital, at least compared with the results from hospitals in the United States.

[Patient safety culture based on a non-punitive response to error and freedom of expression of healthcare professionals].

PubMed

Mahjoub, Mohamed; Bouafia, Nabiha; Cheikh, Asma Ben; Ezzi, Olfa; Njah, Mansour

2016-11-25

This study provided an overview of healthcare professionals’ perception of patient safety based on analysis of the concept of freedom of expression and non-punitive response in order to identify and correct errors in our health system. This concept is a cornerstone of the patient safety culture among healthcare professionals and plays a central role in the quality improvement strategy..

Factors influencing patient safety in Sweden: perceptions of patient safety officers in the county councils

PubMed Central

2013-01-01

Background National, regional and local activities to improve patient safety in Sweden have increased over the last decade. There are high ambitions for improved patient safety in Sweden. This study surveyed health care professionals who held key positions in their county council’s patient safety work to investigate their perceptions of the conditions for this work, factors they believe have been most important in reaching the current level of patient safety and factors they believe would be most important for achieving improved patient safety in the future. Methods The study population consisted of 218 health care professionals holding strategic positions in patient safety work in Swedish county councils. Using a questionnaire, the following topics were analysed in this study: profession/occupation; number of years involved in a designated task on patient safety issues; knowledge/overview of the county council’s patient safety work; ability to influence this work; conditions for this work; and the importance of various factors for current and future levels of patient safety. Results The response rate to the questionnaire was 79%. The conditions that had the highest number of responses in complete agreement were “patients’ involvement is important for patient safety” and “patient safety work has good support from the county council’s management”. Factors that were considered most important for achieving the current level of patient safety were root cause and risk analyses, incident reporting and the Swedish Patient Safety Law. An organizational culture that encourages reporting and avoids blame was considered most important for improved patient safety in the future, closely followed by improved communication between health care practitioners and patients. Conclusion Health care professionals with important positions in the Swedish county councils’ patient safety work believe that conditions for this work are somewhat constrained. They attribute the current levels of patient safety to a broad range of factors and believe that many different solutions can contribute to enhanced patient safety in the future, suggesting that this work must be multifactorial. PMID:23391301

75 FR 81440 - Establishment of Class E Airspace; Central City, NE

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... this action to enhance the safety and management of Instrument Flight Rule (IFR) operations at the... airspace at Central City, NE, to accommodate new Area Navigation (RNAV) Standard Instrument Approach... this incorporation by reference action under 1 CFR part 51, subject to the annual revision of FAA Order...

Central Libraries in Uncertain Times.

ERIC Educational Resources Information Center

Kenney, Brian J.

2001-01-01

Discusses security and safety issues for public libraries, especially high-profile central facilities, in light of the September 11 terrorist attacks. Highlights include inspecting bags as patrons enter as well as exit; the need for security guidelines for any type of disaster or emergency; building design; and the importance of communication.…

An economic analysis of adherence engineering to improve use of best practices during central line maintenance procedures.

PubMed

Nelson, Richard E; Angelovic, Aaron W; Nelson, Scott D; Gleed, Jeremy R; Drews, Frank A

2015-05-01

Adherence engineering applies human factors principles to examine non-adherence within a specific task and to guide the development of materials or equipment to increase protocol adherence and reduce human error. Central line maintenance (CLM) for intensive care unit (ICU) patients is a task through which error or non-adherence to protocols can cause central line-associated bloodstream infections (CLABSIs). We conducted an economic analysis of an adherence engineering CLM kit designed to improve the CLM task and reduce the risk of CLABSI. We constructed a Markov model to compare the cost-effectiveness of the CLM kit, which contains each of the 27 items necessary for performing the CLM procedure, compared with the standard care procedure for CLM, in which each item for dressing maintenance is gathered separately. We estimated the model using the cost of CLABSI overall ($45,685) as well as the excess LOS (6.9 excess ICU days, 3.5 excess general ward days). Assuming the CLM kit reduces the risk of CLABSI by 100% and 50%, this strategy was less costly (cost savings between $306 and $860) and more effective (between 0.05 and 0.13 more quality-adjusted life-years) compared with not using the pre-packaged kit. We identified threshold values for the effectiveness of the kit in reducing CLABSI for which the kit strategy was no longer less costly. An adherence engineering-based intervention to streamline the CLM process can improve patient outcomes and lower costs. Patient safety can be improved by adopting new approaches that are based on human factors principles.

Beyond Control Centers

NASA Technical Reports Server (NTRS)

Trimble, Jay

2017-01-01

For NASA's Resource Prospector (RP) Lunar Rover Mission, we are moving away from a control center concept, to a fully distributed operation utilizing control nodes, with decision support from anywhere via mobile devices. This operations concept will utilize distributed information systems, notifications, mobile data access, and optimized mobile data display for off-console decision support. We see this concept of operations as a step in the evolution of mission operations from a central control center concept to a mission operations anywhere concept. The RP example is part of a trend, in which mission expertise for design, development and operations is distributed across countries and across the globe. Future spacecraft operations will be most cost efficient and flexible by following this distributed expertise, enabling operations from anywhere. For the RP mission we arrived at the decision to utilize a fully distributed operations team, where everyone operates from their home institution, based on evaluating the following factors: the requirement for physical proximity for near-real time command and control decisions; the cost of distributed control nodes vs. a centralized control center; the impact on training and mission preparation of flying the team to a central location. Physical proximity for operational decisions is seldom required, though certain categories of decisions, such as launch abort, or close coordination for mission or safety-critical near-real-time command and control decisions may benefit from co-location. The cost of facilities and operational infrastructure has not been found to be a driving factor for location in our studies. Mission training and preparation benefit from having all operators train and operate from home institutions.

2009 Human Factors and Roadway Safety Workshop : Opening Session [SD .WMV (720x480/29fps/546.0 MB)

DOT National Transportation Integrated Search

2009-11-05

Iowa Department of Transportation Research and Technology Bureau video presentation from the 2009 human factors and roadway safety workshop session titled: 2009 Human Factors and Roadway Safety Workshop Opening Session : Sandra Larson, director, Iowa...

14 CFR 27.303 - Factor of safety.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Factor of safety. 27.303 Section 27.303 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Strength Requirements General § 27.303 Factor of safety. Unless...

Reducing Central Line-Associated Bloodstream Infection Rates in the Context of a Caring-Healing Environment: A Patient Safety Program Evaluation.

PubMed

Hanson, Daphne

Central line-associated bloodstream infections (CLABSIs) prove to be detrimental to both the patient and the hospital. The present study was a quality improvement training project to affect CLABSI rates in the cardiac intensive care unit in the context of a caring-healing environment, and contributed to a culture of patient safety to empower staff to speak up if they see a breach in protocol at any time. A caring-healing environment encouraged staff to take the extra time and precautions to prevent infections for their patients and created a better quality of care for the patients.

[Organizational wellbeing and psychosocial risk factors in a sample of Italian Public Administration work environments].

PubMed

Fida, Roberta; Gualandri, M; Avallone, F

2011-01-01

It has been recognized both by the scientific community and within the framework of social policies in Europe that the physical and psychosocial working environments pose potential risks for workers and organizational wellbeing. In particular psychosocial risks concern aspects of the design and management of work and its social and organizational contexts which have the potential for causing psychological or physical problems. This article examines the psychosocial risk factors of several types of Italian Public Administration offices (municipal, provincial, regional, central government, university, police headquarters, chamber of commerce, etc.) with the aim of obtaining a picture of the most problematic risk factors for each type. The participants of this survey consisted of about 23,500 employees of different types of Public Administration offices. The Multidimensional Organizational Health Questionnaire (MOHQ, 3) was used to collect the data. Results from ANOVA indicated that perceptions of fairness and job demands were the most problematic risk factors. Perception of safety at work was another problematic risk factor in specific types of work. The results revealed a high perception of stress in all workers over the entire range of the public administration offices studied.

What influences youth to operate all-terrain vehicles safely?

PubMed Central

Grummon, A. H.; Heaney, C. A.; Dellinger, W. A.; Wilkins, J. R.

2014-01-01

The operation of all-terrain vehicles (ATVs) by youth has contributed to the incidence of serious and fatal injuries among children. This study explored factors related to the frequency with which youth wore a helmet and refrained from engaging in three risky driving behaviors (driving at risky speeds, on paved roads and on unfamiliar terrain) while operating an ATV. Youth (n = 248) aged 9–14 from central Ohio and one of their parents completed self-report measures of ATV safety behaviors, youth general propensity for risk taking, protection motivation and parental behaviors to facilitate youth safety. Data from two focus groups provided insight on quantitative results. Analyses revealed considerable variation in the frequency with which youth performed the safety behaviors, with 13- and 14-year-olds reporting less frequent safe behavior than 9- to 12-year-olds. Multiple regression analyses suggested that parental behaviors, such as providing reminders to wear a helmet, were associated with more frequent helmet use but were not associated with risky driving behaviors. Youth’s general propensity toward risk taking was not associated with helmet use and only associated with riskydriving behaviors among the 13- and 14-year-olds. Self-efficacy was an important predictor across both age groups and behaviors. Implications for injury prevention are discussed. PMID:24740837

Prevalence of injections and knowledge of safe injections among rural residents in Central China.

PubMed

Yan, Y W; Yan, J; Zhang, G P; Gao, Z L; Jian, H X

2007-08-01

Abuse of the injection services, namely unnecessary injections and unsafe injections, exists extensively in developing countries. Unsafe injection practices contribute to the transmission of blood-borne pathogens. The aims of this study were to survey the prevalence of injections and knowledge of injection safety among the rural residents in Jingzhou district, Hubei, China and to provide scientific data for developing a health educational programme. A retrospective cross-sectional study was conducted in 12 villages, which were selected from the Jingzhou district by the random sampling method. 50 rural residents were interviewed per village using a questionnaire. Among the 595 residents studied, 192 had received at least one injection in the past three months, with an injection prevalence of 32.3 percent and an average of 0.93 injections. 90.3 percent of the rural residents knew that unsafe injections could transmit the following blood-borne pathogens: human immunodeficiency virus (74.4 percent), hepatitis B virus (55.8 percent) and hepatitis C virus (22.9 percent). Logistic regression analysis showed that the residents' age, educational level and residential area were important factors in influencing their knowledge about injection safety. The results indicated that the injection prevalence was high among rural residents in the study area, and their knowledge regarding injection safety should be further improved.

The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations.

PubMed

Pardo, Gabriel; Jones, David E

2017-12-01

The treatment landscape for relapsing forms of multiple sclerosis (RMS) has expanded considerably over the last 10 years with the approval of multiple new disease-modifying therapies (DMTs), and others in late-stage clinical development. All DMTs for RMS are believed to reduce central nervous system immune-mediated inflammatory processes, which translate into demonstrable improvement in clinical and radiologic outcomes. However, some DMTs are associated with long-lasting effects on the immune system and/or serious adverse events, both of which may complicate the use of subsequent therapies. When customizing a treatment program, a benefit-risk assessment must consider multiple factors, including the efficacy of the DMT to reduce disease activity, the short- and long-term safety and immunologic profiles of each DMT, the criteria used to define switching treatment, and the risk tolerance of each patient. A comprehensive benefit-risk assessment can only be achieved by evaluating the immunologic, safety, and efficacy data for DMTs in the controlled clinical trial environment and the postmarketing clinical practice setting. This review is intended to help neurologists make informed decisions when treating RMS by summarizing the known data for each DMT and raising awareness of the multiple considerations involved in treating people with RMS throughout the entire course of their disease.

Simulation tools for developing policies for complex systems: modeling the health and safety of refugee communities.

PubMed

Anderson, James; Chaturvedi, Alok; Cibulskis, Mike

2007-12-01

The U.S. Committee for Refugees and Immigrants estimated that there were over 33 million refugees and internally displaced persons (IDPs) in the world at the beginning of 2005. IDP/Refugee communities behave in complex ways making it difficult to make policy decisions regarding the provision of humanitarian aid and health and safety. This paper reports the construction of an agent-based model that has been used to study humanitarian assistance policies executed by governments and NGOs that provide for the health and safety of refugee communities. Agent-based modeling (ABM) was chosen because the more widely used alternatives impose unrealistic restrictions and assumptions on the system being modeled and primarily apply to aggregate data. We created intelligent agents representing institutions, organizations, individuals, infrastructure, and governments and analyzed the resulting interactions and emergent behavior using a Central Composite Design of Experiments with five factors. The resulting model allows policy makers and analysts to create scenarios, to make rapid changes in parameters, and provides a test bed for concepts and strategies. Policies can be examined to see how refugee communities might respond to alternative courses of action and how these actions are likely to affect the health and well-being of the community.

Safety climate and attitude as evaluation measures of organizational safety.

PubMed

Isla Díaz, R; Díaz Cabrera, D

1997-09-01

The main aim of this research is to develop a set of evaluation measures for safety attitudes and safety climate. Specifically it is intended: (a) to test the instruments; (b) to identify the essential dimensions of the safety climate in the airport ground handling companies; (c) to assess the quality of the differences in the safety climate for each company and its relation to the accident rate; (d) to analyse the relationship between attitudes and safety climate; and (e) to evaluate the influences of situational and personal factors on both safety climate and attitude. The study sample consisted of 166 subjects from three airport companies. Specifically, this research was centered on ground handling departments. The factor analysis of the safety climate instrument resulted in six factors which explained 69.8% of the total variance. We found significant differences in safety attitudes and climate in relation to type of enterprise.

Critical factors and paths influencing construction workers' safety risk tolerances.

PubMed

Wang, Jiayuan; Zou, Patrick X W; Li, Penny P

2016-08-01

While workers' safety risk tolerances have been regarded as a main reason for their unsafe behaviors, little is known about why different people have different risk tolerances even when confronting the same situation. The aim of this research is to identify the critical factors and paths that influence workers' safety risk tolerance and to explore how they contribute to accident causal model from a system thinking perceptive. A number of methods were carried out to analyze the data collected through interviews and questionnaire surveys. In the first and second steps of the research, factor identification, factor ranking and factor analysis were carried out, and the results show that workers' safety risk tolerance can be influenced by four groups of factors, namely: (1) personal subjective perception; (2) work knowledge and experiences; (3) work characteristics; and (4) safety management. In the third step of the research, hypothetical influencing path model was developed and tested by using structural equation modeling (SEM). It is found that the effects of external factors (safety management and work characteristics) on risk tolerance are larger than that of internal factors (personal subjective perception and work knowledge & experiences). Specifically, safety management contributes the most to workers' safety risk tolerance through its direct effect and indirect effect; while personal subjective perception comes the second and can act as an intermedia for work characteristics. This research provides an in-depth insight of workers' unsafe behaviors by depicting the contributing factors as shown in the accident causal model developed in this research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Defining Desirable Central Nervous System Drug Space through the Alignment of Molecular Properties, in Vitro ADME, and Safety Attributes

PubMed Central

2010-01-01

As part of our effort to increase survival of drug candidates and to move our medicinal chemistry design to higher probability space for success in the Neuroscience therapeutic area, we embarked on a detailed study of the property space for a collection of central nervous system (CNS) molecules. We carried out a thorough analysis of properties for 119 marketed CNS drugs and a set of 108 Pfizer CNS candidates. In particular, we focused on understanding the relationships between physicochemical properties, in vitro ADME (absorption, distribution, metabolism, and elimination) attributes, primary pharmacology binding efficiencies, and in vitro safety data for these two sets of compounds. This scholarship provides guidance for the design of CNS molecules in a property space with increased probability of success and may lead to the identification of druglike candidates with favorable safety profiles that can successfully test hypotheses in the clinic. PMID:22778836

Compliance of middle school-aged babysitters in central Pennsylvania with national recommendations for emergency preparedness and safety practices.

PubMed

Hackman, Nicole M; Cass, Katie; Olympia, Robert P

2012-06-01

To determine the compliance of middle school-aged babysitters with national recommendations for emergency preparedness and safety practices. A prospective, self-administered questionnaire-based study was conducted at 3 middle schools in central Pennsylvania. A total of 1364 questionnaires were available for analysis. Responding babysitters (n = 890) reported previous training that included babysitter (21%), first aid (64%), and cardiopulmonary resuscitation (59%) training. Reported unsafe babysitter practices were leaving a child unattended (36%) and opening the door to a stranger (24%). The most common emergency experience encountered by responding babysitters included cut or scrape (83%), burns (28%), and choking (14%). Ten percent of responding babysitters have activated the 911 system. Middle school-aged babysitters will likely encounter common household emergencies and therefore benefit from first aid training; however, very little difference in safety knowledge was found between trained and untrained babysitters, suggesting modifications in babysitter training programs may be required.

Teaching patient safety and human factors in undergraduate nursing curricula in England: a pilot survey.

PubMed

Robson, Wayne; Clark, Debbie; Pinnock, David; White, Nick; Baxendale, Bryn

Patient safety is a key priority for all healthcare systems, and there is growing recognition for the need to educate tomorrow's nurses about the role of human factors in reducing avoidable harm to patients. A pilot survey was sent to 20 schools of nursing in England to explore the teaching of patient safety and human factors. All 13 schools that responded (65% response rate) stated that patient safety was covered in their curricula and was allocated more than 4 hours; all the classes included human factors. Only two respondents indicated their teaching to be multi-professional. Awareness of the World Health Organization's multiprofessional patient safety curriculum guide was poor. Faculties also seemed unaware that the Institute for Healthcare Improvement provides free online patient safety modules for students and that there is a global network of student patient safety chapters.

Quasi-Static Probabilistic Structural Analyses Process and Criteria

NASA Technical Reports Server (NTRS)

Goldberg, B.; Verderaime, V.

1999-01-01

Current deterministic structural methods are easily applied to substructures and components, and analysts have built great design insights and confidence in them over the years. However, deterministic methods cannot support systems risk analyses, and it was recently reported that deterministic treatment of statistical data is inconsistent with error propagation laws that can result in unevenly conservative structural predictions. Assuming non-nal distributions and using statistical data formats throughout prevailing stress deterministic processes lead to a safety factor in statistical format, which integrated into the safety index, provides a safety factor and first order reliability relationship. The embedded safety factor in the safety index expression allows a historically based risk to be determined and verified over a variety of quasi-static metallic substructures consistent with the traditional safety factor methods and NASA Std. 5001 criteria.

Chapter 2: The Need for Physical Protection, Safety, and Regulation

ERIC Educational Resources Information Center

Brazelton, T. Berry; Greenspan, Stanley I.

2007-01-01

This article discusses the need for physical protection and care of infants and young children and families. One of the most important preventable challenges to children's physical safety and protection is toxic substances in their environment. Many toxic substances that affect the central nervous system are in drinking water, soil, air, and areas…

Safety improvement from edge lines on rural two-lane highways (with three-years before and one-year after crash data analysis).

DOT National Transportation Integrated Search

2012-04-01

The previous study Impact of Edge Lines on Safety of Rural Two-Lane Highways completed in 2005 concluded: with edge lines, centralization of vehicles positions is more apparent during night time, which reduces the risk of run-off road (ROR) and he...

Development of a software safety process and a case study of its use

NASA Technical Reports Server (NTRS)

Knight, John C.

1993-01-01

The goal of this research is to continue the development of a comprehensive approach to software safety and to evaluate the approach with a case study. The case study is a major part of the project, and it involves the analysis of a specific safety-critical system from the medical equipment domain. The particular application being used was selected because of the availability of a suitable candidate system. We consider the results to be generally applicable and in no way particularly limited by the domain. The research is concentrating on issues raised by the specification and verification phases of the software lifecycle since they are central to our previously-developed rigorous definitions of software safety. The theoretical research is based on our framework of definitions for software safety. In the area of specification, the main topics being investigated are the development of techniques for building system fault trees that correctly incorporate software issues and the development of rigorous techniques for the preparation of software safety specifications. The research results are documented. Another area of theoretical investigation is the development of verification methods tailored to the characteristics of safety requirements. Verification of the correct implementation of the safety specification is central to the goal of establishing safe software. The empirical component of this research is focusing on a case study in order to provide detailed characterizations of the issues as they appear in practice, and to provide a testbed for the evaluation of various existing and new theoretical results, tools, and techniques. The Magnetic Stereotaxis System is summarized.

Security Implications of Physical Design Attributes in the Emergency Department.

PubMed

Pati, Debajyoti; Pati, Sipra; Harvey, Thomas E

2016-07-01

Security, a subset of safety, is equally important in the efficient delivery of patient care. The emergency department (ED) is susceptible to violence creating concerns for the safety and security of patients, staff, and visitors and for the safe and efficient delivery of care. Although there is an implicit and growing recognition of the role of the physical environment, interventions typically have been at the microlevel. The objective of this study was to identify physical design attributes that potentially influence safety and efficiency of ED operations. An exploratory, qualitative research design was adopted to examine the efficiency and safety correlates of ED physical design attributes. The study comprised a multimeasure approach involving multidisciplinary gaming, semistructured interviews, and touring interviews of frontline staff in four EDs at three hospital systems across three states. Five macro physical design attributes (issues that need to be addressed at the design stage and expensive to rectify once built) emerged from the data as factors substantially associated with security issues. They are design issues pertaining to (a) the entry zone, (b) traffic management, (c) patient room clustering, (d) centralization versus decentralization, and (e) provisions for special populations. Data from this study suggest that ED security concerns are generally associated with three sources: (a) gang-related violence, (b) dissatisfied patients, and (c) behavioral health patients. Study data show that physical design has an important role in addressing the above-mentioned concerns. Implications for ED design are outlined in the article. © The Author(s) 2016.

Health implications of exposure to radiofrequency/microwave energies

PubMed Central

Michaelson, S M

1982-01-01

ABSTRACT The rapid development of and the increase in the number and variety of devices that emit microwave/radiofrequency (MW/RF) energies has resulted in a growing interest regarding the potential effects on health of these energies. The frequency ranges considered in this review are: 300 kHz to 300 MHz (radiofrequency) and 300 MHz to 300 GHz (microwaves). Investigations have shown that exposure to certain power densities for several minutes or hours can result in pathophysiological manifestations in laboratory animals. Such effects may or may not be characterised by a measurable rise in temperature, which is a function of thermal regulatory processes and active adaptation by the animal. The end result is either a reversible or irreversible change, depending on the irradiation conditions and the physiological state of the animal. At lower power densities, evidence of pathological changes or physiological alteration is non-existent or equivocal. Much discussion, nevertheless, has taken place on the relative importance of thermal or non-thermal effects of radiofrequency and microwave radiation. Several retrospective studies have been done on human populations exposed or believed to have been exposed to MW/RF energies. Those performed in the US have not shown any relationship of altered morbidity or mortality to MW/RF exposure. Reactions referrable to the central nervous system and cardiovascular effects from exposure of man to microwave energy have been reported mostly in Eastern European publications. Individuals suffering from various ailments or psychological factors may exhibit the same dysfunctions of the central nervous and cardiovascular systems as those reported to result from exposure to MW/RF; thus it is extremely difficult, if not impossible, to rule out other factors in attempting to relate MW/RF exposure to clinical conditions. There is a need to set limits on the amount of exposure to MW/RF energies that individuals can accept with safety. Operative protection standards have apparently provided adequate safety to workers and the general population to permit the use of MW/RF energies without harm or detriment. PMID:7039662

Analysis on Dangerous Source of Large Safety Accident in Storage Tank Area

NASA Astrophysics Data System (ADS)

Wang, Tong; Li, Ying; Xie, Tiansheng; Liu, Yu; Zhu, Xueyuan

2018-01-01

The difference between a large safety accident and a general accident is that the consequences of a large safety accident are particularly serious. To study the tank area which factors directly or indirectly lead to the occurrence of large-sized safety accidents. According to the three kinds of hazard source theory and the consequence cause analysis of the super safety accident, this paper analyzes the dangerous source of the super safety accident in the tank area from four aspects, such as energy source, large-sized safety accident reason, management missing, environmental impact Based on the analysis of three kinds of hazard sources and environmental analysis to derive the main risk factors and the AHP evaluation model is established, and after rigorous and scientific calculation, the weights of the related factors in four kinds of risk factors and each type of risk factors are obtained. The result of analytic hierarchy process shows that management reasons is the most important one, and then the environmental factors and the direct cause and Energy source. It should be noted that although the direct cause is relatively low overall importance, the direct cause of Failure of emergency measures and Failure of prevention and control facilities in greater weight.

2009 Human Factors and Roadway Safety Workshop : National Perspectives on Safety [SD .WMV (720x480/29fps/227.0 MB)

DOT National Transportation Integrated Search

2009-11-05

Iowa Department of Transportation Research and Technology Bureau video presentation from the 2009 human factors and roadway safety workshop session titled: National Perspectives on Safety : Essie Wagner, program analyst, National Highway Traffic Safe...

Safety climate in university and college laboratories: impact of organizational and individual factors.

PubMed

Wu, Tsung-Chih; Liu, Chi-Wei; Lu, Mu-Chen

2007-01-01

Universities and colleges serve to be institutions of education excellence; however, problems in the areas of occupational safety may undermine such goals. Occupational safety must be the concern of every employee in the organization, regardless of job position. Safety climate surveys have been suggested as important tools for measuring the effectiveness and improvement direction of safety programs. Thus, this study aims to investigate the influence of organizational and individual factors on safety climate in university and college laboratories. Employees at 100 universities and colleges in Taiwan were mailed a self-administered questionnaire survey; the response rate was 78%. Multivariate analysis of variance revealed that organizational category of ownership, the presence of a safety manager and safety committee, gender, age, title, accident experience, and safety training significantly affected the climate. Among them, accident experience and safety training affected the climate with practical significance. The authors recommend that managers should address important factors affecting safety issues and then create a positive climate by enforcing continuous improvements.

Design and rationale of the MICHELANGELO Organization to Assess Strategies in Acute Ischemic Syndromes (OASIS)-5 trial program evaluating fondaparinux, a synthetic factor Xa inhibitor, in patients with non-ST-segment elevation acute coronary syndromes.

PubMed

Mehta, Shamir R; Yusuf, Salim; Granger, Christopher B; Wallentin, Lars; Peters, Ron J G; Bassand, Jean-Pierre; Budaj, Andrzej; Joyner, Campbell; Chrolavicius, Susan; Fox, Keith A A

2005-12-01

Factor Xa plays a central role in the generation of thrombin, making it a novel target for treatment of arterial thrombosis. Fondaparinux, a synthetic pentasaccharide, is a factor Xa inhibitor, which has been shown to be superior to enoxaparin for the prevention of venous thrombosis. We designed a large, phase III, randomized trial to evaluate the efficacy and safety of fondaparinux compared with enoxaparin in acute coronary syndromes. The OASIS-5 trial is a randomized, double-blind trial of fondaparinux versus enoxaparin in 20,000 patients with unstable angina or non-ST-segment elevation myocardial infarction. The primary objective is to determine whether fondaparinux is noninferior to enoxaparin in preventing the composite of death, new myocardial infarction, and refractory ischemia at 9 days (primary outcome) and at 30 days (secondary outcome) after randomization. There will be additional follow-up of all patients for 3 to 6 months after randomization. If noninferiority is established at 9 days, superiority will be tested. The primary safety outcome is to evaluate the rates of major bleeds in the 2 groups with the balance of benefit and risk assessed by comparing the impact on the composite of the primary and safety outcomes. Secondary outcomes are each component of the composite primary outcome separately at days 9, 30, and up to 6 months. The TIMACS, a major substudy using a partial 2x2 factorial design evaluating whether early angiography and intervention (within 24 hours) are superior to a more delayed approach (after 36 hours) in reducing major ischemic events at 6 months after randomization. The MICHELANGELO OASIS 5 program will provide a comprehensive and reliable evaluation of fondaparinux in a broad spectrum of patients with ACS.

Efficacy and safety of rivaroxaban in patients with diabetes and nonvalvular atrial fibrillation: the Rivaroxaban Once-daily, Oral, Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF Trial).

PubMed

Bansilal, Sameer; Bloomgarden, Zachary; Halperin, Jonathan L; Hellkamp, Anne S; Lokhnygina, Yuliya; Patel, Manesh R; Becker, Richard C; Breithardt, Günter; Hacke, Werner; Hankey, Graeme J; Nessel, Christopher C; Singer, Daniel E; Berkowitz, Scott D; Piccini, Jonathan P; Mahaffey, Kenneth W; Fox, Keith A A

2015-10-01

The prevalence of both atrial fibrillation (AF) and diabetes mellitus (DM) are rising, and these conditions often occur together. Also, DM is an independent risk factor for stroke in patients with AF. We aimed to examine the safety and efficacy of rivaroxaban vs warfarin in patients with nonvalvular AF and DM in a prespecified secondary analysis of the ROCKET AF trial. We stratified the ROCKET AF population by DM status, assessed associations with risk of outcomes by DM status and randomized treatment using Cox proportional hazards models, and tested for interactions between randomized treatments. For efficacy, primary outcomes were stroke (ischemic or hemorrhagic) or non-central nervous system embolism. For safety, the primary outcome was major or nonmajor clinically relevant bleeding. The 5,695 patients with DM (40%) in ROCKET AF were younger, were more obese, and had more persistent AF, but fewer had previous stroke (the CHADS2 score includes DM and stroke). The relative efficacy of rivaroxaban and warfarin for prevention of stroke and systemic embolism was similar in patients with (1.74 vs 2.14/100 patient-years, hazard ratio [HR] 0.82) and without (2.12 vs 2.32/100 patient-years, HR 0.92) DM (interaction P = .53). The safety of rivaroxaban vs warfarin regarding major bleeding (HRs 1.00 and 1.12 for patients with and without DM, respectively; interaction P = .43), major or nonmajor clinically relevant bleeding (HRs 0.98 and 1.09; interaction P = .17), and intracerebral hemorrhage (HRs 0.62 and 0.72; interaction P = .67) was independent of DM status. Adjusted exploratory analyses suggested 1.3-, 1.5-, and 1.9-fold higher 2-year rates of stroke, vascular mortality, and myocardial infarction in DM patients. The relative efficacy and safety of rivaroxaban vs warfarin was similar in patients with and without DM, supporting use of rivaroxaban as an alternative to warfarin in diabetic patients with AF. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Modeling the Relationship between Safety Climate and Safety Performance in a Developing Construction Industry: A Cross-Cultural Validation Study

PubMed Central

Zahoor, Hafiz; Chan, Albert P. C.; Utama, Wahyudi P.; Gao, Ran; Zafar, Irfan

2017-01-01

This study attempts to validate a safety performance (SP) measurement model in the cross-cultural setting of a developing country. In addition, it highlights the variations in investigating the relationship between safety climate (SC) factors and SP indicators. The data were collected from forty under-construction multi-storey building projects in Pakistan. Based on the results of exploratory factor analysis, a SP measurement model was hypothesized. It was tested and validated by conducting confirmatory factor analysis on calibration and validation sub-samples respectively. The study confirmed the significant positive impact of SC on safety compliance and safety participation, and negative impact on number of self-reported accidents/injuries. However, number of near-misses could not be retained in the final SP model because it attained a lower standardized path coefficient value. Moreover, instead of safety participation, safety compliance established a stronger impact on SP. The study uncovered safety enforcement and promotion as a novel SC factor, whereas safety rules and work practices was identified as the most neglected factor. The study contributed to the body of knowledge by unveiling the deviations in existing dimensions of SC and SP. The refined model is expected to concisely measure the SP in the Pakistani construction industry, however, caution must be exercised while generalizing the study results to other developing countries. PMID:28350366

Modeling the Relationship between Safety Climate and Safety Performance in a Developing Construction Industry: A Cross-Cultural Validation Study.

PubMed

Zahoor, Hafiz; Chan, Albert P C; Utama, Wahyudi P; Gao, Ran; Zafar, Irfan

2017-03-28

This study attempts to validate a safety performance (SP) measurement model in the cross-cultural setting of a developing country. In addition, it highlights the variations in investigating the relationship between safety climate (SC) factors and SP indicators. The data were collected from forty under-construction multi-storey building projects in Pakistan. Based on the results of exploratory factor analysis, a SP measurement model was hypothesized. It was tested and validated by conducting confirmatory factor analysis on calibration and validation sub-samples respectively. The study confirmed the significant positive impact of SC on safety compliance and safety participation , and negative impact on number of self-reported accidents/injuries . However, number of near-misses could not be retained in the final SP model because it attained a lower standardized path coefficient value. Moreover, instead of safety participation , safety compliance established a stronger impact on SP. The study uncovered safety enforcement and promotion as a novel SC factor, whereas safety rules and work practices was identified as the most neglected factor. The study contributed to the body of knowledge by unveiling the deviations in existing dimensions of SC and SP. The refined model is expected to concisely measure the SP in the Pakistani construction industry, however, caution must be exercised while generalizing the study results to other developing countries.

Development of an evidence-based framework of factors contributing to patient safety incidents in hospital settings: a systematic review

PubMed Central

McEachan, Rosemary R C; Giles, Sally J; Sirriyeh, Reema; Watt, Ian S; Wright, John

2012-01-01

Objective The aim of this systematic review was to develop a ‘contributory factors framework’ from a synthesis of empirical work which summarises factors contributing to patient safety incidents in hospital settings. Design A mixed-methods systematic review of the literature was conducted. Data sources Electronic databases (Medline, PsycInfo, ISI Web of knowledge, CINAHL and EMBASE), article reference lists, patient safety websites, registered study databases and author contacts. Eligibility criteria Studies were included that reported data from primary research in secondary care aiming to identify the contributory factors to error or threats to patient safety. Results 1502 potential articles were identified. 95 papers (representing 83 studies) which met the inclusion criteria were included, and 1676 contributory factors extracted. Initial coding of contributory factors by two independent reviewers resulted in 20 domains (eg, team factors, supervision and leadership). Each contributory factor was then coded by two reviewers to one of these 20 domains. The majority of studies identified active failures (errors and violations) as factors contributing to patient safety incidents. Individual factors, communication, and equipment and supplies were the other most frequently reported factors within the existing evidence base. Conclusions This review has culminated in an empirically based framework of the factors contributing to patient safety incidents. This framework has the potential to be applied across hospital settings to improve the identification and prevention of factors that cause harm to patients. PMID:22421911

Scientific evaluation of the safety factor for the acceptable daily intake (ADI). Case study: butylated hydroxyanisole (BHA).

PubMed

Würtzen, G

1993-01-01

The principles of 'data-derived safety factors' are applied to toxicological and biochemical information on butylated hydroxyanisole (BHA). The calculated safety factor for an ADI is, by this method, comparable to the existing internationally recognized safety evaluations. Relevance for humans of forestomach tumours in rodents is discussed. The method provides a basis for organizing data in a way that permits an explicit assessment of its relevance.

14. DETAIL OF EAST END OF CENTRAL CONTROL CONSOLE IN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. DETAIL OF EAST END OF CENTRAL CONTROL CONSOLE IN SLC-3W CONTROL ROOM SHOWING BLANK PANEL AND COMPLEX SAFETY OFFICER PANEL. CONSOLES AND CHAIRS NEAR NORTH WALL IN BACKGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Knowledge, attitudes, beliefs, values, preferences, and feasibility in relation to the use of injection safety devices in healthcare settings: a systematic review.

PubMed

Tarabay, Rami; El Rassi, Rola; Dakik, Abeer; Harb, Alain; Ballout, Rami A; Diab, Batoul; Khamassi, Selma; Akl, Elie A

2016-07-13

Adopting technologies such as injection safety devices in healthcare settings can enhance injection safety. Developing guidelines for appropriate adoption of such technologies need to consider factors beyond evidence for their health effects. The objective of this study is to systematically review the published literature for evidence among healthcare workers and patients about knowledge, attitudes, beliefs, values, preferences, and feasibility in relation to the use of injection safety devices in healthcare settings. We included both qualitative and quantitative studies conducted with the general public, patients, and healthcare workers, administrators, or policy makers. We searched MEDLINE, EMBASE, CINHAL and CENTRAL. We used a duplicate and independent approach to title and abstract screening, full text screening, data abstraction and risk of bias assessment. Out of a total of 6568 identified citations, we judged fourteen studies as eligible for this systematic review. All these studies were surveys, conducted with healthcare workers in high-income countries. We did not identify any qualitative study, or a study of the general public, patients, healthcare administrators or policy makers. We did not identify any study assessing knowledge, or values assigned to outcomes relevant to injection safety devices. Each of the included studies suffered from methodological limitations, which lowers our confidence in their findings. Based on the findings of six studies, the injection safety devices were generally perceived as easy to use and as an improvement compared with conventional syringes. Some of these studies reported few technical problems while using the devices. In three studies assessing perceived safety, the majority of participants judged the devices as safe. Two studies reported positive perceptions of healthcare workers regarding patient tolerance of these injection safety devices. One study found that less than half the nurses felt comfortable using the insulin pens. Findings from four studies assessing preference and satisfaction were not consistent. This systematic review identified evidence that injection safety devices are generally perceived as easy to use, safe, and tolerated by patients. There were few reports of technical problems while using the devices and some discomfort by nurses using the insulin pens.

To what extent can theory account for the findings of road safety evaluation studies?

PubMed

Elvik, Rune

2004-09-01

This paper proposes a conceptual framework that can be used to assess to what extent the findings of road safety evaluation research make sense from a theoretical point of view. The effects of road safety measures are modelled as passing through two causal chains. One of these, termed the engineering effect, refers to the intended effects of a road safety measure on a set of risk factors related to accident occurrence or injury severity. The engineering effect of road safety measures is modelled in terms of nine basic risk factors, one or more of which any road safety measure needs to influence in order to have the intended effect on accidents or injuries. The other causal chain producing the effects of road safety measures is termed the behavioural effect, and refers to road user behavioural adaptations to road safety measures. The behavioural effect is related to the engineering effect, in the sense that certain properties of the engineering effect of a road safety measure influence the likelihood that behavioural adaptation will occur. The behavioural effect of a road safety measure is modelled in terms of six factors that influence the likelihood that behavioural adaptation will occur. The nine basic risk factors representing the engineering effect of a road safety measure, and the six factors influencing the likelihood of behavioural adaptation can be used as checklists in assessing whether or not the findings of road safety evaluation studies make sense from a theoretical point of view. At the current state of knowledge, a more stringent evaluation of the extent to which theory can explain the findings of road safety evaluation studies is, in most cases, not possible. Copyright 2003 Elsevier Ltd.

Psychometrics of the AAN Caregiver Driving Safety Questionnaire and contributors to caregiver concern about driving safety in older adults.

PubMed

Carvalho, Janessa O; Springate, Beth; Bernier, Rachel A; Davis, Jennifer

2018-03-01

ABSTRACTBackground:The American Academy of Neurology (AAN) updated their practice parameters in the evaluation of driving risk in dementia and developed a Caregiver Driving Safety Questionnaire, detailed in their original manuscript (Iverson Gronseth, Reger, Classen, Dubinsky, & Rizzo, 2010). They described four factors associated with decreased driving ability in dementia patients: history of crashes or citations, informant-reported concerns, reduced mileage, and aggressive driving. An informant-reported AAN Caregiver Driving Safety Questionnaire was designed with these elements, and the current study was the first to explore the factor structure of this questionnaire. Additionally, we examined associations between these factors and cognitive and behavioral measures in patients with mild cognitive impairment or early Alzheimer's disease and their informants. Exploratory factor analysis revealed a four-component structure, consistent with the theory behind the AAN scale composition. These four factor scores also were significantly associated with performance on cognitive screening instruments and informant reported behavioral dysfunction. Regressions revealed that behavioral dysfunction predicted caregiver concerns about driving safety beyond objective patient cognitive dysfunction. In this first known quantitative exploration of the scale, our results support continued use of this scale in office driving safety assessments. Additionally, patient behavioral changes predicted caregiver concerns about driving safety over and above cognitive status, which suggests that caregivers may benefit from psychoeducation about cognitive factors that may negatively impact driving safety.

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey.

PubMed

Smits, Marleen; Keizer, Ellen; Giesen, Paul; Deilkås, Ellen Catharina Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2018-03-01

To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness. Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience. Overall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors. Our study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents' profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture. Key Points Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that: • healthcare providers in Dutch GP cooperatives perceive patient safety culture positively; • triage nurses scored higher than GPs, and older and more experienced healthcare professionals scored higher than younger and less experienced professionals - on several patient safety culture factors; and • within the GP cooperatives, safety climate and openness of communication had the largest potential for improvement.

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey

PubMed Central

Smits, Marleen; Keizer, Ellen; Giesen, Paul; Deilkås, Ellen Catharina Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2018-01-01

Objective To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness. Design Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience. Results Overall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors. Conclusions Our study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents’ profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture. Key Points Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that: • healthcare providers in Dutch GP cooperatives perceive patient safety culture positively; • triage nurses scored higher than GPs, and older and more experienced healthcare professionals scored higher than younger and less experienced professionals – on several patient safety culture factors; and • within the GP cooperatives, safety climate and openness of communication had the largest potential for improvement. PMID:29334826

Does Excessive Daytime Sleepiness Affect Children's Pedestrian Safety?

PubMed Central

Avis, Kristin T.; Gamble, Karen L.; Schwebel, David C.

2014-01-01

Study Objectives: Many cognitive factors contribute to unintentional pedestrian injury, including reaction time, impulsivity, risk-taking, attention, and decision-making. These same factors are negatively influenced by excessive daytime sleepiness (EDS), which may place children with EDS at greater risk for pedestrian injury. Design, Participants, and Methods: Using a case-control design, 33 children age 8 to 16 y with EDS from an established diagnosis of narcolepsy or idiopathic hypersomnia (IHS) engaged in a virtual reality pedestrian environment while unmedicated. Thirty-three healthy children matched by age, race, sex, and household income served as controls. Results: Children with EDS were riskier pedestrians than healthy children. They were twice as likely to be struck by a virtual vehicle in the virtual pedestrian environment than healthy controls. Attentional skills of looking at oncoming traffic were not impaired among children with EDS, but decision-making for when to cross the street safely was significantly impaired. Conclusions: Results suggest excessive daytime sleepiness (EDS) from the clinical sleep disorders known as the hypersomnias of central origin may have significant consequences on children's daytime functioning in a critical domain of personal safety, pedestrian skills. Cognitive processes involved in safe pedestrian crossings may be impaired in children with EDS. In the pedestrian simulation, children with EDS appeared to show a pattern consistent with inattentional blindness, in that they “looked but did not process” information in their pedestrian environment. Results highlight the need for heightened awareness of potentially irreversible consequences of untreated sleep disorders and identify a possible target for pediatric injury prevention. Citation: Avis KT; Gamble KL; Schwebel DC. Does excessive daytime sleepiness affect children's pedestrian safety? SLEEP 2014;37(2):283-287. PMID:24497656

Impact of the roll out of comprehensive emergency obstetric care on institutional birth rate in rural Nepal.

PubMed

Maru, Sheela; Bangura, Alex Harsha; Mehta, Pooja; Bista, Deepak; Borgatta, Lynn; Pande, Sami; Citrin, David; Khanal, Sumesh; Banstola, Amrit; Maru, Duncan

2017-03-04

Increasing institutional births rates and improving access to comprehensive emergency obstetric care are central strategies for reducing maternal and neonatal deaths globally. While some studies show women consider service availability when determining where to deliver, the dynamics of how and why institutional birth rates change as comprehensive emergency obstetric care availability increases are unclear. In this pre-post intervention study, we surveyed two exhaustive samples of postpartum women before and after comprehensive emergency obstetric care implementation at a hospital in rural Nepal. We developed a logistic regression model of institutional birth factors through manual backward selection of all significant covariates within and across periods. Qualitatively, we analyzed birth stories through immersion crystallization. Institutional birth rates increased after comprehensive emergency obstetric care implementation (from 30 to 77%, OR 7.7) at both hospital (OR 2.5) and low-level facilities (OR 4.6, p < 0.01 for all). The logistic regression indicated that comprehensive emergency obstetric care availability (OR 5.6), belief that the hospital is the safest birth location (OR 44.8), safety prioritization in decision-making (OR 7.7), and higher income (OR 1.1) predict institutional birth (p ≤ 0.01 for all). Qualitative analysis revealed comprehensive emergency obstetric care awareness, increased social expectation for institutional birth, and birth planning as important factors. Comprehensive emergency obstetric care expansion appears to have generated significant demand for institutional births through increased safety perceptions and birth planning. Increasing comprehensive emergency obstetric care availability increases birth safety, but it may also be a mechanism for increasing the institutional birth rate in areas of under-utilization.

Space station crew safety alternatives study. Volume 3: Safety impact of human factors

NASA Technical Reports Server (NTRS)

Rockoff, L. A.; Raasch, R. F.; Peercy, R. L., Jr.

1985-01-01

The first 15 years of accumulated space station concepts for Initial Operational Capability (IOC) during the early 1990's was considered. Twenty-five threats to the space station are identified and selected threats addressed as impacting safety criteria, escape and rescue, and human factors safety concerns. Of the 25 threats identified, eight are discussed including strategy options for threat control: fire, biological or toxic contamination, injury/illness, explosion, loss of pressurization, radiation, meteoroid penetration and debris. Of particular interest here is volume three (of five volumes) pertaining to the safety impact of human factors.

Central line-associated bloodstream infections in adult hematology patients with febrile neutropenia: an evaluation of surveillance definitions using differential time to blood culture positivity.

PubMed

Freeman, Joshua T; Elinder-Camburn, Anna; McClymont, Catherine; Anderson, Deverick J; Bilkey, Mary; Williamson, Deborah A; Berkahn, Leanne; Roberts, Sally A

2013-01-01

We used differential time to positivity between central and peripheral blood cultures to evaluate the positive predictive value (PPV) of the National Healthcare Safety Network central line-associated bloodstream infection (CLABSI) surveillance definition among hematology patients with febrile neutropenia. The PPV was 27.7%, which suggests that, when the definition is applied to this population, CLABSI rates will be substantially overestimated.

Critical safety assurance factors for manned spacecraft - A fire safety perspective

NASA Technical Reports Server (NTRS)

Rodney, George A.

1990-01-01

Safety assurance factors for manned spacecraft are discussed with a focus on the Space Station Freedom. A hazard scenario is provided to demonstrate a process commonly used by safety engineers and other analysts to identify onboard safety risks. Fire strategies are described, including a review of fire extinguishing agents being considered for the Space Station. Lessons learned about fire safety technology in other areas are also noted. NASA and industry research on fire safety applications is discussed. NASA's approach to ensuring safety for manned spacecraft is addressed in the context of its multidiscipline program.

Quantitative and Qualitative Analysis of Nutrition and Food Safety Information in School Science Textbooks of India

ERIC Educational Resources Information Center

Subba Rao, G. M.; Vijayapushapm, T.; Venkaiah, K.; Pavarala, V.

2012-01-01

Objective: To assess quantity and quality of nutrition and food safety information in science textbooks prescribed by the Central Board of Secondary Education (CBSE), India for grades I through X. Design: Content analysis. Methods: A coding scheme was developed for quantitative and qualitative analyses. Two investigators independently coded the…

A Safe School Climate: A Systemic Approach and the School Counselor

ERIC Educational Resources Information Center

Hernandez, Thomas J.; Seem, Susan R.

2004-01-01

The climate of the school is central to the educational mission of a school (Anderson, 1998; Sherman et al., 1997; Jenkins, 1997; Lockwood, 1997). Anderson surveyed recent school safety research and found that altering a school's internal climate can have a significant positive effect on the feeling of safety in the school community. Gottfredson…

Central collecting and evaluating of major accidents and near-miss-events in the Federal Republic of Germany--results, experiences, perspectives.

PubMed

Uth, Hans-Joachim; Wiese, Norbert

2004-07-26

Lessons learnt from accidents are essential sources for updating state of the art requirements in process safety. To improve this input by a systematic way in the FRG, a central body for collecting and evaluating major accident (ZEMA) was established in 1993. ZEMA is part of the Federal Environmental Agency. All events which are to be notified due to the German Regulation on Major Accidents (Störfall-Verordnung) are centrally collected, analysed (deducing lessons learnt) and documented by ZEMA. The bureau is also responsible for the dissemination of the lessons learnt to all stake holders. This work is done in co-operation with the German Major-Accident Hazard Commission (Störfallkommission) and other international bodies like European MAHB. At the time being, over 375 events from 1980 to 2002 are registered in Germany. For each event, a separate data sheet is published in annual reports, first started in 1993. All information is also available at. A summary evaluation on the events from 1993 to 1999 is presented and some basic lessons learnt are shown. The results from root cause analysis underline the importance of maintenance, detailed knowledge of chemical properties, human factor issues and the role of safety organisation especially connected with subcontractors. The German notification system is described in detail and some experience with the system is reported. Keeping in mind that collecting reports from notified major accidents is only a small amount compared with all the events which might be interesting to learn from, the German Major-Accident Hazard Commission has established a separate body, the subcommittee "Incident Evaluation", which is in charge with collecting and evaluating of minor and near-miss events. Since 1994, a concept for the registration and evaluation of those non-notifiable events was developed. From 2000 on, the concept has been put into operation. Its main elements are; 1. reporting of the incident by the plant operator to an information collecting point of its trust, 2. passing the anonymous report to the "Incident Evaluation" subcommittee, 3. evaluation and classification whether the incident is safety relevant or not and, 4. publishing the relevant information to all interested stake holders, preparing of summary evaluation results in certain areas. Up to now, two brochures on "waste gas pipes" and "obstructions of pipes" were published.

Factors related to increasing safety belt use in states with safety belt use laws : second annual report to Congress

DOT National Transportation Integrated Search

1989-01-01

This report is the second in a series of four annual reports to the Congress on provisions of state safety belt use laws and other programmatic factors related to increasing safety belt use levels. The first Congressional Report reviewed what was kno...

Factors related to increasing safety belt use in states with safety belt use laws : second annual report to Congress, 1988.

DOT National Transportation Integrated Search

1989-01-01

This report. is the second in a series of four annual reports to the : Congress on provisions of state safety belt use laws and other : programmatic factors related to increasing safety belt use levels. : The first Congressional Report reviewed what ...

Electrical safety for high voltage arrays

NASA Technical Reports Server (NTRS)

Marshall, N. A.

1983-01-01

A number of key electrical safety requirements for the high voltage arrays of central station photovoltaic power systems are explored. The suitability of representative industrial DC power switchgear for control and fault protection was evaluated. Included were AC/DC circuit breakers, electromechanical contactors and relays, load interruptors, cold disconnect devices, sectionalizing switches, and high voltage DC fuses. As appropriate, steady state and transient characteristics were analyzed. Failure modes impacting upon operation and maintenance safety were also identified, as were the voltage withstand and current interruption levels.

How Effective Are Incident-Reporting Systems for Improving Patient Safety? A Systematic Literature Review

PubMed Central

Stavropoulou, Charitini; Doherty, Carole; Tosey, Paul

2015-01-01

Context Incident-reporting systems (IRSs) are used to gather information about patient safety incidents. Despite the financial burden they imply, however, little is known about their effectiveness. This article systematically reviews the effectiveness of IRSs as a method of improving patient safety through organizational learning. Methods Our systematic literature review identified 2 groups of studies: (1) those comparing the effectiveness of IRSs with other methods of error reporting and (2) those examining the effectiveness of IRSs on settings, structures, and outcomes in regard to improving patient safety. We used thematic analysis to compare the effectiveness of IRSs with other methods and to synthesize what was effective, where, and why. Then, to assess the evidence concerning the ability of IRSs to facilitate organizational learning, we analyzed studies using the concepts of single-loop and double-loop learning. Findings In total, we identified 43 studies, 8 that compared IRSs with other methods and 35 that explored the effectiveness of IRSs on settings, structures, and outcomes. We did not find strong evidence that IRSs performed better than other methods. We did find some evidence of single-loop learning, that is, changes to clinical settings or processes as a consequence of learning from IRSs, but little evidence of either improvements in outcomes or changes in the latent managerial factors involved in error production. In addition, there was insubstantial evidence of IRSs enabling double-loop learning, that is, a cultural change or a change in mind-set. Conclusions The results indicate that IRSs could be more effective if the criteria for what counts as an incident were explicit, they were owned and led by clinical teams rather than centralized hospital departments, and they were embedded within organizations as part of wider safety programs. PMID:26626987

The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research.

PubMed

Sexton, John B; Helmreich, Robert L; Neilands, Torsten B; Rowan, Kathy; Vella, Keryn; Boyden, James; Roberts, Peter R; Thomas, Eric J

2006-04-03

There is widespread interest in measuring healthcare provider attitudes about issues relevant to patient safety (often called safety climate or safety culture). Here we report the psychometric properties, establish benchmarking data, and discuss emerging areas of research with the University of Texas Safety Attitudes Questionnaire. Six cross-sectional surveys of health care providers (n = 10,843) in 203 clinical areas (including critical care units, operating rooms, inpatient settings, and ambulatory clinics) in three countries (USA, UK, New Zealand). Multilevel factor analyses yielded results at the clinical area level and the respondent nested within clinical area level. We report scale reliability, floor/ceiling effects, item factor loadings, inter-factor correlations, and percentage of respondents who agree with each item and scale. A six factor model of provider attitudes fit to the data at both the clinical area and respondent nested within clinical area levels. The factors were: Teamwork Climate, Safety Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition. Scale reliability was 0.9. Provider attitudes varied greatly both within and among organizations. Results are presented to allow benchmarking among organizations and emerging research is discussed. The Safety Attitudes Questionnaire demonstrated good psychometric properties. Healthcare organizations can use the survey to measure caregiver attitudes about six patient safety-related domains, to compare themselves with other organizations, to prompt interventions to improve safety attitudes and to measure the effectiveness of these interventions.

The role of psychological factors in workplace safety.

PubMed

Kotzé, Martina; Steyn, Leon

2013-01-01

Workplace safety researchers and practitioners generally agree that it is necessary to understand the psychological factors that influence people's workplace safety behaviour. Yet, the search for reliable individual differences regarding psychological factors associated with workplace safety has lead to sparse results and inconclusive findings. The aim of this study was to investigate whether there are differences between the psychological factors, cognitive ability, personality and work-wellness of employees involved in workplace incidents and accidents and/or driver vehicle accidents and those who are not. The study population (N = 279) consisted of employees employed at an electricity supply organisation in South Africa. Mann-Whitney U-test and one-way ANOVA were conducted to determine the differences in the respective psychological factors between the groups. These results showed that cognitive ability did not seem to play a role in workplace incident/accident involvement, including driver vehicle accidents, while the wellness factors burnout and sense of coherence, as well as certain personality traits, namely conscientiousness, pragmatic and gregariousness play a statistically significant role in individuals' involvement in workplace incidents/accidents/driver vehicle accidents. Safety practitioners, managers and human resource specialists should take cognisance of the role of specifically work-wellness in workplace safety behaviour, as management can influence these negative states that are often caused by continuously stressful situations, and subsequently enhance work place safety.

A grounded theory of female adolescents' dating experiences and factors influencing safety: the dynamics of the Circle.

PubMed

Toscano, Sharyl E

2007-09-20

This paper describes the nature and characteristics of the dating relationships of adolescent females, including any of their experiences of abuse. A grounded theory approach was used with 22 theoretically sampled female adolescents ages 15-18. Several important themes emerged: Seven stages of dating consistently described the relationships of female adolescents. A circle consisting of two interacting same sex peer groups provided structure for each teen as they navigated the dating course. The circle was the central factor affecting a female adolescent's potential for risk or harm in dating relationships. Teens defined abuse as an act where the intention is to hurt. Having once succumbed to sexual pressure, teens felt unable to refuse sex in subsequent situations. An awareness of both the stages of dating and the dynamics of the circle will assist health care providers to plan and implement interventions in the female adolescent population. Study findings on factors and influences that support non-abusive versus abusive relationship might help identify female teens at risk and/or support interventions aimed at preventing dating violence.

A grounded theory of female adolescents' dating experiences and factors influencing safety: the dynamics of the Circle

PubMed Central

Toscano, Sharyl E

2007-01-01

Background This paper describes the nature and characteristics of the dating relationships of adolescent females, including any of their experiences of abuse. Methods A grounded theory approach was used with 22 theoretically sampled female adolescents ages 15–18. Results Several important themes emerged: Seven stages of dating consistently described the relationships of female adolescents. A circle consisting of two interacting same sex peer groups provided structure for each teen as they navigated the dating course. The circle was the central factor affecting a female adolescent's potential for risk or harm in dating relationships. Teens defined abuse as an act where the intention is to hurt. Having once succumbed to sexual pressure, teens felt unable to refuse sex in subsequent situations. Conclusion An awareness of both the stages of dating and the dynamics of the circle will assist health care providers to plan and implement interventions in the female adolescent population. Study findings on factors and influences that support non-abusive versus abusive relationship might help identify female teens at risk and/or support interventions aimed at preventing dating violence. PMID:17883833

DEXAMETHASONE IMPLANT FOR DIABETIC MACULAR EDEMA IN NAIVE COMPARED WITH REFRACTORY EYES: The International Retina Group Real-Life 24-Month Multicenter Study. The IRGREL-DEX Study.

PubMed

Iglicki, Matias; Busch, Catharina; Zur, Dinah; Okada, Mali; Mariussi, Miriana; Chhablani, Jay Kumar; Cebeci, Zafer; Fraser-Bell, Samantha; Chaikitmongkol, Voraporn; Couturier, Aude; Giancipoli, Ermete; Lupidi, Marco; Rodríguez-Valdés, Patricio J; Rehak, Matus; Fung, Adrian Tien-Chin; Goldstein, Michaella; Loewenstein, Anat

2018-04-24

To investigate efficacy and safety of repeated dexamethasone (DEX) implants over 24 months, in diabetic macular edema (DME) eyes that were treatment naive compared with eyes refractory to anti-vascular endothelial growth factor treatment, in a real-life environment. This multicenter international retrospective study assessed best-corrected visual acuity and central subfield thickness (CST) of naive and refractory eyes to anti-vascular endothelial growth factor injections treated with dexamethasone implants. Safety data (intraocular pressure rise and cataract surgery) were recorded. A total of 130 eyes from 125 patients were included. Baseline best-corrected visual acuity and CST were similar for naive (n = 71) and refractory eyes (n = 59). Both groups improved significantly in vision after 24 months (P < 0.001). However, naive eyes gained statistically significantly more vision than refractory eyes (+11.3 ± 10.0 vs. 7.3 ± 2.7 letters, P = 0.01) and were more likely to gain ≥10 letters (OR 3.31, 95% CI 1.19-9.24, P = 0.02). At 6, 12, and 24 months, CST was significantly decreased compared with baseline in both naive and refractory eyes; however, CST was higher in refractory eyes than in naive eyes (CST 279 ± 61 vs. 313 ± 125 μm, P = 0.10). Over a follow-up of 24 months, vision improved in diabetic macular edema eyes after treatment with dexamethasone implants, both in eyes that were treatment naive and eyes refractory to anti-vascular endothelial growth factor treatment; however, improvement was greater in naive eyes.

NSRD-10: Leak Path Factor Guidance Using MELCOR

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

Louie, David; Humphries, Larry L.

Estimates of the source term from a U.S. Department of Energy (DOE) nuclear facility requires that the analysts know how to apply the simulation tools used, such as the MELCOR code, particularly for a complicated facility that may include an air ventilation system and other active systems that can influence the environmental pathway of the materials released. DOE has designated MELCOR 1.8.5, an unsupported version, as a DOE ToolBox code in its Central Registry, which includes a leak-path-factor guidance report written in 2004 that did not include experimental validation data. To continue to use this MELCOR version requires additional verificationmore » and validations, which may not be feasible from a project cost standpoint. Instead, the recent MELCOR should be used. Without any developer support and lack of experimental data validation, it is difficult to convince regulators that the calculated source term from the DOE facility is accurate and defensible. This research replaces the obsolete version in the 2004 DOE leak path factor guidance report by using MELCOR 2.1 (the latest version of MELCOR with continuing modeling development and user support) and by including applicable experimental data from the reactor safety arena and from applicable experimental data used in the DOE-HDBK-3010. This research provides best practice values used in MELCOR 2.1 specifically for the leak path determination. With these enhancements, the revised leak-path-guidance report should provide confidence to the DOE safety analyst who would be using MELCOR as a source-term determination tool for mitigated accident evaluations.« less

Blood donation in Chile: Replacement and volunteer donors.

PubMed

Herrera, Claudia; Martínez, Cristina; Armanet, Leonor; Cárcamo, Amalia; Boye, Patricia; Lyng, Cecilia

2010-01-01

In recent years, the Chilean Health Ministry has developed a strategy in order to improve the safety and opportunity of the blood supply through the creation of a nationally co-ordinated blood transfusion service, centralizing collection management, production and testing in three Blood Centers along the country and promoting voluntary, regular, blood donation. In 2007, a comprehensive study of the situation of Blood Transfusion Services in Chile concluded that several critical factors make it difficult to achieve a safe and adequate access to blood and blood components in the country. For example there is a low donation rate (14.3/1000 inhabitants), very low percentage of voluntary donors (10%), excessive amount of blood banks collecting, processing and testing blood revealing an atomized non-centralized system, lack of a national IT system and insufficient national standards. There are two regions in the country, Bio Bio and Valparaíso, where Regional Blood Centers are located, that have put in place several strategies in order to obtain better results. Copyright 2009 The International Association for Biologicals. Published by Elsevier Ltd. All rights reserved.

Passive MHD Spectroscopy for Enabling Magnetic Reconstructions on Spherical Tokamak Plasmas at General Fusion Inc

NASA Astrophysics Data System (ADS)

O'Shea, Peter; Laberge, Michel; Mossman, Alex; Reynolds, Meritt

2017-10-01

Magnetic reconstructions on lab based plasma injectors at General Fusion relies heavily on edge magnetic (``Bdot'') probes. On plasma experiments built for field compression (PCS) tests, the number and locations of Bdot probes is limited by mechanical constraints. Additional information about the q profiles near the core in our Spector plasmas is obtained using passive MHD spectroscopy. The coaxial helicity injection (CHI) formation process naturally generates hollow current profiles and reversed shear early in each discharge. Central Ohmic heating naturally peaks the current profiles as our plasmas evolve in time, simultaneously reducing the core safety factor, q(0), and reverse shear. As the central, non-monotonic q-profile crosses rational flux surfaces, we observe transient magnetic reconnection events (MRE's) due to the double tearing mode. Modal analysis allows us to infer the q surfaces involved in each burst. The parametric dependence of the timing of MRE's allows us to estimate the continuous time evolution of the core q profile. Combining core MHD spectroscopy with edge magnetic probe measurements greatly enhances our certainty of the overall q profile.

ERDA's central receiver solar thermal power system studies

NASA Technical Reports Server (NTRS)

Lippy, L. J.; Heaton, T. R.

1977-01-01

The utilization of solar energy for electrical power production was studied. Efforts underway on the central receiver solar thermal power system are presented. Preliminary designs are included of pilot plant utilizing large numbers of heliostats in a collector field. Safety hazards are also discussed, as well as the most beneficial location of such a plant within the United States.

76 FR 45217 - Fisheries of the Exclusive Economic Zone Off Alaska; Central Gulf of Alaska Rockfish Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

..., management, safety, and economic gains realized under the Rockfish Pilot Program and viability of the Gulf of...-BA97 Fisheries of the Exclusive Economic Zone Off Alaska; Central Gulf of Alaska Rockfish Program... available for public review and comment. The groundfish fisheries in the exclusive economic zone of Alaska...

Evaluating the Effectiveness of an Educational Intervention to Improve the Patient Safety Attitudes of Intern Pharmacists

PubMed Central

Fois, Romano A.; McLachlan, Andrew J.; Chen, Timothy F.

2017-01-01

Objective. To evaluate the effectiveness of a face-to-face educational intervention in improving the patient safety attitudes of intern pharmacists. Methods. A patient safety education program was delivered to intern pharmacists undertaking The University of Sydney Intern Training Program in 2014. Their patient safety attitudes were evaluated immediately prior to, immediately after, and three-months post-intervention. Underlying attitudinal factors were identified using exploratory factor analysis. Changes in factor scores were examined using analysis of variance. Results. Of the 120 interns enrolled, 95 (78.7%) completed all three surveys. Four underlying attitudinal factors were identified: attitudes towards addressing errors, questioning behaviors, blaming individuals, and reporting errors. Improvements in all attitudinal factors were evident immediately after the intervention. However, only improvements in attitudes towards blaming individuals involved in errors were sustained at three months post-intervention. Conclusion. The educational intervention was associated with short-term improvements in pharmacist interns’ patient safety attitudes. However, other factors likely influenced their attitudes in the longer term. PMID:28289295

Evaluating the Effectiveness of an Educational Intervention to Improve the Patient Safety Attitudes of Intern Pharmacists.

PubMed

Walpola, Ramesh L; Fois, Romano A; McLachlan, Andrew J; Chen, Timothy F

2017-02-25

Objective. To evaluate the effectiveness of a face-to-face educational intervention in improving the patient safety attitudes of intern pharmacists. Methods. A patient safety education program was delivered to intern pharmacists undertaking The University of Sydney Intern Training Program in 2014. Their patient safety attitudes were evaluated immediately prior to, immediately after, and three-months post-intervention. Underlying attitudinal factors were identified using exploratory factor analysis. Changes in factor scores were examined using analysis of variance. Results. Of the 120 interns enrolled, 95 (78.7%) completed all three surveys. Four underlying attitudinal factors were identified: attitudes towards addressing errors, questioning behaviors, blaming individuals, and reporting errors. Improvements in all attitudinal factors were evident immediately after the intervention. However, only improvements in attitudes towards blaming individuals involved in errors were sustained at three months post-intervention. Conclusion. The educational intervention was associated with short-term improvements in pharmacist interns' patient safety attitudes. However, other factors likely influenced their attitudes in the longer term.

[Quality management and safety culture in medicine: context and concepts].

PubMed

Wischet, Werner; Eitzinger, Claudia

2009-01-01

The publication of the IOM report "To err is human: building a safer health system" in 1999 put spotlight on the primacy of the principle of primum non nocere and made patient safety a central topic of quality management. A key conclusion of the report was the need for a well-developed safety culture. While concepts of quality management have evolved along the lines of ISO and Total Quality Management over the last decades patient safety still has not got the same amount of attention (PubMed). Evidence from other safety-critical areas but also from the field of medicine itself suggests that an efficient culture of safety is a conditio sine qua non for the sustainable improvement of patient safety. Considering these arguments the present paper aims at emphasizing the importance of an efficient culture of safety for patient safety and quality management in healthcare. In addition, key instruments of safety culture as well as their limitations will be presented.

The role of organizational trust in safety climate's influence on organizational outcomes.

PubMed

Kath, Lisa M; Magley, Vicki J; Marmet, Matthew

2010-09-01

Based on elements of social exchange theory and other conceptualizations of trust, a model was developed situating organizational trust as a central component to the relationship that safety climate has with organizational outcomes. Specifically, the model specified that two facets of safety climate--upward safety communication and management attitudes toward safety--would be positively related to organizational trust. Increased levels of trust would then predict increased motivation to engage in safe job-related behaviors, increased job satisfaction, and decreased turnover intentions. Another hypothesis investigated whether job safety relevance would moderate the relationship between safety climate and trust. Online survey research was conducted with 599 employees from 97 work groups across a New England grocery store chain. Hierarchical linear modeling indicated support for trust mediating the relationship between safety climate and organizational outcomes; further, the relationship between safety climate and trust was stronger within work groups where safety was more relevant. 2009 Elsevier Ltd. All rights reserved.

Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate.

PubMed

Hystad, Sigurd W; Bartone, Paul T; Eid, Jarle

2014-01-01

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents.

Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate

PubMed Central

Hystad, Sigurd W.; Bartone, Paul T.; Eid, Jarle

2013-01-01

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents. PMID:24454524

Factors associated with the enactment of safety belt and motorcycle helmet laws.

PubMed

Law, Teik Hua; Noland, Robert B; Evans, Andrew W

2013-07-01

It has been shown that road safety laws, such as motorcycle helmet and safety belt laws, have a significant effect in reducing road fatalities. Although an expanding body of literature has documented the effects of these laws on road safety, it remains unclear which factors influence the likelihood that these laws are enacted. This study attempts to identify the factors that influence the decision to enact safety belt and motorcycle helmet laws. Using panel data from 31 countries between 1963 and 2002, our results reveal that increased democracy, education level, per capita income, political stability, and more equitable income distribution within a country are associated with the enactment of road safety laws. © 2012 Society for Risk Analysis.

Human factors systems approach to healthcare quality and patient safety

PubMed Central

Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.

2013-01-01

Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724

Human factors and ergonomics as a patient safety practice

PubMed Central

Carayon, Pascale; Xie, Anping; Kianfar, Sarah

2014-01-01

Background Human factors and ergonomics (HFE) approaches to patient safety have addressed five different domains: usability of technology; human error and its role in patient safety; the role of healthcare worker performance in patient safety; system resilience; and HFE systems approaches to patient safety. Methods A review of various HFE approaches to patient safety and studies on HFE interventions was conducted. Results This paper describes specific examples of HFE-based interventions for patient safety. Studies show that HFE can be used in a variety of domains. Conclusions HFE is a core element of patient safety improvement. Therefore, every effort should be made to support HFE applications in patient safety. PMID:23813211

Safety climate practice in Korean manufacturing industry.

PubMed

Baek, Jong-Bae; Bae, Sejong; Ham, Byung-Ho; Singh, Karan P

2008-11-15

Safety climate survey was sent to 642 plants in 2003 to explore safety climate practices in the Korean manufacturing plants, especially in hazardous chemical treating plants. Out of 642 plants contacted 195 (30.4%) participated in the surveys. Data were collected by e-mail using SQL-server and mail. The main objective of this study was to explore safety climate practices (level of safety climate and the underlying problems). In addition, the variables that may influence the level of safety climate among managers and workers were explored. The questionnaires developed by health and safety executive (HSE) in the UK were modified to incorporate differences in Korean culture. Eleven important factors were summarized. Internal reliability of these factors was validated. Number of employees in the company varied from less than 30 employees (9.2%) to over 1000 employees (37.4%). Both managers and workers showed generally high level of safety climate awareness. The major underlying problems identified were inadequate health and safety procedures/rules, pressure for production, and rule breaking. The length of employment was a significant contributing factor to the level of safety climate. In this study, participants showed generally high level of safety climate, and length of employment affected the differences in the level of safety climate. Managers' commitment to comply safety rules, procedures, and effective safety education and training are recommended.

Potential North American Clinical Trials Network (NACTN) for Treatment of Spinal Cord Injury: A Consortium of Military, Veterans Administration, and Civilian Hospitals

DTIC Science & Technology

2008-05-01

invaluable to characterize the trajectory (natural history ) of individuals who have suffered a spinal cord injury. The registry was initially designed...Princeton, NJ 08540-7814 Phone: +1 609 375 2017 Fax: +1 609 375 2683 Email: Elinor.Cappuccio@afoundation.org Central Medical Monitor Steve R...continuously monitored. Every safety event will be reviewed by both the local and central Medical Monitor. The central Medical Monitor will be a

Barriers and Facilitators to Central Venous Catheter Insertion: A Qualitative Study.

PubMed

Cameron, Kenzie A; Cohen, Elaine R; Hertz, Joelle R; Wayne, Diane B; Mitra, Debi; Barsuk, Jeffrey H

2018-03-14

The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators. Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas. We conducted semistructured interviews to assess perceptions of barriers and facilitators to CVC insertion. Deidentified transcripts were analyzed using a grounded theory approach and the constant comparative method. We subsequently mapped identified barriers and facilitators to our SBML curriculum to determine whether or not the curriculum addresses these factors. We interviewed 28 providers at six Veterans Administration Medical Centers, identifying the following five overarching factors of perceived barriers to CVC insertion: (1) equipment, (2) personnel/staff, (3) setting or organizational context, (4) patient or provider, and (5) time-related barriers. Three overarching factors of facilitators emerged: (1) equipment, (2) personnel, and (3) setting or organizational context facilitators. The SBML curriculum seems to address most identified barriers, while leveraging many facilitators; building on the commonly identified facilitator of nursing staff contribution by expanding the curriculum to explicitly include nurse involvement could improve team efficiency and organizational culture of safety. Many identified facilitators (e.g., ability to use ultrasound, personnel confidence/competence) were also identified as barriers. Evidence-based SBML programs have the potential to amplify these facilitators while addressing the barriers by providing an opportunity to practice and master CVC insertion skills.

75 FR 5536 - Pipeline Safety: Control Room Management/Human Factors, Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors, Correction AGENCY: Pipeline and Hazardous Materials Safety... following correcting amendments: PART 192--TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM...

14 CFR 25.619 - Special factors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Special factors. 25.619 Section 25.619... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction General § 25.619 Special factors. The factor of safety prescribed in § 25.303 must be multiplied by the highest pertinent special factor of safety...

Impact of economic incentives on costs and benefits of occupational health and safety.

PubMed

Pawłowska, Z; Rzepecki, J

2000-01-01

The most common type of economic incentive used in the field of health and safety is experience rating of insurance premiums. The impact of this incentive on occupational health and safety (OHS) costs in the company was analysed by comparing insurance costs with other OHS costs associated with inadequate working conditions, such as accident costs borne by a company. Accident costs were estimated on the basis of research carried out in 10 companies. Insurance costs and their adjustments according to the health and safety level in a company were calculated according to an experience rating model developed in the Central Institute for Labour Protection.

The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research

PubMed Central

Sexton, John B; Helmreich, Robert L; Neilands, Torsten B; Rowan, Kathy; Vella, Keryn; Boyden, James; Roberts, Peter R; Thomas, Eric J

2006-01-01

Background There is widespread interest in measuring healthcare provider attitudes about issues relevant to patient safety (often called safety climate or safety culture). Here we report the psychometric properties, establish benchmarking data, and discuss emerging areas of research with the University of Texas Safety Attitudes Questionnaire. Methods Six cross-sectional surveys of health care providers (n = 10,843) in 203 clinical areas (including critical care units, operating rooms, inpatient settings, and ambulatory clinics) in three countries (USA, UK, New Zealand). Multilevel factor analyses yielded results at the clinical area level and the respondent nested within clinical area level. We report scale reliability, floor/ceiling effects, item factor loadings, inter-factor correlations, and percentage of respondents who agree with each item and scale. Results A six factor model of provider attitudes fit to the data at both the clinical area and respondent nested within clinical area levels. The factors were: Teamwork Climate, Safety Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition. Scale reliability was 0.9. Provider attitudes varied greatly both within and among organizations. Results are presented to allow benchmarking among organizations and emerging research is discussed. Conclusion The Safety Attitudes Questionnaire demonstrated good psychometric properties. Healthcare organizations can use the survey to measure caregiver attitudes about six patient safety-related domains, to compare themselves with other organizations, to prompt interventions to improve safety attitudes and to measure the effectiveness of these interventions. PMID:16584553

Human factors and systems engineering approach to patient safety for radiotherapy.

PubMed

Rivera, A Joy; Karsh, Ben-Tzion

2008-01-01

The traditional approach to solving patient safety problems in healthcare is to blame the last person to touch the patient. But since the publication of To Err is Human, the call has been instead to use human factors and systems engineering methods and principles to solve patient safety problems. However, an understanding of the human factors and systems engineering is lacking, and confusion remains about what it means to apply their principles. This paper provides a primer on them and their applications to patient safety.

Patient safety - the role of human factors and systems engineering.

PubMed

Carayon, Pascale; Wood, Kenneth E

2010-01-01

Patient safety is a global challenge that requires knowledge and skills in multiple areas, including human factors and systems engineering. In this chapter, numerous conceptual approaches and methods for analyzing, preventing and mitigating medical errors are described. Given the complexity of healthcare work systems and processes, we emphasize the need for increasing partnerships between the health sciences and human factors and systems engineering to improve patient safety. Those partnerships will be able to develop and implement the system redesigns that are necessary to improve healthcare work systems and processes for patient safety.

21 CFR 601.32 - General factors relevant to safety and effectiveness.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES (CONTINUED) BIOLOGICS LICENSING Diagnostic Radiopharmaceuticals § 601.32 General factors relevant to safety and effectiveness. FDA's determination of the safety and effectiveness of a diagnostic radiopharmaceutical includes consideration of the following: (a) The proposed use of the diagnostic...

Practicing chemical process safety: a look at the layers of protection.

PubMed

Sanders, Roy E

2004-11-11

This presentation will review a few public perceptions of safety in chemical plants and refineries, and will compare these plant workplace risks to some of the more traditional occupations. The central theme of this paper is to provide a "within-the-fence" view of many of the process safety practices that world class plants perform to pro-actively protect people, property, profits as well as the environment. It behooves each chemical plant and refinery to have their story on an image-rich presentation to stress stewardship and process safety. Such a program can assure the company's employees and help convince the community that many layers of safety protection within our plants are effective, and protect all from harm.

Memorial Hermann: high reliability from board to bedside.

PubMed

Shabot, M Michael; Monroe, Douglas; Inurria, Juan; Garbade, Debbi; France, Anne-Claire

2013-06-01

In 2006 the Memorial Hermann Health System (MHHS), which includes 12 hospitals, began applying principles embraced by high reliability organizations (HROs). Three factors support its HRO journey: (1) aligned organizational structure with transparent management systems and compressed reporting processes; (2) Robust Process Improvement (RPI) with high-reliability interventions; and (3) cultural establishment, sustainment, and evolution. The Quality and Safety strategic plan contains three domains, each with a specific set of measures that provide goals for performance: (1) "Clinical Excellence;" (2) "Do No Harm;" and (3) "Saving Lives," as measured by the Serious Safety Event rate. MHHS uses a uniform approach to performance improvement--RPI, which includes Six Sigma, Lean, and change management, to solve difficult safety and quality problems. The 9 acute care hospitals provide multiple opportunities to integrate high-reliability interventions and best practices across MHHS. For example, MHHS partnered with the Joint Commission Center for Transforming Healthcare in its inaugural project to establish reliable hand hygiene behaviors, which improved MHHS's average hand hygiene compliance rate from 44% to 92% currently. Soon after compliance exceeded 85% at all 12 hospitals, the average rate of central line-associated bloodstream and ventilator-associated pneumonias decreased to essentially zero. MHHS's size and diversity require a disciplined approach to performance improvement and systemwide achievement of measurable success. The most significant cultural change at MHHS has been the expectation for 100% compliance with evidence-based quality measures and 0% incidence of patient harm.

[Quality Management and Quality Specifications of Laboratory Tests in Clinical Studies--Challenges in Pre-Analytical Processes in Clinical Laboratories].

PubMed

Ishibashi, Midori

2015-01-01

The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.

Impact of daylight saving time on road traffic collision risk: a systematic review

PubMed Central

Carey, Rachel N; Sarma, Kiran M

2017-01-01

Background Bills have been put forward in the UK and Republic of Ireland proposing a move to Central European Time (CET). Proponents argue that such a change will have benefits for road safety, with daylight being shifted from the morning, when collision risk is lower, to the evening, when risk is higher. Studies examining the impact of daylight saving time (DST) on road traffic collision risk can help inform the debate on the potential road safety benefits of a move to CET. The objective of this systematic review was to examine the impact of DST on collision risk. Methods Major electronic databases were searched, with no restrictions as to date of publication (the last search was performed in January 2017). Access to unpublished reports was requested through an international expert group. Studies that provided a quantitative analysis of the effect of DST on road safety-related outcomes were included. The primary outcomes of interest were road traffic collisions, injuries and fatalities. Findings Twenty-four studies met the inclusion criteria. Seventeen examined the short-term impact of transitions around DST and 12 examined long-term effects. Findings from the short-term studies were inconsistent. The long-term findings suggested a positive effect of DST. However, this cannot be attributed solely to DST, as a range of road collision risk factors vary over time. Interpretation The evidence from this review cannot support or refute the assertion that a permanent shift in light from morning to evening will have a road safety benefit. PMID:28674131

The role of bromocriptine-QR in the management of type 2 diabetes expert panel recommendations.

PubMed

Garber, Alan J; Blonde, Lawrence; Bloomgarden, Zachary T; Handelsman, Yehuda; Dagogo-Jack, Samuel

2013-01-01

To review available data on the efficacy and safety of bromocriptine-QR (BQR) and to consider its role in the management of Type 2 diabetes mellitus (T2DM). Published literature reporting the efficacy and safety of BQR in the treatment of T2DM was reviewed, including peer-reviewed abstracts and poster presentations. BQR is an oral hypoglycemic agent with a novel mechanism of action that appears to involve enhancement of morning central nervous system (CNS) dopaminergic activity, resulting in improved insulin sensitivity and reduced hepatic glucose output. Adjunctive treatment with BQR in the dosing range of 1.6 to 4.8 mg/d may result in a mean (95% confidence interval [CI]) reduction in glycated hemoglobin (A1c) levels of 0.69% (0.97%, 0.41%). Treatment with BQR appears to be associated with minimal intrinsic risk of hypoglycemia, and does not appear to be associated with clinically significant adverse effects on weight, triglycerides, free fatty acids, or blood pressure. The favorable cardiovascular risk profile of BQR suggests that it may be useful in the treatment of patients with T2DM with a history of cardiovascular disease (CVD) or who have significant risk factors for CVD. However, knowledge of the efficacy and safety of BQR is limited by the relatively small clinical trials database. As a result, there is currently insufficient information on the safety and efficacy of adjunctive BQR in T2DM patients being treated with several common diabetes regimens (e.g., thiazolidinediones, insulin).

Patient safety in psychiatric inpatient care: a literature review.

PubMed

Kanerva, A; Lammintakanen, J; Kivinen, T

2013-08-01

Patient safety is widely discussed, but little has been written from the perspective of psychiatric inpatient care, nor on which factors create its patient safety. This paper seeks to understand the concept of patient safety and its intension in psychiatric inpatient care, and to identify factors in organization management, staff and patients' roles which constitute patient safety in such units. A literature search was conducted, and the articles selected were analysed by identifying factors defined to be connected to patient safety and classifying them according to their connection to organization management, staff and patient roles. According to the literature, organization safety culture is present in all aspects of patient safety. Organization management has the main role in patient safety within the organization culture, for example, through leadership, safety practices and creating good working conditions and environment for the staff. Staff's role is influenced by management, but has more individual input in different areas, while the patient's role is more that of an informant so that care can be planned according to the patient's preferences. When developing patient safety it is important to remember the diversity of the concept so that all areas are considered in the developmental work. © 2012 John Wiley & Sons Ltd.

Direct Killing of Patients in Humanitarian Situations and Armed Conflicts: The Profession of Medicine Is Losing Its Meaning

PubMed Central

Asgary, Ramin

2015-01-01

During armed conflicts over the past several years, attacks on humanitarian workers and patients have increased, including the most recent overt killing of patients in their hospital beds in South Sudan and Central African Republic, and bombardments of hospitals in Iraq, Syria, and other countries. Direct attacks on patients inside hospitals, as well as social structural dynamics that undermine patient safety and security, are met with apparent indifference by international and medical communities. How can the medical profession remain silent and stand by while these factors render its core mission futile? In this article, I aim to shed light on this issue, and its implications for the future of the neutral and impartial provision of medical care; provide an analysis of underlying and contributing factors; discuss current international strategies; reflect on the responsibility of health providers; explore ways to strengthen our roles as physician advocates; and call for the medical profession to do more to protect medicine's core values. PMID:25646255

Learning health 'safety' within non-technical skills interprofessional simulation education: a qualitative study.

PubMed

Gordon, Morris; Fell, Christopher W R; Box, Helen; Farrell, Michael; Stewart, Alison

2017-01-01

Healthcare increasingly recognises and focusses on the phenomena of 'safe practice' and 'patient safety.' Success with non-technical skills (NTS) training in other industries has led to widespread transposition to healthcare education, with communication and teamwork skills central to NTS frameworks. This study set out to identify how the context of interprofessional simulation learning influences NTS acquisition and development of 'safety' amongst learners. Participants receiving a non-technical skills (NTS) safety focussed training package were invited to take part in a focus group interview which set out to explore communication, teamwork, and the phenomenon of safety in the context of the learning experiences they had within the training programme. The analysis was aligned with a constructivist paradigm and took an interactive methodological approach. The analysis proceeded through three stages, consisting of open, axial, and selective coding, with constant comparisons taking place throughout each phase. Each stage provided categories that could be used to explore the themes of the data. Additionally, to ensure thematic saturation, transcripts of observed simulated learning encounters were then analysed. Six themes were established at the axial coding level, i.e., analytical skills, personal behaviours, communication, teamwork, context, and pedagogy. Underlying these themes, two principal concepts emerged, namely: intergroup contact anxiety - as both a result of and determinant of communication - and teamwork, both of which must be considered in relation to context. These concepts have subsequently been used to propose a framework for NTS learning. This study highlights the role of intergroup contact anxiety and teamwork as factors in NTS behaviour and its dissipation through interprofessional simulation learning. Therefore, this should be a key consideration in NTS education. Future research is needed to consider the role of the affective non-technical attributes of intergroup contact anxiety and teamwork as focuses for education and determinants of safe behaviour. AUM: Anxiety/uncertainty management; NTS: Non-technical skills; TINSELS: Training in non-technical skills to enhance levels of medicines safety.

Cross-validation of an employee safety climate model in Malaysia.

PubMed

Bahari, Siti Fatimah; Clarke, Sharon

2013-06-01

Whilst substantial research has investigated the nature of safety climate, and its importance as a leading indicator of organisational safety, much of this research has been conducted with Western industrial samples. The current study focuses on the cross-validation of a safety climate model in the non-Western industrial context of Malaysian manufacturing. The first-order factorial validity of Cheyne et al.'s (1998) [Cheyne, A., Cox, S., Oliver, A., Tomas, J.M., 1998. Modelling safety climate in the prediction of levels of safety activity. Work and Stress, 12(3), 255-271] model was tested, using confirmatory factor analysis, in a Malaysian sample. Results showed that the model fit indices were below accepted levels, indicating that the original Cheyne et al. (1998) safety climate model was not supported. An alternative three-factor model was developed using exploratory factor analysis. Although these findings are not consistent with previously reported cross-validation studies, we argue that previous studies have focused on validation across Western samples, and that the current study demonstrates the need to take account of cultural factors in the development of safety climate models intended for use in non-Western contexts. The results have important implications for the transferability of existing safety climate models across cultures (for example, in global organisations) and highlight the need for future research to examine cross-cultural issues in relation to safety climate. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Safety voice for ergonomics (SAVE) project: protocol for a workplace cluster-randomized controlled trial to reduce musculoskeletal disorders in masonry apprentices.

PubMed

Kincl, Laurel D; Anton, Dan; Hess, Jennifer A; Weeks, Douglas L

2016-04-27

Masons have the highest rate of overexertion injuries among all construction trades and rank second for occupational back injuries in the United States. Identified ergonomic solutions are the primary method of reducing exposure to risk factors associated with musculoskeletal disorders. However, many construction workers lack knowledge about these solutions, as well as basic ergonomic principles. Construction apprentices, as they embark on their careers, are greatly in need of ergonomics training to minimize the cumulative exposure that leads to musculoskeletal disorders. Apprentices receive safety training; however, ergonomics training is often limited or non-existent. In addition, apprenticeship programs often lack "soft skills" training on how to appropriately respond to work environments and practices that are unsafe. The SAVE program - SAfety Voice for Ergonomics - strives to integrate evidence-based health and safety training strategies into masonry apprenticeship skills training to teach ergonomics, problem solving, and speaking up to communicate solutions that reduce musculoskeletal injury risk. The central hypothesis is that the combination of ergonomics training and safety voice promotion will be more effective than no training or either ergonomics training alone or safety voice training alone. Following the development and pilot testing of the SAVE intervention, SAVE will be evaluated in a cluster-randomized controlled trial at 12 masonry training centers across the U.S. Clusters of apprentices within centers will be assigned at random to one of four intervention groups (n = 24 per group): (1) ergonomics training only, (2) safety voice training only, (3) combined ergonomics and safety voice training, or (4) control group with no additional training intervention. Outcomes assessed at baseline, at the conclusion of training, and then at six and 12 months post training will include: musculoskeletal symptoms, general health perceptions, knowledge of ergonomic and safety voice principles, and perception and attitudes about ergonomic and safety voice issues. Masons continue to have a high rate of musculoskeletal disorders. The trade has an expected increase of 40 % in the number of workers by 2020. Therefore, a vetted intervention for apprentices entering the trade, such as SAVE, could reduce the burden of musculoskeletal disorders currently plaguing the trade. ClinicalTrials.gov Identifier: NCT02676635 , 2 February 2016.

Light Water Reactor Sustainability Program: Risk-Informed Safety Margins Characterization (RISMC) Pathway Technical Program Plan

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

Smith, Curtis; Rabiti, Cristian; Martineau, Richard

Safety is central to the design, licensing, operation, and economics of Nuclear Power Plants (NPPs). As the current Light Water Reactor (LWR) NPPs age beyond 60 years, there are possibilities for increased frequency of Systems, Structures, and Components (SSCs) degradations or failures that initiate safety-significant events, reduce existing accident mitigation capabilities, or create new failure modes. Plant designers commonly “over-design” portions of NPPs and provide robustness in the form of redundant and diverse engineered safety features to ensure that, even in the case of well-beyond design basis scenarios, public health and safety will be protected with a very high degreemore » of assurance. This form of defense-in-depth is a reasoned response to uncertainties and is often referred to generically as “safety margin.” Historically, specific safety margin provisions have been formulated, primarily based on “engineering judgment.”« less

Does the concept of safety culture help or hinder systems thinking in safety?

PubMed

Reiman, Teemu; Rollenhagen, Carl

2014-07-01

The concept of safety culture has become established in safety management applications in all major safety-critical domains. The idea that safety culture somehow represents a "systemic view" on safety is seldom explicitly spoken out, but nevertheless seem to linger behind many safety culture discourses. However, in this paper we argue that the "new" contribution to safety management from safety culture never really became integrated with classical engineering principles and concepts. This integration would have been necessary for the development of a more genuine systems-oriented view on safety; e.g. a conception of safety in which human, technological, organisational and cultural factors are understood as mutually interacting elements. Without of this integration, researchers and the users of the various tools and methods associated with safety culture have sometimes fostered a belief that "safety culture" in fact represents such a systemic view about safety. This belief is, however, not backed up by theoretical or empirical evidence. It is true that safety culture, at least in some sense, represents a holistic term-a totality of factors that include human, organisational and technological aspects. However, the departure for such safety culture models is still human and organisational factors rather than technology (or safety) itself. The aim of this paper is to critically review the various uses of the concept of safety culture as representing a systemic view on safety. The article will take a look at the concepts of culture and safety culture based on previous studies, and outlines in more detail the theoretical challenges in safety culture as a systems concept. The paper also presents recommendations on how to make safety culture more systemic. Copyright © 2013 Elsevier Ltd. All rights reserved.

Remote sensing of WUI fuel treatment effectiveness following the 2007 wildfires in central Idaho

Treesearch

Andrew T. Hudak; Theresa B. Jain; Penelope Morgan; Jess T. Clark

2011-01-01

The 2007 East Zone and Cascade wildfires in central Idaho burned through fuel treatments in the wildland-urban interface (WUI) surrounding two local communities: Secesh Meadows and Warm Lake. The WUI fuel treatments funded by the National Fire Plan were designed to increase fire fighter safety, protect people and property, and mitigate severe fire effects on natural...

Determinants of safety outcomes and performance: A systematic literature review of research in four high-risk industries.

PubMed

Cornelissen, Pieter A; Van Hoof, Joris J; De Jong, Menno D T

2017-09-01

In spite of increasing governmental and organizational efforts, organizations still struggle to improve the safety of their employees as evidenced by the yearly 2.3 million work-related deaths worldwide. Occupational safety research is scattered and inaccessible, especially for practitioners. Through systematically reviewing the safety literature, this study aims to provide a comprehensive overview of behavioral and circumstantial factors that endanger or support employee safety. A broad search on occupational safety literature using four online bibliographical databases yielded 27.527 articles. Through a systematic reviewing process 176 online articles were identified that met the inclusion criteria (e.g., original peer-reviewed research; conducted in selected high-risk industries; published between 1980-2016). Variables and the nature of their interrelationships (i.e., positive, negative, or nonsignificant) were extracted, and then grouped and classified through a process of bottom-up coding. The results indicate that safety outcomes and performance prevail as dependent research areas, dependent on variables related to management & colleagues, work(place) characteristics & circumstances, employee demographics, climate & culture, and external factors. Consensus was found for five variables related to safety outcomes and seven variables related to performance, while there is debate about 31 other relationships. Last, 21 variables related to safety outcomes and performance appear understudied. The majority of safety research has focused on addressing negative safety outcomes and performance through variables related to others within the organization, the work(place) itself, employee demographics, and-to a lesser extent-climate & culture and external factors. This systematic literature review provides both scientists and safety practitioners an overview of the (under)studied behavioral and circumstantial factors related to occupational safety behavior. Scientists could use this overview to study gaps, and validate or falsify relationships. Safety practitioners could use the insights to evaluate organizational safety policies, and to further development of safety interventions. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Safety and the Human Factor.

ERIC Educational Resources Information Center

Smith, Ann

1982-01-01

Discusses four elements of safety programs: (1) safety training; (2) safety inspections; (3) accident investigations; and (4) protective safety equipment. Also discusses safety considerations in water/wastewater treatment facilities focusing on falls, drowning hazards, trickling filters, confined space entry, collection/distribution system safety,…

Examining psychosocial and physical hazards in the Ghanaian mining industry and their implications for employees' safety experience.

PubMed

Amponsah-Tawiah, Kwesi; Jain, Aditya; Leka, Stavroula; Hollis, David; Cox, Tom

2013-06-01

In addition to hazardous conditions that are prevalent in mines, there are various physical and psychosocial risk factors that can affect mine workers' safety and health. Without due diligence to mine safety, these risk factors can affect workers' safety experience, in terms of near misses, disabling injuries and accidents experienced or witnessed by workers. This study sets out to examine the effects of physical and psychosocial risk factors on workers' safety experience in a sample of Ghanaian miners. 307 participants from five mining companies responded to a cross sectional survey examining physical and psychosocial hazards and their implications for employees' safety experience. Zero-inflated Poisson regression models indicated that mining conditions, equipment, ambient conditions, support and security, and work demands and control are significant predictors of near misses, disabling injuries, and accidents experienced or witnessed by workers. The type of mine had important implications for workers' safety experience. Copyright © 2013 Elsevier Ltd and National Safety Council. All rights reserved.

Establishing a culture for patient safety - the role of education.

PubMed

Milligan, Frank J

2007-02-01

This paper argues that the process of making significant moves towards a patient safety culture requires changes in healthcare education. Improvements in patient safety are a shared international priority as too many errors and other forms of unnecessary harm are currently occurring in the process of caring for and treating patients. A description of the patient safety agenda is given followed by a brief analysis of human factors theory and its use in other safety critical industries, most notably aviation. The all too common problem of drug administration errors is used to illustrate the relevance of human factors theory to healthcare education with specific mention made of the Human Factors Analysis and Classification System (HFACS).

Operator performance-enhancing technologies to improve safety. A US DOT safety initiative for meeting the human-centered systems challenge.

DOT National Transportation Integrated Search

1999-11-01

The program implements DOT Human Factors Coordinating Committee (HFCC) recommendations for a coordinated Departmental Human Factors Research Program to advance the human-centered systems approach for enhancing transportation safety. Human error is a ...

75 FR 56972 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts... Factors AGENCY: Pipeline and Hazardous Materials Safety Administration (PHMSA); DOT. ACTION: Notice of...: Background There are roughly 170,000 miles of hazardous liquid pipelines, 295,000 miles of gas transmission...

Microbiological food safety: a dilemma of developing societies.

PubMed

Akhtar, Saeed; Sarker, Mahfuzur R; Hossain, Ashfaque

2014-11-01

Current food safety issues are deleteriously reshaping the life style of the population in the developing world. Socioeconomic status of the population in poorer economies is one of the major determinants to delineate the availability of safe food to the vulnerable population. Assessment of the prevalence of foodborne illness in developing world is the most neglected area to control disease. Botulism, Shigellosis, Campylobacteriosis, Escherichia coli infection, Staphylococcus aureus infection, Salmonellosis, Listeriosis and Cholerae are extensively prevalent and pose a major threat to human health in underdeveloped communities. The existing food safety status of many African, South Asian, Central, and South American developing countries is distressing therefore; it seems much timely to highlight the areas for the improvement to ensure the supply of safe food to the population in these regions. Extensive literature search at PubMed, Science Direct and Medline was carried out during the current year to catch on relevant data from 1976 to date, using selective terms like food safety, South East Asia, Africa, Central and South America, and foodborne illness etc. Efforts were made to restrict the search to low income countries of these regions with reference to specific foodborne pathogens. This report briefly discusses the present food safety situation in these developing countries and associated consequences as prime issues, suggesting foodborne illness to be the most distressing threat for human health and economic growth.

Is the notion of central fatigue based on a solid foundation?

PubMed

Contessa, Paola; Puleo, Alessio; De Luca, Carlo J

2016-02-01

Exercise-induced muscle fatigue has been shown to be the consequence of peripheral factors that impair muscle fiber contractile mechanisms. Central factors arising within the central nervous system have also been hypothesized to induce muscle fatigue, but no direct empirical evidence that is causally associated to reduction of muscle force-generating capability has yet been reported. We developed a simulation model to investigate whether peripheral factors of muscle fatigue are sufficient to explain the muscle force behavior observed during empirical studies of fatiguing voluntary contractions, which is commonly attributed to central factors. Peripheral factors of muscle fatigue were included in the model as a time-dependent decrease in the amplitude of the motor unit force twitches. Our simulation study indicated that the force behavior commonly attributed to central fatigue could be explained solely by peripheral factors during simulated fatiguing submaximal voluntary contractions. It also revealed important flaws regarding the use of the interpolated twitch response from electrical stimulation of the muscle as a means for assessing central fatigue. Our analysis does not directly refute the concept of central fatigue. However, it raises important concerns about the manner in which it is measured and about the interpretation of the commonly accepted causes of central fatigue and questions the very need for the existence of central fatigue. Copyright © 2016 the American Physiological Society.

Safety culture assessment in petrochemical industry: a comparative study of two algerian plants.

PubMed

Boughaba, Assia; Hassane, Chabane; Roukia, Ouddai

2014-06-01

To elucidate the relationship between safety culture maturity and safety performance of a particular company. To identify the factors that contribute to a safety culture, a survey questionnaire was created based mainly on the studies of Fernández-Muñiz et al. The survey was randomly distributed to 1000 employees of two oil companies and realized a rate of valid answer of 51%. Minitab 16 software was used and diverse tests, including the descriptive statistical analysis, factor analysis, reliability analysis, mean analysis, and correlation, were used for the analysis of data. Ten factors were extracted using the analysis of factor to represent safety culture and safety performance. The results of this study showed that the managers' commitment, training, incentives, communication, and employee involvement are the priority domains on which it is necessary to stress the effort of improvement, where they had all the descriptive average values lower than 3.0 at the level of Company B. Furthermore, the results also showed that the safety culture influences the safety performance of the company. Therefore, Company A with a good safety culture (the descriptive average values more than 4.0), is more successful than Company B in terms of accident rates. The comparison between the two petrochemical plants of the group Sonatrach confirms these results in which Company A, the managers of which are English and Norwegian, distinguishes itself by the maturity of their safety culture has significantly higher evaluations than the company B, who is constituted of Algerian staff, in terms of safety management practices and safety performance.

Safety Culture Assessment in Petrochemical Industry: A Comparative Study of Two Algerian Plants

PubMed Central

Boughaba, Assia; Hassane, Chabane; Roukia, Ouddai

2014-01-01

Background To elucidate the relationship between safety culture maturity and safety performance of a particular company. Methods To identify the factors that contribute to a safety culture, a survey questionnaire was created based mainly on the studies of Fernández-Muñiz et al. The survey was randomly distributed to 1000 employees of two oil companies and realized a rate of valid answer of 51%. Minitab 16 software was used and diverse tests, including the descriptive statistical analysis, factor analysis, reliability analysis, mean analysis, and correlation, were used for the analysis of data. Ten factors were extracted using the analysis of factor to represent safety culture and safety performance. Results The results of this study showed that the managers' commitment, training, incentives, communication, and employee involvement are the priority domains on which it is necessary to stress the effort of improvement, where they had all the descriptive average values lower than 3.0 at the level of Company B. Furthermore, the results also showed that the safety culture influences the safety performance of the company. Therefore, Company A with a good safety culture (the descriptive average values more than 4.0), is more successful than Company B in terms of accident rates. Conclusion The comparison between the two petrochemical plants of the group Sonatrach confirms these results in which Company A, the managers of which are English and Norwegian, distinguishes itself by the maturity of their safety culture has significantly higher evaluations than the company B, who is constituted of Algerian staff, in terms of safety management practices and safety performance. PMID:25180135

FY 1991 safety program status report

NASA Technical Reports Server (NTRS)

1991-01-01

In FY 1991, the NASA Safety Division continued efforts to enhance the quality and productivity of its safety oversight function. Recent initiatives set forth in areas such as training, risk management, safety assurance, operational safety, and safety information systems have matured into viable programs contributing to the safety and success of activities throughout the Agency. Efforts continued to develop a centralized intra-agency safety training program with establishment of the NASA Safety Training Center at the Johnson Space Center (JSC). The objective is to provide quality training for NASA employees and contractors on a broad range of safety-related topics. Courses developed by the Training Center will be presented at various NASA locations to minimize travel and reach the greatest number of people at the least cost. In FY 1991, as part of the ongoing efforts to enhance the total quality of NASA's safety work force, the Safety Training Center initiated development of a Certified Safety Professional review course. This course provides a comprehensive review of the skills and knowledge that well-rounded safety professionals must possess to qualify for professional certification. FY 1992 will see the course presented to NASA and contractor employees at all installations via the NASA Video Teleconference System.

Effect of current federal regulations on handgun safety features.

PubMed

Milne, John S; Hargarten, Stephen W; Kellermann, Arthur L; Wintemute, Garen J

2003-01-01

In the late 1960s, the Bureau of Alcohol, Tobacco, and Firearms implemented the "factoring criteria," a set of minimum size and safety standards required for any handgun imported into the United States. These standards, however, were not applied to guns manufactured domestically. We determine whether extending the factoring criteria to all handguns sold in the United States, as has been proposed in Congress, would increase the likelihood that safety devices would be included in new handgun designs. Imported and domestic handgun models produced in 1996 were examined to determine the prevalence of 4 passively acting safety devices on pistols and 1 passive safety device on revolvers. Domestic models were also scored against the factoring criteria. Compared with domestic pistol models, imported pistols were more likely to include a firing pin block (odds ratio [OR] 2.43; 95% confidence interval [CI] 1.54 to 3.85) and a loaded chamber indicator (OR 1.59; 95% CI 0.98 to 2.56). Domestic pistol models that already met the factoring criteria were more likely to include a loaded chamber indicator (OR 12.05; 95% CI 2.74 to 53.02), a grip safety (OR 24.12; 95% CI 7.8 to 74.33), and a firing pin block (OR 4.92; 95% CI 2.35 to 10.29) than domestic models that did not meet the criteria. Although pistol models that meet the factoring criteria are more likely to contain safety devices than those that do not, the net effect is modest. Thus, the factoring criteria alone are insufficient to ensure consistent incorporation of safety features into new handgun designs.

14 CFR 23.619 - Special factors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Special factors. 23.619 Section 23.619... Special factors. The factor of safety prescribed in § 23.303 must be multiplied by the highest pertinent special factors of safety prescribed in §§ 23.621 through 23.625 for each part of the structure whose...

Assessment of safety culture among job positions in high-rise construction: a hybrid fuzzy multi criteria decision-making (FMCDM) approach.

PubMed

Ardeshir, A; Mohajeri, M

2018-06-01

The construction industry is known as one of the most dangerous industries, which not only requires sound operation of executive laws and regulations, but also necessitates the safety culture of all workers at workshops. Therefore, the aim of this research is to identify the factors of safety culture and ranking occupations in jobsites based on those factors in order to proactively improve the safety culture of construction projects and subsequently promote safety conditions and worksites. In this study, safety culture criteria are weighted by a combination of Fuzzy Decision Trail and Evaluation Laboratory and Fuzzy ANP methods. Next, different job positions in high-rise projects are ranked using the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution method. Findings demonstrated that the project manager, site superintendent and supervisor occupations had the highest and labourers had the lowest level of safety culture in the high-rise construction industry. Furthermore, factors such as safety supervision and training must be considered more seriously in order to create a positive safety culture among workers.

Take a Seat.

ERIC Educational Resources Information Center

Grant, Deborah R.

1999-01-01

Examines the factors involved in purchasing school furnishings that will help ensure its long-time use, safety, and ability to resist abuse. Cost and safety factors discussed include resisting trendy colors to reduce cost in furniture matching, managing computer and office wiring for safety, considering ergonomics in the purchasing decision, and…

Listening to food workers: Factors that impact proper health and hygiene practice in food service.

PubMed

Clayton, Megan L; Clegg Smith, Katherine; Neff, Roni A; Pollack, Keshia M; Ensminger, Margaret

2015-01-01

Foodborne disease is a significant problem worldwide. Research exploring sources of outbreaks indicates a pronounced role for food workers' improper health and hygiene practice. To investigate food workers' perceptions of factors that impact proper food safety practice. Interviews with food service workers in Baltimore, MD, USA discussing food safety practices and factors that impact implementation in the workplace. A social ecological model organizes multiple levels of influence on health and hygiene behavior. Issues raised by interviewees include factors across the five levels of the social ecological model, and confirm findings from previous work. Interviews also reveal many factors not highlighted in prior work, including issues with food service policies and procedures, working conditions (e.g., pay and benefits), community resources, and state and federal policies. Food safety interventions should adopt an ecological orientation that accounts for factors at multiple levels, including workers' social and structural context, that impact food safety practice.

Bilateral effects of hospital patient-safety procedures on nurses' job satisfaction.

PubMed

Inoue, T; Karima, R; Harada, K

2017-09-01

The aim of this study was to examine how hospital patient-safety procedures affect the job satisfaction of hospital nurses. Additionally, we investigated the association between perceived autonomy and hospital patient-safety procedures and job satisfaction. Recently, measures for patient safety have been recognized as an essential requirement in hospitals. Hospital patient-safety procedures may enhance the job satisfaction of nurses by improving the quality of their work. However, such procedures may also decrease their job satisfaction by imposing excessive stress on nurses because they cannot make mistakes. The participants included 537 nurses at 10 private hospitals in Japan (The surveys were collected from March to July 2012). Factors related to hospital patient-safety procedures were demonstrated using factor analysis, and the associations between these factors and nurses' self-perceived autonomy and job satisfaction were examined using structural equation modelling. Five factors regarding hospital patient-safety procedures were extracted. Additionally, structural equation modelling revealed statistically significant associations between these factors and the nurses' self-perceived autonomy and job satisfaction. The findings showed that nurses' perceived autonomy of the workplace enhanced their job satisfaction and that their perceptions of hospital patient-safety procedures promoted their job satisfaction. However, some styles of chief nurses' leadership regarding patient safety restrict nurses' independent and autonomous decision-making and actions, resulting in a lowering of job satisfaction. This study demonstrated that hospital patient-safety procedures have ambiguous effects on nurses' job satisfaction. In particular, chief nurses' leadership relating to patient safety can have a positive or negative effect on nurses' job satisfaction. The findings indicated that hospital managers should demonstrate positive attitudes to improve patient safety for nurses' job satisfaction. In addition, policymakers in the hospitals should consider that chief nurses' leadership styles may reduce autonomy and suppress nurses' job satisfaction. © 2017 The Authors International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

Mother-daughter correlation of central obesity and other noncommunicable disease risk factors: Tehran Lipid and Glucose Study.

PubMed

Heidari, Zahra; Hosseinpanah, Farhad; Barzin, Maryam; Safarkhani, Maryam; Azizi, Fereidoun

2015-03-01

This study aimed to investigate the mother-daughter correlation for central obesity and other noncommunicable disease risk factors. The authors used metabolic and anthropometric data from the Tehran Lipid and Glucose Study, enrolling 1041 mother-daughter pairs for the current study. Three age strata were defined: 3 to 9 years for childhood (146 mother-daughter pairs), 10 to 17 years for adolescence (395 mother-daughter pairs), and 18 to 25 years for early adulthood (500 mother-daughter pairs). Familial associations for central obesity and other noncommunicable disease risk factors were assessed. The prevalence of central obesity was 44.7% in mothers and 11.2% in daughters (6.2% in the 3-9, 19.2% in the 10-17, and 6.4% in the 18-25 years groups). Mothers with central obesity were more likely than nonobese mothers to have daughters with central obesity (10.5% and 1.7%, respectively; P = .0001). Central obesity indices among daughters were positively correlated with those of their mothers in all 3 age strata. Correlations for other noncommunicable disease risk factors were analyzed before and after adjusting the risk factor levels for mothers' and daughters' waist circumferences (WCs) within each group to determine whether risk factor correlations were, in part, a result of the central obesity correlations. After the non-communicable disease risk factor levels of participants were adjusted for their WCs, the mother-daughter correlations remained significant. The consistent association of central obesity between mothers and daughters may indicate the key role that could be played by the mother in the primary prevention of central obesity, particularly in high-risk families. © 2012 APJPH.

Computing factors of safety against wind-induced tree stem damage.

PubMed

Niklas, K J

2000-04-01

The drag forces, bending moments and stresses acting on stems differing in size and location within the mechanical infrastructure of a large wild cherry (Prunus serotina Ehrh.) tree are estimated and used to calculate the factor of safety against wind-induced mechanical failure based on the mean breaking stress of intact stems and samples of wood drawn from this tree. The drag forces acting on stems are calculated based on stem projected areas and field measurements of wind speed taken within the canopy and along the length of the trunk. The bending moments and stresses resulting from these forces are shown to increase basipetally in a nearly log-log linear fashion toward the base of the tree. The factor of safety, however, varies in a sinusoidal manner such that the most distal stems have the highest factors of safety, whereas stems of intermediate location and portions of the trunk near ground level have equivalent and much lower factors of safety. This pattern of variation is interpreted to indicate that, as a course of normal growth and development, trees similar to the one examined in this study maintain a cadre of stems prone to wind-induced mechanical damage that can reduce the probability of catastrophic tree failure by reducing the drag forces acting on older portions of the tree. Comparisons among real and hypothetical stems with different taper experiencing different vertical wind speed profiles show that geometrically self-similar stems have larger factors of safety than stems tapering according to elastic or stress self-similarity, and that safety factors are less significantly influenced by the 'geometry' of the wind-profile.

Efficacy and safety of nerve growth factor for the treatment of neurological diseases: a meta-analysis of 64 randomized controlled trials involving 6,297 patients

PubMed Central

Zhao, Meng; Li, Xiao-yan; Xu, Chun-ying; Zou, Li-ping

2015-01-01

OBJECTIVE: China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine. More than 10 years ago, in 2003, nerve growth factor injection was listed as a national drug. The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases. DATA RETRIEVAL: A computer-based retrieval was performed from six databases, including the Cochrane Library, PubMed, EMBASE, Sino Med, CNKI, and the VIP database, searching from the clinical establishment of nerve growth factor for treatment until December 31, 2013. The key words for the searches were “nerve growth factor, randomized controlled trials” in Chinese and in English. DATA SELECTION: Inclusion criteria: any study published in English or Chinese referring to randomized controlled trials of nerve growth factor; patients with neurological diseases such as peripheral nerve injury, central nerve injury, cranial neuropathy, and nervous system infections; patients older than 7 years; similar research methods and outcomes assessing symptoms; and measurement of nerve conduction velocities. The meta-analysis was conducted using Review Manager 5.2.3 software. MAIN OUTCOME MEASURES: The total effective rate, the incidence of adverse effects, and the nerve conduction velocity were recorded for each study. RESULTS: Sixty-four studies involving 6,297 patients with neurological diseases were included. The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group (P < 0.0001, RR: 1.35, 95%CI: 1.30–1.40). The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group (P < 0.00001, MD: 4.59 m/s, 95%CI: 4.12–5.06). The incidence of pain or scleroma at the injection site in the nerve growth factor group was also higher than that in the control group (P < 0.00001, RR: 6.30, 95%CI: 3.53–11.27), but such adverse effects were mild. CONCLUSION: Nerve growth factor can significantly improve nerve function in patients with nervous system disease and is safe and effective. PMID:26109961

A multi-agent safety response model in the construction industry.

PubMed

Meliá, José L

2015-01-01

The construction industry is one of the sectors with the highest accident rates and the most serious accidents. A multi-agent safety response approach allows a useful diagnostic tool in order to understand factors affecting risk and accidents. The special features of the construction sector can influence the relationships among safety responses along the model of safety influences. The purpose of this paper is to test a model explaining risk and work-related accidents in the construction industry as a result of the safety responses of the organization, the supervisors, the co-workers and the worker. 374 construction employees belonging to 64 small Spanish construction companies working for two main companies participated in the study. Safety responses were measured using a 45-item Likert-type questionnaire. The structure of the measure was analyzed using factor analysis and the model of effects was tested using a structural equation model. Factor analysis clearly identifies the multi-agent safety dimensions hypothesized. The proposed safety response model of work-related accidents, involving construction specific results, showed a good fit. The multi-agent safety response approach to safety climate is a useful framework for the assessment of organizational and behavioral risks in construction.

Effect of A Reduction in glomerular filtration rate after NEphrectomy on arterial STiffness and central hemodynamics: rationale and design of the EARNEST study.

PubMed

Moody, William E; Tomlinson, Laurie A; Ferro, Charles J; Steeds, Richard P; Mark, Patrick B; Zehnder, Daniel; Tomson, Charles R; Cockcroft, John R; Wilkinson, Ian B; Townend, Jonathan N

2014-02-01

There is strong evidence of an association between chronic kidney disease (CKD) and cardiovascular disease. To date, however, proof that a reduction in glomerular filtration rate (GFR) is a causative factor in cardiovascular disease is lacking. Kidney donors comprise a highly screened population without risk factors such as diabetes and inflammation, which invariably confound the association between CKD and cardiovascular disease. There is strong evidence that increased arterial stiffness and left ventricular hypertrophy and fibrosis, rather than atherosclerotic disease, mediate the adverse cardiovascular effects of CKD. The expanding practice of live kidney donation provides a unique opportunity to study the cardiovascular effects of an isolated reduction in GFR in a prospective fashion. At the same time, the proposed study will address ongoing safety concerns that persist because most longitudinal outcome studies have been undertaken at single centers and compared donor cohorts with an inappropriately selected control group. The reduction in GFR accompanying uninephrectomy causes (1) a pressure-independent increase in aortic stiffness (aortic pulse wave velocity) and (2) an increase in peripheral and central blood pressure. This is a prospective, multicenter, longitudinal, parallel group study of 440 living kidney donors and 440 healthy controls. All controls will be eligible for living kidney donation using current UK transplant criteria. Investigations will be performed at baseline and repeated at 12 months in the first instance. These include measurement of arterial stiffness using applanation tonometry to determine pulse wave velocity and pulse wave analysis, office blood pressure, 24-hour ambulatory blood pressure monitoring, and a series of biomarkers for cardiovascular and bone mineral disease. These data will prove valuable by characterizing the direction of causality between cardiovascular and renal disease. This should help inform whether targeting reduced GFR alongside more traditional cardiovascular risk factors is warranted. In addition, this study will contribute important safety data on living kidney donors by providing a longitudinal assessment of well-validated surrogate markers of cardiovascular disease, namely, blood pressure and arterial stiffness. If any adverse effects are detected, these may be potentially reversed with the early introduction of targeted therapy. This should ensure that kidney donors do not come to long-term harm and thereby preserve the ongoing expansion of the living donor transplant program (NCT01769924). © 2014.

Safety climate and safety behaviors in the construction industry: The importance of co-workers commitment to safety.

PubMed

Schwatka, Natalie V; Rosecrance, John C

2016-06-16

There is growing empirical evidence that as safety climate improves work site safety practice improve. Safety climate is often measured by asking workers about their perceptions of management commitment to safety. However, it is less common to include perceptions of their co-workers commitment to safety. While the involvement of management in safety is essential, working with co-workers who value and prioritize safety may be just as important. To evaluate a concept of safety climate that focuses on top management, supervisors and co-workers commitment to safety, which is relatively new and untested in the United States construction industry. Survey data was collected from a cohort of 300 unionized construction workers in the United States. The significance of direct and indirect (mediation) effects among safety climate and safety behavior factors were evaluated via structural equation modeling. Results indicated that safety climate was associated with safety behaviors on the job. More specifically, perceptions of co-workers commitment to safety was a mediator between both management commitment to safety climate factors and safety behaviors. These results support workplace health and safety interventions that build and sustain safety climate and a commitment to safety amongst work teams.

Patient Safety: The Role of Human Factors and Systems Engineering

PubMed Central

Carayon, Pascale; Wood, Kenneth E.

2011-01-01

Patient safety is a global challenge that requires knowledge and skills in multiple areas, including human factors and systems engineering. In this chapter, numerous conceptual approaches and methods for analyzing, preventing and mitigating medical errors are described. Given the complexity of healthcare work systems and processes, we emphasize the need for increasing partnerships between the health sciences and human factors and systems engineering to improve patient safety. Those partnerships will be able to develop and implement the system redesigns that are necessary to improve healthcare work systems and processes for patient safety. PMID:20543237

Self-organized stationary states of inductively driven tokamaks

NASA Astrophysics Data System (ADS)

Jardin, S. C.; Ferraro, N.; Krebs, I.; Chen, J.

2014-10-01

We report on a mechanism for preventing the current and temperature profiles from peaking in a stationary state tokamak. For certain parameters, regardless of the initial state, the plasma profiles will evolve into a self-organized state with the safety factor q slightly above 1 and constant in a central volume. This large shear free region is unstable to interchange modes for any pressure gradient, and the instability drives a strong (1,1) helical flow. This flow has the property that V × B is the gradient of a potential, so it does not affect the magnetic field evolution. However, the driven flow appears in the temperature evolution equation and dominates over the thermal conductivity in the center of the discharge. The net effect is to keep the central temperature (and resistivity) profiles flat so that the resistive steady state preserves the self organized state with q slightly above 1 and constant in the central volume. This mechanism was discovered with the M3D-C1 toroidal 3D MHD code, and could possibly explain the mechanism at play in non-sawtoothing discharges with q0 just above 1 such as hybrid modes in DIII-D and ASDEX-U and long-lived modes in NSTX and MAST. This work was supported by US DOE Contract No. DE-AC02-09CHI1446, MPPC, and SciDAC CEMM.

Sociotechnical attributes of safe and unsafe work systems.

PubMed

Kleiner, Brian M; Hettinger, Lawrence J; DeJoy, David M; Huang, Yuang-Hsiang; Love, Peter E D

2015-01-01

Theoretical and practical approaches to safety based on sociotechnical systems principles place heavy emphasis on the intersections between social-organisational and technical-work process factors. Within this perspective, work system design emphasises factors such as the joint optimisation of social and technical processes, a focus on reliable human-system performance and safety metrics as design and analysis criteria, the maintenance of a realistic and consistent set of safety objectives and policies, and regular access to the expertise and input of workers. We discuss three current approaches to the analysis and design of complex sociotechnical systems: human-systems integration, macroergonomics and safety climate. Each approach emphasises key sociotechnical systems themes, and each prescribes a more holistic perspective on work systems than do traditional theories and methods. We contrast these perspectives with historical precedents such as system safety and traditional human factors and ergonomics, and describe potential future directions for their application in research and practice. The identification of factors that can reliably distinguish between safe and unsafe work systems is an important concern for ergonomists and other safety professionals. This paper presents a variety of sociotechnical systems perspectives on intersections between social--organisational and technology--work process factors as they impact work system analysis, design and operation.

Emotional Safety in Adventure Therapy Programs: Can It Be Defined?

ERIC Educational Resources Information Center

Vincent, Suzanne M.

1995-01-01

Ninety-eight adventure therapy professionals analyzed a proposed definition of emotional safety and rated 26 factors hypothesized to affect an individual's level of emotional safety during adventure activities. Factors were related to specific techniques used by instructors, instructor skills and abilities, the physical environment, and group…

Mission Safety Evaluation Report for STS-43, Postflight Edition

NASA Technical Reports Server (NTRS)

Hill, William C.; Finkel, Seymour I.

1991-01-01

Some of the topics covered include: (1) an STS-43 mission summary; (2) safety risks factors/issues; (3) resolved STS-43 safety risk factors; (4) STS-40 inflight anomalies; (5) STS-37 inflight anomalies; and (6) STS-43 inflight anomalies. Background information and a list of acronyms are also presented.

Mission Safety Evaluation Report for STS-32, Postflight Edition

NASA Technical Reports Server (NTRS)

Hill, William C.; Finkel, Seymour I.

1990-01-01

The topics covered include: (1) an STS-32 mission summary; (2) safety risk factors/issues; (3) resolved STS-32 safety risk factors; (4) STS-32 inflight anomalies; (5) STS-28 inflight anomalies; and (6) STS-32 inflight anomalies. Background information and a list of acronyms are also presented.

16 CFR 1119.4 - Factors considered in determining civil penalties.

Code of Federal Regulations, 2011 CFR

2011-01-01

... penalties. 1119.4 Section 1119.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS CIVIL PENALTY FACTORS § 1119.4 Factors considered in determining civil penalties...) of the FFA, specify factors considered by the Commission in determining the amount of a civil penalty...

16 CFR 1119.4 - Factors considered in determining civil penalties.

Code of Federal Regulations, 2012 CFR

2012-01-01

... penalties. 1119.4 Section 1119.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS CIVIL PENALTY FACTORS § 1119.4 Factors considered in determining civil penalties...) of the FFA, specify factors considered by the Commission in determining the amount of a civil penalty...

16 CFR 1119.4 - Factors considered in determining civil penalties.

Code of Federal Regulations, 2014 CFR

2014-01-01

... penalties. 1119.4 Section 1119.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS CIVIL PENALTY FACTORS § 1119.4 Factors considered in determining civil penalties...) of the FFA, specify factors considered by the Commission in determining the amount of a civil penalty...

Observation of internal transport barrier in ELMy H-mode plasmas on the EAST tokamak

NASA Astrophysics Data System (ADS)

Yang, Y.; Gao, X.; Liu, H. Q.; Li, G. Q.; Zhang, T.; Zeng, L.; Liu, Y. K.; Wu, M. Q.; Kong, D. F.; Ming, T. F.; Han, X.; Wang, Y. M.; Zang, Q.; Lyu, B.; Li, Y. Y.; Duan, Y. M.; Zhong, F. B.; Li, K.; Xu, L. Q.; Gong, X. Z.; Sun, Y. W.; Qian, J. P.; Ding, B. J.; Liu, Z. X.; Liu, F. K.; Hu, C. D.; Xiang, N.; Liang, Y. F.; Zhang, X. D.; Wan, B. N.; Li, J. G.; Wan, Y. X.; EAST Team

2017-08-01

The internal transport barrier (ITB) has been obtained in ELMy H-mode plasmas by neutron beam injection and lower hybrid wave heating on the Experimental Advanced Superconducting Tokamak (EAST). The ITB structure has been observed in profiles of ion temperature, electron temperature, and electron density within ρ < 0.5. It was also observed that the ITB formation is stepwise. Due to the ITB formation, the confinement quality H 98y2 increases from 1 to 1.1 and the normalized beta, β N, increases from 1.5 to near 2. The fishbone activity observed during the ITB phase suggests the central safety factor q(0) ˜ 1. Transport coefficients are calculated by particle balance and power balance analysis, showing an obvious reduction after the ITB formation.

The relationship between employees' perceptions of safety and organizational culture.

PubMed

O'Toole, Michael

2002-01-01

With limited resources to help reduce occupational injuries, companies struggle with how to best focus these resources to achieve the greatest reduction in injuries for the optimal cost. Safety culture has been identified as a critical factor that sets the tone for importance of safety within an organization. An employee safety perception survey was conducted, and injury data were collected over a 45-month period from a large ready-mix concrete producer located in the southwest region of the United States. The results of this preliminary study suggest that the reductions in injuries experienced at the company locations was strongly impacted by the positive employee perceptions on several key factors. Management's commitment to safety was the factor with the greatest positive perception by employees taking the survey. This study was set up as a pilot project and did not unitize an experimental design. That weakness reduces the strength of these findings but adds to the importance of expanding the pilot project with an appropriate experimental design. Management leadership has been identified, along with several other factors, to influence employee perceptions of the safety management system. Those perceptions, in turn, appear to influence employee decisions that relate to at-risk behaviors and decisions on the job. The results suggest that employee perceptions of the safety system are related to management's commitment to safety, which, in turn, appear to be related to injury rates. Management should focus on how to best leverage these key factors to more positively impact injury rates within their companies.

Workforce perceptions of hospital safety culture: development and validation of the patient safety climate in healthcare organizations survey.

PubMed

Singer, Sara; Meterko, Mark; Baker, Laurence; Gaba, David; Falwell, Alyson; Rosen, Amy

2007-10-01

To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's alpha coefficients ranged from 0.50 to 0.89. It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes.

Cultural factors influencing safety need to be addressed in design and operation of technology.

PubMed

Meshkati, N

1996-10-01

Cultural factors which influence aviation safety in aircraft design, air traffic control, and human factors training are examined. Analysis of the Avianca Flight 052 crash in New York in January, 1990, demonstrates the catastrosphic effects cultural factors can play. Cultural factors include attitude toward work and technology, organizational hierarchy, religion, and population stereotyping.

Missing focus on Human Factors – organizational and cognitive ergonomics – in the safety management for the petroleum industry

PubMed Central

Johnsen, Stig O; Kilskar, Stine Skaufel; Fossum, Knut Robert

2017-01-01

More attention has recently been given to Human Factors in petroleum accident investigations. The Human Factors areas examined in this article are organizational, cognitive and physical ergonomics. A key question to be explored is as follows: To what degree are the petroleum industry and safety authorities in Norway focusing on these Human Factors areas from the design phase? To investigate this, we conducted an innovative exploratory study of the development of four control centres in Norwegian oil and gas industry in collaboration between users, management and Human Factors experts. We also performed a literature survey and discussion with the professional Human Factors network in Norway. We investigated the Human Factors focus, reasons for not considering Human Factors and consequences of missing Human Factors in safety management. The results revealed an immature focus and organization of Human Factors. Expertise on organizational ergonomics and cognitive ergonomics are missing from companies and safety authorities and are poorly prioritized during the development. The easy observable part of Human Factors (i.e. physical ergonomics) is often in focus. Poor focus on Human Factors in the design process creates demanding conditions for human operators and impact safety and resilience. There is lack of non-technical skills such as communication and decision-making. New technical equipment such as Closed Circuit Television is implemented without appropriate use of Human Factors standards. Human Factors expertise should be involved as early as possible in the responsible organizations. Verification and validation of Human Factors should be improved and performed from the start, by certified Human Factors experts in collaboration with the workforce. The authorities should check-back that the regulatory framework of Human Factors is communicated, understood and followed. PMID:29278242

Modeling the impact of spatial relationships on horizontal curve safety.

PubMed

Findley, Daniel J; Hummer, Joseph E; Rasdorf, William; Zegeer, Charles V; Fowler, Tyler J

2012-03-01

The curved segments of roadways are more hazardous because of the additional centripetalforces exerted on a vehicle, driver expectations, and other factors. The safety of a curve is dependent on various factors, most notably by geometric factors, but the location of a curve in relation to other curves is also thought to influence the safety of those curves because of a driver's expectation to encounter additional curves. The link between an individual curve's geometric characteristics and its safety performance has been established, but spatial considerations are typically not included in a safety analysis. The spatial considerations included in this research consisted of four components: distance to adjacent curves, direction of turn of the adjacent curves, and radius and length of the adjacent curves. The primary objective of this paper is to quantify the spatial relationship between adjacent horizontal curves and horizontal curve safety using a crash modification factor. Doing so enables a safety professional to more accurately estimate safety to allocate funding to reduce or prevent future collisions and more efficiently design new roadway sections to minimize crash risk where there will be a series of curves along a route. The most important finding from this research is the statistical significance of spatial considerations for the prediction of horizontal curve safety. The distances to adjacent curves were found to be a reliable predictor of observed collisions. This research recommends a model which utilizes spatial considerations for horizontal curve safety prediction in addition to current Highway Safety Manual prediction capabilities using individual curve geometric features. Copyright © 2011 Elsevier Ltd. All rights reserved.

Improved preclinical cardiovascular therapeutic indices with long-term inhibition of norepinephrine reuptake using reboxetine

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

Fossa, Anthony A., E-mail: anthony.fossa@icardiac.com; Wisialowski, Todd A.; Cremers, Thomas

2012-11-01

Norepinephrine reuptake inhibitors (NRIs) acutely increase norepinephrine (NE) levels, but therapeutic antidepressant activity is only observed after weeks of treatment because central NE levels progressively increase during continued drug exposure. Similarly, while NRIs acutely increase blood pressure (BP) and heart rate (HR) due to enhanced sympathetic neurotransmission, chronic treatment changes the responsiveness of the central noradrenergic system and suppresses these effects via autonomic regulation. To better understand the relationship between NE increases and cardiovascular safety, we investigated acute and chronic effects of the NRI reboxetine on central NE release and on BP and HR and electrical alternans, a measure ofmore » arrhythmia liability, in guinea pigs. NE release was assessed by microdialysis in medial prefrontal cortex (mPFC) and hypothalamic paraventricular nucleus (PVN); BP and HR were measured by telemetry. Animals were treated for 28 days with 15 mg/kg/day of reboxetine or vehicle via an osmotic minipump and then challenged with acute intravenous doses of reboxetine. Animals chronically treated with reboxetine had 2-fold higher extracellular basal NE levels in mPFC and PVN compared to basal levels after chronic vehicle treatment. BP was significantly increased after the first day of treatment, and gradually returned to vehicle levels by day 21. These data indicate that chronic NRI treatment may lead to an increase in central NE levels and a concomitant reduction in BP based on exposure–response curves compared to vehicle treatment, suggesting a larger separation between preclinical estimates of efficacy vs. safety compared to acute NRI treatment. -- Highlights: ► Acute RBX produces blood pressure increases acutely that decrease with chronic RBX ► Chronic RBX increases brain NE levels, a preclinical surrogate of improved efficacy ► Short-term screening of NRI often underestimates the chronic therapeutic index ► Chronic cardiovascular safety and efficacy more adequately address therapeutic index ► Similar paradigms may exist with other centrally and peripherally acting drugs.« less

Safety and Efficacy Study of VY-AADC01 for Advanced Parkinson's Disease

ClinicalTrials.gov

2018-02-27

Idiopathic Parkinson's Disease; Parkinson's Disease; Basal Ganglia Disease; Brain Diseases; Central Nervous System Diseases; Movement Disorders; Nervous System Diseases; Neurodegenerative Diseases; Parkinsonian Disorders

A review of antithrombotic therapy and the rationale and design of the randomized edoxaban in patients with peripheral artery disease (ePAD) trial adding edoxaban or clopidogrel to aspirin after femoropopliteal endovascular intervention.

PubMed

Tangelder, Marco J D; Nwachuku, Chuke E; Jaff, Michael; Baumgartner, Iris; Duggal, Anil; Adams, George; Ansel, Gary; Grosso, Michael; Mercuri, Michele; Shi, Minggao; Minar, Erich; Moll, Frans L

2015-04-01

Compared with the coronary setting, knowledge about antithrombotic therapies after endovascular treatment (EVT) is inadequate in patients with peripheral artery disease (PAD). Based on a review of trials and guidelines, which is summarized in this article, there is scant evidence that antithrombotic drugs improve outcome after peripheral EVT. To address this knowledge gap, the randomized, open-label, multinational edoxaban in patients with Peripheral Artery Disease (ePAD) study (ClinicalTrials.gov identifier NCT01802775) was designed to explore the safety and efficacy of a combined regimen of antiplatelet therapy with clopidogrel and anticoagulation with edoxaban, a selective and direct factor Xa inhibitor, both combined with aspirin. As of July 2014, 203 patients (144 men; mean age 67 years) from 7 countries have been enrolled. These patients have been allocated to once-daily edoxaban [60 mg for 3 months (or 30 mg in the presence of factors associated with increased exposure)] or clopidogrel (75 mg/d for 3 months). All patients received aspirin (100 mg/d) for the 6-month duration of the study. The primary safety endpoint is major or clinically relevant nonmajor bleeding; the primary efficacy endpoint is restenosis or reocclusion at the treated segment(s) measured at 1, 3, and 6 months using duplex ultrasound scanning. All outcomes will be assessed and adjudicated centrally in a masked fashion. The ePAD study is the first of its kind to investigate a combined regimen of antiplatelet therapy and anticoagulation through factor Xa inhibition with edoxaban. © The Author(s) 2015.

Subjectively and objectively assessed social and physical environmental correlates of preschoolers' accelerometer-based physical activity.

PubMed

Eichinger, Michael; Schneider, Sven; De Bock, Freia

2017-11-06

Overweight and low levels of physical activity (PA) in preschoolers are major public health concerns. However, to date only few studies have investigated subjective and objective correlates of PA across different socioecological domains in preschoolers. We therefore simultaneously investigate associations between preschoolers' objectively measured leisure-time PA and a comprehensive set of subjective and objective potential PA correlates across the behavioral, social and physical environmental domains on both family- and community-level. In this cross-sectional study time spent in moderate-to-vigorous PA (MVPA) and total PA (TPA) were measured by combined accelerometry and heart rate monitoring in 735 3-6 year-old children from 52 preschools in Southern Germany. Family- and community-level potential correlates of PA from different domains (behavioral, social and physical environmental) were subjectively (i.e. by parent proxy-report) and objectively assessed. Their associations with PA on weekend days and weekday afternoons were tested by covariate-adjusted multilevel regression models. While none of the objective social and physical environmental factors showed associations with PA, subjective parental traffic safety perceptions were positively associated with MVPA and TPA on weekends. Also, preschoolers' participation in organized sports was positively correlated with MVPA (on weekends) and TPA (both on weekends and weekday afternoons). Subjective traffic safety perceptions and participation in organized sports, an indicator and a result of parental support towards PA - i.e. subjective parental perceptions of environmental factors and family-level correlates which are more proximal to preschoolers - might be more central to PA in preschool age than objectively assessed community-level environmental features which tend to be more distal correlates. If replicable, targeting parental perceptions of environmental factors and parental support for PA in preschool age might be powerful leverages for public health policy.

Does excessive daytime sleepiness affect children's pedestrian safety?

PubMed

Avis, Kristin T; Gamble, Karen L; Schwebel, David C

2014-02-01

Many cognitive factors contribute to unintentional pedestrian injury, including reaction time, impulsivity, risk-taking, attention, and decision-making. These same factors are negatively influenced by excessive daytime sleepiness (EDS), which may place children with EDS at greater risk for pedestrian injury. Using a case-control design, 33 children age 8 to 16 y with EDS from an established diagnosis of narcolepsy or idiopathic hypersomnia (IHS) engaged in a virtual reality pedestrian environment while unmedicated. Thirty-three healthy children matched by age, race, sex, and household income served as controls. Children with EDS were riskier pedestrians than healthy children. They were twice as likely to be struck by a virtual vehicle in the virtual pedestrian environment than healthy controls. Attentional skills of looking at oncoming traffic were not impaired among children with EDS, but decision-making for when to cross the street safely was significantly impaired. Results suggest excessive daytime sleepiness (EDS) from the clinical sleep disorders known as the hypersomnias of central origin may have significant consequences on children's daytime functioning in a critical domain of personal safety, pedestrian skills. Cognitive processes involved in safe pedestrian crossings may be impaired in children with EDS. In the pedestrian simulation, children with EDS appeared to show a pattern consistent with inattentional blindness, in that they "looked but did not process" information in their pedestrian environment. Results highlight the need for heightened awareness of potentially irreversible consequences of untreated sleep disorders and identify a possible target for pediatric injury prevention.

Traffic safety in the U.S.: re-examining major opportunities.

PubMed

Sivak, Michael; Luoma, Juha; Flannagan, Michael J; Bingham, C Raymond; Eby, David W; Shope, Jean T

2007-01-01

This article examines five major road-safety risk factors: exceeding posted speed limits, not using safety belts, driving while intoxicated, nighttime driving, and young drivers. The importance of each of these factors is documented, known effective countermeasures (both policy and technology based) are discussed, and impediments to the implementation of these countermeasures in the United States are examined. Based on current understanding of the five major risk factors, and of the available countermeasures, there appear to be a variety of opportunities to make substantial gains in road safety using existing knowledge. The limited implementation of a variety of known countermeasures therefore appears to be inconsistent with high-level, strategic goals to improve road safety. Consequently, a recommendation is made to comprehensively re-examine the balance between the countermeasures discussed in this article and economic, mobility, and privacy concerns. IMPACT ON PUBLIC SAFETY: Such a re-examination is likely to result in broad support for these countermeasures, with a consequent major improvement in road safety.

Assessing characteristics related to the use of seatbelts and cell phones by drivers: application of a bivariate probit model.

PubMed

Russo, Brendan J; Kay, Jonathan J; Savolainen, Peter T; Gates, Timothy J

2014-06-01

The effects of cell phone use and safety belt use have been an important focus of research related to driver safety. Cell phone use has been shown to be a significant source of driver distraction contributing to substantial degradations in driver performance, while safety belts have been demonstrated to play a vital role in mitigating injuries to crash-involved occupants. This study examines the prevalence of cell phone use and safety belt non-use among the driving population through direct observation surveys. A bivariate probit model is developed to simultaneously examine the factors that affect cell phone and safety belt use among motor vehicle drivers. The results show that several factors may influence drivers' decision to use cell phones and safety belts, and that these decisions are correlated. Understanding the factors that affect both cell phone use and safety belt non-use is essential to targeting policy and programs that reduce such behavior. Copyright © 2014 Elsevier Ltd. All rights reserved.

Patient safety in primary care: a survey of general practitioners in The Netherlands.

PubMed

Gaal, Sander; Verstappen, Wim; Wensing, Michel

2010-01-21

Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general practitioners (GPs) on patient safety were examined. A web-based survey of a sample of GPs was undertaken. The items were derived from aspects of patient safety issues identified in a prior interview study. The questionnaire used 10 clinical cases and 15 potential risk factors to explore GPs' views on patient safety. A total of 68 GPs responded (51.5% response rate). None of the clinical cases was uniformly judged as particularly safe or unsafe by the GPs. Cases judged to be unsafe by a majority of the GPs concerned either the maintenance of medical records or prescription and monitoring of medication. Cases which only a few GPs judged as unsafe concerned hygiene, the diagnostic process, prevention and communication. The risk factors most frequently judged to constitute a threat to patient safety were a poor doctor-patient relationship, insufficient continuing education on the part of the GP and a patient age over 75 years. Language barriers and polypharmacy also scored high. Deviation from evidence-based guidelines and patient privacy in the reception/waiting room were not perceived as risk factors by most of the GPs. The views of GPs on safety and risk in primary care did not completely match those presented in published papers and policy documents. The GPs in the present study judged a broader range of factors than in previously published research on patient safety in primary care, including a poor doctor-patient relationship, to pose a potential threat to patient safety. Other risk factors such as infection prevention, deviation from guidelines and incident reporting were judged to be less relevant than by policy makers.

AAV5-Factor VIII Gene Transfer in Severe Hemophilia A.

PubMed

Rangarajan, Savita; Walsh, Liron; Lester, Will; Perry, David; Madan, Bella; Laffan, Michael; Yu, Hua; Vettermann, Christian; Pierce, Glenn F; Wong, Wing Y; Pasi, K John

2017-12-28

Patients with hemophilia A rely on exogenous factor VIII to prevent bleeding in joints, soft tissue, and the central nervous system. Although successful gene transfer has been reported in patients with hemophilia B, the large size of the factor VIII coding region has precluded improved outcomes with gene therapy in patients with hemophilia A. We infused a single intravenous dose of a codon-optimized adeno-associated virus serotype 5 (AAV5) vector encoding a B-domain-deleted human factor VIII (AAV5-hFVIII-SQ) in nine men with severe hemophilia A. Participants were enrolled sequentially into one of three dose cohorts (low dose [one participant], intermediate dose [one participant], and high dose [seven participants]) and were followed through 52 weeks. Factor VIII activity levels remained at 3 IU or less per deciliter in the recipients of the low or intermediate dose. In the high-dose cohort, the factor VIII activity level was more than 5 IU per deciliter between weeks 2 and 9 after gene transfer in all seven participants, and the level in six participants increased to a normal value (>50 IU per deciliter) that was maintained at 1 year after receipt of the dose. In the high-dose cohort, the median annualized bleeding rate among participants who had previously received prophylactic therapy decreased from 16 events before the study to 1 event after gene transfer, and factor VIII use for participant-reported bleeding ceased in all the participants in this cohort by week 22. The primary adverse event was an elevation in the serum alanine aminotransferase level to 1.5 times the upper limit of the normal range or less. Progression of preexisting chronic arthropathy in one participant was the only serious adverse event. No neutralizing antibodies to factor VIII were detected. The infusion of AAV5-hFVIII-SQ was associated with the sustained normalization of factor VIII activity level over a period of 1 year in six of seven participants who received a high dose, with stabilization of hemostasis and a profound reduction in factor VIII use in all seven participants. In this small study, no safety events were noted, but no safety conclusions can be drawn. (Funded by BioMarin Pharmaceutical; ClinicalTrials.gov number, NCT02576795 ; EudraCT number, 2014-003880-38 .).

Mapping the nomological network of employee self-determined safety motivation: A preliminary measure in China.

PubMed

Jiang, Li; Tetrick, Lois E

2016-09-01

The present study introduced a preliminary measure of employee safety motivation based on the definition of self-determination theory from Fleming (2012) research and validated the structure of self-determined safety motivation (SDSM) by surveying 375 employees in a Chinese high-risk organization. First, confirmatory factor analysis (CFA) was used to examine the factor structure of SDSM, and indices of five-factor model CFA met the requirements. Second, a nomological network was examined to provide evidence of the construct validity of SDSM. Beyond construct validity, the analysis also produced some interesting results concerning the relationship between leadership antecedents and safety motivation, and between safety motivation and safety behavior. Autonomous motivation was positively related to transformational leadership, negatively related to abusive supervision, and positively related to safety behavior. Controlled motivation with the exception of introjected regulation was negatively related to transformational leadership, positively related to abusive supervision, and negatively related to safety behavior. The unique role of introjected regulation and future research based on self-determination theory were discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Regulation and safety implementation of nanotechnology for chemical enterprises in the Central Europe Space

NASA Astrophysics Data System (ADS)

Falk, A.; Hartl, S.; Sinner, F.

2013-04-01

As result of the gradually increasing nanotechnology sector there is the necessity of a contemporary analysis of the present regulations used for nanomaterials, to outline the current situation of the nanotechnology sector, to promote international cooperation and research's coordination to overcome disciplinary boundaries, to fill the gap between more and less experienced regions and to turn investments in R&D in industrial innovations. The general objective of the Central Europe project NANOFORCE, which is developed by national and regional chemistry associations and R&D Centres of the Central Europe area, is to foster the innovative nanotechnology-sector networks across Central Europe regions by bringing together public and private organizations to carry out collaborative and interdisciplinary researches on nanomaterials (in the frame of REACH Regulation) and to turn the most promising laboratory results into innovative industrial applications. To build up a legal advisory board for chemical enterprises starting in nanotechnology, a state of the art report on existing safety procedures and nanotech related regulations was produced to give an overview on currently available regulations used by chemical industries and manufacturing companies within the European region to secure their products. The main emphasis was placed on REACH regulation to search for relevant sections concentrating on nanomaterials which are applicable for nanotechnology. In addition, all relevant directives and amendments of REACH were screened with regard to identify gaps where action is still needed and give possible recommendations for the European Commission. Beyond literature research a questionnaire for producers, users, researchers and financiers was developed with the goal to collect information about the nanotechnology sector in the CE region concerning development, financial status, and international cooperation within joint ventures, safety and nanotoxicology.

The impact of airport characteristics on airport surface accidents and incidents.

PubMed

Wilke, Sabine; Majumdar, Arnab; Ochieng, Washington Y

2015-06-01

Airport surface safety and in particular runway and taxiway safety is acknowledged globally as one of aviation's greatest challenges. To improve this key area of aviation safety, it is necessary to identify and understand the causal and contributing factors on safety occurrences. While the contribution of human factors, operations, and procedures has been researched extensively, the impact of the airport and its associated characteristics itself has received little or no attention. This paper introduces a novel methodology for risk and hazard assessment of airport surface operations, and models the relationships between airport characteristics, and (a) the rate of occurrences, (b) the severity of occurrences, and (c) the causal factors underlying occurrences. The results show for the first time how the characteristics of airports, and in particular its infrastructure and operations, influence the safety of surface operations. Copyright © 2015 Elsevier Ltd. and National Safety Council. Published by Elsevier Ltd. All rights reserved.

Phase 2 Randomized, Double-Masked, Vehicle-Controlled Trial of Recombinant Human Nerve Growth Factor for Neurotrophic Keratitis.

PubMed

Bonini, Stefano; Lambiase, Alessandro; Rama, Paolo; Sinigaglia, Francesco; Allegretti, Marcello; Chao, Wendy; Mantelli, Flavio

2018-04-10

To evaluate the safety and efficacy of topical recombinant human nerve growth factor (rhNGF) for treating moderate-to-severe neurotrophic keratitis (NK), a rare degenerative corneal disease resulting from impaired corneal innervation. Phase 2 multicenter, randomized, double-masked, vehicle-controlled trial. Patients with stage 2 (moderate) or stage 3 (severe) NK in 1 eye. The REPARO phase 2 study assessed safety and efficacy in 156 patients randomized 1:1:1 to rhNGF 10 μg/ml, 20 μg/ml, or vehicle. Treatment was administered 6 drops per day for 8 weeks. Patients then entered a 48- or 56-week follow-up period. Safety was assessed in all patients who received study treatment, whereas efficacy was by intention to treat. Corneal healing (defined as <0.5-mm maximum diameter of fluorescein staining in the lesion area) was assessed by masked central readers at week 4 (primary efficacy end point) and week 8 (key secondary end point) of controlled treatment. Corneal healing was reassessed post hoc by masked central readers using a more conservative measure (0-mm staining in the lesion area and no other persistent staining). At week 4 (primary end point), 19.6% of vehicle-treated patients achieved corneal healing (<0.5-mm lesion staining) versus 54.9% receiving rhNGF 10 μg/ml (+35.3%; 97.06% confidence interval [CI], 15.88-54.71; P < 0.001) and 58.0% receiving rhNGF 20 μg/ml (+38.4%; 97.06% CI, 18.96-57.83; P < 0.001). At week 8 (key secondary end point), 43.1% of vehicle-treated patients achieved less than 0.5-mm lesion staining versus 74.5% receiving rhNGF 10 μg/ml (+31.4%; 97.06% CI, 11.25-51.49; P = 0.001) and 74.0% receiving rhNGF 20 μg/ml (+30.9%; 97.06% CI, 10.60-51.13; P = 0.002). Post hoc analysis of corneal healing by the more conservative measure (0-mm lesion staining and no other persistent staining) maintained statistically significant differences between rhNGF and vehicle at weeks 4 and 8. More than 96% of patients who healed after controlled rhNGF treatment remained recurrence free during follow-up. Treatment with rhNGF was well tolerated; adverse effects were mostly local, mild, and transient. Topical rhNGF is safe and more effective than vehicle in promoting healing of moderate-to-severe NK. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

49 CFR Appendix A to Part 385 - Explanation of Safety Audit Evaluation Criteria

Code of Federal Regulations, 2010 CFR

2010-10-01

... safety management controls in place, is included in Appendix B, VII. List of Acute and Critical... having similar characteristics are combined together into six regulatory areas called “factors.” The regulatory factors, evaluated on the basis of the adequacy of the carrier's safety management controls, are...

Implementation of a children's hospital-wide central venous catheter insertion and maintenance bundle.

PubMed

Helder, Onno; Kornelisse, René; van der Starre, Cynthia; Tibboel, Dick; Looman, Caspar; Wijnen, René; Poley, Marten; Ista, Erwin

2013-10-14

Central venous catheter-associated bloodstream infections in children are an increasingly recognized serious safety problem worldwide, but are often preventable. Central venous catheter bundles have proved effective to prevent such infections. Successful implementation requires changes in the hospital system as well as in healthcare professionals' behaviour. The aim of the study is to evaluate process and outcome of implementation of a state-of-the-art central venous catheter insertion and maintenance bundle in a large university children's hospital. An interrupted time series design will be used; the study will encompass all children who need a central venous catheter. New state-of-the-art central venous catheter bundles will be developed. The Pronovost-model will guide the implementation process. We developed a tailored multifaceted implementation strategy consisting of reminders, feedback, management support, local opinion leaders, and education. Primary outcome measure is the number of catheter-associated infections per 1000 line-days. The process outcome is degree of adherence to use of these central venous catheter bundles is the secondary outcome. A cost-effectiveness analysis is part of the study. Outcomes will be monitored during three periods: baseline, pre-intervention, and post-intervention for over 48 months. This model-based implementation strategy will reveal the challenges of implementing a hospital-wide safety program. This work will add to the body of knowledge in the field of implementation. We postulate that healthcare workers' willingness to shift from providing habitual care to state-of-the-art care may reflect the need for consistent care improvement. Trial registration: Dutch trials registry, trial # 3635. Dutch trials registry (http://www.trialregister.nl), trial # 3635.

The efficacy and safety of novel oral anticoagulants for the preventive treatment in atrial fibrillation patients: a systematic review and meta-analysis.

PubMed

Liu, Guang Jian; Wang, Yun Fu; Chen, Ping You; Chang, Wei; Tu, Ming Li; Chang, Li Ying; Cheng, Ping; Luo, Jie

2014-09-01

Novel oral anticoagulants, including direct factor Xa inhibitors and direct factor IIa inhibitors, have been used to prevent stroke in patients with atrial fibrillation (AF) for a decade. In this study, the efficacy and safety of the novel oral anticoagulants were assessed in AF patients. No language restrictions were applied. Study selection and data extraction were carried out by searching PubMed, EMBASE, OVID, the BIOSIS, the Web of Science, Clinical Trials Registers, Cochrane Central Register of Controlled Trials and the China Academic Library and Information System. Each database was searched from its inception date to June 2013. Using odds ratio (OR) as an indicator, we systematically evaluated the primary efficacy endpoints and safety endpoints, as well as 10 secondary endpoints. Compared to the control drugs, the novel oral anticoagulants showed an OR decreased by 26% (OR: 0.74, 95% confidence interval (CI): 0.62-0.88) for stroke or systemic embolism, decreased by 24% (OR: 0.76, 95% CI: 0.64-0.90) for major bleeding, decreased by 10% (OR: 0.90, 95% CI: 0.84-0.95) for death from any cause, decreased by 27% for disabling or fatal stroke (OR: 0.73, 95% CI: 0.54-0.97), decreased by 31% (OR: 0.69, 95% CI: 0.60-0.8) for fatal bleeding, and decreased by 8% (OR: 0.92, 95% CI: 0.88-0.95) for serious adverse events. However, there was no significant difference in acute myocardial infarction, systemic embolism, major bleeding or clinically relevant non-major, all bleeding events, all adverse events and liver function disorder, between the novel oral anticoagulants and control drugs (p > 0.05). Compared to the control drugs, the novel oral anticoagulants showed higher efficiency and safety in patients with AF, as evidenced by their superior performance not only in reducing the risk of stroke or systemic embolism with a lower risk of major bleeding but also in decreasing the incidence of death from any cause, disabling or fatal stroke, serious adverse events and fatal bleeding.

Longitudinal Study of Sustained-Release Dexamethasone Intravitreal Implant in Patients with Diabetic Macular Edema.

PubMed

Aknin, Isabelle; Melki, Laurent

2016-01-01

Observational studies are needed to confirm the long-term efficacy and safety of Ozurdex® intravitreal implant in real life. Among 29 patients with persistent diabetic macular edema (DME), of whom 14 (48%) patients did not have any previous treatments and 22 (76%) any previous antivascular endothelial growth factor (anti-VEGF) injections, significant visual acuity (VA) improvement was observed with a mean gain of 13.8 letters at month 6 (p < 0.0001), 12.7 letters at month 12 (p = 0.0032) and 16.5 letters at month 18 (p = 0.0313). During the follow-up, a total of 17 (59%) patients had a VA improvement of ≥15 letters. Significant central macular thickness decrease was observed with a mean reduction of 159.07 μm at month 6 (p < 0.0001), 181.8 μm at month 12 (p < 0.0001) and 236.17 μm at month 18 (p = 0.0313). No serious adverse events were reported. With a good efficacy and safety, manageable adverse events and an injection rate much lower compared to that of anti-VEGF, this study confirms the use of Ozurdex® for the treatment of persistent DME. © 2016 S. Karger AG, Basel.

Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies

PubMed Central

Mackey, Tim K.; Nayyar, Gaurvika

2016-01-01

Background Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. Sources of data A review was conducted of the English literature with search terms ‘online pharmacies’, ‘Internet pharmacies’, ‘cyber pharmacies’, ‘rogue pharmacies’, and ‘e-pharmacies’ using PubMed, JSTOR, and Google Scholar from 1999–2005. Areas of agreement Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Areas of controversy Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Growing points Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. Areas timely for developing research There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. PMID:27151957

Epidemiology of tick-borne encephalitis (TBE) in Europe and its prevention by available vaccines

PubMed Central

Amicizia, Daniela; Domnich, Alexander; Panatto, Donatella; Lai, Piero Luigi; Cristina, Maria Luisa; Avio, Ulderico; Gasparini, Roberto

2013-01-01

Tick-borne Encephalitis (TBE), which is caused by a Flavivirus, is the most common tick-transmitted disease in Central and Eastern Europe and Russia. Today, TBE is endemic in 27 European countries, and has become an international public health problem. The epidemiology of TBE is changing owing to various factors, such as improvements in diagnosis and case reporting, increased recreational activities in areas populated by ticks, and changes in climatic conditions affecting tick habitats. Vaccination remains the most effective protective measure against TBE for people living in risk zones, occupationally exposed subjects and travelers to endemic areas. The vaccines currently in use are FSME-Immun®, Encepur®, EnceVir® and TBE vaccine Moscow®. The numerous studies performed on the efficacy and safety of these vaccines have shown a high level of immunogenicity and an excellent safety profile. Several studies have also shown a high level of cross-protection among strains belonging to different subtypes.   In the present paper we attempted to describe the continuously changing epidemiology of TBE in European States and to overview clinical development of available vaccines paying particular attention on cross-protection elicited by the vaccines. PMID:23377671

Conditions for the successful integration of Human and Organizational Factors (HOF) in the nuclear safety analysis.

PubMed

Tosello, Michèle; Lévêque, Françoise; Dutillieu, Stéphanie; Hernandez, Guillaume; Vautier, Jean-François

2012-01-01

This communication presents some elements which come from the experience feedback at CEA about the conditions for the successful integration of HOF in the nuclear safety analysis. To point out some of these conditions, one of the concepts proposed by Edgar Morin to describe the functioning of "complex" systems: the dialogical principle has been used. The idea is to look for some dialogical pairs. The elements of this kind of pair are both complementary and antagonist to one another. Three dialogical pairs are presented in this communication. The first two pairs are related to the organization of the HOF network and the last one is related to the methods which are used to analyse the working situations. The three pairs are: specialist - non-specialist actors of the network, centralized - distributed human resources in the network and microscopic - macroscopic levels of HOF methods to analyse the working situations. To continuously improve these three dialogical pairs, it is important to keep the differences which exist between the two elements of a pair and to find and maintain a balance between the two elements of the pairs.

Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies.

PubMed

Mackey, Tim K; Nayyar, Gaurvika

2016-06-01

Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. A review was conducted of the English literature with search terms 'online pharmacies', 'Internet pharmacies', 'cyber pharmacies', 'rogue pharmacies', and 'e-pharmacies' using PubMed, JSTOR, and Google Scholar from 1999-2005. Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A methodology to quantitatively evaluate the safety of a glazing robot.

PubMed

Lee, Seungyeol; Yu, Seungnam; Choi, Junho; Han, Changsoo

2011-03-01

A new construction method using robots is spreading widely among construction sites in order to overcome labour shortages and frequent construction accidents. Along with economical efficiency, safety is a very important factor for evaluating the use of construction robots in construction sites. However, the quantitative evaluation of safety is difficult compared with that of economical efficiency. In this study, we suggested a safety evaluation methodology by defining the 'worker' and 'work conditions' as two risk factors, defining the 'worker' factor as posture load and the 'work conditions' factor as the work environment and the risk exposure time. The posture load evaluation reflects the risk of musculoskeletal disorders which can be caused by work posture and the risk of accidents which can be caused by reduced concentration. We evaluated the risk factors that may cause various accidents such as falling, colliding, capsizing, and squeezing in work environments, and evaluated the operational risk by considering worker exposure time to risky work environments. With the results of the evaluations for each factor, we calculated the general operational risk and deduced the improvement ratio in operational safety by introducing a construction robot. To verify these results, we compared the safety of the existing human manual labour and the proposed robotic labour construction methods for manipulating large glass panels. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Research on station management in subway operation safety

NASA Astrophysics Data System (ADS)

Li, Yiman

2017-10-01

The management of subway station is an important part of the safe operation of urban subway. In order to ensure the safety of subway operation, it is necessary to study the relevant factors that affect station management. In the protection of subway safety operations on the basis of improving the quality of service, to promote the sustained and healthy development of subway stations. This paper discusses the influencing factors of subway operation accident and station management, and analyzes the specific contents of station management security for subway operation, and develops effective suppression measures. It is desirable to improve the operational quality and safety factor for subway operations.

A Spanish-language patient safety questionnaire to measure medical and nursing students' attitudes and knowledge.

PubMed

Mira, José J; Navarro, Isabel M; Guilabert, Mercedes; Poblete, Rodrigo; Franco, Astolfo L; Jiménez, Pilar; Aquino, Margarita; Fernández-Trujillo, Francisco J; Lorenzo, Susana; Vitaller, Julián; de Valle, Yohana Díaz; Aibar, Carlos; Aranaz, Jesús M; De Pedro, José A

2015-08-01

To design and validate a questionnaire for assessing attitudes and knowledge about patient safety using a sample of medical and nursing students undergoing clinical training in Spain and four countries in Latin America. In this cross-sectional study, a literature review was carried out and total of 786 medical and nursing students were surveyed at eight universities from five countries (Chile, Colombia, El Salvador, Guatemala, and Spain) to develop and refine a Spanish-language questionnaire on knowledge and attitudes about patient safety. The scope of the questionnaire was based on five dimensions (factors) presented in studies related to patient safety culture found in PubMed and Scopus. Based on the five factors, 25 reactive items were developed. Composite reliability indexes and Cronbach's alpha statistics were estimated for each factor, and confirmatory factor analysis was conducted to assess validity. After a pilot test, the questionnaire was refined using confirmatory models, maximum-likelihood estimation, and the variance-covariance matrix (as input). Multiple linear regression models were used to confirm external validity, considering variables related to patient safety culture as dependent variables and the five factors as independent variables. The final instrument was a structured five-point Likert self-administered survey (the "Latino Student Patient Safety Questionnaire") consisting of 21 items grouped into five factors. Compound reliability indexes (Cronbach's alpha statistic) calculated for the five factors were about 0.7 or higher. The results of the multiple linear regression analyses indicated good model fit (goodness-of-fit index: 0.9). Item-total correlations were higher than 0.3 in all cases. The convergent-discriminant validity was adequate. The questionnaire designed and validated in this study assesses nursing and medical students' attitudes and knowledge about patient safety. This instrument could be used to indirectly evaluate whether or not students in health disciplines are acquiring and thus likely to put into practice the professional skills currently considered most appropriate for patient safety.

Ethanol and corticotropin releasing factor receptor modulation of central amygdala neurocircuitry: An update and future directions.

PubMed

Silberman, Yuval; Winder, Danny G

2015-05-01

The central amygdala is a critical brain region for many aspects of alcohol dependence. Much of the work examining the mechanisms by which the central amygdala mediates the development of alcohol dependence has focused on the interaction of acute and chronic ethanol with central amygdala corticotropin releasing factor signaling. This work has led to a great deal of success in furthering the general understanding of central amygdala neurocircuitry and its role in alcohol dependence. Much of this work has primarily focused on the hypothesis that ethanol utilizes endogenous corticotropin releasing factor signaling to upregulate inhibitory GABAergic transmission in the central amygdala. Work that is more recent suggests that corticotropin releasing factor also plays an important role in mediating anxiety-like behaviors via the enhancement of central amygdala glutamatergic transmission, implying that ethanol/corticotropin releasing factor interactions may modulate excitatory neurotransmission in this brain region. In addition, a number of studies utilizing optogenetic strategies or transgenic mouse lines have begun to examine specific central amygdala neurocircuit dynamics and neuronal subpopulations to better understand overall central amygdala neurocircuitry and the role of neuronal subtypes in mediating anxiety-like behaviors. This review will provide a brief update on this literature and describe some potential future directions that may be important for the development of better treatments for alcohol addiction. Copyright © 2015 Elsevier Inc. All rights reserved.

The study on length and diameter ratio of nail as preliminary design for slope stabilization

NASA Astrophysics Data System (ADS)

Gunawan, Indra; Silmi Surjandari, Niken; Muslih Purwana, Yusep

2017-11-01

Soil nailing technology has been widely applied in practice for reinforced slope. The number of studies for the effective design of nail-reinforced slopes has also increased. However, most of the previous study was focused on a safety factor of the slope; the ratio of length and diameter itself has likely never been studied before. The aim of this study is to relate the length and diameter ratio of the nail with the safety factor of the 20 m height of sand slope in the various angle of friction and steepness of the slope. Simplified Bishop method was utilized to analyze the safety factor of the slope. This study is using data simulation to calculate the safety factor of the slope with soil nailing reinforcement. The results indicate that safety factor of slope stability increases with the increase of length and diameter ratio of the nail. At any angle of friction and steepness of the slope, certain effective length and diameter ratio was obtain. These results may be considered as a preliminary design for slope stabilization.

Reinforcing mechanism of anchors in slopes: a numerical comparison of results of LEM and FEM

NASA Astrophysics Data System (ADS)

Cai, Fei; Ugai, Keizo

2003-06-01

This paper reports the limitation of the conventional Bishop's simplified method to calculate the safety factor of slopes stabilized with anchors, and proposes a new approach to considering the reinforcing effect of anchors on the safety factor. The reinforcing effect of anchors can be explained using an additional shearing resistance on the slip surface. A three-dimensional shear strength reduction finite element method (SSRFEM), where soil-anchor interactions were simulated by three-dimensional zero-thickness elasto-plastic interface elements, was used to calculate the safety factor of slopes stabilized with anchors to verify the reinforcing mechanism of anchors. The results of SSRFEM were compared with those of the conventional and proposed approaches for Bishop's simplified method for various orientations, positions, and spacings of anchors, and shear strengths of soil-grouted body interfaces. For the safety factor, the proposed approach compared better with SSRFEM than the conventional approach. The additional shearing resistance can explain the influence of the orientation, position, and spacing of anchors, and the shear strength of soil-grouted body interfaces on the safety factor of slopes stabilized with anchors.

Safety performance factor.

PubMed

Venkataraman, Naray

2008-01-01

Workplace safety performance is computed using frequency rate (FR) and severity rate (SR). Only work time lost due to occupational incidents that need to be reported is counted. FR and SR are the 2 most important safety performance indicators that are applied universally; however, calculations differ from country to country. All injuries and time lost should be considered while calculating safety performance. The extent of severity does not matter as every incident is counted. So, a new factor has to be defined; it should be based on the hours or days lost due to each occupational incident, irrespective of its severity. The new safety performance factor is defined as the average human-hour unit lost due to occupational accidents/incidents, including fatalities, first-aid incidents, bruises and cuts. The formula is simple and easy to apply.

The impact of safety organizing, trusted leadership, and care pathways on reported medication errors in hospital nursing units.

PubMed

Vogus, Timothy J; Sutcliffe, Kathleen M

2011-01-01

Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on the joint benefits of safety organizing and other contextual factors that help foster safety. Although we know that organizational practices often have more powerful effects when combined with other mutually reinforcing practices, little research exists on the joint benefits of safety organizing and other contextual factors believed to foster safety. Specifically, we examined the benefits of bundling safety organizing with leadership (trust in manager) and design (use of care pathways) factors on reported medication errors. A total of 1033 RNs and 78 nurse managers in 78 emergency, internal medicine, intensive care, and surgery nursing units in 10 acute-care hospitals in Indiana, Iowa, Maryland, Michigan, and Ohio who completed questionnaires between December 2003 and June 2004. Cross-sectional analysis of medication errors reported to the hospital incident reporting system for the 6 months after the administration of the survey linked to survey data on safety organizing, trust in manager, use of care pathways, and RN characteristics and staffing. Multilevel Poisson regression analyses indicated that the benefits of safety organizing on reported medication errors were amplified when paired with high levels of trust in manager or the use of care pathways. Safety organizing plays a key role in improving patient safety on hospital nursing units especially when bundled with other organizational components of a safety supportive system.

Implementation of safety management systems in Hong Kong construction industry - A safety practitioner's perspective.

PubMed

Yiu, Nicole S N; Sze, N N; Chan, Daniel W M

2018-02-01

In the 1980s, the safety management system (SMS) was introduced in the construction industry to mitigate against workplaces hazards, reduce the risk of injuries, and minimize property damage. Also, the Factories and Industrial Undertakings (Safety Management) Regulation was introduced on 24 November 1999 in Hong Kong to empower the mandatory implementation of a SMS in certain industries including building construction. Therefore, it is essential to evaluate the effectiveness of the SMS in improving construction safety and identify the factors that influence its implementation in Hong Kong. A review of the current state-of-the-practice helped to establish the critical success factors (CSFs), benefits, and difficulties of implementing the SMS in the construction industry, while structured interviews were used to establish the key factors of the SMS implementation. Results of the state-of-the-practice review and structured interviews indicated that visible senior commitment, in terms of manpower and cost allocation, and competency of safety manager as key drivers for the SMS implementation. More so, reduced accident rates and accident costs, improved organization framework, and increased safety audit ratings were identified as core benefits of implementing the SMS. Meanwhile, factors such as insufficient resources, tight working schedule, and high labor turnover rate were the key challenges to the effective SMS implementation in Hong Kong. The findings of the study were consistent and indicative of the future development of safety management practice and the sustainable safety improvement of Hong Kong construction industry in the long run. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

Assessing medical students' perceptions of patient safety: the medical student safety attitudes and professionalism survey.

PubMed

Liao, Joshua M; Etchegaray, Jason M; Williams, S Tyler; Berger, David H; Bell, Sigall K; Thomas, Eric J

2014-02-01

To develop and test the psychometric properties of a survey to measure students' perceptions about patient safety as observed on clinical rotations. In 2012, the authors surveyed 367 graduating fourth-year medical students at three U.S. MD-granting medical schools. They assessed the survey's reliability and construct and concurrent validity. They examined correlations between students' perceptions of organizational cultural factors, organizational patient safety measures, and students' intended safety behaviors. They also calculated percent positive scores for cultural factors. Two hundred twenty-eight students (62%) responded. Analyses identified five cultural factors (teamwork culture, safety culture, error disclosure culture, experiences with professionalism, and comfort expressing professional concerns) that had construct validity, concurrent validity, and good reliability (Cronbach alphas > 0.70). Across schools, percent positive scores for safety culture ranged from 28% (95% confidence interval [CI], 13%-43%) to 64% (30%-98%), while those for teamwork culture ranged from 47% (32%-62%) to 74% (66%-81%). They were low for error disclosure culture (range: 10% [0%-20%] to 27% [20%-35%]), experiences with professionalism (range: 7% [0%-15%] to 23% [16%-30%]), and comfort expressing professional concerns (range: 17% [5%-29%] to 38% [8%-69%]). Each cultural factor correlated positively with perceptions of overall patient safety as observed in clinical rotations (r = 0.37-0.69, P < .05) and at least one safety behavioral intent item. This study provided initial evidence for the survey's reliability and validity and illustrated its applicability for determining whether students' clinical experiences exemplify positive patient safety environments.

Central nervous system prophylaxis with intrathecal liposomal cytarabine in a subset of high-risk patients with diffuse large B-cell lymphoma receiving first line systemic therapy in a prospective trial.

PubMed

González-Barca, E; Canales, M; Salar, A; Ferreiro-Martínez, J J; Ferrer-Bordes, S; García-Marco, J A; Sánchez-Blanco, J J; García-Frade, J; Peñalver, J; Bello-López, J L; Sancho, J M; Caballero, D

2016-05-01

The dissemination in the central nervous system (CNS) is an uncommon but fatal complication occurring in patients with diffuse large B-cell lymphoma (DLBCL). Standard prophylaxis has been demonstrated to reduce CNS relapse and improve survival rates. Intrathecal (IT) liposomal cytarabine allows maintaining elevated drug levels in the cerebrospinal fluid for an extended period of time. Data on the efficacy and safety of liposomal cytarabine as CNS prophylaxis in patients with DLBCL are still insufficient. The objective of the present study was to evaluate the effectiveness and safety of the prophylaxis with IT liposomal cytarabine in prevention of CNS relapse in high-risk patients with DLBCL who were included in a trial of first line systemic therapy with 6 cycles of dose-dense R-CHOP every 14 days. Twenty-four (18.6 %) out of 129 patients were identified to have risk factors for CNS involvement, defined as follows: >30 % bone marrow infiltration, testes infiltration, retroperitoneal mass ≥10 cm, Waldeyer ring, or bulky cervical nodes involvement. Liposomal cytarabine (50 mg) was administered by lumbar puncture the first day of the 1st, 2nd, and 6th cycle of R-CHOP14 scheme. Among 70 IT infusions, grade 3-4 adverse events reported were headache (one patient) and nausea/vomiting (one patient). With a median follow-up of 40.1 months, no CNS involvement by DLBCL was observed in any patient. In conclusion, IT liposomal cytarabine is safe, feasible, and effective for CNS prophylaxis, causing few associated risks and little discomfort to patients with DLBCL.

Subconjunctival sirolimus in the treatment of diabetic macular edema.

PubMed

Krishnadev, Nupura; Forooghian, Farzin; Cukras, Catherine; Wong, Wai; Saligan, Leorey; Chew, Emily Y; Nussenblatt, Robert; Ferris, Frederick; Meyerle, Catherine

2011-11-01

Diabetic macular edema (DME) is a leading cause of blindness in the developed world. Sirolimus has been shown to inhibit the production, signaling, and activity of many growth factors relevant to the development of diabetic retinopathy. This phase I/II study assesses the safety of multiple subconjunctival sirolimus injections for the treatment of DME, with some limited efficacy data. In this phase I/II prospective, open-label pilot study, five adult participants with diabetic macular edema involving the center of the fovea and best-corrected ETDRS visual acuity score of ≤74 letters (20/32 or worse) received 20 μl (440 μg) of subconjunctival sirolimus at baseline, month 2 and every 2 months thereafter, unless there was resolution of either retinal thickening on OCT or leakage on fluorescein angiography. Main outcome measures included best-corrected visual acuity and central retinal thickness on OCT at 6 months and 1 year, as well as safety outcomes. Repeated subconjunctival sirolimus injections were well-tolerated, with no significant drug-related adverse events. There was no consistent treatment effect related to sirolimus; one participant experienced a 2-line improvement in visual acuity and 2 log unit decrease in retinal thickness at 6 months and 1 year, two remained essentially stable, one had stable visual acuity but improvement of central retinal thickness of 1 and 3 log units at 6 months and 1 year respectively, and one had a 2-line worsening of visual acuity and a 1 log unit increase in retinal thickness at 6 months and 1 year. Results in the fellow eyes with diabetic macular edema, not treated with sirolimus, were similar. Subconjunctival sirolimus appears safe to use in patients with DME. Assessment of possible treatment benefit will require a randomized trial.

Subconjunctival sirolimus in the treatment of diabetic macular edema

PubMed Central

Krishnadev, Nupura; Forooghian, Farzin; Cukras, Catherine; Wong, Wai; Saligan, Leorey; Chew, Emily Y.; Nussenblatt, Robert; Ferris, Frederick

2011-01-01

Background Diabetic macular edema (DME) is a leading cause of blindness in the developed world. Sirolimus has been shown to inhibit the production, signaling, and activity of many growth factors relevant to the development of diabetic retinopathy. This phase I/II study assesses the safety of multiple subconjunctival sirolimus injections for the treatment of DME, with some limited efficacy data. Methods In this phase I/II prospective, open-label pilot study, five adult participants with diabetic macular edema involving the center of the fovea and best-corrected ETDRS visual acuity score of ≤74 letters (20/32 or worse) received 20 μl (440 μg) of subconjunctival sirolimus at baseline, month 2 and every 2 months thereafter, unless there was resolution of either retinal thickening on OCT or leakage on fluorescein angiography. Main outcome measures included best-corrected visual acuity and central retinal thickness on OCT at 6 months and 1 year, as well as safety outcomes. Results Repeated subconjunctival sirolimus injections were well-tolerated, with no significant drug-related adverse events. There was no consistent treatment effect related to sirolimus; one participant experienced a 2-line improvement in visual acuity and 2 log unit decrease in retinal thickness at 6 months and 1 year, two remained essentially stable, one had stable visual acuity but improvement of central retinal thickness of 1 and 3 log units at 6 months and 1 year respectively, and one had a 2-line worsening of visual acuity and a 1 log unit increase in retinal thickness at 6 months and 1 year. Results in the fellow eyes with diabetic macular edema, not treated with sirolimus, were similar. Conclusions Subconjunctival sirolimus appears safe to use in patients with DME. Assessment of possible treatment benefit will require a randomized trial. PMID:21567211

A Contemporary Assessment of Mechanical Complication Rates and Trainee Perceptions of Central Venous Catheter Insertion.

PubMed

Heidemann, Lauren; Nathani, Niket; Sagana, Rommel; Chopra, Veneet; Heung, Michael

2017-08-01

Limited data exist regarding rates of mechanical complications of ultrasound-guided, nontunneled central venous catheters (CVC). Similarly, trainee perceptions surrounding CVC complications are largely unknown. To evaluate contemporary CVC mechanical complication rates, associated risk factors, and trainee perspectives. A single-center retrospective review of CVC procedures between June 1, 2014, and May 1, 2015. Electronic survey distributed to internal medicine trainees. Intensive care units and the emergency department at an academic hospital. Electronic health records of patients with CVC procedures were reviewed for complications. Demographic and procedural characteristics were compared for complicated vs uncomplicated procedures. Student t tests and chi-square tests were used to compare continuous and categorical variables, respectively. Of the 730 reviewed records, 14 serious mechanical complications occurred due to pneumothorax (n = 5), bleeding (n = 3), vascular injury (n = 3), stroke (n = 1), and death (n = 2). Risk factors for complicated vs uncomplicated CVC placement included subclavian location (21.4% vs 7.8%, = 0.001), number of attempts (2.2 vs 1.5, = 0.02), unsuccessful CVC (21.4% vs. 4.3%, = 0.001), attending supervision (61.5% vs 34.7%, = 0.04), low body mass index (mean 25.7 kg/ m² vs 31.5 kg/m², = 0.001), anticoagulation (28.6% vs 20.6%, = 0.048), and ventilation (78.5% vs 66.5%, = 0.001). Survey data suggested deficiencies in managing unsuccessful CVC procedures; specifically, only 35% (N = 21/60) of trainees regularly perform chest x-rays after failed CVC attempt. We observed a 1.9% rate of mechanical complications associated with CVC placement. Our study confirms historical data that unsuccessful CVC attempts are an important risk factor for complications. Education regarding unsuccessful CVC placement may improve patient safety. © 2017 Society of Hospital Medicine

Risk factors for bacteremia and central line-associated blood stream infections in children with acute myelogenous leukemia: A single-institution report.

PubMed

Rogers, Ashley E J; Eisenman, Kristen M; Dolan, Susan A; Belderson, Kristin M; Zauche, Jocelyn R; Tong, Suhong; Gralla, Jane; Hilden, Joanne M; Wang, Michael; Maloney, Kelly W; Dominguez, Samuel R

2017-03-01

Central line-associated blood stream infections (CLABSIs) are a source of high morbidity and mortality in children with acute myelogenous leukemia (AML). To understand the epidemiology and risk factors associated with the development of CLABSI in children with AML. We retrospectively reviewed all patients with AML over a 5-year period between 2007 and 2011 at the Children's Hospital Colorado. Cases and controls were classified on the basis of the presence of a CLABSI as defined by the National Healthcare Safety Network. Of 40 patients in the study, 25 (62.5%) developed at least one CLABSI during therapy. The majority of CLABSIs were due to oral or gastrointestinal organisms (83.0%). Skin organisms accounted for 8.5%. In a multivariable analysis, the strongest risk factors associated with CLABSI were diarrhea (odds ratio [OR] 6.7, 95% confidence interval [CI] 1.6-28.7), receipt of blood products in the preceding 4-7 days (OR 10.0, 95%CI 3.2-31.0), not receiving antibiotics (OR 8.3, 95%CI 2.8-25.0), and chemotherapy cycle (OR 3.5, 95%CI 1.4-8.9). CLABSIs led to increased morbidity, with 13 cases (32.5%) versus two controls (1.9%) requiring transfer to the pediatric intensive care unit (P < 0.001). Three (7.5%) of 40 CLABSI events resulted in or contributed to death. Intensified line care efforts cannot eliminate all CLABSIs in the patients with AML. Exploring the role of mucosal barrier breakdown and/or the use of antibiotic prophylaxis may be effective strategies for further prevention of CLABSIs, supporting ongoing trials in this patient population. © 2016 Wiley Periodicals, Inc.

Visceral pain hypersensitivity in functional gastrointestinal disorders.

PubMed

Farmer, A D; Aziz, Q

2009-01-01

Functional gastrointestinal disorders (FGIDs) are a highly prevalent group of heterogeneous disorders whose diagnostic criteria are symptom based in the absence of a demonstrable structural or biochemical abnormality. Chronic abdominal pain or discomfort is a defining characteristic of these disorders and a proportion of patients may display heightened pain sensitivity to experimental visceral stimulation, termed visceral pain hypersensitivity (VPH). We examined the most recent literature in order to concisely review the evidence for some of the most important recent advances in the putative mechanisms concerned in the pathophysiology of VPH. VPH may occur due to anomalies at any level of the visceral nociceptive neuraxis. Important peripheral and central mechanisms of sensitization that have been postulated include a wide range of ion channels, neurotransmitter receptors and trophic factors. Data from functional brain imaging studies have also provided evidence for aberrant central pain processing in cortical and subcortical regions. In addition, descending modulation of visceral nociceptive pathways by the autonomic nervous system, hypothalamo-pituitary-adrenal axis and psychological factors have all been implicated in the generation of VPH. Particular areas of controversy have included the development of efficacious treatment of VPH. Therapies have been slow to emerge, mainly due to concerns regarding safety. The burgeoning field of genome wide association studies may provide further evidence for the pleiotropic genetic basis of VPH development. Tangible progress will only be made in the treatment of VPH when we begin to individually characterize patients with FGIDs based on their clinical phenotype, genetics and visceral nociceptive physiology.

Respect for woman's decision-making in spontaneous birth: A thematic synthesis study

PubMed Central

MirzaeeRabor, Firoozeh; Mirzaee, Fattaneh; MirzaiiNajmabadi, Khadigeh; Taghipour, Ali

2016-01-01

Background: Participation of woman in decision-making processes is one of the key indicators of an appropriate relationship between a woman and the health care professionals. This study aimed to recognize the factors facilitating respect for woman's decision-making in spontaneous birth. Materials and Methods: This paper employed a meta-synthesis on articles published in four biomedical databases including MEDLINE, Web of Science, CINAHL, and Cochrane Library. All qualitative studies published after 1990 and directly or indirectly discussing the women's and the health care professional's attitudes toward respect for woman's decision-making in spontaneous birth were searched. Of 5372 citations, 95 full-text papers were considered, of which 14 satisfied the inclusion criteria. Results: In this meta-synthesis, initial codes were obtained through meticulous, line-by-line coding of the findings of the primary studies. Then, thematic synthesis was performed on the codes to search for concepts, and 20 descriptive themes were obtained in the second stage. Finally, through an inductive process, five new interpretations were obtained in the last stage of the thematic synthesis. These interpretations included confidence to health care providers, the central role of midwives in maintenance of women's dignity, childbirth as a natural phenomenon, the impact of contextual conditions, and the political and human factors affecting the delivery management and women seek place of safety for childbirth. Conclusions: Studies suggested that midwifes have a central role in maintenance of women's dignity and their experience of childbirth. PMID:27904626

Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

PubMed

Lee, Yuna S H; Stone, Patricia W; Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M

Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.

Workforce Perceptions of Hospital Safety Culture: Development and Validation of the Patient Safety Climate in Healthcare Organizations Survey

PubMed Central

Singer, Sara; Meterko, Mark; Baker, Laurence; Gaba, David; Falwell, Alyson; Rosen, Amy

2007-01-01

Objective To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. Data Sources/Study Setting Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. Study Design Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. Data Collection We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). Principal Findings We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's α coefficients ranged from 0.50 to 0.89. Conclusions It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes. PMID:17850530

Ontogenetic changes in size, allometry, and mechanical design of tropical rain forest trees.

PubMed

Sterck, F; Bongers, F

1998-02-01

Size, allometry, and mechanical design were measured for trees of three canopy species in a tropical rain forest in French Guiana. Mechanical design was expressed as the safety factor, using the elastic-stability model, and the wind resistance factor, using the constant-stress model. Changes with ontogeny were described as regressions using stem diameter as the independent variable, and they were compared between species. Height, crown size, and the wind resistance factor increased with ontogeny. The safety factor decreased to a minimum and then increased continuously in thicker trees. The crown width/height ratio did not change with ontogeny. Interspecific differences in allometry and mechanical design were related to the adult stature of the species, and not to shade tolerance. The short stature species (Vouacapoua americana) was less slender (height:DBH [stem diameter at 1.3 m] ratio) and had a higher crown width/height ratio than the tall stature species (Goupia glabra and Dicorynia guianensis). Vouacapoua had a higher safety factor, but a similar wind resistance factor. The safety factors of our study species were lower than those of two temperate tree species because of a higher slenderness. Differences in safety factors between tropical and temperate trees may result from unrealistic assumptions of the elastic-stability model, and may also be related to lower light levels and-or wind rates in the tropics.

Exploring organisational competences in Human Factors and UX project work: managing careers, project tactics and organisational strategy.

PubMed

Furniss, Dominic; Curzon, Paul; Blandford, Ann

2018-06-01

Organisational competence in Human Factors and UX (user experience) has not been looked at before despite its relevance to project success. We define organisational competence as the collective competence of the individuals, bringing together their complementary abilities to deliver an outcome that is typically more than the sum of its parts. Twenty-two UX and Human Factors practitioners were interviewed about their project work in two contrasting domains: web design and safety-critical systems to explore organisational competences. Through doing a FRAM analysis, 29 functions and 6 main areas of competences were identified: the central project process; the process of learning about the problem; maintaining and developing client relations; staff development; evolving practices; and the management of documentation for audit and quality control. These dynamic and situated competences form a web of interactions. Managing competences is essential for project success. Implications for managing careers, project tactics and organisational strategy are discussed. Practitioner Summary: Organisational competences impact how routine and non-routine project work is performed, but these have received little attention in the literature. Six key areas of competences in Human Factors and UX project work were identified from practitioner interviews. Managing combinations of adaptive competences is important for developing careers, project tactics and organisational strategies.

Design for human factors (DfHF): a grounded theory for integrating human factors into production design processes.

PubMed

Village, Judy; Searcy, Cory; Salustri, Filipo; Patrick Neumann, W

2015-01-01

The 'design for human factors' grounded theory explains 'how' human factors (HF) went from a reactive, after-injury programme in safety, to being proactively integrated into each step of the production design process. In this longitudinal case study collaboration with engineers and HF Specialists in a large electronics manufacturer, qualitative data (e.g. meetings, interviews, observations and reflections) were analysed using a grounded theory methodology. The central tenet in the theory is that when HF Specialists acclimated to the engineering process, language and tools, and strategically aligned HF to the design and business goals of the organisation, HF became a means to improve business performance. This led to engineers 'pulling' HF Specialists onto their team. HF targets were adopted into engineering tools to communicate HF concerns quantitatively, drive continuous improvement, visibly demonstrate change and lead to benchmarking. Senior management held engineers accountable for HF as a key performance indicator, thus integrating HF into the production design process. Practitioner Summary: Research and practice lack explanations about how HF can be integrated early in design of production systems. This three-year case study and the theory derived demonstrate how ergonomists changed their focus to align with design and business goals to integrate HF into the design process.

Listening to food workers: Factors that impact proper health and hygiene practice in food service

PubMed Central

Clegg Smith, Katherine; Neff, Roni A.; Pollack, Keshia M.; Ensminger, Margaret

2015-01-01

Background Foodborne disease is a significant problem worldwide. Research exploring sources of outbreaks indicates a pronounced role for food workers' improper health and hygiene practice. Objective To investigate food workers' perceptions of factors that impact proper food safety practice. Method Interviews with food service workers in Baltimore, MD, USA discussing food safety practices and factors that impact implementation in the workplace. A social ecological model organizes multiple levels of influence on health and hygiene behavior. Results Issues raised by interviewees include factors across the five levels of the social ecological model, and confirm findings from previous work. Interviews also reveal many factors not highlighted in prior work, including issues with food service policies and procedures, working conditions (e.g., pay and benefits), community resources, and state and federal policies. Conclusion Food safety interventions should adopt an ecological orientation that accounts for factors at multiple levels, including workers' social and structural context, that impact food safety practice. PMID:26243248

Prevention of central venous catheter infections: a survey of paediatric ICU nurses' knowledge and practice.

PubMed

Ullman, Amanda J; Long, Debbie A; Rickard, Claire M

2014-02-01

Central venous catheters are important in the management of paediatric intensive care unit patients, but can have serious complications which worsen the patients' health, prolong hospital stays and increase the cost of care. Evidence-based recommendations for preventing catheter-related bloodstream infections are available, but it is unknown how widely these are known or practiced in the paediatric intensive care environment. To assess nursing knowledge of evidence based guidelines to prevent catheter-related bloodstream infections; the extent to which Australia and New Zealand paediatric intensive cares have adopted prevention practices; and to identify the factors that encouraged their adoption and improve nursing knowledge. Cross-sectional surveys using convenience sampling. Tertiary level paediatric intensive care units in Australia and New Zealand. Paediatric intensive care nursing staff and nurse managers. Between 2010 and 2011, the 'Paediatric Intensive Care Nurses' Knowledge of Evidence-Based Catheter-Related Bloodstream Infection Prevention Questionnaire' was distributed to paediatric intensive care nursing staff and the 'Catheter-Related Bloodstream Infection Prevention Practices Survey' was distributed to nurse managers to measure knowledge, practices and culture. The questionnaires were completed by 253 paediatric intensive care nurses (response rate: 34%). The mean total knowledge score was 5.5 (SD=1.4) out of a possible ten, with significant variation of total scores between paediatric intensive care sites (p=0.01). Other demographic characteristics were not significantly associated with variation in total knowledge scores. All nursing managers from Australian and New Zealand paediatric intensive care units participated in the survey (n=8; response rate: 100%). Wide practice variation was reported, with inconsistent adherence to recommendations. Safety culture was not significantly associated with mean knowledge scores per site. This study has identified that there is variation in the infection prevention approach and nurses' knowledge about catheter-related bloodstream infection prevention. The presence of an improved safety culture, years of paediatric intensive care experience and higher qualifications did not influence the nurses' uptake of recommendations, therefore further factors need to be explored in order to improve understanding and implementation of best practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

'They aren't really black fellas but they are easy to talk to': Factors which influence Australian Aboriginal women's decision to disclose intimate partner violence during pregnancy.

PubMed

Spangaro, Jo; Herring, Sigrid; Koziol-Mclain, Jane; Rutherford, Alison; Frail, Mary-Anne; Zwi, Anthony B

2016-10-01

intimate partner violence is a significant global health problem but remains largely hidden. Understanding decisions about whether or not to disclose violence in response to routine enquiry in health settings can inform safe and responsive systems. Elevated rates of violence and systematic disadvantage found among Indigenous women globally, can impact on their decisions to disclose violence. This study aimed to test, among Indigenous women, a model for decisions on whether to disclose intimate partner violence in the context of antenatal routine screening. we employed Qualitative Configurative Analysis, a method developed for the social sciences to study complex phenomena with intermediate sample sizes. Data were drawn from single semi- structured interviews with Indigenous women 28+ weeks pregnant attending antenatal care. Interviews addressed decisions to disclose recent intimate partner violence in the context of routine enquiry during the antenatal care. Interview transcripts were binary coded for conditions identified a priori from the model being tested and also from themes identified within the current study and analysed using Qualitative Configurative Analysis to determine causal conditions for the outcome of disclosure or non-disclosure of violence experienced. five Aboriginal and Maternal Infant Health Services (two urban and three regional), and one mainstream hospital, in New South Wales, Australia. indigenous women who had experienced partner violence in the previous year and who had been asked about this as part of an antenatal booking-in visit. Of the 12 participants six had elected to disclose their experience of violence to the midwife, and six had chosen not to do so. pathways to disclosure and non-disclosure were mapped using Qualitative Configurative Analysis. Conditions relevant to decisions to disclose were similar to the conditions for non-Aboriginal women found in our earlier study. Unique to Aboriginal women's decisions to disclose abuse was cultural safety. Cultural safety included elements we titled: Borrowed trust, Build the relationship first, Come at it slowly and People like me are here. The absence of cultural safety Its absence was also a factor in decisions not to disclose experiences of violence by this group of women. cultural safety was central to Indigenous women's decision to disclose violence and processes for creating safety are identified. Other forms of safety which influenced disclosure included: safety from detection by the abuser; safety from shame; and safety from institutional control. Disclosure was promoted by direct asking by the midwife and a perception of care. Non-disclosure was associated with a lack of care and a lack of all four types of safety. Experiences of institutional racism were associated with Indigenous women's perceived risk of control by others, particularly child protection services. policies to ask abuse questions at first visits and models where continuity of care is not maintained, are problematic for Aboriginal women, among whom relationship building is important as is ample warning about questions to be asked. Strategies are needed to build cultural safety to counter widespread racism and promote safe opportunities for Indigenous women to disclose intimate partner violence and receive support. Elements of cultural safety are necessary for vulnerable or marginalised populations to fully utilise available health services. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Relationships between Safe Pesticide Practice and Perceived Benefits and Subjective Norm, and the Moderation Role of Information Acquisition: Evidence from 971 Farmers in China.

PubMed

Wang, Jianhua; Deng, Yuanyuan; Ma, Yuting

2017-08-25

Improper use of pesticides among farmers has caused food safety issues which are serious threats to public health in China. A central question concerns how to motivate farmers to self-regulate their pesticide usage. The paper aims to identify the influence of an internal driving factor, i.e., perceived benefits, and an external driving factor, i.e., subjective norm, on farmers' safe pesticide behaviors, and whether the two factors are moderated by the exposure to information on government policies and the market, based on a sample of 971 farmers selected from 5 Chinese provinces. The results revealed that farmers' safe pesticide usage was predominately driven by perceived benefits whereas external pressure or subjective norm did not play much of a role. Interaction effects were found between the exposure to market information and perceived benefits, and also between subjective norm and exposure to government policy. Extensions agencies are recommended to effectively convey to farmers the benefits to follow safe pesticide practices. Meanwhile, surveillance and monitoring systems should be established so that the prices of their agricultural products are reflected by the quality of the products.

Sociotechnical attributes of safe and unsafe work systems

PubMed Central

Kleiner, Brian M.; Hettinger, Lawrence J.; DeJoy, David M.; Huang, Yuang-Hsiang; Love, Peter E.D.

2015-01-01

Theoretical and practical approaches to safety based on sociotechnical systems principles place heavy emphasis on the intersections between social–organisational and technical–work process factors. Within this perspective, work system design emphasises factors such as the joint optimisation of social and technical processes, a focus on reliable human–system performance and safety metrics as design and analysis criteria, the maintenance of a realistic and consistent set of safety objectives and policies, and regular access to the expertise and input of workers. We discuss three current approaches to the analysis and design of complex sociotechnical systems: human–systems integration, macroergonomics and safety climate. Each approach emphasises key sociotechnical systems themes, and each prescribes a more holistic perspective on work systems than do traditional theories and methods. We contrast these perspectives with historical precedents such as system safety and traditional human factors and ergonomics, and describe potential future directions for their application in research and practice. Practitioner Summary: The identification of factors that can reliably distinguish between safe and unsafe work systems is an important concern for ergonomists and other safety professionals. This paper presents a variety of sociotechnical systems perspectives on intersections between social–organisational and technology–work process factors as they impact work system analysis, design and operation. PMID:25909756

Safety update on the use of recombinant activated factor VII in approved indications.

PubMed

Neufeld, Ellis J; Négrier, Claude; Arkhammar, Per; Benchikh el Fegoun, Soraya; Simonsen, Mette Duelund; Rosholm, Anders; Seremetis, Stephanie

2015-06-01

This updated safety review summarises the large body of safety data available on the use of recombinant activated factor VII (rFVIIa) in approved indications: haemophilia with inhibitors, congenital factor VII (FVII) deficiency, acquired haemophilia and Glanzmann's thrombasthenia. Accumulated data up to 31 December 2013 from clinical trials as well as post-marketing data (registries, literature reports and spontaneous reports) were included. Overall, rFVIIa has shown a consistently favourable safety profile, with no unexpected safety concerns, in all approved indications. No confirmed cases of neutralising antibodies against rFVIIa have been reported in patients with congenital haemophilia, acquired haemophilia or Glanzmann's thrombasthenia. The favourable safety profile of rFVIIa can be attributed to the recombinant nature of rFVIIa and its localised mechanism of action at the site of vascular injury. Recombinant FVIIa activates factor X directly on the surface of activated platelets, which are present only at the site of injury, meaning that systemic activation of coagulation is avoided and the risk of thrombotic events (TEs) thus reduced. Nonetheless, close monitoring for signs and symptoms of TE is warranted in all patients treated with any pro-haemostatic agent, including rFVIIa, especially the elderly and any other patients with concomitant conditions and/or predisposing risk factors to thrombosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quantifying Geographic Variation in Health Care Outcomes in the United States before and after Risk-Adjustment.

PubMed

Rosenberg, Barry L; Kellar, Joshua A; Labno, Anna; Matheson, David H M; Ringel, Michael; VonAchen, Paige; Lesser, Richard I; Li, Yue; Dimick, Justin B; Gawande, Atul A; Larsson, Stefan H; Moses, Hamilton

2016-01-01

Despite numerous studies of geographic variation in healthcare cost and utilization at the local, regional, and state levels across the U.S., a comprehensive characterization of geographic variation in outcomes has not been published. Our objective was to quantify variation in US health outcomes in an all-payer population before and after risk-adjustment. We used information from 16 independent data sources, including 22 million all-payer inpatient admissions from the Healthcare Cost and Utilization Project (which covers regions where 50% of the U.S. population lives) to analyze 24 inpatient mortality, inpatient safety, and prevention outcomes. We compared outcome variation at state, hospital referral region, hospital service area, county, and hospital levels. Risk-adjusted outcomes were calculated after adjusting for population factors, co-morbidities, and health system factors. Even after risk-adjustment, there exists large geographical variation in outcomes. The variation in healthcare outcomes exceeds the well publicized variation in US healthcare costs. On average, we observed a 2.1-fold difference in risk-adjusted mortality outcomes between top- and bottom-decile hospitals. For example, we observed a 2.3-fold difference for risk-adjusted acute myocardial infarction inpatient mortality. On average a 10.2-fold difference in risk-adjusted patient safety outcomes exists between top and bottom-decile hospitals, including an 18.3-fold difference for risk-adjusted Central Venous Catheter Bloodstream Infection rates. A 3.0-fold difference in prevention outcomes exists between top- and bottom-decile counties on average; including a 2.2-fold difference for risk-adjusted congestive heart failure admission rates. The population, co-morbidity, and health system factors accounted for a range of R2 between 18-64% of variability in mortality outcomes, 3-39% of variability in patient safety outcomes, and 22-70% of variability in prevention outcomes. The amount of variability in health outcomes in the U.S. is large even after accounting for differences in population, co-morbidities, and health system factors. These findings suggest that: 1) additional examination of regional and local variation in risk-adjusted outcomes should be a priority; 2) assumptions of uniform hospital quality that underpin rationale for policy choices (such as narrow insurance networks or antitrust enforcement) should be challenged; and 3) there exists substantial opportunity for outcomes improvement in the US healthcare system.

Did Child Restraint Laws Globally Converge? Examining 40 Years of Policy Diffusion.

PubMed

Nazif-Muñoz, José Ignacio

2015-01-01

The objective of the current study is to determine what factors have been associated with the global adoption of mandatory child restraint laws (ChRLs) since 1975. In order to determine what factors explained the global adoption of mandatory ChRLs, Weibull models were analyzed. To carry out this analysis, 170 countries were considered and the time risk corresponded to 5,146 observations for the period 1957-2013. The dependent variable was first time to adopt a ChRL. Independent variables representing global factors were the World Health Organization (WHO) and World Bank's (WB) road safety global campaign; the Geneva Convention on Road Traffic; and the United Nation's (UN) 1958 Vehicle Agreement. Independent variables representing regional factors were the creation of the European Transport Safety Council and being a Commonwealth country. Independent variables representing national factors were population; gross domestic product (GDP) per capita; political violence; existence of road safety nongovernmental organizations (NGOs); and existence of road safety agencies. Urbanization served as a control variable. To examine regional dynamics, Weibull models for Africa, Asia, Europe, North America, Latin America, the Caribbean, and the Commonwealth were also carried out. Empirical estimates from full Weibull models suggest that 2 global factors and 2 national factors are significantly associated with the adoption of this measure. The global factors explaining adoption are the WHO and WB's road safety global campaign implemented after 2004 (P <.01), and the UN's 1958 Vehicle Agreement (P <.001). National factors were GDP (P <.01) and existence of road safety agencies (P <.05). The time parameter ρ for the full Weibull model was 1.425 (P <.001), suggesting that the likelihood of ChRL adoption increased over the observed period of time, confirming that the diffusion of this policy was global. Regional analysis showed that the UN's Convention on Road Traffic was significant in Asia, the creation of the European Transport Safety Council was significant in Europe and North America, and the global campaign was in Africa. In Commonwealth and European and North American countries, the existence of road safety agencies was also positively associated with ChRL adoption. Results of the world models suggest that the WHO and WB's global road safety campaign was effective in disseminating ChRLs after 2004. Furthermore, regions such as Asia and Europe and North America were early adopters since specific regional and national characteristics anticipated the introduction of this policy before 2004. In this particular case, the creation of the European Transport Safety Council was fundamental in promoting ChRLs. Thus, in order to introduce conditions to more rapidly diffuse road safety measures across lagging regions, the maintenance of global efforts and the creation of road safety regional organizations should be encouraged. Lastly, the case of ChRL convergence illustrates how mechanisms of global and regional diffusion need to be analytically differentiated in order better to assess the process of policy diffusion.

The Design of Transportation Equipment in Terms of Human Capabilities. The Role of Engineering Psychology in Transport Safety.

ERIC Educational Resources Information Center

McFarland, Ross A.

Human factors engineering is considered with regard to the design of safety factors for aviation and highway transportation equipment. Current trends and problem areas are identified for jet air transportation and for highway transportation. Suggested solutions to transportation safety problems are developed by applying the techniques of human…

21 CFR 170.22 - Safety factors to be considered.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive Safety § 170.22 Safety factors to... be applied in determining whether the proposed use of a food additive will be safe: Except where... experimentation data to man of 100 to 1, will be used; that is, a food additive for use by man will not be granted...

21 CFR 170.22 - Safety factors to be considered.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) FOOD ADDITIVES Food Additive Safety § 170.22 Safety factors to be considered. In accordance with... proposed use of a food additive will be safe: Except where evidence is submitted which justifies use of a... used; that is, a food additive for use by man will not be granted a tolerance that will exceed 1/100th...

21 CFR 170.22 - Safety factors to be considered.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive Safety § 170.22 Safety factors to... be applied in determining whether the proposed use of a food additive will be safe: Except where... experimentation data to man of 100 to 1, will be used; that is, a food additive for use by man will not be granted...

21 CFR 170.22 - Safety factors to be considered.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive Safety § 170.22 Safety factors to... be applied in determining whether the proposed use of a food additive will be safe: Except where... experimentation data to man of 100 to 1, will be used; that is, a food additive for use by man will not be granted...

16 CFR § 1119.4 - Factors considered in determining civil penalties.

Code of Federal Regulations, 2013 CFR

2013-01-01

... penalties. § 1119.4 Section § 1119.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS CIVIL PENALTY FACTORS § 1119.4 Factors considered in determining civil penalties. (a) Statutory Factors. (1) Section 20(b) of the CPSA, section 5(c)(3) of the FHSA, and section 5...

Hygiene training of food handlers in hospital settings: important factor in the prevention of nosocomial infections.

PubMed

Lazarević, Konstansa; Stojanović, Dusica; Bogdanović, Dragan; Dolićanin, Zana

2013-09-01

The aim of this study was to evaluate the effects of food hygiene training of food handlers on sanitary-hygienic conditions in hospital kitchens, based on microbiological analysis of smears taken in hospital kitchens. The study was conducted in the 1995-2009 period at the Clinical Centre Nis, Serbia. The food hygiene training was conducted in February 2005, by an infection control officer. 1,076 smears in the central kitchen and 4,025 smears in distributive kitchens were taken from hands and work clothes, work surfaces, equipment, and kitchen utensils. Microbiological analysis of smears was carried out in an accredited laboratory of the Public Health Institute Nis (Serbia). A significantly lower percentage of smears with isolates of bacteria (p < 0.001) taken from hands and work clothes, work surfaces, equipment and kitchen utensils in the central and distributive kitchens was observed in the period following the food safety education programme (2005-2009). The most commonly isolated bacteria was: Enterobacter spp., Acinetobacter spp., Citrobacter spp., and E. coli. Our results confirmed that food hygiene training improved hygiene and is also an important component for the prevention of nosocomial infection.

Approaches for the Development of Drugs for Treatment of Obesity and Metabolic Syndrome.

PubMed

Maksimov, Maksim L; Svistunov, Andrey A; Tarasov, Vadim V; Chubarev, Vladimir N; Ávila-Rodriguez, Marco; Barreto, George E; Dralova, Olga V; Aliev, Gjumrakch

2016-01-01

Obesity and metabolic syndrome (MS) are risk factors for diabetes, cancer, some cardiovascular and musculoskeletal diseases. Pharmacotherapy should be used when the body mass index (BMI) exceeds 30 kg/m² or 27 kg/m² with comorbidity. Efficacy and safety of pharmacotherapy depend on the mechanism of action of drugs. In this context, drugs affecting the central and peripheral mediator systems such as cannabinoid receptor antagonists (Rimonabant), neuronal reuptake inhibitor of NE and 5 HT (Sibutramine), neuronal reuptake inhibitor of NE 5-HT DA (Tesofensine), agonist of 5 HT 2C receptors (Lorcaserin) have a high risk of side effects on the central nervous and cardiovascular systems when used for a long period. Apparently, the drugs design targeting obesity should screen safer drugs that affect fat absorption (Orlistat), activate energy metabolism (Adipokines), inhibit MetAP2 (Beloranib) and other peripheral metabolic processes. The use of synergies of anti-obesity drugs with different mechanisms of action is an effective approach for developing new combined pharmaceutical compositions (Contrave®, EmpaticTM, Qsymia et al). The purpose of this article is to review the currently available anti-obesity drugs and some new promising trends in development of anti-obesity therapy.

Determination of current and rotational transform profiles in a current-carrying stellarator using soft x-ray emissivity measurements

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

Ma, X.; Cianciosa, M. R.; Ennis, D. A.

In this research, collimated soft X-ray (SXR) emissivity measurements from multi-channel cameras on the Compact Toroidal Hybrid (CTH) tokamak/torsatron device are incorporated in the 3D equilibrium reconstruction code V3FIT to reconstruct the shape of flux surfaces and infer the current distribution within the plasma. Equilibrium reconstructions of sawtoothing plasmas that use data from both SXR and external magnetic diagnostics show the central safety factor to be near unity under the assumption that SXR iso-emissivity contours lie on magnetic flux surfaces. The reconstruction results are consistent with those using the external magnetic data and a constraint on the location of qmore » = 1 surfaces determined from the sawtooth inversion surface extracted from SXR brightness profiles. The agreement justifies the use of approximating SXR emission as a flux function in CTH, at least within the core of the plasma, subject to the spatial resolution of the SXR diagnostics. Lastly, this improved reconstruction of the central current density indicates that the current profile peakedness decreases with increasing external transform and that the internal inductance is not a relevant measure of how peaked the current profile is in hybrid discharges.« less

Convenience foods, as portrayed by a consumer organisation. Test-Aankoop/Test-Achats (1960-1995).

PubMed

Degreef, Filip

2015-11-01

Food choice, both today and in the past, is driven by a broad range of interacting factors, in which culture is centrally placed. This paper will assess convenience foods by means of a qualitative analysis of comparative product tests done by Belgium's largest consumer organisation Test-Aankoop/Test-Achats, and will focus on the influence of socially and culturally normative values between the years 1960 and 1995. The tests provide a unique insight into attitudes to convenience foods within an organisation that saw its role in Belgian consumer society as being both educator and guide. The organisation's views on health, food safety, modernity, tradition, control over ingredients and content, gender roles and taste shaped its attitude to the role and meaning of what food is supposed to be. The organisation thereby both guided and re-affirmed normative values with respect to convenience foods. Values, which are culturally constructed, have always played a key role in the acceptability of products. Cultural and social inhibitions and fears over control of convenience foods, which persist today, were central in the consumer organisation's representation of convenience food. Copyright © 2015 Elsevier Ltd. All rights reserved.

Determination of current and rotational transform profiles in a current-carrying stellarator using soft x-ray emissivity measurements

NASA Astrophysics Data System (ADS)

Ma, X.; Cianciosa, M. R.; Ennis, D. A.; Hanson, J. D.; Hartwell, G. J.; Herfindal, J. L.; Howell, E. C.; Knowlton, S. F.; Maurer, D. A.; Traverso, P. J.

2018-01-01

Collimated soft X-ray (SXR) emissivity measurements from multi-channel cameras on the Compact Toroidal Hybrid (CTH) tokamak/torsatron device are incorporated in the 3D equilibrium reconstruction code V3FIT to reconstruct the shape of flux surfaces and infer the current distribution within the plasma. Equilibrium reconstructions of sawtoothing plasmas that use data from both SXR and external magnetic diagnostics show the central safety factor to be near unity under the assumption that SXR iso-emissivity contours lie on magnetic flux surfaces. The reconstruction results are consistent with those using the external magnetic data and a constraint on the location of q = 1 surfaces determined from the sawtooth inversion surface extracted from SXR brightness profiles. The agreement justifies the use of approximating SXR emission as a flux function in CTH, at least within the core of the plasma, subject to the spatial resolution of the SXR diagnostics. This improved reconstruction of the central current density indicates that the current profile peakedness decreases with increasing external transform and that the internal inductance is not a relevant measure of how peaked the current profile is in hybrid discharges.

Determination of current and rotational transform profiles in a current-carrying stellarator using soft x-ray emissivity measurements

DOE PAGES

Ma, X.; Cianciosa, M. R.; Ennis, D. A.; ...

2018-01-31

In this research, collimated soft X-ray (SXR) emissivity measurements from multi-channel cameras on the Compact Toroidal Hybrid (CTH) tokamak/torsatron device are incorporated in the 3D equilibrium reconstruction code V3FIT to reconstruct the shape of flux surfaces and infer the current distribution within the plasma. Equilibrium reconstructions of sawtoothing plasmas that use data from both SXR and external magnetic diagnostics show the central safety factor to be near unity under the assumption that SXR iso-emissivity contours lie on magnetic flux surfaces. The reconstruction results are consistent with those using the external magnetic data and a constraint on the location of qmore » = 1 surfaces determined from the sawtooth inversion surface extracted from SXR brightness profiles. The agreement justifies the use of approximating SXR emission as a flux function in CTH, at least within the core of the plasma, subject to the spatial resolution of the SXR diagnostics. Lastly, this improved reconstruction of the central current density indicates that the current profile peakedness decreases with increasing external transform and that the internal inductance is not a relevant measure of how peaked the current profile is in hybrid discharges.« less

Hyalomma anatolicum as the Main Infesting Tick in an Important Livestock Rearing Region, Central Area of Iran.

PubMed

Biglari, Peyvand; Bakhshi, Hasan; Chinikar, Sadegh; Belqeiszadeh, Hamid; Ghaffari, Masoud; Javaherizadeh, Siavash; Faghihi, Faezeh; Telmadarraiy, Zakkyeh

2018-05-01

This study was carried out to determine the infestation of domestic ruminants to ticks in an important livestock-rearing region, located in central part of Iran. Ticks were collected from cattle, sheep, and goats and then were identified with appropriate identification keys to species level in two different ecological regions of plains and mountain in 4 seasons in 2015. Totally 492 ticks from cattle, sheep, and goats in 34 herds were collected. Totally, 18.53% of domestic animals were infected by ticks. All ticks were belonged to family Ixodidae and classified into three genera and six species comprising Hyalomma anatolicum (38.83%) , Hy. Asiaticum (23.37%), Hy. marginatum (2.85%), Hy. sp. (3.45%), Rhipicephalus sanguineus (14.02%) and Haemaphysalis sulcata (10.98%). Sex ratio of the collected specimens showed 241 (48.99%) male, 219 (44.51%) female and 32 (6.5%) nymph. Studied area is important for production of livestock and dairy products. Annually, many livestock products are exported to other parts from this region; therefore, it is very important to identify the infection rate of tick-borne diseases as well as safety factors on livestock.

Impact of daylight saving time on road traffic collision risk: a systematic review.

PubMed

Carey, Rachel N; Sarma, Kiran M

2017-07-02

Bills have been put forward in the UK and Republic of Ireland proposing a move to Central European Time (CET). Proponents argue that such a change will have benefits for road safety, with daylight being shifted from the morning, when collision risk is lower, to the evening, when risk is higher. Studies examining the impact of daylight saving time (DST) on road traffic collision risk can help inform the debate on the potential road safety benefits of a move to CET. The objective of this systematic review was to examine the impact of DST on collision risk. Major electronic databases were searched, with no restrictions as to date of publication (the last search was performed in January 2017). Access to unpublished reports was requested through an international expert group. Studies that provided a quantitative analysis of the effect of DST on road safety-related outcomes were included. The primary outcomes of interest were road traffic collisions, injuries and fatalities. Twenty-four studies met the inclusion criteria. Seventeen examined the short-term impact of transitions around DST and 12 examined long-term effects. Findings from the short-term studies were inconsistent. The long-term findings suggested a positive effect of DST. However, this cannot be attributed solely to DST, as a range of road collision risk factors vary over time. The evidence from this review cannot support or refute the assertion that a permanent shift in light from morning to evening will have a road safety benefit. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effects of Age at First Childbirth and Other Factors on Central Obesity in Postmenopausal Women: The 2013–2015 Korean National Health and Nutrition Examination Survey

PubMed Central

Lee, Wang Jin; Lee, Joo Ha; Kwag, Byoung Gyu; Chang, Shin Hae; Choi, Yu Jin

2018-01-01

Background Waist circumference is one of the key components of metabolic syndrome. Recent studies demonstrated that the reproductive profile was associated with metabolic syndrome in postmenopausal women. This study focused on the association between central obesity and age at first childbirth. It also considered other factors associated with central obesity in postmenopausal women. Methods This study was based on the 2013–2015 Korean National Health and Nutrition Examination Survey and involved 3,143 naturally postmenopausal women. These women were divided into three groups according to their age at first childbirth: 19 years or younger (n=252), 20–29 years (n=2,695), and 30 years or older (n=196). Multivariate analysis using logistic regression was performed to evaluate the effects of various reproductive factors, including other confounding factors. Results During adjustment for confounding factors, in the early age at first childbirth group, odds ratios (95% confidence intervals) for central obesity decreased. In the final model, younger age at first childbirth was not significantly related to central obesity (waist circumference more than 85 cm) in naturally postmenopausal women after adjusting for other confounding factors. Conclusion Younger age at first childbirth was not significantly associated with central obesity after adjustment for confounding factors. PMID:29788703

The H-PEPSS: an instrument to measure health professionals' perceptions of patient safety competence at entry into practice.

PubMed

Ginsburg, Liane; Castel, Evan; Tregunno, Deborah; Norton, Peter G

2012-08-01

Enhancing competency in patient safety at entry to practice requires introduction and integration of patient safety into health professional education. As efforts to include patient safety in health professional education increase, it is important to capture new health professionals' perspectives of their own patient safety competence at entry to practice. Existing instruments to measure patient safety knowledge, skills and attitudes have been developed largely to examine the impact of specific patient safety curricular initiatives and the psychometric analyses of the instruments used thus far have been exploratory in nature. Confirmatory factor analytic approaches are used to extensively test the Health Professional Education in Patient Safety Survey (H-PEPSS), a newly designed survey rooted in a patient safety competency framework and designed to measure health professionals' self-reported patient safety competence around the time of entry to practice. The H-PEPSS focuses primarily on the socio-cultural aspects of patient safety including culture, teamwork, communication, managing risk and understanding human factors. Results support a parsimonious six-factor measurement model of health professionals' perceptions of patient safety competency. These results support the validity of a reduced version of the H-PEPSS and suggest it can be appropriately used at or near training completion with a variety of health professional groups. Given increased demands for patient safety competency among health professionals at entry to practice and slow, but emerging changes in health professional education, ongoing research to understand the extent of patient safety competency among health professionals around the time of entry to practice will be important.

The H-PEPSS: an instrument to measure health professionals' perceptions of patient safety competence at entry into practice

PubMed Central

Castel, Evan; Tregunno, Deborah; Norton, Peter G

2012-01-01

Background Enhancing competency in patient safety at entry to practice requires introduction and integration of patient safety into health professional education. As efforts to include patient safety in health professional education increase, it is important to capture new health professionals' perspectives of their own patient safety competence at entry to practice. Existing instruments to measure patient safety knowledge, skills and attitudes have been developed largely to examine the impact of specific patient safety curricular initiatives and the psychometric analyses of the instruments used thus far have been exploratory in nature. Methods Confirmatory factor analytic approaches are used to extensively test the Health Professional Education in Patient Safety Survey (H-PEPSS), a newly designed survey rooted in a patient safety competency framework and designed to measure health professionals' self-reported patient safety competence around the time of entry to practice. The H-PEPSS focuses primarily on the socio-cultural aspects of patient safety including culture, teamwork, communication, managing risk and understanding human factors. Results Results support a parsimonious six-factor measurement model of health professionals' perceptions of patient safety competency. These results support the validity of a reduced version of the H-PEPSS and suggest it can be appropriately used at or near training completion with a variety of health professional groups. Conclusions Given increased demands for patient safety competency among health professionals at entry to practice and slow, but emerging changes in health professional education, ongoing research to understand the extent of patient safety competency among health professionals around the time of entry to practice will be important. PMID:22562876

Improving Prediction Accuracy of “Central Line-Associated Blood Stream Infections” Using Data Mining Models

PubMed Central

Noaman, Amin Y.; Jamjoom, Arwa; Al-Abdullah, Nabeela; Nasir, Mahreen; Ali, Anser G.

2017-01-01

Prediction of nosocomial infections among patients is an important part of clinical surveillance programs to enable the related personnel to take preventive actions in advance. Designing a clinical surveillance program with capability of predicting nosocomial infections is a challenging task due to several reasons, including high dimensionality of medical data, heterogenous data representation, and special knowledge required to extract patterns for prediction. In this paper, we present details of six data mining methods implemented using cross industry standard process for data mining to predict central line-associated blood stream infections. For our study, we selected datasets of healthcare-associated infections from US National Healthcare Safety Network and consumer survey data from Hospital Consumer Assessment of Healthcare Providers and Systems. Our experiments show that central line-associated blood stream infections (CLABSIs) can be successfully predicted using AdaBoost method with an accuracy up to 89.7%. This will help in implementing effective clinical surveillance programs for infection control, as well as improving the accuracy detection of CLABSIs. Also, this reduces patients' hospital stay cost and maintains patients' safety. PMID:29085836

Safety climate and mindful safety practices in the oil and gas industry.

PubMed

Dahl, Øyvind; Kongsvik, Trond

2018-02-01

The existence of a positive association between safety climate and the safety behavior of sharp-end workers in high-risk organizations is supported by a considerable body of research. Previous research has primarily analyzed two components of safety behavior, namely safety compliance and safety participation. The present study extends previous research by looking into the relationship between safety climate and another component of safety behavior, namely mindful safety practices. Mindful safety practices are defined as the ability to be aware of critical factors in the environment and to act appropriately when dangers arise. Regression analysis was used to examine whether mindful safety practices are, like compliance and participation, promoted by a positive safety climate, in a questionnaire-based study of 5712 sharp-end workers in the oil and gas industry. The analysis revealed that a positive safety climate promotes mindful safety practices. The regression model accounted for roughly 31% of the variance in mindful safety practices. The most important safety climate factor was safety leadership. The findings clearly demonstrate that mindful safety practices are highly context-dependent, hence, manageable and susceptible to change. In order to improve safety climate in a direction which is favorable for mindful safety practices, the results demonstrate that it is important to give the fundamental features of safety climate high priority and in particular that of safety leadership. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Integrated Crowdsourcing Platform to Investigate Non-Motorized Behavior and Risk Factors on Walking, Running, and Cycling Routes

DOT National Transportation Integrated Search

2017-08-31

There are several factors on the roads that impact bicyclists safety. This research aims to find the most important risk factors on roads, mainly in infrastructure facilities, to improve the safety for walkers, runners, and bicyclists. Most mobile...

Consideration of the FQPA Safety Factor and Other Uncertainty Factors in Cumulative Risk Assessment of Chemicals Sharing a Common Mechanism of Toxicity

EPA Pesticide Factsheets

This guidance document provides OPP's current thinking on application of the provision in FFDCA about an additional safety factor for the protection of infants and children in the context of cumulative risk assessments.

Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment.

PubMed

Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R

2018-05-01

To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

Influence Map Methodology for Evaluating Systemic Safety Issues

NASA Technical Reports Server (NTRS)

2008-01-01

"Raising the bar" in safety performance is a critical challenge for many organizations, including Kennedy Space Center. Contributing-factor taxonomies organize information about the reasons accidents occur and therefore are essential elements of accident investigations and safety reporting systems. Organizations must balance efforts to identify causes of specific accidents with efforts to evaluate systemic safety issues in order to become more proactive about improving safety. This project successfully addressed the following two problems: (1) methods and metrics to support the design of effective taxonomies are limited and (2) influence relationships among contributing factors are not explicitly modeled within a taxonomy.

Slope Stability Analysis for Shallow Landslides using TRIGRS: A Case Study for Sta. Cruz, Zambales, Philippines

NASA Astrophysics Data System (ADS)

Mendoza, J. P. A.

2016-12-01

The Philippines, being located in the circum-Pacific, bounded by multiple subduction zones, open seas and ocean, is one of the most hazard-prone countries in the world (Benson, 1997). This widespread recurrence of natural hazards in the country requires much attention for disaster management (Aurelio, 2006). On the average, 21 typhoons enter the Philippine area of responsibility annually with 6-9 making a landfall. Several rainfall-induced landslide events are reported annually particularly during and after the inundation of major typhoons which imposes hazards to communities and causes destruction of properties due to the moving mass and possible flash floods it may induce. Shallow landslides are the most commonly observed failure involving soil-mantled slopes and are considered major geohazards, often causing property damage and other economic loss. Hence numerous studies on landslide susceptibility including numerical models based on infinite slope equation are used in order to identify slopes prone to occurrences of shallow landslides. The study aims to determine the relationships between the slope and elevation to the factor of safety for laterite-mantled topography by incorporating precipitation values in the determination of landslide susceptibility. Using a DEM, flow direction map and slope map of the Sta Cruz (Zambales, Philippines), the FORTRAN based program TRIGRS, was used to generate the values for the factors of safety in the study area. Overlays with a generated slope map and elevation map were used to determine relationships of the mentioned factors and the factors of safety. A slope in a topography mantled with lateritic soil will fail at a slope angle higher than 20 degrees. Generally, the factor of safety decreases as the slope angle increases; this increases the probability and risk of slope failure. Elevation has no bearing on the computation for the factor of safety. The factor of safety is heavily dependent on the slope angle. The value of generated factor of safety coincides with the published geohazard map from Mines and Geosciences Bureau(MGB).

Efficacy and safety of sequential use of everolimus in Japanese patients with advanced renal cell carcinoma after failure of first-line treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitor: a multicenter phase II clinical trial.

PubMed

Oyama, Masafumi; Sugiyama, Takayuki; Nozawa, Masahiro; Fujimoto, Kiyohide; Kishida, Takeshi; Kimura, Go; Tokuda, Noriaki; Hinotsu, Shiro; Shimozuma, Kojiro; Akaza, Hideyuki; Ozono, Seiichiro

2017-06-01

Many studies have shown the efficacy of everolimus after pretreatment with vascular endothelial growth factor receptor-tyrosine kinase inhibitors. We investigated the efficacy and safety of everolimus as a second-line treatment after the failure of vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy in Japanese patients with advanced renal cell carcinoma. This was an open-label, multicenter, phase II trial conducted in Japan through the central registration system. A total of 57  patients were enrolled. Patients were administered 10 mg of everolimus q.d. orally. The primary efficacy endpoint was progression-free survival achieved by administration of everolimus. The median progression-free survival of patients administered everolimus was 5.03 months (95% confidence interval: 3.70-6.20). The median overall survival was not reached. The objective response rate was 9.4% (95% confidence interval: 3.1-20.7). The progression-free survival in the group of <100% relative dose intensity was 6.70 months (95% confidence interval: 4.13-11.60), and that in the group of 100% relative dose intensity was 3.77 months (hazard ratio: 2.79, 95% confidence interval: 2.77-5.63). The commonly observed adverse events and laboratory abnormalities were stomatitis (49.1%), hypertriglyceridemia (26.4%), interstitial lung disease (26.4%), anemia (22.6%) and hypercholesterolemia (22.6%). The median progression-free survival was almost similar to that recorded in the RECORD-1 study, whereas prolongation of overall survival was observed in the present study compared with the RECORD-1 study. The treatment outcomes of first-line vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy and second-line everolimus treatment in Japanese patients were successfully established in the present study. © The Author 2017. Published by Oxford University Press.

Landslide Hazard Assessment near Kedarnath Temple in Himalayan region considering cloudburst tragedy in 2013

NASA Astrophysics Data System (ADS)

Ansari, T. A.; Singh, T. N., Sr.

2017-12-01

The world famous Shri Kedarnath Temple in Uttarakhand state of India is located in the western extremity of the young and dynamically active Central Himalaya. As Indian plate is moving towards Eurasian plate which has steep slopes, highly variable altitudes and uncertain climatic conditions. Due to high seismic activity Himalayan rock mass is highly fractured, shattered and inherently weakness pose threat for landslide. On 16th and 17th June 2013, was witness an extreme climatic events of century in the history of the region, the high intensity rainfall, (> 400mm) caused number of landslide which have adverse economic and societal impacts, including the potential for heavy loss of human and widespread devastation of natural resources, infrastructures. The study region is at high altitude around 3583 meters, which is affected from impact of glacial melt due to climate change and future increase in rainfall subjected to high level uncertainty of landslides. Aerial and field survey has been done of the region and most vulnerable landslide locations of hill slope and road cut slope are studied for future prospect of safety. SLIDE 6.0, PHASE27 (numerical software) for slope stability, geomechanical profile of rock and kinematics analysis to know the type of failures. Rock quality tunneling index (Q), Geological strength (GSI), Slope mass Rating (SMR) and factor of safety were determined to know the slope instability. Our finding provides an important aspect for future safety as provide the information for landslide warning system and engineering countermeasures.

Overall requirements for an advanced underground coal extraction system. [environment effects, miner health and safety, production cost, and coal conservation

NASA Technical Reports Server (NTRS)

Goldsmith, M.; Lavin, M. L.

1980-01-01

Underground mining systems suitable for coal seams expoitable in the year 2000 are examined with particular relevance to the resources of Central Appalachia. Requirements for such systems may be summarized as follows: (1) production cost; (2)miner safety; (3) miner health; (4) environmental impact; and (5) coal conservation. No significant trade offs between production cost and other performance indices were found.

National Conference for College and University Safety Educators Association (First, Central Missouri State University, Warrensburg, August 16-17, 1975). Sefety Monographs for Schools and Colleges No. 36.

ERIC Educational Resources Information Center

Green, Jack N., Ed.

This publication is a compilation of five papers that were originally presented at the 1975 National Conference of the College and University Safety Educators Association. Most of the booklet consists of the text of these papers; also included are a copy of the conference agenda and a complete roster of conference participants. The five papers…

14 CFR 31.25 - Factor of safety.

Code of Federal Regulations, 2011 CFR

2011-01-01

... STANDARDS: MANNED FREE BALLOONS Strength Requirements § 31.25 Factor of safety. (a) Except as specified in... of temperature, and other operating characteristics, or both, that may affect strength of the balloon...

University of Central Florida / Deep Space Industries Asteroid Regolith Simulants

NASA Astrophysics Data System (ADS)

Britt, Daniel; Covey, Steven D.; Schultz, Cody

2017-10-01

Introduction: The University of Central Florida (UCF), in partnership with Deep Space Industries (DSI) are working under a NASA Phase 2 SBIR contract to develop and produce a family of asteroid regolith simulants for use in research, engineering, and mission operations testing. We base simulant formulas on the mineralogy, particle size, and physical characteristics of CI, CR, CM, C2, CV, and L-Chondrite meteorites. The advantage in simulating meteorites is that the vast majority of meteoritic materials are common rock forming minerals that are available in commercial quantities. While formulas are guided by the meteorites our approach is one of constrained maximization under the limitations of safety, cost, source materials, and ease of handling. In all cases our goal is to deliver a safe, high fidelity analog at moderate cost.Source Materials, Safety, and Biohazards: A critical factor in any useful simulant is to minimize handling risks for biohazards or toxicity. All the terrestrial materials proposed for these simulants were reviewed for potential toxicity. Of particular interest is the organic component of volatile rich carbonaceous chondrites which contain polycyclic aromatic hydrocarbons (PAHs), some of which are known carcinogens and mutagens. Our research suggests that we can maintain rough chemical fidelity by substituting much safer sub-bituminous coal as our organic analog. A second safety consideration is the choice of serpentine group materials. While most serpentine polymorphs are quite safe we avoid fibrous chrysotile because of its asbestos content. Terrestrial materials identified as inputs for our simulants are common rock forming minerals that are available in commercial quantities. These include olivine, pyroxene, plagioclase feldspar, smectite, serpentine, saponite, pyrite, and magnetite in amounts that are appropriate for each type. For CI's and CR’s, their olivines tend to be Fo100 which is rare on Earth. We have substituted Fo90 olivine, but the loss of mineralogical fidelity is offset by a major cost advantage.Family of Simulants: The CI, CR, and CM simulants are currently available in commercial quantities from Deep Space Industries and the full list will be available by mid-2018.

[Monitoring of nursing service context factors: first descriptive results of a cross-sectional Swiss study prior the introduction of SwissDRG].

PubMed

Kleinknecht-Dolf, Michael; Spichiger, Elisabeth; Frei, Irena Anna; Müller, Marianne; Martin, Jacqueline S; Spirig, Rebecca

2015-04-01

The adoption of DRG-based payment systems has narrowed hospitals' financial margins, necessitating streamlining and process optimization. The experience of other countries shows that this restructuring can influence context factors essential to the delivery of nursing care. As a result, nursing care quality and patient safety may be impacted. The Sinergia Project aims to develop a monitoring model and related instruments to continuously monitor the impact of DRG-based reimbursement on central nursing service context factors. The descriptive, quantitative results were collected within the framework of a study with a mixed methods design by means of an online survey in which nurses from five hospitals participated. The results show that the nursing service context factors examined (nursing care complexity, quality of the work environment, management, moral distress and job satisfaction), have relevance in all practice areas as regards practice setting and nursing care delivery. Patterns can be recognized that are consistent with those found in the literature and which could be an indication of the relationships between the context factors above, as was hypothesized in the model. The study has provided the participating hospitals with useful data upon which to base discussions on ensuring quality of nursing care and practice development, in addition to information important to the further development of the model and the instruments employed.

Safety Profile of Biologic Drugs in the Therapy of Ulcerative Colitis: A Systematic Review and Network Meta-Analysis.

PubMed

Moćko, Paweł; Kawalec, Paweł; Pilc, Andrzej

2016-08-01

We compared the safety profile of biologic drugs in patients with moderately to severely active ulcerative colitis (UC). A systematic literature search was performed using Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases through February 9, 2016. We included randomized controlled trials (RCTs) that compared the safety of biologic drugs (infliximab, adalimumab, golimumab, and vedolizumab) with one another or with placebo in patients with UC. Two reviewers independently conducted the search and selection of studies and rated the risk of bias in each trial. The network meta-analysis (NMA) was conducted for an induction phase (6-8 weeks) and maintenance phase (52-54 weeks) with a Bayesian hierarchical random effects model in Aggregate Data Drug Information System (ADDIS) software. The PROSPERO registration number was CRD42016032607. Seven RCTs were included in the systematic review with NMA. In the case of the induction phase, the NMA could be conducted for the assessment of the relative safety profile of adalimumab, golimumab, and vedolizumab, and in the case of the maintenance phase of infliximab, adalimumab, golimumab, and vedolizumab. The methodological quality of the included RCTs was evaluated as low risk of bias, but high risk of bias in the case of attrition bias (incomplete outcome data) according to the Cochrane criteria. No significant differences were found in the rate of adverse events in patients treated with the reviewed biologics. Vedolizumab was most likely to have the most favorable safety profile in the induction phase as was infliximab for the maintenance phase. The assessment of the relative safety profile revealed no significant differences between the biologic drugs. Further studies are needed to confirm our findings including head-to-head comparisons between the analyzed biologics. © 2016 Pharmacotherapy Publications, Inc.

Nutrition, poverty alleviation, and development in Central America and Panama.

PubMed

Immink, Maarten D C

2010-03-01

This paper reviews research with policy relevance for food and nutrition in Central America and similar areas. The research was conducted by the Institute of Nutrition of Central America and Panama (INCAP) during the last three decades of the past millennium (1970-99). Six policy areas were selected for this review: agricultural commercialization and rural development; wage and price policies; human resource development; social safety nets, particularly complementary food programs; multi-sectoral nutrition planning; and food and nutrition monitoring for policy formulation. The contents and major conclusions of the work are described, as well as their public policy implications.

Education of staff--a key factor for a safe environment in day care.

PubMed

Sellström, E; Bremberg, S

2000-05-01

In order to create a safe environment in day-care settings, an understanding of factors within the organization of day care, factors which influence safety, is essential. Day-care directors in 83 daycare centres completed a mail-in survey that contained questions about professional experience, the day-care centre's organization of child safety measures and a battery of questions designed to evaluate the directors' perceptions and beliefs about child safety. The day-care directors also carried out a safety inspection at their centre. The results were analysed using the multivariate logistic regression technique. The existence of a continuing plan for continued staff education in child safety was shown to be the strongest predictor of few safety hazards in day-care centres. The day-care directors' perceptions and beliefs about injury prevention were of less importance. This study indicates that in order to promote safety in day-care settings, an on-going plan for continued staff education in child safety should be a matter of routine. The introduction of such a plan should be the concern of the individual day-care directors, policy-makers and managers at the local and national level, and health professionals working in this field.

Vascular endothelial growth factor Trap-Eye for macular edema secondary to central retinal vein occlusion: six-month results of the phase 3 COPERNICUS study.

PubMed

Boyer, David; Heier, Jeffrey; Brown, David M; Clark, W Lloyd; Vitti, Robert; Berliner, Alyson J; Groetzbach, Georg; Zeitz, Oliver; Sandbrink, Rupert; Zhu, Xiaoping; Beckmann, Karola; Haller, Julia A

2012-05-01

To assess the efficacy and safety of intravitreal vascular endothelial growth factor (VEGF) Trap-Eye in eyes with macular edema secondary to central retinal vein occlusion (CRVO). Multicenter, randomized, prospective, controlled trial. One hundred eighty-nine eyes with macular edema secondary to CRVO. Eyes were randomized 3:2 to receive VEGF Trap-Eye 2 mg or sham injection monthly for 6 months. The proportion of eyes with a ≥15-letter gain or more in best-corrected visual acuity (BCVA) at week 24 (primary efficacy end point), mean changes in BCVA and central retinal thickness (CRT), and proportion of eyes progressing to neovascularization of the anterior segment, optic disc, or elsewhere in the retina. At week 24, 56.1% of VEGF Trap-Eye treated eyes gained 15 letters or more from baseline versus 12.3% of sham-treated eyes (P<0.001). The VEGF Trap-Eye treated eyes gained a mean of 17.3 letters versus sham-treated eyes, which lost 4.0 letters (P<0.001). Central retinal thickness decreased by 457.2 μm in eyes treated with VEGF Trap-Eye versus 144.8 μm in sham-treated eyes (P<0.001), and progression to any neovascularization occurred in 0 and 5 (6.8%) of eyes treated with VEGF Trap-Eye and sham-treated eyes, respectively (P = 0.006). Conjunctival hemorrhage, reduced visual acuity, and eye pain were the most common adverse events (AEs). Serious ocular AEs were reported by 3.5% of VEGF Trap-Eye patients and 13.5% of sham patients. Incidences of nonocular serious AEs generally were well balanced between both groups. At 24 weeks, monthly intravitreal injection of VEGF Trap-Eye 2 mg in eyes with macular edema resulting from CRVO improved visual acuity and CRT, eliminated progression resulting from neovascularization, and was associated with a low rate of ocular AEs related to treatment. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

A rough set-based measurement model study on high-speed railway safety operation.

PubMed

Hu, Qizhou; Tan, Minjia; Lu, Huapu; Zhu, Yun

2018-01-01

Aiming to solve the safety problems of high-speed railway operation and management, one new method is urgently needed to construct on the basis of the rough set theory and the uncertainty measurement theory. The method should carefully consider every factor of high-speed railway operation that realizes the measurement indexes of its safety operation. After analyzing the factors that influence high-speed railway safety operation in detail, a rough measurement model is finally constructed to describe the operation process. Based on the above considerations, this paper redistricts the safety influence factors of high-speed railway operation as 16 measurement indexes which include staff index, vehicle index, equipment index and environment. And the paper also provides another reasonable and effective theoretical method to solve the safety problems of multiple attribute measurement in high-speed railway operation. As while as analyzing the operation data of 10 pivotal railway lines in China, this paper respectively uses the rough set-based measurement model and value function model (one model for calculating the safety value) for calculating the operation safety value. The calculation result shows that the curve of safety value with the proposed method has smaller error and greater stability than the value function method's, which verifies the feasibility and effectiveness.

Factors Influencing Young Children's Risk of Unintentional Injury: Parenting Style and Strategies for Teaching about Home Safety

ERIC Educational Resources Information Center

Morrongiello, Barbara A.; Corbett, Michael; Lasenby, Jennifer; Johnston, Natalie; McCourt, Meghan

2006-01-01

This study examined mothers' teaching about home-safety issues to 24-30 month and 36-42 month old children, explored the relationship of teaching strategies to parenting styles, and assessed how these factors are related to children's risk of unintentional injury. A structured interview assessed home-safety issues relevant to falls, burns, cuts,…

Risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation.

PubMed

Atchison, Christie M; Amankwah, Ernest; Wilhelm, Jean; Arlikar, Shilpa; Branchford, Brian R; Stock, Arabela; Streiff, Michael; Takemoto, Clifford; Ayala, Irmel; Everett, Allen; Stapleton, Gary; Jacobs, Marshall L; Jacobs, Jeffrey P; Goldenberg, Neil A

2018-02-01

Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St. Petersburg, Florida, United States of America) from 2006 to 2013. Hospital-associated venous thromboembolism cases were identified based on ICD-9 discharge codes and validated using radiological record review. We randomly selected two contemporaneous cardiovascular intensive care unit controls without hospital-associated venous thromboembolism for each hospital-associated venous thromboembolism case, and limited the study population to patients who had undergone cardiothoracic surgery or therapeutic cardiac catheterisation. Odds ratios and 95% confidence intervals for associations between putative risk factors and hospital-associated venous thromboembolism were determined using univariate and multivariate logistic regression. Among 2718 admissions to the cardiovascular intensive care unit during the study period, 65 met the criteria for hospital-associated venous thromboembolism (occurrence rate, 2%). Restriction to cases and controls having undergone the procedures of interest yielded a final study population of 57 hospital-associated venous thromboembolism cases and 76 controls. In a multiple logistic regression model, major infection (odds ratio=5.77, 95% confidence interval=1.06-31.4), age ⩽1 year (odds ratio=6.75, 95% confidence interval=1.13-160), and central venous catheterisation (odds ratio=7.36, 95% confidence interval=1.13-47.8) were found to be statistically significant independent risk factors for hospital-associated venous thromboembolism in these children. Patients with all three factors had a markedly increased post-test probability of having hospital-associated venous thromboembolism. Major infection, infancy, and central venous catheterisation are independent risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or cardiac catheter-based intervention, which, in combination, define a high-risk group for hospital-associated venous thromboembolism.

The predictive validity of safety climate.

PubMed

Johnson, Stephen E

2007-01-01

Safety professionals have increasingly turned their attention to social science for insight into the causation of industrial accidents. One social construct, safety climate, has been examined by several researchers [Cooper, M. D., & Phillips, R. A. (2004). Exploratory analysis of the safety climate and safety behavior relationship. Journal of Safety Research, 35(5), 497-512; Gillen, M., Baltz, D., Gassel, M., Kirsch, L., & Vacarro, D. (2002). Perceived safety climate, job Demands, and coworker support among union and nonunion injured construction workers. Journal of Safety Research, 33(1), 33-51; Neal, A., & Griffin, M. A. (2002). Safety climate and safety behaviour. Australian Journal of Management, 27, 66-76; Zohar, D. (2000). A group-level model of safety climate: Testing the effect of group climate on microaccidents in manufacturing jobs. Journal of Applied Psychology, 85(4), 587-596; Zohar, D., & Luria, G. (2005). A multilevel model of safety climate: Cross-level relationships between organization and group-level climates. Journal of Applied Psychology, 90(4), 616-628] who have documented its importance as a factor explaining the variation of safety-related outcomes (e.g., behavior, accidents). Researchers have developed instruments for measuring safety climate and have established some degree of psychometric reliability and validity. The problem, however, is that predictive validity has not been firmly established, which reduces the credibility of safety climate as a meaningful social construct. The research described in this article addresses this problem and provides additional support for safety climate as a viable construct and as a predictive indicator of safety-related outcomes. This study used 292 employees at three locations of a heavy manufacturing organization to complete the 16 item Zohar Safety Climate Questionnaire (ZSCQ) [Zohar, D., & Luria, G. (2005). A multilevel model of safety climate: Cross-level relationships between organization and group-level climates. Journal of Applied Psychology, 90(4), 616-628]. In addition, safety behavior and accident experience data were collected for 5 months following the survey and were statistically analyzed (structural equation modeling, confirmatory factor analysis, exploratory factor analysis, etc.) to identify correlations, associations, internal consistency, and factorial structures. Results revealed that the ZSCQ: (a) was psychometrically reliable and valid, (b) served as an effective predictor of safety-related outcomes (behavior and accident experience), and (c) could be trimmed to an 11 item survey with little loss of explanatory power. Practitioners and researchers can use the ZSCQ with reasonable certainty of the questionnaire's reliability and validity. This provides a solid foundation for the development of meaningful organizational interventions and/or continued research into social factors affecting industrial accident experience.

Anti-vascular endothelial growth factor for neovascular age-related macular degeneration: a meta-analysis of randomized controlled trials.

PubMed

Nguyen, Chu Luan; Oh, Lawrence J; Wong, Eugene; Wei, Joe; Chilov, Michael

2018-05-30

To evaluate the relative efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) agents for the treatment of neovascular age-related macular degeneration (AMD). Systematic literature review identifying RCTs comparing anti-VEGF agents to another treatment published before June 2016. Efficacy assessed by mean change in best corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline at up to 2 years followup. Safety assessed by proportions of patients with death, arteriothrombotic and venous thrombotic events, and at least one serious systemic adverse event at up to 2 years of followup. Fifteen RCTs selected for meta-analysis (8320 patients). Two trials compared pegaptanib, and three trials compared ranibizumab versus control. Eight trials compared bevacizumab with ranibizumab. Two trials compared aflibercept with ranibizumab. There were no significant differences between bevacizumab and ranibizumab for BCVA at 1 or 2 years (weighted mean difference = - 0.57, 95% CI - 1.55 to 0.41, P = 0.25 and weighted mean difference = - 0.76, 95% CI - 2.25 to 0.73, P = 0.32, respectively). Ranibizumab was more effective in reducing CMT at 1 year (weighted mean difference = 4.49, 95% CI 1.13 to 7.84, P = 0.009). Risk ratios comparing rates of serious systemic adverse events at 1 and 2 years were slightly out of favour for bevacizumab. Aflibercept compared with ranibizumab demonstrated similar mean change in BCVA, reduction in CMT, and safety at 1 year. Bevacizumab and ranibizumab had equivalent efficacy for BCVA, while ranibizumab had greater reduction in CMT and less rate of serious systemic adverse events. Aflibercept and ranibizumab had comparable efficacy for BCVA and CMT. This provides information to balance comparable effects on vision and risk of adverse events between anti-VEGF agents.

Occupational Violence and Aggression Experienced by Nursing and Caring Professionals.

PubMed

Shea, Tracey; Sheehan, Cathy; Donohue, Ross; Cooper, Brian; De Cieri, Helen

2017-03-01

To examine the extent and source of occupational violence and aggression (OVA) experienced by nursing and caring professionals. This study also examines the relative contributions of demographic characteristics and workplace and individual safety factors in predicting OVA. A cross-sectional study design with data collected using an online survey of employees in the nursing and caring professions in Victoria, Australia. Survey data collected from 4,891 members of the Australian Nursing and Midwifery Federation (Victorian branch) were analyzed using logistic regression. Sixty-seven percent of respondents reported experiencing OVA in the preceding 12 months, with nearly 20% experiencing OVA on a weekly or daily basis. The dominant sources of OVA were patients (79%) or relatives of patients (48%). Logistic regression analysis revealed that respondents working in public hospitals and aged care facilities were more likely to experience OVA, compared to those working in other workplaces. While higher levels of safety compliance reduced the likelihood of experiencing OVA, role overload and workplace safety factors such as prioritization of employee safety and leading indicators of occupational health and safety were stronger predictors. The likelihood of healthcare workers experiencing OVA varies across demographic and workplace characteristics. While some demographic characteristics and individual safety factors were significant predictors, our results suggest that a greater reduction in OVA could be achieved by improving workplace safety. The study's outcomes identify workforce segments that are most vulnerable to OVA. The study also highlights workplace safety factors such as the prioritization of employee safety that might assist in the reduction of OVA. © 2016 Sigma Theta Tau International.

The use of GIS tools for road infrastructure safety management

NASA Astrophysics Data System (ADS)

Budzyński, Marcin; Kustra, Wojciech; Okraszewska, Romanika; Jamroz, Kazimierz; Pyrchla, Jerzy

2018-01-01

There are many factors that influence accidents and their severity. They can be grouped within the system of man, vehicle and environment. The article focuses on how GIS tools can be used to manage road infrastructure safety. To ensure a better understanding and identification of road factors, GIS tools help with the acquisition of road parameter data. Their other role is helping with a clear and effective presentation of risk ranking. GIS is key to identifying high-risk sections and supports the effective communication of safety levels. This makes it a vital element of safety management. The article describes the use of GIS for the collection and visualisation of road parameter data which are not available in any of the existing databases, i.e. horizontal curve parameters. As we know from research and statistics, they are important factors that determine the safety of road infrastructure. Finally, new research is proposed as well as the possibilities for applying GIS tools for the purposes of road safety inspection.

Exploring the possibility of a common structural model measuring associations between safety climate factors and safety behaviour in health care and the petroleum sectors.

PubMed

Olsen, Espen

2010-09-01

The aim of the present study was to explore the possibility of identifying general safety climate concepts in health care and petroleum sectors, as well as develop and test the possibility of a common cross-industrial structural model. Self-completion questionnaire surveys were administered in two organisations and sectors: (1) a large regional hospital in Norway that offers a wide range of hospital services, and (2) a large petroleum company that produces oil and gas worldwide. In total, 1919 and 1806 questionnaires were returned from the hospital and petroleum organisation, with response rates of 55 percent and 52 percent, respectively. Using a split sample procedure principal factor analysis and confirmatory factor analysis revealed six identical cross-industrial measurement concepts in independent samples-five measures of safety climate and one of safety behaviour. The factors' psychometric properties were explored with satisfactory internal consistency and concept validity. Thus, a common cross-industrial structural model was developed and tested using structural equation modelling (SEM). SEM revealed that a cross-industrial structural model could be identified among health care workers and offshore workers in the North Sea. The most significant contributing variables in the model testing stemmed from organisational management support for safety and supervisor/manager expectations and actions promoting safety. These variables indirectly enhanced safety behaviour (stop working in dangerous situations) through transitions and teamwork across units, and teamwork within units as well as learning, feedback, and improvement. Two new safety climate instruments were validated as part of the study: (1) Short Safety Climate Survey (SSCS) and (2) Hospital Survey on Patient Safety Culture-short (HSOPSC-short). Based on development of measurements and structural model assessment, this study supports the possibility of a common safety climate structural model across health care and the offshore petroleum industry. 2010 Elsevier Ltd. All rights reserved.

A Qualitative Study on Organizational Factors Affecting Occupational Accidents.

PubMed

Eskandari, Davood; Jafari, Mohammad Javad; Mehrabi, Yadollah; Kian, Mostafa Pouya; Charkhand, Hossein; Mirghotbi, Mostafa

2017-03-01

Technical, human, operational and organizational factors have been influencing the sequence of occupational accidents. Among them, organizational factors play a major role in causing occupational accidents. The aim of this research was to understand the Iranian safety experts' experiences and perception of organizational factors. This qualitative study was conducted in 2015 by using the content analysis technique. Data were collected through semi-structured interviews with 17 safety experts working in Iranian universities and industries and analyzed with a conventional qualitative content analysis method using the MAXQDA software. Eleven organizational factors' sub-themes were identified: management commitment, management participation, employee involvement, communication, blame culture, education and training, job satisfaction, interpersonal relationship, supervision, continuous improvement, and reward system. The participants considered these factors as effective on occupational accidents. The mentioned 11 organizational factors are probably involved in occupational accidents in Iran. Naturally, improving organizational factors can increase the safety performance and reduce occupational accidents.

B-cell-targeted therapies in systemic lupus erythematosus and ANCA-associated vasculitis: current progress.

PubMed

Md Yusof, Md Yuzaiful; Vital, Edward M J; Emery, Paul

2013-08-01

B cells play a central role in the pathogenesis of systemic lupus erythematosus and anti-neutrophil cytoplasmic antibody-associated vasculitis. There are various strategies for targeting B cells including depletion, inhibition of survival factors, activation and inhibition of co-stimulatory molecules. Controlled trials in systemic lupus erythematosus have shown positive results for belimumab, promising results for epratuzumab and negative results for rituximab. The failure of rituximab in controlled trials has been attributed to trial design, sample size and outcome measures rather than true inefficacy. In anti-neutrophil cytoplasmic antibody-associated vasculitis, rituximab is effective for remission induction and in relapsing disease. However, the optimal long-term re-treatment strategy remains to be determined. Over the next 5 years, evidence will be available regarding the clinical efficacy of these novel therapies, biomarkers and their long-term safety.

Alpha-driven magnetohydrodynamics (MHD) and MHD-induced alpha loss in the Tokamak Fusion Test Reactor

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

Chang, Z.; Nazikian, R.; Fu, G.Y.

1997-02-01

Alpha-driven toroidal Alfven eigenmodes (TAEs) are observed as predicted by theory in the post neutral beam phase in high central q (safety factor) deuterium-tritium (D-T) plasmas in the Tokamak Fusion Test Reactor (TFTR). The mode location, poloidal structure and the importance of q profile for TAE instability are discussed. So far no alpha particle loss due to these modes was detected due to the small mode amplitude. However, alpha loss induced by kinetic ballooning modes (KBMs) was observed in high confinement D-T discharges. Particle orbit simulation demonstrates that the wave-particle resonant interaction can explain the observed correlation between the increasemore » in alpha loss and appearance of multiple high-n (n {ge} 6, n is the toroidal mode number) modes.« less

[Hygienic evaluation of the effectiveness of the concept of improvement the water supply in the south-eastern region of the Republic of Tatarstan].

PubMed

Ivanov, A V; Tafeeva, E A; Davletova, N Kh

2014-01-01

In the paper there is presented the hygienic assessment of the effectiveness of the implementation of a program aimed at improving conditions of the water supply in the oil producing regions of the Republic of Tatarstan. As a result of realization of measures it was able to improve the quality of drinking water in terms of chemical safety and to reduce the risk to public health. For the present time the following factors: water quality of the water source, the mismatch of sanitary protective zone to requirements of sanitary laws and failure to comply with security measures on its territory, deterioration of water quality during transport and imperfection of laboratory control monitoring were shown to make the highest contribution to the disadvantage of centralized drinking water systems.

Effects of electrode gap and electric current on chlorine generation of electrolyzed deep ocean water.

PubMed

Hsu, Guoo-Shyng Wang; Hsu, Shun-Yao

2018-04-01

Electrolyzed water is a sustainable disinfectant, which can comply with food safety regulations and is environmental friendly. A two-factor central composite design was adopted for studying the effects of electrode gap and electric current on chlorine generation efficiency of electrolyzed deep ocean water. Deep ocean water was electrolyzed in a glass electrolyzing cell equipped with platinum-plated titanium anode and cathode in a constant-current operation mode. Results showed that current density, chlorine concentration, and electrolyte temperature increased with electric current, while electric efficiency decreased with electric current and electrode gap. An electrode gap of less than 11.7 mm, and a low electric current appeared to be a more energy efficient design and operation condition for the electrolysis system. Copyright © 2017. Published by Elsevier B.V.

Patient safety culture in Norwegian nursing homes.

PubMed

Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter

2017-06-20

Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values <0.05 were considered to be significant. Out of the 463 employees invited, 288 (62.2%) answered the questionnaire. Response rates varied between 56.9% and 72.2% across the five nursing homes. In multiple linear regression analysis, we found that increasing age and job position among the healthcare providers were associated with significantly increased mean scores for the patient safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture assessment may help nursing home leaders to initiate targeted quality improvement interventions. Further research should investigate associations between patient safety culture and the occurrence of adverse events in nursing homes.

Review of Safety Reports Involving Electronic Flight Bags.

DOT National Transportation Integrated Search

2010-04-01

Safety events in which Electronic Flight Bags (EFBs) were a factor are reviewed. Relevant reports were obtained from the public Aviation Safety Reporting System (ASRS) database and the National Transportation Safety Board (NTSB) accident report datab...

Development of a safety decision-making scenario to measure worker safety in agriculture.

PubMed

Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

2014-04-01

Human factors play an important role in the management of occupational safety, especially in high-hazard workplaces such as commercial grain-handling facilities. Employee decision-making patterns represent an essential component of the safety system within a work environment. This research describes the process used to create a safety decision-making scenario to measure the process that grain-handling employees used to make choices in a safety-related work task. A sample of 160 employees completed safety decision-making simulations based on a hypothetical but realistic scenario in a grain-handling environment. Their choices and the information they used to make their choices were recorded. Although the employees emphasized safety information in their decision-making process, not all of their choices were safe choices. Factors influencing their choices are discussed, and implications for industry, management, and workers are shared.

Advancing a sociotechnical systems approach to workplace safety – developing the conceptual framework

PubMed Central

Carayon, Pascale; Hancock, Peter; Leveson, Nancy; Noy, Ian; Sznelwar, Laerte; van Hootegem, Geert

2015-01-01

Traditional efforts to deal with the enormous problem of workplace safety have proved insufficient, as they have tended to neglect the broader sociotechnical environment that surrounds workers. Here, we advocate a sociotechnical systems approach that describes the complex multi-level system factors that contribute to workplace safety. From the literature on sociotechnical systems, complex systems and safety, we develop a sociotechnical model of workplace safety with concentric layers of the work system, socio-organisational context and the external environment. The future challenges that are identified through the model are highlighted. Practitioner Summary: Understanding the environmental, organisational and work system factors that contribute to workplace safety will help to develop more effective and integrated solutions to deal with persistent workplace safety problems. Solutions to improve workplace safety need to recognise the broad sociotechnical system and the respective interactions between the system elements and levels. PMID:25831959

Investigation and identification of factors affecting migrating peasant workers' usage of safety footwear in the Chinese construction industry.

PubMed

Suo, Qinghui; Zhang, Daming

2017-09-01

A sample of 300 migrating peasant workers from 15 Chinese building construction sites completed a demographic questionnaire to investigate the usage of safety footwear. The survey form was constructed based on the theory of planned behaviour, and a total of 12 questions focusing on the workers' past experience, attitudes, subjective norms and perceived behavioural control were included in the survey. It was found that 92% of the participants did not wear safety footwear while working on construction sites, although more than 91% of them believed that safety footwear would protect the foot from injury; none of the participants had been provided free safety footwear by their employer. Regression analysis shows that employers' attitude is the most important factor affecting their usage of safety footwear, 'providing free safety footwear' and 'comfortability of the safety footwear' ranking second and third respectively.

Advancing a sociotechnical systems approach to workplace safety--developing the conceptual framework.

PubMed

Carayon, Pascale; Hancock, Peter; Leveson, Nancy; Noy, Ian; Sznelwar, Laerte; van Hootegem, Geert

2015-01-01

Traditional efforts to deal with the enormous problem of workplace safety have proved insufficient, as they have tended to neglect the broader sociotechnical environment that surrounds workers. Here, we advocate a sociotechnical systems approach that describes the complex multi-level system factors that contribute to workplace safety. From the literature on sociotechnical systems, complex systems and safety, we develop a sociotechnical model of workplace safety with concentric layers of the work system, socio-organisational context and the external environment. The future challenges that are identified through the model are highlighted. Understanding the environmental, organisational and work system factors that contribute to workplace safety will help to develop more effective and integrated solutions to deal with persistent workplace safety problems. Solutions to improve workplace safety need to recognise the broad sociotechnical system and the respective interactions between the system elements and levels.

Human factors in safety and business management.

PubMed

Vogt, Joachim; Leonhardt, Jorg; Koper, Birgit; Pennig, Stefan

2010-02-01

Human factors in safety is concerned with all those factors that influence people and their behaviour in safety-critical situations. In aviation these are, for example, environmental factors in the cockpit, organisational factors such as shift work, human characteristics such as ability and motivation of staff. Careful consideration of human factors is necessary to improve health and safety at work by optimising the interaction of humans with their technical and social (team, supervisor) work environment. This provides considerable benefits for business by increasing efficiency and by preventing incidents/accidents. The aim of this paper is to suggest management tools for this purpose. Management tools such as balanced scorecards (BSC) are widespread instruments and also well known in aviation organisations. Only a few aviation organisations utilise management tools for human factors although they are the most important conditions in the safety management systems of aviation organisations. One reason for this is that human factors are difficult to measure and therefore also difficult to manage. Studies in other domains, such as workplace health promotion, indicate that BSC-based tools are useful for human factor management. Their mission is to develop a set of indicators that are sensitive to organisational performance and help identify driving forces as well as bottlenecks. Another tool presented in this paper is the Human Resources Performance Model (HPM). HPM facilitates the integrative assessment of human factors programmes on the basis of a systematic performance analysis of the whole system. Cause-effect relationships between system elements are defined in process models in a first step and validated empirically in a second step. Thus, a specific representation of the performance processes is developed, which ranges from individual behaviour to system performance. HPM is more analytic than BSC-based tools because HPM also asks why a certain factor is facilitating or obstructing success. A significant need for research and development is seen here because human factors are of increasing importance for organisational success. This paper suggests integrating human factors in safety management of aviation businesses - a top-ranking partner of technology and finance - and managing it with professional tools. The tools HPM and BSC were identified as potentially useful for this purpose. They were successfully applied in case studies briefly presented in this paper. In terms of specific safety-steering tools in the aviation industry, further elaboration and empirical study is crucial. Statement of Relevance: The importance of human factors is recognised by operators at the sharp end of aviation, where flights are conducted or coordinated. At the blunt end, measurement tools are needed to manage operational resources.

Impact of Lead Time and Safety Factor in Mixed Inventory Models with Backorder Discounts

NASA Astrophysics Data System (ADS)

Lo, Ming-Cheng; Chao-Hsien Pan, Jason; Lin, Kai-Cing; Hsu, Jia-Wei

This study investigates the impact of safety factor on the continuous review inventory model involving controllable lead time with mixture of backorder discount and partial lost sales. The objective is to minimize the expected total annual cost with respect to order quantity, backorder price discount, safety factor and lead time. A model with normal demand is also discussed. Numerical examples are presented to illustrate the procedures of the algorithms and the effects of parameters on the result of the proposed models are analyzed.

Risk factors associated with PICC-related upper extremity venous thrombosis in cancer patients.

PubMed

Yi, Xiao-lei; Chen, Jie; Li, Jia; Feng, Liang; Wang, Yan; Zhu, Jia-An; Shen, E; Hu, Bing

2014-03-01

To investigate the incidence and risk factors for peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer. With the widespread use of peripherally inserted central venous catheters, peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer leads to increasing morbidity and mortality. It is very important to further explore the incidence and risk factors for peripherally inserted central venous catheters-related venous thrombosis. Consecutive patients with cancer who were scheduled to receive peripherally inserted central venous catheters, between September 2009 and May 2012, were prospectively studied in our centre. They were investigated for venous thrombosis by Doppler sonography three times a day within 30 days after catheter insertion. Univariable and multivariable logistic regressions' analyses were performed to identify the risk factors for peripherally inserted central venous catheters-related thrombosis. A total of 89 patients with cancer were studied in our research. Of these, 81 patients were followed up within one month. The mean interval between catheter insertion and the onset of thrombosis was 12.45 ± 6.17 days. The multivariable analyses showed that chemotherapy history, less activities and diabetes were the key risk factors for thrombosis. Peripherally inserted central venous catheters-related upper extremity venous thrombosis had high incidence rate, and most cases had no significant symptoms. The history of chemotherapy, less activities and diabetes were found to be the key risk factors. It should be routinely scanned in high-risk patients every 3-5 days after catheter insertion, which would then find blood clots in time and reduce the incidence of pulmonary embolism. Risk factors associated with peripherally inserted central venous catheters-related upper extremity venous thrombosis are of critical importance in improving the quality of patients' life. It is very important to grasp the indications to reduce the incidence rate of peripherally inserted central venous catheters-related upper extremity venous thrombosis. © 2013 John Wiley & Sons Ltd.

Safety Psychology Applicating on Coal Mine Safety Management Based on Information System

NASA Astrophysics Data System (ADS)

Hou, Baoyue; Chen, Fei

In recent years, with the increase of intensity of coal mining, a great number of major accidents happen frequently, the reason mostly due to human factors, but human's unsafely behavior are affected by insecurity mental control. In order to reduce accidents, and to improve safety management, with the help of application security psychology, we analyse the cause of insecurity psychological factors from human perception, from personality development, from motivation incentive, from reward and punishment mechanism, and from security aspects of mental training , and put forward countermeasures to promote coal mine safety production,and to provide information for coal mining to improve the level of safety management.

29 CFR 1918.62 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2010 CFR

2010-07-01

... appendix II to this part. A design safety factor of at least five shall be maintained for the common sizes... cranes, designed to be used with lesser wire rope safety factors; (ii) According to design factors in... pre-slung drafts. (3) Eye splices shall consist of at least three full tucks. Short splices shall...

29 CFR 1918.62 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2011 CFR

2011-07-01

... appendix II to this part. A design safety factor of at least five shall be maintained for the common sizes... cranes, designed to be used with lesser wire rope safety factors; (ii) According to design factors in... pre-slung drafts. (3) Eye splices shall consist of at least three full tucks. Short splices shall...

Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi® system: from cadaveric models to clinical cases.

PubMed

Yeo, Shen Ann; Noh, Gyoung Tae; Han, Jeong Hee; Cheong, Chinock; Stein, Hubert; Kerdok, Amy; Min, Byung Soh

2017-12-01

There has been little enthusiasm for performing robotic colectomy for colon cancer in recent years due to multiple factors, one being that the previous robotic systems such as the da Vinci Si ® (dVSi) were poorly designed for multi-quadrant surgery. The new da Vinci Xi ® (dVXi) system enables colectomy with central mesocolic excision to be performed easily in a single docking procedure. We developed a universal port placement strategy to allow right and left hemicolectomies to be performed via a suprapubic approach and a Pfannensteil extraction site. This proof of concept paper describes the development and subsequent clinical application of this setup. After extensive training on the dVXi system concepts in collaboration with clinical development engineers, we developed a port placement strategy which was tested and adapted after performing experimental surgery in three cadaveric models. Subsequently our port placement was used for two clinical cases of suprapubic right and left hemicolectomy. With some modifications of port placements after the initial cadaveric colectomies, we have developed a potentially universal suprapubic port placement strategy for robotic colectomy with complete mesocolic excision and central vascular ligation using the dVXi robotic system. This port placement strategy was applied successfully in our first two clinical cases. Based on our cadaveric laboratory as well as our initial clinical application, the suprapubic port placement strategy for the dVXi system with its improved features over the dVSi can feasibly perform right and left hemicolectomy with complete mesocolic excision and central vascular ligation. Further studies will be required to establish efficacy as well as safety profile of these procedures.

Central line-associated bloodstream infection in a trauma intensive care unit: impact of implementation of Society for Healthcare Epidemiology of America/Infectious Diseases Society of America practice guidelines.

PubMed

Mazi, Waleed; Begum, Zikra; Abdulla, Diaa; Hesham, Ahmed; Maghari, Sami; Assiri, Abdullah; Senok, Abiola

2014-08-01

This study aimed to assess the impact implementation of the basic Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) practice recommendations in reducing central line-associated bloodstream infection (CLABSI) in intensive care units (ICUs). The prospective study was conducted from January 2011-December 2012 at the 23-bed trauma ICU in Saudi Arabia. The basic SHEA/IDSA practice recommendations were introduced and implemented during the year 2012. Laboratory-confirmed CLABSIs were identified, and the antimicrobial susceptibility of isolates was determined. Data were collected and analyzed for benchmarking with the National Healthcare Safety Network. There was a 58% decline in the CLABSI incidence rate from 3.87 to 1.5 per 1,000 central line days in 2011 and 2012, respectively (standardized infection ratio, 0.42; P = .043). Three institutional risk factors were identified and resolved: health care personnel education, removal of nonessential catheters, and use of a catheter cart. Three Klebsiella pneumoniae isolates susceptible only to imipenem, 1 pandrug resistant Acinetobacter baumannii, and 2 Enterococcus faecalis, with 1 isolate resistant to vancomycin, were identified in 2012. The basic SHEA/ISDA practice recommendation is an effective prevention model for the reduction of CLABSIs in the ICU. Additional measures are needed to control the spread of multidrug-resistant organisms. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Recent clinically relevant highlights from the Diabetic Retinopathy Clinical Research Network.

PubMed

Krick, Tracy W; Bressler, Neil M

2018-05-01

To present some recent clinically relevant results from Diabetic Retinopathy Clinical Research (DRCR) Network trials that may guide management of diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR). Among eyes with DME and visual acuity 20/50 or worse, aflibercept, on average, had greater improvement in visual acuity over 2 years compared with bevacizumab or ranibizumab. Aflibercept is associated with higher rates of improvements in diabetic retinopathy severity among eyes with PDR and vision-impairing DME at baseline compared with bevacizumab or ranibizumab. Among eyes with persistent central-involved DME after at least six antivascular endothelial growth factor (anti-VEGF) injections, no difference in mean visual acuity improvement was observed between eyes that received continued ranibizumab and sham injections versus ranibizumab and intravitreous sustained dexamethasone drug-delivery system, especially for phakic eyes. For eyes with PDR, ranibizumab was associated with lower rates of developing PDR-worsening events compared with panretinal photocoagulation, especially among eyes that did not receive ranibizumab for central-involved DME at baseline. Ranibizumab is cost-effective for PDR for eyes with, not without, vision-impairing central-involved DME, highlighting challenges when safety and efficacy results are at odds with cost-effectiveness results. Aflibercept for DME, in certain circumstances, is more likely to have superior visual acuity and anatomical outcomes compared with bevacizumab or ranibizumab. No vision benefits are apparent, especially for phakic eyes, by adding intravitreous corticosteroids for persistent DME following anti-VEGF injections.

Bringing central line-associated bloodstream infection prevention home: CLABSI definitions and prevention policies in home health care agencies.

PubMed

Rinke, Michael L; Bundy, David G; Milstone, Aaron M; Deuber, Kristin; Chen, Allen R; Colantuoni, Elizabeth; Miller, Marlene R

2013-08-01

A study was conducted to investigate health care agency central line-associated bloodstream infection (CLABSI) definitions and prevention policies and pare them to the Joint Commission National Patient Safety Goal (NPSG.07.04.01), the Centers for Disease Control and Prevention (CDC) CLABSI prevention recommendations, and a best-practice central line care bundle for inpatients. A telephone-based survey was conducted in 2011 of a convenience sample of home health care agencies associated with children's hematology/oncology centers. Of the 97 eligible home health care agencies, 57 (59%) completed the survey. No agency reported using all five aspects of the National Healthcare and Safety Network/Association for Professionals in Infection Control and Epidemiology CLABSI definition and adjudication process, and of the 50 agencies that reported tracking CLABSI rates, 20 (40%) reported using none. Only 10 agencies (18%) had policies consistent with all elements of the inpatient-focused NPSG.07.04.01, 10 agencies (18%) were consistent with all elements of the home care targeted CDC CLABSI prevention recommendations, and no agencies were consistent with all elements of the central line care bundle. Only 14 agencies (25%) knew their overall CLABSI rate: mean 0.40 CLABSIs per 1,000 central line days (95% confidence interval [CI], 0.18 to 0.61). Six agencies (11%) knew their agency's pediatric CLABSI rate: mean 0.54 CLABSIs per 1,000 central line days (95% CI, 0.06 to 1.01). The policies of a national sample of home health care agencies varied significantly from national inpatient and home health care agency targeted standards for CLABSI definitions and prevention. Future research should assess strategies for standardizing home health care practices consistent with evidence-based recommendations.

Development and validation of a predictive model for the influences of selected product and process variables on ascorbic acid degradation in simulated fruit juice.

PubMed

Gabriel, Alonzo A; Cayabyab, Jochelle Elysse C; Tan, Athalie Kaye L; Corook, Mark Lester F; Ables, Errol John O; Tiangson-Bayaga, Cecile Leah P

2015-06-15

A predictive response surface model for the influences of product (soluble solids and titratable acidity) and process (temperature and heating time) parameters on the degradation of ascorbic acid (AA) in heated simulated fruit juices (SFJs) was established. Physicochemical property ranges of freshly squeezed and processed juices, and a previously established decimal reduction times of Escherichiacoli O157:H7 at different heating temperatures were used in establishing a Central Composite Design of Experiment that determined the combinations of product and process variable used in the model building. Only the individual linear effects of temperature and heating time significantly (P<0.05) affected AA reduction (%AAr). Validating systems either over- or underestimated actual %AAr with bias factors 0.80-1.20. However, all validating systems still resulted in acceptable predictive efficacy, with accuracy factor 1.00-1.26. The model may be useful in establishing unique process schedules for specific products, for the simultaneous control and improvement of food safety and quality. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploring the modulation of hypoxia-inducible factor (HIF)-1α by volatile anesthetics as a possible mechanism underlying volatile anesthetic-induced CNS injury.

PubMed

Giles, Emma K; Lawrence, Andrew J; Duncan, Jhodie R

2014-09-01

This review summarizes recent research on the potential cognitive and behavioural abnormalities induced by exposure to volatile anesthetics and suggests a role of hypoxia-inducible factor (HIF)-1α in mediating these events. Volatile anesthetics are widely utilized in clinical and research settings, yet the long-term safety of exposure to these agents is under debate. Findings from various animal models suggest volatile anesthetics induce widespread apoptosis in the central nervous system (CNS) that correlates with lasting deficits in learning and memory. Longitudinal analysis of clinical data highlight an increased risk of developmental disorders later in life when children are exposed to volatile anesthetics, particularly when exposures occur over multiple sessions. However, the mechanisms underlying these events have yet to be established. Considering the extensive use of volatile anesthetics, it is crucial that these events are better understood. The possible role of HIF-1α in volatile anesthetic-induced CNS abnormalities will be suggested and areas requiring urgent attention will be outlined.

Cross-industry Performance Modeling: Toward Cooperative Analysis

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

Reece, Wendy Jane; Blackman, Harold Stabler

One of the current unsolved problems in human factors is the difficulty in acquiring information from lessons learned and data collected among human performance analysts in different domains. There are several common concerns and generally accepted issues of importance for human factors, psychology and industry analysts of performance and safety. Among these are the need to incorporate lessons learned in design, to carefully consider implementation of new designs and automation, and the need to reduce human performance-based contributions to risk. In spite of shared concerns, there are several roadblocks to widespread sharing of data and lessons learned from operating experiencemore » and simulation, including the fact that very few publicly accessible data bases exist (Gertman & Blackman, 1994, and Kirwan, 1997). There is a need to draw together analysts and analytic methodologies to comprise a centralized source of data with sufficient detail to be meaningful while ensuring source anonymity. We propose that a generic source of performance data and a multi-domain data store may provide the first steps toward cooperative performance modeling and analysis across industries.« less

Cross-Industry Performance Modeling: Toward Cooperative Analysis

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

H. S. Blackman; W. J. Reece

One of the current unsolved problems in human factors is the difficulty in acquiring information from lessons learned and data collected among human performance analysts in different domains. There are several common concerns and generally accepted issues of importance for human factors, psychology and industry analysts of performance and safety. Among these are the need to incorporate lessons learned in design, to carefully consider implementation of new designs and automation, and the need to reduce human performance-based contributions to risk. In spite of shared concerns, there are several road blocks to widespread sharing of data and lessons learned from operatingmore » experience and simulation, including the fact that very few publicly accessible data bases exist(Gertman & Blackman, 1994, and Kirwan, 1997). There is a need to draw together analysts and analytic methodologies to comprise a centralized source of data with sufficient detail to be meaningful while ensuring source anonymity. We propose that a generic source of performance data and a multi-domain data store may provide the first steps toward cooperative performance modeling and analysis across industries.« less

Packaging- and transportation-related occurrence reports : FY 1996 annual report

DOT National Transportation Integrated Search

1997-02-01

The Oak Ridge National Laboratory (ORNL) Packaging and Transportation Safety Program (PATS) has been charged with the responsibility of retrieving reports and information pertaining to transportation and packaging incidents from the centralized ORPS ...

Patient Safety Center Organization

DTIC Science & Technology

2007-06-01

placement Medicine, Surgery Lumbar puncture* Medicine Thoracentesis* Medicine Shoulder dystocia Obstetrics & Gynecology Mock code-depressed newborn...Airway 2) Team Training (using SimMan), 3) Endoscopy, 4) Shoulder Dystocia , 5) Episiotomy, and 6) Central Line Placement. The second group is

Chemicals under the Toxic Substances Control Act (TSCA)

EPA Pesticide Factsheets

This web area will allow stakeholders to search and view centralized chemical info from various systems. This page will focus on TSCA chemical data such as health and safety studies, risk assessments and hazard characterizations.

Safety of licensed vaccines in HIV-infected persons: a systematic review protocol

PubMed Central

2014-01-01

Background Safety of vaccines remains a cornerstone of building public trust on the use of these cost-effective and life-saving public health interventions. In some settings, particularly Sub-Saharan Africa, there is a high prevalence of HIV infection and a high burden of vaccine-preventable diseases. There is evidence suggesting that the immunity induced by some commonly used vaccines is not durable in HIV-infected persons, and therefore, repeated vaccination may be considered to ensure optimal vaccine-induced immunity in this population. However, some vaccines, particularly the live vaccines, may be unsafe in HIV-infected persons. There is lack of evidence on the safety profile of commonly used vaccines among HIV-infected persons. We are therefore conducting a systematic review to assess the safety profile of routine vaccines administered to HIV-infected persons. Methods/Design We will select studies conducted in any setting where licensed and effective vaccines were administered to HIV-infected persons. We will search for eligible studies in PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Africa-Wide, PDQ-Evidence and CINAHL as well as reference lists of relevant publications. We will screen search outputs, select studies and extract data in duplicate, resolving discrepancies by discussion and consensus. Discussion Globally, immunisation is a major public health strategy to mitigate morbidity and mortality caused by various infectious disease-causing agents. In general, there are efforts to increase vaccination coverage worldwide, and for these efforts to be successful, safety of the vaccines is paramount, even among people living with HIV, who in some situations may require repeated vaccination. Results from this systematic review will be discussed in the context of the safety of routine vaccines among HIV-infected persons. From the safety perspective, we will also discuss whether repeat vaccination strategies may be feasible among HIV-infected persons. Systematic review registration PROSPERO CRD42014009794. PMID:25212760

Results of a community-based survey of construction safety climate for Hispanic workers.

PubMed

Marin, Luz S; Cifuentes, Manuel; Roelofs, Cora

2015-01-01

Hispanic construction workers experience high rates of occupational injury, likely influenced by individual, organizational, and social factors. To characterize the safety climate of Hispanic construction workers using worker, contractor, and supervisor perceptions of the workplace. We developed a 40-item interviewer-assisted survey with six safety climate dimensions and administered it in Spanish and English to construction workers, contractors, and supervisors. A safety climate model, comparing responses and assessing contributing factors was created based on survey responses. While contractors and construction supervisors' (n = 128) scores were higher, all respondents shared a negative perception of safety climate. Construction workers had statistically significantly lower safety climate scores compared to supervisors and contractors (30·6 vs 46·5%, P<0·05). Safety climate scores were not associated with English language ability or years lived in the United States. We found that Hispanic construction workers in this study experienced a poor safety climate. The Hispanic construction safety climate model we propose can serve as a framework to guide organizational safety interventions and evaluate safety climate improvements.

Results of a community-based survey of construction safety climate for Hispanic workers

PubMed Central

Marin, Luz S; Cifuentes, Manuel; Roelofs, Cora

2015-01-01

Background: Hispanic construction workers experience high rates of occupational injury, likely influenced by individual, organizational, and social factors. Objectives: To characterize the safety climate of Hispanic construction workers using worker, contractor, and supervisor perceptions of the workplace. Methods: We developed a 40-item interviewer-assisted survey with six safety climate dimensions and administered it in Spanish and English to construction workers, contractors, and supervisors. A safety climate model, comparing responses and assessing contributing factors was created based on survey responses. Results: While contractors and construction supervisors’ (n = 128) scores were higher, all respondents shared a negative perception of safety climate. Construction workers had statistically significantly lower safety climate scores compared to supervisors and contractors (30.6 vs 46.5%, P<0.05). Safety climate scores were not associated with English language ability or years lived in the United States. Conclusions: We found that Hispanic construction workers in this study experienced a poor safety climate. The Hispanic construction safety climate model we propose can serve as a framework to guide organizational safety interventions and evaluate safety climate improvements. PMID:26145454

Radiation exposure and safety practices during pediatric central line placement

PubMed Central

Saeman, Melody R.; Burkhalter, Lorrie S.; Blackburn, Timothy J.; Murphy, Joseph T.

2015-01-01

Purpose Pediatric surgeons routinely use fluoroscopy for central venous line (CVL) placement. We examined radiation safety practices and patient/surgeon exposure during fluoroscopic CVL. Methods Fluoroscopic CVL procedures performed by 11 pediatric surgeons in 2012 were reviewed. Fluoroscopic time (FT), patient exposure (mGy), and procedural data were collected. Anthropomorphic phantom simulations were used to calculate scatter and dose (mSv). Surgeons were surveyed regarding safety practices. Results 386 procedures were reviewed. Median FT was 12.8 seconds. Median patient estimated effective dose was 0.13 mSv. Median annual FT per surgeon was 15.4 minutes. Simulations showed no significant difference (p = 0.14) between reported exposures (median 3.5 mGy/min) and the modeled regression exposures from the C-arm default mode (median 3.4 mGy/min). Median calculated surgeon exposure was 1.5 mGy/year. Eight of 11 surgeons responded to the survey. Only three reported 100% lead protection and frequent dosimeter use. Conclusion We found non-standard radiation training, safety practices, and dose monitoring for the 11 surgeons. Based on simulations, the C-arm default setting was typically used instead of low dose. While most CVL procedures have low patient/surgeon doses, every effort should be used to minimize patient and occupational exposure, suggesting the need for formal hands-on training for non-radiologist providers using fluoroscopy. PMID:25837269

Cultural safety as an ethic of care: a praxiological process.

PubMed

McEldowney, Rose; Connor, Margaret J

2011-10-01

New writings broadening the construct of cultural safety, a construct initiated in Aotearoa New Zealand, are beginning to appear in the literature. Therefore, it is considered timely to integrate these writings and advance the construct into a new theoretical model. The new model reconfigures the constructs of cultural safety and cultural competence as an ethic of care informed by a postmodern perspective. Central to the new model are three interwoven, co-occurring components: an ethic of care, which unfolds within a praxiological process shaped by the context. Context is expanded through identifying the three concepts of relationality, generic competence, and collectivity, which are integral to each client-nurse encounter. The competence associated with cultural safety as an ethic of care is always in the process of development. Clients and nurses engage in a dialogue to establish the level of cultural safety achieved at given points in a care trajectory.

21 CFR 315.6 - Evaluation of safety.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Evaluation of safety. 315.6 Section 315.6 Food and... USE DIAGNOSTIC RADIOPHARMACEUTICALS § 315.6 Evaluation of safety. (a) Factors considered in the safety...)(1) To establish the safety of a diagnostic radiopharmaceutical, FDA may require, among other...

Physical design correlates of efficiency and safety in emergency departments: a qualitative examination.

PubMed

Pati, Debajyoti; Harvey, Thomas E; Pati, Sipra

2014-01-01

The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency.

Human Factors Science: Brief History and Applications to Healthcare.

PubMed

Parker, Sarah Henrickson

2015-12-01

This section will define the science of human factors, its origins, its impact on safety in other domains, and its impact and potential for impact on patient safety. Copyright © 2015 Mosby, Inc. All rights reserved.

Establishing crash modification factors and their use.

DOT National Transportation Integrated Search

2014-08-01

A critical component in the Association of State Highway and Transportation Officials (AASHTO) Highway Safety Manual : (HSM) safety management process is the Crash Modification Factor (CMF). It is used to estimate the change in the : expected (ave...

Clustering of risk factors for cardiometabolic diseases in low-income, female adolescents.

PubMed

Melo, Elza M F S de; Azevedo, George D; Silva, João B da; Lemos, Telma M A M; Maranhão, Técia M O; Freitas, Ana K M S O; Spyrides, Maria H; Costa, Eduardo C

2016-02-16

To assess the prevalence and clustering patterns of cardiometabolic risk factors among low-income, female adolescents. Cross-sectional study involving 196 students of public schools (11-19 years old). The following risk factors were considered in the analysis: excess weight, central obesity, dyslipidemia, high blood pressure, and high fasting glucose. The ratio between observed and expected prevalence and its confidence interval were used to identify clustering of risk factors that exceeded expected prevalence in the population. The most prevalent risk factors were dyslipidemia (70.9%), and central obesity (39.8%), followed by excess weight (29.6%), and high blood pressure (12.8%). A total of 42.9% of adolescents had two or more risk factors, and 24% had three or more. Excess weight, central obesity, and dyslipidemia were common risk factors in the clustering patterns that showed higher-than-expected prevalence. Clustering of risk factors (≥ two factors) among the adolescents showed considerable prevalence, and there was a non-casual coexistence of excess weight, central obesity, and dyslipidemia (mainly low HDL-cholesterol).

Factors influencing nurses' perceptions of occupational safety.

PubMed

Samur, Menevse; Intepeler, Seyda Seren

2017-01-02

To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think "labor force and other resources" are insufficient. In the occupational safety subdimensions "occupational illnesses and complaints" and "administrative support and approaches," they considered occupational safety to be insufficient. "Doctor-nurse-colleague relationships," "exposure to violence," and "work unit" (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.

Error reduction, patient safety and institutional ethics committees.

PubMed

Meaney, Mark E

2004-01-01

Institutional ethics committees remain largely absent from the literature on error reduction and patient safety. In this paper, the author endeavors to fill the gap. As noted in the Hastings Center's recent report, "Promoting Patient Safety," the occurrence of medical error involves complex web of multiple factors. Human misstep is certainly one such factor, but not the only one. This paper builds on the Hastings Center's report in arguing that institutional ethics committees ought to play an integral role in the transformation of a "culture of blame" to a "culture of safety" in healthcare delivery.

Improving safety in small enterprises through an integrated safety management intervention.

PubMed

Kines, Pete; Andersen, Dorte; Andersen, Lars Peter; Nielsen, Kent; Pedersen, Louise

2013-02-01

This study tests the applicability of a participatory behavior-based injury prevention approach integrated with safety culture initiatives. Sixteen small metal industry enterprises (10-19 employees) are randomly assigned to receive the intervention or not. Safety coaching of owners/managers result in the identification of 48 safety tasks, 85% of which are solved at follow-up. Owner/manager led constructive dialogue meetings with workers result in the prioritization of 29 tasks, 79% of which are accomplished at follow-up. Intervention enterprises have significant increases on six of eight safety-perception-survey factors, while comparisons increase on only one factor. Both intervention and comparison enterprises demonstrate significant increases in their safety observation scores. Interview data validate and supplement these results, providing some evidence for behavior change and the initiation of safety culture change. Given that over 95% of enterprises in most countries have less than 20 employees, there is great potential for adapting this integrated approach to other industries. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

Analysis of Aviation Safety Reporting System Incident Data Associated with the Technical Challenges of the System-Wide Safety and Assurance Technologies Project

NASA Technical Reports Server (NTRS)

Withrow, Colleen A.; Reveley, Mary S.

2015-01-01

The Aviation Safety Program (AvSP) System-Wide Safety and Assurance Technologies (SSAT) Project asked the AvSP Systems and Portfolio Analysis Team to identify SSAT-related trends. SSAT had four technical challenges: advance safety assurance to enable deployment of NextGen systems; automated discovery of precursors to aviation safety incidents; increasing safety of human-automation interaction by incorporating human performance, and prognostic algorithm design for safety assurance. This report reviews incident data from the NASA Aviation Safety Reporting System (ASRS) for system-component-failure- or-malfunction- (SCFM-) related and human-factor-related incidents for commercial or cargo air carriers (Part 121), commuter airlines (Part 135), and general aviation (Part 91). The data was analyzed by Federal Aviation Regulations (FAR) part, phase of flight, SCFM category, human factor category, and a variety of anomalies and results. There were 38 894 SCFM-related incidents and 83 478 human-factorrelated incidents analyzed between January 1993 and April 2011.

Keeping patients safe in healthcare organizations: a structuration theory of safety culture.

PubMed

Groves, Patricia S; Meisenbach, Rebecca J; Scott-Cawiezell, Jill

2011-08-01

This paper presents a discussion of the use of structuration theory to facilitate understanding and improvement of safety culture in healthcare organizations. Patient safety in healthcare organizations is an important problem worldwide. Safety culture has been proposed as a means to keep patients safe. However, lack of appropriate theory limits understanding and improvement of safety culture. The proposed structuration theory of safety culture was based on a critique of available English-language literature, resulting in literature published from 1983 to mid-2009. CINAHL, Communication and Mass Media Complete, ABI/Inform and Google Scholar databases were searched using the following terms: nursing, safety, organizational culture and safety culture. When viewed through the lens of structuration theory, safety culture is a system involving both individual actions and organizational structures. Healthcare organization members, particularly nurses, share these values through communication and enact them in practice, (re)producing an organizational safety culture system that reciprocally constrains and enables the actions of the members in terms of patient safety. This structurational viewpoint illuminates multiple opportunities for safety culture improvement. Nurse leaders should be cognizant of competing value-based culture systems in the organization and attend to nursing agency and all forms of communication when attempting to create or strengthen a safety culture. Applying structuration theory to the concept of safety culture reveals a dynamic system of individual action and organizational structure constraining and enabling safety practice. Nurses are central to the (re)production of this safety culture system. © 2011 Blackwell Publishing Ltd.

A Qualitative Study on Organizational Factors Affecting Occupational Accidents

PubMed Central

ESKANDARI, Davood; JAFARI, Mohammad Javad; MEHRABI, Yadollah; KIAN, Mostafa Pouya; CHARKHAND, Hossein; MIRGHOTBI, Mostafa

2017-01-01

Background: Technical, human, operational and organizational factors have been influencing the sequence of occupational accidents. Among them, organizational factors play a major role in causing occupational accidents. The aim of this research was to understand the Iranian safety experts’ experiences and perception of organizational factors. Methods: This qualitative study was conducted in 2015 by using the content analysis technique. Data were collected through semi-structured interviews with 17 safety experts working in Iranian universities and industries and analyzed with a conventional qualitative content analysis method using the MAXQDA software. Results: Eleven organizational factors’ sub-themes were identified: management commitment, management participation, employee involvement, communication, blame culture, education and training, job satisfaction, interpersonal relationship, supervision, continuous improvement, and reward system. The participants considered these factors as effective on occupational accidents. Conclusion: The mentioned 11 organizational factors are probably involved in occupational accidents in Iran. Naturally, improving organizational factors can increase the safety performance and reduce occupational accidents. PMID:28435824

Evaluation and review of the safety management system implementation in the Royal Thai Air Force

NASA Astrophysics Data System (ADS)

Chaiwan, Sakkarin

This study was designed to determine situation and effectiveness of the safety management system currently implemented in the Royal Thai Air Force. Reviewing the ICAO's SMS and the RTAF's SMS was conducted to identify similarities and differences between the two safety management systems. Later, the researcher acquired safety statistics from the RTAF Safety Center to investigate effectiveness of its safety system. The researcher also collected data to identify other factors affecting effectiveness of the safety system during conducting in-depth interviews. Findings and Conclusions: The study shows that the Royal Thai Air Force has never applied the International Civil Aviation Organization's Safety management System to its safety system. However, the RTAF's SMS and the ICAO's SMS have been developed based on the same concepts. These concepts are from Richard H. Woods's book, Aviation safety programs: A management handbook. However, the effectiveness of the Royal Thai Air Force's safety system is in good stance. An accident rate has been decreasing regularly but there are no known factors to describe the increasing rate, according to the participants' opinion. The participants have informed that there are many issues to be resolved to improve the RTAF's safety system. Those issues are cooperation among safety center's staffs, attitude toward safety of the RTAF senior commanders, and safety standards.

Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study

PubMed Central

Panagioti, Maria; Blakeman, Thomas; Hann, Mark; Bower, Peter

2017-01-01

Background Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions. Methods The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents. Results Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97). Conclusions We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents. PMID:28559454

Healthcare quality and safety: a review of policy, practice and research.

PubMed

Waring, Justin; Allen, Davina; Braithwaite, Jeffrey; Sandall, Jane

2016-02-01

Over the last two decades healthcare quality and safety have risen to the fore of health policy and research. This has largely been informed by theoretical and empirical ideas found in the fields of ergonomics and human factors. These have enabled significant advances in our understanding and management of quality and safety. However, a parallel and at time neglected sociological literature on clinical quality and safety is presented as offering additional, complementary, and at times critical insights on the problems of quality and safety. This review explores the development and contributions of both the mainstream and more sociological approaches to safety. It shows that where mainstream approaches often focus on the influence of human and local environment factors in shaping quality, a sociological perspective can deepen knowledge of the wider social, cultural and political factors that contextualise the clinical micro-system. It suggests these different perspectives can easily complement one another, offering a more developed and layered understanding of quality and safety. It also suggests that the sociological literature can bring to light important questions about the limits of the more mainstream approaches and ask critical questions about the role of social inequality, power and control in the framing of quality and safety. © 2015 Foundation for the Sociology of Health & Illness.

The development and psychometric evaluation of a safety climate measure for primary care.

PubMed

de Wet, C; Spence, W; Mash, R; Johnson, P; Bowie, P

2010-12-01

Building a safety culture is an important part of improving patient care. Measuring perceptions of safety climate among healthcare teams and organisations is a key element of this process. Existing measurement instruments are largely developed for secondary care settings in North America and many lack adequate psychometric testing. Our aim was to develop and test an instrument to measure perceptions of safety climate among primary care teams in National Health Service for Scotland. Questionnaire development was facilitated through a steering group, literature review, semistructured interviews with primary care team members, a modified Delphi and completion of a content validity index by experts. A cross-sectional postal survey utilising the questionnaire was undertaken in a random sample of west of Scotland general practices to facilitate psychometric evaluation. Statistical methods, including exploratory and confirmatory factor analysis, and Cronbach and Raykov reliability coefficients were conducted. Of the 667 primary care team members based in 49 general practices surveyed, 563 returned completed questionnaires (84.4%). Psychometric evaluation resulted in the development of a 30-item questionnaire with five safety climate factors: leadership, teamwork, communication, workload and safety systems. Retained items have strong factor loadings to only one factor. Reliability coefficients was satisfactory (α = 0.94 and ρ = 0.93). This study is the first stage in the development of an appropriately valid and reliable safety climate measure for primary care. Measuring safety climate perceptions has the potential to help primary care organisations and teams focus attention on safety-related issues and target improvement through educational interventions. Further research is required to explore acceptability and feasibility issues for primary care teams and the potential for organisational benchmarking.

Canadian Pacific Railway Investigation of Safety-Related Occurrences Protocol considered helpful by both labor and management.

DOT National Transportation Integrated Search

2006-09-01

The Federal Railroad Administration (FRA) Human Factors Research and Development (R&D) Program sponsored an Alternative Safety Measures Program designed to explore alternative methods for evaluating whether safety programs improve safety outcomes and...

Canadian Pacific Railway mechanical services' 5-Alive safety program shows promise in reducing injuries.

DOT National Transportation Integrated Search

2006-09-01

The Federal Railroad Administration (FRA) Human Factors Research and Development (R&D) Program is sponsoring an Alternative Safety Measures Program to explore alternative methods for evaluating whether safety programs improve safety outcomes and the ...

Calibration factors handbook : safety prediction models calibrated with Texas highway system.

DOT National Transportation Integrated Search

2009-10-01

Highway safety is an ongoing concern to the Texas Department of Transportation (TxDOT). As part of its : proactive commitment to improving highway safety, TxDOT is moving toward including quantitative safety : analyses earlier in the project developm...

49 CFR 385.7 - Factors to be considered in determining a safety rating.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information from safety reviews, compliance reviews and any other data. The factors may include all or some of... if their degree of formalization, automation, etc., is found to be substantially below the norm for...

ADOT state-specific crash prediction models : an Arizona needs study.

DOT National Transportation Integrated Search

2016-12-01

The predictive method in the Highway Safety Manual (HSM) includes a safety performance function (SPF), : crash modification factors (CMFs), and a local calibration factor (C), if available. Two alternatives exist for : applying the HSM prediction met...

21 CFR 170.22 - Safety factors to be considered.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Safety factors to be considered. 170.22 Section 170.22 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... experimental animals. ...

Factors associated with the patient safety climate at a teaching hospital1

PubMed Central

Luiz, Raíssa Bianca; Simões, Ana Lúcia de Assis; Barichello, Elizabeth; Barbosa, Maria Helena

2015-01-01

Objectives: to investigate the association between the scores of the patient safety climate and socio-demographic and professional variables. Methods: an observational, sectional and quantitative study, conducted at a large public teaching hospital. The Safety Attitudes Questionnaire was used, translated and validated for Brazil. Data analysis used the software Statistical Package for Social Sciences. In the bivariate analysis, we used Student's t-test, analysis of variance and Spearman's correlation of (α=0.05). To identify predictors for the safety climate scores, multiple linear regression was used, having the safety climate domain as the main outcome (α=0.01). Results: most participants were women, nursing staff, who worked in direct care to adult patients in critical areas, without a graduate degree and without any other employment. The average and median total score of the instrument corresponded to 61.8 (SD=13.7) and 63.3, respectively. The variable professional performance was found as a factor associated with the safety environment for the domain perception of service management and hospital management (p=0.01). Conclusion: the identification of factors associated with the safety environment permits the construction of strategies for safe practices in the hospitals. PMID:26487138

Study on the factors affecting the quality of public bus transportation service in Bali Province using factor analysis

NASA Astrophysics Data System (ADS)

Susilawati, M.; Nilakusmawati, D. P. E.

2017-06-01

The volume of mobility flows are increasing day by day and the condition of the number of people using private transport modes contribute to traffic congestion. With the limited capacity of the road, one of the alternatives solution to reduce congestion is to optimize the use of public transport. The purposes of this study are to determine the factors that influence user’s satisfaction on the quality of public bus transportation service and determine variables that became identifier on the dominant factor affecting user’s satisfaction. The study was conducted for the public bus transportation between districts in the province of Bali, which is among the eight regencies and one municipality, using a questionnaire as a data collection instrument. Service variables determinant of user’s satisfaction in this study, described in 25 questions, which were analyzed using factor analysis. The results showed there were six factors that explain the satisfaction of users of public transport in Bali, with a total diversity of data that can be parsed by 61.436%. These factors are: Safety and comfort, Responsiveness, Capacity, Tangible, Safety, Reliability. The dominant factor affecting public transport user satisfaction is the safety and comfort, with the most influential variable is feeling concerned about the personal safety of users when on the bus.

Methodology to develop crash modification functions for road safety treatments with fully specified and hierarchical models.

PubMed

Chen, Yongsheng; Persaud, Bhagwant

2014-09-01

Crash modification factors (CMFs) for road safety treatments are developed as multiplicative factors that are used to reflect the expected changes in safety performance associated with changes in highway design and/or the traffic control features. However, current CMFs have methodological drawbacks. For example, variability with application circumstance is not well understood, and, as important, correlation is not addressed when several CMFs are applied multiplicatively. These issues can be addressed by developing safety performance functions (SPFs) with components of crash modification functions (CM-Functions), an approach that includes all CMF related variables, along with others, while capturing quantitative and other effects of factors and accounting for cross-factor correlations. CM-Functions can capture the safety impact of factors through a continuous and quantitative approach, avoiding the problematic categorical analysis that is often used to capture CMF variability. There are two formulations to develop such SPFs with CM-Function components - fully specified models and hierarchical models. Based on sample datasets from two Canadian cities, both approaches are investigated in this paper. While both model formulations yielded promising results and reasonable CM-Functions, the hierarchical model was found to be more suitable in retaining homogeneity of first-level SPFs, while addressing CM-Functions in sub-level modeling. In addition, hierarchical models better capture the correlations between different impact factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Factors associated with self-reported inattentive driving at highway-rail grade crossings.

PubMed

Zhao, Shanshan; Khattak, Aemal J

2017-12-01

This research identified factors associated with inattentive driving at Highway-Rail Grade Crossings (HRGCs) by investigating drivers' self-reported inattentive driving experiences and factors pertaining to their socioeconomic, personality, attitudinal, and other characteristics. A random selection of 2500 households in Nebraska received a survey questionnaire designed for licensed motor vehicle drivers; respondents returned 980 questionnaires. Factor analysis identified latent variables evaluating drivers' patience and inclination to wait for trains, attitudes toward new technology, law enforcement or education regarding HRGC safety, and the propensity to commit serious traffic violations at HRGCs. The investigation utilized a structural equation model for analysis. This model indicated that drivers with a higher risk of inattentive driving at HRGCs were: female, younger in age, from households with higher incomes, with shorter tenure (in years) in their current city of residence, more frequently used HRGCs, received less information on safety at HRGCs, had less patience to wait for trains to pass and had less interest in safety improvement technology, law enforcement or safety education at HRGCs. These research findings provide useful information for future research and to policy makers for improving public safety. Additionally, the results are useful for safety educational program providers for targeted program delivery to drivers that are more vulnerable to distracted driving at HRGCs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Persuasive appeals in road safety communication campaigns: Theoretical frameworks and practical implications from the analysis of a decade of road safety campaign materials.

PubMed

Guttman, Nurit

2015-11-01

Communication campaigns are employed as an important tool to promote road safety practices. Researchers maintain road safety communication campaigns are more effective when their persuasive appeals, which are central to their communicative strategy, are based on explicit theoretical frameworks. This study's main objectives were to develop a detailed categorization of persuasive appeals used in road safety communication campaigns that differentiate between appeals that appear to be similar but differ conceptually, and to indicate the advantages, limitations and ethical issues associated with each type, drawing on behavior change theories. Materials from over 300 campaigns were obtained from 41 countries, mainly using road safety organizations' websites. Drawing on the literature, five types of main approaches were identified, and the analysis yielded a more detailed categorizations of appeals within these general categories. The analysis points to advantages, limitations, ethical issues and challenges in using different types of appeals. The discussion summarizes challenges in designing persuasive-appeals for road safety communication campaigns. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reprint of "Persuasive appeals in road safety communication campaigns: Theoretical frameworks and practical implications from the analysis of a decade of road safety campaign materials".

PubMed

Guttman, Nurit

2016-12-01

Communication campaigns are employed as an important tool to promote road safety practices. Researchers maintain road safety communication campaigns are more effective when their persuasive appeals, which are central to their communicative strategy, are based on explicit theoretical frameworks. This study's main objectives were to develop a detailed categorization of persuasive appeals used in road safety communication campaigns that differentiate between appeals that appear to be similar but differ conceptually, and to indicate the advantages, limitations and ethical issues associated with each type, drawing on behavior change theories. Materials from over 300 campaigns were obtained from 41 countries, mainly using road safety organizations' websites. Drawing on the literature, five types of main approaches were identified, and the analysis yielded a more detailed categorizations of appeals within these general categories. The analysis points to advantages, limitations, ethical issues and challenges in using different types of appeals. The discussion summarizes challenges in designing persuasive-appeals for road safety communication campaigns. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Long-Term Safety and Efficacy Follow-Up Study of Subjects Who Completed the Phase I Clinical Trial of Neurostem®-AD

ClinicalTrials.gov

2012-09-27

Alzheimer Disease; Dementia; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Tauopathies; Neurodegenerative Diseases; Delirium, Dementia, Amnestic, Cognitive Disorders; Mental Disorders

76 FR 37002 - Safety Zone; Central Astoria Independence Celebration Fireworks Event, Wards Island, NY

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... the fireworks display. Due to the dangers posed by the pyrotechnics used in this fireworks display... and would expose spectators, vessels, and other property to the hazards associated with pyrotechnics...

Packaging- and transportation-related occurrence reports : FY 1994 annual report

DOT National Transportation Integrated Search

1995-03-01

The Oak Ridge National Laboratory, through its support to the Department of Energys Office of Facility Safety Analysis, EH-32, retrieves reports and information pertaining to transportation and : packaging occurrences from the centralized Occurrence ...

Data mining and visualization of the Alabama accident database

DOT National Transportation Integrated Search

2000-08-01

The Alabama Department of Public Safety has developed and maintains a centralized database that contain traffic accident data collected from crash report completed by local police officers and state troopers. The Critical Analysis Reporting Environme...

Hazardous Material Transportation Risks in the Puget Sound Region

DOT National Transportation Integrated Search

1981-09-01

In order to contribute to workable hazardous materials accident prevention and response systems, public safety risks of transporting hazardous materials in the Central Puget Sound Region of Washington State are determined. Risk spectrums are obtained...

Space-brain: The negative effects of space exposure on the central nervous system.

PubMed

Jandial, Rahul; Hoshide, Reid; Waters, J Dawn; Limoli, Charles L

2018-01-01

Journey to Mars will be a large milestone for all humankind. Throughout history, we have learned lessons about the health dangers associated with exploratory voyages to expand our frontiers. Travelling through deep space, the final frontier, is planned for the 2030s by NASA. The lessons learned from the adverse health effects of space exposure have been encountered from previous, less-lengthy missions. Prolonged multiyear deep space travel to Mars could be encumbered by significant adverse health effects, which could critically affect the safety of the mission and its voyagers. In this review, we discuss the health effects of the central nervous system by space exposure. The negative effects from space radiation and microgravity have been detailed. Future aims and recommendations for the safety of the voyagers have been discussed. With proper planning and anticipation, the mission to Mars can be done safely and securely.

New drugs: evidence relating to their therapeutic value after introduction to the market.

PubMed

Ujeyl, Mariam; Schlegel, Claudia; Walter, Siegbert; Gundert-Remy, Ursula

2012-02-01

Drug approval is based on three criteria: quality, efficacy, and safety. We investigated the types of study design and statistical methods employed to demonstrate safety and efficacy of proprietary medicinal products (PMPs) that were approved for use in the European Union through the centralized procedure. We retrospectively analyzed the European Public Assessment Reports of PMPs that the European Medicinal Agency approved, either initially or for extended indications, in 2009 and 2010. Data were analyzed for 39 PMPs: 64% of these were new active substances, and 36% were approved for extended indications. 46% of the PMPs had been studied in an active-control trial. In only 28%, superiority of the new PMPs compared to active control had been tested. 46% of the approvals included testing of a patient-relevant primary endpoint. The median size of population used to demonstrate safety was 1700 persons. The centralized procedure does not require comparative information from active-control trials. Accordingly, as our descriptive analysis revealed, this information is often not available at the time of market introduction. Pivotal studies only rarely clearly demonstrate an added therapeutic value of a new PMP compared to existing alternatives.

Migration, violence, and safety among migrant sex workers: a qualitative study in two Guatemalan communities.

PubMed

Rocha-Jiménez, Teresita; Brouwer, Kimberly C; Silverman, Jay G; Morales-Miranda, Sonia; Goldenberg, Shira M

2016-09-01

Despite reports of high levels of violence among women migrants in Central America, limited evidence exists regarding the health and safety of migrant sex workers in Central America. This study is based on 16 months of field research (November 2012-February 2014), including ethnographic fieldwork, in-depth interviews, and focus groups conducted with 52 internal and international migrant female sex workers in Tecún Umán and Quetzaltenango, Guatemala, key transit and destination communities for both international and internal migrants. The analysis explored migration-related determinants of susceptibility to violence experienced by migrant sex workers across different phases of migration. Violence in home communities and economic considerations were key drivers of migration. Unsafe transit experiences (eg undocumented border crossings) and negative interactions with authorities in destination settings (eg extortion) contributed to migrant sex workers' susceptibility to violence, while enhanced access to information on immigration policies and greater migration and sex work experience were found to enhance agency and resilience. Findings suggest the urgent need for actions that promote migrant sex workers' safety in communities of origin, transit, and destination, and programmes aimed at preventing and addressing human rights violations within the context of migration and sex work.

[Exploratory study of road safety in Brazzaville and Pointe-Noire in Republic of the Congo].

PubMed

Batala Mpondo, Georges; Bouanga, Marianne; Saya, Yvette Marie Clarisse; Maurice, Pierre; Burigusa, Guillaume

2014-01-01

Although road accidents in the Congo are reaching alarming levels (2,720 accidents in 2010 and 3,126 accidents in 2011), especially with the massive arrival of "Jakarta" mopeds, no evaluation has been conducted to identify and understand the factors responsible for this problem. This article reports the results of an exploratory study conducted in Brazzaville and Pointe-Noire based on information collected from existing documents and by semidirective questionnaire of people from various sectors able to elucidate the problem of road safety. Using William Haddon's matrix, the parameters investigated were : road user behaviour ; environmental and technological factors ; characteristics of road accident victims ; quality of care ; intervention times and organization of prevention. This study demonstrated the absence of a road safety policy in Congo. It also showed that the main factors responsible for road accidents are behavioural (failure to wear safety belts, failure to comply with road signs, fatigue, use of a telephone while driving, etc.), followed by environmental and technological factors (insufficient traffic lights, absence of sidewalks, disorganized occupation of roads, general state of vehicles). This study shows that, in order to improve road safety in the Congo, it is essential to promote the development of national road safety policies and an action plan, intervention on the determinants of road accidents, and a change of road user behaviours (compulsory use of safety belts, ban on the use of a telephone and smoking while driving, etc.). Effective organization of the management of road accident victims and allocation of a budget to implement a road safety policy are also necessary.

The Dread Factor: How Hazards and Safety Training Influence Learning and Performance

ERIC Educational Resources Information Center

Burke, Michael J.; Salvador, Rommel O.; Smith-Crowe, Kristin; Chan-Serafin, Suzanne; Smith, Alexis; Sonesh, Shirley

2011-01-01

On the basis of hypotheses derived from social and experiential learning theories, we meta-analytically investigated how safety training and workplace hazards impact the development of safety knowledge and safety performance. The results were consistent with an expected interaction between the level of engagement of safety training and hazardous…

Rates of central line-associated bloodstream infection in tertiary care hospitals in 3 Arabian gulf countries: 6-year surveillance study.

PubMed

Balkhy, Hanan H; El-Saed, Aiman; Al-Abri, Seif S; Alsalman, Jameela; Alansari, Huda; Al Maskari, Zaina; El Gammal, Ayman; Al Nasser, Wafa; AlJardani, Amina; Althaqafi, Abdulhakeem

2017-05-01

The objective of this study was to compare central line-associated bloodstream infection (CLABSI) rates in Gulf Cooperation Council (GCC) states with those of the U.S. National Healthcare Safety Network (NHSN) and International Nosocomial Infection Control Consortium (INICC) using pooled data from 6 hospitals in 3 GCC countries. The overall CLABSI rate was 3.1 per 1,000 central line days. After adjusting for differences in intensive care unit types, the risk of CLABSI in GCC hospitals was 146% higher than NHSN hospitals but 33% lower than INICC hospitals. Copyright © 2017. Published by Elsevier Inc.

Use of Six Sigma strategies to pull the line on central line-associated bloodstream infections in a neurotrauma intensive care unit.

PubMed

Loftus, Kelli; Tilley, Terry; Hoffman, Jason; Bradburn, Eric; Harvey, Ellen

2015-01-01

The creation of a consistent culture of safety and quality in an intensive care unit is challenging. We applied the Six Sigma Define-Measure-Analyze-Improve-Control (DMAIC) model for quality improvement (QI) to develop a long-term solution to improve outcomes in a high-risk neurotrauma intensive care unit. We sought to reduce central line utilization as a cornerstone in preventing central line-associated bloodstream infections (CLABSIs). This study describes the successful application of the DMAIC model in the creation and implementation of evidence-based quality improvement designed to reduce CLABSIs to below national benchmarks.

Improved guidelines for estimating the Highway safety manual calibration factors.

DOT National Transportation Integrated Search

2016-01-01

Crash prediction models can be used to predict the number of crashes and evaluate roadway safety. Part C of the first edition of the Highway Safety Manual (HSM) provides safety performance functions (SPFs). The HSM addendum that includes freeway and ...

42 CFR 87.4 - For what purposes may grants be awarded?

Code of Federal Regulations, 2013 CFR

2013-10-01

... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH... Safety and Health Act authorizes grants for research, experiments, and demonstrations relating to occupational safety and health, including studies of the psychological factors involved. This authority...

42 CFR 87.4 - For what purposes may grants be awarded?

Code of Federal Regulations, 2012 CFR

2012-10-01

... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH... Safety and Health Act authorizes grants for research, experiments, and demonstrations relating to occupational safety and health, including studies of the psychological factors involved. This authority...

42 CFR 87.4 - For what purposes may grants be awarded?

Code of Federal Regulations, 2014 CFR

2014-10-01

... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH... Safety and Health Act authorizes grants for research, experiments, and demonstrations relating to occupational safety and health, including studies of the psychological factors involved. This authority...

Developing a smartphone based warning system application to enhance the safety at work zones : final report.

DOT National Transportation Integrated Search

2016-05-01

Collisions in the work zone have always been a contributing factor to compromising safety on urban roadways. The National Highway Traffic Safety Administration (NHTSA) and the State Transportation Authorities have implemented many safety countermeasu...

The science of human factors: separating fact from fiction

PubMed Central

Russ, Alissa L; Fairbanks, Rollin J; Karsh, Ben-Tzion; Militello, Laura G; Saleem, Jason J; Wears, Robert L

2013-01-01

Background Interest in human factors has increased across healthcare communities and institutions as the value of human centred design in healthcare becomes increasingly clear. However, as human factors is becoming more prominent, there is growing evidence of confusion about human factors science, both anecdotally and in scientific literature. Some of the misconceptions about human factors may inadvertently create missed opportunities for healthcare improvement. Methods The objective of this article is to describe the scientific discipline of human factors and provide common ground for partnerships between healthcare and human factors communities. Results The primary goal of human factors science is to promote efficiency, safety and effectiveness by improving the design of technologies, processes and work systems. As described in this article, human factors also provides insight on when training is likely (or unlikely) to be effective for improving patient safety. Finally, we outline human factors specialty areas that may be particularly relevant for improving healthcare delivery and provide examples to demonstrate their value. Conclusions The human factors concepts presented in this article may foster interdisciplinary collaborations to yield new, sustainable solutions for healthcare quality and patient safety. PMID:23592760

Cross-cultural differences in driving skills: a comparison of six countries.

PubMed

Ozkan, Türker; Lajunen, Timo; Chliaoutakis, Joannes El; Parker, Dianne; Summala, Heikki

2006-09-01

The first aim of the present study was to investigate the applicability of the two-factor structure (perceptual-motor skills by 11 items, e.g., "fluent driving"; safety skills by 9 items, e.g., "conforming to the speed limits") of the Driver Skill Inventory (DSI) among British, Dutch, Finnish, Greek, Iranian, and Turkish drivers. It was also hypothesized that the combination of self reported high ratings of perceptual-motor skills and low ratings of safety skills creates a serious risk for dangerous driving and road accident involvement. The second aim of this study was, therefore, to investigate this asymmetric relationship between perceptual-motor and safety skills in traffic penalties and accident involvement. Two hundred and forty two drivers were chosen from each of the six countries, matched for age and sex. The results of exploratory factor analyses together with target rotation showed that the two-factor structure of DSI found in "safe" Northern and Western European countries were highly congruent. However, the safety skills factor of DSI in Greece, Iran, and Turkey was relatively incongruent in spite of high factor similarity found in perceptual-motor skills. The asymmetric relationship between perceptual-motor and safety skills on traffic penalties was found in Finland and Turkey. A negative relationship between safety skills and the number of accidents was found both in Greece and Iran while a positive relationship between perceptual-motor skills and the number of accidents was found only in Iran.

Proceedings of the human factors workshop : improving railroad safety through understanding close calls.

DOT National Transportation Integrated Search

2004-05-01

On April 23 and 24, 2003, the Federal Railroad Administrations Office of Research and Development held a Human Factors Workshop: Improving Railroad Safety Through Understanding Close Calls in Baltimore, Maryland. The purpose of the workshop ...

Delinking resident duty hours from patient safety

PubMed Central

2014-01-01

Patient safety is a powerful motivating force for change in modern medicine, and is often cited as a rationale for reducing resident duty hours. However, current data suggest that resident duty hours are not significantly linked to important patient outcomes. We performed a narrative review and identified four potential explanations for these findings. First, we question the relevance of resident fatigue in the creation of harmful errors. Second, we discuss factors, including workload, experience, and individual characteristics, that may be more important determinants of resident fatigue than are duty hours. Third, we describe potential adverse effects that may arise from – and, therefore, counterbalance any potential benefits of – duty hour reductions. Fourth, we explore factors that may mitigate any risks to patient safety associated with using the services of resident trainees. In summary, it may be inappropriate to justify a reduction in working hours on the grounds of a presumed linkage between patient safety and resident duty hours. Better understanding of resident-related factors associated with patient safety will be essential if improvements in important patient safety outcomes are to be realized through resident-focused strategies. PMID:25561349