expanded safety experience: Topics by Science.gov

Sample records for expanded safety experience

Student Work Safety Guidelines in Roadside Applications and Work Zones : Safety Guidelines for Transportation Researchers

DOT National Transportation Integrated Search

2018-01-01

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...
The impact of the consumer on healthcare delivery.

PubMed

Scott, Cheryl M

2003-01-01

The authors of the lead articles are correct that the customer experience should be at the forefront of our attention and work in healthcare delivery. Expanding our current definitions of customer satisfaction and patient safety to include the important intangibles of "experience" will be key. However, a singular focus on patient or consumer experience is not enough in the long run. A solid business model and an understanding of the healthcare market dynamics are also required. The promises we make in support of our business strategy are at the core of how we interact with our patients, how we ensure their safety, and how we build their loyalty. Our work as healthcare leaders should be to keep those promises.
Fire Safety - Multiple Languages

MedlinePlus

... Arabic (العربية) Expand Section Fire Safety at Home - English PDF Fire Safety at Home - العربية (Arabic) PDF ... Bosnian (bosanski) Expand Section Fire Safety at Home - English PDF Fire Safety at Home - bosanski (Bosnian) PDF ...
DOE Office of Scientific and Technical Information (OSTI.GOV)

Hopper, Calvin Mitchell

In May 1973 the University of New Mexico conducted the first nationwide criticality safety training and education week-long short course for nuclear criticality safety engineers. Subsequent to that course, the Los Alamos Critical Experiments Facility (LACEF) developed very successful 'hands-on' subcritical and critical training programs for operators, supervisors, and engineering staff. Since the inception of the US Department of Energy (DOE) Nuclear Criticality Technology and Safety Project (NCT&SP) in 1983, the DOE has stimulated contractor facilities and laboratories to collaborate in the furthering of nuclear criticality as a discipline. That effort included the education and training of nuclear criticality safetymore » engineers (NCSEs). In 1985 a textbook was written that established a path toward formalizing education and training for NCSEs. Though the NCT&SP went through a brief hiatus from 1990 to 1992, other DOE-supported programs were evolving to the benefit of NCSE training and education. In 1993 the DOE established a Nuclear Criticality Safety Program (NCSP) and undertook a comprehensive development effort to expand the extant LACEF 'hands-on' course specifically for the education and training of NCSEs. That successful education and training was interrupted in 2006 for the closing of the LACEF and the accompanying movement of materials and critical experiment machines to the Nevada Test Site. Prior to that closing, the Lawrence Livermore National Laboratory (LLNL) was commissioned by the US DOE NCSP to establish an independent hands-on NCSE subcritical education and training course. The course provided an interim transition for the establishment of a reinvigorated and expanded two-week NCSE education and training program in 2011. The 2011 piloted two-week course was coordinated by the Oak Ridge National Laboratory (ORNL) and jointly conducted by the Los Alamos National Laboratory (LANL) classroom education and facility training, the Sandia National Laboratory (SNL) hands-on criticality experiments training, and the US DOE National Criticality Experiment Research Center (NCERC) hands-on criticality experiments training that is jointly supported by LLNL and LANL and located at the Nevada National Security Site (NNSS) This paper provides the description of the bases, content, and conduct of the piloted, and future US DOE NCSP Criticality Safety Engineer Training and Education Project.« less
The Pioneering Role of the Vaccine Safety Datalink Project (VSD) to Advance Collaborative Research and Distributed Data Networks

PubMed Central

Fahey, Kevin R.

2015-01-01

Introduction: Large-scale distributed data networks consisting of diverse stakeholders including providers, patients, and payers are changing health research in terms of methods, speed and efficiency. The Vaccine Safety Datalink (VSD) set the stage for expanded involvement of health plans in collaborative research. Expanding Surveillance Capacity and Progress Toward a Learning Health System: From an initial collaboration of four integrated health systems with fewer than 10 million covered lives to 16 diverse health plans with nearly 100 million lives now in the FDA Sentinel, the expanded engagement of health plan researchers has been essential to increase the value and impact of these efforts. The collaborative structure of the VSD established a pathway toward research efforts that successfully engage all stakeholders in a cohesive rather than competitive manner. The scientific expertise and methodology developed through the VSD such as rapid cycle analysis (RCA) to conduct near real-time safety surveillance allowed for the development of the expanded surveillance systems that now exist. Building on Success and Lessons Learned: These networks have learned from and built on the knowledge base and infrastructure created by the VSD investigators. This shared technical knowledge and experience expedited the development of systems like the FDA’s Mini-Sentinel and the Patient Centered Outcomes Research Institute (PCORI)’s PCORnet Conclusion: This narrative reviews the evolution of the VSD, its contribution to other collaborative research networks, longer-term sustainability of this type of distributed research, and how knowledge gained from the earlier efforts can contribute to a continually learning health system. PMID:26793736
GROWTH OF THE INTERNATIONAL CRITICALITY SAFETY AND REACTOR PHYSICS EXPERIMENT EVALUATION PROJECTS

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

J. Blair Briggs; John D. Bess; Jim Gulliford

2011-09-01

Since the International Conference on Nuclear Criticality Safety (ICNC) 2007, the International Criticality Safety Benchmark Evaluation Project (ICSBEP) and the International Reactor Physics Experiment Evaluation Project (IRPhEP) have continued to expand their efforts and broaden their scope. Eighteen countries participated on the ICSBEP in 2007. Now, there are 20, with recent contributions from Sweden and Argentina. The IRPhEP has also expanded from eight contributing countries in 2007 to 16 in 2011. Since ICNC 2007, the contents of the 'International Handbook of Evaluated Criticality Safety Benchmark Experiments1' have increased from 442 evaluations (38000 pages), containing benchmark specifications for 3955 critical ormore » subcritical configurations to 516 evaluations (nearly 55000 pages), containing benchmark specifications for 4405 critical or subcritical configurations in the 2010 Edition of the ICSBEP Handbook. The contents of the Handbook have also increased from 21 to 24 criticality-alarm-placement/shielding configurations with multiple dose points for each, and from 20 to 200 configurations categorized as fundamental physics measurements relevant to criticality safety applications. Approximately 25 new evaluations and 150 additional configurations are expected to be added to the 2011 edition of the Handbook. Since ICNC 2007, the contents of the 'International Handbook of Evaluated Reactor Physics Benchmark Experiments2' have increased from 16 different experimental series that were performed at 12 different reactor facilities to 53 experimental series that were performed at 30 different reactor facilities in the 2011 edition of the Handbook. Considerable effort has also been made to improve the functionality of the searchable database, DICE (Database for the International Criticality Benchmark Evaluation Project) and verify the accuracy of the data contained therein. DICE will be discussed in separate papers at ICNC 2011. The status of the ICSBEP and the IRPhEP will be discussed in the full paper, selected benchmarks that have been added to the ICSBEP Handbook will be highlighted, and a preview of the new benchmarks that will appear in the September 2011 edition of the Handbook will be provided. Accomplishments of the IRPhEP will also be highlighted and the future of both projects will be discussed. REFERENCES (1) International Handbook of Evaluated Criticality Safety Benchmark Experiments, NEA/NSC/DOC(95)03/I-IX, Organisation for Economic Co-operation and Development-Nuclear Energy Agency (OECD-NEA), September 2010 Edition, ISBN 978-92-64-99140-8. (2) International Handbook of Evaluated Reactor Physics Benchmark Experiments, NEA/NSC/DOC(2006)1, Organisation for Economic Co-operation and Development-Nuclear Energy Agency (OECD-NEA), March 2011 Edition, ISBN 978-92-64-99141-5.« less
Pilot trial of intravenous autologous culture-expanded mesenchymal stem cell transplantation in multiple sclerosis.

PubMed

Cohen, Jeffrey A; Imrey, Peter B; Planchon, Sarah M; Bermel, Robert A; Fisher, Elizabeth; Fox, Robert J; Bar-Or, Amit; Sharp, Susan L; Skaramagas, Thomai T; Jagodnik, Patricia; Karafa, Matt; Morrison, Shannon; Reese Koc, Jane; Gerson, Stanton L; Lazarus, Hillard M

2018-04-01

Mesenchymal stem cells (MSCs) exhibit immunomodulatory, tissue-protective, and repair-promoting properties in vitro and in animals. Clinical trials in several human conditions support the safety and efficacy of MSC transplantation. Published experience in multiple sclerosis (MS) is modest. To assess feasibility, safety, and tolerability and explore efficacy of autologous MSC transplantation in MS. Participants with relapsing-remitting multiple sclerosis (RRMS) or secondary progressive multiple sclerosis (SPMS), Expanded Disability Status Scale score 3.0-6.5, disease activity or progression in the prior 2 years, and optic nerve involvement were enrolled. Bone-marrow-derived MSCs were culture-expanded and then cryopreserved. After confirming fulfillment of release criteria, 1-2 × 10 6 MSCs/kg were thawed and administered IV. In all, 24 of 26 screened patients were infused: 16 women and 8 men, 10 RRMS and 14 SPMS, mean age 46.5, mean Expanded Disability Status Scale score 5.2, 25% with gadolinium-enhancing magnetic resonance imaging (MRI) lesions. Mean cell dosage (requiring 1-3 passages) was 1.9 × 10 6 MSCs/kg (range, 1.5-2.0) with post-thaw viability uniformly ⩾95%. Cell infusion was tolerated well without treatment-related severe or serious adverse events, or evidence of disease activation. Autologous MSC transplantation in MS appears feasible, safe, and well tolerated. Future trials to assess efficacy more definitively are warranted.
Using the Tritium Plasma Experiment to evaluate ITER PFC safety

NASA Astrophysics Data System (ADS)

Longhurst, Glen R.; Anderl, Robert A.; Bartlit, John R.; Causey, Rion A.; Haines, John R.

The Tritium Plasma Experiment was assembled at Sandia National Laboratories, Livermore to investigate interactions between dense plasmas at low energies and plasma-facing component materials. This apparatus has the unique capability of replicating plasma conditions in a tokamak divertor with particle flux densities of 2 x 10(exp 19) ions/((sq cm)(s)) and a plasma temperature of about 15 eV using a plasma that includes tritium. With the closure of the Tritium Research Laboratory at Livermore, the experiment was moved to the Tritium Systems Test Assembly facility at Los Alamos National Laboratory. An experimental program has been initiated there using the Tritium Plasma Experiment to examine safety issues related to tritium in plasma-facing components, particularly the ITER divertor. Those issues include tritium retention and release characteristics, tritium permeation rates and transient times to coolant streams, surface modification and erosion by the plasma, the effects of thermal loads and cycling, and particulate production. A considerable lack of data exists in these areas for many of the materials, especially beryllium, being considered for use in ITER. Not only will basic material behavior with respect to safety issues in the divertor environment be examined, but innovative techniques for optimizing performance with respect to tritium safety by material modification and process control will be investigated. Supplementary experiments will be carried out at the Idaho National Engineering Laboratory and Sandia National Laboratory to expand and clarify results obtained on the Tritium Plasma Experiment.
77 FR 5472 - Pipeline Safety: Expanding the Use of Excess Flow Valves in Gas Distribution Systems to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

..., Regulatory Certainty, and Job Creation Act of 2011 (PL112-90), have imposed additional demands on their... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Part 192 [Docket ID PHMSA-2011-0009] RIN 2137-AE71 Pipeline Safety: Expanding the Use of Excess Flow Valves...
Health Informatics in Developing Countries: A Review of Unintended Consequences of IT Implementations, as They Affect Patient Safety and Recommendations on How to Address Them.

PubMed

Park, Hyeoun-Ae

2016-11-10

Patient safety concerns every healthcare organization. Adoption of Health information technology (HIT) appears to have the potential to address this issue, however unanticipated and undesirable consequences from implementing HIT could lead to new and more complex hazards. This could be particularly problematic in developing countries, where regulations, policies and implementations are few, less standandarized and in some cases almost non-existing. Based on the available information and our own experience, we conducted a review of unintended consequences of HIT implementations, as they affect patient safety in developing countries. We found that user dependency on the system, alert fatigue, less communications among healthcare actors and workarounds topics should be prioritize. Institution should consider existing knowledge, learn from other experiences and model their implementations to avoid known consequences. We also recommend that they monitor and communicate their own efforts to expand knowledge in the region.
Expanding the seat belt program strategies toolbox: a starter kit for trying new program ideas : traffic tech.

DOT National Transportation Integrated Search

2016-10-01

The National Highway Traffic Safety Administration has just : released a new resource for developing seat belt programs in : the traffic safety communityExpanding the Seat Belt Program : Toolbox: A Starter Kit for Trying New Program Ideas. : Resea...
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.
Initiation of Insensitive High Explosives Using Multiple Wave Interactions

NASA Astrophysics Data System (ADS)

Francois, Elizabeth

Insensitive High Explosives (IHEs) increase safety in many types of weapons. However, the safety comes at the cost of performance. Initiation of IHE requires large boosters and powerful detonators as well. Multipoint initiation is being utilized to exploit explosive wave interactions to create overdriven states, greatly facilitating the initiation of IHEs. This presentation will focus on recent explosive experiments where the minimum spot size for single-point initiation in PBX 9502 was determined. Below this threshold, PBX 9502 could not be initiated. This was then expanded to three initiation points, which were smaller this threshold. Measurements of the velocity and pressure of the wave interactions were measured using Photon Doppler Velocimetry (PDV). Initiation was observed, and the resulting pressures at the double and triple points were found to be above the CJ state for PBX 9502. Further testing will be performed using cutback experiments to isolate the overdriven state, and quantify the duration of the phenomenon.
Evaluation of the AHRQ Patient Safety Initiative: Synthesis of Findings

PubMed Central

Farley, Donna O; Damberg, Cheryl L

2009-01-01

Objective To present overall findings from the 4-year evaluation of the national patient safety initiative operated by the Agency for Healthcare Research and Quality (AHRQ). Data Sources Interviews with AHRQ staff, grantees, and other patient safety stakeholders; published materials; and internal AHRQ documents. Study Design The evaluation was structured to address a system framework of five components involved in improving safety. The initiative's contributions to improving each system component were assessed qualitatively, comparing results from three separate analyses—AHRQ's achievement of its patient safety goals, our own assessment of the initiative's activities, and independent stakeholder ratings of AHRQ's contributions. Findings and Conclusions AHRQ has faced a daunting challenge for improving patient safety, given the complex problems of the U.S. health care system and the limited resources AHRQ has had to address them. The patient safety initiative achieved strongest progress for its contributions to knowledge of patient safety epidemiology and effective practices, where AHRQ has considerable experience, and to strengthening infrastructure to support adoption of safe practices. Progress was slower in establishing a national monitoring capability and dissemination of safe practices for adoption. AHRQ needs to expand efforts to apply new knowledge for stimulating use of safe practices in the field. PMID:21456115
The SCALE Verified, Archived Library of Inputs and Data - VALID

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

Marshall, William BJ J; Rearden, Bradley T

The Verified, Archived Library of Inputs and Data (VALID) at ORNL contains high quality, independently reviewed models and results that improve confidence in analysis. VALID is developed and maintained according to a procedure of the SCALE quality assurance (QA) plan. This paper reviews the origins of the procedure and its intended purpose, the philosophy of the procedure, some highlights of its implementation, and the future of the procedure and associated VALID library. The original focus of the procedure was the generation of high-quality models that could be archived at ORNL and applied to many studies. The review process associated withmore » model generation minimized the chances of errors in these archived models. Subsequently, the scope of the library and procedure was expanded to provide high quality, reviewed sensitivity data files for deployment through the International Handbook of Evaluated Criticality Safety Benchmark Experiments (IHECSBE). Sensitivity data files for approximately 400 such models are currently available. The VALID procedure and library continue fulfilling these multiple roles. The VALID procedure is based on the quality assurance principles of ISO 9001 and nuclear safety analysis. Some of these key concepts include: independent generation and review of information, generation and review by qualified individuals, use of appropriate references for design data and documentation, and retrievability of the models, results, and documentation associated with entries in the library. Some highlights of the detailed procedure are discussed to provide background on its implementation and to indicate limitations of data extracted from VALID for use by the broader community. Specifically, external users of data generated within VALID must take responsibility for ensuring that the files are used within the QA framework of their organization and that use is appropriate. The future plans for the VALID library include expansion to include additional experiments from the IHECSBE, to include experiments from areas beyond criticality safety, such as reactor physics and shielding, and to include application models. In the future, external SCALE users may also obtain qualification under the VALID procedure and be involved in expanding the library. The VALID library provides a pathway for the criticality safety community to leverage modeling and analysis expertise at ORNL.« less
Researchers' Roles in Patient Safety Improvement.

PubMed

Pietikäinen, Elina; Reiman, Teemu; Heikkilä, Jouko; Macchi, Luigi

2016-03-01

In this article, we explore how researchers can contribute to patient safety improvement. We aim to expand the instrumental role researchers have often occupied in relation to patient safety improvement. We reflect on our own improvement model and experiences as patient safety researchers in an ongoing Finnish multi-actor innovation project through self-reflective narration. Our own patient safety improvement model can be described as systemic. Based on the purpose of the innovation project, our improvement model, and the improvement models of the other actors in the project, we have carried out a wide range of activities. Our activities can be summarized in 8 overlapping patient safety improvement roles: modeler, influencer, supplier, producer, ideator, reflector, facilitator, and negotiator. When working side by side with "practice," researchers are offered and engage in several different activities. The way researchers contribute to patient safety improvement and balance between different roles depends on the purpose of the study, as well as on the underlying patient safety improvement models. Different patient safety research paradigms seem to emphasize different improvement roles, and thus, they also face different challenges. Open reflection on the underlying improvement models and roles can help researchers with different backgrounds-as well as other actors involved in patient safety improvement-in structuring their work and collaborating productively.
Large Scale Experiments on Spacecraft Fire Safety

NASA Technical Reports Server (NTRS)

Urban, David L.; Ruff, Gary A.; Minster, Olivier; Toth, Balazs; Fernandez-Pello, A. Carlos; T'ien, James S.; Torero, Jose L.; Cowlard, Adam J.; Legros, Guillaume; Eigenbrod, Christian;

2012-01-01

Full scale fire testing complemented by computer modelling has provided significant know how about the risk, prevention and suppression of fire in terrestrial systems (cars, ships, planes, buildings, mines, and tunnels). In comparison, no such testing has been carried out for manned spacecraft due to the complexity, cost and risk associated with operating a long duration fire safety experiment of a relevant size in microgravity. Therefore, there is currently a gap in knowledge of fire behaviour in spacecraft. The entire body of low-gravity fire research has either been conducted in short duration ground-based microgravity facilities or has been limited to very small fuel samples. Still, the work conducted to date has shown that fire behaviour in low-gravity is very different from that in normal-gravity, with differences observed for flammability limits, ignition delay, flame spread behaviour, flame colour and flame structure. As a result, the prediction of the behaviour of fires in reduced gravity is at present not validated. To address this gap in knowledge, a collaborative international project, Spacecraft Fire Safety, has been established with its cornerstone being the development of an experiment (Fire Safety 1) to be conducted on an ISS resupply vehicle, such as the Automated Transfer Vehicle (ATV) or Orbital Cygnus after it leaves the ISS and before it enters the atmosphere. A computer modelling effort will complement the experimental effort. Although the experiment will need to meet rigorous safety requirements to ensure the carrier vehicle does not sustain damage, the absence of a crew removes the need for strict containment of combustion products. This will facilitate the possibility of examining fire behaviour on a scale that is relevant to spacecraft fire safety and will provide unique data for fire model validation. This unprecedented opportunity will expand the understanding of the fundamentals of fire behaviour in spacecraft. The experiment is being developed by an international topical team that is collaboratively defining the experiment requirements and performing supporting analysis, experimentation and technology development. This paper presents the objectives, status and concept of this project.

Large Scale Experiments on Spacecraft Fire Safety

NASA Technical Reports Server (NTRS)

Urban, David; Ruff, Gary A.; Minster, Olivier; Fernandez-Pello, A. Carlos; Tien, James S.; Torero, Jose L.; Legros, Guillaume; Eigenbrod, Christian; Smirnov, Nickolay; Fujita, Osamu;

2012-01-01

Full scale fire testing complemented by computer modelling has provided significant knowhow about the risk, prevention and suppression of fire in terrestrial systems (cars, ships, planes, buildings, mines, and tunnels). In comparison, no such testing has been carried out for manned spacecraft due to the complexity, cost and risk associated with operating a long duration fire safety experiment of a relevant size in microgravity. Therefore, there is currently a gap in knowledge of fire behaviour in spacecraft. The entire body of low-gravity fire research has either been conducted in short duration ground-based microgravity facilities or has been limited to very small fuel samples. Still, the work conducted to date has shown that fire behaviour in low-gravity is very different from that in normal gravity, with differences observed for flammability limits, ignition delay, flame spread behaviour, flame colour and flame structure. As a result, the prediction of the behaviour of fires in reduced gravity is at present not validated. To address this gap in knowledge, a collaborative international project, Spacecraft Fire Safety, has been established with its cornerstone being the development of an experiment (Fire Safety 1) to be conducted on an ISS resupply vehicle, such as the Automated Transfer Vehicle (ATV) or Orbital Cygnus after it leaves the ISS and before it enters the atmosphere. A computer modelling effort will complement the experimental effort. Although the experiment will need to meet rigorous safety requirements to ensure the carrier vehicle does not sustain damage, the absence of a crew removes the need for strict containment of combustion products. This will facilitate the possibility of examining fire behaviour on a scale that is relevant to spacecraft fire safety and will provide unique data for fire model validation. This unprecedented opportunity will expand the understanding of the fundamentals of fire behaviour in spacecraft. The experiment is being developed by an international topical team that is collaboratively defining the experiment requirements and performing supporting analysis, experimentation and technology development. This paper presents the objectives, status and concept of this project.

A business planning model to identify new safety net clinic locations.

PubMed

Langabeer, James; Helton, Jeffrey; DelliFraine, Jami; Dotson, Ebbin; Watts, Carolyn; Love, Karen

2014-01-01

Community health clinics serving the poor and underserved are geographically expanding due to changes in U.S. health care policy. This paper describes the experience of a collaborative alliance of health care providers in a large metropolitan area who develop a conceptual and mathematical decision model to guide decisions on expanding its network of community health clinics. Community stakeholders participated in a collaborative process that defined constructs they deemed important in guiding decisions on the location of community health clinics. This collaboration also defined key variables within each construct. Scores for variables within each construct were then totaled and weighted into a community-specific optimal space planning equation. This analysis relied entirely on secondary data available from published sources. The model built from this collaboration revolved around the constructs of demand, sustainability, and competition. It used publicly available data defining variables within each construct to arrive at an optimal location that maximized demand and sustainability and minimized competition. This is a model that safety net clinic planners and community stakeholders can use to analyze demographic and utilization data to optimize capacity expansion to serve uninsured and Medicaid populations. Communities can use this innovative model to develop a locally relevant clinic location-planning framework.
78 FR 9107 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-07

... maintaining high-quality inspections. The railroad also believes that the waiver's expanded scope will not compromise railroad safety. In support of the expanded scope of the existing waiver, BNSF's petition further... CFR part 232. Specifically, BNSF requests to expand the scope of the existing waiver that granted...

Wildfires

MedlinePlus

... motels Expand sub-navigation Hotel fire safety tips Marijuana grow & extraction facilities Nightclubs and other assembly occupancies ... Fire behavior research Fire loss and injury research Benefits of home fire sprinklers Expand sub-navigation Environmental ...
Human Adipose‐Derived Stem Cells Expanded Under Ambient Oxygen Concentration Accumulate Oxidative DNA Lesions and Experience Procarcinogenic DNA Replication Stress

PubMed Central

Renoud, Marie‐Laure; Hoede, Claire; Gonzalez, Ignacio; Jones, Natalie; Longy, Michel; Sensebé, Luc; Cazaux, Christophe

2016-01-01

Abstract Adipose‐derived stem cells (ADSCs) have led to growing interest in cell‐based therapy because they can be easily harvested from an abundant tissue. ADSCs must be expanded in vitro before transplantation. This essential step causes concerns about the safety of adult stem cells in terms of potential transformation. Tumorigenesis is driven in its earliest step by DNA replication stress, which is characterized by the accumulation of stalled DNA replication forks and activation of the DNA damage response. Thus, to evaluate the safety of ADSCs during ex vivo expansion, we monitored DNA replication under atmospheric (21%) or physiologic (1%) oxygen concentration. Here, by combining immunofluorescence and DNA combing, we show that ADSCs cultured under 21% oxygen accumulate endogenous oxidative DNA lesions, which interfere with DNA replication by increasing fork stalling events, thereby leading to incomplete DNA replication and fork collapse. Moreover, we found by RNA sequencing (RNA‐seq) that culture of ADSCs under atmospheric oxygen concentration leads to misexpression of cell cycle and DNA replication genes, which could contribute to DNA replication stress. Finally, analysis of acquired small nucleotide polymorphism shows that expansion of ADSCs under 21% oxygen induces a mutational bias toward deleterious transversions. Overall, our results suggest that expanding ADSCs at a low oxygen concentration could reduce the risk for DNA replication stress‐associated transformation, as occurs in neoplastic tissues. Stem Cells Translational Medicine 2017;6:68–76 PMID:28170194
Predictors of Cell Phone Use in Distracted Driving: Extending the Theory of Planned Behavior.

PubMed

Tian, Yan; Robinson, James D

2017-09-01

This study examines the predictors of six distracted driving behaviors, and the survey data partially support Ajzen's (1991) Theory of Planned Behavior (TPB). The data suggest that the attitude variable predicted intention to engage in all six distracted driving behaviors (reading and sending text messages, making and answering cell phone calls, reading/viewing social media, and posting on social media while driving). Extending the model to include past experience and the variable perceived safety of technology yielded an improvement in the prediction of the distraction variables. Specifically, past experience predicted all six distracted driving behaviors, and the variable perceived safety of technology predicted intentions to read/view social media and intention to post on social media while driving. The study provides evidence for the importance of incorporating expanded variables into the original TPB model to predict cell phone use behaviors while driving, and it suggests that it is essential to tailor campaign materials for each specific cell phone use behavior to reduce distracted driving.
76 FR 21253 - Safety Zone; M/V DAVY CROCKETT, Columbia River

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

...-AA00 Safety Zone; M/V DAVY CROCKETT, Columbia River AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The U.S. Coast Guard is extending and expanding the emergency safety zone established on... January 28, 2011. The safety zone is necessary to help ensure the safety of the response workers and...
Teaching Health and Safety: Preparing Staff for the Unexpected.

ERIC Educational Resources Information Center

Cronin, Greg

1999-01-01

Discusses methods for training camp counselors in safety standards. Safety awareness and camp wellness should be introduced during staff interviews. During precamp training, staff should complete a test in OSHA requirements, followed by role playing to expand staff's knowledge in each OSHA safety and health area. First aid training, fire safety,…
Planning a study abroad clinical experience.

PubMed

Wright, Dolores J

2010-05-01

Not only is globalization expanding areas of human activity, it is also influencing the variety of educational offerings in universities. Therefore, globalization must be considered by nurse educators as they reevaluate ways of preparing nursing students to meet the health care needs of populations they currently serve and will care for in the future. Study abroad programs have been encouraged to be part of the college experience in the United States for more than 30 years; however, these programs have been relatively lacking in nursing education. Most of the study abroad programs described in the nursing literature are research-based or first-person accounts of an experience and provide little information about planning a study abroad program. This article describes a study abroad learning experience for senior nursing students and discusses the issues such as student selection, student safety, and available clinical experiences that need to be considered before undertaking such an endeavor.
Implementation of GIS-based highway safety analyses : bridging the gap

DOT National Transportation Integrated Search

2001-01-01

In recent years, efforts have been made to expand the analytical features of the Highway Safety Information System (HSIS) by integrating Geographic Information System (GIS) capabilities. The original version of the GIS Safety Analysis Tools was relea...
77 FR 14007 - Sunshine Act Meeting Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-08

... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Sunshine Act Meeting Notice Federal Register CITATION OF... THE MEETING: The Defense Nuclear Facilities Safety Board (Board) is expanding the matters to be.../ resolution of safety and technical issues across the defense nuclear facilities complex. Since this panel...
Building on the Past- Looking to the Future: Part 2: A Focus on Expanding Horizons

NASA Astrophysics Data System (ADS)

Nash, Sally K.; Rehm, Raymond B.; Wong, Teresa K.; Guidry, Richard W.; Wolf, Scott L.

2010-09-01

The history of space endeavors stretches far from the first liquid-fueled rocket created by the father of modern rocketry, Robert Goddard, in 1926 and will certainly extend far beyond the construction of the International Space Station(ISS) scheduled to be complete with the addition of the Permanent Multipurpose Module on STS-133/ULF5. National Aeronautics and Space Administration(NASA) and the ISS International Partners(IPs) will be the unrelenting venue used to satisfy the curiosities of man as we seek an understanding of space through various experiments(also referred to as payloads) conducted in microgravity. The NASA Payload Safety Review Panel(PSRP) continues to serve as the lead for the review and assessment of payload hardware to assure facility and crew safety. This is the second in a series of papers and presentations that illustrate challenges and lessons learned in the areas of communication, safety requirements, and processes which have been vital to the PSRP.
Building on the Past - Looking to the Future. Part 2: A Focus on Expanding Horizons

NASA Technical Reports Server (NTRS)

Nash, Sally K.; Rehm, Raymond; Wong, Teresa K.; Guidry, Richard; Wolf, Scott L.

2010-01-01

The history of space endeavors stretches far from the first liquid-fueled rocket created by the father of modern rocketry, Robert Goddard, in 1926 and will certainly extend far beyond the construction of the International Space Station (ISS) scheduled to be complete with the addition of the Permanent Multipurpose Module on STS-133/ULF5. National Aeronautics and Space Administration (NASA) and the ISS International Partners (IPs) will be the unrelenting venue used to satisfy the curiosities of man as we seek an understanding of space through various experiments (also referred to as payloads) conducted in microgravity. The NASA Payload Safety Review Panel (PSRP) continues to serve as the lead for the review and assessment of payload hardware to assure facility and crew safety. This is the second in a series of papers and presentations that illustrate challenges and lessons learned in the areas of communication, safety requirements, and processes which have been vital to the PSRP.
Balloon-Expandable Stent Graft for Treating Uretero-Iliac Artery Fistula

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

Guntau, Moritz, E-mail: guntau@med.uni-marburg.de; Hegele, Axel; Rheinheimer, Stephan

PurposeTo evaluate the safety, efficacy and outcome of percutaneous balloon-expandable covered stent graft placement for uretero-iliac artery fistula (UAF) treatment.MethodsThis retrospective study evaluated the single-center experience of percutaneous balloon-expandable covered stent graft placement (ADVANTA™, Atrium Hudson, NH, USA) in UAF. Data were obtained from a prospective institutional database. Patient follow-up included complications, symptoms recurrence and mortality rate.ResultsTen UAFs in eight patients (3 males; 5 females) with a mean age of 64.5 (35–77) years were identified. All patients had a history pelvic malignancy, extirpative surgery (n = 6), long-term ureteral stenting (n = 7) and pelvic radiation (n = 5). All procedures were completed successfully without complications.more » Thirty-day mortality rate was zero. At a median follow-up of 6 (1–60) months, one patient suffered recurrent hematuria requiring a secondary stent graft placement 26 months after the initial treatment. During follow-up, five patients died of the underlying disease (43, 66, 105, and 183 and 274 days after the last procedure).ConclusionPercutaneous balloon-expandable stent graft placement in UAF is a safe and effective treatment option. Implantation of stent grafts should be considered as treatment of choice in UAF.« less
Smoke Alarms for People Who Are Deaf or Hard-of-Hearing

MedlinePlus

... motels Expand sub-navigation Hotel fire safety tips Marijuana grow & extraction facilities Nightclubs and other assembly occupancies ... Fire behavior research Fire loss and injury research Benefits of home fire sprinklers Expand sub-navigation Environmental ...
Manufacturing and NDE of Large Composite Structures for Space Transportation at MSFC

NASA Technical Reports Server (NTRS)

McGill, Preston; Russell, Sam

2000-01-01

This paper presents the Marshall Space Flight Center's (MSFC's) vision to manufacture, increase safety and reduce the cost of launch vehicles. Nondestructive evaluations of large composite structures are tested for space transportation at MSFC. The topics include: 1) 6 1/2 Generations of Airplanes in a Century; 2) Shuttle Safety Upgrades; 3) Generations of Reusable Launch Vehicles; 4) RLV Technology Demonstration Path; 5) Second Generation; 6) Key NASA Requirements; 7) X-33 Elements; 8) Future-X Pathfinder Projects and Experiments; 9) Focus Area Technical Goals; 10) X-34 Expanded View; 11) X-38 Spacecraft with De-Orbit Propulsion Stage (DPS); 12) Deorbit Module (DM) Critical Design Review (CDR) Design; 13) Forward Structural Adapter (FSA) CDR Design; 14) X-38 DPS CDR Design; 15) RLV Focused Propulsion Technologies; and 16) Challenges in Technology. This paper is presented in viewgraph form.
Optical sensing technologies for rapid food safety and quality inspection

USDA-ARS?s Scientific Manuscript database

Public concerns for food safety and foodborne illness have risen in recent years. There is a need to expand efforts to prevent and mitigate any food contamination that can potentially be harmful to human health. Researchers at the Environmental Microbial and Food Safety Laboratory, ARS, USDA is one...
78 FR 48907 - Intertek Testing Services NA, Inc.: Grant of Expansion of Recognition and Request To Remove a...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-12

... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2007-0039... Recognition AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Notice. SUMMARY: This notice announces the Occupational Safety and Health Administration's final decision expanding the scope...
The private funding of public research. New directions in the administration of occupational and environmental health research.

PubMed

Cullen, M R; Upton, A; Buffler, P; Robins, T; Schenker, M; Fine, L; Wiencek, R; Widess, E; Chiazze, L

1994-12-01

Dr. Cullen: The experience with the new research models, starting with the prototypic experience of the rubber industry studies of the 1970s and expanding to diverse sectors of American industry in the 1980s, has yielded some important lessons for the future. In closing this symposium I shall try to summarize these briefly. Certain strengths of the evolving process seem common to each of the models. Alone and collectively, the new research arrangements have quite apparently served to increase substantially the pool of funds available to the academic sector for the study of occupational health and safety problems. As a consequence, a larger pool of investigators has participated in the research process, greatly strengthening the future academic capability and experience of our fragilely supported teaching centers. Combined with the involvement of the academic centers in the review process, there has been an undeniable broadening and deepening of the nation's research output and long-term capability in occupational health. On the side of the private sector, the new relationships have led to marked progress in the knowledge base about health and safety problems, with a heavily directed focus on those of greatest relevance to the industries involved. The credibility of the knowledge acquired has been enhanced, an important achievement in a society in which perception of truth is often as important as the truth itself! Because of the requirements of the process for broad involvement by the organizations which undertake these activities, health and safety have achieved far greater visibility and attention by corporate and union leaders who may have previously had no involvement in issues of health and safety.(ABSTRACT TRUNCATED AT 250 WORDS)
Safety and efficacy of self-expandable metal stents for obstructive proximal and distal large bowel cancer.

PubMed

Mitra, V; Hu, M; Majumdar, D; Krishnan, V; Chaudhury, B; Hancock, J; Dwarakanath, D

2017-03-01

Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction). The majority (88%) had self-expanded metal stents inserted for palliation. Technical and clinical success rates were 98.7% and 91.2%, respectively. One patient had stent-related perforation; there was no procedure-related mortality. Conclusion This study shows that self-expanded metal stent insertion in malignant colorectal obstruction is safe and effective and can be successfully delivered in a district general hospital with high technical and clinical success rates.
Empowering self-defense training.

PubMed

Thompson, Martha E

2014-03-01

The purpose of self-defense training is to expand people's options, yet it is often framed as a solely physical, and limiting, response to violence. I draw on my own experience as a self-defense instructor and that of others in the self-defense movement to argue that an empowerment approach to self-defense training contributes to the anti-violence movement in multiple ways: providing a pathway to increase women's and girls' safety and their potential for becoming powerful and effective social change agents right now, providing an informed and embodied understanding of violence, and offering comprehensive options to recognize, prevent, and interrupt violence.
Expanded HTA, Legitimacy and Independence

PubMed Central

Syrett, Keith

2016-01-01

This brief commentary seeks to develop the analysis of Daniels, Porteny and Urrutia of the implications of expansion of the scope of health technology assessment (HTA) beyond issues of safety, efficacy, and cost-effectiveness. Drawing in particular on experience in the United Kingdom, it suggests that such expansion can be understood not only as a response to the problem of insufficiency of evidence, but also to that of legitimacy. However, as expansion of HTA also renders it more visibly political in character, it is plausible that its legitimacy may be undermined, rather than enhanced by, independence from the policy process. PMID:27694685
Assessing the Safety of Expanded Polytetrafluoroethylene Synthetic Grafts in Living Donor Liver Transplantation: Graft Migration Into Hollow Viscous Organs - Diagnosis and Treatment Options.

PubMed

Hsu, Shih-Chao; Thorat, Ashok; Yang, Horng-Ren; Poon, Kin-Shing; Li, Ping-Chun; Yeh, Chun-Chieh; Chen, Te-Hung; Jeng, Long-Bin

2017-07-06

BACKGROUND Our recent studies have highlighted the importance and safety of backtable venoplasty for middle hepatic vein (MHV) and inferior right hepatic veins (IRHV) reconstruction using expanded polytetrafluoroethylene (ePTFE) vascular grafts. In this study, we aim to analyze the complications associated with ePTFE graft use and discuss the management of the rare, but, potentially life threatening complications directly related to ePTFE conduits. MATERIAL AND METHODS From January 2012 to October 2015 a total of 397 patients underwent living donor liver transplantation (LDLT). The ePTFE vascular grafts were used during the backtable venoplasty for outflow reconstruction in 262 of the liver allografts. Recipients who developed ePTFE-related complications were analyzed. RESULTS ePTFE-related complications developed in 1.52% (4/262) of the patients. One patient (0.38%) developed complete thrombosis with sepsis at 24 months post-transplantation and died due to multiorgan failure. Three patients (1.1%) developed graft migration into the second portion of the duodenum, without overt peritonitis. Surgical exploration and ePTFE graft removal was done in all the patients. One patient died due to overwhelming sepsis. CONCLUSIONS ePTFE graft migration into the duodenum causing perforation is a new set of complications that has been recently described in LDLT and can be treated effectively by surgical removal of the infected vascular graft and duodenal perforation closure. Despite of such complications, in our experience, ePTFE use in LDLT continues to have wide safety margin, with a complication rate of only 1.52%.

Aviation Safety Program Atmospheric Environment Safety Technologies (AEST) Project

NASA Technical Reports Server (NTRS)

Colantonio, Ron

2011-01-01

Engine Icing: Characterization and Simulation Capability: Develop knowledge bases, analysis methods, and simulation tools needed to address the problem of engine icing; in particular, ice-crystal icing Airframe Icing Simulation and Engineering Tool Capability: Develop and demonstrate 3-D capability to simulate and model airframe ice accretion and related aerodynamic performance degradation for current and future aircraft configurations in an expanded icing environment that includes freezing drizzle/rain Atmospheric Hazard Sensing and Mitigation Technology Capability: Improve and expand remote sensing and mitigation of hazardous atmospheric environments and phenomena
Innovative Advances in Connectivity and Community Pharmacist Patient Care Services: Implications for Patient Safety.

PubMed

Bacci, Jennifer L; Berenbrok, Lucas A

2018-06-07

The scope of community pharmacy practice has expanded beyond the provision of drug product to include the provision of patient care services. Likewise, the community pharmacist's approach to patient safety must also expand beyond prevention of errors during medication dispensing to include optimization of medications and prevention of adverse events throughout the entire medication use process. Connectivity to patient data and other healthcare providers has been a longstanding challenge in community pharmacy with implications for the delivery and safety of patient care. Here, we describe three innovative advances in connectivity in community pharmacy practice that enhance patient safety in the provision of community pharmacist patient care services across the entire medication use process. Specifically, we discuss the growing use of immunization information systems, quality improvement platforms, and health information exchanges in community pharmacy practice and their implications for patient safety. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Beyond Decision Making for Outdoor Leaders: Expanding the Safety Behavior Research Agenda

ERIC Educational Resources Information Center

Jackson, Jeff S.

2016-01-01

The study of safety behaviour of designated outdoor leaders primarily revolves around their decision making and judgement. The last ten years, however, have seen relatively little peer-reviewed research regarding guide or instructor safety cognition and behaviour. The narrow decision making focus of modern work makes for a field of study…
Fatality reduction by safety belts for front-seat occupants of cars and light trucks : updated and expanded estimates based on 1986-99 FARS data

DOT National Transportation Integrated Search

2000-12-01

The National Highway Traffic Safety Administration estimated in 1984 that manual 3-point safety belts : reduce the fatality risk of front-seat occupants of passenger cars by 45 percent relative to the unrestrained : occupant. The agency still relies ...
HIPAA's Individual Right of Access to Genomic Data: Reconciling Safety and Civil Rights.

PubMed

Evans, Barbara J

2018-01-04

In 2014, the United States granted individuals a right of access to their own laboratory test results, including genomic data. Many observers feel that this right is in tension with regulatory and bioethical standards designed to protect the safety of people who undergo genomic testing. This commentary attributes this tension to growing pains within an expanding federal regulatory program for genetic and genomic testing. The Genetic Information Nondiscrimination Act of 2008 expanded the regulatory agenda to encompass civil rights and consumer safety. The individual access right, as it applies to genomic data, is best understood as a civil-rights regulation. Competing regulatory objectives-safety and civil rights-were not successfully integrated during the initial rollout of genomic civil-rights regulations after 2008. Federal law clarifies how to prioritize safety and civil rights when the two come into conflict, although with careful policy design, the two need not collide. This commentary opens a dialog about possible solutions to advance safety and civil rights together. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.
Carbon Monoxide Poisoning - Multiple Languages

MedlinePlus

... Prevention Guidelines: You Can Prevent Carbon Monoxide Exposure - English PDF Prevention Guidelines: You Can Prevent Carbon Monoxide ... Expand Section Carbon Monoxide - Furnace Safety Fact Sheet - English PDF Carbon Monoxide - Furnace Safety Fact Sheet - العربية ( ...
PRB rail loadings shatter record

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

Buchsbaum, L.

Rail transport of coal in the Powder River Basin has expanded, with a record 2,197 trains loaded in a month. Arch Coal's Thunder basin mining complex has expanded by literally bridging the joint line railway. The dry fork mine has also celebrated its safety achievements. 4 photos.
Comparing the Affordable Care Act's Financial Impact on Safety-Net Hospitals in States That Expanded Medicaid and Those That Did Not.

PubMed

Dobson, Allen; DaVanzo, Joan E; Haught, Randy; Phap-Hoa, Luu

2017-11-01

Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals’ significant uncompensated care costs and shore up their financial stability. To examine how the ACA’s Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not. Using Medicare hospital cost reports for federal fiscal years 2012 and 2015, the authors compared changes in Medicaid inpatient days as a percentage of total inpatient days, Medicaid revenues as a percentage of total net patient revenues, uncompensated care costs as a percentage of total operating costs, and hospital operating margins. Medicaid expansion had a significant, favorable financial impact on safety-net hospitals. From 2012 to 2015, safety-net hospitals in expansion states, compared to those in nonexpansion states, experienced larger increases in Medicaid inpatient days and Medicaid revenues as well as reduced uncompensated care costs. These changes improved operating margins for safety-net hospitals in expansion states. Margins for safety-net hospitals in nonexpansion states, meanwhile, declined.
Biotherapeutics in non-clinical development: Strengthening the interface between safety, pharmacokinetics-pharmacodynamics and manufacturing.

PubMed

Ulrich, Peter; Blaich, Guenter; Baumann, Andreas; Fagg, Rajni; Hey, Adam; Kiessling, Andrea; Kronenberg, Sven; Lindecrona, Rikke Hvid; Mohl, Silke; Richter, Wolfgang F; Tibbitts, Jay; Crameri, Flavio; Weir, Lucinda

2018-04-01

Biological drugs comprise a wide field of different modalities with respect to structure, pharmacokinetics and pharmacological function. Considerable non-clinical experience in the development of proteins (e.g. insulin) and antibodies has been accumulated over the past thirty years. In order to improve the efficacy and the safety of these biotherapeutics, Fc modifications (e.g. Fc silent antibody versions), combinations (antibody-drug conjugates, protein-nanoparticle combinations), and new constructs (darpins, fynomers) have been introduced. In the last decade, advanced therapy medicinal products (ATMPs) in research and development have become a considerable and strongly growing part of the biotherapeutic portfolio. ATMPs consisting of gene and cell therapy modalities or even combinations of them, further expand the level of complexity, which already exists in non-clinical development strategies for biological drugs and has thereby led to a further diversification of expertise in safety and PKPD assessment of biological drugs. It is the fundamental rationale of the BioSafe meetings, held yearly in the EU and in the US, to convene experts on a regular basis and foster knowledge exchange and mutual understanding in this fast growing area. In order to reflect at least partially the variety of the biotherapeutics field, the 2016 EU BioSafe meeting addressed the following topics in six sessions: (i) In vitro Meets in vivo to Leverage Biologics Development (ii) New developments and regulatory considerations in the cell and gene therapy field (iii) CMC Challenges with Biologics development (iv) Minipigs in non-clinical safety assessment (v) Opportunities of PKPD Assessment in Less Common Administration Routes In the breakout sessions the following questions were discussed: (i) Cynomolgus monkey as a reprotoxicology Species: Impact of Immunomodulators on Early Pregnancy Maintenance (ii) Safety Risk of Inflammation and Autoimmunity Induced by Immunomodulators (iii) Experience with non-GMP Material in Pivotal Non-clinical Safety Studies to Support First in Man (FiM) Trials (iv) Safety Assessment of Combination Products for Non-oncology. Copyright © 2018 Elsevier Inc. All rights reserved.
An Approach for Validating Actinide and Fission Product Burnup Credit Criticality Safety Analyses: Criticality (k eff) Predictions

DOE PAGES

Scaglione, John M.; Mueller, Don E.; Wagner, John C.

2014-12-01

One of the most important remaining challenges associated with expanded implementation of burnup credit in the United States is the validation of depletion and criticality calculations used in the safety evaluation—in particular, the availability and use of applicable measured data to support validation, especially for fission products (FPs). Applicants and regulatory reviewers have been constrained by both a scarcity of data and a lack of clear technical basis or approach for use of the data. In this study, this paper describes a validation approach for commercial spent nuclear fuel (SNF) criticality safety (k eff) evaluations based on best-available data andmore » methods and applies the approach for representative SNF storage and transport configurations/conditions to demonstrate its usage and applicability, as well as to provide reference bias results. The criticality validation approach utilizes not only available laboratory critical experiment (LCE) data from the International Handbook of Evaluated Criticality Safety Benchmark Experiments and the French Haut Taux de Combustion program to support validation of the principal actinides but also calculated sensitivities, nuclear data uncertainties, and limited available FP LCE data to predict and verify individual biases for relevant minor actinides and FPs. The results demonstrate that (a) sufficient critical experiment data exist to adequately validate k eff calculations via conventional validation approaches for the primary actinides, (b) sensitivity-based critical experiment selection is more appropriate for generating accurate application model bias and uncertainty, and (c) calculated sensitivities and nuclear data uncertainties can be used for generating conservative estimates of bias for minor actinides and FPs. Results based on the SCALE 6.1 and the ENDF/B-VII.0 cross-section libraries indicate that a conservative estimate of the bias for the minor actinides and FPs is 1.5% of their worth within the application model. Finally, this paper provides a detailed description of the approach and its technical bases, describes the application of the approach for representative pressurized water reactor and boiling water reactor safety analysis models, and provides reference bias results based on the prerelease SCALE 6.1 code package and ENDF/B-VII nuclear cross-section data.« less
Expertise in physiological breech birth: A mixed-methods study.

PubMed

Walker, Shawn; Parker, Pam; Scamell, Mandie

2018-06-01

The safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of "expertise" remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service. We performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience = 135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5-30 upright breech births). Data were pooled and analyzed using constant comparative methods. Expertise is defined by its ongoing function, the generation of comparatively good outcomes, and confidence and competence among colleagues. Although clinical experience is important, expertise is developed and expressed in social clinical roles, which expand as experience grows: clinician, mentor, specialist, and expert. To develop expertise within a service, clinicians who have an interest in breech birth should be supported to perform these roles within specialist teams. Specialist breech teams may facilitate the development of expertise within maternity care settings. Evaluation of expertise based on enablement of women and colleagues, as well as outcomes, will potentially avoid the pitfalls of alienation produced by some forms of specialist authority. © 2017 Wiley Periodicals, Inc.
Preoperative Embolization of Extra-axial Hypervascular Tumors with Onyx

PubMed Central

Fusco, Matthew R.; Salem, Mohamed M.; Reddy, Arra S.; Ogilvy, Christopher S.; Kasper, Ekkehard M.; Thomas, Ajith J.

2016-01-01

Objective Preoperative endovascular embolization of intracranial tumors is performed to mitigate anticipated intraoperative blood loss. Although the usage of a wide array of embolic agents, particularly polyvinyl alcohol (PVA), has been described for a variety of tumors, literature detailing the efficacy, safety and complication rates for the usage of Onyx is relatively sparse. Materials and Methods We reviewed our single institutional experience with pre-surgical Onyx embolization of extra-axial tumors to evaluate its efficacy and safety and highlight nuances of individualized cases. Results Five patients underwent pre-surgical Onyx embolization of large or giant extra-axial tumors within 24 hours of surgical resection. Four patients harbored falcine or convexity meningiomas (grade I in 2 patients, grade II in 1 patient and grade III in one patient), and one patient had a grade II hemangiopericytoma. Embolization proceeded uneventfully in all cases and there were no complications. Conclusion This series augments the expanding literature confirming the safety and efficacy of Onyx in the preoperative embolization of extra-axial tumors, underscoring its advantage of being able to attain extensive devascularization via only one supplying pedicle. PMID:27114961
Preoperative Embolization of Extra-axial Hypervascular Tumors with Onyx.

PubMed

Fusco, Matthew R; Salem, Mohamed M; Gross, Bradley A; Reddy, Arra S; Ogilvy, Christopher S; Kasper, Ekkehard M; Thomas, Ajith J

2016-03-01

Preoperative endovascular embolization of intracranial tumors is performed to mitigate anticipated intraoperative blood loss. Although the usage of a wide array of embolic agents, particularly polyvinyl alcohol (PVA), has been described for a variety of tumors, literature detailing the efficacy, safety and complication rates for the usage of Onyx is relatively sparse. We reviewed our single institutional experience with pre-surgical Onyx embolization of extra-axial tumors to evaluate its efficacy and safety and highlight nuances of individualized cases. Five patients underwent pre-surgical Onyx embolization of large or giant extra-axial tumors within 24 hours of surgical resection. Four patients harbored falcine or convexity meningiomas (grade I in 2 patients, grade II in 1 patient and grade III in one patient), and one patient had a grade II hemangiopericytoma. Embolization proceeded uneventfully in all cases and there were no complications. This series augments the expanding literature confirming the safety and efficacy of Onyx in the preoperative embolization of extra-axial tumors, underscoring its advantage of being able to attain extensive devascularization via only one supplying pedicle.
The Tuscan Mobile Simulation Program: a description of a program for the delivery of in situ simulation training.

PubMed

Ullman, Edward; Kennedy, Maura; Di Delupis, Francesco Dojmi; Pisanelli, Paolo; Burbui, Andrea Giuliattini; Cussen, Meaghan; Galli, Laura; Pini, Riccardo; Gensini, Gian Franco

2016-09-01

Simulation has become a critical aspect of medical education. It allows health care providers the opportunity to focus on safety and high-risk situations in a protected environment. Recently, in situ simulation, which is performed in the actual clinical setting, has been used to recreate a more realistic work environment. This form of simulation allows for better team evaluation as the workers are in their traditional roles, and can reveal latent safety errors that often are not seen in typical simulation scenarios. We discuss the creation and implementation of a mobile in situ simulation program in emergency departments of three hospitals in Tuscany, Italy, including equipment, staffing, and start-up costs for this program. We also describe latent safety threats identified in the pilot in situ simulations. This novel approach has the potential to both reduce the costs of simulation compared to traditional simulation centers, and to expand medical simulation experiences to providers and healthcare organizations that do not have access to a large simulation center.
Revised fire safety system cuts emergency response time.

PubMed

Keir, D C

1979-03-01

As Margaret R. Pardee Memorial Hospital, Hendersonville, NC. expanded, fire safety plans had to be reevaluated. With each new addition, fire safety responsibilities for hospital personnel multiplied and overlapped. Confusion resulted, and a revised, simplified, and coordinated fire safety system was devised. Seventeen false alarms within one year, caused by a faulty sprinkler system, gave hospital personnel ample opportunity to test the system and iron out unexpected problems.
Development and Testing of a Nutrition, Food Safety, and Physical Activity Checklist for EFNEP and FSNE Adult Programs

ERIC Educational Resources Information Center

Bradford, Traliece; Serrano, Elena L.; Cox, Ruby H.; Lambur, Michael

2010-01-01

Objective: To develop and assess reliability and validity of the Nutrition, Food Safety, and Physical Activity Checklist to measure nutrition, food safety, and physical activity practices among adult Expanded Food and Nutrition Education Program (EFNEP) and Food Stamp Nutrition Education program (FSNE) participants. Methods: Test-retest…
Falls and fear of falling among community-dwelling seniors: the dynamic tension between exercising precaution and striving for independence.

PubMed

Ward-Griffin, Catherine; Hobson, Sandra; Melles, Pauline; Kloseck, Marita; Vandervoort, Anthony; Crilly, Richard

2004-01-01

The purpose of this phenomenological study was to explore the everyday experience of community-dwelling elders, with particular attention to seniors' perceptions of safety, fear of falling, independence, and quality of life. We also aimed to identify contextual factors that influence the health of elders who had fallen and/or had a fear of falling. Data from in-depth interviews with a purposeful sample (n = 9) of elders were analysed using interpretative analysis procedures. Both individual and team analysis was undertaken until interpretations of the experiences of the participants were inductively developed and crystallized into a holistic interpretation of the participants' shared experience. The holistic experience was comprised of two opposing, dynamic life forces: exercising precaution and striving for independence. Within each life force, participants used five major strategies that simultaneously constrained and expanded their life space. Health-promoting practice and policy implications, as well as areas for further research, are discussed.
Programmable Infusion Pumps in ICUs: An Analysis of Corresponding Adverse Drug Events

PubMed Central

Bower, Anthony G.; Paddock, Susan M.; Hilborne, Lee H.; Wallace, Peggy; Rothschild, Jeffrey M.; Griffin, Anne; Fairbanks, Rollin J.; Carlson, Beverly; Panzer, Robert J.; Brook, Robert H.

2007-01-01

Background Patients in intensive care units (ICUs) frequently experience adverse drug events involving intravenous medications (IV-ADEs), which are often preventable. Objectives To determine how frequently preventable IV-ADEs in ICUs match the safety features of a programmable infusion pump with safety software (“smart pump”) and to suggest potential improvements in smart-pump design. Design Using retrospective medical-record review, we examined preventable IV-ADEs in ICUs before and after 2 hospitals replaced conventional pumps with smart pumps. The smart pumps alerted users when programmed to deliver duplicate infusions or continuous-infusion doses outside hospital-defined ranges. Participants 4,604 critically ill adults at 1 academic and 1 nonacademic hospital. Measurements Preventable IV-ADEs matching smart-pump features and errors involved in preventable IV-ADEs. Results Of 100 preventable IV-ADEs identified, 4 involved errors matching smart-pump features. Two occurred before and 2 after smart-pump implementation. Overall, 29% of preventable IV-ADEs involved overdoses; 37%, failures to monitor for potential problems; and 45%, failures to intervene when problems appeared. Error descriptions suggested that expanding smart pumps’ capabilities might enable them to prevent more IV-ADEs. Conclusion The smart pumps we evaluated are unlikely to reduce preventable IV-ADEs in ICUs because they address only 4% of them. Expanding smart-pump capabilities might prevent more IV-ADEs. PMID:18095043
Changes to Puerto Rico's motorcycle rider law.

DOT National Transportation Integrated Search

2017-04-01

In 2007 Puerto Rico enacted Law 107, a motorcycle safety law that introduced or expanded previous safety-related statutes : such as requiring motorcycle riders and passengers to wear (1) reflective vests at night and protective gear at all times of d...
Analysis of new entrant motor carrier safety performance and compliance using SafeStat

DOT National Transportation Integrated Search

2000-03-01

This report documents the findings of a special study undertaken to update, confirm and expand upon previous studies on the comparative (to experienced carriers) safety performance and compliance of large commercial motor vehicle operators (motor car...

Training strategies and outcomes of ab interno trabeculectomy with the trabectome

PubMed Central

Fallano, Katherine; Bussel, Igor; Kagemann, Larry; Lathrop, Kira L.; Loewen, Nils

2017-01-01

Plasma-mediated ab interno trabeculectomy with the trabectome was first approved by the US Food and Drug Administration in 2004 for use in adult and pediatric glaucomas. Since then, increased clinical experience and updated outcome data have led to its expanded use, including a range of glaucomas and angle presentations, previously deemed to be relatively contraindicated. The main benefits are a high degree of safety, ease, and speed compared to traditional filtering surgery and tube shunts. The increasing burden of glaucoma and expanding life expectancy has resulted in demand for well-trained surgeons. In this article, we discuss the results of trabectome surgery in standard and nonstandard indications. We present training strategies of the surgical technique that include a pig eye model, and visualization exercises that can be performed before and at the conclusion of standard cataract surgery in patients who do not have glaucoma. We detail the mechanism of enhancing the conventional outflow pathway and describe methods of visualization and function testing. PMID:28529695
Comprehensive Lifecycle for Assuring System Safety

NASA Technical Reports Server (NTRS)

Knight, John C.; Rowanhill, Jonathan C.

2017-01-01

CLASS is a novel approach to the enhancement of system safety in which the system safety case becomes the focus of safety engineering throughout the system lifecycle. CLASS also expands the role of the safety case across all phases of the system's lifetime, from concept formation to decommissioning. As CLASS has been developed, the concept has been generalized to a more comprehensive notion of assurance becoming the driving goal, where safety is an important special case. This report summarizes major aspects of CLASS and contains a bibliography of papers that provide additional details.
Computation of Low Speed Cavity Noise

NASA Technical Reports Server (NTRS)

Blech, Richard A. (Technical Monitor); Loh, Ching Y.

2004-01-01

Over the last five years, the Aircraft Icing Project of the NASA Aviation Safety Program has developed a number of in-flight icing education and training aids to support increased awareness for pilots of the hazards associated with atmospheric icing conditions. Through the development of this work, a number of new instructional design approaches and media delivery methods have been introduced to enhance the learning experience, expand user interactivity and participation, and, hopefully, increase the learner retention rates. The goal of using these multimedia techniques is to increase the effectiveness of the training materials. This paper will describe the multimedia technology that has been introduced and give examples of how it was used.
Safety Performance of Exterior Wall Insulation Material Based on Large Security Concept

NASA Astrophysics Data System (ADS)

Zuo, Q. L.; Wang, Y. J.; Li, J. S.

2018-05-01

In order to evaluate the fire spread characteristics of building insulation materials under corner fire, an experiment is carried out with small-scale fire spread test system. The change rule of the parameters such as the average height of the flame, the average temperature of the flame and the shape of the flame are analyzed. The variations of the fire spread characteristic parameters of the building insulation materials are investigated. The results show that the average temperature of Expanded Polystyrene (EPS) board, with different thickness, decrease - rise - decrease - increase. During the combustion process, the fire of 4cm thick plate spreads faster.
Arterial Embolization for the Treatment of Renal Masses and Traumatic Renal Injuries.

PubMed

Ramaswamy, Raja S; Darcy, Michael D

2016-09-01

Renal artery embolization (RAE) for a variety of indications has been performed for several decades. RAE techniques have been refined over time for clinical efficacy and a more favorable safety profile. Owing to improved catheters, embolic agents for precise delivery, and clinical experience, RAE is increasingly used as an adjunct to, or as the preferred alternative to surgical interventions. The indications for RAE are expanding for many urologic and medical conditions. In this article, we focus on the role and technical aspects of RAE in the treatment of renal masses and traumatic renal injuries. Copyright © 2016 Elsevier Inc. All rights reserved.
Obey the Rules Governing Chemical Hazards in Schools.

ERIC Educational Resources Information Center

Christiansen, Carl L.

1988-01-01

Describes how the largest school district in Utah complied with the regulations for school safety--the Occupational Safety and Health Administration expanded chemical hazard communication standard and the Environmental Protection Agency Emergency Planning and Community Right-to-Know Act of 1986. (MLF)
Platelet-lysate-expanded mesenchymal stromal cells as a salvage therapy for severe resistant graft-versus-host disease in a pediatric population.

PubMed

Lucchini, Giovanna; Introna, Martino; Dander, Erica; Rovelli, Attilio; Balduzzi, Adriana; Bonanomi, Sonia; Salvadè, Agnese; Capelli, Chiara; Belotti, Daniela; Gaipa, Giuseppe; Perseghin, Paolo; Vinci, Paola; Lanino, Edoardo; Chiusolo, Patrizia; Orofino, Maria Grazia; Marktel, Sarah; Golay, Jose; Rambaldi, Alessandro; Biondi, Andrea; D'Amico, Giovanna; Biagi, Ettore

2010-09-01

Despite advances in graft-versus-host-disease (GVHD) treatment, it is estimated that overall survival (OS) at 2 years for hematopoietic cell transplantation (HCT) recipients who experience steroid-resistant GVHD is 10%. Among recent therapeutic approaches for GVHD treatment, mesenchymal stromal cells (MSCs) hold a key position. We describe a multicenter experience of 11 pediatric patients diagnosed with acute or chronic GVHD (aGVHD, cGVHD) treated for compassionate use with GMP-grade unrelated HLA-disparate donors' bone marrow-derived MSCs, expanded in platelet-lysate (PL)-containing medium. Eleven patients (aged 4-15 years) received intravenous (i.v.) MSCs for aGVHD or cGVHD, which was resistant to multiple lines of immunosuppression. The median dose was 1.2 x 10(6)/kg (range: 0.7-3.7 x 10(6)/kg). No acute side effects were observed, and no late side effects were reported at a median follow-up of 8 months (range: 4-18 months). Overall response was obtained in 71.4% of patients, with complete response in 23.8% of cases. None of our patients presented GVHD progression upon MSC administration, but 4 patients presented GVHD recurrence 2 to 5 months after infusion. Two patients developed chronic limited GVHD. This study underlines the safety of PL-expanded MSC use in children. MSC efficacy seems to be greater in aGVHD than in cGVHD, even after failure of multiple lines of immunosuppression. Copyright (c) 2010 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
78 FR 77554 - Reports, Forms and Record Keeping Requirements; Agency Information Collection Activity Under OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... information described is the ``Consolidated Child Restraint System Registration, Labeling and Defect...: National Highway Traffic Safety Administration Title: Consolidated Child Restraint System Registration... the Federal motor vehicle safety standard for child restraint systems (CRSs) to expand its...
Food Safety - Multiple Languages

MedlinePlus

... dialect)) PDF Centers for Disease Control and Prevention French (français) Expand Section Keep Food and Water Safe After a Disaster or Emergency - ... Water Safe After a Disaster or Emergency - français (French) HTML ... Centers for Disease Control and Prevention Haitian Creole (Kreyol ayisyen) Expand Section Keep Food and Water Safe After a Disaster or Emergency - ...
Expanding the specialty of occupational and environmental medicine: the role of the chief health officer. The Sappington Lecture.

PubMed

Baker, E L

1997-09-01

Passage of the Occupational Safety and Health Act in 1971 represented a major milestone for occupational and environmental medicine. Creation of the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) flowed directly from the legislation, and the specialty of occupational medicine entered a new era. As the 25th anniversaries of OSHA and NIOSH are celebrated, consideration of the future of the specialty of occupational and environmental medicine seems timely. In this lecture, an expanded role for the specialty is proposed, based on an analysis of the forces shaping the practice of public health and the opportunities that these forces present. This analysis suggests considering the concept of a "Chief Health Officer" serving the broad health needs of the workplace.
Clinician perceptions of personal safety and confidence to manage inpatient aggression in a forensic psychiatric setting.

PubMed

Martin, T; Daffern, M

2006-02-01

Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention.
Avation Safety Reporting System (ASRS) 40th Anniversary

NASA Image and Video Library

2016-09-28

Avation Safety Reporting System (ASRS) 40th Anniversary lunch and open house at the Sunnyvale office. Thomas A Edwards, Deputy Center Director NASA Ames (Left), presents a plaque On the anniversary of the aviation safety reporting system, this award is in recognition of 18 years of outstanding leadership as Program Director, resulting in strong program growth, expanded partnership and a widely recognized impact on National and Global transportation safety. Presented to Linda J. Connell, ASRS Program Director (Right)
76 FR 31853 - Safety Zone; Commencement Bay, Tacoma, WA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... inspection or copying at the Docket Management Facility (M-30), U.S. Department of Transportation, West..., to include rescue simulations performed by low-flying helicopters. This rule expands the safety zone... 12866, Regulatory Planning and Review, and does not require an assessment of potential costs and...
Status of Occupational Health and Safety and Related Challenges in Expanding Economy of Tanzania.

PubMed

Mrema, Ezra J; Ngowi, Aiwerasia V; Mamuya, Simon H D

2015-01-01

Occupational health and safety is related with economic activities undertaken in the country. As the economic activities grow and expand, occupational injuries and diseases are more likely to increase among workers in different sectors of economy such as agriculture, mining, transport, and manufacture. This may result in high occupational health and safety services demand, which might be difficult to meet by developing countries that are prioritizing economic expansion without regard to their impact on occupational health and safety. To describe the status of occupational health and safety in Tanzania and outline the challenges in provision of occupational health services under the state of an expanding economy. Tanzania's economy is growing steadily, with growth being driven by communications, transport, financial intermediation, construction, mining, agriculture, and manufacturing. Along with this growth, hazards emanating from work in all sectors of the economy have increased and varied. The workers exposed to these hazards suffer from illness and injuries and yet they are not provided with adequate occupational health services. Services are scanty and limited to a few enterprises that can afford it. Existing laws and regulations are not comprehensive enough to cover the entire population. Implementation of legislation is weak and does not protect the workers. Most Tanzanians are not covered by the occupational health and safety law and do not access occupational health services. Thus an occupational health and safety services strategy, backed by legislations and provided with the necessary resources (competent experts, financial and technological resources), is a necessity in Tanzania. The existing legal provisions require major modifications to meet international requirements and standards. OHS regulations and legislations need refocusing, revision, and strengthening to cover all working population. Capacities should be improved through training and research to enable enforcement. Finally the facilities and resources should be made available for OHS services to match with the growing economy. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Study design and rationale of the 'Balloon-Expandable Cobalt Chromium SCUBA Stent versus Self-Expandable COMPLETE-SE Nitinol Stent for the Atherosclerotic ILIAC Arterial Disease (SENS-ILIAC Trial) Trial': study protocol for a randomized controlled trial.

PubMed

Choi, Woong Gil; Rha, Seung Woon; Choi, Cheol Ung; Kim, Eung Ju; Oh, Dong Joo; Cho, Yoon Hyung; Park, Sang Ho; Lee, Seung Jin; Hur, Ae Yong; Ko, Young Guk; Park, Sang Min; Kim, Ki Chang; Kim, Joo Han; Kim, Min Woong; Kim, Sang Min; Bae, Jang Ho; Bong, Jung Min; Kang, Won Yu; Seo, Jae Bin; Jung, Woo Yong; Cho, Jang Hyun; Kim, Do Hoi; Ahn, Ji Hoon; Kim, Soo Hyun; Jang, Ji Yong

2016-06-25

The self-expandable COMPLETE™ stent (Medtronic) has greater elasticity, allowing it to regain its shape after the compression force reduces, and has higher trackability, thus is easier to maneuver through tortuous vessels, whereas the balloon-expandable SCUBA™ stent (Medtronic) has higher radial stiffness and can afford more accurate placement without geographic miss, which is important in aortoiliac bifurcation lesions. To date, there have been no randomized control trials comparing efficacy and safety between the self-expanding stent and balloon-expandable stent in advanced atherosclerotic iliac artery disease. The purpose of our study is to examine primary patency (efficacy) and incidence of stent fracture and geographic miss (safety) between two different major representative stents, the self-expanding nitinol stent (COMPLETE-SE™) and the balloon-expanding cobalt-chromium stent (SCUBA™), in stenotic or occlusive iliac arterial lesions. This trial is designed as a prospective, randomized, multicenter trial to demonstrate a noninferiority of SCUBA™ stent to COMPLETE-SE™ stent following balloon angioplasty in iliac arterial lesions, and a total of 280 patients will be enrolled. The primary end point of this study is the rate of primary patency in the treated segment at 12 months after intervention as determined by catheter angiography, computed tomography angiography, or duplex ultrasound. The SENS-ILIAC trial will give powerful insight into whether the stent choice according to deployment mechanics would impact stent patency, geographic miss, or stent fracture in patients undergoing stent implantation in iliac artery lesions. National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier: NCT01834495 ), registration date: May 8, 2012.
Virtual Road Safety Audits: Recommended Procedures for Using Driving Simulation and Technology to Expand Existing Practices

DOT National Transportation Integrated Search

2018-02-02

One approach that has been proposed to address the limitations of the current reactive safetymonitoring approaches is the use of road safety audits (RSAs). As part of an RSA, the existing or expected characteristics and traffic conditions of a locati...
Exploration of Heterogeneity in Distributed Research Network Drug Safety Analyses

ERIC Educational Resources Information Center

Hansen, Richard A.; Zeng, Peng; Ryan, Patrick; Gao, Juan; Sonawane, Kalyani; Teeter, Benjamin; Westrich, Kimberly; Dubois, Robert W.

2014-01-01

Distributed data networks representing large diverse populations are an expanding focus of drug safety research. However, interpreting results is difficult when treatment effect estimates vary across datasets (i.e., heterogeneity). In a previous study, risk estimates were generated for selected drugs and potential adverse outcomes. Analyses were…
Initiation of Insensitive High Explosives Using Multiple Wave Interactions

NASA Astrophysics Data System (ADS)

Francois, Elizabeth; Burritt, Rosmary; Biss, Matt; Bowden, Patrick

2017-06-01

Insensitive High Explosives (IHEs) increase safety in many types of weapons. However, the safety comes at the cost of performance. Initiation of IHE requires large boosters and powerful detonators as well. Multipoint initiation is being utilized to exploit explosive wave interactions to create overdriven states, greatly facilitating the initiation of IHEs. This presentation will build from recent explosive experiments where the minimum spot size for single-point initiation in PBX 9502 was determined. Below this threshold, PBX 9502 could not be initiated. This was then expanded to three initiation points, which were smaller this threshold. Measurements of the velocity and pressure of the wave interactions were measured using Photon Doppler Velocimetry (PDV). Initiation was observed, and the resulting pressures at the double and triple points were found to be above the CJ state for PBX 9502. Based on these results, further tests were conducted to isolate and measure the longevity and pressure of this phenomenon using cut-back tests. All results will be presented and discussed.
NASA's Commercial Crew Program, the Next Step in U.S. Space Transportation

NASA Technical Reports Server (NTRS)

Mango, Edward J., Jr.

2013-01-01

The Commercial Crew Program (CCP) is leading NASA's efforts to develop the next U.S. capability for crew transportation and rescue services to and from the International Space Station (ISS) by the middecade timeframe. The outcome of this capability is expected to stimulate and expand the U.S. space transportation industry. NASA is relying on its decades of human space flight experience to certify U.S. crewed vehicles to the ISS and is doing so in a two phase certification approach. NASA certification will cover all aspects of a crew transportation system, including: Development, test, evaluation, and verification. Program management and control. Flight readiness certification. Launch, landing, recovery, and mission operations. Sustaining engineering and maintenance/upgrades. To ensure NASA crew safety, NASA certification will validate technical and performance requirements, verify compliance with NASA requirements, validate that the crew transportation system operates in the appropriate environments, and quantify residual risks. The Commercial Crew Program will present progress to date and how it manages safety and reduces risk.
The RESTORE program of restorative justice for sex crimes: vision, process, and outcomes.

PubMed

Koss, Mary P

2014-06-01

The article reports empirical evaluation of RESTORE, a restorative justice (RJ) conferencing program adapted to prosecutor-referred adult misdemeanor and felony sexual assaults. RESTORE conferences included voluntary enrollment, preparation, and a face-to-face meeting where primary and secondary victims voice impacts, and responsible persons acknowledge their acts and together develop a re-dress plan that is supervised for 1 year. Process data included referral and consent rates, participant characteristics, observational ratings of conferences compared with program design, services delivered, and safety monitoring. Outcome evaluation used 22 cases to assess (a) pre-post reasons for choosing RESTORE, (b) preparation and conference experiences, (c) overall program and justice satisfaction, and (d) completion rates. This is the first peer-reviewed quantitative evaluation of RJ conferencing for adult sexual assault. Although the data have limitations, the results support cautious optimism regarding feasibility, safety, and satisfactory outcomes. They help envision how conferencing could expand and individualize justice options for sexual assault.

In-Flight Icing Training for Pilots Using Multimedia Technology

NASA Technical Reports Server (NTRS)

Burke, Kevin M.; VanZante, Judith Foss; Bond, Thomas H.

2004-01-01

Over the last five years, the Aircraft Icing Project of the NASA Aviation Safety Program has developed a number of in-flight icing education and training aids to support increased awareness for pilots of the hazards associated with atmospheric icing conditions. Through the development of this work, a number of new instructional design approaches and media delivery methods have been introduced to enhance the learning experience, expand user interactivity and participation, and, hopefully, increase the learner retention rates. The goal of using these multimedia techniques is to increase the effectiveness of the training materials. This paper will describe the mutlimedia technology that has been introduced and give examples of how it was used.
78 FR 35976 - Petitions for Modification of Application of Existing Mandatory Safety Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

.... (4) Training will be provided for operators to lower the grader blade to provide additional stopping... surface: (1) The operator will pump expanding cement slurry down the well to form a plug which runs from... operator will pump expanding cement slurry down the well to form a plug which runs from at least 200 feet...
76 FR 72666 - Pipeline Safety: Expanding the Use of Excess Flow Valves in Gas Distribution Systems to...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-25

... technical feasibility and cost of the installation of such valves; (D) The public safety benefits of the... public comment regarding the technical challenges, and the potential costs and the potential benefits of... a cost-benefit perspective. DATES: Persons interested in submitting written comments on this ANPRM...
Child Safety - Multiple Languages

MedlinePlus

... Cantonese dialect) (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Karen (S’gaw Karen) Korean (한국어) Nepali (नेपा ... हिन्दी (Hindi) Bilingual PDF Health Information Translations Japanese (日本語) Expand Section Child Safety Checklist - 日本語 (Japanese) ...
Responding to the Unthinkable: School Crisis Response and Recovery

ERIC Educational Resources Information Center

Cowan, Katherine C.; Rossen, Eric

2014-01-01

The mental health implications of crisis exposure have emerged as a critical and challenging facet of school safety and crisis response, expanding our focus to encompass both psychological and physical safety, as well as prevention and recovery. Best practice reflects this evolution in our understanding and encompasses the continuum of crisis and…
78 FR 4354 - Proposed Establishment of Area Navigation (RNAV) Routes; OR

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

... would enhance safety and efficiency, expand the use of RNAV in the National Airspace System, and provide.... The FAA's authority to issue rules regarding aviation safety is found in Title 49 of the United States... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 71 [Docket No. FAA-2012...
Orbit transfer vehicle engine study, phase A, extension 1: Volume 2: Study results

NASA Technical Reports Server (NTRS)

Mellish, J. A.

1981-01-01

Because of the advantage of the Advanced Expander Cycle Engine brought out in initial studies, further design optimization and comparative analyses were undertaken. The major results and conclusion derived are summarized. The primary areas covered are (1) thrust chamber geometry optimization, (2) expander cycle optimization, (3) alternate low thrust capability, (4) safety and reliability, (5) development risk comparison, and (6) cost comparisons. All of the results obtained were used to baseline the initial design concept for the OTV Advanced Expander Cycle Engine Point Design Study.
Mesenchymal Stem Cell Transplantation in Multiple Sclerosis

PubMed Central

Cohen, Jeffrey A.

2013-01-01

Mesenchymal stem cells (MSCs) are a pluripotent non-hematopoietic precursor cells that can be isolated from bone marrow and numerous other tissues, culture-expanded to purity, and induced to differentiate in vitro and in vivo into mesodermal derivatives. MSCs exhibit many phenotypic and functional similarities to pericytes. The immunomodulatory, tissue protective, and repair-promoting properties of MSCs demonstrated both in vitro and in animal models make them an attractive potential therapy for MS and other conditions characterized by inflammation and/or tissue injury. Other potential advantages of MSCs as a therapeutic include the relative ease of culture expansion, relative immunoprivilege allowing allogeneic transplantation, and their ability to traffic from blood to areas of tissue allowing intravascular administration. The overall published experience with MSC transplantation in MS is modest, but several small case series and preliminary studies yielded promising results. Several groups, including us, recently initiated formal studies of autologous, culture-expanded, bone-marrow-derived MSC transplantation in MS. Although there are several potential safety concerns, to date, the procedure has been well tolerated. Future studies that more definitively assess efficacy also will need to address several technical issues. PMID:23294498
Initial perceptions of key stakeholders in Ontario regarding independent prescriptive authority for pharmacists.

PubMed

Pojskic, Nedzad; MacKeigan, Linda; Boon, Heather; Austin, Zubin

2014-01-01

A number of jurisdictions, both in Canada and internationally, have recently expanded pharmacists' scope of practice to allow prescriptive authority. To ascertain the initial perceptions of the Ontario government and health professional stakeholder groups regarding the prospect of prescriptive authority for pharmacists. Qualitative research methods were used; data sources were policy documents and semi-structured interviews with key informants from the Ontario government and pharmacy and medical professional organizations. Purposive and snowball sampling strategies were used to identify 17 key informants. Fifty-one relevant policy documents were retrieved through searches of organizational websites and interviewee suggestions. Interview transcripts and documents were content analyzed independently by 2 researchers; and once consensus was achieved on key themes, the primary investigator analyzed the remainder. Pharmacy organizations and Ontario government representatives both expressed support for pharmacist prescriptive authority, suggesting that it would enhance patient access to primary care. Medical organizations were opposed to this expanded pharmacist role, arguing that pharmacists' lack of training and experience in diagnosis and prescribing would endanger patient safety. Other concerns were fragmentation of care and pharmacists' lack of access to patient clinical information. Some government and pharmacy informants felt that pharmacist prescribing would decrease health system costs through substitution of cheaper health professionals for physicians, while others felt that costs would increase due to increased utilization of services. Medical organizations preferred delegated medical authority as the policy alternative to pharmacist prescribing. Widely different views were expressed by the Ontario government and pharmacy organizations on the one hand and medical professional organizations on the other hand, regarding the potential impact of pharmacist prescribing on patient safety and access to primary care. This is likely due, at least in part, to the lack of evidence on the expected impact of this expanded pharmacist role. More research is needed to help inform discussions regarding this issue. Copyright © 2014 Elsevier Inc. All rights reserved.
Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases.

PubMed

van Halsema, Emo E; Wong Kee Song, Louis M; Baron, Todd H; Siersema, Peter D; Vleggaar, Frank P; Ginsberg, Gregory G; Shah, Pari M; Fleischer, David E; Ratuapli, Shiva K; Fockens, Paul; Dijkgraaf, Marcel G W; Rando, Giacomo; Repici, Alessandro; van Hooft, Jeanin E

2013-01-01

Temporary placement of self-expandable stents has been increasingly used for the management of benign esophageal diseases. To evaluate the safety of endoscopic removal of esophageal self-expandable stents placed for the treatment of benign esophageal diseases. Multicenter retrospective study. Six tertiary care centers in the United States and Europe. A total of 214 patients with benign esophageal diseases undergoing endoscopic stent removal. Endoscopic stent removal. Endoscopic techniques for stent removal, time to stent removal, and adverse events related to stent removal. A total of 214 patients underwent a total of 329 stent extractions. Stents were mainly placed for refractory strictures (49.2%) and fistulae (49.8%). Of the removed stents, 52% were fully covered self-expandable metal stents (FCSEMSs), 28.6% were partially covered self-expandable metal stents (PCSEMSs), and 19.5% were self-expandable plastic stents. A total of 35 (10.6%) procedure-related adverse events were reported, including 7 (2.1%) major adverse events. Multivariate analysis revealed that use of PCSEMSs (P < .001) was a risk factor for adverse events during stent removal. Favorable factors for successful stent removal were FCSEMSs (P ≤ .012) and stent migration (P = .010). No significant associations were found for stent indwelling time (P = .145) and stent embedding (P = .194). Retrospective analysis, only tertiary care centers. With an acceptable major adverse event rate of 2.1%, esophageal stent removal in the setting of benign disease was found to be a safe and feasible procedure. FCSEMSs were more successfully removed than self-expandable plastic stents and PCSEMSs. Adverse events caused by stent removal were not time dependent. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Covered Balloon-Expanding Stents in Airway Stenosis.

PubMed

Majid, Adnan; Kheir, Fayez; Chung, Jey; Alape, Daniel; Husta, Bryan; Oh, Scott; Folch, Erik

2017-04-01

The balloon-expanding stents are widely available but rarely described for use within the tracheobronchial tree. This report describes our experience with these stents in airway stenosis particularly as a lobar salvage therapy. This was a retrospective review of all records in which the balloon-expanding stents were used at a tertiary medical center. Ages, sex, location of stenosis, etiology of stenosis, stent size, duration of stent placement and associated interventions for airway stenosis were recorded. Patient's self-reported respiratory symptoms, dyspnea scale, and radiographic imaging at baseline and after stent placement were also reported. Twenty-one Atrium iCAST stents were inserted in 18 patients with malignant and benign airway disease. The median age was 69.5 years (interquartile range, 53.5 to 74). Most stents (n=20, 95%) were deployed in the lobar airways. There was a significant improvement in the modified Medical Research Council dyspnea scale from median of 3 to 2 (P<0.05). Self-reported respiratory symptoms improved in 14 patients (78%, P<0.05). Radiographic improvement post Atrium iCAST stent placement was achieved in 15 patients (83%). No deaths were related to airway stenting complications. Adverse events related to stents included migration (n=2, 9.5%), granulation tissue formation (n=2, 9.5%) and mucus plugging (n=1, 4.8%). Lobar stenting with balloon-expanding metallic stents appears feasible, safe and improves symptoms as well as radiographic atelectasis in patients with lobar airway stenosis in this small case series. Larger studies are needed to confirm this observation and to address long-term safety.
Expanded Learning (Afterschool) Leaders' Perceptions Regarding Most Important Elements for Program Quality and Use of Self-Assessment Tools for Continuous Improvement

ERIC Educational Resources Information Center

Boesch, Julie Anne

2014-01-01

California allocates $550 million to expanded learning through After School Education and Safety (ASES) state grants, and $140 million of federal money in 21st Century Community Learning Center grants each year; more than all other states combined. Much variability exists in program quality, and research has identified mixed results as to the…
How to design the optimal self-expandable oesophageal metallic stents: 22 years of experience in 645 patients with malignant strictures.

PubMed

Na, Han Kyu; Song, Ho-Young; Kim, Jin Hyoung; Park, Jung-Hoon; Kang, Min Kyoung; Lee, Jongjin; Oh, Se Jin

2013-03-01

To evaluate the clinical efficacy and safety of self-expandable metallic stent (SEMS) placement for malignant oesophageal strictures and their relationship with stent designs. Seven generations of SEMS were used to treat 645 consecutive patients with oesophageal strictures. Logistic regression models were constructed to identify predictive factors associated with complications. Stent placement was technically successful in 641 of 645 patients (99.4%). The clinical success rate was 95.5%. There were 260 (40.3%) complications after stent placement. Due to complications, 68 stents were removed; 66 of 68 stents (97.1%) were removed successfully. Stainless steel (SS) stents (odds ratio [OR] 4.18; 95% confidence interval [CI] 2.10, 8.32) and radiation therapy (RT) before stent placement (OR 4.23; CI 2.02, 8.83) were significantly associated with severe pain. Flared ends (OR 9.63; CI 3.38, 27.43), stricture length <6 cm (OR 2.01; CI 1.13, 3.60), and a stent diameter <18 mm (OR 3.00; CI 1.32, 6.84) were predictive factors of stent migration. Polyurethane membranes were associated with more frequent tumour ingrowth than polytetrafluoroethylene (PTFE) membranes (P = 0.002). Despite the relatively high complication rate, retrievable self-expandable PTFE-covered nitinol stents equipped with a head and a tail appeared to be an effective treatment for malignant oesophageal strictures.
Increasing the number of trained health and safety professionals in agricultural medicine: evaluation of the "building capacity" program, 2007-2013.

PubMed

Rudolphi, Josie M; Donham, Kelley J

2015-01-01

ABSTRACT The University of Iowa began training health care professionals to care for farmers' occupational health needs since 1974. In order to geographically expand this training to practicing health and safety professionals, the "Building Capacity: A National Resource of Agricultural Medicine Professionals" program was developed and launched in 2006. The model began in 1987 as a program of Iowa's Center for Agricultural Safety and Health. In 2006, with funding from the National Institute for Occupational Safety and Health (NIOSH), Great Plains Center for Agricultural Health (GPCAH), the program was expanded beyond the Iowa borders. The principal component of the program, the 40-hour course, Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals-the Core Course (AMCC) is now being offered to health and safety professionals in nine states in the United States, in Australia, and a modified version presented in Turkey. An initial paper evaluated the first phase of the program, years 2007-2010. This paper compares the first phase (2007-2010) with the second phase (2011-2013), which has involved over 500 health and safety professionals. This paper also describes evaluation of the course and changes resulting from the evaluation. Finally, this paper describes best practices for operating this program and makes recommendations for future courses, as well as other trainings within the field.
Strengths and Deficiencies in the Content of US Radiology Private Practices' Websites.

PubMed

Johnson, Evan J; Doshi, Ankur M; Rosenkrantz, Andrew B

2017-03-01

The Internet provides a potentially valuable mechanism for radiology practices to communicate with patients and enhance the patient experience. The aim of this study was to assess the websites of US radiology private practices, with attention to the frequency of content of potential patient interest. The 50 largest private practice radiology facilities in the United States were identified from RadiologyBusiness.com. Websites were reviewed for information content and functionality. Content regarding radiologists' names, medical schools, residencies, fellowships, photographs, and board certification status; contact for billing questions; and ability to make online payments was present on 80% to 98% of sites. Content regarding examination preparation, contrast use, examination duration, description of examination experience, scheduling information, directions, privacy policy, radiologists' role in interpretation, and ACR accreditation was present on 60% to 78%. Content regarding accepted insurers, delivery of results to referrers, report turnaround times, radiologists' years of experience, radiation safety, and facility hours was present on 40% to 58%. Content regarding technologist certification, registration forms, instructions for requesting a study on disc, educational videos, and patient testimonials was present on 20% to 38%. Content regarding examination prices, patient satisfaction scores, peer review, online scheduling, online report and image access, and parking was present on <20%. Radiology practices' websites most frequently provided information regarding their radiologists' credentials, as well as billing and payment options. Information regarding quality, safety, and the examination experience, as well as non-payment-related online functionality, was less common. These findings regarding the most common deficiencies may be useful for radiology practices in expanding their websites' content, thereby improving communication and potentially the patient experience. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Transcatheter aortic valve replacement using a self-expanding bioprosthesis in patients with severe aortic stenosis at extreme risk for surgery.

PubMed

Popma, Jeffrey J; Adams, David H; Reardon, Michael J; Yakubov, Steven J; Kleiman, Neal S; Heimansohn, David; Hermiller, James; Hughes, G Chad; Harrison, J Kevin; Coselli, Joseph; Diez, Jose; Kafi, Ali; Schreiber, Theodore; Gleason, Thomas G; Conte, John; Buchbinder, Maurice; Deeb, G Michael; Carabello, Blasé; Serruys, Patrick W; Chenoweth, Sharla; Oh, Jae K

2014-05-20

This study sought to evaluate the safety and efficacy of the CoreValve transcatheter heart valve (THV) for the treatment of severe aortic stenosis in patients at extreme risk for surgery. Untreated severe aortic stenosis is a progressive disease with a poor prognosis. Transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis is a potentially effective therapy. We performed a prospective, multicenter, nonrandomized investigation evaluating the safety and efficacy of self-expanding TAVR in patients with symptomatic severe aortic stenosis with prohibitive risks for surgery. The primary endpoint was a composite of all-cause mortality or major stroke at 12 months, which was compared with a pre-specified objective performance goal (OPG). A total of 41 sites in the United States recruited 506 patients, of whom 489 underwent attempted treatment with the CoreValve THV. The rate of all-cause mortality or major stroke at 12 months was 26.0% (upper 2-sided 95% confidence bound: 29.9%) versus 43.0% with the OPG (p < 0.0001). Individual 30-day and 12-month events included all-cause mortality (8.4% and 24.3%, respectively) and major stroke (2.3% and 4.3%, respectively). Procedural events at 30 days included life-threatening/disabling bleeding (12.7%), major vascular complications (8.2%), and need for permanent pacemaker placement (21.6%). The frequency of moderate or severe paravalvular aortic regurgitation was lower 12 months after self-expanding TAVR (4.2%) than at discharge (10.7%; p = 0.004 for paired analysis). TAVR with a self-expanding bioprosthesis was safe and effective in patients with symptomatic severe aortic stenosis at prohibitive risk for surgical valve replacement. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
"Without this program, women can lose their lives": migrant women's experiences with the Safe Abortion Referral Programme in Chiang Mai, Thailand.

PubMed

Tousaw, Ellen; La, Ra Khin; Arnott, Grady; Chinthakanan, Orawee; Foster, Angel M

2017-11-01

For displaced and migrant women in northern Thailand, access to health care is often limited, unwanted pregnancy is common, and unsafe abortion is a major contributor to maternal death and disability. Based on a pilot project and situational analysis research, in 2015 a multinational team introduced the Safe Abortion Referral Programme (SARP) in Chiang Mai, Thailand, to reduce the socio-linguistic, economic, documentation, and transportation barriers women from Burma face in accessing safe and legal abortion care in Thailand. Our qualitative study documented the experiences of women with unwanted pregnancies who accessed the SARP in order to inform programme improvement and expansion. We conducted 22 in-depth, in-person interviews and analysed them for content and themes using deductive and inductive techniques. Women were overwhelmingly positive about their experiences using the SARP. They reported lack of costs, friendly programme staff, accompaniment to and interpretation at the providing facility, and safety of services as key features. Financial and legal circumstances shaped access to the programme and women learned about the SARP through word-of-mouth and community workshops. After accessing the SARP and receiving support, women became community advocates for reproductive health. Efforts to expand the programme and raise awareness in migrant communities appear warranted. Our findings suggest that referral programmes for safe and legal abortion can be successful in settings with large displaced and migrant populations. Identifying ways to work within legal constraints to expand access to safe services has the potential to reduce harm from unsafe abortion even in humanitarian settings.
Exercise Training in Progressive Multiple Sclerosis: A Comparison of Recumbent Stepping and Body Weight-Supported Treadmill Training.

PubMed

Pilutti, Lara A; Paulseth, John E; Dove, Carin; Jiang, Shucui; Rathbone, Michel P; Hicks, Audrey L

2016-01-01

Background: There is evidence of the benefits of exercise training in multiple sclerosis (MS); however, few studies have been conducted in individuals with progressive MS and severe mobility impairment. A potential exercise rehabilitation approach is total-body recumbent stepper training (TBRST). We evaluated the safety and participant-reported experience of TBRST in people with progressive MS and compared the efficacy of TBRST with that of body weight-supported treadmill training (BWSTT) on outcomes of function, fatigue, and health-related quality of life (HRQOL). Methods: Twelve participants with progressive MS (Expanded Disability Status Scale scores, 6.0-8.0) were randomized to receive TBRST or BWSTT. Participants completed three weekly sessions (30 minutes) of exercise training for 12 weeks. Primary outcomes included safety assessed as adverse events and patient-reported exercise experience assessed as postexercise response and evaluation of exercise equipment. Secondary outcomes included the Multiple Sclerosis Functional Composite, the Modified Fatigue Impact Scale, and the Multiple Sclerosis Quality of Life-54 questionnaire scores. Assessments were conducted at baseline and after 12 weeks. Results: Safety was confirmed in both exercise groups. Participants reported enjoying both exercise modalities; however, TBRST was reviewed more favorably. Both interventions reduced fatigue and improved HRQOL (P ≤ .05); there were no changes in function. Conclusions: Both TBRST and BWSTT seem to be safe, well tolerated, and enjoyable for participants with progressive MS with severe disability. Both interventions may also be efficacious for reducing fatigue and improving HRQOL. TBRST should be further explored as an exercise rehabilitation tool for patients with progressive MS.
The Safety of Acupuncture in Patients with Cancer Therapy–Related Thrombocytopenia

PubMed Central

Cybularz, Paul A.; Brothers, Karen; Singh, Gurneet M.; Feingold, Jennifer L.; Niesley, Michelle L.

2015-01-01

Abstract Background: Acceptance of acupuncture as an efficacious integrative modality for oncology-related side-effect management is rapidly expanding. It is imperative that guidelines regarding safe treatment supported by clinical experience are established. Oncology patients frequently experience thrombocytopenia as a side-effect of chemotherapy or radiation. However, safety data for acupuncture in adult patients with cancer who are thrombocytopenic is lacking. Materials and Methods: The medical records of 684 patients who received acupuncture treatments in an established acupuncture program at a private cancer treatment hospital were reviewed for adverse events occurring within the context of thrombocytopenia. Results: Of 2135 visits eligible for evaluation, 98 individual acupuncture visits occurred in patients with platelet counts <100,000/μL, including nine visits in which platelet counts were <50,000/μL. No adverse events of increased bruising or bleeding were noted. Medications and nutritional supplements or botanicals that may influence coagulation were also tabulated, with no apparent adverse events in this patient population. Conclusions: Discrepancies in the literature highlight the need to create cohesive safety guidelines backed by clinical research, specifically for groups at higher risk for adverse events. The preliminary evidence put forth in this study lays the foundation that supports the notion that acupuncture can be used safely with a high-need oncology population within an integrated model of care. In this descriptive retrospective case series of adult oncology patients with thrombocytopenia, no adverse events of increased bruising or bleeding were documented. Prospective trials are needed to confirm these initial observations. PMID:26401193
Can We Do That Here? Establishing the Scope of Surgical Practice at a New Safety-Net Community Hospital Through a Transparent, Collaborative Review of Physician Privileges.

PubMed

O'Neill, Sean M; Seresinghe, Sarah; Sharma, Arun; Russell, Tara A; Crawford, L'Orangerie; Frencher, Stanley K

2018-01-01

Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms. Staff privileging decisions were initially based only on physicians' training and experience, but this resulted in several cases that tested the boundaries of what a small community hospital was prepared to handle. A collaborative, transparent process to review physician privileges was developed. This began with physician-only review of procedure lists, followed by a larger, multidisciplinary group to assess system-level factors. Specific questions were used to guide discussion, and unanimous approval from all stakeholders was required to include a procedure. An initial list of 558 procedures across 11 specialties was reduced to 321 (57.5%). No new cases that fall outside these new boundaries have arisen. An inclusive process was crucial for obtaining buy-in and establishing cultural norms. Arranging transfer agreements remains a significant challenge. Accumulation of institutional experience continues through regular performance reviews. As this hospital's capabilities mature, a blueprint has been established for expanding surgical scope of practice based explicitly on system-level factors. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Orbit transfer vehicle engine study, phase A extension. Volume 2A: Study results

NASA Technical Reports Server (NTRS)

1980-01-01

Engine trade studies and systems analyses leading to a baseline engine selection for advanced expander cycle engine are discussed with emphasis on: (1) performance optimization of advanced expander cycle engines in the 10 to 20K pound thrust range; (2) selection of a recommended advanced expander engine configuration based on maximized performance and minimized mission risk, and definition of the components for this configuration; (3) characterization of the low thrust adaptation requirements and performance for the staged combustion engine; (4) generation of a suggested safety and reliability approach for OTV engines independent of engine cycle; (5) definition of program risk relationships between expander and staged combustion cycle engines; and (6) development of schedules and costs for the DDT&E, production, and operation phases of the 10K pound thrust expander engine program.
Overview of experimental support for fission-product transport analyses at Oak Ridge National Laboratory

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

Wichner, R.P.

The program was designed to determine fission product and aerosol release rates from irradiated fuel under accident conditions, to identify the chemical forms of the released material, and to correlate the results with experimental and specimen conditions with the data from related experiments. These tests of PWR fuel were conducted and fuel specimen and test operating data are presented. The nature and rate of fission product vapor interaction with aerosols were studied. Aerosol deposition rates and transport in the reactor vessel during LWR core-melt accidents were studied. The Nuclear Safety Pilot Plant is dedicated to developing an expanded data basemore » on the behavior of aerosols generated during a severe accident.« less
Orbital Transfer Vehicle (OTV) engine study. Phase A: Extension

NASA Technical Reports Server (NTRS)

Sobin, A. J.

1980-01-01

The current Phase A-Extension of the OTV engine study program aims to provide additional expander and staged combustion cycle data that will lead to design definition of the OTV engine. The proposed program effort seeks to optimize the expander cycle engine concept (consistent with identified OTV engine requirements), investigate the feasibility of kitting the staged combustion cycle engine to provide extended thrust operation, and conduct in-depth analysis of development risk, crew safety, and reliability for both cycles. Additional tasks address the costing of a 10/K thrust expander cycle engine and support of OTV systems study contractors.
Traveler Trustworthy Autonomy

NASA Technical Reports Server (NTRS)

Skoog, Mark A.

2016-01-01

NASAs Armstrong Flight Research Center has been engaged in the development of highly automatic safety systems for aviation since the mid 80s. For the past three years under Seedling and Center Innovation funding this work has moved toward the development of a software architecture applicable to autonomous safety. This work is now broadening and accelerating to address the airworthiness issues surrounding making a case for trustworthy autonomy. This software architecture is called the expandable variable-autonomy architecture (EVAA) and utilizes a run-time assurance approach to safety assurance.
A Framework for School Safety and Risk Management: Results from a Study of 18 Targeted School Shooters

ERIC Educational Resources Information Center

Lenhardt, Ann Marie C.; Graham, Lemuel W.; Farrell, Melissa L.

2018-01-01

Targeted violence continues to pose a threat to school safety. Reported here are the results of a study of 18 cases of school shooters from 1996 to 2012. Variables examined are individual factors and behaviors, family dynamics, and triggering events. Results indicate the need for expanded school-based mental health services, threat assessment, and…
Water for Agriculture: the Convergence of Sustainability and Safety.

PubMed

Markland, Sarah M; Ingram, David; Kniel, Kalmia E; Sharma, Manan

2017-05-01

Agricultural water is a precious and limited resource. Increasingly more water types and sources are being explored for use in irrigation within the United States and across the globe. As outlined in this chapter, the Produce Safety Rule (PSR) in the Food Safety and Modernization Act (FSMA) provide irrigation water standards for application of water to fruits and vegetables consumed raw. These rules for production and use of water will continue to develop and be required as the world experiences aspects of a changing climate including flooding as well as drought conditions. Research continues to assess the use of agricultural water types. The increased use of reclaimed water in the United States as well as for selected irrigation water needs for specific crops may provide increased water availability. The use of surface water can be used in irrigation as well, but several studies have shown the presence of some enteric bacterial pathogens (enterohemorrhagic E. coli , Salmonella spp. and Listeria monocytogenes ) in these waters that may contaminate fruits and vegetables. There have been outbreaks of foodborne illness in the U.S., South America, Europe, and Australia related to the use of contaminated water in fruit and vegetable irrigation or washing. Unreliable water supplies, more stringent microbial water standards, mitigation technologies and expanded uses of reclaimed waters have all increased interest in agricultural water.
Video techniques and data compared with observation in emergency trauma care

PubMed Central

Mackenzie, C; Xiao, Y

2003-01-01

Video recording is underused in improving patient safety and understanding performance shaping factors in patient care. We report our experience of using video recording techniques in a trauma centre, including how to gain cooperation of clinicians for video recording of their workplace performance, identify strengths of video compared with observation, and suggest processes for consent and maintenance of confidentiality of video records. Video records are a rich source of data for documenting clinician performance which reveal safety and systems issues not identified by observation. Emergency procedures and video records of critical events identified patient safety, clinical, quality assurance, systems failures, and ergonomic issues. Video recording is a powerful feedback and training tool and provides a reusable record of events that can be repeatedly reviewed and used as research data. It allows expanded analyses of time critical events, trauma resuscitation, anaesthesia, and surgical tasks. To overcome some of the key obstacles in deploying video recording techniques, researchers should (1) develop trust with video recorded subjects, (2) obtain clinician participation for introduction of a new protocol or line of investigation, (3) report aggregated video recorded data and use clinician reviews for feedback on covert processes and cognitive analyses, and (4) involve multidisciplinary experts in medicine and nursing. PMID:14645896
Planning the Safety of Atrial Fibrillation Ablation Registry Initiative (SAFARI) as a Collaborative Pan-Stakeholder Critical Path Registry Model: a Cardiac Safety Research Consortium "Incubator" Think Tank.

PubMed

Al-Khatib, Sana M; Calkins, Hugh; Eloff, Benjamin C; Packer, Douglas L; Ellenbogen, Kenneth A; Hammill, Stephen C; Natale, Andrea; Page, Richard L; Prystowsky, Eric; Jackman, Warren M; Stevenson, William G; Waldo, Albert L; Wilber, David; Kowey, Peter; Yaross, Marcia S; Mark, Daniel B; Reiffel, James; Finkle, John K; Marinac-Dabic, Danica; Pinnow, Ellen; Sager, Phillip; Sedrakyan, Art; Canos, Daniel; Gross, Thomas; Berliner, Elise; Krucoff, Mitchell W

2010-01-01

Atrial fibrillation (AF) is a major public health problem in the United States that is associated with increased mortality and morbidity. Of the therapeutic modalities available to treat AF, the use of percutaneous catheter ablation of AF is expanding rapidly. Randomized clinical trials examining the efficacy and safety of AF ablation are currently underway; however, such trials can only partially determine the safety and durability of the effect of the procedure in routine clinical practice, in more complex patients, and over a broader range of techniques and operator experience. These limitations of randomized trials of AF ablation, particularly with regard to safety issues, could be addressed using a synergistically structured national registry, which is the intention of the SAFARI. To facilitate discussions about objectives, challenges, and steps for such a registry, the Cardiac Safety Research Consortium and the Duke Clinical Research Institute, Durham, NC, in collaboration with the US Food and Drug Administration, the American College of Cardiology, and the Heart Rhythm Society, organized a Think Tank meeting of experts in the field. Other participants included the National Heart, Lung and Blood Institute, the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, the Society of Thoracic Surgeons, the AdvaMed AF working group, and additional industry representatives. The meeting took place on April 27 to 28, 2009, at the US Food and Drug Administration headquarters in Silver Spring, MD. This article summarizes the issues and directions presented and discussed at the meeting. Copyright 2010 Mosby, Inc. All rights reserved.
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.
7 CFR 1217.60 - Programs, plans, and projects.

Code of Federal Regulations, 2013 CFR

2013-01-01

... and advertising designed to: (1) Maintain, develop, expand and grow markets for softwood lumber; (2... strength, safety, environmental and sustainable benefits and technical applications of softwood lumber; and...
7 CFR 1217.60 - Programs, plans, and projects.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and advertising designed to: (1) Maintain, develop, expand and grow markets for softwood lumber; (2... strength, safety, environmental and sustainable benefits and technical applications of softwood lumber; and...
7 CFR 1217.60 - Programs, plans, and projects.

Code of Federal Regulations, 2014 CFR

2014-01-01

... and advertising designed to: (1) Maintain, develop, expand and grow markets for softwood lumber; (2... strength, safety, environmental and sustainable benefits and technical applications of softwood lumber; and...
Expanding the Envelope of UAS Certification: What it Takes to Type Certify a UAS for Precision Agricultural Spraying

NASA Technical Reports Server (NTRS)

Maddalon, J. M.; Hayhurst, K. J.; Neogi, N. A.; Verstynen, H. A.; Clothier, R. A.

2016-01-01

One of the key challenges to the development of a commercial Unmanned Air-craft System (UAS) market is the lack of explicit consideration of UAS in the current regulatory framework. Despite recent progress, additional steps are needed to enable broad UAS types and operational models. This paper discusses recent research that examines how a risk-based approach for safety might change the process and substance of airworthiness requirements for UAS. The project proposed risk-centric airworthiness requirements for a midsize un-manned rotorcraft used for agricultural spraying and also identified factors that may contribute to distinguishing safety risk among different UAS types and operational concepts. Lessons learned regarding how a risk-based approach can expand the envelope of UAS certification are discussed.
Medication Safety During Pregnancy: Improving Evidence-Based Practice.

PubMed

Sinclair, Susan M; Miller, Richard K; Chambers, Christina; Cooper, Elizabeth M

2016-01-01

Nearly 90% of women in the United States have taken medications during pregnancy. Medication exposures during pregnancy can result in adverse pregnancy and neonatal outcomes including birth defects, fetal loss, intrauterine growth restriction, prematurity, and longer-term neurodevelopmental outcomes. Advising pregnant women about the safety of medication use during pregnancy is complicated by a lack of data necessary to engage the woman in an informed discussion. Routinely, health care providers turn to the package insert, yet this information can be incomplete and can be based entirely on animal studies. Often, adequate safety data are not available. In a busy clinical setting, health care providers need to be able to quickly locate the most up-to-date information in order to counsel pregnant women concerned about medication exposure. Deciding where to locate the best available information is difficult, particularly when the needed information does not exist. Pregnancy registries are initiated to obtain more data about the safety of specific medication exposures during pregnancy; however, these studies are slow to produce meaningful information, and when they do, the information may not be readily available in a published form. Health care providers have valuable data in their everyday practice that can expand the knowledge base about medication safety during pregnancy. This review aims to discuss the limitations of the package insert regarding medication safety during pregnancy, highlight additional resources available to health care providers to inform practice, and communicate the importance of pregnancy registries for expanding knowledge about medication safety during pregnancy. © 2016 by the American College of Nurse-Midwives.
Review article: practical current issues in perioperative patient safety.

PubMed

Eichhorn, John H

2013-02-01

This brief review provides an overview and, importantly, a context perspective of relevant current practical issues in perioperative patient safety. The dramatic improvement in anesthesia patient safety over the last 30 years was not initiated by electronic monitors but, rather, largely by a set of behaviours known as "safety monitoring" that were then made decidedly more effective by extending the human senses through electronic monitoring, for example, capnography and pulse oximetry. In the highly developed world, this current success is threatened by complacency and production pressure. In some areas of the developing/underdeveloped world, the challenge is implementing the components of anesthesia practice that will bring safety improvements to parallel the overall current success, for instance, applying the World Federation of Societies of Anaesthesiologists (WFSA) "International Standards for A Safe Practice of Anaesthesia". Generally, expanding the current success in safety involves many practical issues. System issues involve research, effective reporting mechanisms and analysis/broadcasting of results, perioperative communication (including "speaking up to power"), and checklists. Monitoring issues involve enforcing existing published monitoring standards and also recognizing the risk of danger to the patient from hypoventilation during procedural sedation and from postoperative intravenous pain medications. Issues of clinical care include medication errors in the operating room, cerebral hypoperfusion (especially in the head-up position), dangers of airway management, postoperative residual weakness from muscle relaxants, operating room fires, and risks specific in obstetric anesthesia. Recognition of the issues outlined here and empowerment of all anesthesia professionals, from the most senior professors and administrators to the newest practitioners, should help maintain, solidify, and expand the improvements in anesthesia and perioperative patient safety.
Using computer graphics to enhance astronaut and systems safety

NASA Technical Reports Server (NTRS)

Brown, J. W.

1985-01-01

Computer graphics is being employed at the NASA Johnson Space Center as a tool to perform rapid, efficient and economical analyses for man-machine integration, flight operations development and systems engineering. The Operator Station Design System (OSDS), a computer-based facility featuring a highly flexible and versatile interactive software package, PLAID, is described. This unique evaluation tool, with its expanding data base of Space Shuttle elements, various payloads, experiments, crew equipment and man models, supports a multitude of technical evaluations, including spacecraft and workstation layout, definition of astronaut visual access, flight techniques development, cargo integration and crew training. As OSDS is being applied to the Space Shuttle, Orbiter payloads (including the European Space Agency's Spacelab) and future space vehicles and stations, astronaut and systems safety are being enhanced. Typical OSDS examples are presented. By performing physical and operational evaluations during early conceptual phases. supporting systems verification for flight readiness, and applying its capabilities to real-time mission support, the OSDS provides the wherewithal to satisfy a growing need of the current and future space programs for efficient, economical analyses.
Adapting Cognitive Task Analysis to Investigate Clinical Decision Making and Medication Safety Incidents.

PubMed

Russ, Alissa L; Militello, Laura G; Glassman, Peter A; Arthur, Karen J; Zillich, Alan J; Weiner, Michael

2017-05-03

Cognitive task analysis (CTA) can yield valuable insights into healthcare professionals' cognition and inform system design to promote safe, quality care. Our objective was to adapt CTA-the critical decision method, specifically-to investigate patient safety incidents, overcome barriers to implementing this method, and facilitate more widespread use of cognitive task analysis in healthcare. We adapted CTA to facilitate recruitment of healthcare professionals and developed a data collection tool to capture incidents as they occurred. We also leveraged the electronic health record (EHR) to expand data capture and used EHR-stimulated recall to aid reconstruction of safety incidents. We investigated 3 categories of medication-related incidents: adverse drug reactions, drug-drug interactions, and drug-disease interactions. Healthcare professionals submitted incidents, and a subset of incidents was selected for CTA. We analyzed several outcomes to characterize incident capture and completed CTA interviews. We captured 101 incidents. Eighty incidents (79%) met eligibility criteria. We completed 60 CTA interviews, 20 for each incident category. Capturing incidents before interviews allowed us to shorten the interview duration and reduced reliance on healthcare professionals' recall. Incorporating the EHR into CTA enriched data collection. The adapted CTA technique was successful in capturing specific categories of safety incidents. Our approach may be especially useful for investigating safety incidents that healthcare professionals "fix and forget." Our innovations to CTA are expected to expand the application of this method in healthcare and inform a wide range of studies on clinical decision making and patient safety.
An Approach for Validating Actinide and Fission Product Burnup Credit Criticality Safety Analyses--Criticality (keff) Predictions

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

Scaglione, John M; Mueller, Don; Wagner, John C

2011-01-01

One of the most significant remaining challenges associated with expanded implementation of burnup credit in the United States is the validation of depletion and criticality calculations used in the safety evaluation - in particular, the availability and use of applicable measured data to support validation, especially for fission products. Applicants and regulatory reviewers have been constrained by both a scarcity of data and a lack of clear technical basis or approach for use of the data. U.S. Nuclear Regulatory Commission (NRC) staff have noted that the rationale for restricting their Interim Staff Guidance on burnup credit (ISG-8) to actinide-only ismore » based largely on the lack of clear, definitive experiments that can be used to estimate the bias and uncertainty for computational analyses associated with using burnup credit. To address the issue of validation, the NRC initiated a project with the Oak Ridge National Laboratory to (1) develop and establish a technically sound validation approach (both depletion and criticality) for commercial spent nuclear fuel (SNF) criticality safety evaluations based on best-available data and methods and (2) apply the approach for representative SNF storage and transport configurations/conditions to demonstrate its usage and applicability, as well as to provide reference bias results. The purpose of this paper is to describe the criticality (k{sub eff}) validation approach, and resulting observations and recommendations. Validation of the isotopic composition (depletion) calculations is addressed in a companion paper at this conference. For criticality validation, the approach is to utilize (1) available laboratory critical experiment (LCE) data from the International Handbook of Evaluated Criticality Safety Benchmark Experiments and the French Haut Taux de Combustion (HTC) program to support validation of the principal actinides and (2) calculated sensitivities, nuclear data uncertainties, and the limited available fission product LCE data to predict and verify individual biases for relevant minor actinides and fission products. This paper (1) provides a detailed description of the approach and its technical bases, (2) describes the application of the approach for representative pressurized water reactor and boiling water reactor safety analysis models to demonstrate its usage and applicability, (3) provides reference bias results based on the prerelease SCALE 6.1 code package and ENDF/B-VII nuclear cross-section data, and (4) provides recommendations for application of the results and methods to other code and data packages.« less
Review of Occupational Health and Safety Organization in Expanding Economies: The Case of Southern Africa.

PubMed

Moyo, Dingani; Zungu, Muzimkhulu; Kgalamono, Spoponki; Mwila, Chimba D

2015-01-01

Globally, access to occupational health and safety (OHS) by workers has remained at very low levels. The organization and implementation of OHS in South Africa, Zimbabwe, Zambia, and Botswana has remained at suboptimal levels. Inadequacy of human resource capital, training, and education in the field of OHS has had a major negative impact on the improvement of worker access to such services in expanding economies. South Africa, Zimbabwe, Zambia, and Botswana have expanding economies with active mining and agricultural activities that pose health and safety risks to the working population. A literature review and country systems inquiry on the organization of OHS services in the 4 countries was carried out. Because of the infancy and underdevelopment of OHS in southern Africa, literature on the status of this topic is limited. In the 4 countries under review, OHS services are a function shared either wholly or partially by 3 ministries, namely Health, Labor, and Mining. Other ministries, such as Environment and Agriculture, carry small fragments of OHS function. The 4 countries are at different stages of OHS legislative frameworks that guide the practice of health and safety in the workplace. Inadequacies in human resource capital and expertise in occupational health and safety are noted major constraints in the implementation and compliance to health and safety initiatives in the work place. South Africa has a more mature system than Zimbabwe, Zambia, and Botswana. Lack of specialized training in occupational health services, such as occupational medicine specialization for physicians, has been a major drawback in Zimbabwe, Zambia, and Botswana. The full adoption and success of OHS systems in Southern Africa remains constrained. Training and education in OHS, especially in occupational medicine, will enhance the development and maturation of occupational health in southern Africa. Capacitating primary health services with basic occupational health knowledge would be invaluable in bridging the current skills deficit. Introducing short courses and foundational tracks in occupational medicine for general medical practitioners would be invaluable. Copyright © 2015 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.
Supra-plasma expanders: the future of treating blood loss and anemia without red cell transfusions?

PubMed

Tsai, Amy G; Vázquez, Beatriz Y Salazar; Hofmann, Axel; Acharya, Seetharama A; Intaglietta, Marcos

2015-01-01

Oxygen delivery capacity during profoundly anemic conditions depends on blood's oxygen-carrying capacity and cardiac output. Oxygen-carrying blood substitutes and blood transfusion augment oxygen-carrying capacity, but both have given rise to safety concerns, and their efficacy remains unresolved. Anemia decreases oxygen-carrying capacity and blood viscosity. Present studies show that correcting the decrease of blood viscosity by increasing plasma viscosity with newly developed plasma expanders significantly improves tissue perfusion. These new plasma expanders promote tissue perfusion, increasing oxygen delivery capacity without increasing blood oxygen-carrying capacity, thus treating the effects of anemia while avoiding the transfusion of blood.

The role of autologous hematopoietic progenitor and cell reinfusion for intensive chemotherapy in women with poor-prognosis breast cancer. Clinical studies with ex-vivo expanded cells produced with the Aastrom Replicell technology.

PubMed

Chabannon, C; Novakovitch, G; Blache, J L; Olivero, S; Camerlo, J; Genre, D; Maraninchi, D; Viens, P

1999-04-01

In recent years, we have initiated two clinical studies, to evaluate the usefulness of ex-vivo expanded cells in patients with breast cancer who receive sequential high-dose chemotherapy. Ex-vivo expanded cells were produced from autologous cryopreserved bone marrow nucleated cells, using a biomedical device. The Aastrom Replicell system cultures cells in animal serum-replete medium, with a combination of flt3-L, PIXY321 and Epo, for 12 days. The initial pilot trial was set up to establish the feasibility and safety of the technique: 6 patients completed the study. An ongoing randomized study searches to establish whether ex-vivo expanded cells provide a clinical benefit.
ARE660 Wind Generator: Low Wind Speed Technology for Small Turbine Development

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

Robert W. Preus; DOE Project Officer - Keith Bennett

2008-04-23

This project is for the design of a wind turbine that can generate most or all of the net energy required for homes and small businesses in moderately windy areas. The purpose is to expand the current market for residential wind generators by providing cost effective power in a lower wind regime than current technology has made available, as well as reduce noise and improve reliability and safety. Robert W. Preus’ experience designing and/or maintaining residential wind generators of many configurations helped identify the need for an improved experience of safety for the consumer. Current small wind products have unreliablemore » or no method of stopping the wind generator in fault or high wind conditions. Consumers and their neighbors do not want to hear their wind generators. In addition, with current technology, only sites with unusually high wind speeds provide payback times that are acceptable for the on-grid user. Abundant Renewable Energy’s (ARE) basic original concept for the ARE660 was a combination of a stall controlled variable speed small wind generator and automatic fail safe furling for shutdown. The stall control for a small wind generator is not novel, but has not been developed for a variable speed application with a permanent magnet alternator (PMA). The fail safe furling approach for shutdown has not been used to our knowledge.« less
A study of software standards used in the avionics industry

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J.

1994-01-01

Within the past decade, software has become an increasingly common element in computing systems. In particular, the role of software used in the aerospace industry, especially in life- or safety-critical applications, is rapidly expanding. This intensifies the need to use effective techniques for achieving and verifying the reliability of avionics software. Although certain software development processes and techniques are mandated by government regulating agencies, no one methodology has been shown to consistently produce reliable software. The knowledge base for designing reliable software simply has not reached the maturity of its hardware counterpart. In an effort to increase our understanding of software, the Langley Research Center conducted a series of experiments over 15 years with the goal of understanding why and how software fails. As part of this program, the effectiveness of current industry standards for the development of avionics is being investigated. This study involves the generation of a controlled environment to conduct scientific experiments on software processes.
Implicit affective cues and attentional tuning: an integrative review.

PubMed

Friedman, Ronald S; Förster, Jens

2010-09-01

A large and growing number of studies support the notion that arousing positive emotional states expand, and that arousing negative states constrict, the scope of attention on both the perceptual and conceptual levels. However, these studies have predominantly involved the manipulation or measurement of conscious emotional experiences (e.g., subjective feelings of happiness or anxiety). This raises the question: Do cues that are merely associated with benign versus threatening situations but do not elicit conscious feelings of positive or negative emotional arousal independently expand or contract attentional scope? Integrating theoretical advances in affective neuroscience, positive psychology, and social cognition, the authors propose that rudimentary intero- and exteroceptive stimuli may indeed become associated with the onset of arousing positive or negative emotional states and/or with appraisals that the environment is benign or threatening and thereby come to moderate the scope of attention in the absence of conscious emotional experience. Specifically, implicit "benign situation" cues are posited to broaden, and implicit "threatening situation" cues to narrow, the range of both perceptual and conceptual attentional selection. An extensive array of research findings involving a diverse set of such implicit affective cues (e.g., enactment of approach and avoidance behaviors, incidental exposure to colors signaling safety vs. danger) is marshaled in support of this proposition. Potential alternative explanations for and moderators of these attentional tuning effects, as well as their higher level neuropsychological underpinnings, are also discussed along with prospective extensions to a range of other situational cues and domains of social cognitive processing.
[Chemical safety, health, and environment: prospects for governance in the Brazilian context].

PubMed

Freitas, Carlos Machado de; Porto, Marcelo Firpo S; Moreira, Josino Costa; Pivetta, Fatima; Machado, Jorge M Huet; Freitas, Nilton B B de; Arcuri, Arline S

2002-01-01

Chemical safety is acknowledged by Agenda 21 as one of the most serious problems worldwide, involving governance at the national and international levels. In Brazil, chemical safety problems have increased in intensity and extent, far beyond the capacity to deal with them. The problems are all the more serious in Brazil because issues of democracy, security, sustainability, and equity, all fundamental to governance, are still incipient and still far from being solved. New societal arrangements and a new, contextualized and more participatory science form the basis for developing and expanding strategies for governance to deal with the problem of chemical safety.
Introducing students to patient safety through an online interprofessional course.

PubMed

Blue, Amy V; Charles, Laurine; Howell, David; Koutalos, Yiannis; Mitcham, Maralynne; Nappi, Jean; Zoller, James

2010-01-01

Interprofessional education (IPE) is increasingly called upon to improve health care systems and patient safety. Our institution is engaged in a campus-wide IPE initiative. As a component of this initiative, a required online interprofessional patient-safety-focused course for a large group (300) of first-year medical, dental, and nursing students was developed and implemented. We describe our efforts with developing the course, including the use of constructivist and adult learning theories and IPE competencies to structure students' learning in a meaningful fashion. The course was conducted online to address obstacles of academic calendars and provide flexibility for faculty participation. Students worked in small groups online with a faculty facilitator. Thematic modules were created with associated objectives, online learning materials, and assignments. Students posted completed assignments online and responded to group members' assignments for purposes of group discussion. Students worked in interprofessional groups on a project requiring them to complete a root cause analysis and develop recommendations based on a fictional sentinel event case. Through project work, students applied concepts learned in the course related to improving patient safety and demonstrated interprofessional collaboration skills. Projects were presented during a final in-class session. Student course evaluation results suggest that learning objectives and content goals were achieved. Faculty course evaluation results indicate that the course was perceived to be a worthwhile learning experience for students. We offer the following recommendations to others interested in developing an in-depth interprofessional learning experience for a large group of learners: 1) consider a hybrid format (inclusion of some face-to-face sessions), 2) address IPE and broader curricular needs, 3) create interactive opportunities for shared learning and working together, 4) provide support to faculty facilitators, and 5) recognize your learners' educational level. The course has expanded to include students from additional programs for the current academic year.
Introducing students to patient safety through an online interprofessional course

PubMed Central

Blue, Amy V; Charles, Laurine; Howell, David; Koutalos, Yiannis; Mitcham, Maralynne; Nappi, Jean; Zoller, James

2010-01-01

Interprofessional education (IPE) is increasingly called upon to improve health care systems and patient safety. Our institution is engaged in a campus-wide IPE initiative. As a component of this initiative, a required online interprofessional patient-safety-focused course for a large group (300) of first-year medical, dental, and nursing students was developed and implemented. We describe our efforts with developing the course, including the use of constructivist and adult learning theories and IPE competencies to structure students’ learning in a meaningful fashion. The course was conducted online to address obstacles of academic calendars and provide flexibility for faculty participation. Students worked in small groups online with a faculty facilitator. Thematic modules were created with associated objectives, online learning materials, and assignments. Students posted completed assignments online and responded to group members’ assignments for purposes of group discussion. Students worked in interprofessional groups on a project requiring them to complete a root cause analysis and develop recommendations based on a fictional sentinel event case. Through project work, students applied concepts learned in the course related to improving patient safety and demonstrated interprofessional collaboration skills. Projects were presented during a final in-class session. Student course evaluation results suggest that learning objectives and content goals were achieved. Faculty course evaluation results indicate that the course was perceived to be a worthwhile learning experience for students. We offer the following recommendations to others interested in developing an in-depth interprofessional learning experience for a large group of learners: 1) consider a hybrid format (inclusion of some face-to-face sessions), 2) address IPE and broader curricular needs, 3) create interactive opportunities for shared learning and working together, 4) provide support to faculty facilitators, and 5) recognize your learners’ educational level. The course has expanded to include students from additional programs for the current academic year. PMID:23745069
Use of telescience for biomedical research during space flight

NASA Technical Reports Server (NTRS)

Huntoon, Carolyn L.; Schneider, Howard J.; Karamanos, Gayle M.

1991-01-01

When the U.S. first embarked on a manned space flight program, NASA's use of medical telescience was focused on crew health monitoring. In recent years, medical telescience use has been expanded to include support of basic research in space medicine. It enables ground support personnel to assist on-board crews in the performance of experiments and improves the quality and quantity of data return. NASA is continuing to develop its telescience capabilities. Future plans include telemedicine that will enable physicians on Earth to support crewmembers during flight and telescience that will enable investigators at their home institutions to support and conduct in-flight medical research. NASA's use of telescience for crew safety and biomedical research from Project Mercury to the present is described and NASA's plans for the future are presented.
Endovascular stents: a review of their use in peripheral arterial disease.

PubMed

Kudagi, Vinod S; White, Christopher J

2013-06-01

Technological advances in the past decade have shifted revascularization strategies from traditional open surgical approaches toward lower-morbidity percutaneous endovascular treatments for patients with lower extremity peripheral arterial disease (PAD). The continuing advances in stent design, more than any other advances, have fueled the growth of catheter-based procedures by improving the safety, durability, and predictability of percutaneous revascularization. Although the 2007 TransAtlantic Inter-Society Consensus (TASC) guidelines recommend endovascular therapy for type A and B aortoiliac and femoropopliteal lesions, recent developments in stent technology and increased experience of interventionists have suggested that a strategy of endovascular therapy first is appropriate in experienced hands for TASC type D lesions. The role of endovascular interventions is also expanding in the treatment of limb-threatening ischemia.
A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol.

PubMed

Robert, Glenn B; Anderson, Janet E; Burnett, Susan J; Aase, Karina; Andersson-Gare, Boel; Bal, Roland; Calltorp, Johan; Nunes, Francisco; Weggelaar, Anne-Marie; Vincent, Charles A; Fulop, Naomi J

2011-10-26

although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER) study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. in-depth multi-level (macro, meso and micro-system) analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient complaints and claims). the protocol is based on the premise that future research, policy and practice need to address the sociology of improvement in equal measure to the science and technique of improvement, or at least expand the discipline of improvement to include these critical organisational and cultural processes. We define the 'organisational and cultural characteristics associated with better quality of care' in a broad sense that encompasses all the features of a hospital that might be hypothesised to impact upon clinical effectiveness, patient safety and/or patient experience.
Two examples of industrial applications of shock physics research

NASA Astrophysics Data System (ADS)

Sanai, Mohsen

1996-05-01

An in-depth understanding of shock physics phenomena has led to many industrial applications. Two recent applications discussed in this paper are a method for assessing explosion safety in industrial plants and a bomb-resistant luggage container for widebody aircraft. Our explosion safety assessment is based on frequent use of computer simulation of postulated accidents to model in detail the detonation of energetic materials, the formation and propagation of the resulting airblast, and the projection of fragments of known material and mass. Using a general load-damage analysis technique referred to as the pressure-impulse (PI) method, we have developed a PC-based computer algorithm that includes a continually expanding library of PI load and damage curves, which can predict and graphically display common structural damage modes and the response of humans to postulated explosion accidents. A second commercial application of shock physics discussed here is a bomb-resistant luggage container for widebody aircraft that can protect the aircraft from a terrorist bomb hidden inside the luggage. This hardened luggage container (HLC) relies on blast management and debris containment provided by a flexible flow-through blanket woven from threads made with a strong lightweight material, such as Spectra or Kevlar. This mitigation blanket forms a continuous and seamless shell around the sides of the luggage container that are parallel to the aircraft axis, leaving the two ends of the container unprotected. When an explosion occurs, the mitigation blanket expands into a nearly circular shell that contains the flying debris while directing the flow into the adjacent containers. The HLC concept has been demonstrated through full-scale experiments conducted at SRI. We believe that these two examples represent a broad class of potential industrial hazard applications of the experimental, analytical, and computational tools possessed by the shock physics community.
Using FDA reports to inform a classification for health information technology safety problems

PubMed Central

Ong, Mei-Sing; Runciman, William; Coiera, Enrico

2011-01-01

Objective To expand an emerging classification for problems with health information technology (HIT) using reports submitted to the US Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. Design HIT events submitted to MAUDE were retrieved using a standardized search strategy. Using an emerging classification with 32 categories of HIT problems, a subset of relevant events were iteratively analyzed to identify new categories. Two coders then independently classified the remaining events into one or more categories. Free-text descriptions were analyzed to identify the consequences of events. Measurements Descriptive statistics by number of reported problems per category and by consequence; inter-rater reliability analysis using the κ statistic for the major categories and consequences. Results A search of 899 768 reports from January 2008 to July 2010 yielded 1100 reports about HIT. After removing duplicate and unrelated reports, 678 reports describing 436 events remained. The authors identified four new categories to describe problems with software functionality, system configuration, interface with devices, and network configuration; the authors' classification with 32 categories of HIT problems was expanded by the addition of these four categories. Examination of the 436 events revealed 712 problems, 96% were machine-related, and 4% were problems at the human–computer interface. Almost half (46%) of the events related to hazardous circumstances. Of the 46 events (11%) associated with patient harm, four deaths were linked to HIT problems (0.9% of 436 events). Conclusions Only 0.1% of the MAUDE reports searched were related to HIT. Nevertheless, Food and Drug Administration reports did prove to be a useful new source of information about the nature of software problems and their safety implications with potential to inform strategies for safe design and implementation. PMID:21903979
Institutionalizing Expanded Schools: Evaluation Findings from the Second Year of TASC's National Demonstration

ERIC Educational Resources Information Center

Sinclair, Beth; Russell, Christina A.; McCann, Colleen; Hildreth, Jeanine L.

2014-01-01

Policy Studies Associates (PSA) is conducting a five-year evaluation of the implementation and impact of the national demonstration of a model for expanded learning time developed by "The After-School Corporation" (TASC). This model, called "ExpandED Schools," aims to transform the educational experiences of students in ways…
Atezolizumab in Platinum-treated Locally Advanced or Metastatic Urothelial Carcinoma: Clinical Experience from an Expanded Access Study in the United States.

PubMed

Pal, Sumanta Kumar; Hoffman-Censits, Jean; Zheng, Hanzhe; Kaiser, Constanze; Tayama, Darren; Bellmunt, Joaquim

2018-05-01

Atezolizumab (anti-programmed death-ligand 1) was approved in the USA, Europe, and elsewhere for treatment-naive and platinum-treated locally advanced/metastatic urothelial carcinoma (mUC). To report efficacy and safety from an atezolizumab expanded access study. This single-arm, open-label study enrolled 218 patients at 36 US sites. Key eligibility criteria included progression during/following ≥1 platinum-based chemotherapy for mUC or in perioperative setting (progression within 12 mo) and Eastern Cooperative Oncology Group performance status (ECOG PS) 0-2. Patients received atezolizumab1200mg intravenously every 3 wk until loss of clinical benefit, unacceptable toxicity, consent withdrawal, decision to discontinue, death, atezolizumab commercial availability, or study closure. Key end points reported herein included Response Evaluation Criteria in Solid Tumors v1.1 objective response rate and duration, disease control rate (DCR; response or stable disease), and safety. All patients received prior systemic therapy (68% mUC; 27% adjuvant; and 26% neoadjuvant). At baseline, 57% of 214 treated patients had ECOG PS ≥1, 19% had hemoglobin <10g/dl, and 25% had liver metastases. Median treatment duration was 9 wk (interquartile range [IQR], 6-12 wk). Median follow-up duration was 2.3 mo (IQR, 1.6-3.4 mo) overall and 2.7 mo (IQR, 2.0-3.5 mo) in patients not known to have died. Seventeen of 114 evaluable patients (15%) had objective responses (16 ongoing at study termination). DCR was 49%. Treatment-related adverse events (mostly fatigue) occurred in 98 of 214 treated patients. The benefit/risk profile of atezolizumab was consistent with that observed in previous studies, despite pretreatment and poor prognostic factors. These results suggest a potential role for atezolizumab in a broader patient range than typically eligible for phase 1-3 studies. In this expanded access study, atezolizumab was active and tolerable in a range of patients with platinum-treated metastatic urothelial carcinoma. Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Final Environmental Assessment: For the M270 Multiple Launch Rocket System (MLRS) Expanded Training Use Areas at Avon Park Air Force Range, Florida

DTIC Science & Technology

2005-11-10

Florida Final Environmental Assessment VOC Volatile Organic Compound WSF Weapon Safety Footprint WWII World War II Executive Summary 11/10/05 M270...Air Force, 2003b). World War I brought military training camps and flying schools to Florida, and stimulated shipbuilding, agriculture, and...turpentine operations. Increased defense spending for World War II expanded industry and agriculture further. Avon Park Army Air Field was built from
Hennepin Health: a safety-net accountable care organization for the expanded Medicaid population.

PubMed

Sandberg, Shana F; Erikson, Clese; Owen, Ross; Vickery, Katherine D; Shimotsu, Scott T; Linzer, Mark; Garrett, Nancy A; Johnsrud, Kimry A; Soderlund, Dana M; DeCubellis, Jennifer

2014-11-01

Health care payment and delivery models that challenge providers to be accountable for outcomes have fueled interest in community-level partnerships that address the behavioral, social, and economic determinants of health. We describe how Hennepin Health--a county-based safety-net accountable care organization in Minnesota--has forged such a partnership to redesign the health care workforce and improve the coordination of the physical, behavioral, social, and economic dimensions of care for an expanded community of Medicaid beneficiaries. Early outcomes suggest that the program has had an impact in shifting care from hospitals to outpatient settings. For example, emergency department visits decreased 9.1 percent between 2012 and 2013, while outpatient visits increased 3.3 percent. An increasing percentage of patients have received diabetes, vascular, and asthma care at optimal levels. At the same time, Hennepin Health has realized savings and reinvested them in future improvements. Hennepin Health offers lessons for counties, states, and public hospitals grappling with the problem of how to make the best use of public funds in serving expanded Medicaid populations and other communities with high needs. Project HOPE—The People-to-People Health Foundation, Inc.
Engineering and public health at CDC.

PubMed

Earnest, G Scott; Reed, Laurence D; Conover, D; Estill, C; Gjessing, C; Gressel, M; Hall, R; Hudock, S; Hudson, H; Kardous, C; Sheehy, J; Topmiller, J; Trout, D; Woebkenberg, M; Amendola, A; Hsiao, H; Keane, P; Weissman, D; Finfinger, G; Tadolini, S; Thimons, E; Cullen, E; Jenkins, M; McKibbin, R; Conway, G; Husberg, B; Lincoln, J; Rodenbeck, S; Lantagne, D; Cardarelli, J

2006-12-22

Engineering is the application of scientific and technical knowledge to solve human problems. Using imagination, judgment, and reasoning to apply science, technology, mathematics, and practical experience, engineers develop the design, production, and operation of useful objects or processes. During the 1940s, engineers dominated the ranks of CDC scientists. In fact, the first CDC director, Assistant Surgeon General Mark Hollis, was an engineer. CDC engineers were involved in malaria control through the elimination of standing water. Eventually the CDC mission expanded to include prevention and control of dengue, typhus, and other communicable diseases. The development of chlorination, water filtration, and sewage treatment were crucial to preventing waterborne illness. Beginning in the 1950s, CDC engineers began their work to improve public health while developing the fields of environmental health, industrial hygiene, and control of air pollution. Engineering disciplines represented at CDC today include biomedical, civil, chemical, electrical, industrial, mechanical, mining, and safety engineering. Most CDC engineers are located in the National Institute for Occupational Safety and Health (NIOSH) and the Agency for Toxic Substances and Disease Registry (ATSDR). Engineering research at CDC has a broad stakeholder base. With the cooperation of industry, labor, trade associations, and other stakeholders and partners, current work includes studies of air contaminants, mining, safety, physical agents, ergonomics, and environmental hazards. Engineering solutions remain a cornerstone of the traditional "hierarchy of controls" approach to reducing public health hazards.
Orbit transfer vehicle engine study. Volume 2: Technical report

NASA Technical Reports Server (NTRS)

1980-01-01

The orbit transfer vehicle (OTV) engine study provided parametric performance, engine programmatic, and cost data on the complete propulsive spectrum that is available for a variety of high energy, space maneuvering missions. Candidate OTV engines from the near term RL 10 (and its derivatives) to advanced high performance expander and staged combustion cycle engines were examined. The RL 10/RL 10 derivative performance, cost and schedule data were updated and provisions defined which would be necessary to accommodate extended low thrust operation. Parametric performance, weight, envelope, and cost data were generated for advanced expander and staged combustion OTV engine concepts. A prepoint design study was conducted to optimize thrust chamber geometry and cooling, engine cycle variations, and controls for an advanced expander engine. Operation at low thrust was defined for the advanced expander engine and the feasibility and design impact of kitting was investigated. An analysis of crew safety and mission reliability was conducted for both the staged combustion and advanced expander OTV engine candidates.
Primary Self-Expandable Nitinol Stent Placement in Focal Lesions of Infrarenal Abdominal Aorta: Long Term Results

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

Lastovickova, Jarmila, E-mail: jala@medicon.cz; Peregrin, Jan H.

Purpose. To evaluate the technical and clinical success, safety and long term results of percutaneous transluminal angioplasty/self-expandable nitinol stent placement of infrarenal abdominal aorta focal lesions. Materials and Methods. Eighteen patients underwent PTA of focal atherosclerotic occlusive disease of distal abdominal aorta. Two symptomatic occlusions and 16 stenoses in 10 male and 8 female patients (mean age 68.2 years) were treated with primary self-expandable nitinol stent placement. Results. Primary self-expandable nitinol stent placement was technically successful in all 18 procedures; clinical success was achieved in 100% of patients. No complications associated with the procedure occurred. During the 49.4 months ofmore » mean follow up (range 3-96, 4 months) all treated aortic segments remained patent. Conclusions. Endovascular treatment (primary self-expandable nitinol stent placement) of focal atherosclerotic lesions of distal abdominal aorta is a safe method with excellent primary technical and clinical success rates and favourable Long term results.« less
High Performing Schools in High Risk Environments: A Study on Leadership, School Safety, and Student Achievement at Two Urban Middle Schools in Los Angeles County

ERIC Educational Resources Information Center

Frias, Gus

2010-01-01

In the United States of America, all students and staff have a constitutional right to attend schools that are safe, secure, and successful. Despite this right, at many public schools, education leaders have failed to ensure the safety and high academic achievement of all students. The purpose of this research study is to expand knowledge about…

Determining animal drug combinations based on efficacy and safety.

PubMed

Kratzer, D D; Geng, S

1986-08-01

A procedure for deriving drug combinations for animal health is used to derive an optimal combination of 200 mg of novobiocin and 650,000 IU of penicillin for nonlactating cow mastitis treatment. The procedure starts with an estimated second order polynomial response surface equation. That surface is translated into a probability surface with contours called isoprobs. The isoprobs show drug amounts that have equal probability to produce maximal efficacy. Safety factors are incorporated into the probability surface via a noncentrality parameter that causes the isoprobs to expand as safety decreases, resulting in lower amounts of drug being used.
Hydrogen flammability limits and implications on fire safety of transportation vehicles

DOT National Transportation Integrated Search

2008-01-01

The recent establishment of the National University Transportation Center at MST under the "Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users," expands the research and education activities to include alternative tr...
Clinician's guide to assessing and counseling older drivers, 3rd Edition.

DOT National Transportation Integrated Search

2015-01-01

The American Geriatrics Society (AGS) entered into a cooperative agreement with the U. S . : Department of Transportations National Highway Traffic Safety Administration (NHTSA) to : update and expand the Physicians Guide to Assessing and Couns...
Biodegradable stents for the treatment of refractory or recurrent benign esophageal stenosis.

PubMed

Imaz-Iglesia, Iñaki; García-Pérez, Sonia; Nachtnebel, Anna; Martín-Águeda, Belén; Sánchez-Piedra, Carlos; Karadayi, Bilgehan; Demirbaş, Ali Rıza

2016-06-01

Esophageal stents are used for the treatment of refractory and recurrent dyphagias. In 2007, esophageal biodegradable stents (EBS) were authorised as an alternative to existing metal and plastic stents in Europe. The advantages claimed for EBS are fewer complications concerning tissue ingrowth, stent migration and stent removal. We performed a systematic review to evaluate the efficacy and safety of EBS compared to fully-covered self-expanding metal stents, self-expanding plastic stents, and esophageal dilation for the treatment of refractory or recurrent benign esophageal stenosis. Three comparative studies (one randomized controlled trial and two cohort studies) were assessed. The studies used different inclusion criteria, had a very small (sample) size and the quality of the evidence was very low. Expert commentary: The current evidence is insufficient to determine the relative efficacy or safety of esophageal biodegradable stents. The results of this systematic review should be updated once new evidence is available.
Expanded clay hot mix study : final report: part I.

DOT National Transportation Integrated Search

1969-04-01

This is part I of a two part final report on expanded clay hot mix to: (1) evaluate the use of various expanded clay bituminous mixtures under high traffic counts, (2) accumulate through experience testing, suitable information on the physical proper...
The dentist's care-taking perspective of dental fear patients - a continuous and changing challenge.

PubMed

Gyllensvärd, K; Qvarnström, M; Wolf, E

2016-08-01

The aim was to analyse the care taking of dental fear patients from the perspective of the dentist, using a qualitative methodology. In total, 11 dentists from both the private and public dental service were selected through a purposive sampling according to their experience of treating dental fear patients, their gender, age, service affiliation and location of undergraduate education. Data were obtained using one semi-structured interview with each informant. The interviews were taped and verbatim transcribed. The text was analysed using qualitative content analysis. The theme, 'The transforming autodidactic process of care taking', covering the interpretative level of data content was identified. The first main category covering the descriptive level of data was 'The continuous and changing challenge', with the subcategories 'The emotional demand' and 'The financial stress'. The second main category identified was 'The repeated collection of experience', with the subcategories 'The development of resources' and 'The emotional change'. The dentists' experience of treating dental fear patients was considered a challenging self-taught process under continuous transformation. The competence and routine platform expanded over time, parallel to a change of connected emotions from frustration towards safety, although challenges remained. © 2016 John Wiley & Sons Ltd.
Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America.

PubMed

Stadler, Walter M; Figlin, Robert A; McDermott, David F; Dutcher, Janice P; Knox, Jennifer J; Miller, Wilson H; Hainsworth, John D; Henderson, Charles A; George, Jeffrey R; Hajdenberg, Julio; Kindwall-Keller, Tamila L; Ernstoff, Marc S; Drabkin, Harry A; Curti, Brendan D; Chu, Luis; Ryan, Christopher W; Hotte, Sebastien J; Xia, Chenghua; Cupit, Lisa; Bukowski, Ronald M

2010-03-01

The Advanced Renal Cell Carcinoma Sorafenib (ARCCS) program made sorafenib available to patients with advanced renal cell carcinoma (RCC) before regulatory approval. In this nonrandomized, open-label expanded access program, 2504 patients from the United States and Canada were treated with oral sorafenib 400 mg twice daily. Safety and efficacy were explored overall and in subgroups of patients including those with no prior therapy, nonclear cell (nonclear cell) RCC, brain metastases, prior bevacizumab treatment, and elderly patients. Sorafenib was approved for RCC 6 months after study initiation, at which time patients with no prior therapy or with nonclear cell RCC could enroll in an extension protocol for continued assessment for a period of 6 months. The most common grade > or =2 drug-related adverse events were hand-foot skin reaction (18%), rash (14%), hypertension (12%), and fatigue (11%). In the 1891 patients evaluable for response, complete response was observed in 1 patient, partial response in 67 patients (4%), and stable disease for at least 8 weeks in 1511 patients (80%). Median progression-free survival in the extension population was 36 weeks (95% confidence interval [CI], 33-45 weeks; censorship rate, 56%); median overall survival in the entire population was 50 weeks (95% CI, 46-52 weeks; censorship rate, 63%). The efficacy and safety results were similar across the subgroups. Sorafenib 400 mg twice daily demonstrated activity and a clinically acceptable toxicity profile in all patient subsets enrolled in the ARCCS expanded access program (clinicaltrials.gov identifier: NCT00111020).
Rethinking impact evaluation and carbon reduction analysis on electric bus vehicles in China

NASA Astrophysics Data System (ADS)

Li, Zhenyu; Li, Chao; Liao, Kai; Yin, Zhifang

2018-02-01

New energy bus vehicles (NEBVs) are expanding in China, but they have some problems such as technology, high cost and safety etc., thus NEBVs should be comprehensively evaluated from costs, technologies, environment, and based on the evaluation results, some changes should be improved. This paper firstly analyses the current status of both vehicle development and existing policies, identifies the main characteristics and the main problems in term of the economic, standard, policy, etc., by scenario analysis, forecasts the future growth from now to 2030 and calculates the emission reduction in low level scenario and high level scenario. In 2020 and 2030, 6 million and 24 million ton of CO2 emission will be reduced respectively. Finally, the paper makes a conclusion of Chinese experiences and gives some measures for the future development.
Generalized weighted ratio method for accurate turbidity measurement over a wide range.

PubMed

Liu, Hongbo; Yang, Ping; Song, Hong; Guo, Yilu; Zhan, Shuyue; Huang, Hui; Wang, Hangzhou; Tao, Bangyi; Mu, Quanquan; Xu, Jing; Li, Dejun; Chen, Ying

2015-12-14

Turbidity measurement is important for water quality assessment, food safety, medicine, ocean monitoring, etc. In this paper, a method that accurately estimates the turbidity over a wide range is proposed, where the turbidity of the sample is represented as a weighted ratio of the scattered light intensities at a series of angles. An improvement in the accuracy is achieved by expanding the structure of the ratio function, thus adding more flexibility to the turbidity-intensity fitting. Experiments have been carried out with an 850 nm laser and a power meter fixed on a turntable to measure the light intensity at different angles. The results show that the relative estimation error of the proposed method is 0.58% on average for a four-angle intensity combination for all test samples with a turbidity ranging from 160 NTU to 4000 NTU.
Violence against women in North America.

PubMed

Erlick Robinson, G

2003-08-01

Although North America is viewed as a place where women have equal rights and status, violence against women is still rampant. Forty to 51% of women experience some type of violence in their lifetime including child abuse, physical violence, rape and domestic violence. The perpetrator is most likely to be a current or former partner. Such violence stems from historical views of women as property and may flourish because of the public's reluctance to get involved in family matters. The concept of violence has been expanded to include non-traditional types such as sexual harassment, breeches of fiduciary trust and stalking. Treatment of victims of violence must include ensuring their safety, encouraging them to make healthy choices and helping them to understand they are not at fault. Education at all levels is required to change attitudes which perpetuate violence despite laws which forbid it.
Effects of an Advanced Reactor’s Design, Use of Automation, and Mission on Human Operators

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

Jeffrey C. Joe; Johanna H. Oxstrand

The roles, functions, and tasks of the human operator in existing light water nuclear power plants (NPPs) are based on sound nuclear and human factors engineering (HFE) principles, are well defined by the plant’s conduct of operations, and have been validated by years of operating experience. However, advanced NPPs whose engineering designs differ from existing light-water reactors (LWRs) will impose changes on the roles, functions, and tasks of the human operators. The plans to increase the use of automation, reduce staffing levels, and add to the mission of these advanced NPPs will also affect the operator’s roles, functions, and tasks.more » We assert that these factors, which do not appear to have received a lot of attention by the design engineers of advanced NPPs relative to the attention given to conceptual design of these reactors, can have significant risk implications for the operators and overall plant safety if not mitigated appropriately. This paper presents a high-level analysis of a specific advanced NPP and how its engineered design, its plan to use greater levels of automation, and its expanded mission have risk significant implications on operator performance and overall plant safety.« less
Lasers and laser-like devices: part one.

PubMed

Stewart, Nicholas; Lim, Adrian C; Lowe, Patricia M; Goodman, Greg

2013-08-01

Lasers have been used in dermatology for nearly 50 years. Through their selective targeting of skin chromophores they have become the preferred treatment for many skin conditions, including vascular malformations, photorejuvenation and acne scars. The technology and design of lasers continue to evolve, allowing greater control of laser parameters and resulting in increased safety and efficacy for patients. Innovations have allowed the range of conditions and the skin types amenable to treatment, in both general and cosmetic dermatology, to expand over the last decade. Integrated skin cooling and laser beam fractionation, for example, have improved safety, patient tolerance and decreased downtime. Furthermore, the availability and affordability of quality devices continues to increase, allowing clinicians not only to access laser therapies more readily but also to develop their personal experience in this field. As a result, most Australian dermatologists now have access to laser therapies, either in their own practice or within referable proximity, and practical knowledge of these technologies is increasingly required and expected by patients. Non-laser energy devices utilising intense pulsed light, plasma, radiofrequency, ultrasound and cryolipolysis contribute to the modern laser practitioners' armamentarium and will also be discussed. © 2013 The Authors. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.
Dissolved phosphorus retention of light-weight expanded shale and masonry sand used in subsurface flow treatment wetlands.

PubMed

Forbes, Margaret G; Dickson, Kenneth R; Golden, Teresa D; Hudak, Paul; Doyle, Robert D

2004-02-01

Using surface flow constructed wetlands for long-term phosphorus (P) retention presents a challenge due to the fact that P is stored primarily in the sediments. Subsurface flow wetlands have the potential to greatly increase P retention; however, the substrate needs to have both high hydraulic conductivity and high P sorption capacity. The objective of our study was to assess the P retention capacity of two substrates, masonry sand and lightweight expanded shale. We used sorption/desorption isotherms, flow-through column experiments, and pilot-scale wetlands to quantify P retained from treated municipal wastewater. Langmuir sorption isotherms predicted that the expanded shale has a maximum sorption capacity of 971 mg/kg and the masonry sand 58.8 mg/kg. In column desorption and column flow-through experiments, the masonry sand desorbed P when exposed to dilute P solutions. The expanded shale, however, had very little desorption and phosphorus did not break through the columns during our experiment. In pilot cells, masonry sand retained (mean +/- standard deviation) 45 +/- 62 g P/m2/yr and expanded shale retained 164 +/- 110 g P/m2/yr. We conclude that only the expanded shale would be a suitable substrate for retaining P in a subsurface flow wetland.
Health Topics: MedlinePlus

MedlinePlus

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Evaluation of Education and Outreach Programs

DOT National Transportation Integrated Search

2011-12-01

Education and outreach are acknowledged, if only anecdotally, for contributing to an overall safer rail environment. The use of education and outreach programs as a means to improve highway-rail safety has expanded over the years since 1970 and the i...
Development of a portable weigh-in-motion system.

DOT National Transportation Integrated Search

2013-03-01

Weigh-In-Motion (WIM) data is used for a variety of roadway design and safety purposes. In compliance with Federal Highway Administration (FHWA) mandates, many states have installed permanent WIM sites to measure vehicle weight. Expanding current sit...
Experiments with linear compressors for phase shifting in pulse tube crycoolers

NASA Astrophysics Data System (ADS)

Lewis, Michael; Bradley, Peter; Radebaugh, Ray

2012-06-01

For the past year NIST has been investigating the use of mechanical phase shifters as warm expanders for pulse tube cryocoolers. Unlike inertance tubes, which have a limited phase shifting ability at low acoustic powers, mechanical phase shifters have the ability to provide nearly any phase angle between the mass flow and the pressure. We discuss our results with experiments and modeling on a commercially available miniature linear compressor operating as an expander on the warm-end of a 4 K pulse tube, whose temperature is nominally about 35 K. We also present results on experiments with a linear compressor operating at room temperature but coupled to the 4 K stage through secondary regenerators and secondary pulse tubes. Experiments on a small pulse tube test apparatus with both 4He and 3He showed improved efficiency when using the mechanical expander over that of inertance tubes. Phase locking techniques using function generators and power amplifiers for control of phase angle are detailed. The use of expanders demonstrates flexible control in optimizing phase angles for improved cryocooler performance.
A longitudinal study of an intervention to improve road safety climate: climate as an organizational boundary spanner.

PubMed

Naveh, Eitan; Katz-Navon, Tal

2015-01-01

This study presents and tests an intervention to enhance organizational climate and expands existing conceptualization of organizational climate to include its influence on employee behaviors outside the organization's physical boundaries. In addition, by integrating the literatures of climate and work-family interface, the study explored climate spillover and crossover from work to the home domain. Focusing on an applied practical problem within organizations, we investigated the example of road safety climate and employees' and their families' driving, using a longitudinal study design of road safety intervention versus control groups. Results demonstrated that the intervention increased road safety climate and decreased the number of traffic violation tickets and that road safety climate mediated the relationship between the intervention and the number of traffic violation tickets. Road safety climate spilled over to the family domain but did not cross over to influence family members' driving. (c) 2015 APA, all rights reserved.
Childhood lead poisoning associated with lead dust contamination of family vehicles and child safety seats - Maine, 2008.

PubMed

2009-08-21

Persons employed in high-risk lead-related occupations can transport lead dust home from a worksite through clothing, shoes, tools, or vehicles. During 2008, the Maine Childhood Lead Poisoning Prevention Program (MCLPPP) identified 55 new cases of elevated (>or=15 microg/dL) venous blood lead levels (BLLs) among children aged <6 years through mandated routine screening. Although 90% of childhood lead poisoning cases in Maine during 2003-2007 had been linked to lead hazards in the child's home, no lead-based paint or dust or water with elevated lead levels were found inside the homes associated with six of the 2008 cases (i.e., five families, including one family with two affected siblings). An expanded environmental investigation determined that these six children were exposed to lead dust in the family vehicles and in child safety seats. The sources of the lead dust were likely household contacts who worked in high-risk lead exposure occupations. Current recommendations for identifying and reducing risk from take-home lead poisoning include 1) ensuring that children with elevated BLLs are identified through targeted blood lead testing, 2) directing prevention activities to at-risk workers and employers, and 3) improving employer safety protocols. State and federal prevention programs also should consider, when appropriate, expanded environmental lead dust testing to include vehicles and child safety seats.
The Safety and efficacy of a new self-expandable intratracheal nitinol stent for the tracheal collapse in dogs

PubMed Central

Kim, Joon-young; Han, Hyun-jung; Yun, Hun-young; Lee, Bora; Jang, Ha-young; Eom, Ki-dong; Park, Hee-myung

2008-01-01

To evaluate the potential utility of a self-expandable intratracheal nitinol stent with flared ends for the treatment of tracheal collapse in dogs, endotracheal stenting therapy was performed under fluoroscopic guidance in four dogs with severe tracheal collapse. During the 4 to 7 month follow-up, after stent implantation, clinical signs, including dyspnea and respiratory distress, dramatically improved in all dogs. The radiographs showed that the implanted stents improved the tracheal collapse, and there were no side effects such as collapse, shortening or migration of the stents. In conclusion, the self-expandable intratracheal nitinol stents provided adequate stability to the trachea and were effective for attenuating the clinical signs associated with severe tracheal collapse. PMID:18296893

The EXPAND study: Efficacy and safety of rivaroxaban in Japanese patients with non-valvular atrial fibrillation.

PubMed

Shimokawa, Hiroaki; Yamashita, Takeshi; Uchiyama, Shinichiro; Kitazono, Takanari; Shimizu, Wataru; Ikeda, Takanori; Kamouchi, Masahiro; Kaikita, Koichi; Fukuda, Koji; Origasa, Hideki; Sakuma, Ichiro; Saku, Keijiro; Okumura, Yasuo; Nakamura, Yuichiro; Morimoto, Hideo; Matsumoto, Naoki; Tsuchida, Akihito; Ako, Junya; Sugishita, Nobuyoshi; Shimizu, Shogo; Atarashi, Hirotsugu; Inoue, Hiroshi

2018-05-01

The EXPAND study examined the real-world efficacy and safety of rivaroxaban for the prevention of stroke and systemic embolism (SE) in Japanese patients with non-valvular atrial fibrillation (NVAF). This multicenter, prospective, non-interventional, observational, cohort study was conducted at 684 medical centers in Japan. A total of 7141 NVAF patients ≥20 years of age (mean, 71.6 ± 9.4 years) who were being or about to be treated with rivaroxaban (10 mg/day, 43.5%; 15 mg/day, 56.5%) were followed for an average of 897.1 (±206.8) days with a high follow-up rate (99.65%). The mean CHADS 2 score at baseline was 2.1 (1.3) (0-1, 37%; 2, 29%; ≥3, 34%). The total incidence rate of symptomatic stroke and SE (primary efficacy endpoint) was 1.0%/year, and 0.5%, 0.9%, and 1.7%/year for those with CHADS 2 scores of 0-1, 2, and ≥3, respectively. Cumulative incidence rates for major bleeding (primary safety endpoint) and non-major bleeding (secondary safety endpoint) were 1.2%/year and 4.9%/year, respectively. Differences were noted between new and current users only for major bleeding event rate (1.7% vs. 1.1%/year, P = 0.0024). Comparisons with previous studies suggested that rivaroxaban is effective and safe for low-risk patients (0-1 CHADS 2 ), as shown for warfarin in the XANTUS international prospective post-marketing study. The EXPAND study demonstrated that low dosages of rivaroxaban for Japanese NVAF patients in real-world clinical practice, including those with CHADS 2 scores 0-1, resulted in low rates of stroke and SE, and major and non-major bleeding. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.
PReSaFe: A model of barriers and facilitators to patients providing feedback on experiences of safety.

PubMed

De Brún, Aoife; Heavey, Emily; Waring, Justin; Dawson, Pamela; Scott, Jason

2017-08-01

The importance of involving patients in reporting on safety is increasingly recognized. Whilst studies have identified barriers to clinician incident reporting, few have explored barriers and facilitators to patient reporting of safety experiences. This paper explores patient perspectives on providing feedback on safety experiences. Patients (n=28) were invited to take part in semi-structured interviews when given a survey about their experiences of safety following hospital discharge. Transcripts were thematically analysed using NVivo10. Patients were recruited from four hospitals in the UK. Three themes were identified as barriers and facilitators to patient involvement in providing feedback on their safety experiences. The first, cognitive-cultural, found that whilst safety was a priority for most, some felt the term was not relevant to them because safety was the "default" position, and/or because safety could not be disentangled from the overall experience of care. The structural-procedural theme indicated that reporting was facilitated when patients saw the process as straightforward, but that disinclination or perceived inability to provide feedback was a barrier. Finally, learning and change illustrated that perception of the impact of feedback could facilitate or inhibit reporting. When collecting patient feedback on experiences of safety, it is important to consider what may help or hinder this process, beyond the process alone. We present a staged model of prerequisite barriers and facilitators and hypothesize that each stage needs to be achieved for patients to provide feedback on safety experiences. Implications for collecting meaningful data on patients' safety experiences are considered. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
Safer trocar insertion for closed laparoscopic access: ex vivo assessment of an improved Veress needle.

PubMed

Nevler, Avinoam; Har-Zahav, Gil; Rosin, Danny; Gutman, Mordechai

2016-02-01

Laparoscopic surgery is widely practiced surgical technique in the modern surgical toolbox. The Veress needle insertion technique, while faster and easier, is associated with higher rates of iatrogenic complications (injury to internal organs, major blood vessels, etc.), morbidity and even mortality with a reported overall risk of 0.32% during surgical interventions. In order to increase the safety and ease of closed insertion technique, we designed and tested an improved prototype of the Veress needle. The new Veress needle includes a distal expandable portion that allows elevation of the abdominal wall and safe insertion of the first trocar over it. The needle was assessed by measurement of ease of insertion, ease of trocar advancement, associated tissue damage, device integrity and weight-bearing capacity on an ex vivo Gallus domesticus animal model: The prototype was tested over 20 times using different traction forces. The experiment was qualitatively repeated on an ex vivo porcine model. In the G. domesticus model, the improved needle supported forces of up to 5.75 kg F. No damage or mechanical malfunction was seen at any stage of the experiment. Needle penetration, ease of trocar insertion, system anchoring and weight-bearing capacity were rated (1-5) by four raters--mean 4.9 ± 0.31. Inter-rater agreement was high (free marginal κ 0.75). The porcine experiment revealed similar ease of use with neither complication nor damage to the abdominal wall. We believe that the new Veress system is easy to use, requires no additional training, non-inferior in its capabilities compared to the traditional Veress needle, with the advantage of improving the safety of the first trocar insertion phase of the operation.
Openness to experience, work experience and patient safety.

PubMed

Chang, Hao-Yuan; Friesner, Daniel; Lee, I-Chen; Chu, Tsung-Lan; Chen, Hui-Ling; Wu, Wan-Er; Teng, Ching-I

2016-11-01

The purpose of this study is to examine how the interaction between nurse openness and work experience is related to patient safety. No study has yet examined the interactions between these, and how openness and work experience jointly impact patient safety. This study adopts a cross-sectional design, using self-reported work experience, perceived time pressure and measures of patient safety, and was conducted in a major medical centre. The sample consisted of 421 full-time nurses from all available units in the centre. Proportionate random sampling was used. Patient safety was measured using the self-reported frequency of common adverse events. Openness was self-rated using items identified in the relevant literature. Nurse openness is positively related to the patient safety construct (B = 0.08, P = 0.03). Moreover, work experience reduces the relation between openness and patient safety (B = -0.12, P < 0.01). The relationship between openness, work experience and patient safety suggests a new means of improving patient care in a health system setting. Nurse managers may enhance patient safety by assessing nurse openness and assigning highly open nurses to duties that make maximum use of that trait. © 2016 John Wiley & Sons Ltd.
Patient Reporting of Safety experiences in Organisational Care Transfers (PRoSOCT): a feasibility study of a patient reporting tool as a proactive approach to identifying latent conditions within healthcare systems

PubMed Central

Scott, Jason; Waring, Justin; Heavey, Emily; Dawson, Pamela

2014-01-01

Background It is increasingly recognised that patients can play a role in reporting safety incidents. Studies have tended to focus on patients within hospital settings, and on the reporting of patient safety incidents as defined within a medical model of safety. This study aims to determine the feasibility of collecting and using patient experiences of safety as a proactive approach to identifying latent conditions of safety as patients undergo organisational care transfers. Methods and analysis The study comprises three components: (1) patients’ experiences of safety relating to a care transfer, (2) patients’ receptiveness to reporting experiences of safety, (3) quality improvement using patient experiences of safety. (1) A safety survey and evaluation form will be distributed to patients discharged from 15 wards across four clinical areas (cardiac, care of older people, orthopaedics and stroke) over 1 year. Healthcare professionals involved in the care transfer will be provided with a regular summary of patient feedback. (2) Patients (n=36) who return an evaluation form will be sampled representatively based on the four clinical areas and interviewed about their experiences of healthcare and safety and completing the survey. (3) Healthcare professionals (n=75) will be invited to participate in semistructured interviews and focus groups to discuss their experiences with and perceptions of receiving and using patient feedback. Data analysis will explore the relationship between patient experiences of safety and other indicators and measures of quality and safety. Interview and focus group data will be thematically analysed and triangulated with all other data sources using a convergence coding matrix. Ethics and dissemination The study has been granted National Health Service (NHS) Research Ethics Committee approval. Patient experiences of safety will be disseminated to healthcare teams for the purpose of organisational development and quality improvement. Results will be disseminated to study participants as well as through peer-reviewed outputs. PMID:24833698
Harnessing hospital purchase power to design safe care delivery.

PubMed

Ebben, Steven F; Gieras, Izabella A; Gosbee, Laura Lin

2008-01-01

Since the Institute of Medicine's well-publicized 1999 report To Err is Human, the healthcare patient safety movement has grown at an exponential pace. However, much more can be done to advance patient safety from a care process design vantage point-improving safety through effective care processes and technology integration. While progress is being made, the chasm between technology developers and caregivers remains a profound void. Why hasn't more been done to expand our view of patient safety to include technology design? Healthcare organizations have not consolidated their purchasing power to expect improved designs. This article will (1) provide an assessment of the present state of healthcare technology management and (2) provide recommendations for collaborative design of safe healthcare delivery systems.
Robot-assisted vitreoretinal surgery: current perspectives

PubMed Central

Roizenblatt, Marina; Edwards, Thomas L; Gehlbach, Peter L

2018-01-01

Vitreoretinal microsurgery is among the most technically challenging of the minimally invasive surgical techniques. Exceptional precision is required to operate on micron scale targets presented by the retina while also maneuvering in a tightly constrained and fragile workspace. These challenges are compounded by inherent limitations of the unassisted human hand with regard to dexterity, tremor and precision in positioning instruments. The limited human ability to visually resolve targets on the single-digit micron scale is a further limitation. The inherent attributes of robotic approaches therefore, provide logical, strategic and promising solutions to the numerous challenges associated with retinal microsurgery. Robotic retinal surgery is a rapidly emerging technology that has witnessed an exponential growth in capabilities and applications over the last decade. There is now a worldwide movement toward evaluating robotic systems in an expanding number of clinical applications. Coincident with this expanding application is growth in the number of laboratories committed to “robotic medicine”. Recent technological advances in conventional retina surgery have also led to tremendous progress in the surgeon’s capabilities, enhanced outcomes, a reduction of patient discomfort, limited hospitalization and improved safety. The emergence of robotic technology into this rapidly advancing domain is expected to further enhance important aspects of the retinal surgery experience for the patients, surgeons and society. PMID:29527537
Robot-assisted vitreoretinal surgery: current perspectives.

PubMed

Roizenblatt, Marina; Edwards, Thomas L; Gehlbach, Peter L

2018-01-01

Vitreoretinal microsurgery is among the most technically challenging of the minimally invasive surgical techniques. Exceptional precision is required to operate on micron scale targets presented by the retina while also maneuvering in a tightly constrained and fragile workspace. These challenges are compounded by inherent limitations of the unassisted human hand with regard to dexterity, tremor and precision in positioning instruments. The limited human ability to visually resolve targets on the single-digit micron scale is a further limitation. The inherent attributes of robotic approaches therefore, provide logical, strategic and promising solutions to the numerous challenges associated with retinal microsurgery. Robotic retinal surgery is a rapidly emerging technology that has witnessed an exponential growth in capabilities and applications over the last decade. There is now a worldwide movement toward evaluating robotic systems in an expanding number of clinical applications. Coincident with this expanding application is growth in the number of laboratories committed to "robotic medicine". Recent technological advances in conventional retina surgery have also led to tremendous progress in the surgeon's capabilities, enhanced outcomes, a reduction of patient discomfort, limited hospitalization and improved safety. The emergence of robotic technology into this rapidly advancing domain is expected to further enhance important aspects of the retinal surgery experience for the patients, surgeons and society.
Toward a National Framework for the Secondary Use of Health Data: An American Medical Informatics Association White Paper

PubMed Central

Safran, Charles; Bloomrosen, Meryl; Hammond, W. Edward; Labkoff, Steven; Markel-Fox, Suzanne; Tang, Paul C.; Detmer, Don E.

2007-01-01

Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers’ needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard “good practices” for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use. PMID:17077452
Evaluation of education and outreach programs : research results.

DOT National Transportation Integrated Search

2011-12-01

"Education and outreach are acknowledged, if only anecdotally, for contributing to an overall safer rail environment. The use of education and outreach programs as a means to improve highway-rail safety has expanded over the years since 1970 and the ...
METHOD AND APPARATUS FOR REACTOR SAFETY CONTROL

DOEpatents

Huston, N.E.

1961-06-01

A self-contained nuclear reactor fuse controlled device tron absorbing material, normally in a compact form but which can be expanded into an extended form presenting a large surface for neutron absorption when triggered by an increase in neutron flux, is described.
Multiphysics Object-Oriented Simulation Environment (MOOSE)

ScienceCinema

None

2017-12-09

Nuclear reactor operators can expand safety margins with more precise information about how materials behave inside operating reactors. INL's new simulation platform makes such studies easier & more informative by letting researchers "plug-n-play" their mathematical models, skipping years of computer code development.
Drug Safety - Multiple Languages

MedlinePlus

... Expand Section Guide to Over the Counter Medications - English PDF Guide to Over the Counter Medications - Amarɨñña / ... Information Translations Guide to Over the Counter Medications - English PDF Guide to Over the Counter Medications - العربية ( ...
Pet Food Safety A Shared Concern

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

Buchanan, Robert L; Baker, Robert C; Charlton, Adrian J

2011-01-01

The safety of the food supply is a subject of intense interest to consumers, particularly as a result of large scale outbreaks that involve hundreds and sometimes thousands of consumers. During the last decade this concern about food safety has expanded to include the diets of companion animals as a result of several incidences of chemical toxicities and infectious disease transmission. This has led to increased research into the causes and controls for these hazards for both companion animals and their owners. The following summary provides an introduction to the issues, challenges, and new tools being developed to ensure thatmore » commercial pet foods are both nutritious and safe.« less
International cooperation in veterinary public health curricula using web-based distance interactive education.

PubMed

Lipman, Len J; Barnier, Valérie M; de Balogh, Katalin K

2003-01-01

The expanding field of Veterinary Public Health places new demands on the knowledge and skills of veterinarians. Veterinary curricula must therefore adapt to this new profile. Through the introduction of case studies dealing with up-to-date issues, students are being trained to solve (real-life) problems and come up with realistic solutions. At the Department of Public Health and Food Safety of the Veterinary Faculty at the University of Utrecht in the Netherlands, positive experiences have resulted from the new opportunities offered by the use of information and communication technology (ICT) in education. The possibility of creating a virtual classroom on the Internet through the use of WebCT software has enabled teachers and students to tackle emerging issues by working together with students in other countries and across disciplines. This article presents some of these experiences, through which international exchange of ideas and realities were stimulated, in addition to consolidating relations between universities in different countries. Long-distance education methodologies provide an important tool to achieve the increasing need for international cooperation in Veterinary Public Health curricula.
Project 57 Air Monitoring Report: January 1 through December 31, 2015

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

Mizell, Steve A; Nikolich, George; Shadel, Craig

2017-01-01

On April 24, 1957, the Atomic Energy Commission (AEC, now the Department of Energy [DOE]) conducted the Project 57 safety experiment in western Emigrant Valley north east of the Nevada National Security Site (NNSS, formerly the Nevada Test Site) on lands withdrawn by the Department of Defense (DOD) for the Nevada Test and Training Range (NTTR). The test was undertaken to develop (1) a means of estimating plutonium distribution resulting from a non-nuclear detonation; (2) biomedical evaluation techniques for use in plutonium-laden environments; (3) methods of surface decontamination; and (4) instruments and field procedures for prompt estimation of alpha contaminationmore » (Shreve, 1958). Although the test did not result in the fission of nuclear materials, it did disseminate plutonium across the land surface. Following the experiment, the AEC fenced the contaminated area and returned control of the surrounding land to the DOD. Various radiological surveys were performed in the area and in 2007, the DOE expanded the demarked Contamination Area by posting signs 200 to 400 feet (60 to 120 meters) outside of the original fence.« less
Project 57 Air Monitoring Report: January 1 through December 31, 2016

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

Mizell, Steve A.; Nikolich, George; Shadel, Craig

On April 24, 1957, the Atomic Energy Commission (AEC, now the Department of Energy [DOE]) conducted the Project 57 safety experiment in western Emigrant Valley northeast of the Nevada National Security Site (NNSS, formerly the Nevada Test Site) on lands withdrawn by the Department of Defense (DOD) for the Nevada Test and Training Range (NTTR). The test was undertaken to develop (1) a means of estimating plutonium distribution resulting from a non-nuclear detonation; (2) biomedical evaluation techniques for use in plutonium-laden environments; (3) methods of surface decontamination; and (4) instruments and field procedures for prompt estimation of alpha contamination (Shreve,more » 1958). Although the test did not result in the fission of nuclear materials, it did disseminate plutonium across the land surface. Following the experiment, the AEC fenced the contaminated area and returned control of the surrounding land to the DOD. Various radiological surveys were performed in the area and in 2007, the DOE expanded the demarked Contamination Area (CA) by posting signs 200 to 400 ft (60 to 120 m) outside of the original fence.« less
Balancing tradeoffs in the Denali Wilderness: an expanded approach to normative research using stated choice analysis

Treesearch

Steven R. Lawson; Robert Manning

2002-01-01

Wilderness experiences are thought to be comprised of or defined by three dimensions, including social, resource, and management conditions. Decisions about how to manage wilderness recreation in Denali National Park involve potential tradeoffs among the conditions of resource, social, and managerial attributes of the wilderness experience. This study expands the...
A pilot study about the oncologic safety of colonic self-expandable metal stents (SEMS) in obstructive colon cancer: is occlusion always better than "silent" perforation?

PubMed

Zanghì, A; Piccolo, G; Cavallaro, A; Pulvirenti, E; Lo Menzo, E; Cardì, F; Di Vita, M; Cappellani, A

2016-12-01

To evaluate the oncologic safety of colonic self-expandable metal stents (SEMS) in obstructive colon cancer. We retrospectively reviewed all the patients who were treated with endoscopic placement of a self-expandable metallic stent (SEMS) at our institution. A total of 26 patients were identified during the study period, of which 24 patients (92.30%) were treated with SEMS as a bridge-to-surgery and 2 (7.69%) as palliation. In 22 cases (80.76%), the stenosis was localized to the left side. Clinical success with resolution of bowel obstructions was achieved in 22 (84.61%) patients within a short period of time. Among patients treated successfully with SEMS insertion as bridge to surgery (n = 22), 20 (90.9%) underwent one-stage surgery with primary anastomosis while 2 patients (9.09%) underwent colostomy due to intraoperative evidence of a covered perforation by cancer tissue in the pelvis. Patients with subclinical perforation developed an early peritoneal carcinomatosis, 10 patients treated with curative intent subsequently developed liver metastasis after 24 months. We reported an overall poor outcome among patients treated with the insertion of SEMS. This led us to think that, in some cases, occlusion may be better than a "silent" perforation.
The Cancer Family Caregiving Experience: An Updated and Expanded Conceptual Model

PubMed Central

Fletcher, Barbara Swore; Miaskowski, Christine; Given, Barbara; Schumacher, Karen

2011-01-01

Objective The decade from 2000–2010 was an era of tremendous growth in family caregiving research specific to the cancer population. This research has implications for how cancer family caregiving is conceptualized, yet the most recent comprehensive model of cancer family caregiving was published ten years ago. Our objective was to develop an updated and expanded comprehensive model of the cancer family caregiving experience, derived from concepts and variables used in research during past ten years. Methods A conceptual model was developed based on cancer family caregiving research published from 2000–2010. Results Our updated and expanded model has three main elements: 1) the stress process, 2) contextual factors, and 3) the cancer trajectory. Emerging ways of conceptualizing the relationships between and within model elements are addressed, as well as an emerging focus on caregiver-patient dyads as the unit of analysis. Conclusions Cancer family caregiving research has grown dramatically since 2000 resulting in a greatly expanded conceptual landscape. This updated and expanded model of the cancer family caregiving experience synthesizes the conceptual implications of an international body of work and demonstrates tremendous progress in how cancer family caregiving research is conceptualized. PMID:22000812

Adjustable perineal male sling using tissue expander as an effective treatment of post-prostatectomy urinary incontinence.

PubMed

Balci, Melih; Tuncel, Altug; Bilgin, Ovunc; Aslan, Yilmaz; Atan, Ali

2015-01-01

To report our intermediate experience in treating patients with severe incontinence using an adjustable perineal male sling with a tissue expander. An adjustable male sling procedure was performed on 21 patients with severe incontinence. The underlying etiology of urinary incontinence was radical prostatectomy in 13 patients, open prostatectomy in 5 patients and transurethral prostate resection in 3 patients. The difference between the classical and the adjustable sling is that in the latter there is a 25 mL tissue expander between the two layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via an inflation port, in case of recurrence or persistence of incontinence. The mean age of the patients was 66.2 ± 7.3 (50-79) years and mean pad usage was 6.4 ± 0.6 per day. The mean follow-up time was 40.1 ± 23.2 (6-74) months. The balloon was postoperatively inflated on average with 11.6 ± 5.7 (5-25) mL. After the mean 40.1 months of follow-up, 16 of the 21 patients (76.2%) were dry (11 patients, 0 pads; 5 patients using safety pads), 3 patients (14%) had mild and 2 (9.8%) had moderate degree post-prostatectomy urinary incontinence (PPI). The average maximum urine flow rate of the patients was 15.6 ± 4.7 (10-31) mL/s. No residual urine was found. In 2 patients, all parts of the device were removed due to infection and discomfort, and in 3 patients only the inflation component was removed due to local scrotal infection. Our results show that using an adjustable perineal male sling with a tissue expander seems to be an efficient, and safe surgical treatment option in patients with PPI.
Efficacy and complications in the use of self-expanding colonic stents: an analysis of 15 years' experience.

PubMed

Samper Wamba, J D; Fernández Martínez, A; González Pastrana, L; López González, L; Balboa Arregui, Ó

2015-01-01

To analyze the efficacy and safety of the procedure for placing self-expanding stents in the colon. To evaluate the factors associated with complications. To analyze the dose of radiation delivered in the procedure. This was a retrospective descriptive study of 478 procedures done at a single center to place self-expanding metallic stents in the colon. A total of 423 nitinol stents and 79 stainless steel stents were placed. We included all colonic obstructions, of which 446 had malignant causes and 8 had benign causes. We excluded patients with intestinal perforation, severe colonic bleeding, short life expectancy, or lesions located less than 5 cm from the anus. We collected the dosimetric data and analyzed the technical success, clinical success, and complications during follow-up. The procedure was a technical success in 92.26% of cases (n=441) and a clinical success in 78.45% (n=375); complications occurred during follow-up in 18.5% of cases. Complications occurred more frequently with the stainless steel stents than with the nitinol stents (OR: 3.2; 95% CI: 1.8-5.7). The mean value of the dose area product was 35 Gy*cm(2). When instead of being done by the interventional radiologist working together with an endoscopist the procedure was done exclusively by the interventional radiologist, the time under fluoroscopy (p=0.001), dose area product (p=0.029), and kinetic energy released per unit mass (p=0.001) were greater. The procedure for placing self-expanding colonic stents is efficacious and safe with an acceptable rate of complications. The doses of radiation delivered were low, and the radiation doses and time under fluoroscopy were lower when the procedure was done together with an endoscopist. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.
Safety Grooving

NASA Technical Reports Server (NTRS)

1985-01-01

Safety grooving, the cutting of grooves in concrete to increase traction and prevent injury, was first developed to reduce aircraft accidents on wet runways. Represented by the International Grooving and Grinding Association (IG&GA), the industry expanded into highway and pedestrian applications. The technique originated at Langley, which assisted in testing the grooving at airports and on highways. Skidding was reduced, stopping distance decreased, and a vehicle's cornering ability on curves was increased. The process has been extended to animal holding pens, steps, parking lots and other potentially slippery surfaces.
High-dose irradiated food: Current progress, applications, and prospects

NASA Astrophysics Data System (ADS)

Feliciano, Chitho P.

2018-03-01

Food irradiation as an established and mature technology has gained more attention in the food industry for ensuring food safety and quality. Primarily used for phytosanitary applications, its use has been expanded for developing various food products for varied purposes (e.g. ready-to-eat & ready-to-cook foods, hospital diets, etc.). This paper summarized and analyzed the recent progress and application of high-dose irradiation and discussed its prospects in the field of food product development, its safety and quality.
The Path to NGATS

NASA Technical Reports Server (NTRS)

Scardina, John

2006-01-01

NGATS operational Improvements and benefits include: 1) Broad area and precision navigation to access and capacity; 2) Airspace access and management to capacity; 3) 4D trajectory based ATM to capacity and efficiency; 4) Reduced separation between aircraft to capacity; 5) Flight deck situational awareness and delegation to capacity and safety; 6) ATM decision support to capacity; 7) Improved weather data and dissemination to capacity and safety; 8) Reduced cost to deliver ATM services to cost; 9) Greatly expanded airport network and improved terminals to capacity.
Site selection plan and installation guidelines for a nationwide differential GPS service

DOT National Transportation Integrated Search

1997-08-05

The Global Positioning System (GPS), in its current form, is used within the transportation industry for vehicle tracking and navigation. With the advent of a nationwide differential GPS (DGPS) service, this role will expand to include public safety,...
77 FR 21777 - Expanded Charge for Peer Review of the NIOSH document Titled: “Criteria for a Recommended...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

....html for Docket number NIOSH-245. After consultation with the Occupational Safety and Health... consideration which are posted here: http://www.cdc.gov/niosh/review/peer/HISA/diacetyl-pr.html . This entry...
[Operating Room Nurses' Experiences of Securing for Patient Safety].

PubMed

Park, Kwang Ok; Kim, Jong Kyung; Kim, Myoung Sook

2015-10-01

This study was done to evaluate the experience of securing patient safety in hospital operating rooms. Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.
Orbit Transfer Vehicle (OTV) advanced expander cycle engine point design study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1981-01-01

The objective of the study was to generate the system design of a performance-optimized, advanced LOX/hydrogen expander cycle space engine. The engine requirements are summarized, and the development and operational experience with the expander cycle RL10 engine were reviewed. The engine development program is outlined.
Tissue expansion in the treatment of pressure ulcers.

PubMed

Esposito, G; Di Caprio, G; Ziccardi, P; Scuderi, N

1991-03-01

The authors report their experience using skin expanders in 11 patients with severe bed sores. The expanders, with different volumes, from 250 to 1000 cc, were generally overfilled using the cutaneous tonometer. In fact, with the information revealed by this apparatus on the skin in expansion, the authors were able to reduce the filling intervals without risking ulceration. In their experience, the results obtained were satisfactory: All patients treated achieved surgical recovery. The authors see a wide future for skin-expander use in pressure-ulcer treatment. They have a working hypothesis about using expanders to progressively advance sensitive skin in areas subject to ulceration. This hypothesis is based on the possibility of reexpanding the same flap several times, as has been seen in the treatment of other types of pathology.
Twelve years' experience with direct-to-consumer advertising of prescription drugs in Canada: a cautionary tale.

PubMed

Mintzes, Barbara; Morgan, Steve; Wright, James M

2009-05-27

Direct-to-consumer advertising (DTCA) of prescription drugs is illegal in Canada as a health protection measure, but is permitted in the United States. However, in 2000, Canadian policy was changed to allow 'reminder' advertising of prescription drugs. This is a form of advertising that states the brand name without health claims. 'Reminder' advertising is prohibited in the US for drugs that have 'black box' warnings of serious risks. This study examines spending on DTCA in Canada from 1995 to 2006, 12 years spanning this policy shift. We ask how annual per capita spending compares to that in the US, and whether drugs with Canadian or US regulatory safety warnings are advertised to the Canadian public in reminder advertising. Prescription drug advertising spending data were extracted from a data set on health sector spending in Canada obtained from a market research company, TNS Media Inc. Spending was adjusted for inflation and compared with US spending. Inflation-adjusted spending on branded DTCA in Canada grew from under CAD$2 million per year before 1999 to over $22 million in 2006. The major growth was in broadcast advertising, accounting for 83% of spending in 2006. US annual per capita spending was on average 24 times Canadian levels. Celebrex (celecoxib), which has a US black box and was subject to three safety advisories in Canada, was the most heavily advertised drug on Canadian television in 2005 and 2006. Of 8 brands with >$500,000 spending, which together accounted for 59% of branded DTCA in all media, 6 were subject to Canadian safety advisories, and 4 had US black box warnings. Branded 'reminder' advertising has grown rapidly in Canada since 2000, mainly due to a growth in television advertising. Although DTCA spending per capita is much lower in Canada than in the US, there is no evidence of safer content or product choice; many heavily-advertised drugs in Canada have been subject to safety advisories. For governments searching for compromise solutions to industry pressure for expanded advertising, Canada's experience stands as a stark warning.
Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.

PubMed

Garg, Sachin K; Lyles, Courtney R; Ackerman, Sara; Handley, Margaret A; Schillinger, Dean; Gourley, Gato; Aulakh, Veenu; Sarkar, Urmimala

2016-02-06

Text messaging is an affordable, ubiquitous, and expanding mobile communication technology. However, safety net health systems in the United States that provide more care to uninsured and low-income patients may face additional financial and infrastructural challenges in utilizing this technology. Formative evaluations of texting implementation experiences are limited. We interviewed safety net health systems piloting texting initiatives to study facilitators and barriers to real-world implementation. We conducted telephone interviews with various stakeholders who volunteered from each of the eight California-based safety net systems that received external funding to pilot a texting-based program of their choosing to serve a primary care need. We developed a semi-structured interview guide based partly on the Consolidated Framework for Implementation Research (CFIR), which encompasses several domains: the intervention, individuals involved, contextual factors, and implementation process. We inductively and deductively (using CFIR) coded transcripts, and categorized themes into facilitators and barriers. We performed eight interviews (one interview per pilot site). Five sites had no prior texting experience. Sites applied texting for programs related to medication adherence and monitoring, appointment reminders, care coordination, and health education and promotion. No site texted patient-identifying health information, and most sites manually obtained informed consent from each participating patient. Facilitators of implementation included perceived enthusiasm from patients, staff and management belief that texting is patient-centered, and the early identification of potential barriers through peer collaboration among grantees. Navigating government regulations that protect patient privacy and guide the handling of protected health information emerged as a crucial barrier. A related technical challenge in five sites was the labor-intensive tracking and documenting of texting communications due to an inability to integrate texting platforms with electronic health records. Despite enthusiasm for the texting programs from the involved individuals and organizations, inadequate data management capabilities and unclear privacy and security regulations for mobile health technology slowed the initial implementation and limited the clinical use of texting in the safety net and scope of pilots. Future implementation work and research should investigate how different texting platform and intervention designs affect efficacy, as well as explore issues that may affect sustainability and the scalability.
Twelve Years' Experience with Direct-to-Consumer Advertising of Prescription Drugs in Canada: A Cautionary Tale

PubMed Central

Mintzes, Barbara; Morgan, Steve; Wright, James M.

2009-01-01

Background Direct-to-consumer advertising (DTCA) of prescription drugs is illegal in Canada as a health protection measure, but is permitted in the United States. However, in 2000, Canadian policy was changed to allow ‘reminder’ advertising of prescription drugs. This is a form of advertising that states the brand name without health claims. ‘Reminder’ advertising is prohibited in the US for drugs that have ‘black box’ warnings of serious risks. This study examines spending on DTCA in Canada from 1995 to 2006, 12 years spanning this policy shift. We ask how annual per capita spending compares to that in the US, and whether drugs with Canadian or US regulatory safety warnings are advertised to the Canadian public in reminder advertising. Methodology/Principal Findings Prescription drug advertising spending data were extracted from a data set on health sector spending in Canada obtained from a market research company, TNS Media Inc. Spending was adjusted for inflation and compared with US spending. Inflation-adjusted spending on branded DTCA in Canada grew from under CAD$2 million per year before 1999 to over $22 million in 2006. The major growth was in broadcast advertising, accounting for 83% of spending in 2006. US annual per capita spending was on average 24 times Canadian levels. Celebrex (celecoxib), which has a US black box and was subject to three safety advisories in Canada, was the most heavily advertised drug on Canadian television in 2005 and 2006. Of 8 brands with >$500,000 spending, which together accounted for 59% of branded DTCA in all media, 6 were subject to Canadian safety advisories, and 4 had US black box warnings. Conclusions/Significance Branded ‘reminder’ advertising has grown rapidly in Canada since 2000, mainly due to a growth in television advertising. Although DTCA spending per capita is much lower in Canada than in the US, there is no evidence of safer content or product choice; many heavily-advertised drugs in Canada have been subject to safety advisories. For governments searching for compromise solutions to industry pressure for expanded advertising, Canada's experience stands as a stark warning. PMID:19479084
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.
Using Human 'Experiments of Nature' to Predict Drug Safety Issues: An Example with PCSK9 Inhibitors.

PubMed

Jerome, Rebecca N; Pulley, Jill M; Roden, Dan M; Shirey-Rice, Jana K; Bastarache, Lisa A; R Bernard, Gordon; B Ekstrom, Leeland; Lancaster, William J; Denny, Joshua C

2018-03-01

When a new drug enters the market, its full array of side effects remains to be defined. Current surveillance approaches targeting these effects remain largely reactive. There is a need for development of methods to predict specific safety events that should be sought for a given new drug during development and postmarketing activities. We present here a safety signal identification approach applied to a new set of drug entities, inhibitors of the serine protease proprotein convertase subtilisin/kexin type 9 (PCSK9). Using phenome-wide association study (PheWAS) methods, we analyzed available genotype and clinical data from 29,722 patients, leveraging the known effects of changes in PCSK9 to identify novel phenotypes in which this protein and its inhibitors may have impact. PheWAS revealed a significantly reduced risk of hypercholesterolemia (odds ratio [OR] 0.68, p = 7.6 × 10 -4 ) in association with a known loss-of-function variant in PCSK9, R46L. Similarly, laboratory data indicated significantly reduced beta mean low-density lipoprotein cholesterol (- 14.47 mg/dL, p = 2.58 × 10 -23 ) in individuals carrying the R46L variant. The R46L variant was also associated with an increased risk of spina bifida (OR 5.90, p = 2.7 × 10 -4 ), suggesting that further investigation of potential connections between inhibition of PCSK9 and neural tube defects may be warranted. This novel methodology provides an opportunity to put in place new mechanisms to assess the safety and long-term tolerability of PCSK9 inhibitors specifically, and other new agents in general, as they move into human testing and expanded clinical use.
A Synthetic Vision Preliminary Integrated Safety Analysis

NASA Technical Reports Server (NTRS)

Hemm, Robert; Houser, Scott

2001-01-01

This report documents efforts to analyze a sample of aviation safety programs, using the LMI-developed integrated safety analysis tool to determine the change in system risk resulting from Aviation Safety Program (AvSP) technology implementation. Specifically, we have worked to modify existing system safety tools to address the safety impact of synthetic vision (SV) technology. Safety metrics include reliability, availability, and resultant hazard. This analysis of SV technology is intended to be part of a larger effort to develop a model that is capable of "providing further support to the product design and development team as additional information becomes available". The reliability analysis portion of the effort is complete and is fully documented in this report. The simulation analysis is still underway; it will be documented in a subsequent report. The specific goal of this effort is to apply the integrated safety analysis to SV technology. This report also contains a brief discussion of data necessary to expand the human performance capability of the model, as well as a discussion of human behavior and its implications for system risk assessment in this modeling environment.
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.
Economic approaches to measuring the significance of food safety in international trade.

PubMed

Caswell, J A

2000-12-20

International trade in food products has expanded rapidly in recent years. This paper presents economic approaches for analyzing the effects on trade in food products of the food safety requirements of governments and private buyers. Important economic incentives for companies to provide improved food safety arise from (1) public incentives such as ex ante requirements for sale of a product with sufficient quality and ex post penalties (liability) for sale of products with deficient quality, and (2) private incentives for producing quality such as internal performance goals (self-regulation) and the external (certification) requirements of buyers. The World Trade Organization's Sanitary Phytosanitary Agreement facilitates scrutiny of the benefits and costs of country-level regulatory programs and encourages regulatory rapprochement on food safety issues. Economists can help guide risk management decisions by providing estimates of the benefits and costs of programs to improve food safety and by analyzing their effect on trade in food products.
Conscious Leadership.

PubMed

Ward, Suzanne F; Haase, Beth

2016-11-01

Health care leaders need to use leadership methodologies that support safe patient care, satisfy employees, and improve the bottom line. Conscious leaders help create desirable personal and professional life experiences for themselves using specific tools that include mindfulness, context, and the observer-self, and they strive to help their employees learn to use these tools as well. In perioperative nursing, conscious leaders create an environment in which nurses are supported in their aim to provide the highest level of patient care and in which transformations are encouraged to take place; this environment ultimately promotes safety, contributes to fulfilling and meaningful work, and enhances a facility's financial viability. This article discusses some of the key concepts behind conscious leadership, how perioperative leaders can reach and maintain expanded consciousness, and how they can best assist their staff members in their own evolution to a more mindful state. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Constructing experimental devices for half-ton synthesis of gadolinium-loaded liquid scintillator and its performance.

PubMed

Park, Young Seo; Jang, Yeong Min; Joo, Kyung Kwang

2018-04-01

This paper describes in brief features of various experimental devices constructed for half-ton synthesis of gadolinium(Gd)-loaded liquid scintillator (GdLS) and also includes the performances and detailed chemical and physical results of a 0.5% high-concentration GdLS. Various feasibility studies on useful apparatus used for loading Gd into solvents have been carried out. The transmittance, Gd concentration, density, light yield, and moisture content were measured for quality control. We show that with the help of adequate automated experimental devices and tools, it is possible to perform ton scale synthesis of GdLS at moderate laboratory scale without difficulty. The synthesized GdLS was satisfactory to meet chemical, optical, and physical properties and various safety requirements. These synthesizing devices can be expanded into massive scale next-generation neutrino experiments of several hundred tons.

[A place of intravenous immunoglobulins in current clinical practice: Privigen is a novel 10% immunoglobulin].

PubMed

Latysheva, T V; Latysheva, E A; Martynova, I A

2016-01-01

Intravenous immunoglobulins (IVIGs) were initially designed to treat patients with primary immunodeficiencies (PID). Due to the multidirectional effect of IVIGs on the immune system, a range of nosological entities, in which these agents are successfully administered, is steadily expanding. As of now, IVIGs are successfully used in neurology, rheumatology, hematology, and oncology and they are essential drugs for many patients. In spite of the long experience with IVIGs, their mechanism of action remains unclear, numerous investigations for their clinical introduction are being continued. Therefore, there is a growing need to increase the production of the drugs, which gives rise to the emergence of novel medications, which differ in their composition and manufacture technologies, on the pharmacological market. The 10% intravenous immunoglobulin privigen, the safety and efficacy of which has been proven in foreign practice, is a novel drug on the Russian market.
Regulating transgenic crops sensibly: lessons from plant breeding, biotechnology and genomics.

PubMed

Bradford, Kent J; Van Deynze, Allen; Gutterson, Neal; Parrott, Wayne; Strauss, Steven H

2005-04-01

The costs of meeting regulatory requirements and market restrictions guided by regulatory criteria are substantial impediments to the commercialization of transgenic crops. Although a cautious approach may have been prudent initially, we argue that some regulatory requirements can now be modified to reduce costs and uncertainty without compromising safety. Long-accepted plant breeding methods for incorporating new diversity into crop varieties, experience from two decades of research on and commercialization of transgenic crops, and expanding knowledge of plant genome structure and dynamics all indicate that if a gene or trait is safe, the genetic engineering process itself presents little potential for unexpected consequences that would not be identified or eliminated in the variety development process before commercialization. We propose that as in conventional breeding, regulatory emphasis should be on phenotypic rather than genomic characteristics once a gene or trait has been shown to be safe.
NASA's Commercial Crew Program, The Next Step in U.S. Space Transportation

NASA Technical Reports Server (NTRS)

Mango, Edward J.; Thomas, Rayelle E.

2013-01-01

The Commercial Crew Program (CCP) is leading NASA's efforts to develop the next U.S. capability for crew transportation and rescue services to and from the International Space Station (ISS) by the mid-decade timeframe. The outcome of this capability is expected to stimulate and expand the U.S. space transportation industry. NASA is relying on its decades of human space flight experience to certify U.S. crewed vehicles to the ISS and is doing so in a two phase certification approach. NASA Certification will cover all aspects of a crew transportation system, including development, test, evaluation, and verification; program management and control; flight readiness certification; launch, landing, recovery, and mission operations; sustaining engineering and maintenance/upgrades. To ensure NASA crew safety, NASA Certification will validate technical and performance requirements, verify compliance with NASA requirements, validate the crew transportation system operates in appropriate environments, and quantify residual risks.
Constructing experimental devices for half-ton synthesis of gadolinium-loaded liquid scintillator and its performance

NASA Astrophysics Data System (ADS)

Park, Young Seo; Jang, Yeong Min; Joo, Kyung Kwang

2018-04-01

This paper describes in brief features of various experimental devices constructed for half-ton synthesis of gadolinium(Gd)-loaded liquid scintillator (GdLS) and also includes the performances and detailed chemical and physical results of a 0.5% high-concentration GdLS. Various feasibility studies on useful apparatus used for loading Gd into solvents have been carried out. The transmittance, Gd concentration, density, light yield, and moisture content were measured for quality control. We show that with the help of adequate automated experimental devices and tools, it is possible to perform ton scale synthesis of GdLS at moderate laboratory scale without difficulty. The synthesized GdLS was satisfactory to meet chemical, optical, and physical properties and various safety requirements. These synthesizing devices can be expanded into massive scale next-generation neutrino experiments of several hundred tons.
A data-driven model for estimating industry average numbers of hospital security staff.

PubMed

Vellani, Karim H; Emery, Robert J; Reingle Gonzalez, Jennifer M

2015-01-01

In this article the authors report the results of an expanded survey, financed by the International Healthcare Security and Safety Foundation (IHSSF), applied to the development of a model for determining the number of security officers required by a hospital.
Passenger vehicle driver cell phone use : results from the fall 2000 National Occupant Protection Use Survey

DOT National Transportation Integrated Search

2001-07-01

The National Highway Traffic Safety Administration's National Occupant Protection Use Survey (NOPUS) expanded its data collection protocols during October and November 2000 to obtain national estimates of driver cell phone use. The results of NOPUS f...
Prevention of Child Abuse: Possibilities for Educational Systems.

ERIC Educational Resources Information Center

Holmes, Christine P.

1987-01-01

Educators' roles in identification of abused/neglected children, subsequent reporting, and techniques for interviewing suspected abused children are discussed. Educators' expanded role in abuse prevention, involving such activities as offering courses in parenting, child safety/protection, and human sexuality, is examined, followed by a…
Adipose-derived mesenchymal stem cells (AdMSC) for the treatment of secondary-progressive multiple sclerosis: A triple blinded, placebo controlled, randomized phase I/II safety and feasibility study.

PubMed

Fernández, Oscar; Izquierdo, Guillermo; Fernández, Victoria; Leyva, Laura; Reyes, Virginia; Guerrero, Miguel; León, Antonio; Arnaiz, Carlos; Navarro, Guillermo; Páramo, Maria Dolores; Cuesta, Antonio De la; Soria, Bernat; Hmadcha, Abdelkrim; Pozo, David; Fernandez-Montesinos, Rafael; Leal, Maria; Ochotorena, Itziar; Gálvez, Patricia; Geniz, Maria Angeles; Barón, Francisco Javier; Mata, Rosario; Medina, Cristina; Caparrós-Escudero, Carlos; Cardesa, Ana; Cuende, Natividad

2018-01-01

Currently available treatments for secondary progressive multiple sclerosis(SPMS) have limited efficacy and/or safety concerns. Adipose-mesenchymal derived stem cells(AdMSCs) represent a promising option and can be readily obtained using minimally invasive procedures. In this triple-blind, placebo-controlled study, cell samples were obtained from consenting patients by lipectomy and subsequently expanded. Patients were randomized to a single infusion of placebo, low-dose(1x106cells/kg) or high-dose(4x106cells/kg) autologous AdMSC product and followed for 12 months. Safety was monitored recording adverse events, laboratory parameters, vital signs and spirometry. Expanded disability status score (EDSS), magnetic-resonance-imaging, and other measures of possible treatment effects were also recorded. Thirty-four patients underwent lipectomy for AdMSCs collection, were randomized and thirty were infused (11 placebo, 10 low-dose and 9 high-dose); 4 randomized patients were not infused because of karyotype abnormalities in the cell product. Only one serious adverse event was observed in the treatment arms (urinary infection, considered not related to study treatment). No other safety parameters showed changes. Measures of treatment effect showed an inconclusive trend of efficacy. Infusion of autologous AdMSCs is safe and feasible in patients with SPMS. Larger studies and probably treatment at earlier phases would be needed to investigate the potential therapeutic benefit of this technique.
Providing Nuclear Criticality Safety Analysis Education through Benchmark Experiment Evaluation

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

John D. Bess; J. Blair Briggs; David W. Nigg

2009-11-01

One of the challenges that today's new workforce of nuclear criticality safety engineers face is the opportunity to provide assessment of nuclear systems and establish safety guidelines without having received significant experience or hands-on training prior to graduation. Participation in the International Criticality Safety Benchmark Evaluation Project (ICSBEP) and/or the International Reactor Physics Experiment Evaluation Project (IRPhEP) provides students and young professionals the opportunity to gain experience and enhance critical engineering skills.
Physics of reactor safety. Quarterly report, January--March 1977. [LMFBR

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

None

1977-06-01

This report summarizes work done on reactor safety, Monte Carlo analysis of safety-related critical assembly experiments, and planning of DEMI safety-related critical experiments. Work on reactor core thermal-hydraulics is also included.
Quality and Safety Education for Nurses (QSEN): The Key is Systems Thinking.

PubMed

Dolansky, Mary A; Moore, Shirley M

2013-09-30

Over a decade has passed since the Institute of Medicine's reports on the need to improve the American healthcare system, and yet only slight improvement in quality and safety has been reported. The Quality and Safety Education for Nurses (QSEN) initiative was developed to integrate quality and safety competencies into nursing education. The current challenge is for nurses to move beyond the application of QSEN competencies to individual patients and families and incorporate systems thinking in quality and safety education and healthcare delivery. This article provides a history of QSEN and proposes a framework in which systems thinking is a critical aspect in the application of the QSEN competencies. We provide examples of how using this framework expands nursing focus from individual care to care of the system and propose ways to teach and measure systems thinking. The conclusion calls for movement from personal effort and individual care to a focus on care of the system that will accelerate improvement of healthcare quality and safety.
Reserve Li/SOC12 Battery Safety Testing

NASA Technical Reports Server (NTRS)

Dils, C. T.; Garoutte, K. F.

1984-01-01

A reserve Lithium/Thionyl Chloride Battery concept is developed and undergoing feasibility testing in terms of performance, safety and abusive conditions. The feasibility of employing a battery of this type to replace thermal batteries in certain applications is demonstrated. Excellent performance of a Li/SOCl2 reserve battery is obtained across the temperature range from 0 C to +44 C. Performance improvement over the thermal battery usage is greater by a factor of 3 when discharge time and energy density are compared. Performance over an expanded temperature range is also possible. Safety and abusive testing is accomplished successfully on a series of five units. Further performance improvements can be achieved with regard to battery weight and volume reductions.
The Transformative Experience in Engineering Education

NASA Astrophysics Data System (ADS)

Goodman, Katherine Ann

This research evaluates the usefulness of transformative experience (TE) in engineering education. With TE, students 1) apply ideas from coursework to everyday experiences without prompting (motivated use); 2) see everyday situations through the lens of course content (expanded perception); and 3) value course content in new ways because it enriches everyday affective experience (affective value). In a three-part study, we examine how engineering educators can promote student progress toward TE and reliably measure that progress. For the first study, we select a mechanical engineering technical elective, Flow Visualization, that had evidence of promoting expanded perception of fluid physics. Through student surveys and interviews, we compare this elective to the required Fluid Mechanics course. We found student interest in fluids fell into four categories: complexity, application, ubiquity, and aesthetics. Fluid Mechanics promotes interest from application, while Flow Visualization promotes interest based in ubiquity and aesthetics. Coding for expanded perception, we found it associated with students' engineering identity, rather than a specific course. In our second study, we replicate atypical teaching methods from Flow Visualization in a new design course: Aesthetics of Design. Coding of surveys and interviews reveals that open-ended assignments and supportive teams lead to increased ownership of projects, which fuels risk-taking, and produces increased confidence as an engineer. The third study seeks to establish parallels between expanded perception and measurable perceptual expertise. Our visual expertise experiment uses fluid flow images with both novices and experts (students who had passed fluid mechanics). After training, subjects sort images into laminar and turbulent categories. The results demonstrate that novices learned to sort the flow stimuli in ways similar to subjects in prior perceptual expertise studies. In contrast, the experts' significantly better results suggest they are accessing conceptual fluids knowledge to perform this new, visual task. The ability to map concepts onto visual information is likely a necessary step toward expanded perception. Our findings suggest that open-ended aesthetic experiences with engineering content unexpectedly support engineering identity development, and that visual tasks could be developed to measure conceptual understanding, promoting expanded perception. Overall, we find TE a productive theoretical framework for engineering education research.
Removal process of prion and parvovirus from human platelet lysates used as clinical-grade supplement for ex vivo cell expansion.

PubMed

Kao, Yu-Chun; Bailey, Andy; Samminger, Bernhard; Tanimoto, Junji; Burnouf, Thierry

2016-07-01

Pooled human platelet lysate (HPL) is becoming the new gold standard as supplement for ex vivo cell culture for clinical protocols. However, the risk of pathogen contamination of HPL increases with the platelet pool size. We hypothesized that hollow fiber anion exchange membrane chromatography using QyuSpeed D (QSD) could remove resistant and untested bloodborne pathogens, such as parvoviruses and prions, from HPL-supplemented growth media without substantially affecting their capacity to support ex vivo cell expansion. Frozen or thawed platelet concentrates were serum-converted and centrifuged for obtaining HPL that was added to various growth media (ca. 100 mL), filtered through a 0.6-mL QSD membrane and characterized for proteins, growth factors and chemical composition. Capacity to expand Chinese hamster ovary, periodontal ligament, gingival fibroblast cells and Wharton's jelly mesenchymal stromal cells was studied. Removal of porcine parvovirus (PPV) and of the 263K prion strain of hamster-adapted scrapie was studied by spiking experiments following international guidelines. QSD had minimal impact on HPL-supplemented medium composition in proteins, growth factors and chemical content, nor capacity to expand and differentiate cells. In addition, QSD could remove ≥5.58 log10 [TCID50/mL] and ≥3.72 log10 of PPV and the 263K prion, respectively. QSD hollow fiber chromatography can be used to improve the virus and prion safety of HPL-supplemented media to safely expand cells for clinical protocols. These data bring new perspectives for increasingly safer use of pooled HPL in cell therapy and regenerative medicine applications. Copyright © 2016 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Safety Behaviors in Adults With Social Anxiety: Review and Future Directions.

PubMed

Piccirillo, Marilyn L; Taylor Dryman, M; Heimberg, Richard G

2016-09-01

Safety behaviors are considered an important factor in the maintenance of social anxiety disorder (SAD). Safety behaviors are typically employed by socially anxious individuals to reduce anxiety in feared social situations. However, by preventing individuals with social anxiety from gathering evidence that would disconfirm their maladaptive beliefs about social situations, the use of safety behaviors ultimately maintains social anxiety over time. Twenty years ago, Wells and colleagues (1995) demonstrated that use of safety behaviors diminishes the efficacy of exposure treatment for SAD, suggesting that reduction in the use of safety behaviors during exposure can enhance treatment response. Research on safety behaviors has expanded considerably since Wells et al.'s seminal publication, and our understanding of the role safety behaviors may play in the maintenance of social anxiety has grown in breadth and depth. In this paper, we present a detailed review of the published research on safety behaviors relevant to social anxiety and social-anxiety-related processes. Finally, we evaluate the impact of safety behaviors on the outcome of treatment for SAD, and we look to the literature on safety behaviors in other anxiety disorders to inform our understanding of use of safety behaviors during exposure and to facilitate future research in SAD. Copyright © 2015. Published by Elsevier Ltd.
The value and potential of animal research in enabling astronaut health - Transition from Spacelab to Space Station Freedom

NASA Technical Reports Server (NTRS)

Garshnek, V.; Ballard, R. W.

1993-01-01

Maintaining astronaut health is a critical aspect of human space exploration. Three decades of space research have demonstrated that microgravity produces significant physiological changes in astronauts. For long-duration missions, the possibility exists that these changes may prevent the achievement of full health and safety and may therefore require countermeasures. Meeting this goal depends on a strong biomedical foundation. Although much research is conducted with humans, some of the most critical work involves a necessary in-depth look into complex problem areas requiring invasive procedures using animals. Much of this research cannot be performed in humans within the bounds of accepted medical practice. A large portion of knowledge and experience in flying animals and applying the data to astronaut health has been obtained through the Spacelab experience and can be applied to a space station situation (expanded to accommodate necessary standardization and flexibility). The objectives of this paper are to (a) discuss the value and potential of animal research in answering critical questions to enable astronaut health for advanced missions, (b) discuss how previous Spacelab operational experience in animal studies can be applied to facilitate transition into a space station era, and (c) review capabilities of biological facilities projected for Space Station Freedom.
Successful range-expanding plants experience less above-ground and below-ground enemy impact.

PubMed

Engelkes, Tim; Morriën, Elly; Verhoeven, Koen J F; Bezemer, T Martijn; Biere, Arjen; Harvey, Jeffrey A; McIntyre, Lauren M; Tamis, Wil L M; van der Putten, Wim H

2008-12-18

Many species are currently moving to higher latitudes and altitudes. However, little is known about the factors that influence the future performance of range-expanding species in their new habitats. Here we show that range-expanding plant species from a riverine area were better defended against shoot and root enemies than were related native plant species growing in the same area. We grew fifteen plant species with and without non-coevolved polyphagous locusts and cosmopolitan, polyphagous aphids. Contrary to our expectations, the locusts performed more poorly on the range-expanding plant species than on the congeneric native plant species, whereas the aphids showed no difference. The shoot herbivores reduced the biomass of the native plants more than they did that of the congeneric range expanders. Also, the range-expanding plants developed fewer pathogenic effects in their root-zone soil than did the related native species. Current predictions forecast biodiversity loss due to limitations in the ability of species to adjust to climate warming conditions in their range. Our results strongly suggest that the plants that shift ranges towards higher latitudes and altitudes may include potential invaders, as the successful range expanders may experience less control by above-ground or below-ground enemies than the natives.
Identifying countermeasure strategies to increase safety of older pedestrians : traffic tech.

DOT National Transportation Integrated Search

2013-07-01

Pedestrian deaths accounted for 13% of all traffic fatalities : in 2010. While adults 65 and older made up 13% of the U.S. : population, they accounted for 19% of all pedestrian fatalities : in 2010. This age group is rapidly expanding in size : and ...
Developing a sustainable freight transportation framework with the consideration of improving safety and minimizing carbon emissions.

DOT National Transportation Integrated Search

2011-09-01

Despite the difficulties of the American economy in recent years the transportation sector continues to expand. Freight transportation alone has been projected to increase enormously even if the economy as a whole only manages a very moderate growth....
Highway Safety Information System guidebook for the Utah state data files. Volume 1 : SAS file formats

DOT National Transportation Integrated Search

1996-06-01

This volume expands on the presentations in the main manual by presenting further discussions and examples. Contents: Appendix A: The Costs of Travel Surveys; Appendix B: Census Data for Travel Surveys; Appendix C: An Example of the Systems Capabilit...

Characterization of nanomaterial test solutions for terrestrial plant dose-response studies: A comparative study of DLS and SAXS

EPA Science Inventory

Industrial applications of nanomaterials have expanded at an increasing rate in recent years, accompanied by the need for comprehensive toxicological assessments to establish environmental health and safety standards. Relatively few studies have examined the effects of nanoparti...
Analysis of roadside safety devices for use on very high-speed roadways.

DOT National Transportation Integrated Search

2009-09-01

The Texas Department of Transportation (TxDOT) is embarking on a multi-decade effort to expand : the states transportation system. TxDOT has expressed an interest in using very high design speeds (above : 80 mph) for some of these facilities to pr...
Teaching cultural safety in a New Zealand nursing education program.

PubMed

Richardson, Fran; Carryer, Jenny

2005-05-01

Cultural safety education is a concept unique to nursing in New Zealand. It involves teaching nursing students to recognize and understand the dynamics of cultural, personal, and professional power and how these shape nursing and health care relationships. This article describes the findings of a research study on the experience of teaching cultural safety. As a teacher of cultural safety, the first author was interested in exploring the experience of teaching the topic with other cultural safety teachers. A qualitative approach situated in a critical theory paradigm was used for the study. The study was informed by the ideas of Foucault and feminist theory. Fourteen women between ages 20 and 60 were interviewed about their experience of teaching cultural safety. Five women were Maori (the indigenous people of New Zealand), and 9 were Pakeha (the Maori name for New Zealanders of European descent). Following data analysis, three major themes were identified: that the Treaty of Waitangi provides for an examination of power in cultural safety education; that the broad concept of difference influences the experience of teaching cultural safety; and that the experience of teaching cultural safety has personal, professional, and political dimensions. These dimensions are experienced differently by Maori and Pakeha teachers.
Tracing the foundations of a conceptual framework for a patient safety ontology.

PubMed

Runciman, William B; Baker, G Ross; Michel, Philippe; Dovey, Susan; Lilford, Richard J; Jensen, Natasja; Flin, Rhona; Weeks, William B; Lewalle, Pierre; Larizgoitia, Itziar; Bates, David

2010-12-01

In work for the World Alliance for Patient Safety on research methods and measures and on defining key concepts for an International Patient Safety Classification (ICPS), it became apparent that there was a need to try to understand how the meaning of patient safety and underlying concepts relate to the existing safety and quality frameworks commonly used in healthcare. To unfold the concept of patient safety and how it relates to safety and quality frameworks commonly used in healthcare and to trace the evolution of the ICPS framework as a basis of the electronic capture of the component elements of patient safety. The ICPS conceptual framework for patient safety has its origins in existing frameworks and an international consultation process. Although its 10 classes and their semantic relationships may be used as a reference model for different disciplines, it must remain dynamic in the ever-changing world of healthcare. By expanding the ICPS by examining data from all available sources, and ensuring rigorous compliance with the latest principles of informatics, a deeper interdisciplinary approach will progressively be developed to address the complex, refractory problem of reducing healthcare-associated harm.
Expanding ICU facilities in an epidemic: recommendations based on experience from the SARS epidemic in Hong Kong and Singapore.

PubMed

Gomersall, Charles D; Tai, Dessmon Y H; Loo, Shi; Derrick, James L; Goh, Mia Siang; Buckley, Thomas A; Chua, Catherine; Ho, Ka Man; Raghavan, Geeta P; Ho, Oi Man; Lee, Lay Beng; Joynt, Gavin M

2006-07-01

Epidemics have the potential to severely strain intensive care resources and may require an increase in intensive care capability. Few intensivists have direct experience of rapidly expanding intensive care services in response to an epidemic. This contribution presents the recommendations of an expert group from Hong Kong and Singapore who had direct experience of expanding intensive care services in response to the epidemic of severe acute respiratory syndrome. These recommendations cover training, infection control, staffing, communication and ethical issues. The issue of what equipment to purchase is not addressed. Early preparations should include fit testing of negative pressure respirators, training of reserve staff, sourcing of material for physical modifications to the ICU, development of infection control policies and training programmes, and discussion of triage and quarantine issues.
77 FR 45558 - 4.9 GHz Band

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

...The Commission allocated the 4940-4990 MHz (4.9 GHz) band in 2002 for fixed and mobile use and dedicated the band for public safety broadband communications. In the ten years since, the band has gone underutilized. The purpose of these proposed rules is to invigorate and maximize use of the 4.9 GHz band and attract more users while improving spectrum efficiency. The Commission seeks comment on formal coordination requirements, expanded eligibility, how the band can complement the 700 MHz public safety broadband network, technical rule changes, aeronautical mobile operations, interoperability standards, and deployment reporting.
Current status of the expanded GRAPES collaboration experiment at Ooty in India

NASA Astrophysics Data System (ADS)

Gupta, S.K.; Anita, H.M.; Iyer, A.; Jagadeesan, P.; Jain, A.; Karthikeyan, S.; Manoharan, P.K.; Mohanty, P.K.; Nayak, P.K.; Rao, B.S.; Ravindran, K.C.; Tanaka, H.; Tonwar, S.C.; Ogio, S.; Okuda, T.; Oshima, A.; Shimizu, N.; Yoshikoshi, T.; Badruddin; Hasan, R.; Ahmad, Shakeel; Mishra, A.P.; Shrivastava, P.K.; Koul, R.; Shah, G.N.; Mir, T.A.; Mufti, S.; Raha, S.; Ghosh, S.; Joarder, P.; Saha, S.; Boruah, K.; Datta, P.; Boruah, P.K.; Baruah, A.G.; Baishya, R.; Saikia, J.; Banerjee, D.; Subramanian, P.; Bhadra, A.; Kumar, S.; Agarwal, R.; Dubey, S.K.; Bhattacharjee, P.

GRAPES-3 experiment employs a high-density array of scintillators and a large area tracking muon telescope. The GRAPES collaboration is being expanded with addition of several major facilities. These include a Cerenkov telescope and low frequency dipole array for the measurement of shower energy. Addition of several modules of muon telescopes to cover a larger area, expansion of the scintillator array with greater separation between detectors. Installation of a neutron monitor is also planned. The current status of the experiment would be summarized.
Understanding adolescent development: implications for driving safety.

PubMed

Keating, Daniel P

2007-01-01

The implementation of Graduated Driver Licensing (GDL) programs has significantly improved the crash and fatality rates of novice teen drivers, but these rates remain unacceptably high. A review of adolescent development research was undertaken to identify potential areas of improvement. Research support for GDL was found to be strong, particularly regarding early acquisition of expertise in driving safety (beyond driving skill), and to limitations that reduce opportunities for distraction. GDL regimes are highly variable, and no US jurisdictions have implemented optimal regimes. Expanding and improving GDL to enhance acquisition of expertise and self-regulation are indicated for implementation and for applied research. Driver training that effectively incorporates safety goals along with driving skill is another target. The insurance industry will benefit from further GDL enhancements. Benefits may accrue to improved driver training, improved simulation devices during training, and automated safety feedback instrumentation.
Enhanced Time Out: An Improved Communication Process.

PubMed

Nelson, Patricia E

2017-06-01

An enhanced time out is an improved communication process initiated to prevent such surgical errors as wrong-site, wrong-procedure, or wrong-patient surgery. The enhanced time out at my facility mandates participation from all members of the surgical team and requires designated members to respond to specified time out elements on the surgical safety checklist. The enhanced time out incorporated at my facility expands upon the safety measures from the World Health Organization's surgical safety checklist and ensures that all personnel involved in a surgical intervention perform a final check of relevant information. Initiating the enhanced time out at my facility was intended to improve communication and teamwork among surgical team members and provide a highly reliable safety process to prevent wrong-site, wrong-procedure, and wrong-patient surgery. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Patient safety culture: finding meaning in patient experiences.

PubMed

Bishop, Andrea C; Cregan, Brianna R

2015-01-01

The purpose of this paper is to determine what patient and family stories can tell us about patient safety culture within health care organizations and how patients experience patient safety culture. A total of 11 patient and family stories of adverse event experiences were examined in September 2013 using publicly available videos on the Canadian Patient Safety Insitute web site. Videos were transcribed verbatim and collated as one complete data set. Thematic analysis was used to perform qualitative inquiry. All qualitative analysis was done using NVivo 10 software. A total of three themes were identified: first, Being Passed Around; second, Not Having the Conversation; and third, the Person Behind the Patient. Results from this research also suggest that while health care organizations and providers might expect patients to play a larger role in managing their health, there may be underlying reasons as to why patients are not doing so. The findings indicate that patient experiences and narratives are useful sources of information to better understand organizational safety culture and patient experiences of safety while hospitalized. Greater inclusion and analysis of patient safety narratives is important in understanding the needs of patients and how patient safety culture interventions can be improved to ensure translation of patient safety strategies at the frontlines of care. Greater acknowledgement of the patient and family experience provides organizations with an integral perspective to assist in defining and addressing deficiencies within their patient safety culture and to identify opportunities for improvement.
Umbilical cord blood expansion with nicotinamide provides long-term multilineage engraftment.

PubMed

Horwitz, Mitchell E; Chao, Nelson J; Rizzieri, David A; Long, Gwynn D; Sullivan, Keith M; Gasparetto, Cristina; Chute, John P; Morris, Ashley; McDonald, Carolyn; Waters-Pick, Barbara; Stiff, Patrick; Wease, Steven; Peled, Amnon; Snyder, David; Cohen, Einat Galamidi; Shoham, Hadas; Landau, Efrat; Friend, Etty; Peleg, Iddo; Aschengrau, Dorit; Yackoubov, Dima; Kurtzberg, Joanne; Peled, Tony

2014-07-01

Delayed hematopoietic recovery is a major drawback of umbilical cord blood (UCB) transplantation. Transplantation of ex vivo-expanded UCB shortens time to hematopoietic recovery, but long-term, robust engraftment by the expanded unit has yet to be demonstrated. We tested the hypothesis that a UCB-derived cell product consisting of stem cells expanded for 21 days in the presence of nicotinamide and a noncultured T cell fraction (NiCord) can accelerate hematopoietic recovery and provide long-term engraftment. In a phase I trial, 11 adults with hematologic malignancies received myeloablative bone marrow conditioning followed by transplantation with NiCord and a second unmanipulated UCB unit. Safety, hematopoietic recovery, and donor engraftment were assessed and compared with historical controls. No adverse events were attributable to the infusion of NiCord. Complete or partial neutrophil and T cell engraftment derived from NiCord was observed in 8 patients, and NiCord engraftment remained stable in all patients, with a median follow-up of 21 months. Two patients achieved long-term engraftment with the unmanipulated unit. Patients transplanted with NiCord achieved earlier median neutrophil recovery (13 vs. 25 days, P < 0.001) compared with that seen in historical controls. The 1-year overall and progression-free survival rates were 82% and 73%, respectively. UCB-derived hematopoietic stem and progenitor cells expanded in the presence of nicotinamide and transplanted with a T cell-containing fraction contain both short-term and long-term repopulating cells. The results justify further study of NiCord transplantation as a single UCB graft. If long-term safety is confirmed, NiCord has the potential to broaden accessibility and reduce the toxicity of UCB transplantation. Clinicaltrials.gov NCT01221857. Gamida Cell Ltd.
A Novel Self-Expandable, Radioactive Airway Stent Loaded with 125I Seeds: A Feasibility and Safety Study in Healthy Beagle Dog.

PubMed

Wang, Yong; Guo, Jin-He; Zhu, Guang-Yu; Zhu, Hai-Dong; Chen, Li; Lu, Jian; Wang, Chao; Teng, Gao-Jun

2017-07-01

Airway stent placement is an effective treatment for the immediate palliation of malignant airway obstruction. However, restenosis caused by tumor ingrowth and/or overgrowth after stenting is common. The purpose of this study was to investigate the feasibility and safety of a novel self-expandable stent loaded with 125 I seeds in healthy beagle dog. Under fluoroscopic guidance, forty-eight self-expandable airway stents loaded with 125 I seeds were perorally placed in the main trachea of 48 healthy beagle dogs, who were randomly divided into four groups (Group A: 0.3 mCi; Group B: 0.6 mCi; Group C: 0.9 mCi; Control group: 0 mCi). The estimated radiation dose was calculated using the isotropic point source approximation. Radiological follow-up examinations and histopathological examinations of stented tracheal segments and their adjacent organs and tissues were performed at 2, 4, 8, and 16 weeks following the stenting. All stents were successfully deployed in the targeted tracheal segment in the beagle dogs without procedure-related complications. Tracheal stenosis became severe gradually in all the four groups, which was not associated with the radioactivity of 125 I seeds (p > 0.05). The tracheal injury scores increased along with the higher dose of radioactive seeds which reached peak at 8 weeks and then turned back slightly at 16 weeks. The adjacent tissue did not show pathohistological changes under microscope, while mild and reversible ultrastructure changes were showed under electronic microscope. This study demonstrates that it is feasible and safe to insert this novel self-expandable airway stent loaded with 125 I seeds in healthy beagle dog.
External Port Tissue Expansion in the Pediatric Population: Confirming Its Safety and Efficacy.

PubMed

Azadgoli, Beina; Fahradyan, Artur; Wolfswinkel, Erik M; Tsuha, Michaela; Magee, William; Hammoudeh, Jeffrey A; Urata, Mark M; Howell, Lori K

2018-06-01

External filling ports in tissue expander-based reconstruction have the advantages of being associated with less pain and emotional distress. However, among practicing surgeons using tissue expansion, a theoretical concern remains regarding higher risk of infection. The authors' goal was to evaluate external port safety in the pediatric population by looking at the complications and overall success rate of reconstruction. A retrospective review of all patients undergoing tissue expansion using external ports at Children's Hospital Los Angeles between January of 2008 and June of 2016 was conducted. Patient demographic and perioperative data were collected and analyzed. Two hundred forty-one expanders were placed in 100 pediatric patients, resulting in 123 procedures for congenital and acquired conditions, with an average age at the time of surgery of 7.1 years (range, 1 month to 19.9 years) and average follow-up length of 2.5 years (range, 2.8 months to 8.8 years). The overall complication rate was 29.9 percent, and the infection rate was 17 percent. The majority of these cases were treated conservatively without additional need for surgery. Of 123 cases, 25 required premature expander removal because of complications. Despite early intervention, 21 of these cases underwent successful completion of their reconstruction according to the preoperative plan, resulting in an overall 96.7 percent success rate of tissue expander reconstruction. In children, who are often less tolerant of the pain and distress associated with internal port expansion, the authors encourage the use of external ports. This study found a high success rate in terms of successful reconstruction, with the majority of complications being treated conservatively. Therapeutic, IV.
Colorado Lightning Mapping Array Collaborations through the GOES-R Visiting Scientist Program

NASA Technical Reports Server (NTRS)

Stano, Geoffrey T.; Szoke, Edward; Rydell, Nezette; Cox, Robert; Mazur, Rebecca

2014-01-01

For the past two years, the GOES-R Proving Ground has solicited proposals for its Visiting Scientist Program. NASA's Short-term Prediction Research and Transition (SPoRT) Center has used this opportunity to support the GOES-R Proving Ground by expanding SPoRT's total lightning collaborations. In 2012, this expanded the evaluation of SPoRT's pseudo-geostationary lightning mapper product to the Aviation Weather Center and Storm Prediction Center. This year, SPoRT has collaborated with the Colorado Lightning Mapping Array (COLMA) and potential end users. In particular, SPoRT is collaborating with the Cooperative Institute for Research in the Atmosphere (CIRA) and Colorado State University (CSU) to obtain these data in real-time. From there, SPoRT is supporting the transition of these data to the local forecast offices in Boulder, Colorado and Cheyenne, Wyoming as well as to Proving Ground projects (e.g., the Hazardous Weather Testbed's Spring Program and Aviation Weather Center's Summer Experiment). This presentation will focus on the results of this particular Visiting Scientist Program trip. In particular, the COLMA data are being provided to both forecast offices for initial familiarization. Additionally, several forecast issues have been highlighted as important uses for COLMA data in the operational environment. These include the utility of these data for fire weather situations, situational awareness for both severe weather and lightning safety, and formal evaluations to take place in the spring of 2014.
Exploring anti-community structure in networks with application to incompatibility of traditional Chinese medicine

NASA Astrophysics Data System (ADS)

Zhu, Jiajing; Liu, Yongguo; Zhang, Yun; Liu, Xiaofeng; Xiao, Yonghua; Wang, Shidong; Wu, Xindong

2017-11-01

Community structure is one of the most important properties in networks, in which a node shares its most connections with the others in the same community. On the contrary, the anti-community structure means the nodes in the same group have few or no connections with each other. In Traditional Chinese Medicine (TCM), the incompatibility problem of herbs is a challenge to the clinical medication safety. In this paper, we propose a new anti-community detection algorithm, Random non-nEighboring nOde expansioN (REON), to find anti-communities in networks, in which a new evaluation criterion, anti-modularity, is designed to measure the quality of the obtained anti-community structure. In order to establish anti-communities in REON, we expand the node set by non-neighboring node expansion and regard the node set with the highest anti-modularity as an anti-community. Inspired by the phenomenon that the node with higher degree has greater contribution to the anti-modularity, an improved algorithm called REONI is developed by expanding node set by the non-neighboring node with the maximum degree, which greatly enhances the efficiency of REON. Experiments on synthetic and real-world networks demonstrate the superiority of the proposed algorithms over the existing methods. In addition, by applying REONI to the herb network, we find that it can discover incompatible herb combinations.
Whole Life Living Skills Curriculum.

ERIC Educational Resources Information Center

Roelofs, Alice R.; And Others

This manual provides ideas to enable Whole Life Program staff and friends to begin expanding on ways to reach and teach survival skills to adults. A list of suggestions for use of the curriculum activities and process appears first. Activities are provided for 11 curriculum areas: emergency procedures; apartment safety; apartment upkeep; food…
Tort liability : a handbook for employees of the Virginia Department of Transportation and Virginia municipal corporations, May 2003.

DOT National Transportation Integrated Search

2003-01-01

Transportation agencies and their employees have always been concerned with providing safe roadways for the public. In recent years, the concern for safety has expanded to include concerns about the high cost of suits brought by those who have suffer...
Medical Device Plug-and-Play Interoperability Standards and Technology Leadership

DTIC Science & Technology

2016-10-01

above for publication in a peer-reviewed journal 4. Expand the release of the Clinical Scenario Repository (CSR), also known as “Good Ideas for...the Clinical Scenario Repository (CSR). The CSR pilot with the American Society of Anesthesiologists (ASA) Committee on Patient Safety and Education
The AOP framework and causality: Meeting chemical risk assessment challenges in the 21st century

EPA Science Inventory

Chemical safety assessments are expanding from a focus on a few chemicals (or chemical mixtures) to the broader “universe” of thousands, if not hundreds of thousands of substances that potentially could impact humans or the environment. This is exemplified in ...
How to Reduce the Threat of Terrorism.

ERIC Educational Resources Information Center

Beres, Louis Rene

1986-01-01

Maintains that the answer to terrorism lies not in higher fences, laser weapons, or expanded commando forces, but in improved understanding of the linkages between U.S. foreign policy and anti-American terrorism. Reviews geopolitical developments, including international law, and concludes that U.S. safety from terrorism will depend upon our…

National model for the statewide application of data collection and management technology to improve highway safety

DOT National Transportation Integrated Search

2005-01-01

The project involves the enhancement of the statewide crash data reporting with automated collection and data capture tools. To that end the project provided funding for computer hardware and peripherals to expand the use of the national model to mor...
Washington State Survey of Adolescent Health Behaviors.

ERIC Educational Resources Information Center

Washington State Dept. of Social and Health Services, Olympia.

The 1992 Washington State Survey of Adolescent Health Behaviors (WSSAHB) was created to collect information regarding a variety of adolescent health behaviors among students in the state of Washington. It expands on two previous administrations of a student tobacco, alcohol, and other drug survey and includes questions about medical care, safety,…
Cold plasma processing to improve food safety

USDA-ARS?s Scientific Manuscript database

Cold plasma is an antimicrobial process being developed for application as a food processing technology. This novel intervention is the subject of an expanding research effort by groups around the world. A variety of devices can be used to generate cold plasma and apply it to the food commodity bein...
New Safety and Technical Challenges and Operational Experience on the JET First Trace Tritium Experiment

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

Pearce, R.J.H.; Bell, A.C.; Brennan, D.

'Trace Tritium Experiments' (TTE) were successfully performed on JET in 2003. The Campaign marked the first use of tritium in JET plasmas since the Deuterium-Tritium Experiment (DTE1) Campaign in 1997, and was the first use of tritium in experiments under the EFDA organisation with the UKAEA as JET Operator. The safety and regulatory preparations for the experiment were extensive. Since JET has been operated by the UKAEA the operations have followed the model of a licensed nuclear site. The safe operation of the JET torus is demonstrated in a safety case. Key Safety Management Requirement (KSMR) and Key Safety Relatedmore » Equipment (KSRE) are identified in the Safety Case for DT operation. The safe operation of the torus is within the bounds of, and under the control of, an Authority to Operate (ATO). New technical challenges were presented by the need to inject and account for small quantities of tritium in very short pulses ({approx}80ms), with an accurate time stamp. The safety and operational management of the campaign are described. Valuable lessons were learned which would help in running future experiments. It is concluded that JET is in a strong position to run future trace tritium and full DT discharges.« less
A subjective evaluation of high-chroma color with wide color-gamut display

NASA Astrophysics Data System (ADS)

Kishimoto, Junko; Yamaguchi, Masahiro; Ohyama, Nagaaki

2009-01-01

Displays tends to expand its color gamut, such as multi-primary color display, Adobe RGB and so on. Therefore displays got possible to display high chroma colors. However sometimes, we feel unnatural some for the image which only expanded chroma. Appropriate gamut mapping method to expand color gamut is not proposed very much. We are attempting preferred expanded color reproduction on wide color gamut display utilizing high chroma colors effectively. As a first step, we have conducted an experiment to investigate the psychological effect of color schemes including highly saturated colors. We used the six-primary-color projector that we have developed for the presentation of test colors. The six-primary-color projector's gamut volume in CIELAB space is about 1.8 times larger than the normal RGB projector. We conducted a subjective evaluation experiment using the SD (Semantic Differential) technique to find the quantitative psychological effect of high chroma colors.
Carbon Dioxide-Based versus Saline Tissue Expansion for Breast Reconstruction: Results of the XPAND Prospective, Randomized Clinical Trial.

PubMed

Ascherman, Jeffrey A; Zeidler, Kamakshi; Morrison, Kerry A; Appel, James Z; Berkowitz, R L; Castle, John; Colwell, Amy; Chun, Yoon; Johnson, Debra; Mohebali, Khashayar

2016-12-01

AeroForm is a new type of remote-controlled, needle-free, carbon dioxide-based expander involving a potentially faster method of tissue expansion. Results are presented here from the AirXpanders Patient Activated Controlled Tissue Expander pivotal trial comparing AeroForm to saline tissue expanders. Women undergoing two-stage breast reconstruction were randomized at 17 U.S. sites in this U.S. Food and Drug Administration-approved investigational device exemption trial. Expansion in the investigational arm was performed by the patient in 10-cc increments up to 30 cc/day of carbon dioxide and in the control arm by the physician with periodic bolus injections of saline. Safety endpoints, expansion and reconstruction times, pain, and satisfaction were assessed. One hundred fifty women were treated: 98 with carbon dioxide expanders (n = 168) and 52 with saline expanders (n = 88). The treatment success rate (all breasts exchanged successfully excluding non-device-related failures) was 96.1 percent for carbon dioxide and 98.8 percent for saline. Median time to full expansion and completion of the second-stage operation was 21.0 and 108.5 days (carbon dioxide) versus 46.0 and 136.5 days (saline), respectively, with a similar rate of overall complications. Ease of use for the carbon dioxide expander was rated high by patients (98 percent) and physicians (90 percent). The AirXpanders Patient Activated Controlled Tissue Expander trial results demonstrate that a carbon dioxide-based expander is an effective method of tissue expansion with a similar overall adverse event rate compared to saline expanders, and provides a more convenient and expedient expansion. Therapeutic, I.
Expanding Eligibility for the Ross Procedure: A Reasonable Proposition?

PubMed

Ghoneim, Aly; Bouhout, Ismail; Losenno, Katie; Poirier, Nancy; Cartier, Raymond; Demers, Philippe; Tousch, Michael; Guo, Linruo; Chu, Michael W A; El-Hamamsy, Ismail

2018-06-01

Although the Ross procedure offers potential benefits in young adults, technical complexity represents a significant limitation. Therefore, the safety of expanding its use in more complex settings is uncertain. The aim of this study was to compare early outcomes of standard isolated Ross procedures vs expanding elgibility to higher-risk clinical settings. From 2011 to 2016, 261 patients (46 ± 12 years) underwent Ross procedures in 2 centres. Patients were divided into 2 groups: standard Ross (n = 166) and expanded eligibility Ross (n = 95). Inclusion criteria for the expanded eligibility group were previous cardiac surgery, acute aortic valve endocarditis, severely impaired left ventricular (LV) function and patients undergoing concomitant procedures. All data were prospectively collected and are 100% complete. Hospital mortality was 0% in the standard group (0/166) vs 2% in the expanded eligibility group (2/95) (P = 0.13). Sixteen patients (10%) developed acute renal injury in the standard group vs 13 (14%) patients in the expanded eligibility group (P = 0.31). There were no postoperative myocardial infarctions, no neurological events, and no infectious complications. Median intensive care unit (ICU) stay in the standard group was 2 vs 3 days in the expanded eligibility group (P = 0.004), whereas median hospital stay was 6 vs 7 days, respectively (range: 3-19 days) (P < 0.001). Aside from longer ICU and hospital lengths of stay after the Ross procedure in higher-risk clinical scenarios, perioperative mortality and morbidity is similar to standard Ross procedures. Expanding the use of the Ross operation in young adults is a safe alternative in centres of expertise. Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Direct transcatheter aortic valve implantation with self-expandable bioprosthesis: feasibility and safety.

PubMed

Fiorina, Claudia; Maffeo, Diego; Curello, Salvatore; Lipartiti, Felicia; Chizzola, Giuliano; D'Aloia, Antonio; Adamo, Marianna; Mastropierro, Rosy; Gavazzi, Emanuele; Ciccarese, Camilla; Chiari, Ermanna; Ettori, Federica

2014-06-01

Balloon valvuloplasty has been considered a mandatory step of the transcatheter aortic valve implantation (TAVI), although it is not without risk. The aim of this work was to evaluate the feasibility and safety of TAVI performed without pre-dilation (direct TAVI) of the stenosed aortic valve. Between June 2012 and June 2013, 55 consecutive TAVI performed without pre-dilation at our institution using the self-expandable CoreValve prosthesis (Medtronic, Minneapolis, MN) were analyzed and compared with 45 pre-dilated TAVI performed the previous year. Inclusion criteria were a symptomatic and severe aortic stenosis. Exclusion criteria were defined as presence of pure aortic regurgitation, degenerated surgical bioprosthesis or bicuspid aortic valve and prior procedure of balloon aortic valvuloplasty performed as a bridge to TAVI. High-burden calcification in the device landing zone, assessed by CT scan, was found in most of the patients. The valve size implanted was similar in both groups. Device success was higher in direct TAVI (85%vs.64%,p=0.014), mostly driven by a significant lower incidence of paravalvular leak (PVL≥2;9%vs.33%,p=0.02). Safety combined end point at 30 days was similar in both groups. Compared to TAVI with pre-dilation, direct TAVI is feasible regardless of the presence of bulky calcified aortic valve and the valve size implanted. Device success was higher in direct TAVI, mostly driven by a lower incidence of paravalvular leak. Safety at 30 days was similar in two groups. Copyright © 2014 Elsevier Inc. All rights reserved.
Anomaly Analysis: NASA's Engineering and Safety Center Checks Recurring Shuttle Glitches

NASA Technical Reports Server (NTRS)

Morring, Frank, Jr.

2004-01-01

The NASA Engineering and Safety Center (NESC), set up in the wake of the Columbia accident to backstop engineers in the space shuttle program, is reviewing hundreds of recurring anomalies that the program had determined don't affect flight safety to see if in fact they might. The NESC is expanding its support to other programs across the agency, as well. The effort, which will later extend to the International Space Station (ISS), is a principal part of the attempt to overcome the normalization of deviance--a situation in which organizations proceeded as if nothing was wrong in the face of evidence that something was wrong--cited by sociologist Diane Vaughn as contributing to both space shuttle disasters.
Use of expanded clay aggregate in bituminous construction.

DOT National Transportation Integrated Search

1959-01-01

In an effort to find a solution to the shortage of aggregate, for use in highway construction, Louisiana Department of Highways initiated a study. : In early 1955, we started experimenting with expanded aggregate or lightweight aggregate as commonly ...
The Association Between Professional Burnout and Engagement With Patient Safety Culture and Outcomes: A Systematic Review.

PubMed

Mossburg, Sarah E; Dennison Himmelfarb, Cheryl

2018-06-25

In the last 20 years, there have been numerous successful efforts to improve patient safety, although recent research still shows a significant gap. Researchers have begun exploring the impact of individual level factors on patient safety culture and safety outcomes. This review examines the state of the science exploring the impact of professional burnout and engagement on patient safety culture and safety outcomes. A systematic search was conducted in CINAHL, PubMed, and Embase. Studies included reported on the relationships among burnout or engagement and safety culture or safety outcomes. Twenty-two studies met inclusion criteria. Ten studies showed a relationship between both safety culture and clinical errors with burnout. Two of 3 studies reported an association between burnout and patient outcomes. Fewer studies focused on engagement. Most studies exploring engagement and safety culture found a moderately strong positive association. The limited evidence on the relationship between engagement and errors depicts inconsistent findings. Only one study explored engagement and patient outcomes, which failed to find a relationship. The burnout/safety literature should be expanded to a multidisciplinary focus. Mixed results of the relationship between burnout and errors could be due to a disparate relationship with perceived versus observed errors. The engagement/safety literature is immature, although high engagement seems to be associated with high safety culture. Extending this science into safety outcomes would be meaningful, especially in light of the recent focus on an abundance-based approach to safety.
New technology innovations with potential for space applications

NASA Astrophysics Data System (ADS)

Krishen, Kumar

2008-07-01

Human exploration and development of space is being pursued by spacefaring nations to explore, use, and enable the development of space and expand the human experience there. The goals include: increasing human knowledge of nature's processes using the space environment; exploring and settling the solar system; achieving routine space travel; and enriching life on Earth through living and working in space. A crucial aspect of future space missions is the development of infrastructure to optimize safety, productivity, and costs. A major component of mission execution is operations management. NASA's International Space Station is providing extensive experience in both infrastructure and operations. In view of this, a vigorously organized approach is needed to implement successful space-, planet-, and ground-based research and operations that entails wise and efficient use of technical and human resources. Many revolutionary technologies being pursued by researchers and technologists may be vital in making space missions safe, reliable, cost-effective, and productive. These include: ionic polymer-metal composite technology; solid-state lasers; time-domain sensors and communication systems; high-temperature superconductivity; nanotechnology; variable specific impulse magneto plasma rocket; fuzzy logic; wavelet technology; and neural networks. An overview of some of these will be presented, along with their application to space missions.
The Use of Crow-AMSAA Plots to Assess Mishap Trends

NASA Technical Reports Server (NTRS)

Dawson, Jeffrey W.

2011-01-01

Crow-AMSAA (CA) plots are used to model reliability growth. Use of CA plots has expanded into other areas, such as tracking events of interest to management, maintenance problems, and safety mishaps. Safety mishaps can often be successfully modeled using a Poisson probability distribution. CA plots show a Poisson process in log-log space. If the safety mishaps are a stable homogenous Poisson process, a linear fit to the points in a CA plot will have a slope of one. Slopes of greater than one indicate a nonhomogenous Poisson process, with increasing occurrence. Slopes of less than one indicate a nonhomogenous Poisson process, with decreasing occurrence. Changes in slope, known as "cusps," indicate a change in process, which could be an improvement or a degradation. After presenting the CA conceptual framework, examples are given of trending slips, trips and falls, and ergonomic incidents at NASA (from Agency-level data). Crow-AMSAA plotting is a robust tool for trending safety mishaps that can provide insight into safety performance over time.
Science and technology issues in spacecraft fire safety

NASA Technical Reports Server (NTRS)

Friedman, Robert; Sacksteder, Kurt R.

1987-01-01

The space station, a permanently-inhabited orbiting laboratory, places new demands on spacecraft fire safety. Long-duration missions may call for more-constrained fire controls, but the accessibility of the space station to a variety of users may call for less-restrictive measures. This paper discusses fire safety issues through a review of the state of the art and a presentation of key findings from a recent NASA Lewis Research Center Workshop. The subjects covered are the fundamental science of low-gravity combustion and the technology advances in fire detection, extinguishment, materials assessment, and atmosphere selection. Key concerns are for the adoption of a fire-safe atmosphere and the substitution for the effective but toxic extinguishant, halon 1301. The fire safety studies and reviews provide several recommendations for further action. One is the expanded research in combustion, sensors, and materials in the low-gravity environment of space. Another is the development of generalized fire-safety standards for spacecraft through cooperative endeavors with aerospace and outside Government and industry sources.
Organized labor and the origins of the Occupational Safety and Health Act.

PubMed

Asher, Robert

2014-11-01

New Solutions is republishing this 1991 article by Robert Asher, which reviews the history of organized labor's efforts in the United States to secure health and safety protections for workers. The 1877 passage of the Massachusetts factory inspection law and the implementation of primitive industrial safety inspection systems in many states paralleled labor action for improved measures to protect workers' health and safety. In the early 1900s labor was focusing on workers' compensation laws. The New Deal expanded the federal government's role in worker protection, supported at least by the Congress of Industrial Organizations (CIO), but challenged by industry and many members of the U.S. Congress. The American Federation of Labor (AFL) and the CIO backed opposing legal and inspection strategies in the late 1940s and through the 1950s. Still, by the late 1960s, several unions were able to help craft the Occupational Safety and Health Act of 1970 and secure new federal protections for U.S. workers.
Disclosure and Fit Capability of the Filtering Facepiece Respirator.

PubMed

Lofgren, Don J

2018-05-01

The filtering facepiece air-purifying respirator is annually purchased in the tens of millions and widely used for worker protection from harmful airborne particulates. The workplace consumers of this safety product, i.e., employers, workers, and safety and health professionals, have assurances of its effectiveness through the respirator certification and disclosure requirements of the National Institute for Occupational Safety and Health. However, the certification of a critical performance requirement has been missing for the approved filtering facepiece respirator since 1995: fit capability. Without this certification, consumers continue to be at risk of purchasing a respirator model that may fit a small percentage of the intended users. This commentary updates and expands an earlier one by this author, addresses the consequences of poorly fitting certified models on the market and lack of disclosure, and calls for further action by National Institute for Occupational Safety and Health to meet the needs and expectations of the consumer.
Safety in Acute Pain Medicine-Pharmacologic Considerations and the Impact of Systems-Based Gaps.

PubMed

Weingarten, Toby N; Taenzer, Andreas H; Elkassabany, Nabil M; Le Wendling, Linda; Nin, Olga; Kent, Michael L

2018-05-02

In the setting of an expanding prevalence of acute pain medicine services and the aggressive use of multimodal analgesia, an overview of systems-based safety gaps and safety concerns in the setting of aggressive multimodal analgesia is provided below. Expert commentary. Recent evidence focused on systems-based gaps in acute pain medicine is discussed. A focused literature review was conducted to assess safety concerns related to commonly used multimodal pharmacologic agents (opioids, nonsteroidal anti-inflammatory drugs, gabapentanoids, ketamine, acetaminophen) in the setting of inpatient acute pain management. Optimization of systems-based gaps will increase the probability of accurate pain assessment, improve the application of uniform evidence-based multimodal analgesia, and ensure a continuum of pain care. While acute pain medicine strategies should be aggressively applied, multimodal regimens must be strategically utilized to minimize risk to patients and in a comorbidity-specific fashion.
Linking Environmental Sustainability, Health, and Safety Data in Health Care: A Research Roadmap.

PubMed

Kaplan, Susan B; Forst, Linda

2017-08-01

Limited but growing evidence demonstrates that environmental sustainability in the health-care sector can improve worker and patient health and safety. Yet these connections are not appreciated or understood by decision makers in health-care organizations or oversight agencies. Several studies demonstrate improvements in quality of care, staff satisfaction, and work productivity related to environmental improvements in the health-care sector. A pilot study conducted by the authors found that already-collected data could be used to evaluate impacts of environmental sustainability initiatives on worker and patient health and safety, yet few hospitals do so. Future research should include a policy analysis of laws that could drive efforts to integrate these areas, elucidation of organizational models that promote sharing of environmental and health and safety data, and development of tools and methods to enable systematic linkage and evaluation of these data to expand the evidence base and improve the hospital environment.
How five leading safety-net hospitals are preparing for the challenges and opportunities of health care reform.

PubMed

Coughlin, Teresa A; Long, Sharon K; Sheen, Edward; Tolbert, Jennifer

2012-08-01

Safety-net hospitals will continue to play a critical role in the US health care system, as they will need to care for the more than twenty-three million people who are estimated to remain uninsured after the Affordable Care Act is implemented. Yet such hospitals will probably have less federal and state support for uncompensated care. At the same time, safety-net hospitals will need to reposition themselves in the marketplace to compete effectively for newly insured people who will have a choice of providers. We examine how five leading safety-net hospitals have begun preparing for reform. Building upon strong organizational attributes such as health information technology and system integration, the study hospitals' preparations include improving the efficiency and quality of care delivery, retaining current and attracting new patients, and expanding the medical home model.
An Evaluation Tool for Agricultural Health and Safety Mobile Applications.

PubMed

Reyes, Iris; Ellis, Tammy; Yoder, Aaron; Keifer, Matthew C

2016-01-01

As the use of mobile devices and their software applications, or apps, becomes ubiquitous, use amongst agricultural working populations is expanding as well. The smart device paired with a well-designed app has potential for improving workplace health and safety in the hands of those who can act upon the information provided. Many apps designed to assess workplace hazards and implementation of worker protections already exist. However, the abundance and diversity of such applications also presents challenges regarding evaluation practices and assignation of value. This is particularly true in the agricultural workspace, as there is currently little information on the value of these apps for agricultural safety and health. This project proposes a framework for developing and evaluating apps that have potential usefulness in agricultural health and safety. The evaluation framework is easily transferable, with little modification for evaluation of apps in several agriculture-specific areas.

Telemedicine to promote patient safety: Use of phone-based interactive voice response system (IVRS) to reduce adverse safety events in predialysis CKD

PubMed Central

Weiner, Shoshana; Fink, Jeffery C.

2017-01-01

Chronic kidney disease (CKD) patients have several features conferring upon them a high risk of adverse safety events, which are defined as incidents with unintended harm related to processes of care or medications. These characteristics include impaired renal function, polypharmacy, and frequent health system encounters. The consequences of such events in CKD can include new or prolonged hospitalization, accelerated renal function loss, acute kidney injury, end-stage renal disease and death. Health information technology administered via telemedicine presents opportunities for CKD patients to remotely communicate safety-related findings to providers for the purpose of improving their care. However, many CKD patients have limitations which hinder their use of telemedicine and access to the broad capabilities of health information technology. In this review we summarize previous assessments of the pre-dialysis CKD populations’ proficiency in using telemedicine modalities and describe the use of interactive voice-response system (IVRS) to gauge the safety phenotype of the CKD patient. We discuss the potential for expanded IVRS use in CKD to address the safety threats inherent to this population. PMID:28224940
How do we keep our residents safe? An educational intervention.

PubMed

Wasser, Tobias D

2015-02-01

Recent evidence suggests that 25-64 % of psychiatry residents are the victims of assault by patients; only a minority, however, feel they receive adequate safety and violence training during residency. To address this disparity, the author designed, implemented, and assessed the effectiveness of a brief educational intervention focused on improving the residents' ability to recognize violence risk and increase attention to safety in the psychiatric interview. The subjects were 13 second-year psychiatry residents. Effectiveness was evaluated via the assessment of the residents' written responses describing their first clinical intervention after hearing a case vignette of a potentially violent patient (before and 1 month following the intervention). Responses were evaluated for any evidence of concerns for safety. The number of residents citing safety concerns increased (38 to 92 %), as did the level of sophistication in their proposed interventions. A brief educational intervention focused on violence risk and interview safety may be effective in increasing residents' attention to safety concerns in their clinical care, and further work will be beneficial to confirm and expand upon these findings.
Time series modeling in traffic safety research.

PubMed

Lavrenz, Steven M; Vlahogianni, Eleni I; Gkritza, Konstantina; Ke, Yue

2018-08-01

The use of statistical models for analyzing traffic safety (crash) data has been well-established. However, time series techniques have traditionally been underrepresented in the corresponding literature, due to challenges in data collection, along with a limited knowledge of proper methodology. In recent years, new types of high-resolution traffic safety data, especially in measuring driver behavior, have made time series modeling techniques an increasingly salient topic of study. Yet there remains a dearth of information to guide analysts in their use. This paper provides an overview of the state of the art in using time series models in traffic safety research, and discusses some of the fundamental techniques and considerations in classic time series modeling. It also presents ongoing and future opportunities for expanding the use of time series models, and explores newer modeling techniques, including computational intelligence models, which hold promise in effectively handling ever-larger data sets. The information contained herein is meant to guide safety researchers in understanding this broad area of transportation data analysis, and provide a framework for understanding safety trends that can influence policy-making. Copyright © 2017 Elsevier Ltd. All rights reserved.
[Application of supply chain integration management of medical consumables].

PubMed

Zhang, Jian

2013-07-01

This paper introduces the background, the content, the information management system of material supply chain integration management and the consumables management process. The system helps to expand the selection of hospital supplies varieties, to reduce consumables management costs, to improve the efficiency of supplies, to ensure supplies safety, reliability and traceability.
78 FR 54775 - Bulk Packaging To Allow for Transfer of Hazardous Liquid Cargoes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

... the selection and use of packaging in the transportation of hazardous materials. This rule will... Pipeline and Hazardous Materials Safety Administration SBA Small Business Administration U.S.C. United... materials to and from bulk packaging on vessels. The Coast Guard is expanding the list of bulk packaging...
A review of the current state-of-the-art methodology for handling bias and uncertainty in performing criticality safety evaluations. Final report

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

Disney, R.K.

1994-10-01

The methodology for handling bias and uncertainty when calculational methods are used in criticality safety evaluations (CSE`s) is a rapidly evolving technology. The changes in the methodology are driven by a number of factors. One factor responsible for changes in the methodology for handling bias and uncertainty in CSE`s within the overview of the US Department of Energy (DOE) is a shift in the overview function from a ``site`` perception to a more uniform or ``national`` perception. Other causes for change or improvement in the methodology for handling calculational bias and uncertainty are; (1) an increased demand for benchmark criticalsmore » data to expand the area (range) of applicability of existing data, (2) a demand for new data to supplement existing benchmark criticals data, (3) the increased reliance on (or need for) computational benchmarks which supplement (or replace) experimental measurements in critical assemblies, and (4) an increased demand for benchmark data applicable to the expanded range of conditions and configurations encountered in DOE site restoration and remediation.« less
Exploring Science Applications for Unmanned Aircraft Systems Aboard UNOLS Ships

NASA Astrophysics Data System (ADS)

Bailey, R.; Lachenmeier, T.; Hatfield, M. C.

2014-12-01

The University of Alaska Fairbanks has been expanding the use of small Unmanned Aircraft Systems (UAS) for science support from a variety of ships for several years. The ease and safety of flying from research vessels offers the science community lower cost access to overhead surveys of marine mammals without impact on sensitive populations, monitoring of AUV operations and collection of transmitted data, extensive surveys of sea ice during formation, melt, and sea temperatures through multiple seasons. As FAA expands access to the Arctic airspace over the Chukchi, Beaufort, and Bering Seas, the opportunities to employ UAS in science applications will become easier to exploit. This presentation describes the changes coming through new FAA rules, through the Alaska FAA Test Site, the Pan-Pacific UAS Test Range Complex which includes Oregon and Hawaii, and even Iceland. Airspace access advances associated with recent operations including the NASA-sponsored MIZOPEX, whale detection, and forming sea ice work in October will be presented, as well as a glider UAS connected to very high altitude balloons collecting atmospheric data. Development of safety procedures for use of UAS on UNOLS ships will be discussed.
Analysis of microgravity space experiments Space Shuttle programmatic safety requirements

NASA Technical Reports Server (NTRS)

Terlep, Judith A.

1996-01-01

This report documents the results of an analysis of microgravity space experiments space shuttle programmatic safety requirements and recommends the creation of a Safety Compliance Data Package (SCDP) Template for both flight and ground processes. These templates detail the programmatic requirements necessary to produce a complete SCDP. The templates were developed from various NASA centers' requirement documents, previously written guidelines on safety data packages, and from personal experiences. The templates are included in the back as part of this report.
No-fault compensation in New Zealand: harmonizing injury compensation, provider accountability, and patient safety.

PubMed

Bismark, Marie; Paterson, Ron

2006-01-01

In 1974 New Zealand jettisoned a tort-based system for compensating medical injuries in favor of a government-funded compensation system. Although the system retained some residual fault elements, it essentially barred medical malpractice litigation. Reforms in 2005 expanded eligibility for compensation to all "treatment injuries," creating a true no-fault compensation system. Compared with a medical malpractice system, the New Zealand system offers more-timely compensation to a greater number of injured patients and more-effective processes for complaint resolution and provider accountability. The unfinished business lies in realizing its full potential for improving patient safety.
An Updated Examination of Aviation Accidents Associated with Turbulence, Wind Shear and Thunderstorm

NASA Technical Reports Server (NTRS)

Evans, Joni K.

2014-01-01

One of the technical challenges within the Atmospheric Environment Safety Technologies (AEST) Project of the Aviation Safety Program was to "improve and expand remote sensing and mitigation of hazardous atmospheric environments and phenomena"1. In 2012, the author performed an analysis comparing various characteristics of accidents associated with different types of atmospheric hazard environments2. This document reports an update to that analysis which was done in preparation for presenting these findings at the 2015 annual meeting of the Transportation Research Board. Specifically, an additional three years of data were available, and a time-trend analysis was added.
Expanding the Operational Use of Total Lightning Ahead of GOES-R

NASA Technical Reports Server (NTRS)

Stano, Geoffrey T.; Wood, Lance; Garner, Tim; Nunez, Roland; Kann, Deirdre; Reynolds, James; Rydell, Nezette; Cox, Rob; Bobb, William R.

2015-01-01

NASA's Short-term Prediction Research and Transition Center (SPoRT) has been transitioning real-time total lightning observations from ground-based lightning mapping arrays since 2003. This initial effort was with the local Weather Forecast Offices (WFO) that could use the North Alabama Lightning Mapping Array (NALMA). These early collaborations established a strong interest in the use of total lightning for WFO operations. In particular the focus started with warning decision support, but has since expanded to include impact-based decision support and lightning safety. SPoRT has used its experience to establish connections with new lightning mapping arrays as they become available. The GOES-R / JPSS Visiting Scientist Program has enabled SPoRT to conduct visits to new partners and expand the number of operational users with access to total lightning observations. In early 2014, SPoRT conducted the most recent visiting scientist trips to meet with forecast offices that will used the Colorado, Houston, and Langmuir Lab (New Mexico) lightning mapping arrays. In addition, SPoRT met with the corresponding Center Weather Service Units (CWSUs) to expand collaborations with the aviation community. These visits were an opportunity to learn about the forecast needs of each office visited as well as to provide on-site training for the use of total lightning, setting the stage for a real-time assessment during May-July 2014. With five lightning mapping arrays covering multiple geographic locations, the 2014 assessment has demonstrated numerous uses of total lightning in varying situations. Several highlights include a much broader use of total lightning for impact-based decision support ranging from airport weather warnings, supporting fire crews, and protecting large outdoor events. The inclusion of the CWSUs has broadened the operational scope of total lightning, demonstrating how these data can support air traffic management, particularly in the Terminal Radar Approach Control Facilities (TRACON) region around an airport. These collaborations continue to demonstrate, from the operational perspective, the utility of total lightning and the importance of continued training and preparation in advance of the Geostationary Lightning Mapper.
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.
Final results from the large sunitinib global expanded-access trial in metastatic renal cell carcinoma.

PubMed

Gore, M E; Szczylik, C; Porta, C; Bracarda, S; Bjarnason, G A; Oudard, S; Lee, S-H; Haanen, J; Castellano, D; Vrdoljak, E; Schöffski, P; Mainwaring, P; Hawkins, R E; Crinò, L; Kim, T M; Carteni, G; Eberhardt, W E E; Zhang, K; Fly, K; Matczak, E; Lechuga, M J; Hariharan, S; Bukowski, R

2015-06-30

We report final results with extended follow-up from a global, expanded-access trial that pre-regulatory approval provided sunitinib to metastatic renal cell carcinoma (mRCC) patients, ineligible for registration-directed trials. Patients ⩾18 years received oral sunitinib 50 mg per day on a 4-weeks-on-2-weeks-off schedule. Safety was assessed regularly. Tumour measurements were scheduled per local practice. A total of 4543 patients received sunitinib. Median treatment duration and follow-up were 7.5 and 13.6 months. Objective response rate was 16% (95% confidence interval (CI): 15-17). Median progression-free survival (PFS) and overall survival (OS) were 9.4 months (95% CI: 8.8-10.0) and 18.7 months (95% CI: 17.5-19.5). Median PFS in subgroups of interest: aged ⩾65 years (33%), 10.1 months; Eastern Cooperative Oncology Group performance status ⩾2 (14%), 3.5 months; non-clear cell histology (12%), 6.0 months; and brain metastases (7%), 5.3 months. OS was strongly associated with the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model (n=4065). The most common grade 3/4 treatment-related adverse events were thrombocytopenia (10%), fatigue (9%), and asthenia, neutropenia, and hand-foot syndrome (each 7%). Final analysis of the sunitinib expanded-access trial provided a good opportunity to evaluate the long-term side effects of a tyrosine kinase inhibitor used worldwide in mRCC. Efficacy and safety findings were consistent with previous results.
How much can you drink before driving? The influence of riding with impaired adults and peers on the driving behaviors of urban and rural youth.

PubMed

Leadbeater, Bonnie J; Foran, Kathleen; Grove-White, Aidan

2008-04-01

Following an ecological model to specify risks for impaired driving, we assessed the effects of youth attitudes about substance use and their experiences of riding in cars with adults and peers who drove after drinking alcohol or smoking cannabis on the youths' own driving after drinking or using cannabis. Participants were 2594 students in grades 10 and 12 (mean age = 16 years and 2 months; 50% girls) from public high schools in urban (994) and rural communities (1600) on Vancouver Island in British Columbia, Canada; 1192 of these were new drivers with restricted licenses. Self-report data were collected in anonymous questionnaires. Regression analyses were used to assess the independent and interacting effects of youth attitudes about substance use and their experiences of riding in cars with adults or peers who drove after drinking alcohol or smoking cannabis on youth driving. Youth driving risk behaviors were associated independently with their own high-risk attitudes and experiences riding with peers who drink alcohol or use cannabis and drive. However, risks were highest for the youth who also report more frequent experiences of riding with adults who drink alcohol or use cannabis and drive. Prevention efforts should be expanded to include the adults and peers who are role models for new drivers and to increase youths' awareness of their own responsibilities for their personal safety as passengers.
Monitoring product safety in the postmarketing environment.

PubMed

Sharrar, Robert G; Dieck, Gretchen S

2013-10-01

The safety profile of a medicinal product may change in the postmarketing environment. Safety issues not identified in clinical development may be seen and need to be evaluated. Methods of evaluating spontaneous adverse experience reports and identifying new safety risks include a review of individual reports, a review of a frequency distribution of a list of the adverse experiences, the development and analysis of a case series, and various ways of examining the database for signals of disproportionality, which may suggest a possible association. Regulatory agencies monitor product safety through a variety of mechanisms including signal detection of the adverse experience safety reports in databases and by requiring and monitoring risk management plans, periodic safety update reports and postauthorization safety studies. The United States Food and Drug Administration is working with public, academic and private entities to develop methods for using large electronic databases to actively monitor product safety. Important identified risks will have to be evaluated through observational studies and registries.
Demographic variables in coal miners’ safety attitude

NASA Astrophysics Data System (ADS)

Yin, Wen-wen; Wu, Xiang; Ci, Hui-Peng; Qin, Shu-Qi; Liu, Jia-Long

2017-03-01

To change unsafe behavior through adjusting people’s safety attitudes has become an important measure to prevent accidents. Demographic variables, as influential factors of safety attitude, are fundamental and essential for the research. This research does a questionnaire survey among coal mine industry workers, and makes variance analysis and correlation analysis of the results in light of age, length of working years, educational level and experiences of accidents. The results show that the coal miners’ age, length of working years and accident experiences correlate lowly with safety attitudes, and those older coal miners with longer working years have better safety attitude, as coal miners without experiences of accident do.However, educational level has nothing to do with the safety attitude. Therefore, during the process of safety management, coal miners with different demographic characteristics should be put more attention to.
International Society for Analytical Cytology biosafety standard for sorting of unfixed cells.

PubMed

Schmid, Ingrid; Lambert, Claude; Ambrozak, David; Marti, Gerald E; Moss, Delynn M; Perfetto, Stephen P

2007-06-01

Cell sorting of viable biological specimens has become very prevalent in laboratories involved in basic and clinical research. As these samples can contain infectious agents, precautions to protect instrument operators and the environment from hazards arising from the use of sorters are paramount. To this end the International Society of Analytical Cytology (ISAC) took a lead in establishing biosafety guidelines for sorting of unfixed cells (Schmid et al., Cytometry 1997;28:99-117). During the time period these recommendations have been available, they have become recognized worldwide as the standard practices and safety precautions for laboratories performing viable cell sorting experiments. However, the field of cytometry has progressed since 1997, and the document requires an update. Initially, suggestions about the document format and content were discussed among members of the ISAC Biosafety Committee and were incorporated into a draft version that was sent to all committee members for review. Comments were collected, carefully considered, and incorporated as appropriate into a draft document that was posted on the ISAC web site to invite comments from the flow cytometry community at large. The revised document was then submitted to ISAC Council for review. Simultaneously, further comments were sought from newly-appointed ISAC Biosafety committee members. This safety standard for performing viable cell sorting experiments was recently generated. The document contains background information on the biohazard potential of sorting and the hazard classification of infectious agents as well as recommendations on (1) sample handling, (2) operator training and personal protection, (3) laboratory design, (4) cell sorter set-up, maintenance, and decontamination, and (5) testing the instrument for the efficiency of aerosol containment. This standard constitutes an updated and expanded revision of the 1997 biosafety guideline document. It is intended to provide laboratories involved in cell sorting with safety practices that take into account the enhanced hazard potential of high-speed sorting. Most importantly, it states that droplet-based sorting of infectious or hazardous biological material requires a higher level of containment than the one recommended for the risk group classification of the pathogen. The document also provides information on safety features of novel instrumentation, new options for personal protective equipment, and recently developed methods for testing the efficiency of aerosol containment.
A systematic review of evidence on the links between patient experience and clinical safety and effectiveness

PubMed Central

Doyle, Cathal; Lennox, Laura; Bell, Derek

2013-01-01

Objective To explore evidence on the links between patient experience and clinical safety and effectiveness outcomes. Design Systematic review. Setting A wide range of settings within primary and secondary care including hospitals and primary care centres. Participants A wide range of demographic groups and age groups. Primary and secondary outcome measures A broad range of patient safety and clinical effectiveness outcomes including mortality, physical symptoms, length of stay and adherence to treatment. Results This study, summarising evidence from 55 studies, indicates consistent positive associations between patient experience, patient safety and clinical effectiveness for a wide range of disease areas, settings, outcome measures and study designs. It demonstrates positive associations between patient experience and self-rated and objectively measured health outcomes; adherence to recommended clinical practice and medication; preventive care (such as health-promoting behaviour, use of screening services and immunisation); and resource use (such as hospitalisation, length of stay and primary-care visits). There is some evidence of positive associations between patient experience and measures of the technical quality of care and adverse events. Overall, it was more common to find positive associations between patient experience and patient safety and clinical effectiveness than no associations. Conclusions The data presented display that patient experience is positively associated with clinical effectiveness and patient safety, and support the case for the inclusion of patient experience as one of the central pillars of quality in healthcare. It supports the argument that the three dimensions of quality should be looked at as a group and not in isolation. Clinicians should resist sidelining patient experience as too subjective or mood-oriented, divorced from the ‘real’ clinical work of measuring safety and effectiveness. PMID:23293244
Beyond Symbolic Processing: Expanding Horizons for Educational Psychology.

ERIC Educational Resources Information Center

Derry, Sharon J.

1992-01-01

The horizons are expanding for educational psychology as important questions are being raised about the extent and nature of the relationship between formal schooling and life experiences. A broadening of perspectives is required to incorporate cultural contexts and forces in which schooling takes part. (SLD)
Designing Online Playgrounds for Learning Mathematics

ERIC Educational Resources Information Center

Johnson, Heather Lynn; Hornbein, Peter; Bryson, Dana

2016-01-01

Fully online courses can provide teachers fresh opportunities to expand their mathematical conceptions and infuse technology into their classroom teaching. In this article, the authors share the experience of two classroom teachers (Hornbein and Bryson) who participated in a fully online mathematics education course--Expanding Conceptions of…

Precast/Prestressed Concrete Experiments Performance on Non-Load Bearing Sandwich Wall Panels

DTIC Science & Technology

2011-01-01

expanded polystyrene (EPS), extruded expanded polystyrene (XPS...34 Ø Strands @ 14.9 kips 3/8" Ø Strands @ 14.9 kips 9" #3@18" XEPS Insulation Extruded Expanded Polystyrene 4" (Metal C-Pins) Metal C-Pins 1’-8" 3" 3...34 3" 8" 1’-4" 8" 2’-8" 11 2 " 6" 11 2 " 3/8" Ø Strands @ 14.9 kips 3/8" Ø Strands @ 14.9 kips 9" #3@18" XEPS Insulation Extruded Expanded Polystyrene
Why carers use adult day respite: a mixed method case study

PubMed Central

2014-01-01

Background We need to improve our understanding of the complex interactions between family carers’ emotional relationships with care-recipients and carers use of support services. This study assessed carer’s expectations and perceptions of adult day respite services and their commitment to using services. Methods A mixed-method case study approach was used with psychological contract providing a conceptual framework. Data collection was situated within an organisational case study, and the total population of carers from the organisation’s day respite service were approached. Fifty respondents provided quantitative and qualitative data through an interview survey. The conceptual framework was expanded to include Maslow’s hierarchy of needs during analysis. Results Carers prioritised benefits for and experiences of care-recipients when making day respite decisions. Respondents had high levels of trust in the service and perceived that the major benefits for care-recipients were around social interaction and meaningful activity with resultant improved well-being. Carers wanted day respite experiences to include all levels of Maslow’s hierarchy of needs from the provision of physiological care and safety through to the higher levels of belongingness, love and esteem. Conclusion The study suggests carers need to trust that care-recipients will have quality experiences at day respite. This study was intended as a preliminary stage for further research and while not generalizable it does highlight key considerations in carers’ use of day respite services. PMID:24906239
Why carers use adult day respite: a mixed method case study.

PubMed

Stirling, Christine M; Dwan, Corinna A; McKenzie, Angela R

2014-06-06

We need to improve our understanding of the complex interactions between family carers' emotional relationships with care-recipients and carers use of support services. This study assessed carer's expectations and perceptions of adult day respite services and their commitment to using services. A mixed-method case study approach was used with psychological contract providing a conceptual framework. Data collection was situated within an organisational case study, and the total population of carers from the organisation's day respite service were approached. Fifty respondents provided quantitative and qualitative data through an interview survey. The conceptual framework was expanded to include Maslow's hierarchy of needs during analysis. Carers prioritised benefits for and experiences of care-recipients when making day respite decisions. Respondents had high levels of trust in the service and perceived that the major benefits for care-recipients were around social interaction and meaningful activity with resultant improved well-being. Carers wanted day respite experiences to include all levels of Maslow's hierarchy of needs from the provision of physiological care and safety through to the higher levels of belongingness, love and esteem. The study suggests carers need to trust that care-recipients will have quality experiences at day respite. This study was intended as a preliminary stage for further research and while not generalizable it does highlight key considerations in carers' use of day respite services.
A path to in-space welding and to other in-space metal processing technologies using Space Shuttle small payloads

NASA Technical Reports Server (NTRS)

Tamir, David

1992-01-01

As we venture into space, it becomes necessary to assemble, expand, and repair space-based structures for our housing, research, and manufacturing. The zero gravity-vacuum of space challenges us to employ construction options which are commonplace on Earth. Rockwell International (RI) has begun to undertake the challenge of space-based construction via numerous options, of which one is welding. As of today, RI divisions have developed appropriate resources and technologies to bring space-based welding within our grasp. Further work, specifically in the area of developing space experiments to test RI technology, is required. RI Space Welding Project's achievements to date, from research and development (R&E) efforts in the areas of microgravity, vacuum, intra- / extra- vehicular activity and spinoff technologies, are reviewed. Special emphasis is given to results for G-169's (Get Away Special) microgravity flights aboard a NASA KC-135. Based on these achievements, a path to actual development of a space welding system is proposed with options to explore spinoff in-space metal processing technologies. This path is constructed by following a series of milestone experiments, of which several are to utilize NASA's Shuttle Small Payload Programs. Conceptual designs of the proposed shuttle payload experiments are discussed with application of lessons learned from G-169's design, development, integration, testing, safety approval process, and KC-135 flights.
Safe sleep, day and night: mothers' experiences regarding infant sleep safety.

PubMed

Lau, Annie; Hall, Wendy

2016-10-01

To explore Canadian mothers' experiences with infant sleep safety. Parents decide when, how and where to place their infants to sleep. It is anticipated that they will follow international Sudden Infant Death Syndrome prevention sleep safety guidelines. Limited evidence is available for how parents take up guidelines; no studies have explored Canadian mothers' experiences regarding infant sleep safety. An inductive qualitative descriptive study using some elements of grounded theory, including concurrent data collection and analysis and memoing. Semi-structured interviews and constant comparative analysis were employed to explore infant sleep safety experiences of 14 Canadian mothers residing in Metro Vancouver. Data collection commenced in December 2012 and ended in July 2013. The core theme, Infant Sleep Safety Cycle, represents a cyclical process encompassing sleep safety from the prenatal period to the first six months of infants' lives. The cyclical process includes five segments: mothers' expectations of sleep safety, their struggles with reality as opposed to maternal visions, modifications of expectations, provision of rationale for choices and shifts in mothers' views of infants' developmental capabilities. Mothers' experiences were influenced by four factors: perceptions of everyone's needs, familial influences, attitudes and judgments from outsiders and resource availability and accessibility. To manage infants' sleep, mothers reframed sleep safety guidelines and downplayed the risk of Sudden Infant Death Syndrome for all forms of sleep at all times. Healthcare providers can support mothers' efforts to manage their infants' sleep challenges. During prenatal and postpartum periods, providers' interventions can influence mothers' efforts to adhere to sleep safety principles. The study findings support healthcare providers' efforts to assist mothers to modify expectations and develop strategies to support sleep safety principles while acknowledging their challenges. © 2016 John Wiley & Sons Ltd.
Verteporfin therapy in age-related macular degeneration (VAM): an open-label multicenter photodynamic therapy study of 4,435 patients.

PubMed

Bessler, Neil M

2004-08-01

To provide broad clinical experience and to gather safety data on photodynamic therapy with verteporfin (Visudyne, Novartis AG, Basel, Switzerland), also termed verteporfin therapy, in patients with predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). The Verteporfin in Age-related Macular Degeneration (VAM) Study was designed to provide expanded access to verteporfin therapy after beneficial results for these cases were reported but before regulatory approval in North America. This open-label multicenter study from September 1999 through June 2000 enrolled among 222 centers patients 50 years or older in the United States, or 40 years or older in Canada, with age-related macular degeneration and subfoveal CNV with a lesion composition that was predominantly classic CNV on fluorescein angiography. Corrected visual acuity with habitual eyewear in the office setting was 20/40 to 20/200, inclusive. All patients received verteporfin therapy and returned for follow-up every 3 months. At those follow-up examinations, additional courses of treatment were recommended if any fluorescein leakage from CNV was identified. Safety information was collected from patient self-reporting, questioning (in person and by telephone), and physician evaluation. Safety was assessed by evaluating the effect of treatment on corrected distance visual acuity and by evaluating adverse events. A total of 4,435 patients were enrolled of whom 4,051 (91%) completed the study after receiving 6,701 treatments. Most patients received only one treatment in VAM before regulatory approval of verteporfin in the United States and Canada. Three hundred patients (6.8%) experienced an adverse event considered by the treating ophthalmologist to be associated with treatment, including 115 (2.6%) with abnormal or decreased vision, of whom 25 (0.6%) experienced acute severe visual acuity decrease, and 14 (0.3%) with transient infusion-related back pain. Patients were advised to avoid exposure to direct sunlight for 24 hours; however, after verteporfin administration only 2 (0.05%) reported a photosensitivity reaction. An additional course of verteporfin therapy was administered to 1,739 of 2,314 patients (75.2%) who had a month 3 examination that was not their close-out visit and 177 of 266 (66.5%) who had a month 6 examination that was not their close-out visit. Verteporfin therapy exhibited no additional or new safety concerns. The therapy associated with a low incidence of adverse events when expanded access was provided in a large, open-label, multicenter study, including a low incidence (0.05%) of reported photosensitivity reactions despite a short photosensitivity protection period (24 hours) following verteporfin administration.
Leadership and Funding: Changes Ahead for Agricultural Safety and Health.

PubMed

Murphy, Dennis J; Lee, Barbara C

2018-01-01

For the last several decades, financial support for agricultural safety and health programs and professionals has primarily been covered by public dollars through federal and state government grant programs and appropriations. This federal and state funding provided a tremendous boost to farm safety and health professionals and program efforts for 30+ years and has provided the foundation and structure for current agricultural safety and health efforts and activities. However, there is reason to question long-term sustainability of a sufficient level of federal and state dollars for agricultural safety and health. Public funding for agricultural safety and health has never quite kept up to inflation, but even more ominous is that the entire agricultural safety and health program has been proposed for elimination each year by the White House budget beginning with the fiscal year 2012. It seems prudent, perhaps even imperative, for the agricultural safety and health community to find alternative support mechanisms. We suggest that now is a great time for agricultural businesses, services, and organizations to step up their financial support. Fortunately, several positive examples have recently surfaced within the agricultural community. As the agricultural industry continues to be a dominant enterprise in the United States, the integration of significant funding and the role of leadership from within the industry must continue to expand.
Safety regulations, firm size, and the risk of accidents in E&P operations on the Gulf of Mexico outer continental shelf

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

Iledare, O.O.; Pulsipher, A.G.; Baumann, R.H.

1996-12-31

The current expanded role of smaller independent oil producers in the OCS has led to concern about the possibility of increased risk of accidents in E&P operations on the Gulf of Mexico OCS. In addition, questions have been posed concerning the effects of the Minerals Management Service`s (MMS) safety regulations and inspection program, firm size, and industry practices on the risk of accidents in E&P operations on the Gulf of Mexico OCS. The specific purposes of the study reported in this paper were to ascertain (1) whether any empirical justification exists for the widespread concern that an increase in independentsmore » relative share of E&P operations in the Gulf OCS region will be detrimental to safety, and (2) whether MMS policies and safety programs have reduced the frequency or severity of accidents on the OCS. Our statistical and descriptive analyses of data on accidents from MMS provide no statistical evidence to support the apprehension that an expanded role for independents in E&P activity constitutes any major threat to safety on the OCS. Further, the results of our econometrics analysis confirm the expectation that the more effective MMS inspectors are at detecting incidents of noncompliance the lower the rate of accidents on the OCS is, ceteris paribus. In addition the results indicate that the variability in platform exposure years--cumulative age of operating platform--in comparison to other factors explains a significant portion of the variation in accidents per operating platform. That is, the platform aging process provides more opportunity for accidents than any other contributing factors. Our econometrics analysis also suggests that, if the other factors contributing to offshore accidents are held constant, the responsiveness of accident rate to drilling activity is inelastic while the response of accident rate to production activity levels is elastic.« less
Investigating the experiences of New Zealand MRI technologists: Exploring intra-orbital metallic foreign body safety practices

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

Jacobs, Philippa K; Henwood, Suzanne; River Radiology, Victoria Clinic, 750 Victoria Street, Hamilton, Waikato

2013-12-15

Qualitative research is lacking regarding the experiences of magnetic resonance imaging (MRI) technologists and their involvement in workplace safety practices. This article provides a gateway to explore, describe and document experiences of MRI technologists in New Zealand (NZ) pertaining to intra-orbital metallic foreign body (IMFB) safety practices. This phenomenological study describes the experiences of seven MRI technologists all with a minimum of 5 years' NZ work experience in MRI. The MRI technologists were interviewed face-to-face regarding their professional IMFB workplace experiences in order to explore historical, current and potential issues. Findings demonstrated that aspects of organization and administration are fundamentallymore » important to MRI technologists. Varying levels of education and knowledge, as well as experience and skills gained, have significantly impacted on MRI technologists’ level of confidence and control in IMFB practices. Participants’ descriptions of their experiences in practice regarding decision-making capabilities further highlight the complexity of these themes. A model was developed to demonstrate the interrelated nature of the themes and the complexity of the situation in totality. Findings of this study have provided insight into the experiences of MRI technologists pertaining to IMFB safety practices and highlighted inconsistencies. It is hoped that these findings will contribute to and improve the level of understanding of MRI technologists and the practices and protocols involved in IMFB safety screening. The scarcity of available literature regarding IMFB safety practices highlights that more research is required to investigate additional aspects that could improve MRI technologists’ experiences.« less
76 FR 31965 - Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

.... ENDURANT STENT GRAFT SYSTEM. FDA-2011-M-0040 P100010 Medtronic Cryocath, ARCTIC FRONT December 17, 2010. LP.... Vascular. LX VASCULAR STENT SYSTEMS. FDA-2011-M-0039 P070026 Depuy, Inc......... CERAMAX CERAMIC HIP.... EXPANDABLE RENAL STENT SYSTEM. FDA-2011-M-0056 P090013 Medtronic, Inc..... REVO MRI SURESCAN IPG February 8...
77 FR 60704 - Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

...] Fenestrated April 4, 2012. AAA Endovascular Graft (with the adjunctive Zenith Alignment Stent). P110029, FDA...\\ plus CoCr April 12, 2012. Coronary Stent on RX System. P110035, FDA-2012-M-0373 Boston Scientific Epic\\TM\\ Vascular Self- April 13, 2012. Corp. Expanding Stent System. P090015, FDA-2012-M-0390 Leica...
77 FR 15779 - Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... 26, 2011. iliac balloon- expandable stent system. P100042, FDA-2011-M-0792 Gen-Probe APTIMA HPV assay..., 2011. XIENCE PRIME LL EVEROLIMUS-eluting coronary stent system. P100041, FDA-2011-M-0837 Edwards.... EVEROLIMUS-eluting platinum chromium coronary stent system. P100024, FDA-2011-M-0866 Dako Denmark A/S...
Professional Commitment, Ethical Reasoning, and the Belief in Regulatory Compliance as Perceived by Safety Professionals

ERIC Educational Resources Information Center

Wells, John W., Jr.

2012-01-01

The awareness of ethical business practices is becoming a focal point in both the business world and academia. As cross-cultural growth expands due to globalization, the perception of ethical behavior invites increasing scrutiny as society witnesses the changing global community. This ever-changing environment of demographics and globalization of…
The peanut genome consortium and peanut genome sequence: Creating a better future through global food security

USDA-ARS?s Scientific Manuscript database

The competitiveness of peanuts in domestic and global markets has been threatened by losses in productivity and quality that are attributed to diseases, pests, environmental stresses and allergy or food safety issues. The U.S. Peanut Genome Initiative (PGI) was launched in 2004, and expanded to a gl...
Consumer Product Category Database

EPA Pesticide Factsheets

The Chemical and Product Categories database (CPCat) catalogs the use of over 40,000 chemicals and their presence in different consumer products. The chemical use information is compiled from multiple sources while product information is gathered from publicly available Material Safety Data Sheets (MSDS). EPA researchers are evaluating the possibility of expanding the database with additional product and use information.
Demonstration Advanced Avionics System (DAAS). Phase 1 report

NASA Technical Reports Server (NTRS)

1981-01-01

An integrated avionics system which provides expanded functional capabilities that significantly enhance the utility and safety of general aviation at a cost commensurate with the general aviation market is discussed. Displays and control were designed so that the pilot can use the system after minimum training. Functional and hardware descriptions, operational evaluation and failure modes effects analysis are included.
Food safety intervention research at the Eastern Regional Research Center: innovative sanitizers, natural antimicrobials and nonthermal processing technologies

USDA-ARS?s Scientific Manuscript database

Foodborne pathogens such as Salmonella, Listeria monocytogenes and Escherichia coli O157:H7cause millions of illnesses every year. A variety of technologies have been advanced in recent years to expand on the suite of tools available to food processors. At the US Department of Agriculture’s Eastern ...
Patient Safety - Multiple Languages

MedlinePlus

... Cantonese dialect) (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) Somali (Af-Soomaali ) ... हिन्दी (Hindi) Bilingual PDF Health Information Translations Japanese (日本語) Expand Section Appointment Reminder - 日本語 (Japanese) Bilingual ...
Analytical Method to Evaluate Failure Potential During High-Risk Component Development

NASA Technical Reports Server (NTRS)

Tumer, Irem Y.; Stone, Robert B.; Clancy, Daniel (Technical Monitor)

2001-01-01

Communicating failure mode information during design and manufacturing is a crucial task for failure prevention. Most processes use Failure Modes and Effects types of analyses, as well as prior knowledge and experience, to determine the potential modes of failures a product might encounter during its lifetime. When new products are being considered and designed, this knowledge and information is expanded upon to help designers extrapolate based on their similarity with existing products and the potential design tradeoffs. This paper makes use of similarities and tradeoffs that exist between different failure modes based on the functionality of each component/product. In this light, a function-failure method is developed to help the design of new products with solutions for functions that eliminate or reduce the potential of a failure mode. The method is applied to a simplified rotating machinery example in this paper, and is proposed as a means to account for helicopter failure modes during design and production, addressing stringent safety and performance requirements for NASA applications.
Plasminogen Activators and Ischemic Stroke: Conditions for Acute Delivery

PubMed Central

del Zoppo, Gregory J

2013-01-01

Appropriate acute treatment with plasminogen activators (PAs) can significantly increase the probability of minimal or no disability in selected ischemic stroke patients. There is a great deal of evidence showing that intravenous recombinant tissue PAs (rt-PA) infusion accomplishes this goal, recanalization with other PAs has also been demonstrated in the development of this treatment. Recanalization of symptomatic, documented carotid or vertebrobasilar arterial territory occlusions have also been achieved by local intra-arterial PA delivery, although only a single prospective double-blinded randomized placebo-controlled study has been reported. The increase in intracerebral hemorrhage with these agents by either delivery approach underscores the need for careful patient selection, dose-appropriate safety and efficacy, proper clinical trial design, and an understanding of the evolution of cerebral tissue injury due to focal ischemia. Principles underlying the evolution of focal ischemia have been expanded by experience with acute PA intervention. Several questions remain open that concern the manner in which PAs can be applied acutely in ischemic stroke and how injury development can be limited. PMID:23539414

UNDERSTANDING THE CAUTIONS AND CONTRAINDICATIONS OF IMMUNOMODULATOR AND BIOLOGIC THERAPIES FOR USE IN INFLAMMATORY BOWEL DISEASE

PubMed Central

Cohn, H. Matthew; Dave, Maneesh; Loftus, Edward V.

2017-01-01

Ulcerative colitis and Crohn’s disease are chronic inflammatory bowel diseases for which there are no cures. These diseases are immunopathogenic, and medical treatment is centered on the temperance of a dysregulated immune response to allow mucosal healing and prevent the sequelae of fistulation and stenosis. Accordingly, the armamentarium of medications, which has expanded immensely in recent history, is not without significant infectious and neoplastic risks. Many of these untoward effects can be mitigated by screening and avoidance of contraindicated medications. This review seeks to highlight the cautions for use of immunomodulators, anticytokine and α4-integrin antagonists. The potential adverse events are further complicated by substantial heterogeneity in disease phenotype in the IBD population. Large patient registries and databases provide considerable experience and knowledge to calculate the incidence of safety outcomes. To identify rarer outcomes after prolonged therapy, more prospective studies and continued adverse event reporting will aid safe application and minimize potential harms. PMID:28708806
A Framework to Expand and Advance Probabilistic Risk Assessment to Support Small Modular Reactors

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

Curtis Smith; David Schwieder; Robert Nourgaliev

2012-09-01

During the early development of nuclear power plants, researchers and engineers focused on many aspects of plant operation, two of which were getting the newly-found technology to work and minimizing the likelihood of perceived accidents through redundancy and diversity. As time, and our experience, has progressed, the realization of plant operational risk/reliability has entered into the design, operation, and regulation of these plants. But, to date, we have only dabbled at the surface of risk and reliability technologies. For the next generation of small modular reactors (SMRs), it is imperative that these technologies evolve into an accepted, encompassing, validated, andmore » integral part of the plant in order to reduce costs and to demonstrate safe operation. Further, while it is presumed that safety margins are substantial for proposed SMR designs, the depiction and demonstration of these margins needs to be better understood in order to optimize the licensing process.« less
Exchange of Computable Patient Data between the Department of Veterans Affairs (VA) and the Department of Defense (DoD): Terminology Mediation Strategy

PubMed Central

Bouhaddou, Omar; Warnekar, Pradnya; Parrish, Fola; Do, Nhan; Mandel, Jack; Kilbourne, John; Lincoln, Michael J.

2008-01-01

Complete patient health information that is available where and when it is needed is essential to providers and patients and improves healthcare quality and patient safety. VA and DoD have built on their previous experience in patient data exchange to establish data standards and terminology services to enable real-time bi-directional computable (i.e., encoded) data exchange and achieve semantic interoperability in compliance with recommended national standards and the eGov initiative. The project uses RxNorm, UMLS, and SNOMED CT terminology standards to mediate codified pharmacy and allergy data with greater than 92 and 60 percent success rates respectively. Implementation of the project has been well received by users and is being expanded to multiple joint care sites. Stable and mature standards, mediation strategies, and a close relationship between healthcare institutions and Standards Development Organizations are recommended to achieve and maintain semantic interoperability in a clinical setting. PMID:18096911
Workshop Report: Crystal City VI-Bioanalytical Method Validation for Biomarkers.

PubMed

Arnold, Mark E; Booth, Brian; King, Lindsay; Ray, Chad

2016-11-01

With the growing focus on translational research and the use of biomarkers to drive drug development and approvals, biomarkers have become a significant area of research within the pharmaceutical industry. However, until the US Food and Drug Administration's (FDA) 2013 draft guidance on bioanalytical method validation included consideration of biomarker assays using LC-MS and LBA, those assays were created, validated, and used without standards of performance. This lack of expectations resulted in the FDA receiving data from assays of varying quality in support of efficacy and safety claims. The AAPS Crystal City VI (CC VI) Workshop in 2015 was held as the first forum for industry-FDA discussion around the general issues of biomarker measurements (e.g., endogenous levels) and specific technology strengths and weaknesses. The 2-day workshop served to develop a common understanding among the industrial scientific community of the issues around biomarkers, informed the FDA of the current state of the science, and will serve as a basis for further dialogue as experience with biomarkers expands with both groups.
Prenatal Imaging: Ultrasonography and Magnetic Resonance Imaging

PubMed Central

Reddy, Uma M.; Filly, Roy A.; Copel, Joshua A.

2009-01-01

The Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop on September 18–19, 2006, to summarize the available evidence on the role and performance of current fetal imaging technology and to establish a research agenda. Ultrasonography is the imaging modality of choice for pregnancy evaluation due to its relatively low cost, real-time capability, safety, and operator comfort and experience. First-trimester ultrasonography extends the available window for fetal observation and raises the possibility of performing an early anatomic survey. Three-dimensional ultrasonography has the potential to expand the clinical application of ultrasonography by permitting local acquisition of volumes and remote review and interpretation at specialized centers. New advances allow performance of fetal magnetic resonance imaging (MRI) without maternal or fetal sedation, with improved characterization and prediction of prognosis of certain fetal central nervous system anomalies such as ventriculomegaly when compared with ultrasonography. Fewer data exist on the usefulness of fetal MRI for non–central nervous system anomalies. PMID:18591320
ESEA at 50

ERIC Educational Resources Information Center

Jennings, Jack

2015-01-01

The author draws on his extensive experience helping lead Congress's education efforts and later a highly respected education research concern to propose a new approach to federal education policy that expands and transforms the federal role. This new approach would significantly expand federal aid to schools that is not restricted to particular…
Network Experiences from a Cross-Sector Biosafety Level-3 Laboratory Collaboration: A Swedish Forum for Biopreparedness Diagnostics.

PubMed

Thelaus, Johanna; Lindberg, Anna; Thisted Lambertz, Susanne; Byström, Mona; Forsman, Mats; Lindmark, Hans; Knutsson, Rickard; Båverud, Viveca; Bråve, Andreas; Jureen, Pontus; Lundin Zumpe, Annelie; Melefors, Öjar

The Swedish Forum for Biopreparedness Diagnostics (FBD) is a network that fosters collaboration among the 4 agencies with responsibility for the laboratory diagnostics of high-consequence pathogens, covering animal health and feed safety, food safety, public health and biodefense, and security. The aim of the network is to strengthen capabilities and capacities for diagnostics at the national biosafety level-3 (BSL-3) laboratories to improve Sweden's biopreparedness, in line with recommendations from the EU and WHO. Since forming in 2007, the FBD network has contributed to the harmonization of diagnostic methods, equipment, quality assurance protocols, and biosafety practices among the national BSL-3 laboratories. Lessons learned from the network include: (1) conducting joint projects with activities such as method development and validation, ring trials, exercises, and audits has helped to build trust and improve communication among participating agencies; (2) rotating the presidency of the network steering committee has fostered trust and commitment from all agencies involved; and (3) planning for the implementation of project outcomes is important to maintain gained competencies in the agencies over time. Contacts have now been established with national agencies of the other Nordic countries, with an aim to expanding the collaboration, broadening the network, finding synergies in new areas, strengthening the ability to share resources, and consolidating long-term financing in the context of harmonized European biopreparedness.
Network Experiences from a Cross-Sector Biosafety Level-3 Laboratory Collaboration: A Swedish Forum for Biopreparedness Diagnostics

PubMed Central

Lindberg, Anna; Thisted Lambertz, Susanne; Byström, Mona; Forsman, Mats; Lindmark, Hans; Knutsson, Rickard; Båverud, Viveca; Bråve, Andreas; Jureen, Pontus; Lundin Zumpe, Annelie; Melefors, Öjar

2017-01-01

The Swedish Forum for Biopreparedness Diagnostics (FBD) is a network that fosters collaboration among the 4 agencies with responsibility for the laboratory diagnostics of high-consequence pathogens, covering animal health and feed safety, food safety, public health and biodefense, and security. The aim of the network is to strengthen capabilities and capacities for diagnostics at the national biosafety level-3 (BSL-3) laboratories to improve Sweden's biopreparedness, in line with recommendations from the EU and WHO. Since forming in 2007, the FBD network has contributed to the harmonization of diagnostic methods, equipment, quality assurance protocols, and biosafety practices among the national BSL-3 laboratories. Lessons learned from the network include: (1) conducting joint projects with activities such as method development and validation, ring trials, exercises, and audits has helped to build trust and improve communication among participating agencies; (2) rotating the presidency of the network steering committee has fostered trust and commitment from all agencies involved; and (3) planning for the implementation of project outcomes is important to maintain gained competencies in the agencies over time. Contacts have now been established with national agencies of the other Nordic countries, with an aim to expanding the collaboration, broadening the network, finding synergies in new areas, strengthening the ability to share resources, and consolidating long-term financing in the context of harmonized European biopreparedness. PMID:28805472
Experiments To Demonstrate Chemical Process Safety Principles.

ERIC Educational Resources Information Center

Dorathy, Brian D.; Mooers, Jamisue A.; Warren, Matthew M.; Mich, Jennifer L.; Murhammer, David W.

2001-01-01

Points out the need to educate undergraduate chemical engineering students on chemical process safety and introduces the content of a chemical process safety course offered at the University of Iowa. Presents laboratory experiments demonstrating flammability limits, flash points, electrostatic, runaway reactions, explosions, and relief design.…
Drug research methodology. Volume 1, The alcohol-highway safety experience and its applicability to other drugs

DOT National Transportation Integrated Search

1980-03-01

This report presents the findings of a workshop concerning the alcohol and highway safety experience, which includes research efforts to define the drinking-driving problem and societal responses to reduce the increased highway safety risk attributab...
Planning the Unplanned Experiment: Assessing the Efficacy of Standards for Safety Critical Software

NASA Technical Reports Server (NTRS)

Graydon, Patrick J.; Holloway, C. Michael

2015-01-01

We need well-founded means of determining whether software is t for use in safety-critical applications. While software in industries such as aviation has an excellent safety record, the fact that software aws have contributed to deaths illustrates the need for justi ably high con dence in software. It is often argued that software is t for safety-critical use because it conforms to a standard for software in safety-critical systems. But little is known about whether such standards `work.' Reliance upon a standard without knowing whether it works is an experiment; without collecting data to assess the standard, this experiment is unplanned. This paper reports on a workshop intended to explore how standards could practicably be assessed. Planning the Unplanned Experiment: Assessing the Ecacy of Standards for Safety Critical Software (AESSCS) was held on 13 May 2014 in conjunction with the European Dependable Computing Conference (EDCC). We summarize and elaborate on the workshop's discussion of the topic, including both the presented positions and the dialogue that ensued.
Developing tools for the safety specification in risk management plans: lessons learned from a pilot project.

PubMed

Cooper, Andrew J P; Lettis, Sally; Chapman, Charlotte L; Evans, Stephen J W; Waller, Patrick C; Shakir, Saad; Payvandi, Nassrin; Murray, Alison B

2008-05-01

Following the adoption of the ICH E2E guideline, risk management plans (RMP) defining the cumulative safety experience and identifying limitations in safety information are now required for marketing authorisation applications (MAA). A collaborative research project was conducted to gain experience with tools for presenting and evaluating data in the safety specification. This paper presents those tools found to be useful and the lessons learned from their use. Archive data from a successful MAA were utilised. Methods were assessed for demonstrating the extent of clinical safety experience, evaluating the sensitivity of the clinical trial data to detect treatment differences and identifying safety signals from adverse event and laboratory data to define the extent of safety knowledge with the drug. The extent of clinical safety experience was demonstrated by plots of patient exposure over time. Adverse event data were presented using dot plots, which display the percentages of patients with the events of interest, the odds ratio, and 95% confidence interval. Power and confidence interval plots were utilised for evaluating the sensitivity of the clinical database to detect treatment differences. Box and whisker plots were used to display laboratory data. This project enabled us to identify new evidence-based methods for presenting and evaluating clinical safety data. These methods represent an advance in the way safety data from clinical trials can be analysed and presented. This project emphasises the importance of early and comprehensive planning of the safety package, including evaluation of the use of epidemiology data.
Spacecraft fire-safety experiments for space station: Technology development mission

NASA Technical Reports Server (NTRS)

Youngblood, Wallace W.

1988-01-01

Three concept designs for low-gravity, fire-safety related experiments are presented, as selected for the purpose of addressing key issues of enhancing safety and yet encouraging access to long-duration, manned spacecraft such as the NASA space station. The selected low-gravity experiments are the following: (1) an investigation of the flame-spread rate and combustion-product evolution of the burning of typical thicknesses of spacecraft materials in very low-speed flows; (2) an evaluation of the interaction of fires and candidate extinguishers in various fire scenarios; and (3) an investigation of the persistence and propagation of smoldering and deep-seated combustion. Each experiment is expected to provide fundamental combustion-science data, as well as the fire-safety applications, and each requires the unique long-duration, low-gravity environment of the space station. Two generic test facilities, i.e., the Combustion Tunnel Facility and the Combustion Facility, are proposed for space station accommodation to support the selected experiments. In addition, three near-term, fire-safety related experiments are described along with other related precursor activities.
Selective Inhibition of Tumor Growth by Clonal NK Cells Expressing an ErbB2/HER2-Specific Chimeric Antigen Receptor

PubMed Central

Schönfeld, Kurt; Sahm, Christiane; Zhang, Congcong; Naundorf, Sonja; Brendel, Christian; Odendahl, Marcus; Nowakowska, Paulina; Bönig, Halvard; Köhl, Ulrike; Kloess, Stephan; Köhler, Sylvia; Holtgreve-Grez, Heidi; Jauch, Anna; Schmidt, Manfred; Schubert, Ralf; Kühlcke, Klaus; Seifried, Erhard; Klingemann, Hans G; Rieger, Michael A; Tonn, Torsten; Grez, Manuel; Wels, Winfried S

2015-01-01

Natural killer (NK) cells are an important effector cell type for adoptive cancer immunotherapy. Similar to T cells, NK cells can be modified to express chimeric antigen receptors (CARs) to enhance antitumor activity, but experience with CAR-engineered NK cells and their clinical development is still limited. Here, we redirected continuously expanding and clinically usable established human NK-92 cells to the tumor-associated ErbB2 (HER2) antigen. Following GMP-compliant procedures, we generated a stable clonal cell line expressing a humanized CAR based on ErbB2-specific antibody FRP5 harboring CD28 and CD3ζ signaling domains (CAR 5.28.z). These NK-92/5.28.z cells efficiently lysed ErbB2-expressing tumor cells in vitro and exhibited serial target cell killing. Specific recognition of tumor cells and antitumor activity were retained in vivo, resulting in selective enrichment of NK-92/5.28.z cells in orthotopic breast carcinoma xenografts, and reduction of pulmonary metastasis in a renal cell carcinoma model, respectively. γ-irradiation as a potential safety measure for clinical application prevented NK cell replication, while antitumor activity was preserved. Our data demonstrate that it is feasible to engineer CAR-expressing NK cells as a clonal, molecularly and functionally well-defined and continuously expandable cell therapeutic agent, and suggest NK-92/5.28.z cells as a promising candidate for use in adoptive cancer immunotherapy. PMID:25373520
Impact of health care adversity on providers: Lessons learned from a staff support program.

PubMed

Trent, Maxine; Waldo, Kimberly; Wehbe-Janek, Hania; Williams, Daniel; Hegefeld, Wendy; Havens, Lisa

2016-08-01

Health care providers often experience traumatic events and adversity that can have negative emotional impacts on the profession and on patients. These impacts are typically multifaceted and can result from many different events, such as unanticipated outcomes, licensing board complaints, claims, and litigation. Because health care providers are exposed to diverse situations, they require adequate and timely support, imperative for provider resilience and patient safety. This study evaluated the success of an institution's second victim health care support program and best practices in responding to these traumatic experiences effectively. Twenty faculty and medical residents who utilized the support program at a large hospital system located in Central Texas from 2001 to 2012 participated in 1 of 6 focus groups. Qualitative data were collected from these groups to describe program requirements for the adequate delivery of health care adversity support and necessary program improvements. Responses were first transcribed verbatim. Each research team member analyzed data using a thematic framework approach. This approach helped to characterize traumatic experiences and to design a support system. The results revealed that (1) provider experiences are traumatic, (2) it is necessary to communicate an adverse event in a confidential and timely manner, preferably with a peer, (3) preemptive education regarding risk management and the legal process is helpful, and (4) there is a need for further support of the specific experience of a board complaint. Focus group data indicated the complexity of the emotional impact of traumatic experiences. Specific program components are needed to create best practices for providers affected by health care adversity, including support when providers face board complaints. The program's unique combination of support and education allowed us to expand upon leading national health care adversity programs. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.
Building on the Past - Looking to the Future. Part 2; A Focus on Expanding Horizons

NASA Technical Reports Server (NTRS)

Guidry, Richard W.; Nash, Sally K.; Rehm, Raymond B.; Wolf, Scott L.; Wong, Teresa K.

2010-01-01

The history of space endeavors stretches far from Robert Goddard s initial flights and will certainly extend far beyond the construction of the International Space Station. As society grows in knowledge of and familiarity with space, the focus of maintaining the safety of the crews and the habitability of the vehicles will be of the utmost importance to the National Aeronautics and Space Administration (NASA) community. Through the years, Payload Safety has developed not only as a Panel, but also as part of the NASA community, striving to enhance the efficiency and understanding of how business should be conducted as more International Partners become involved. The recent accomplishments of the first docking of the Japan Aerospace Exploration Agency (JAXA) HII Transfer Vehicle (HTV 1) and completion of the Japanese Experiment Module (JEM) or KIBO and the Russian MRM2 to the International Space Station (ISS) mark significant steps for the future of ISS. 2010 will mark the final flights of the Shuttle and the completion of ISS assembly. Future delivery of humans and hardware will rely on the Russian Progress and Soyuz, the Japanese HII Transfer Vehicle (HTV), the European Automated Transfer Vehicle (ATV) and US "Commercial Off-The-Shelf" (COTS) and Constellation vehicles. The International Partners (IPs) will have more capability in delivery as well as responsibility for review of hardware they deliver to assure safe operation. This is the second in a series of papers and presentations in what is hoped to be an annual update that illustrates challenges and lessons learned in the areas of communication (how hazard reports can be misunderstood), safety requirements (transitioning from Shuttle-centric to ISS-centric), and processes (review of hardware by RSC-E and Franchised ESA and JAXA PSRP) which have been vital in conducting the business of the Payload Safety Review Panel (PSRP). This year will focus on the items annotated above.
Growth response of broilers to spray-dried plasma in pelleted or expanded feed processed at high temperature.

PubMed

Campbell, J M; Russell, L E; Crenshaw, J D; Behnke, K C; Clark, P M

2006-09-01

A series of 4 experiments evaluated effects of mash conditioning temperature from a pellet mill or expander on performance of broilers fed pelleted diets containing spray-dried plasma (SDP). All experiments utilized Ross x Ross 308 male broilers randomly assigned to their respective treatments (6 or 10 broilers/pen and 8 or 10 pens/treatment). Treatments in Exp. 1 consisted of a control (0% SDP), SDP coated postpelleting, or SDP blended into the meal prepelleting. Experiment 2 and 3 included the same 3 treatments as in Exp. 1 but with additional treatments of SDP blended into the meal and conditioned at 90 or 95 degrees C before pelleting. In Exp. 4, treatments consisted of a control (0% SDP) or SDP blended into the meal and pelleted (85 degrees C conditioning temperature) or expanded (149 degrees C final effective temperature) and then pelleted. Corn-soybean meal-based diets were formulated to be equal in lysine and ME in all experiments. Pelleted diets were conditioned for 15 s at 85 degrees C, and expanded diets were conditioned at 95 degrees C, 29.7 MJ/t, 13.95 kg/cm2 cone pressure, exit temperature of 149 degrees C, and then pelleted through a 4 x 32-mm die. In Exp. 1, ADG and feed intake were improved (P < 0.05) for broilers fed SDP from d 1 to 28 of age, with greater BW at d 42. In Exp. 2, both in early (d 1 to 28 of age) phases, and overall (d 1 to 42 of age), broilers fed SDP had improved (P < 0.05) gain and efficiency. In Exp. 3, ADG, feed intake, efficiency of gain, and BW were improved (P < 0.01) for broilers fed SDP from d 1 to 21 of age, regardless of conditioning temperature. In Exp. 4, broilers fed SDP had improved (P < 0.05) gain, BW, and feed intake regardless of processing method. Overall, the results of all of the experiments demonstrated that pellet conditioning temperature from 85 to 95 degrees C and expander temperatures to 149 degrees C did not impair the positive growth effects of SDP in pelleted or expanded broiler feed.
Exploring Mathematics Teacher Education Fieldwork Experiences through Storytelling

ERIC Educational Resources Information Center

Elrod, Melody Jeane

2017-01-01

Throughout the history of teacher education, the final fieldwork experience has often been called the single most influential experience in teacher preparation programs (Burns, Jacobs, & Yendol-Hoppey, 2016; Feiman-Nemser & Buchmann, 1986; Parker-Katz & Bay, 2008). Though this experience has been expanded to include fieldwork…
Functional safety for the Advanced Technology Solar Telescope

NASA Astrophysics Data System (ADS)

Bulau, Scott; Williams, Timothy R.

2012-09-01

Since inception, the Advanced Technology Solar Telescope (ATST) has planned to implement a facility-wide functional safety system to protect personnel from harm and prevent damage to the facility or environment. The ATST will deploy an integrated safety-related control system (SRCS) to achieve functional safety throughout the facility rather than relying on individual facility subsystems to provide safety functions on an ad hoc basis. The Global Interlock System (GIS) is an independent, distributed, facility-wide, safety-related control system, comprised of commercial off-the-shelf (COTS) programmable controllers that monitor, evaluate, and control hazardous energy and conditions throughout the facility that arise during operation and maintenance. The GIS has been designed to utilize recent advances in technology for functional safety plus revised national and international standards that allow for a distributed architecture using programmable controllers over a local area network instead of traditional hard-wired safety functions, while providing an equivalent or even greater level of safety. Programmable controllers provide an ideal platform for controlling the often complex interrelationships between subsystems in a modern astronomical facility, such as the ATST. A large, complex hard-wired relay control system is no longer needed. This type of system also offers greater flexibility during development and integration in addition to providing for expanded capability into the future. The GIS features fault detection, self-diagnostics, and redundant communications that will lead to decreased maintenance time and increased availability of the facility.
Poison control centers in developing countries and Asia's need for toxicology education

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

Makalinao, Irma R.; Awang, Rahmat

2005-09-01

Poison control centers (PCCs) in developing countries have been set up in response to the challenge of decreasing mortality and morbidity from poisoning. The services range from poison information to actual clinical treatment mostly of acute cases. Lately, PCCs have expanded from their traditional role to one that actively engages in community health studies, toxicovigilance along with treatment of chronic poisoning. Recognizing that types of poisoning and specific needs may vary from country to country, toxicology education that addresses these unique regional issues has become more necessary. Toxicology education, both formal and informal, exists in various stages of development inmore » Asia. Clearly, there are gaps that need to be addressed especially in areas where there are no poison centers or where strengthening is necessary. Collaboration between PCCs in developing countries can help augment available resources including human, analytical and technical expertise. The critical mass of trained toxicologists will fill in the demand for clinical and regulatory specialists and educators as well. This paper highlights the experiences and resources available to the Philippine and Malaysian poison centers and the strengths generated by networking and collaboration. The role of Asia Pacific Association of Medical Toxicology (APAMT) as the Science NGO representative to the Intergovernmental Forum on Chemical Safety (IFCS) forum standing committee in promoting chemical safety at the regional level will be discussed. The 'Clearinghouse on the Sound Management of Chemicals', a platform for engaging multi-stakeholder and interdisciplinary partnerships, will be described as a possible model for capacity building to advance chemical safety through education and training not only in developing countries in Asia but globally as well.« less

Resident Cosmetic Clinic: Practice Patterns, Safety, and Outcomes at an Academic Plastic Surgery Institution.

PubMed

Qureshi, Ali A; Parikh, Rajiv P; Myckatyn, Terence M; Tenenbaum, Marissa M

2016-10-01

Comprehensive aesthetic surgery education is an integral part of plastic surgery residency training. Recently, the ACGME increased minimum requirements for aesthetic procedures in residency. To expand aesthetic education and prepare residents for independent practice, our institution has supported a resident cosmetic clinic for over 25 years. To evaluate the safety of procedures performed through a resident clinic by comparing outcomes to benchmarked national aesthetic surgery outcomes and to provide a model for resident clinics in academic plastic surgery institutions. We identified a consecutive cohort of patients who underwent procedures through our resident cosmetic clinic between 2010 and 2015. Major complications, as defined by CosmetAssure database, were recorded and compared to published aesthetic surgery complication rates from the CosmetAssure database for outcomes benchmarking. Fisher's exact test was used to compare sample proportions. Two hundred and seventy-one new patients were evaluated and 112 patients (41.3%) booked surgery for 175 different aesthetic procedures. There were 55 breast, 19 head and neck, and 101 trunk or extremity aesthetic procedures performed. The median number of preoperative and postoperative visits was 2 and 4 respectively with a mean follow-up time of 35 weeks. There were 3 major complications (2 hematomas and 1 infection requiring IV antibiotics) with an overall complication rate of 1.7% compared to 2.0% for patients in the CosmetAssure database (P = .45). Surgical outcomes for procedures performed through a resident cosmetic clinic are comparable to national outcomes for aesthetic surgery procedures, suggesting this experience can enhance comprehensive aesthetic surgery education without compromising patient safety or quality of care. 4 Risk. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.
Toward the Replacement of Animal Experiments through the Bioinformatics-driven Analysis of 'Omics' Data from Human Cell Cultures.

PubMed

Grafström, Roland C; Nymark, Penny; Hongisto, Vesa; Spjuth, Ola; Ceder, Rebecca; Willighagen, Egon; Hardy, Barry; Kaski, Samuel; Kohonen, Pekka

2015-11-01

This paper outlines the work for which Roland Grafström and Pekka Kohonen were awarded the 2014 Lush Science Prize. The research activities of the Grafström laboratory have, for many years, covered cancer biology studies, as well as the development and application of toxicity-predictive in vitro models to determine chemical safety. Through the integration of in silico analyses of diverse types of genomics data (transcriptomic and proteomic), their efforts have proved to fit well into the recently-developed Adverse Outcome Pathway paradigm. Genomics analysis within state-of-the-art cancer biology research and Toxicology in the 21st Century concepts share many technological tools. A key category within the Three Rs paradigm is the Replacement of animals in toxicity testing with alternative methods, such as bioinformatics-driven analyses of data obtained from human cell cultures exposed to diverse toxicants. This work was recently expanded within the pan-European SEURAT-1 project (Safety Evaluation Ultimately Replacing Animal Testing), to replace repeat-dose toxicity testing with data-rich analyses of sophisticated cell culture models. The aims and objectives of the SEURAT project have been to guide the application, analysis, interpretation and storage of 'omics' technology-derived data within the service-oriented sub-project, ToxBank. Particularly addressing the Lush Science Prize focus on the relevance of toxicity pathways, a 'data warehouse' that is under continuous expansion, coupled with the development of novel data storage and management methods for toxicology, serve to address data integration across multiple 'omics' technologies. The prize winners' guiding principles and concepts for modern knowledge management of toxicological data are summarised. The translation of basic discovery results ranged from chemical-testing and material-testing data, to information relevant to human health and environmental safety. 2015 FRAME.
Innovative use of novel biomarkers to improve the safety of renally-eliminated and nephrotoxic medications.

PubMed

Barreto, Erin F; Rule, Andrew D; Voils, Stacy A; Kane-Gill, Sandra L

2018-06-08

Over the last decade, the discovery and research into the application of novel renal biomarkers to improve medication efficacy and safety has expanded considerably. Pharmacists are uniquely positioned to leverage this new technology for renal assessment to improve medication dosing and monitoring. Serum cystatin C is a relatively new, inexpensive, functional renal biomarker that responds more quickly to changing renal function than creatinine and is not meaningfully affected by age, sex, skeletal muscle mass, dietary intake, or deconditioning. Cystatin C has been proposed as an adjunct or alternative to creatinine for glomerular filtration rate (GFR) assessment and estimation of drug clearance. Tissue inhibitor of metalloproteinase-2●insulin-like growth factor-binding protein 7 ([TIMP-2]●[IGFBP7]) is a composite of two damage biomarkers released into the urine at a checkpoint in mitosis when renal cells undergo stress or sense a future risk of damage. Concentrations of [TIMP-2]●[IGFBP7] increase before a rise in serum creatinine is evident, thus providing insightful information for evaluation in the context of other patient data to predict the risk for impending kidney injury. The purpose for this article is to provide a brief overview of novel renal biomarkers that are being used as a mechanism to improve medication safety, including discussion of cystatin C, as part of drug-dosing algorithms and specifically for vancomycin dosing, and use of [TIMP-2]●[IGFBP7] for risk prediction in acute kidney injury and drug-induced kidney disease. Select cases of clinical experience with use of novel renal biomarkers are outlined, and lessons learned and future applications are described. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Participatory support to farmers in improving safety and health at work: building WIND farmer volunteer networks in Viet Nam.

PubMed

Kawakami, Tsuyoshi; Van, Vhu Nhu; Theu, Nguyen Van; Khai, Ton That; Kogi, Kazutaka

2008-10-01

The government of Viet Nam places a high priority on upgrading the quality of farmers' lives. Providing adequate occupational safety and health (OSH) protection for all farmers is an important challenge. The Ministry of Labour, Invalids and Social Affairs (MOLISA) of Viet Nam trained WIND (Work Improvement in Neighbourhood Development) farmer volunteers. From 2004-2007, MOLISA in cooperation with ministries of health and agriculture trained 480 WIND farmer volunteers in selected 14 provinces. Trained farmer volunteers trained their neighbouring farmers and expanded their networks. The WIND training programme produced in Cantho, Viet Nam in 1996, was used as the core training methodology. The WIND action-checklist, good example photo-sheets, and other participatory training materials were designed for WIND farmer volunteers as practical training tools. The volunteers trained 7,922 farmers. The trained farmers implemented 28,508 improvements in materials handling, work posture, machine and electrical safety, working environments and control of hazardous chemicals, and welfare facilities. The provincial support committees organized follow-up workshops and strengthen the WIND farmer volunteer networks. The system of WIND farmer volunteers proved effective in extending practical OSH protection measures to farmers at grassroots level. The system of WIND farmer volunteers was adopted in the First National Programme on Labour Protection and OSH of Viet Nam as a practical means in OSH and is now further expanding within the framework of the National Programme.
Recent advances in the treatment of rheumatoid arthritis.

PubMed

Mahajan, Tina D; Mikuls, Ted R

2018-05-01

Therapies for rheumatoid arthritis (RA) continue to expand rapidly. The purpose of this review is to discuss novel treatment options, including biosimilars, that are available, as well as to highlight promising agents in development. The purpose is also to discuss new emerging safety signals associated with these drugs and to discuss strategies in tapering therapy. There are several novel RA therapies. These include the interleukin-6 (IL-6) receptor blocker sarilumab, which was approved in 2017. In aggregate, the sarilumab studies show that it is effective in RA, including patients with incomplete responses to methotrexate and anti-tumor necrosis factor inhibitor, and showing superior efficacy when used in higher dose (200 mg every 2 weeks) to standard-dose adalilumab. Other drugs that are currently being studied include the IL-6 cytokine blocker sarikumab, the small targeted molecule filgotinib, and many new biosimilars. Baracitinib failed to achieve approval by the Food and Drug Administration primarily over perceived safety concerns. The two biosimilar drugs currently approved are CT-P13 and SB2, which are based on the reference product infliximab. Although this review summarizes trials examining biologic tapering, additional data are needed to guide clinicians in regards to treatment de-escalation in RA. With the greatly expanded armamentarium of RA treatment options available, it is important for clinicians to understand the data regarding drug efficacy and safety. With remission increasingly attainable, effective drug tapering strategies are needed. Although tapering trials do exist, more studies will be needed to help guide clinical practice.
Multicenter Comparison of Novel Self-Expanding Versus Balloon-Expandable Transcatheter Heart Valves.

PubMed

Husser, Oliver; Kim, Won-Keun; Pellegrini, Costanza; Holzamer, Andreas; Walther, Thomas; Mayr, Patrick N; Joner, Michael; Kasel, Albert M; Trenkwalder, Teresa; Michel, Jonathan; Rheude, Tobias; Kastrati, Adnan; Schunkert, Heribert; Burgdorf, Christof; Hilker, Michael; Möllmann, Helge; Hengstenberg, Christian

2017-10-23

This study sought to compare 2 next-generation transcatheter heart valves (THV), the self-expanding ACURATE neo (NEO) and the balloon-expandable SAPIEN 3 (S3), in terms of device failure and early safety at 30 days. Deployment of these THV showed promising initial clinical results. However, no comparative data are available. Of 1,121 treated patients at 3 centers, a 1-to-2 nearest neighbor matching was performed to identify 2 patients treated with S3 (n = 622) for each patient treated with NEO (n = 311). In-hospital complications were comparable between NEO and S3, including stroke (1.9% vs. 2.4%; p = 0.64), major vascular complications (10.3% vs. 8.5%; p = 0.38), or life-threatening bleeding (4.2% vs. 3.7%; p = 0.72). Device failure with NEO was comparable with S3 (10.9% vs. 9.6%; odds ratio: 1.09 [95% confidence interval: 0.69 to 1.73]; p = 0.71) with more paravalvular leakage (PVL II+, 4.8% vs. 1.8%; p = 0.01), but less elevated gradients (≥20 mm Hg, 3.2% vs. 6.9%; p = 0.02) and pacemaker implantations (9.9% vs. 15.5%; p = 0.02). Thirty-day mortality (2.3% vs. 1.9%; p = 0.74) and the early safety composite endpoint (15.8% vs. 15.6%; hazard ratio: 0.97 [95% confidence interval: 0.68 to 1.39]; p = 0.88) were similar with NEO and S3. Very high success rates were achieved for both valves, and the clinical and procedural results were comparable. Compared with S3, NEO was associated with less new pacemaker implantations and less elevated gradients, but with more paravalvular leakage. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Thirty-Day Outcome of a Multicenter Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China.

PubMed

Miao, Zhongrong; Zhang, Yong; Shuai, Jie; Jiang, Changchun; Zhu, Qiyi; Chen, Kangning; Liu, Li; Li, Baomin; Shi, Xiangqun; Gao, Lianbo; Liu, Yajie; Wang, Feng; Li, Yongli; Liu, Tieyan; Zheng, Hongbo; Wang, Yilong; Wang, Yongjun

2015-10-01

Although recent trials have suggested that stenting is worse than medical therapy for patients with severe symptomatic intracranial atherosclerotic stenosis, it is not clear whether this conclusion applies to a subset of patients with hypoperfusion symptoms. To justify for a new trial in China, we performed a multicenter prospective registry study to evaluate the safety and efficacy of endovascular stenting within 30 days for patients with severe symptomatic intracranial atherosclerotic stenosis. Patients with symptomatic intracranial atherosclerotic stenosis caused by 70% to 99% stenosis combined with poor collaterals were enrolled. The patients were treated either with balloon-mounted stent or with balloon predilation plus self-expanding stent as determined by the operators following a guideline. The primary outcome within 30 days is stroke, transient ischemic attack, and death after stenting. The secondary outcome is successful revascularization. The baseline characteristics and outcomes of the 2 treatment groups were compared. From September 2013 to January 2015, among 354 consecutive patients, 300 patients (aged 58.3±9.78 years) were recruited, including 159 patients treated with balloon-mounted stent and 141 patients with balloon plus self-expanding stent. The 30-day rate of stroke, transient ischemic attack, and death was 4.3%. Successful revascularization was 97.3%. Patients treated with balloon-mounted stent were older, less likely to have middle cerebral artery lesions, more likely to have vertebral artery lesions, more likely to have Mori A lesions, less likely to have Mori C lesions, and likely to have lower degree of residual stenosis than patients treated with balloon plus self-expanding stent. The short-term safety and efficacy of endovascular stenting for patients with severe symptomatic intracranial atherosclerotic stenosis in China is acceptable. Balloon-mounted stent may have lower degree of residual stenosis than self-expanding stent. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01968122. © 2015 American Heart Association, Inc.
Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach.

PubMed

Ricci-Cabello, Ignacio; Reeves, David; Bell, Brian G; Valderas, Jose M

2017-11-01

To identify patient and family practice characteristics associated with patient-reported experiences of safety problems and harm. Cross-sectional study combining data from the individual postal administration of the validated Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire to a random sample of patients in family practices (response rate=18.4%) and practice-level data for those practices obtained from NHS Digital. We built linear multilevel multivariate regression models to model the association between patient-level (clinical and sociodemographic) and practice-level (size and case-mix, human resources, indicators of quality and safety of care, and practice safety activation) characteristics, and outcome measures. Practices distributed across five regions in the North, Centre and South of England. 1190 patients registered in 45 practices purposefully sampled (maximal variation in practice size and levels of deprivation). Self-reported safety problems, harm and overall perception of safety. Higher self-reported levels of safety problems were associated with younger age of patients (beta coefficient 0.15) and lower levels of practice safety activation (0.44). Higher self-reported levels of harm were associated with younger age (0.13) and worse self-reported health status (0.23). Lower self-reported healthcare safety was associated with lower levels of practice safety activation (0.40). The fully adjusted models explained 4.5% of the variance in experiences of safety problems, 8.6% of the variance in harm and 4.4% of the variance in perceptions of patient safety. Practices' safety activation levels and patients' age and health status are associated with patient-reported safety outcomes in English family practices. The development of interventions aimed at improving patient safety outcomes would benefit from focusing on the identified groups. © 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.
Role of champions in the implementation of patient safety practice change.

PubMed

Soo, Stephanie; Berta, Whitney; Baker, G Ross

2009-01-01

Practitioners of patient safety practice change agree that champions are central to the success of implementation. The clinical champion role is a concept that has been widely promoted yet empirically underdeveloped in health services literature. Questions remain as to who these champions are, what roles they play in patient safety practice change and what contexts serve to facilitate their efforts. This investigation used a multiple-case study design to critically examine the role of champions in the implementation of rapid response teams (RRTs), an innovative complex patient safety intervention, in two large urban acute care facilities. An analysis of interviews with key individuals involved in the RRT implementation process revealed a typology of the patient safety practice champion that extended beyond clinical personnel to include managerial and executive staff. Champions engaged to a varying extent in a number of core activities, including education, advocacy, relationship building and boundary spanning. Individuals became champions both through informal emergence and a combination of formal appointment and informal emergence. By identifying and elaborating upon specific features of the champion role, this study aims to expand the dialogue about champions for patient safety practice change.
Numerical modelling of multi-vane expander operating conditions in ORC system

NASA Astrophysics Data System (ADS)

Rak, Józef; Błasiak, Przemysław; Kolasiński, Piotr

2017-11-01

Multi-vane expanders are positive displacement volumetric machines which are nowadays considered for application in micro-power domestic ORC systems as promising alternative to micro turbines and other volumetric expanders. The multi-vane expander features very simple design, low gas flow capacity, low expansion ratios, an advantageous ratio of the power output to the external dimensions and are insensitive to the negative influence of the gas-liquid mixture expansion. Moreover, the multi-vane expander can be easily hermetically sealed, which is one of the key issues in the ORC system design. A literature review indicates that issues concerning the application of multi-vane expanders in such systems, especially related to operating of multi-vane expander with different low-boiling working fluids, are innovative, not fully scientifically described and have the potential for practical implementation. In this paper the results of numerical investigations on multi-vane expander operating conditions are presented. The analyses were performed on three-dimensional numerical model of the expander in ANSYS CFX software. The numerical model of the expander was validated using the data obtained from the experiment carried out on a lab test-stand. Then a series of computational analysis were performed using expanders' numerical model in order to determine its operating conditions under various flow conditions of different working fluids.
Occupational Safety Review of High Technology Facilities

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

Lee Cadwallader

2005-01-31

This report contains reviews of operating experiences, selected accident events, and industrial safety performance indicators that document the performance of the major US DOE magnetic fusion experiments and particle accelerators. These data are useful to form a basis for the occupational safety level at matured research facilities with known sets of safety rules and regulations. Some of the issues discussed are radiation safety, electromagnetic energy exposure events, and some of the more widespread issues of working at height, equipment fires, confined space work, electrical work, and other industrial hazards. Nuclear power plant industrial safety data are also included for comparison.
Expanding Music Listening Experience through Drawing

ERIC Educational Resources Information Center

Han, Yo-Jung

2016-01-01

Drawing while listening to music provides an opportunity for students to imagine and associate, leading to holistic listening experience. The personal qualitative listening experience triggered by music can be revealed in their drawings. In the process of representing of the listening experience through drawing, students can also increase their…
Global Change And Water Availability And Quality: Challenges Ahead

NASA Astrophysics Data System (ADS)

Larsen, M. C.; Ryker, S. J.

2012-12-01

The United States is in the midst of a continental-scale, multi-year water-resources experiment, in which society has not defined testable hypotheses or set the duration and scope of the experiment. What are we doing? We are expanding population at two to three times the national growth rate in our most water-scarce states, in the southwest, where water stress is already great and modeling predicts decreased streamflow by the middle of this century. We are expanding irrigated agriculture from the west into the east, particularly to the southeastern states, where increased competition for ground and surface water has urban, agricultural, and environmental interests at odds, and increasingly, in court. We are expanding our consumption of pharmaceutical and personal care products to historic high levels and disposing of them in surface and groundwater, through sewage treatment plants and individual septic systems that were not designed to treat them. These and other examples of our national-scale experiment are likely to continue well into the 21st century. This experiment and related challenges will continue and likely intensify as non-climatic and climatic factors, such as predicted rising temperature and changes in the distribution of precipitation in time and space, continue to develop.
Transforming primary care in the New Orleans safety-net: the patient experience.

PubMed

Schmidt, Laura A; Rittenhouse, Diane R; Wu, Kevin J; Wiley, James A

2013-02-01

The patient-centered medical home (PCMH) is a key service delivery innovation in health reform. However, there are growing questions about whether the changes in clinics promoted by the PCMH model lead to improvements in the patient experience. To test the hypothesis that PCMH improvements in safety-net primary care clinics are associated with a more positive patient experience. Multilevel cross-sectional analysis of patients nested within the primary care clinics that serve them. Primary care clinic leaders and patients throughout the City of New Orleans health care safety-net. Dependent variables included patient ratings of accessibility, coordination, and confidence in the quality/safety of care. The key independent variable was a score measuring PCMH structural and process improvements at the clinic level. Approximately two thirds of patients in New Orleans gave positive ratings to their clinics on access and quality/safety, but only one third did for care coordination. In all but the largest clinics, patient experiences of care coordination were positively associated with the clinic's use of PCMH structural and process changes. Results for patient ratings of access and quality/safety were mixed. Among primary care clinics in the New Orleans safety-net, use of more PCMH improvements at the clinic level led to more positive patient rating of care coordination, but not of accessibility or confidence in quality/safety. Ongoing efforts to pilot, demonstrate, implement, and evaluate the PCMH should consider how the impact of medical practice transformation could vary across different aspects of the patient experience.
Undergraduate Organic Chemistry Laboratory Safety

NASA Astrophysics Data System (ADS)

Luckenbaugh, Raymond W.

1996-11-01

Each organic chemistry student should become familiar with the educational and governmental laboratory safety requirements. One method for teaching laboratory safety is to assign each student to locate safety resources for a specific class laboratory experiment. The student should obtain toxicity and hazardous information for all chemicals used or produced during the assigned experiment. For example, what is the LD50 or LC50 for each chemical? Are there any specific hazards for these chemicals, carcinogen, mutagen, teratogen, neurotixin, chronic toxin, corrosive, flammable, or explosive agent? The school's "Chemical Hygiene Plan", "Prudent Practices for Handling Hazardous Chemicals in the Laboratory" (National Academy Press), and "Laboratory Standards, Part 1910 - Occupational Safety and Health Standards" (Fed. Register 1/31/90, 55, 3227-3335) should be reviewed for laboratory safety requirements for the assigned experiment. For example, what are the procedures for safe handling of vacuum systems, if a vacuum distillation is used in the assigned experiment? The literature survey must be submitted to the laboratory instructor one week prior to the laboratory session for review and approval. The student should then give a short presentation to the class on the chemicals' toxicity and hazards and describe the safety precautions that must be followed. This procedure gives the student first-hand knowledge on how to find and evaluate information to meet laboartory safety requirements.
Can a supersonically expanding Bose-Einstein Condensates be used to study cosmological inflation?

NASA Astrophysics Data System (ADS)

Banik, Swarnav; Eckel, Stephen; Kumar, Avinash; Jacobson, Ted; Spielman, Ian; Campbell, Gretchen

2017-04-01

The massive scale of the universe makes the experimental study of cosmological inflation difficult. This has led to an interest in developing analogous systems using table top experiments. Here, we present the basic features of an expanding universe by drawing parallels with an expanding toroidal Bose Einstein Condensate (BEC) of 23Na atoms. The toroidal BEC serves as the background vacuum and phonons are the analogue to photons in the expanding universe. We study the dynamics of phonons in both non-expanding and expanding condensates and measure dissipation using the structure factor. We demonstrate red shifting of phonons and quasi-particle production similar to pre-heating after the inflation of universe. At the end of expansion, we also observe spontaneous non-zero winding numbers in the ring. Using Monte-Carlo simulations, we predict the widths of the resulting winding number distribution, which agree well with our experimental findings.
Safety culture : a significant influence on safety in transportation

DOT National Transportation Integrated Search

2017-08-01

An organizations safety culture can influence safety outcomes. Research and experience show that when safety culture is strong, accidents are less frequent and less severe. As a result, building and maintaining strong safety cultures should be a t...
Posttest analysis of the FFTF inherent safety tests

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

Padilla, A. Jr.; Claybrook, S.W.

Inherent safety tests were performed during 1986 in the 400-MW (thermal) Fast Flux Test Facility (FFTF) reactor to demonstrate the effectiveness of an inherent shutdown device called the gas expansion module (GEM). The GEM device provided a strong negative reactivity feedback during loss-of-flow conditions by increasing the neutron leakage as a result of an expanding gas bubble. The best-estimate pretest calculations for these tests were performed using the IANUS plant analysis code (Westinghouse Electric Corporation proprietary code) and the MELT/SIEX3 core analysis code. These two codes were also used to perform the required operational safety analyses for the FFTF reactormore » and plant. Although it was intended to also use the SASSYS systems (core and plant) analysis code, the calibration of the SASSYS code for FFTF core and plant analysis was not completed in time to perform pretest analyses. The purpose of this paper is to present the results of the posttest analysis of the 1986 FFTF inherent safety tests using the SASSYS code.« less
Unmanned aerial vehicles in construction and worker safety.

PubMed

Howard, John; Murashov, Vladimir; Branche, Christine M

2018-01-01

Applications of unmanned aerial vehicles (UAVs) for military, recreational, public, and commercial uses have expanded significantly in recent years. In the construction industry, UAVs are used primarily for monitoring of construction workflow and job site logistics, inspecting construction sites to assess structural integrity, and for maintenance assessments. As is the case with other emerging technologies, occupational safety assessments of UAVs lag behind technological advancements. UAVs may create new workplace hazards that need to be evaluated and managed to ensure their safe operation around human workers. At the same time, UAVs can perform dangerous tasks, thereby improving workplace safety. This paper describes the four major uses of UAVs, including their use in construction, the potential risks of their use to workers, approaches for risk mitigation, and the important role that safety and health professionals can play in ensuring safe approaches to the their use in the workplace. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Reuse prevention syringes for reconstitution of lyophilized vaccines: Operational study and UNICEF plans for expanding introduction.

PubMed

Fleming, Jessica A; Hoekstra, Edward John; Moniaga, Vanda; Widjaya, Anton; Soepardi, Jane; Supartha, Nyoman; Salovaara, Annika; Khamassi, Selma; Nelson, Carib

2009-01-01

Since the 1990s, the United Nation's Children's Fund has encouraged injection safety for immunizations through bundling vaccines with appropriate amounts of supporting equipment and by supplying autodisable (AD) syringes for injections. However, poor vaccine reconstitution practices continue to be reported worldwide. By 2009, UNICEF will begin to phase out the distribution of standard disposable syringes for vaccine reconstitution and replace them with reuse prevention (RUP) syringes, with a full transition expected by the end of 2010. A field evaluation in Indonesia was conducted to identify introduction requirements, issues with healthcare worker training and acceptance, and RUP syringe performance and safety. Managers and health workers felt that RUP syringes improved injection safety and fit easily into country logistical systems. Healthcare workers felt they were intuitive to use, but recommended special training. The integration of RUP reconstitution syringes by UNICEF could increase injection safety by preventing the reuse of syringes and reducing vaccine contamination.

Teamwork and communication: an effective approach to patient safety.

PubMed

Mujumdar, Sandhya; Santos, Diana

2014-01-01

Teamwork and communication failures are leading causes of patient safety incidents in health care. Though health care providers must work in teams, they are not well-trained in teamwork and communication skills. Health care faces the problems of differences in communication styles, communication failures and poor teamwork. There is enough evidence in the literature to show that communication failure is detrimental to patient safety. It is estimated that 80% of serious medical errors worldwide take place because of miscommunication between medical providers. NUH recognizes that effective communication and teamwork are essential in the delivery of high quality safe patient care, especially in a complex organization. NUH is a good example, where there is a rich mix of nationalities and races, in staff and in patients, and there is a rapidly expanding care environment. NUH had to overcome these challenges by adopting a multi-pronged approach. The trials and tribulations of NUH in this journey were worthwhile as the patient safety climate survey scores improved over the years.
Efficacy of stent angioplasty for symptomatic stenoses of the proximal vertebral artery.

PubMed

Weber, W; Mayer, T E; Henkes, H; Kis, B; Hamann, G F; Holtmannspoetter, M; Brueckmann, H; Kuehne, D

2005-11-01

To evaluate the safety and efficacy of stent angioplasty in the treatment of symptomatic arteriosclerotic stenoses of the proximal vertebral artery (VA). Thirty-eight symptomatic stenoses of the vertebral origin were treated with flexible balloon-expandable coronary stents. Angiographic and clinical follow-up examinations were obtained in 26 patients at a mean of 11 months. The immediate post-procedural angiographic results showed no residual stenosis in 33 vessels and mild residual stenoses in five vessels. Periprocedurally, there were two asymptomatic technical complications and one TIA. During follow-up re-stenosis could be detected in 10 cases (36%), and vessel occlusions in two patients. Two stents were broken. One of the restenosis caused a TIA within the follow-up period. Flexible balloon-expandable coronary stents proved to be save and effective in preventing vertebrobasilar stroke but were incapable to preserve the proximal vertebral artery lumen. For the VA origine an adequate stent, self-expanding, bioresorbable, or drug-eluting has to be found.
Advancing the framework for considering the effects of climate change on worker safety and health.

PubMed

Schulte, P A; Bhattacharya, A; Butler, C R; Chun, H K; Jacklitsch, B; Jacobs, T; Kiefer, M; Lincoln, J; Pendergrass, S; Shire, J; Watson, J; Wagner, G R

2016-11-01

In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988-2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008-2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers.
Advancing the framework for considering the effects of climate change on worker safety and health

PubMed Central

Schulte, P.A.; Bhattacharya, A.; Butler, C.R.; Chun, H.K.; Jacklitsch, B.; Jacobs, T.; Kiefer, M.; Lincoln, J.; Pendergrass, S.; Shire, J.; Watson, J.; Wagner, G.R.

2016-01-01

ABSTRACT In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988–2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008–2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers. PMID:27115294
Safety assessment of plant food supplements (PFS).

PubMed

van den Berg, Suzanne J P L; Serra-Majem, Lluis; Coppens, Patrick; Rietjens, Ivonne M C M

2011-12-01

Botanicals and botanical preparations, including plant food supplements (PFS), are widely used in Western diets. The growing use of PFS is accompanied by an increasing concern because the safety of these PFS is not generally assessed before they enter the market. Regulatory bodies have become more aware of this and are increasing their efforts to ensure the safety of PFS. The present review describes an overview of the general framework for the safety assessment of PFS, focusing on the different approaches currently in use to assess the safety of botanicals and/or botanical compounds, including their history of safe use, the tiered approach proposed by the European Food Safety Authority (EFSA), the Threshold of Toxicological Concern (TTC) and the Margin of Exposure (MOE) concept. Moreover, some examples of botanical compounds in PFS that may be of concern are discussed. Altogether, it is clear that "natural" does not equal "safe" and that PFS may contain compounds of concern at levels far above those found in the regular diet. In addition, the traditional use of a PFS compound as a herb or tea does not guarantee its safety when used as a supplement. This points at a need for stricter regulation and control of botanical containing products, especially given their expanding market volume.
The Victim-Offender Overlap and Fear of In-School Victimization: A Longitudinal Examination of Risk Assessment Models

ERIC Educational Resources Information Center

Melde, Chris; Esbensen, Finn-Aage

2009-01-01

Reports of serious violence in schools have raised general awareness and concern about safety in America's schools. In this article, the authors examine the extent to which in-school victimization is associated with students' perceived risk and fear of victimization. By expanding on Ferraro's risk assessment framework, the current study explores…
Back Injuries - Multiple Languages

MedlinePlus

... Cantonese dialect) (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Nepali (नेपाली) Russian (Русский) ... हिन्दी (Hindi) Bilingual PDF Health Information Translations Japanese (日本語) Expand Section Back Health and Safety - 日本語 ( ...
77 FR 50166 - Petitions for Modification of Application of Existing Mandatory Safety Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... less than one shot per 10 feet to permit expanding cement to infiltrate the annulus between the casing... mineable coal seam will be perforated with one shot at the elevation of each coal seam above the lowest... detected. The record will be retained at the mine for one year. The petitioner asserts that the proposed...
Using American Community Survey Data to Expand Access to the School Meals Program

ERIC Educational Resources Information Center

Schirm, Allen, Ed.; Kirkendall, Nancy, Ed.

2012-01-01

The National School Lunch and School Breakfast Programs, administered by the Food and Nutrition Service (FNS) of the U.S. Department of Agriculture (USDA), are key components of the nation's food security safety net, providing free or low-cost meals to millions of schoolchildren each day. To qualify their children each year for free or…
In vitro assessment of MRI issues at 3-Tesla for a breast tissue expander with a remote port.

PubMed

Linnemeyer, Hannah; Shellock, Frank G; Ahn, Christina Y

2014-04-01

A patient with a breast tissue expander may require a diagnostic assessment using magnetic resonance imaging (MRI). To ensure patient safety, this type of implant must undergo in vitro MRI testing using proper techniques. Therefore, this investigation evaluated MRI issues (i.e., magnetic field interactions, heating, and artifacts) at 3-Tesla for a breast tissue expander with a remote port. A breast tissue expander with a remote port (Integra Breast Tissue Expander, Model 3612-06 with Standard Remote Port, PMT Corporation, Chanhassen, MN) underwent evaluation for magnetic field interactions (translational attraction and torque), MRI-related heating, and artifacts using standardized techniques. Heating was evaluated by placing the implant in a gelled-saline-filled phantom and MRI was performed using a transmit/receive RF body coil at an MR system reported, whole body averaged specific absorption rate of 2.9-W/kg. Artifacts were characterized using T1-weighted and GRE pulse sequences. Magnetic field interactions were not substantial and, thus, will not pose a hazard to a patient in a 3-Tesla or less MRI environment. The highest temperature rise was 1.7°C, which is physiologically inconsequential. Artifacts were large in relation to the remote port and metal connector of the implant but will only present problems if the MR imaging area of interest is where these components are located. A patient with this breast tissue expander with a remote port may safely undergo MRI at 3-Tesla or less under the conditions used for this investigation. These findings are the first reported at 3-Tesla for a tissue expander. Copyright © 2014 Elsevier Inc. All rights reserved.
Assessment of safety and efficacy of an indigenous self-expandable fully covered esophageal metal stent for palliation of esophageal cancer.

PubMed

Padhan, R K; Nongthombam, S K; Venuthurimilli, A; Dhingra, R; Sahni, P; Garg, P K

2016-01-01

Patients with unresectable esophageal cancer require palliation for dysphagia. Placement of a self-expandable metal stent (SEMS) is the procedure of choice for palliation of dysphagia. To evaluate the safety and efficacy of an indigenous fully-covered SEMS in patients with esophageal cancer. Eligible patients with unresectable esophageal cancer requiring palliation for dysphagia were included in the study. An indigenous fully covered SEMS of appropriate length was placed under endoscopic and fluoroscopic guidance. Outcome measures assessed were adverse events and improvement in dysphagia. Twenty one patients (mean age 57.71±13.14 years; 17 males) were included. After stenting, dysphagia score decreased from 3.2+0.4 to 0.35+0.74 at 4 weeks. Adverse events included retrosternal pain, respiratory distress and aspiration pneumonia in 12, 2 and 1 patients respectively. Five patients required repeat stenting due to stent migration in 4 (following radiotherapy in 3) and tumour ingrowth in 1. There was primary stent malfunction in one patient. The median survival of patients was 140 (76-199) days, which was higher in those who received radiotherapy. The stent was reasonably safe and effective to relieve dysphagia due to unresectable esophageal cancer.
Participant and Household Characteristics Associated With Graduation From the Expanded Food and Nutrition Education Program.

PubMed

Cooper, Brittany Rhoades; Barale, Karen; Funaiole, Angie; Power, Thomas G; Combe, Angela

2016-01-01

To examine empirically participant and household characteristics associated with Expanded Food and Nutrition Education Program (EFNEP) graduation and to determine whether they differ across 2 counties. Survey of EFNEP participants from 2011 to 2012. Expanded Food and Nutrition Education Program sites serving limited-resource families in 1 rural and 1 urban/suburban county in Washington State. Expanded Food and Nutrition Education Program participants (urban/suburban: n = 647; rural: n = 569). Expanded Food and Nutrition Education Program completion/graduation. Multivariate logistic regression was used to examine associations of participant (ethnicity, race, age, education, pregnancy status, and nutrition knowledge/behavior at baseline) and household (number of people in the house, place of residence, and public assistance services) characteristics with EFNEP graduation. Associations were moderated by county. For the urban/suburban county, participants living with more people (after controlling for the total number of adults) were more likely to graduate. For the rural county, participants living with fewer total adults (after controlling for the total number in the house) and those with better food safety practices at baseline were more likely to graduate. This study aids in understanding which participants are more or less likely to complete EFNEP successfully, and therefore can inform strategies aimed at increasing graduation rates. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Platelet lysate supports the in vitro expansion of human periodontal ligament stem cells for cytotherapeutic use.

PubMed

Wu, Rui-Xin; Yu, Yang; Yin, Yuan; Zhang, Xi-Yu; Gao, Li-Na; Chen, Fa-Ming

2017-08-01

Human platelet lysate (PL) produced under optimal conditions of standardization and safety has been increasingly suggested as the future 'gold standard' supplement to replace fetal bovine serum (FBS) for the ex vivo propagation of mesenchymal stem cells for translational medicine and cell therapy applications. However, the multifaceted effects of PL on tissue-specific stem cells remain largely unexplored. In the present study, we investigated the stem cell behaviours of human periodontal ligament stem cells (PDLSCs) in media with or without PL. Our data indicate that human PL, either as an adjuvant for culture media or as a substitute for FBS, supports the proliferation and expansion of human PDLSCs derived from either 'young' or 'old' donors to the same extent as FBS, without interfering with their immunomodulatory capacities. Although PL appears to inhibit the in vitro differentiation of 'young' or 'old' PDLSCs, their decreased osteogenic potential may be restored to similar or higher levels compared with FBS-expanded cells. PL- and FBS-expanded PDLSCs exhibited a similar potential to form mineralized nodules and expressed similar levels of osteogenic genes. Our data indicate that large clinically relevant quantities of PDLSCs may be yielded by the use of human PL; however, further analysis of its precise composition and function will pave the way for determining optimized, defined culture conditions. In addition to the potential increase in patient safety, our findings highlight the need for further research to develop the potential of PL-expanded PDLSCs for clinical use. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
[Urbanization expanding process and its spatial characteristics in changping district of Beijing, China].

PubMed

Zhang, Feng; Zhang, Xinshi

2005-06-01

Urbanization is a massive and unplanned experiment that already affects large acreages worldwide, and has profound social and ecological consequences for both urban and rural residents. Therefore, to comprehensively quantify the urbanization process and to investigate its ecological consequences become the central issues in urban ecological studies. Combining urbanization expanding index with landscape metrics, this paper quantified the urbanization expanding process and the urbanization spatial characteristics in Changping District of Beijing. The results showed that there were three main urbanization models, i. e., urban fringe belt-expending model, main transportation routes line-expending model, and satellite city panel-expending model. The urbanization expansion index showed that urbanization mainly took place during the period from 1989 to 1996, and the urban landscape metrics indicated that there were urban patches isolated expanding and new urban patches emerged from 1989 to 1996, mainly amalgamated expanding from 1996 to 2001 in urban fringe belt-expanding region. In transportation routes line-expanding region, the urban patches isolated expanding, amalgamated expanding and new urban patches emerging took place simultaneously, and mainly urban patches amalgamated expanding during the former period, and new urban patches constantly turning up around satellite city during the latter in satellite city panel-expanding region. This study showed that urbanization expansion integrating landscape metrics might reveal the urbanization expanding process and its spatial characteristics, and would be a good example for the application of landscape metrics.
Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia.

PubMed

Redman-MacLaren, Michelle L; Api, Unia K; Darius, Matupit; Tommbe, Rachael; Mafile'o, Tracie A; MacLaren, David J

2014-09-06

The social and cultural positions of both researchers and research participants influence qualitative methods and study findings. In Papua New Guinea (PNG), as in other contexts, gender is a key organising characteristic and needs to be central to the design and conduct of research. The colonial history between researcher and participant is also critical to understanding potential power differences. This is particularly relevant to public health research, much of which has emerged from a positivist paradigm. This paper describes our critical reflection of flexible researcher responses enacted during qualitative research in PNG. Led by a senior male HIV researcher from PNG, a male from a PNG university and a female from an Australian university conducted qualitative interviews about faith-based responses to HIV in PNG. The two researchers planned to conduct one-on-one interviews matching gender of participants and interviewer. However, while conducting the study, four participants explicitly requested to be interviewed by both researchers. This experience led us to critically consider socially and culturally situated ways of understanding semi-structured interviewing for public health research in Melanesia. New understandings about public health research include: (i) a challenge to the convention that the researcher holds more power than the research participant, (ii) the importance of audience in Melanesia, (iii) cultural safety can be provided when two people co-interview and (iv) the effect an esteemed leader heading the research may have on people's willingness to participate. Researchers who occupy insider-outsider roles in PNG may provide participants new possibilities to communicate key ideas. Our recent experience has taught us public health research methods that are gender sensitive and culturally situated are pivotal to successful research in Melanesia. Qualitative research requires adaptability and reflexivity. Public health research methods must continue to expand to reflect the diverse worldviews of research participants. Researchers need to remain open to new possibilities for learning.
"Like a family but better because you can actually trust each other": the Expect Respect dating violence prevention program for at-risk youth.

PubMed

Ball, Barbara; Kerig, Patricia K; Rosenbluth, Barri

2009-01-01

Expect Respect, a teen dating violence prevention program, was among four programs selected by the Centers for Disease Control and Prevention to participate in an empowerment evaluation project. As one aspect of this project, a qualitative study was designed to investigate the effects of Expect Respect support groups for at-risk youth. The goal was to understand the "how and why" of the program's impact on participants. Group interviews were conducted with five boys' and five girls' support groups after completion of the program. Settings included public middle and high schools and alternative schools in juvenile detention. Participants were asked to describe significant learning experiences in support groups as well as changes in their relationships resulting from program participation. Youths across all groups reported learning new skills including improved communication, anger control, and alternatives to violence. They reported increased knowledge about healthy relationships and warning signs of dating violence and expanded awareness of their own and others' abusive behaviors. Changed relationship norms were uniquely expressed by a boys' group in juvenile detention. Findings indicate that the experience of emotional safety in groups and positive relationships among group members were instrumental in the learning process.
[Awareness of the risk of air bag-associated injuries essential].

PubMed

Björnstig, Ulf; Haraldsson, Per-Olle; Polland, Werner; Sandström, Thomas

2002-07-11

Restraint systems, such as air bags and seat belts with pretensioners, reduce effectively the risk of serious injuries of car occupants. However, this equipment may have some adverse effects. In a frontal air bag deployment the cushion expands with a speed of about 200 km/h towards the driver. A person within the expansion zone, i.e. within 20 centimetres from the steering wheel hub, may experience a considerable injury risk. Short people, pregnant women and people "out of normal position" are especially at risk, as well as paramedics exposed for accidentally deployed air bags during rescue work. The gas generator in the air bag produces nitrogen in a chemical process. However, small amounts of NaOH (caustic soda) may leak out of the gas generator and may contaminate eyes and wounds and cause injuries and delay healing. The air bag gases may provoke an asthmatic attack in sensible individuals and a few will experience a hearing loss, often in the range of 4,000-6,000 Hz, from the sound impulse that may reach a level of 170 dB. Correct handling, based on a familiarity of the effects and side effects of modern restraint systems, would minimise the risk of adverse effects of this safety equipment.
ESL Literacy: What's Working, Why and How--Family Literacy.

ERIC Educational Resources Information Center

Isserlis, Janet

Experiences with family and intergenerational programs in English Second Language (ESL) literacy are reviewed, and factors that contribute to their success are discussed. It is suggested that as the notion of literacy expands, conceptual boundaries of the population of learners must expand also. While there is much to be learned from existing…
Expanding Area Search Experiments

DTIC Science & Technology

1980-05-01

of the *botrIal eltered In BloCk 20, If dlferent (Mran Re.ort) 1I. SUPPLEMCNTARY NOTES It. K EY WORDS (Continue on te’e oide It nft e408 7 old Identty...Each subject see his own position and the constantly expanding farthest-or. circle displayed on a cathode ray tube, with his velocity being
School/Business Partnerships: We Expanded the Idea into a Mutual-Benefit Plan.

ERIC Educational Resources Information Center

Cameron, S. L.

1987-01-01

Describes a "mutual benefit" arrangement that expanded the school-business partnership model. Westfall Secondary School and an industrial operation in Owen Sound Ontario, Canada, linked their strengths and needs to offer students actual work and project experiences and to give the company useful information, services, and adult basic…

Building an Expanded Learning Time and Opportunities School: Principals' Perspectives

ERIC Educational Resources Information Center

Malone, Helen Janc

2011-01-01

Expanded learning time and opportunities (ELTO) requires a committed school leader who is willing to partner with community-based organizations in order to provide strong academic and enrichment daily experiences for his or her students. This article examines four such leaders and the diverse approaches they took to implement ELTO in their…
Community Conversations: An Approach for Expanding and Connecting Opportunities for Employment for Adolescents with Disabilities

ERIC Educational Resources Information Center

Trainor, Audrey A.; Carter, Erik W.; Swedeen, Beth; Pickett, Kelly

2012-01-01

Although early work experiences can impart a number of benefits to adolescents with disabilities, few students have meaningful access to these opportunities. The authors examined "community conversations" to build capacity and interest in expanding employment opportunities. Events were held in seven different communities and used the…
Reinventing District Central Offices to Expand Student Learning. Issue Brief

ERIC Educational Resources Information Center

Honig, Meredith I.; Copland, Michael A.

2008-01-01

This issue brief examines the role of central office administrators in the reinvention process and what research and experience matters for expanding student learning. The brief includes examples from central office reinvention efforts currently planned or under way in Atlanta Public Schools, New York City Public Schools, and Oakland Unified…
"On Course" for Supporting Expanded Participation and Improving Scientific Reasoning in Undergraduate Thesis Writing

ERIC Educational Resources Information Center

Dowd, Jason E.; Roy, Christopher P.; Thompson, Robert J., Jr.; Reynolds, Julie A.

2015-01-01

The Department of Chemistry at Duke University has endeavored to expand participation in undergraduate honors thesis research while maintaining the quality of the learning experience. Accomplishing this goal has been constrained by limited departmental resources (including faculty time) and increased diversity in students' preparation to engage in…
Questioning LibQUAL+[TM]: Expanding Its Assessment of Academic Library Effectiveness

ERIC Educational Resources Information Center

Edgar, William B.

2006-01-01

This article examines LibQUAL+[TM]'s instrument, fundamental assumption, and research approach and proposes a functional/technical model of academic library effectiveness. This expanded view of library effectiveness complements LibQUAL+[TM], emphasizing it to be dependent upon users' experience of service delivery, as LibQUAL+[TM] recognizes.…
Dynamics of a radially expanding liquid sheet: Experiments

NASA Astrophysics Data System (ADS)

Majumdar, Nayanika; Tirumkudulu, Mahesh

2017-11-01

A recent theory predicts that sinuous waves generated at the center of a radially expanding liquid sheet grow spatially even in absence of a surrounding gas phase. Unlike flat liquid sheets, the thickness of a radially expanding liquid sheet varies inversely with distance from the center of the sheet. To test the predictions of the theory, experiments were carried out on a horizontal, radially expanding liquid sheet formed by collision of a single jet on a solid impactor. The latter was placed on a speaker-vibrator with controlled amplitude and frequency. The growth of sinuous waves was determined by measuring the wave surface inclination angle using reflected laser light under both atmospheric and sub-atmospheric pressure conditions. It is shown that the measured growth rate matches with the predictions of the theory over a large range of Weber numbers for both pressure conditions suggesting that the thinning of the liquid sheet plays a dominant role in setting the growth rate of sinuous waves with minimal influence of the surrounding gas phase on its dynamics. IIT Bombay.
Ignition of expandable polystyrene foam by a hot particle: an experimental and numerical study.

PubMed

Wang, Supan; Chen, Haixiang; Liu, Naian

2015-01-01

Many serious fires have occurred in recent years due to the ignition of external building insulation materials by hot metallic particles. This work studied the ignition of expandable polystyrene foam by hot metallic particles experimentally and numerically. In each experiment, a spherical steel particle was heated to a high temperature (within 1173-1373K) and then dropped to the surface of an expandable polystyrene foam block. The particles used in experiments ranged from 3mm to 7 mm in radius. The observed results for ignition were categorized into two types: "flaming ignition" and "no ignition", and the flaming ignition limit was determined by statistical analysis. According to the experimental observations, a numerical model was proposed, taking into account the reactant consumption and volatiles convection of expandable polystyrene decomposition in air. Three regimes, no ignition, unstable ignition and stable ignition, were identified, and two critical particle temperatures for separating the three regimes were determined. Comparison with the experimental data shows that the model can predict the range of critical ignition temperatures reasonably well. Copyright © 2014 Elsevier B.V. All rights reserved.
Safety huddles to proactively identify and address electronic health record safety

PubMed Central

Menon, Shailaja; Singh, Hardeep; Giardina, Traber D; Rayburn, William L; Davis, Brenda P; Russo, Elise M

2017-01-01

Objective: Methods to identify and study safety risks of electronic health records (EHRs) are underdeveloped and largely depend on limited end-user reports. “Safety huddles” have been found useful in creating a sense of collective situational awareness that increases an organization’s capacity to respond to safety concerns. We explored the use of safety huddles for identifying and learning about EHR-related safety concerns. Design: Data were obtained from daily safety huddle briefing notes recorded at a single midsized tertiary-care hospital in the United States over 1 year. Huddles were attended by key administrative, clinical, and information technology staff. We conducted a content analysis of huddle notes to identify what EHR-related safety concerns were discussed. We expanded a previously developed EHR-related error taxonomy to categorize types of EHR-related safety concerns recorded in the notes. Results: On review of daily huddle notes spanning 249 days, we identified 245 EHR-related safety concerns. For our analysis, we defined EHR technology to include a specific EHR functionality, an entire clinical software application, or the hardware system. Most concerns (41.6%) involved “EHR technology working incorrectly,” followed by 25.7% involving “EHR technology not working at all.” Concerns related to “EHR technology missing or absent” accounted for 16.7%, whereas 15.9% were linked to “user errors.” Conclusions: Safety huddles promoted discussion of several technology-related issues at the organization level and can serve as a promising technique to identify and address EHR-related safety concerns. Based on our findings, we recommend that health care organizations consider huddles as a strategy to promote understanding and improvement of EHR safety. PMID:28031286
Safety first: Instrumentality for reaching safety determines attention allocation under threat.

PubMed

Vogt, Julia; Koster, Ernst H W; De Houwer, Jan

2017-04-01

Theories of attention to emotional information suggest that attentional processes prioritize threatening information. In this article, we suggest that attention will prioritize the events that are most instrumental to a goal in any given context, which in threatening situations is typically reaching safety. To test our hypotheses, we used an attentional cueing paradigm that contained cues signaling imminent threat (i.e., aversive noises) as well as cues that allowed participants to avoid threat (instrumental safety signals). Correct reactions to instrumental safety signals seemingly allowed participants to lower the presentation rate of the threat. Experiment 1 demonstrates that attention prioritizes instrumental safety signals over threat signals. Experiment 2 replicates this finding and additionally compares instrumental safety signals to other action-relevant signals controlling for action relevance as cause of the effects. Experiment 3 demonstrates that when actions toward threat signals permit to avoid threat, attention prioritizes threat signals. Taken together, these results support the view that instrumentality for reaching safety determines the allocation of attention under threat. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
An Advanced One-Dimensional Finite Element Model for Incompressible Thermally Expandable Flow

DOE PAGES

Hu, Rui

2017-03-27

Here, this paper provides an overview of a new one-dimensional finite element flow model for incompressible but thermally expandable flow. The flow model was developed for use in system analysis tools for whole-plant safety analysis of sodium fast reactors. Although the pressure-based formulation was implemented, the use of integral equations in the conservative form ensured the conservation laws of the fluid. A stabilization scheme based on streamline-upwind/Petrov-Galerkin and pressure-stabilizing/Petrov-Galerkin formulations is also introduced. The flow model and its implementation have been verified by many test problems, including density wave propagation, steep gradient problems, discharging between tanks, and the conjugate heatmore » transfer in a heat exchanger.« less
An Advanced One-Dimensional Finite Element Model for Incompressible Thermally Expandable Flow

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

Hu, Rui

Here, this paper provides an overview of a new one-dimensional finite element flow model for incompressible but thermally expandable flow. The flow model was developed for use in system analysis tools for whole-plant safety analysis of sodium fast reactors. Although the pressure-based formulation was implemented, the use of integral equations in the conservative form ensured the conservation laws of the fluid. A stabilization scheme based on streamline-upwind/Petrov-Galerkin and pressure-stabilizing/Petrov-Galerkin formulations is also introduced. The flow model and its implementation have been verified by many test problems, including density wave propagation, steep gradient problems, discharging between tanks, and the conjugate heatmore » transfer in a heat exchanger.« less
FDA Expands List of "Do Not Compound" Drug Products.

PubMed

2017-03-01

EDITOR'S ABSTRACT On October 3, 2016, the U.S. Food and Drug Administration published in the Federal Register an expanded list of drug products that are not to be used in compounding extemporaneous dosage forms. This list contains numerous analgesic or anti-inflammatory agents and other chemicals sometimes used to manage pain and related symptoms. Because pharmacies are licensed by the states and other jurisdictions (districts, territories) as opposed to the federal government, regulation of extemporaneous compounding is inconsistent across the nation and minimal to nonexistent is some jurisdictions. Clinicians are urged to assure that pharmacies they and their patients use adhere to this list and compound only dosage forms for which there is good evidence of both safety and efficacy.
Operation and Development Status of the Spacecraft Fire Experiments (Saffire)

NASA Technical Reports Server (NTRS)

Ruff, Gary A.; Urban, David L.

2016-01-01

Since 2012, a series of Spacecraft Fire Experiments (Saffire) have been under development by the Spacecraft Fire Safety Demonstration (SFS Demo) project, funded by NASA's Advanced Exploration Systems Division. The overall objective of this project is to reduce the uncertainty and risk associated with the design of spacecraft fire safety systems for NASA's exploration missions. The approach to achieving this goal has been to define, develop, and conduct experiments that address gaps in spacecraft fire safety knowledge and capabilities identified by NASA's Fire Safety System Maturation Team. The Spacecraft Fire Experiments (Saffire-I, -II, and -III) are material flammability tests at length scales that are realistic for a spacecraft fire in low-gravity. The specific objectives of these three experiments are to (1) determine how rapidly a large scale fire grows in low-gravity and (2) investigate the low-g flammability limits compared to those obtained in NASA's normal gravity material flammability screening test. The experiments will be conducted in Orbital ATK's Cygnus vehicle after it has unberthed from the International Space Station. The tests will be fully automated with the data downlinked at the conclusion of the test before the Cygnus vehicle reenters the atmosphere. This paper discusses the status of the Saffire-I, II, and III experiments followed by a review of the fire safety technology gaps that are driving the development of objectives for the next series of experiments, Saffire-IV, V, and VI.
Designing a Text Messaging Intervention to Improve Physical Activity Behavior Among Low-Income Latino Patients With Diabetes: A Discrete-Choice Experiment, Los Angeles, 2014-2015.

PubMed

Ramirez, Magaly; Wu, Shinyi; Beale, Elizabeth

2016-12-22

Automated text messaging can deliver self-management education to activate self-care behaviors among people with diabetes. We demonstrated how a discrete-choice experiment was used to determine the features of a text-messaging intervention that are important to urban, low-income Latino patients with diabetes and that could support improvement in their physical activity behavior. In a discrete-choice experiment from December 2014 through August 2015 we conducted a survey to elicit information on patient preferences for 5 features of a text-messaging intervention. We described 2 hypothetical interventions and in 7 pairwise comparisons asked respondents to indicate which they preferred. Respondents (n = 125) were recruited in person from a diabetes management program of a safety-net ambulatory care clinic in Los Angeles; clinicians referred patients to the research assistant after routine clinic visits. Data were analyzed by using conditional logistic regression. We found 2 intervention features that were considered by the survey respondents to be important: 1) the frequency of text messaging and 2) physical activity behavior-change education (the former being more important than the latter). Physical activity goal setting, feedback on physical activity performance, and social support were not significantly important. A discrete-choice experiment is a feasible way to elicit information on patient preferences for a text-messaging intervention designed to support behavior change. However, discrepancies may exist between patients' stated preferences and their actual behavior. Future research should validate and expand our findings.
Modeling microbial products in activated sludge under feast-famine conditions.

PubMed

Ni, Bing-Jie; Fang, Fang; Rittmann, Bruce E; Yu, Han-Qing

2009-04-01

We develop an expanded unified model that integrates production and consumption of internal storage products (X(STO)) into a unified model for extracellular polymeric substances (EPS), soluble microbial products (SMP), and active and inert biomass in activated sludge. We also conducted independent experiments to find needed parameter values and to test the ability of the expanded unified model to describe all the microbial products, along with original substrate and oxygen uptake. The model simulations match all experimental measurements and provide insights into the dynamics of soluble and solid components in activated sludge exposed to dynamic feast-and-famine conditions in two batch experiments and in one cycle of a sequencing batch reactor. In particular, the model illustrates how X(STO) cycles up and down rapidly during feast and famine periods, while EPS and biomass components are relatively stable despite feast and famine. The agreement between model outputs and experimental EPS, SMP, and X(STO) data from distinctly different experiments supports that the expanded unified model properly captures the relationships among the forms of microbial products.
Optimization design of turbo-expander gas bearing for a 500W helium refrigerator

NASA Astrophysics Data System (ADS)

Li, S. S.; Fu, B.; Y Zhang, Q.

2017-12-01

Turbo-expander is the core machinery of the helium refrigerator. Bearing as the supporting element is the core technology to impact the design of turbo-expander. The perfect design and performance study for the gas bearing are essential to ensure the stability of turbo-expander. In this paper, numerical simulation is used to analyze the performance of gas bearing for a 500W helium refrigerator turbine, and the optimization design of the gas bearing has been completed. And the results of the gas bearing optimization have a guiding role in the processing technology. Finally, the turbine experiments verify that the gas bearing has good performance, and ensure the stable operation of the turbine.
The Patient Safety Leadership Academy at the University of Pennsylvania: the first cohort's learning experience.

PubMed

Wurster, Angela B; Pearson, Kathy; Sonnad, Seema S; Mullen, James L; Kaiser, Larry R

2007-01-01

We based the Patient Safety Leadership Academy (PSLA) on the premise that improving management skills could improve patient safety and employee satisfaction. Fellows completed baseline surveys on leadership skills knowledge, patient safety knowledge, and program goals. They completed the same surveys 7 months later at the final PSLA session. The fellows also completed a survey assessing how PSLA improved expertise and comparing PSLA to other patient safety learning opportunities. Matched pairs t tests were used to compare baseline and postprogram results. Baseline scores indicated appropriateness of focusing on leadership, with average leadership knowledge (2.48) significantly lower than patient safety knowledge (3.22). For patient safety, postprogram results were significant for 8 of 10 questions. All results were significant for leadership. Fellows also rated skills covered by the curriculum on a scale of 1 to 10. For all areas, the median score for knowledge gained was 7. When compared with other patient safety learning experiences, participants rated PSLA as 4 or 5, where 1 indicated the other experience much more valuable and 5 much more valuable. PSLA demonstrates that leadership skills are perceived as important by physicians and managers in surgical areas. This study demonstrated that a leadership skills approach to patient safety training could improve knowledge in specific leadership areas and general patient safety.
It is important that they care - older persons' experiences of telephone advice nursing.

PubMed

Holmström, Inger K; Nokkoudenmäki, Mai-Britt; Zukancic, Selma; Sundler, Annelie J

2016-06-01

The aim of the study was to explore older persons' experiences of telephone advice nursing at primary healthcare centres. Telephone advice nursing is expanding worldwide, and the older population is increasing. Little is known about older persons' experiences of telephone advice nursing provided by primary healthcare. This study has a descriptive design with a qualitative inductive approach. Data were collected via interviews with a purposive sample of 10 older persons in 2014. The data were analysed using qualitative content analysis. The older persons' experiences were described in two themes: the patient-friendly aspects of telephone advice nursing and the patient-unfriendly aspects of telephone advice nursing. The themes can be understood as two sides of the same coin; the differences point to both the advantages and disadvantages of the service and are further illuminated through seven subthemes. This study contributes to increased awareness of the advantages and disadvantages of the telephone advice nursing system as experienced by older persons. To be the focus of attention during calls was highlighted as important; and clear communication was deemed crucial. When the communication between the nurse and the older persons was perceived as good and the perspective of the caller was the focus, an experience of safety and satisfaction was described. Older persons had great confidence in the telephone nurses' competence and perceived their ability to access the service as mostly good, even if it was sometimes difficult to use the service. The communicative competence of telephone nurses is essential when providing telephone advice nursing to older persons. In addition, a person-centred approach is important to provide optimal care in telephone advice nursing. © 2016 John Wiley & Sons Ltd.
Development and participant assessment of a practical quality improvement educational initiative for surgical residents.

PubMed

Sellers, Morgan M; Hanson, Kristi; Schuller, Mary; Sherman, Karen; Kelz, Rachel R; Fryer, Jonathan; DaRosa, Debra; Bilimoria, Karl Y

2013-06-01

As patient-safety and quality efforts spread throughout health care, the need for physician involvement is critical, yet structured training programs during surgical residency are still uncommon. Our objective was to develop an extended quality-improvement curriculum for surgical residents that included formal didactics and structured practical experience. Surgical trainees completed an 8-hour didactic program in quality-improvement methodology at the start of PGY3. Small teams developed practical quality-improvement projects based on needs identified during clinical experience. With the assistance of the hospital's process-improvement team and surgical faculty, residents worked through their selected projects during the following year. Residents were anonymously surveyed after their participation to assess the experience. During the first 3 years of the program, 17 residents participated, with 100% survey completion. Seven quality-improvement projects were developed, with 57% completing all DMAIC (Define, Measure, Analyze, Improve, Control) phases. Initial projects involved issues of clinical efficiency and later projects increasingly focused on clinical care questions. Residents found the experience educationally important (65%) and believed they were well equipped to lead similar initiatives in the future (70%). Based on feedback, the timeline was expanded from 12 to 24 months and changed to start in PGY2. Developing an extended curriculum using both didactic sessions and applied projects to teach residents the theory and implementation of quality improvement is possible and effective. It addresses the ACGME competencies of practice-based improvement and learning and systems-based practice. Our iterative experience during the past 3 years can serve as a guide for other programs. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Increasing Patient Safety by Closing the Sterile Production Gap-Part 1. Introduction.

PubMed

Agalloco, James P

2017-01-01

Terminal sterilization is considered the preferred means for the production of sterile drug products because it affords enhanced safety for the patient as the formulation is filled into its final container, sealed, and sterilized. Despite the obvious patient benefits, the use of terminal sterilization is artificially constrained by unreasonable expectations for the minimum time-temperature process to be used. The core misunderstanding with terminal sterilization is a fixation that destruction of a high population of a resistant biological indicator is required. The origin of this misconception is unclear, but it has resulted in sterilization conditions that are extremely harsh (15 min at 121 °C, of F 0 > 8 min), which limit the use of terminal sterilization to extremely heat-stable formulations. These articles outline the artificial nature of the process constraints and describe a scientifically sound means to expand the use of terminal sterilization by identifying the correct process goal-destruction of the bioburden present in the container prior to sterilization. Recognition that the true intention is bioburden destruction in routine products allows for the use of reduced conditions (lower temperatures, shorter process dwell, or both) without added patient risk. By focusing attention on the correct process target, lower time-temperature conditions can be used to expand the use of terminal sterilization to products unable to withstand the harsh conditions that have been mistakenly applied. The first article provides the background and describes the benefits to patient, producer, and regulator. The second article includes validation and operational advice that can be used in the implementation. LAY ABSTRACT: Terminal sterilization is considered the preferred means for the production of sterile drug products because it affords enhanced safety for the patient as the formulation is filled into its final container, sealed, and sterilized. Despite the obvious patient benefits, the use of terminal sterilization is artificially constrained by unreasonable expectations for the minimum time-temperature process to be used. These articles outline the artificial nature of the process constraints and describe a scientifically sound means to expand the use of terminal sterilization by identifying the correct process goal-destruction of the bioburden present in the container prior to sterilization. By focusing attention on the correct process target, lower time-temperature conditions can be used to expand the use of terminal sterilization to products unable to withstand the harsh conditions that have been mistakenly applied. The first article provides the background, and describes the benefits to patient, producer, and regulator. The second article includes validation and operational advice that can be used in the implementation. © PDA, Inc. 2017.

The hybrid reactor project based on the straight field line mirror concept

NASA Astrophysics Data System (ADS)

Ågren, O.; Noack, K.; Moiseenko, V. E.; Hagnestâl, A.; Källne, J.; Anglart, H.

2012-06-01

The straight field line mirror (SFLM) concept is aiming towards a steady-state compact fusion neutron source. Besides the possibility for steady state operation for a year or more, the geometry is chosen to avoid high loads on materials and plasma facing components. A comparatively small fusion hybrid device with "semi-poor" plasma confinement (with a low fusion Q factor) may be developed for industrial transmutation and energy production from spent nuclear fuel. This opportunity arises from a large fission to fusion energy multiplication ratio, Qr = Pfis/Pfus>>1. The upper bound on Qr is primarily determined by geometry and reactor safety. For the SFLM, the upper bound is Qr≈150, corresponding to a neutron multiplicity of keff=0.97. Power production in a mirror hybrid is predicted for a substantially lower electron temperature than the requirement Te≈10 keV for a fusion reactor. Power production in the SFLM seems possible with Q≈0.15, which is 10 times lower than typically anticipated for hybrids (and 100 times smaller than required for a fusion reactor). This relaxes plasma confinement demands, and broadens the range for use of plasmas with supra-thermal ions in hybrid reactors. The SFLM concept is based on a mirror machine stabilized by qudrupolar magnetic fields and large expander tanks beyond the confinement region. The purpose of the expander tanks is to distribute axial plasma loss flow over a sufficiently large area so that the receiving plates can withstand the heat. Plasma stability is not relying on a plasma flow into the expander regions. With a suppressed plasma flow into the expander tanks, a possibility arise for higher electron temperature. A brief presentation will be given on basic theory for the SFLM with plasma stability and electron temperature issues, RF heating computations with sloshing ion formation, neutron transport computations with reactor safety margins and material load estimates, magnetic coil designs as well as a discussion on the implications of the geometry for possible diagnostics. Reactor safety issues are addressed and a vertical orientation of the device could assist passive coolant circulation. Specific attention is put to a device with a 25 m long confinement region and 40 cm plasma radius in the mid-plane. In an optimal case (keff = 0.97) with a fusion power of only 10 MW, such a device may be capable of producing a power of 1.5 GWth.
Ten Ways to Restrict Children's Freedom to Play: The Problem of Surplus Safety

ERIC Educational Resources Information Center

Wyver, Shirley; Tranter, Paul; Naughton, Geraldine; Little, Helen; Sandseter, Ellen Beate Hansen; Bundy, Anita

2010-01-01

Play and playgrounds provide essential experiences for young children's growth, development and enjoyment of life. However, such play experiences are now limited for many children due to excessive fear of risk, or "surplus safety". In this article, the authors examine the pervasiveness of surplus safety in the lives of young children.…
What speeds up the internal clock? Effects of clicks and flicker on duration judgements and reaction time.

PubMed

Wearden, J H; Williams, Emily A; Jones, Luke A

2017-03-01

Four experiments investigated the effect of pre-stimulus events on judgements of the subjective duration of tones that they preceded. Experiments 1 to 4 used click trains, flickering squares, expanding circles, and white noise as pre-stimulus events and showed that (a) periodic clicks appeared to "speed up" the pacemaker of an internal clock but that the effect wore off over a click-free delay, (b) aperiodic click trains, and visual stimuli in the form of flickering squares and expanding circles, also produced similar increases in estimated tone duration, as did white noise, although its effect was weaker. A fifth experiment examined the effects of periodic flicker on reaction time and showed that, as with periodic clicks in a previous experiment, reaction times were shorter when preceded by flicker than without.
Effects of patient safety auditing in hospital care: results of a mixed-method evaluation (part 1).

PubMed

Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Westert, Gert P; Boeijen, Wilma; Teerenstra, Steven; van Gurp, Petra J; Wollersheim, Hub

2018-06-15

To evaluate the effectiveness of internal auditing in hospital care focussed on improving patient safety. A before-and-after mixed-method evaluation study was carried out in eight departments of a university medical center in the Netherlands. Internal auditing and feedback focussed on improving patient safety. The effect of internal auditing was assessed 15 months after the audit, using linear mixed models, on the patient, professional, team and departmental levels. The measurement methods were patient record review on adverse events (AEs), surveys regarding patient experiences, safety culture and team climate, analysis of administrative hospital data (standardized mortality rate, SMR) and safety walk rounds (SWRs) to observe frontline care processes on safety. The AE rate decreased from 36.1% to 31.3% and the preventable AE rate from 5.5% to 3.6%; however, the differences before and after auditing were not statistically significant. The patient-reported experience measures regarding patient safety improved slightly over time (P < 0.001). The SMR, patient safety culture and team climate remained unchanged after the internal audit. The SWRs showed that medication safety and information security were improved (P < 0.05). Internal auditing was associated with improved patient experiences and observed safety on wards. No effects were found on adverse outcomes, safety culture and team climate 15 months after the internal audit.
Corrosion/Erosion Behavior of Silicon Nitride and Silicon Carbide Ceramics - Gas Turbine Experience

DTIC Science & Technology

1979-04-01

C-0138. As part of a program to utilize ceramics in helical expander Brayton cycle turbomachines for coal-fired topping cycles, Myers el a1.7 have...Meyers et al., Reference 7). 7. MEYERS, B., LANDINGHAM, R., MOHR, P., and TAYLOR , K. An Adiabatic Coal-Fired 1350 C Expander in Proceedings: Workshop on
"Making the Readings Come to Life": Expanding Notions of Language Arts at Freedom School

ERIC Educational Resources Information Center

Jackson, Tambra O.

2009-01-01

The Children's Defense Fund Freedom Schools provide literacy-rich, summer experiences for both the K-12 children they serve and the servant-leader interns who serve as teachers. In this article, the author expands upon the scholarship of preparing teachers to be culturally responsive pedagogues of language arts instruction by illuminating…
Negligent Liability Issues Involving Colleges and Students: Balancing the Risks and Benefits of Expanded Programs and Heightened Supervision

ERIC Educational Resources Information Center

Pearson, Douglas R.; Beckham, Joseph C.

2005-01-01

Student affairs professionals recognize that learning experiences transcend the classroom, and they have expanded the range of programs and services available to students well beyond the laboratory and lecture hall. The authors survey judicial opinions involving institutional liability for negligence and conclude that the expansion of educational…
Recording dew gage

Treesearch

Merle G. Lloyd

1963-01-01

The instrument developed by Intermountain Forest and Range Experiment Station to record duration and amount of dew (fig. 1) consists of an expanded polystyrene block mounted on a balance, a clock-driven drum, and a pen geared from the balance to the drum. Changes in weight of the expanded polystyrene block as dew or rain is deposited are recorded on a chart mounted on...
Teachers' Experiences Collaborating in Expanded School Mental Health: Implications for Practice, Policy and Research

ERIC Educational Resources Information Center

Mellin, Elizabeth A.; Ball, Annahita; Iachini, Aidyn; Togno, Nicole; Rodriguez, Ana Maria

2017-01-01

Teachers are critical partners in expanded school mental health (ESMH) collaborations that aim to bring educators, community mental health professionals and families together to leverage expertise and resources for addressing non-academic barriers to learning. Although teachers are in a unique position to observe the day-to-day mental health needs…
Advanced missions safety. Volume 3: Appendices. Part 2: Experiment

NASA Technical Reports Server (NTRS)

Hinton, M. G., Jr.

1972-01-01

Supporting documentation pertaining to the hazards of transporting experimental equipment on the Earth Orbit Shuttle is presented. The subjects discussed are: (1) experiment and hardware definition, (2) hazard analysis, (3) preventive measure assessment, (4) preventive measures statements, (5) remedial measure assessment, and (6) experiment interaction safety considerations.
Practical input optimization for aircraft parameter estimation experiments. Ph.D. Thesis, 1990

NASA Technical Reports Server (NTRS)

Morelli, Eugene A.

1993-01-01

The object of this research was to develop an algorithm for the design of practical, optimal flight test inputs for aircraft parameter estimation experiments. A general, single pass technique was developed which allows global optimization of the flight test input design for parameter estimation using the principles of dynamic programming with the input forms limited to square waves only. Provision was made for practical constraints on the input, including amplitude constraints, control system dynamics, and selected input frequency range exclusions. In addition, the input design was accomplished while imposing output amplitude constraints required by model validity and considerations of safety during the flight test. The algorithm has multiple input design capability, with optional inclusion of a constraint that only one control move at a time, so that a human pilot can implement the inputs. It is shown that the technique can be used to design experiments for estimation of open loop model parameters from closed loop flight test data. The report includes a new formulation of the optimal input design problem, a description of a new approach to the solution, and a summary of the characteristics of the algorithm, followed by three example applications of the new technique which demonstrate the quality and expanded capabilities of the input designs produced by the new technique. In all cases, the new input design approach showed significant improvement over previous input design methods in terms of achievable parameter accuracies.
Gas propagation following a sudden loss of vacuum in a pipe cooled by He I and He II.

NASA Astrophysics Data System (ADS)

Garceau, N.; Guo, W.; Dodamead, T.

2017-12-01

Many cryogenic systems around the world are concerned with the sudden catastrophic loss of vacuum for cost, preventative damage, safety or other reasons. The experiments in this paper were designed to simulate the sudden vacuum break in the beam-line pipe of a liquid helium cooled superconducting particle accelerator. This paper expands previous research conducted at the National High Magnetic Field Laboratory and evaluates the differences between normal helium (He I) and superfluid helium (He II). For the experiments, a straight pipe and was evacuated and immersed in liquid helium at 4.2 K and below 2.17 K. Vacuum loss was simulated by opening a solenoid valve on a buffer tank filled nitrogen gas. Gas front arrival was observed by a temperature rise of the tube. Preliminary results suggested that the speed of the gas front through the experiment decreased exponentially along the tube for both normal liquid helium and super-fluid helium. The system was modified to a helical pipe system to increase propagation length. Testing and analysis on these two systems revealed there was minor difference between He I and He II despite the difference between the two distinct helium phases heat transfer mechanisms: convection vs thermal counterflow. Furthermore, the results indicated that the temperature of the tube wall above the LHe bath also plays a significant role in the initial front propagation. More systematic measurements are planned in with the helical tube system to further verify the results.
New Equipment for Mine Safety

NASA Technical Reports Server (NTRS)

1983-01-01

While planning for the space shuttle, Bendix Corporation with the help of Johnson Space Center expanded the anthropometric data base for aerospace and nonaerospace use in clothing, workplace, etc. The result was the Anthropometric Source Book which was later utilized by the U.S. Bureau of Mines in designing advanced mining systems. The book was particularly valuable in the design of a remote cab used in mining.
The Federal Aviation Administration Plan for Research, Engineering and Development, 1994

DTIC Science & Technology

1994-05-01

Aeronautical Data Link Communications and (COTS) runway incursion system software will Applications, and 051-130 Airport Safety be demonstrated as a... airport departure and ar- efforts rival scheduling plans that optimize daily traffic flows for long-range flights between major city- * OTFP System to...Expanded HARS planning capabilities to in- aviation dispatchers to develop optimized high clude enhanced communications software for altitude flight
Nonlethal Munitions (NLM) Expand Warfighter Capabilities

DTIC Science & Technology

2008-03-01

regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington...the Office of the Project Manager Close Combat Systems (PM CCS), part of Program Executive Office Ammuni- tion (PEO Ammo), deployed the Army’s first...provide com- manders the flexibility to influence the situation favorably with increased safety to U.S. Forces while reducing risk of both noncombatant
V/STOL Concepts and Developed Aircraft. Volume 1. A Historical Report (1940-1986)

DTIC Science & Technology

1986-06-26

in this - direction. Generally, the propellants considered for use create logistic, safety and operational cost problems. Further, the very high...been expanded into multiplace transpcrt devices. The operational use of the individual lift systems creates an important distinction between them in...two separate, alternate thrust vectoring means tc control horizontal translational flight with attitude stabilization being created by the flier’s
Relief, restoration and reform: economic upturn yields modest and uneven health returns.

PubMed

Hurley, Robert; Katz, Aaron; Felland, Laurie

2008-01-01

The sensitivity of state budgets to economic cycles contributes to fluctuations in health coverage, eligibility, benefits and provider payment levels in public programs, as well as support for safety net hospitals and community health centers (CHCs). The aftershocks of the 2001 recession on state budgets were felt well into 2004. More recently, the economic recovery allowed many states to restore cuts and, in some cases, expand health services for low-income people, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Along with bolstering support of safety net providers and raising Medicaid payments for private physicians, some states advanced even more ambitious health reform proposals. Yet across communities, safety net systems face mounting challenges of caring for more uninsured patients, and these pressures will likely increase given the current economic downturn.
A Uniform Framework of Global Nuclear Materials Management

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

Dupree, S.A.; Mangan, D.L.; Sanders, T.L

1999-04-20

Global Nuclear Materials Management (GNMM) anticipates and supports a growing international recognition of the importance of uniform, effective management of civilian, excess defense, and nuclear weapons materials. We expect thereto be a continuing increase in both the number of international agreements and conventions on safety, security, and transparency of nuclear materials, and the number of U.S.-Russian agreements for the safety, protection, and transparency of weapons and excess defense materials. This inventory of agreements and conventions may soon expand into broad, mandatory, international programs that will include provisions for inspection, verification, and transparency, To meet such demand the community must buildmore » on the resources we have, including State agencies, the IAEA and regional organizations. By these measures we will meet the future expectations for monitoring and inspection of materials, maintenance of safety and security, and implementation of transparency measures.« less
An Independent Evaluation of the FMEA/CIL Hazard Analysis Alternative Study

NASA Technical Reports Server (NTRS)

Ray, Paul S.

1996-01-01

The present instruments of safety and reliability risk control for a majority of the National Aeronautics and Space Administration (NASA) programs/projects consist of Failure Mode and Effects Analysis (FMEA), Hazard Analysis (HA), Critical Items List (CIL), and Hazard Report (HR). This extensive analytical approach was introduced in the early 1970's and was implemented for the Space Shuttle Program by NHB 5300.4 (1D-2. Since the Challenger accident in 1986, the process has been expanded considerably and resulted in introduction of similar and/or duplicated activities in the safety/reliability risk analysis. A study initiated in 1995, to search for an alternative to the current FMEA/CIL Hazard Analysis methodology generated a proposed method on April 30, 1996. The objective of this Summer Faculty Study was to participate in and conduct an independent evaluation of the proposed alternative to simplify the present safety and reliability risk control procedure.
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.

From randomized controlled trials to observational studies.

PubMed

Silverman, Stuart L

2009-02-01

Randomized controlled trials are considered the gold standard in the hierarchy of research designs for evaluating the efficacy and safety of a treatment intervention. However, their results can have limited applicability to patients in clinical settings. Observational studies using large health care databases can complement findings from randomized controlled trials by assessing treatment effectiveness in patients encountered in day-to-day clinical practice. Results from these designs can expand upon outcomes of randomized controlled trials because of the use of larger and more diverse patient populations with common comorbidities and longer follow-up periods. Furthermore, well-designed observational studies can identify clinically important differences among therapeutic options and provide data on long-term drug effectiveness and safety.
Design of 3D simulation engine for oilfield safety training

NASA Astrophysics Data System (ADS)

Li, Hua-Ming; Kang, Bao-Sheng

2015-03-01

Aiming at the demand for rapid custom development of 3D simulation system for oilfield safety training, this paper designs and implements a 3D simulation engine based on script-driven method, multi-layer structure, pre-defined entity objects and high-level tools such as scene editor, script editor, program loader. A scripting language been defined to control the system's progress, events and operating results. Training teacher can use this engine to edit 3D virtual scenes, set the properties of entity objects, define the logic script of task, and produce a 3D simulation training system without any skills of programming. Through expanding entity class, this engine can be quickly applied to other virtual training areas.
Activities of the US-Japan Safety Monitor Joint Working Group

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

Richard L. Savercool; Lee C. Cadwallader

2004-09-01

This paper documents the activities of the US-Japan exchange in the area of personnel safety at magnetic and laser fusion experiments. A near-miss event with a visiting scientist to the US in 1992 was the impetus for forming the Joint Working Group on Fusion Safety. This exchnge has been under way for over ten years and has provided many safety insights for both US and Japanese facility personnel at national institutes and at universities. The background and activities of the Joint Working Group are described, including the facilities that have been visited for safety walkthroughs, the participants from both countries,more » and the main safety issues examined during visits. Based on these visits, some operational safety ideas to enhance experiment safety are given. The near-term future plans of the Safety Monitor Joint Working group are also discussed.« less
Risk-based Spacecraft Fire Safety Experiments

NASA Technical Reports Server (NTRS)

Apostolakis, G.; Catton, I.; Issacci, F.; Paulos, T.; Jones, S.; Paxton, K.; Paul, M.

1992-01-01

Viewgraphs on risk-based spacecraft fire safety experiments are presented. Spacecraft fire risk can never be reduced to a zero probability. Probabilistic risk assessment is a tool to reduce risk to an acceptable level.
Little shop of errors: an innovative simulation patient safety workshop for community health care professionals.

PubMed

Tupper, Judith B; Pearson, Karen B; Meinersmann, Krista M; Dvorak, Jean

2013-06-01

Continuing education for health care workers is an important mechanism for maintaining patient safety and high-quality health care. Interdisciplinary continuing education that incorporates simulation can be an effective teaching strategy for improving patient safety. Health care professionals who attended a recent Patient Safety Academy had the opportunity to experience firsthand a simulated situation that included many potential patient safety errors. This high-fidelity activity combined the best practice components of a simulation and a collaborative experience that promoted interdisciplinary communication and learning. Participants were challenged to see, learn, and experience "ah-ha" moments of insight as a basis for error reduction and quality improvement. This innovative interdisciplinary educational training method can be offered in place of traditional lecture or online instruction in any facility, hospital, nursing home, or community care setting. Copyright 2013, SLACK Incorporated.
Refining King and Baxter Magolda's Model of Intercultural Maturity

ERIC Educational Resources Information Center

Perez, Rosemary J.; Shim, Woojeong; King, Patricia M.; Baxter Magolda, Marcia B.

2015-01-01

This study examined 110 intercultural experiences from 82 students attending six colleges and universities to explore how students' interpretations of their intercultural experiences reflected their developmental capacities for intercultural maturity. Our analysis of students' experiences confirmed as well as refined and expanded King and Baxter…
Preventing Harm in the ICU-Building a Culture of Safety and Engaging Patients and Families.

PubMed

Thornton, Kevin C; Schwarz, Jennifer J; Gross, A Kendall; Anderson, Wendy G; Liu, Kathleen D; Romig, Mark C; Schell-Chaple, Hildy; Pronovost, Peter J; Sapirstein, Adam; Gropper, Michael A; Lipshutz, Angela K M

2017-09-01

Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and family engagement in successful quality improvement initiatives in the ICU. We review the evidence supporting the impact of safety culture and provide practical guidance for those wishing to implement initiatives aimed at improving safety culture and more effectively integrate patients and families in such efforts. Literature review using PubMed including evaluation of key studies assessing large-scale quality improvement efforts in the ICU, impact of safety culture on patient outcomes, methodologies for quality improvement commonly used in healthcare, and patient and family engagement. Print and web-based resources from leading patient safety organizations were also searched. Our group completed a review of original studies, review articles, book chapters, and recommendations from leading patient safety organizations. Our group determined by consensus which resources would best inform this review. A strong safety culture is associated with reduced adverse events, lower mortality rates, and lower costs. Quality improvement efforts have been shown to be more effective and sustainable when paired with a strong safety culture. Different methodologies exist for quality improvement in the ICU; a thoughtful approach to implementation that engages frontline providers and administrative leadership is essential for success. Efforts to substantively include patients and families in the processes of quality improvement work in the ICU should be expanded. Efforts to establish a culture of safety and meaningfully engage patients and families should form the foundation for all safety interventions in the ICU. This review describes an approach that integrates components of several proven quality improvement methodologies to enhance safety culture in the ICU and highlights opportunities to include patients and families.
Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study.

PubMed

Smeulers, Marian; Onderwater, Astrid T; van Zwieten, Myra C B; Vermeulen, Hester

2014-04-01

To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative interview study of 20 nurses in an academic medical centre was conducted between March and December of 2011. Three themes emerged from this study: (1) nurses' roles and responsibilities in medication safety: aside from safe preparation and administration, the clinical reasoning of nurses is essential for medication safety; (2) nurses' ability to work safely: knowledge of risks and nurses' work circumstances influence their ability to work safely; and (3) nurses' acceptance of safety practices: advantages, feasibility and appropriateness are important incentives for acceptance of a safety practice. Nurses' experiences coincide with the assumption that they are in a pre-eminent position to enable safe medication management; however, their ability to adequately perform this role depends on sufficient knowledge to assess the risks of medication administration and on the circumstances in which they work. Safe medication management requires a learning climate and professional practice environment that enables further development of professional nursing skills and knowledge. © 2014 John Wiley & Sons Ltd.
Redefining Authentic Research Experiences in Introductory Biology Laboratories and Barriers to Their Implementation

PubMed Central

Spell, Rachelle M.; Guinan, Judith A.; Miller, Kristen R.; Beck, Christopher W.

2014-01-01

Incorporating authentic research experiences in introductory biology laboratory classes would greatly expand the number of students exposed to the excitement of discovery and the rigor of the scientific process. However, the essential components of an authentic research experience and the barriers to their implementation in laboratory classes are poorly defined. To guide future reform efforts in this area, we conducted a national survey of biology faculty members to determine 1) their definitions of authentic research experiences in laboratory classes, 2) the extent of authentic research experiences currently experienced in their laboratory classes, and 3) the barriers that prevent incorporation of authentic research experiences into these classes. Strikingly, the definitions of authentic research experiences differ among faculty members and tend to emphasize either the scientific process or the discovery of previously unknown data. The low level of authentic research experiences in introductory biology labs suggests that more development and support is needed to increase undergraduate exposure to research experiences. Faculty members did not cite several barriers commonly assumed to impair pedagogical reform; however, their responses suggest that expanded support for development of research experiences in laboratory classes could address the most common barrier. PMID:24591509
Redefining authentic research experiences in introductory biology laboratories and barriers to their implementation.

PubMed

Spell, Rachelle M; Guinan, Judith A; Miller, Kristen R; Beck, Christopher W

2014-01-01

Incorporating authentic research experiences in introductory biology laboratory classes would greatly expand the number of students exposed to the excitement of discovery and the rigor of the scientific process. However, the essential components of an authentic research experience and the barriers to their implementation in laboratory classes are poorly defined. To guide future reform efforts in this area, we conducted a national survey of biology faculty members to determine 1) their definitions of authentic research experiences in laboratory classes, 2) the extent of authentic research experiences currently experienced in their laboratory classes, and 3) the barriers that prevent incorporation of authentic research experiences into these classes. Strikingly, the definitions of authentic research experiences differ among faculty members and tend to emphasize either the scientific process or the discovery of previously unknown data. The low level of authentic research experiences in introductory biology labs suggests that more development and support is needed to increase undergraduate exposure to research experiences. Faculty members did not cite several barriers commonly assumed to impair pedagogical reform; however, their responses suggest that expanded support for development of research experiences in laboratory classes could address the most common barrier.
Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration.

PubMed

Moon, Sung-Hoon; Kim, Myung-Hwan; Park, Do Hyun; Song, Tae Joon; Eum, Junbum; Lee, Sang Soo; Seo, Dong Wan; Lee, Sung Koo

2010-07-01

Fully covered self-expandable metal stent (FCSEMS) placement has recently been tried in the management of refractory pancreatic-duct strictures associated with advanced chronic pancreatitis. The major limitation of FCSEMSs was frequent migration. To assess the safety, migration rate, and removability of modified FCSEMSs with antimigration features used for the treatment of benign pancreatic-duct strictures. Prospective study. Tertiary academic center. Thirty-two patients with chronic painful pancreatitis and dominant ductal stricture. Transpapillary endoscopic placement of FCSEMSs in the pancreatic duct with removal after 3 months. Technical and functional success and adverse events associated with the placement of metal stents. FCSEMSs were successfully placed in all patients through the major (n = 27) or minor (n = 5) duodenal papilla. All patients achieved pain relief from stent placement. There was no occurrence of stent-induced pancreatitis or pancreatic sepsis. No stent migrated, and all stents were easily removed. Follow-up ERCP 3 months after stent placement showed resolution of duct strictures in all patients. Pancreatograms obtained at FCSEMS removal displayed de novo focal pancreatic duct strictures in 5 patients, but all were asymptomatic. No long-term follow-up. Temporary 3-month placement of FCSEMSs was effective in resolving pancreatic-duct strictures in chronic pancreatitis, with an acceptable morbidity profile. Modified FCSEMSs can prevent stent migration, but may be associated with de novo duct strictures. Further trials are needed to assess long-term safety and efficacy. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
78 FR 54923 - Federal Advisory Council on Occupational Safety and Health

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

... federal workforce; experience and competence in occupational safety and health; and willingness and... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2013-0013] Federal Advisory Council on Occupational Safety and Health AGENCY: Occupational Safety and Health...
Pediatric emergency and essential surgical care in Zambian hospitals: a nationwide study.

PubMed

Bowman, Kendra G; Jovic, Goran; Rangel, Shawn; Berry, William R; Gawande, Atul A

2013-06-01

Pediatric surgical care in developing countries is not well studied. We sought to identify the range of pediatric surgery available, the barriers to provision, and level of safety of surgery performed for the entire pediatric population in Zambia. In cooperation with the Ministry of Health, we validated and adapted a World Health Organization instrument. During onsite visits, the availability of 32 emergency and essential surgical procedures relevant to children was surveyed. The availability of basic World Health Organization surgical safety criteria was determined. A single interviewer visited 103 (95%) of 108 surgical hospitals in Zambia and carried out 495 interviews. An average of 68% of the 32 emergency and essential surgical procedures was available (range 32%-100%). Lack of surgical skill was the primary reason for referral in 72% of procedure types, compared with 24%, 2% and 3% due to lack of equipment, supplies and anesthesia skills, respectively (p<0.001). Minimum pediatric surgical safety criteria were met by 14% of hospitals. The primary limitation to providing pediatric surgical care in Zambia is lack of surgical skills. Minimum safety standards were met by 14% of hospitals. Efforts to improve pediatric surgery should prioritize teaching surgical skills to expand access and providing safety training, equipment and supplies to increase safety. Copyright © 2013 Elsevier Inc. All rights reserved.
Annual report to Congress: Department of Energy activities relating to the Defense Nuclear Facilities Safety Board, Calendar Year 1999

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

None

2000-02-01

This is the tenth Annual Report to the Congress describing Department of Energy activities in response to formal recommendations and other interactions with the Defense Nuclear Facilities Safety Board (Board). The Board, an independent executive-branch agency established in 1988, provides advice and recommendations to the Secretary of Energy regarding public health and safety issues at the Department's defense nuclear facilities. The Board also reviews and evaluates the content and implementation of health and safety standards, as well as other requirements, relating to the design, construction, operation, and decommissioning of the Department's defense nuclear facilities. During 1999, Departmental activities resulted inmore » the closure of nine Board recommendations. In addition, the Department has completed all implementation plan milestones associated with three Board recommendations. One new Board recommendation was received and accepted by the Department in 1999, and a new implementation plan is being developed to address this recommendation. The Department has also made significant progress with a number of broad-based initiatives to improve safety. These include expanded implementation of integrated safety management at field sites, opening of a repository for long-term storage of transuranic wastes, and continued progress on stabilizing excess nuclear materials to achieve significant risk reduction.« less
Practices and exploration on competition of molecular biological detection technology among students in food quality and safety major.

PubMed

Chang, Yaning; Peng, Yuke; Li, Pengfei; Zhuang, Yingping

2017-07-08

With the increasing importance in the application of the molecular biological detection technology in the field of food safety, strengthening education in molecular biology experimental techniques is more necessary for the culture of the students in food quality and safety major. However, molecular biology experiments are not always in curricula of Food quality and safety Majors. This paper introduced a project "competition of molecular biological detection technology for food safety among undergraduate sophomore students in food quality and safety major", students participating in this project needed to learn the fundamental molecular biology experimental techniques such as the principles of molecular biology experiments and genome extraction, PCR and agarose gel electrophoresis analysis, and then design the experiments in groups to identify the meat species in pork and beef products using molecular biological methods. The students should complete the experimental report after basic experiments, write essays and make a presentation after the end of the designed experiments. This project aims to provide another way for food quality and safety majors to improve their knowledge of molecular biology, especially experimental technology, and enhances them to understand the scientific research activities as well as give them a chance to learn how to write a professional thesis. In addition, in line with the principle of an open laboratory, the project is also open to students in other majors in East China University of Science and Technology, in order to enhance students in other majors to understand the fields of molecular biology and food safety. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(4):343-350, 2017. © 2017 The International Union of Biochemistry and Molecular Biology.
The attitudes of emergency department nurses towards patient safety.

PubMed

Durgun, Hanife; Kaya, Hülya

2017-11-23

This research was planned to identify the attitudes of emergency department nurses towards patient safety. The study was performed as descriptive. The universe of the research the universe comprised hospitals defined as 3rd level according to Turkish health care classification, which provides service to all health disciplines in Istanbul. The sample consisted of emergency department (ED) nurses who work in those hospitals. The data was collected by using tools such as the "Information Questionnaire" and the "Patient Safety Attitudes Scale". In this study, the attitudes of ED nurses towards patient safety were found to be average and was not related to age, gender, education level, nursing experience, ED experience, ED certification, patient safety training, nurse's self sufficiency perception of patient safety, hospital's quality certification or ED quality certification. The attitudes of nurses towards patient safety were compared by age, gender, marital status, education level, ED experience and there was no meaningful difference. However, a meaningful difference was found between the age groups and the "defining stress" sub-dimension of the Patient Safety Attitudes Scale. ED nurses' status of certification for emergency care, patient safety training, training of quality, hospitals' or ED's quality certification status had no significant statistical difference. Copyright © 2017 Elsevier Ltd. All rights reserved.
Maintenance of safety behaviors via response-produced stimuli.

PubMed

Angelakis, Ioannis; Austin, Jennifer L

2015-11-01

Animal studies suggest that safety behaviors may be maintained by internally or externally produced safety signals, which function as positive reinforcers. We designed two experiments to test this phenomenon with humans. Participants played a computerized game in which they could earn or lose treasures by clicking on a map. In baseline, losses could be postponed by pressing a pedal that also produced a blue bar at the bottom of the screen. During test conditions, no losses were programmed, and pedal presses turned the bar from yellow to blue (Test 1) or blue to yellow (Test 2). In Experiment 2, new participants were exposed to the same conditions but were given information about the safety of the test environment. In both experiments, participants engaged in high rates of pedal pressing when presses were followed by blue bars, suggesting the bar functioned as a safety signal. We discuss how these findings may relate to safety behaviors commonly observed in certain mental health disorders. © The Author(s) 2015.
On the dynamics of the Mouth of the Columbia River: Results from a three-dimensional fully coupled wave-current interaction model

NASA Astrophysics Data System (ADS)

Akan, Çiǧdem; Moghimi, Saeed; Özkan-Haller, H. Tuba; Osborne, John; Kurapov, Alexander

2017-07-01

Numerical simulations were performed using a 3-D ocean circulation model (ROMS) two-way coupled to a phase-averaged wave propagation model (SWAN), to expand our understanding of the dynamics of wave-current interactions at the Mouth of the Columbia River (MCR). First, model results are compared with water elevations, currents, temperature, salinity, and wave measurements obtained by the U.S. Army Corp of Engineers during the Mega-Transect Experiment in 2005. We then discuss the effects of the currents on the waves and vice versa. Results show that wave heights are intensified notably at the entrance of the mouth in the presence of the tidal currents, especially in ebb flows. We also find nonlocal modifications to the wave field because of wave focusing processes that redirect wave energy toward the inlet mouth from adjacent areas, resulting in the presence of a tidal signatures in areas where local currents are weak. The model also suggests significant wave amplification at the edge of the expanding plume in the later stages of ebb, some tens of kilometers offshore of the inlet mouth, with potential implications for navigation safety. The effect of waves on the location of the plume is also analyzed, and results suggest that the plume is shifted in the down-wave direction when wave effects are considered, and that this shift is more pronounced for larger waves, and consistent with the presence of alongshore advection terms in the salt advection equation, which are related to the Stokes velocities associated with waves.
An Ethical Justification for Expanding the Notion of Effectiveness in Vaccine Post-Market Monitoring: Insights from the HPV Vaccine in Canada.

PubMed

Komparic, Ana; Smith, Maxwell J; Thompson, Alison

2016-04-01

Health regulators must carefully monitor the real-world safety and effectiveness of marketed vaccines through post-market monitoring in order to protect the public's health and promote those vaccines that best achieve public health goals. Yet, despite the fact that vaccines used in collective immunization programmes should be assessed in the context of a public health response, post-market effectiveness monitoring is often limited to assessing immunogenicity or limited programmatic features, rather than assessing effectiveness across populations. We argue that post-market monitoring ought to be expanded in two ways to reflect a 'public health notion of post-market effectiveness', which incorporates normative public health considerations: (i) effectiveness monitoring should yield higher quality data and grant special attention to underrepresented and vulnerable populations; and (ii) the scope of effectiveness should be expanded to include a consideration of the various social factors that maximize (and minimize) a vaccine's effectiveness at the population level, paying particular attention to how immunization programmes impact related health gradients. We use the case of the human papillomavirus vaccine in Canada to elucidate how expanding post-market effectiveness monitoring is necessary to close the gap between clinical practice and public health, and to ensure that vaccines are effective in a morally relevant sense.
A national portfolio of bone oncology trials—The Canadian experience in 2012

PubMed Central

Kuchuk, I.; Simos, D.; Addison, C.L.; Clemons, M.

2012-01-01

Background The impact of both cancer and its treatment on bone is an essential component of oncological practice. Bone oncology not only affects patients with both early stage and metastatic disease but also covers the entire spectrum of tumour types. We therefore decided to review and summarise bone oncology-related trials that are currently being conducted in Canada. Method We assessed ongoing and recently completed trials in Canada. We used available North American and Canadian cancer trial websites and also contacted known investigators in this field for their input. Results Twenty seven clinical trials were identified. Seven pertained to local treatment of bone metastasis from any solid tumour type. Seven were systemic treatment trials, five focused on bone biology and predictive factors, three evaluated safety of bone-targeted agents, three were adjuvant trials and two trials investigated impact of cancer therapy on bone health. The majority of trials were related to systemic treatment and bone biology in breast cancer. Most were small, single centre, grant-funded studies. Not surprisingly the larger safety and adjuvant studies were pharmaceutical company driven. Discussion Despite the widespread interest in bone-targeted therapies our survey would suggest that most studies are single centre and breast cancer focused. If major advances in bone oncology are to be made then collaborative strategies are needed to not only increase current sample sizes but to also expand these studies into non-breast cancer populations. PMID:26909263

Safety and core design of large liquid-metal cooled fast breeder reactors

NASA Astrophysics Data System (ADS)

Qvist, Staffan Alexander

In light of the scientific evidence for changes in the climate caused by greenhouse-gas emissions from human activities, the world is in ever more desperate need of new, inexhaustible, safe and clean primary energy sources. A viable solution to this problem is the widespread adoption of nuclear breeder reactor technology. Innovative breeder reactor concepts using liquid-metal coolants such as sodium or lead will be able to utilize the waste produced by the current light water reactor fuel cycle to power the entire world for several centuries to come. Breed & burn (B&B) type fast reactor cores can unlock the energy potential of readily available fertile material such as depleted uranium without the need for chemical reprocessing. Using B&B technology, nuclear waste generation, uranium mining needs and proliferation concerns can be greatly reduced, and after a transitional period, enrichment facilities may no longer be needed. In this dissertation, new passively operating safety systems for fast reactors cores are presented. New analysis and optimization methods for B&B core design have been developed, along with a comprehensive computer code that couples neutronics, thermal-hydraulics and structural mechanics and enables a completely automated and optimized fast reactor core design process. In addition, an experiment that expands the knowledge-base of corrosion issues of lead-based coolants in nuclear reactors was designed and built. The motivation behind the work presented in this thesis is to help facilitate the widespread adoption of safe and efficient fast reactor technology.
The ethics and safety of medical student global health electives

PubMed Central

Dell, Evelyn M.; Varpio, Lara; Petrosoniak, Andrew; Gajaria, Amy

2014-01-01

Objectives To explore and characterize the ethical and safety challenges of global health experiences as they affect medical students in order to better prepare trainees to face them. Methods Semi-structured interviews were conducted with 23 Canadian medical trainees who had participated in global health experiences during medical school. Convenience and snowball sampling were utilized. Using Moustakas’s transcendental phenomenological approach, participant descriptions of ethical dilemmas and patient/trainee safety problems were analyzed. This generated an aggregate that illustrates the essential meanings of global health experience ethical and safety issues faced. Results We interviewed 23 participants who had completed 38 electives (71%, n=27, during pre-clinical years) spend-ing a mean 6.9 weeks abroad, and having visited 23 countries. Sixty percent (n=23) had pre-departure training while 36% (n=14) had post-experience debriefing. Three macro-level themes were identified: resource disparities and provision of care; navigating clinical ethical dilemmas; and threats to trainee safety. Conclusions Medical schools have a responsibility to ensure ethical and safe global health experiences. However, our findings suggest that medical students are often poorly prepared for the ethical and safety dilemmas they encounter during these electives. Medical students require intensive pre-departure training that will prepare them emotionally to deal with these dilemmas. Such training should include discussions of how to comply with clinical limitations. PMID:25341214
47 CFR 5.311 - Additional requirements related to safety of the public.

Code of Federal Regulations, 2014 CFR

2014-10-01

... safety of the public. In addition to the notification requirements of § 5.309, for experiments that may... bands and geographic area as the planned experiment and, as appropriate, their end users; (b) Rapid identification, and elimination, of any harm the experiment may cause; and (c) Identifying an alternate means for...
47 CFR 5.311 - Additional requirements related to safety of the public.

Code of Federal Regulations, 2013 CFR

2013-10-01

... safety of the public. In addition to the notification requirements of § 5.309, for experiments that may... bands and geographic area as the planned experiment and, as appropriate, their end users; (b) Rapid identification, and elimination, of any harm the experiment may cause; and (c) Identifying an alternate means for...
76 FR 39902 - Federal Advisory Council on Occupational Safety and Health (FACOSH)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

... matters involving the Federal workforce, experience and competence in occupational safety and health, and... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0116] Federal Advisory Council on Occupational Safety and Health (FACOSH) AGENCY: Occupational Safety and Health...
10 CFR 70.62 - Safety program and integrated safety analysis.

Code of Federal Regulations, 2013 CFR

2013-01-01

...; (iv) Potential accident sequences caused by process deviations or other events internal to the... of occurrence of each potential accident sequence identified pursuant to paragraph (c)(1)(iv) of this... have experience in nuclear criticality safety, radiation safety, fire safety, and chemical process...
10 CFR 70.62 - Safety program and integrated safety analysis.

Code of Federal Regulations, 2014 CFR

2014-01-01

...; (iv) Potential accident sequences caused by process deviations or other events internal to the... of occurrence of each potential accident sequence identified pursuant to paragraph (c)(1)(iv) of this... have experience in nuclear criticality safety, radiation safety, fire safety, and chemical process...
10 CFR 70.62 - Safety program and integrated safety analysis.

Code of Federal Regulations, 2012 CFR

2012-01-01

...; (iv) Potential accident sequences caused by process deviations or other events internal to the... of occurrence of each potential accident sequence identified pursuant to paragraph (c)(1)(iv) of this... have experience in nuclear criticality safety, radiation safety, fire safety, and chemical process...
Revisiting the Separation of Ferrocene and Acetylferrocene by Adsorption Chromatography: Adding a Third Component

ERIC Educational Resources Information Center

Hwa, Rebecca; Weizman, Haim

2007-01-01

The separation of ferrocene and acetylferrocene by column chromatography is a widely used experiment in undergraduate organic labs. The experiment was expanded into a three-component mixture to increase the challenge of the experiment and to make TLC analysis necessary. (Contains 2 figures.)
Efficacy and Safety of Pembrolizumab in Patients Enrolled in KEYNOTE-030 in the United States: An Expanded Access Program.

PubMed

Gangadhar, Tara C; Hwu, Wen-Jen; Postow, Michael A; Hamid, Omid; Daud, Adil; Dronca, Roxana; Joseph, Richard; O'Day, Steven J; Hodi, F S; Pavlick, Anna C; Kluger, Harriet; Oxborough, Romina P; Yang, Aiming; Gazdoiu, Mihaela; Kush, Debra A; Ebbinghaus, Scot; Salama, April K S

KEYNOTE-030 (ClinicalTrials.gov ID, NCT02083484) was a global expanded access program that allowed access to pembrolizumab, an antiprogrammed death 1 antibody, for patients with advanced melanoma before its regulatory approval. Patients with unresectable stage III/IV melanoma that progressed after standard-of-care therapy, including ipilimumab and, if BRAF mutant, a BRAF inhibitor, were eligible to receive pembrolizumab 2 mg/kg every 3 weeks. Response was assessed by immune-related response criteria by investigator review. Adverse events (AEs) were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. In the United States, 979 patients enrolled between April and September 2014. Of the 947 evaluable patients, 621 (65.6%) remained on treatment and transitioned to receive commercial pembrolizumab following approval by the Food and Drug Administration, whereas 326 (34.4%) discontinued, most commonly for disease progression (39.6%) or death (26.4%). Objective response rate was 14.5% (95% confidence interval, 12.2%-16.8%) in the treated population (n=947) and 22.1% (95% confidence interval, 18.8%-25.5%) in patients who had ≥1 response assessment reported (n=619). Twelve patients achieved complete response. One hundred eighty-one (19.1%) patients experienced ≥1 treatment-related AE, most commonly general disorders (8.0%), skin/subcutaneous tissue disorders (7.3%), and gastrointestinal disorders (6.4%); 29 (3.1%) patients experienced ≥1 grade 3/4 treatment-related AE. Immune-mediated AEs were also reported. There were no treatment-related deaths. The safety and efficacy observed in this expanded access program were consistent with those previously reported for similar populations and support the use of pembrolizumab for patients with advanced melanoma.
Movement maintains forebrain neurogenesis via peripheral neural feedback in larval zebrafish

PubMed Central

Hall, Zachary Jonas

2018-01-01

The postembryonic brain exhibits experience-dependent development, in which sensory experience guides normal brain growth. This neuroplasticity is thought to occur primarily through structural and functional changes in pre-existing neurons. Whether neurogenesis also mediates the effects of experience on brain growth is unclear. Here, we characterized the importance of motor experience on postembryonic neurogenesis in larval zebrafish. We found that movement maintains an expanded pool of forebrain neural precursors by promoting progenitor self-renewal over the production of neurons. Physical cues associated with swimming (bodily movement) increase neurogenesis and these cues appear to be conveyed by dorsal root ganglia (DRG) in the zebrafish body: DRG-deficient larvae exhibit attenuated neurogenic responses to movement and targeted photoactivation of DRG in immobilized larvae expands the pallial pool of proliferative cells. Our results demonstrate the importance of movement in neurogenic brain growth and reveal a fundamental sensorimotor association that may couple early motor and brain development. PMID:29528285
Testing Drugs and Trying Cures: Experiment and Medicine in Medieval and Early Modern Europe.

PubMed

Leong, Elaine; Rankin, Alisha

2017-01-01

This article examines traditions of testing drugs (as substances) and trying cures (on patients) in medieval and early modern Europe. It argues that the history of drug testing needs to be a more central story to overall histories of scientific experiment. The practice of conducting thoughtful-and sometimes contrived-tests on drugs has a rich and varied tradition dating back to antiquity, which expanded in the Middle Ages and early modern period. Learned physicians paired text-based knowledge (reason) with hands-on testing (experience or experiment) in order to make claims about drugs' properties or effects on humans. Lay practitioners similarly used hands-on testing to gain knowledge of pharmaceutical effects. Although drug testing practices expanded in scale, actors, and sites, therpublished a work extolling the virtues of drugs froe was significant continuity from the Middle Ages to the eighteenth century.
National Earthquake Hazards Reduction Program; time to expand

USGS Publications Warehouse

Steinbrugge, K.V.

1990-01-01

All of us in earthquake engineering, seismology, and many related disciplines have been directly or indirectly affected by the National Earthquake Hazards Reduction Program (NEHRP). This program was the result of the Earthquake Hazards Reduction Act of 1977 (Public Law 95-124). With well over a decade of experience, should this expression of public policy now take a different or expanded role?
Agency and Expanding Capabilities in Early Grade Classrooms: What It Could Mean for Young Children

ERIC Educational Resources Information Center

Adair, Jennifer Keys

2014-01-01

In this essay, Jennifer Keys Adair aims to clarify the concept of "agency" as a tool for improving the educational experiences of young children in the early grades. She conceptualizes agency in the context of schooling as the ability to influence what and how something is learned in order to expand capabilities, drawing on economic…
Biochar amendment reduces rice Cd uptake in polluted and unpolluted paddy soils: a long term field experiment

NASA Astrophysics Data System (ADS)

Bian, R.; Cui, L.; Pan, G.; Li, L.

2012-04-01

The bioavailability of Cd in agricultural soils has been a great health concern due to the potential risk through exposure of agro-food produced in Cd-contaminated fields. Yet, rice subject to Cd contamination appears to have expanded at the last decade due to irrigation with waste water and chemical fertilization in south china. This is supposed to raise the Cd accumulation of rice grain. Therefore, techniques to reduce Cd mobility and plant uptake have been a urgent demand for food safety in China.A field experiment was performed in a high-polluted (HP), mid-pollute (MP) and unpolluted (UP) paddy soil with biochar(BC) amendment in 2011. BC was applied in HP, MP and UP in 2008, 2009, 2009 with the rates of 0, 10, 20, 40t ha-1 in HP, MP and 0, 40t ha-1 in UP. The experiment was monitored in 2011. It was observed that BC amendment did not affect rice grain yield but significantly increased soil pH by 0.58-0.77, 1.30 units in MP, UP and there was no difference in HP. The Cacl2 extracted Cd in soil was decreased by 18.1%-28.9% in HP, 49.3%-67.5% in MP and 83.1% in UP, respectively. Meanwhile, H2O extractable Cd in soil was decreased by 20.0%-31.7% in HP, 32.7%-44.2% in MP and 25.0% in UP, respectively. With the BC treatment, rice grain Cd concentration was decreased 4.7%-17.6% in HP, 35.9%-53.4% in MP. Especially in UP field, the rice grain Cd concentration was decreased from 0.22mg kg-1 to 0.07mg kg-1 which was below National standard (0.20mg kg-1) in China. The straw and root Cd contents were also significantly decreased with BC application. Therefore, BC amendment in polluted and unpolluted fields can sustainably reduce rice Cd uptake and it may offer a basic option to reduce Cd levels in rice. Keywords: Biochar, Cd, bioavailability, paddy soil, food safety
Apollo experience report: Safety activities

NASA Technical Reports Server (NTRS)

Rice, C. N.

1975-01-01

A description is given of the flight safety experiences gained during the Apollo Program and safety, from the viewpoint of program management, engineering, mission planning, and ground test operations was discussed. Emphasis is placed on the methods used to identify the risks involved in flight and in certain ground test operations. In addition, there are discussions on the management and engineering activities used to eliminate or reduce these risks.
Perceptions of patient safety culture among healthcare employees in tertiary hospitals of Heilongjiang province in northern China: a cross-sectional study.

PubMed

Li, Ying; Zhao, Yanming; Hao, Yanhua; Jiao, Mingli; Ma, Hongkun; Teng, Baijun; Yang, Kai; Sun, Tongbo; Wu, Qunhong; Qiao, Hong

2018-04-19

Assessing the patient safety culture is necessary for improving patient safety. Research on patient safety culture has attracted considerable attention. Currently, there is little research on patient safety culture in China generally, and in Heilongjiang in northern China specifically. The aim of the study is to explore the perception of healthcare employees about patient safety culture and to determine whether perception differs per sex, age, profession, years of experience, education level and marital status. Cross-sectional study. Thirteen tertiary hospitals in Heilongjiang, northern China. About 1024 healthcare employees. The perception of healthcare employees was measured using the safety attitude questionnaire, which include six dimensions. Higher scores represented more positive attitudes. An analysis of variance was used to compare socio-demographic differences per position, marital status and education; t-tests were used for sex, age and experience. A total of 1024 (85.33%) valid questionnaires were returned. The mean score of the six dimensions was 73.74/100; work conditions (80.19) had the highest score of all the dimensions, and safety climate (70.48) had the lowest. Across distinct dimensions, there were significant differences in perceptions of patient safety culture per sex, age, years of experience, position, marital status and education level (P < 0.05). The findings can help in assessing perceived patient safety culture among healthcare employees and identifying dimensions that require improvement. Interventions aimed at specific socio-demographic groups are necessary to improve patient safety culture.
Application of a model for delivering occupational safety and health to smaller businesses: Case studies from the US

PubMed Central

Cunningham, Thomas R.; Sinclair, Raymond

2015-01-01

Smaller firms are the majority in every industry in the US, and they endure a greater burden of occupational injuries, illnesses, and fatalities than larger firms. Smaller firms often lack the necessary resources for effective occupational safety and health activities, and many require external assistance with safety and health programming. Based on previous work by researchers in Europe and New Zealand, NIOSH researchers developed for occupational safety and health intervention in small businesses. This model was evaluated with several intermediary organizations. Four case studies which describe efforts to reach small businesses with occupational safety and health assistance include the following: trenching safety training for construction, basic compliance and hazard recognition for general industry, expanded safety and health training for restaurants, and fall prevention and respirator training for boat repair contractors. Successful efforts included participation by the initiator among the intermediaries’ planning activities, alignment of small business needs with intermediary offerings, continued monitoring of intermediary activities by the initiator, and strong leadership for occupational safety and health among intermediaries. Common challenges were a lack of resources among intermediaries, lack of opportunities for in-person meetings between intermediaries and the initiator, and balancing the exchanges in the initiator–intermediary–small business relationships. The model offers some encouragement that initiator organizations can contribute to sustainable OSH assistance for small firms, but they must depend on intermediaries who have compatible interests in smaller businesses and they must work to understand the small business social system. PMID:26300585
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.
Application of a model for delivering occupational safety and health to smaller businesses: Case studies from the US.

PubMed

Cunningham, Thomas R; Sinclair, Raymond

2015-01-01

Smaller firms are the majority in every industry in the US, and they endure a greater burden of occupational injuries, illnesses, and fatalities than larger firms. Smaller firms often lack the necessary resources for effective occupational safety and health activities, and many require external assistance with safety and health programming. Based on previous work by researchers in Europe and New Zealand, NIOSH researchers developed for occupational safety and health intervention in small businesses. This model was evaluated with several intermediary organizations. Four case studies which describe efforts to reach small businesses with occupational safety and health assistance include the following: trenching safety training for construction, basic compliance and hazard recognition for general industry, expanded safety and health training for restaurants, and fall prevention and respirator training for boat repair contractors. Successful efforts included participation by the initiator among the intermediaries' planning activities, alignment of small business needs with intermediary offerings, continued monitoring of intermediary activities by the initiator, and strong leadership for occupational safety and health among intermediaries. Common challenges were a lack of resources among intermediaries, lack of opportunities for in-person meetings between intermediaries and the initiator, and balancing the exchanges in the initiator-intermediary-small business relationships. The model offers some encouragement that initiator organizations can contribute to sustainable OSH assistance for small firms, but they must depend on intermediaries who have compatible interests in smaller businesses and they must work to understand the small business social system.

The Worker Exposure Failure Modes and Effects Analysis

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

Lee C. Cadwallader

2004-09-01

This paper documents the activities of the US-Japan exchange in the area of personnel safety at magnetic and laser fusion experiments. A near-miss event with a visiting scientist to the US in 1992 was the impetus for forming the Joint Working Group on Fusion Safety. This exchange has been under way for over ten years and has provided many safety insights for both US and Japanese facility personnel at national institutes and at universities. The background and activities of the Joint Working Group are described, including the facilities that have been visited for safety walkthroughs, the participants from both countries,more » and the main safety issues examined during visits. Based on these visits, some operational safety ideas to enhance experiment safety are given. The near-term future plans of the Safety Monitor Joint Working Group are also discussed.« less
A multidisciplinary protocol for planned skin-preserving delayed breast reconstruction for patients with locally advanced breast cancer requiring postmastectomy radiation therapy: 3-year follow-up.

PubMed

Kronowitz, Steven J; Lam, Candace; Terefe, Welela; Hunt, Kelly K; Kuerer, Henry M; Valero, Vicente; Lance, Samuel; Robb, Geoffrey L; Feng, Lei; Buchholz, Thomas A

2011-06-01

The authors examined the safety of a protocol for planned skin-preserving delayed breast reconstruction after postmastectomy radiotherapy with placement of a tissue expander for patients with locally advanced breast cancer (stages IIB and III). The authors compared 47 patients treated according to the protocol between December 2003 and May 2008 with 47 disease-stage-matched control patients who underwent standard delayed reconstruction after postmastectomy radiotherapy (no skin preservation or tissue expander) during the same period. Protocol-group complication rates were 21 percent for skin-preserving mastectomy and placement of the expander (stage 1), 5 percent for postmastectomy radiotherapy, 25 percent for expander reinflation after radiotherapy, and 24 percent for skin-preserving delayed reconstruction. The complication rate for standard delayed reconstruction was 38 percent. Tissue-expander loss rates were 32 percent overall, 9 percent for stage 1, 5 percent for postmastectomy radiotherapy, and 22 percent for reinflation. Wound-healing complications after reconstruction occurred in 3 percent of protocol-group and 10 percent of control-group patients. The median follow-up time for patients still alive at last follow-up was 40 months (range, 8.5 to 85.3 months). Three-year recurrence-free survival rates were 92 percent (95 percent CI, 83 to 100 percent) and 86 percent (95 percent CI, 76 to 98 percent) for the protocol and control groups, respectively (p = 0.87). In patients with locally advanced breast cancer, skin-preserving mastectomy with a deflated tissue expander on the chest wall during postmastectomy radiotherapy does not increase locoregional recurrence risk and is associated with lower complication rates of definitive reconstruction.
Human factors in modern traffic systems.

PubMed

Noy, Y I

1997-10-01

Traffic systems are undergoing enormous change with the advent of Intelligent Transport Systems (ITS). Although productivity and quality of mobility are emerging interests, safety remains the predominant preoccupation of ITS human factors. It should be evident that while intelligent technologies may have the potential to improve traffic safety, they also have the potential to adversely affect it. Ultimately, the effect on safety depends on the specific technologies that are invoked and the manner in which they are incorporated within the vehicle as well as within the larger road transportation system. Current automotive developments can be characterized as technology-centred solutions rather than user-centred solutions. Greater effort must be directed at understanding and accommodating the human element in the road transportation system in order that future transportation objectives can be achieved. There is a need to expand the scope of traditional human factors to include macro-level effects as well as to place greater emphasis on understanding human interactions with other elements of the system. There is also increasing recognition of the urgent need for systematic procedures and criteria for testing the safety of ITS prior to large-scale market penetration.
Overview of the National Aeronautics and Space Administration's Nondestructive Evaluation (NDE) Program

NASA Technical Reports Server (NTRS)

Generazio, Edward R.

2002-01-01

NASA's Office of Safety and Mission Assurance sponsors an Agency-wide NDE Program that supports Aeronautics and Space Transportation Technology, Human Exploration and Development of Space, Earth Science, and Space Science Enterprises. For each of these Enterprises, safety is the number one priority. Development of the next generation aero-space launch and transportation vehicles, satellites, and deep space probes have highlighted the enabling role that NDE plays in these advanced technology systems. Specific areas of advanced component development, component integrity, and structural heath management are critically supported by NDE technologies. The simultaneous goals of assuring safety, maintaining overall operational efficiency, and developing and utilizing revolutionary technologies to expand human activity and space-based commerce in the frontiers of air and space places increasing demands on the Agencies NDE infrastructure and resources. In this presentation, an overview of NASA's NDE Program will be presented, that includes a background and status of current Enterprise NDE issues, and the NDE investment areas being developed to meet Enterprise safety and mission assurance needs through the year 2009 and beyond.
Safety and efficacy of vismodegib in patients aged ≥65 years with advanced basal cell carcinoma.

PubMed

Chang, Anne Lynn S; Lewis, Karl D; Arron, Sarah T; Migden, Michael R; Solomon, James A; Yoo, Simon; Day, Bann-Mo; McKenna, Edward F; Sekulic, Aleksandar

2016-11-15

Because many patients with unresectable basal cell carcinoma (BCC) are aged ≥65 years, this study explores the efficacy and safety of vismodegib in these patients with locally advanced (la) or metastatic (m) basal cell carcinoma (BCC) in the ERIVANCE BCC trial and the expanded access study (EAS).We compared patients aged ≥65 years to patients aged <65 years taking vismodegib 150 mg/day, using descriptive statistics for response and safety. Patients aged ≥65 years (laBCC/mBCC) were enrolled in ERIVANCE BCC (33/14) and EAS (27/26). Investigator-assessed best overall response rate in patients ≥65 and <65 years was 46.7%/35.7% and 72.7%/52.6% (laBCC/mBCC), respectively, in ERIVANCE BCC and 45.8%/33.3% and 46.9%/28.6%, respectively, in EAS. These differences were not clinically meaningful. Safety was similar in both groups, although those aged ≥65 years had a higher percentage of grade 3-5 adverse events than those aged <65 years. Vismodegib demonstrated similar clinical activity and adverse events regardless of age.
Capacity of hospitals to partner with academia to meet experiential education requirements for pharmacy students.

PubMed

Scheckelhoff, Douglas J; Bush, Colleen G; Flynn, Arlene A; MacKinnon, George E; Myers, Charles E; Kahaleh, Abby A; Knapp, Katherine K; Meier, Joy L; Schwinghammer, Terrence L; Sheaffer, Steven L; Thompson, Brent J; McCluskey, Charles F

2008-11-01

Current hospital and health-system participation in and the future capacity for experiential education for pharmacy students was investigated. An online survey of ASHP members identified as U.S. pharmacy directors was conducted to assess their current and future involvement in partnering with colleges and schools to meet the experiential education requirements for doctor of pharmacy students and the current status of the student learning experiences. Questionnaire items examined the factors on which expanded involvement in experiential education would depend, the nature of support provided by colleges and schools, the types of experiences available for students, respondents' perceptions of factors influencing the quality of experiential education, the value of experiential education to the sites, respondents' challenges and concerns about experiential education, and respondents' current capacity and projections for introductory and advanced experiences through 2012. Data from 549 respondents were analyzed. Most respondents indicated that they had conducted advanced experiences for their 2007 graduates and anticipated that they would continue to do so. Among the top challenges identified regarding advanced experiences were concerns about time to serve and be trained as preceptors and a lack of standardization and coordination among colleges and schools. Hospitals forecasting their future capacity to accommodate students indicated that their projections were highly dependent on the number of pharmacists at their hospitals. Many respondents noted that their capacity projections were tied to their ability to expand clinical services at their hospitals. A survey of pharmacy directors suggested an ability of U.S. hospitals to conduct advanced experiential education opportunities for pharmacy students through 2012 and to expand introductory experiences.
Fundamentals of Aeronautical and Aerospace Medical Science,

DTIC Science & Technology

1981-07-17

internal air bubbles and gas embol - isms can appear; over 18 kilometers it is necessary to use a pressure suit to maintain life safety. 10. Airtight...examinations have expanded this to fractures , muscle and skin injuries, blood spots, muscle tension and weakness, heart and intracranial hemorrhaging...vertebra inclines forward and when the front edge of the vertebra is subjected to a concentration of negative overweightness, fractures occur. If the
The evolving role of radiologists within the health care system.

PubMed

Knechtges, Paul Martin; Carlos, Ruth C

2007-09-01

The traditional view of radiologists as physicians who add value to the health care system solely by generating and interpreting diagnostic images is outdated. Radiologists' roles have expanded to encompass economic gatekeeping, political advocacy, public health delivery, patient safety, quality-of-care improvement, and information technology. It is through these roles that radiologists will continue to find new ways to add value to the health care system.
Civil Forensic Psychiatry - part 3: practical aspects of managing a medico-legal practice.

PubMed

Samuels, Anthony H

2018-06-01

This is the third in a series of papers on Civil Forensic Psychiatry and provides practical advice for forensic psychiatrists, general psychiatrists and trainees who are expanding or contemplating a medico-legal aspect to their practice. Attention to the practice setting, office layout, recording of information, management of documentation, screening of briefs and proper timetabling can improve safety, quality, reliability and workload manageability.
Clinical outcome after the use of a new craniocaudal expandable implant for vertebral compression fracture treatment: one year results from a prospective multicentric study.

PubMed

Noriega, David; Krüger, Antonio; Ardura, Francisco; Hansen-Algenstaedt, Nils; Hassel, Frank; Barreau, Xavier; Beyerlein, Jörg

2015-01-01

The purpose of this prospective multicentric observational study was to confirm the safety and clinical performance of a craniocaudal expandable implant used in combination with high viscosity PMMA bone cement for the treatment of vertebral compression fractures. Thirty-nine VCFs in 32 patients were treated using the SpineJack minimally invasive surgery protocol. Outcome was determined by using the Visual Analogue Scale for measuring pain, the Oswestry Disability Index for scoring functional capacity, and the self-reporting European Quality of Life scores for the quality of life. Safety was evaluated by reporting all adverse events. The occurrence of cement leakages was assessed by either radiographs or CT scan or both. Statistically significant improvements were found regarding pain, function, and quality of life. The global pain score reduction at 1 year was 80.9% compared to the preoperative situation and the result of the Oswestry Disability Index showed a decrease from 65.0% at baseline to 10.5% at 12 months postoperatively. The cement leakage rate was 30.8%. No device- or surgery-related complications were found. This observational study demonstrates promising and persistent results consisting of immediate and sustained pain relief and durable clinical improvement after the procedure and throughout the 1-year follow-up period.
The use of retrievable fully covered self-expanding metal stent in refractory postoperative restenosis of benign esophageal stricture in children.

PubMed

Zhang, Jie; Ren, Lixin; Huo, Jirong; Zhu, Zhiyuan; Liu, Deliang

2013-11-01

This study analyzes the efficacy and safety of a retrievable, fully covered self-expanding metal stent (cSEMS) in the treatment of refractory benign esophageal restenosis in children. This is a retrospective analysis of the application of a newly designed cSEMS in treating refractory benign postoperative restenosis in five children with ages ranging from 16 months to 8 years. Efficacy and safety were evaluated during the follow-up period. cSEMS with or without an antireflux valve at the distal end were successfully placed and removed in five children. These five patients were followed up for 4-12 months after stent removal. Among the five patients, ulcerative stricture was observed in two patients because of reflux esophagitis, while three patients showed no signs of stricture recurrence. Stent migration was observed in three patients, two of which required the stent to be reset. The narrow esophagus was successfully expended to a diameter of 12-13 mm. Besides the observation of mild granulation tissue growth in one case, no severe complications were observed during surgery and after stent placement. Our study suggests that a retrievable, fully covered SEMS is safe and partially effective for treating refractory benign postoperative esophageal restenosis in children during short-term observation. © 2013.
Characterization and Application of a Disposable Rotating Bed Bioreactor for Mesenchymal Stem Cell Expansion.

PubMed

Neumann, Anne; Lavrentieva, Antonina; Heilkenbrinker, Alexandra; Loenne, Maren; Kasper, Cornelia

2014-11-27

Recruitment of mesenchymal stromal cells (MSC) into the field of tissue engineering is a promising development since these cells can be expanded vivo to clinically relevant numbers and, after expansion, retain their ability to differentiate into various cell lineages. Safety requirements and the necessity to obtain high cell numbers without frequent subcultivation of cells raised the question of the possibility of expanding MSC in one-way (single-use) disposable bioreactors. In this study, umbilical cord-derived MSC (UC-MSC) were expanded in a disposable Z 2000 H bioreactor under dynamic conditions. Z was characterized regarding residence time and mixing in order to evaluate the optimal bioreactor settings, enabling optimal mass transfer in the absence of shear stress, allowing an reproducible expansion of MSC, while maintaining their stemness properties. Culture of the UC-MSC in disposable Z 2000 H bioreactor resulted in a reproducible 8-fold increase of cell numbers after 5 days. Cells were shown to maintain specific MSC surface marker expression as well as trilineage differentiation potential and lack stress-induced premature senescence.
Proposal for Certifying Expandable Planetary Surface Habitation Structures

NASA Technical Reports Server (NTRS)

Dorsey, John T.

2011-01-01

A factor-of-safety (FS) of 4.0 is currently used to design habitation structures made from structural soft goods. This approach is inconsistent with using a FS of 2.0 for metallic and polymeric composite pressure vessels as well as soft good structures such as space suits and parachutes. This inconsistency arises by using the FS to improperly account for the unknown effects of a variety of environmental and loading uncertainties. Using a 4.0 FS not only results in additional structural mass, it also makes it difficult to gain insight into the limitations of the material and/or product form and thus, it becomes difficult to make improvements. In order to bring consistency to the design and certification of expandable habitat structures, the approach used by the Federal Aviation Administration (FAA) to certify polymeric composite aircraft structures is used as a model and point of departure. A draft certification plan for Expandable Habitat Structures is developed in this paper and offered as an option for placing habitats made from soft goods on an equal footing with other structural implementations.
Analysis of time in establishing synchronization radio communication system with expanded spectrum conditions for communication with mobile robots

NASA Astrophysics Data System (ADS)

Latinovic, T. S.; Kalabic, S. B.; Barz, C. R.; Petrica, P. Paul; Pop-Vădean, A.

2018-01-01

This paper analyzes the influence of the Doppler Effect on the length of time to establish synchronization pseudorandom sequences in radio communications systems with an expanded spectrum. Also, this paper explores the possibility of using secure wireless communication for modular robots. Wireless communication could be used for local and global communication. We analyzed a radio communication system integrator, including the two effects of the Doppler signal on the duration of establishing synchronization of the received and locally generated pseudorandom sequence. The effects of the impact of the variability of the phase were analyzed between the said sequences and correspondence of the phases of these signals with the interval of time of acquisition of received sequences. An analysis of these impacts is essential in the transmission of signal and protection of the transfer of information in the communication systems with an expanded range (telecommunications, mobile telephony, Global Navigation Satellite System GNSS, and wireless communication). Results show that wireless communication can provide a safety approach for communication with mobile robots.
False Dichotomies and Health Policy Research Designs: Randomized Trials Are Not Always the Answer.

PubMed

Soumerai, Stephen B; Ceccarelli, Rachel; Koppel, Ross

2017-02-01

Some medical scientists argue that only data from randomized controlled trials (RCTs) are trustworthy. They claim data from natural experiments and administrative data sets are always spurious and cannot be used to evaluate health policies and other population-wide phenomena in the real world. While many acknowledge biases caused by poor study designs, in this article we argue that several valid designs using administrative data can produce strong findings, particularly the interrupted time series (ITS) design. Many policy studies neither permit nor require an RCT for cause-and-effect inference. Framing our arguments using Campbell and Stanley's classic research design monograph, we show that several "quasi-experimental" designs, especially interrupted time series (ITS), can estimate valid effects (or non-effects) of health interventions and policies as diverse as public insurance coverage, speed limits, hospital safety programs, drug abuse regulation and withdrawal of drugs from the market. We further note the recent rapid uptake of ITS and argue for expanded training in quasi-experimental designs in medical and graduate schools and in post-doctoral curricula.
Utilizing HDTV as Data for Space Flight

NASA Technical Reports Server (NTRS)

Grubbs, Rodney; Lindblom, Walt

2006-01-01

In the aftermath of the Space Shuttle Columbia accident February 1, 2003, the Columbia Accident Investigation Board recognized the need for better video data from launch, on-orbit, and landing to assess the status and safety of the shuttle orbiter fleet. The board called on NASA to improve its imagery assets and update the Agency s methods for analyzing video. This paper will feature details of several projects implemented prior to the return to flight of the Space Shuttle, including an airborne HDTV imaging system called the WB-57 Ascent Video Experiment, use of true 60 Hz progressive scan HDTV for ground and airborne HDTV camera systems, and the decision to utilize a wavelet compression system for recording. This paper will include results of compression testing, imagery from the launch of STS-114, and details of how commercial components were utilized to image the shuttle launch from an aircraft flying at 400 knots at 60,000 feet altitude. The paper will conclude with a review of future plans to expand on the upgrades made prior to return to flight.
[Audiovisual telecommunication by multimedia technology in HNO medicine. ISDN--internet--ATM].

PubMed

Plinkert, P K; Plinkert, B; Kurek, R; Zenner, H P

2000-11-01

Telemedicine includes all medical activities in diagnosis, therapeutics, or social medicine undertaken by means of an electronic transfer medium, enabling the transmission of visual and acoustic information over long distances to doctors not personally present at the place of the requested consultation. Most experience with telemedicine applications has been gained in the field of diagnosis (teleconsultation, teleradiology, telepathology) and is expanding to quality control and quality assurance. Decisive for each form of application is its availability, practicability, cost, safety, and especially quality of audiovisual transmission. For telesurgical applications, particularly the use of minimally invasive techniques in otorhinolaryngology, head, and neck surgery, the high quality transmission of audiovisual data in real time is necessary. Rapid expansion and further developments in transmission technologies and networks in the last decade have created several technologies with increased quality and costs. In this paper, we tested different transmission media for audiovisual telecommunication--integrated services digital network (ISDN), Internet, and asynchronous transfer mode (ATM)--using real time video transmission of typical operations in otorhinolaryngology. Their applications, costs, and future perspectives are discussed.
[Plants as an alternative source of therapeutic proteins].

PubMed

Łucka, Marta; Kowalczyk, Tomasz; Szemraj, Janusz; Sakowicz, Tomasz

2015-03-22

In recent years, there has been an increased interest of researchers in developing efficient plant heterologous expression systems of proteins for a wide range of applications. It represents an alternative to the traditional strategy utilizing bacterial, yeast, insect or mammalian cells. New techniques of identification and characterization and effective methods of plant genetic transformation allow the range of recombinant protein products to be expanded. Great expectations are associated with the use of plants as bioreactors for the production of specific proteins of therapeutic interest. This strategy offers a number of advantages, the most important being: the possibility of a significant reduction in production costs, the safety of the products obtained and full eukaryotic post-translational modifications of proteins. A group of proteins of special interest is pharmaceuticals, and a number of successful experiments have confirmed the possibility of obtaining heterogeneous proteins with therapeutic potential: monoclonal antibodies, vaccine antigens, and a variety of cytokines. This work is focused on selected recombinant proteins belonging to those groups expression of which was achieved in plant cells. These proteins may be used in the future for therapy or prevention of viral, bacterial or cancer diseases.
Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.

PubMed

Smith, Scott Alan; Yount, Naomi; Sorra, Joann

2017-02-16

A number of private and public companies calculate and publish proprietary hospital patient safety scores based on publicly available quality measures initially reported by the U.S. federal government. This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (Hospital SOPS) assesses provider and staff perceptions of hospital patient safety culture. Consumer Reports (CR), a U.S. based non-profit organization, calculates and shares with its subscribers a Hospital Safety Score calculated annually from patient experience survey data and outcomes data gathered from federal databases. Linking data collected during similar time periods, we analyzed relationships between staff perceptions of patient safety culture composites and the CR Hospital Safety Score and its five components using multiple multivariate linear regressions. We analyzed data from 164 hospitals, with patient safety culture survey responses from 140,316 providers and staff, with an average of 856 completed surveys per hospital and an average response rate per hospital of 56%. Higher overall Hospital SOPS composite average scores were significantly associated with higher overall CR Hospital Safety Scores (β = 0.24, p < 0.05). For 10 of the 12 Hospital SOPS composites, higher patient safety culture scores were associated with higher CR patient experience scores on communication about medications and discharge. This study found a relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases. As hospital managers allocate resources to improve patient safety culture within their organizations, their efforts may also indirectly improve consumer-focused, publicly reported hospital rating scores like the Consumer Reports Hospital Safety Score.
Large-Scale Spacecraft Fire Safety Tests

NASA Technical Reports Server (NTRS)

Urban, David; Ruff, Gary A.; Ferkul, Paul V.; Olson, Sandra; Fernandez-Pello, A. Carlos; T'ien, James S.; Torero, Jose L.; Cowlard, Adam J.; Rouvreau, Sebastien; Minster, Olivier;

2014-01-01

An international collaborative program is underway to address open issues in spacecraft fire safety. Because of limited access to long-term low-gravity conditions and the small volume generally allotted for these experiments, there have been relatively few experiments that directly study spacecraft fire safety under low-gravity conditions. Furthermore, none of these experiments have studied sample sizes and environment conditions typical of those expected in a spacecraft fire. The major constraint has been the size of the sample, with prior experiments limited to samples of the order of 10 cm in length and width or smaller. This lack of experimental data forces spacecraft designers to base their designs and safety precautions on 1-g understanding of flame spread, fire detection, and suppression. However, low-gravity combustion research has demonstrated substantial differences in flame behavior in low-gravity. This, combined with the differences caused by the confined spacecraft environment, necessitates practical scale spacecraft fire safety research to mitigate risks for future space missions. To address this issue, a large-scale spacecraft fire experiment is under development by NASA and an international team of investigators. This poster presents the objectives, status, and concept of this collaborative international project (Saffire). The project plan is to conduct fire safety experiments on three sequential flights of an unmanned ISS re-supply spacecraft (the Orbital Cygnus vehicle) after they have completed their delivery of cargo to the ISS and have begun their return journeys to earth. On two flights (Saffire-1 and Saffire-3), the experiment will consist of a flame spread test involving a meter-scale sample ignited in the pressurized volume of the spacecraft and allowed to burn to completion while measurements are made. On one of the flights (Saffire-2), 9 smaller (5 x 30 cm) samples will be tested to evaluate NASAs material flammability screening tests. The first flight (Saffire-1) is scheduled for July 2015 with the other two following at six-month intervals. A computer modeling effort will complement the experimental effort. Although the experiment will need to meet rigorous safety requirements to ensure the carrier vehicle does not sustain damage, the absence of a crew removes the need for strict containment of combustion products. This will facilitate the first examination of fire behavior on a scale that is relevant to spacecraft fire safety and will provide unique data for fire model validation.

Improving patient safety in Libya: insights from a British health system perspective.

PubMed

Elmontsri, Mustafa; Almashrafi, Ahmed; Dubois, Elizabeth; Banarsee, Ricky; Majeed, Azeem

2018-04-16

Purpose Patient safety programmes aim to make healthcare safe for both patients and health professionals. The purpose of this paper is to explore the UK's patient safety improvement programmes over the past 15 years and explore what lessons can be learnt to improve Libyan healthcare patient safety. Design/methodology/approach Publications focusing on UK patient safety were searched in academic databases and content analysed. Findings Several initiatives have been undertaken over the past 15 years to improve British healthcare patient safety. Many stakeholders are involved, including regulatory and professional bodies, educational providers and non-governmental organisations. Lessons can be learnt from the British journey. Practical implications Developing a national patient safety strategy for Libya, which reflects context and needs is paramount. Above all, Libyan patient safety programmes should reference internationally approved guidelines, evidence, policy and learning from Britain's unique experience. Originality/value This review examines patient safety improvement strategies adopted in Britain to help developing country managers to progress local strategies based on lessons learnt from Britain's unique experience.
Thematic Analysis of Women's Perspectives on the Meaning of Safety During Hospital-Based Birth.

PubMed

Lyndon, Audrey; Malana, Jennifer; Hedli, Laura C; Sherman, Jules; Lee, Henry C

2018-05-01

To explore women's birth experiences to develop an understanding of their perspectives on patient safety during hospital-based birth. Qualitative description using thematic analysis of interview data. Seventeen women ages 29 to 47 years. Women participated in individual or small group interviews about their birth experiences, the physical environment, interactions with clinicians, and what safety meant to them in the context of birth. An interdisciplinary group of five investigators from nursing, medicine, product design, and journalism analyzed transcripts thematically to examine how women experienced feeling safe or unsafe and identify opportunities for improvements in care. Participants experienced feelings of safety on a continuum. These feelings were affected by confidence in providers, the environment and organizational factors, interpersonal interactions, and actions people took during risk moments of rapid or confusing change. Well-organized teams and sensitive interpersonal interactions that demonstrated human connection supported feelings of safety, whereas some routine aspects of care threatened feelings of safety. Physical and emotional safety are inextricably embedded in the patient experience, yet this connection may be overlooked in some inpatient birth settings. Clinicians should be mindful of how the birth environment and their behaviors in it can affect a woman's feelings of safety during birth. Human connection is especially important during risk moments, which represent a liminal space at the intersection of physical and emotional safety. At least one team member should focus on the provision of emotional support during rapidly changing situations to mitigate the potential for negative experiences that can result in emotional harm. Copyright © 2018 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
Planning the Unplanned Experiment: Towards Assessing the Efficacy of Standards for Safety-Critical Software

NASA Technical Reports Server (NTRS)

Graydon, Patrick J.; Holloway, C. M.

2015-01-01

Safe use of software in safety-critical applications requires well-founded means of determining whether software is fit for such use. While software in industries such as aviation has a good safety record, little is known about whether standards for software in safety-critical applications 'work' (or even what that means). It is often (implicitly) argued that software is fit for safety-critical use because it conforms to an appropriate standard. Without knowing whether a standard works, such reliance is an experiment; without carefully collecting assessment data, that experiment is unplanned. To help plan the experiment, we organized a workshop to develop practical ideas for assessing software safety standards. In this paper, we relate and elaborate on the workshop discussion, which revealed subtle but important study design considerations and practical barriers to collecting appropriate historical data and recruiting appropriate experimental subjects. We discuss assessing standards as written and as applied, several candidate definitions for what it means for a standard to 'work,' and key assessment strategies and study techniques and the pros and cons of each. Finally, we conclude with thoughts about the kinds of research that will be required and how academia, industry, and regulators might collaborate to overcome the noted barriers.
Expanding protection motivation theory: investigating an application to animal owners and emergency responders in bushfire emergencies.

PubMed

Westcott, Rachel; Ronan, Kevin; Bambrick, Hilary; Taylor, Melanie

2017-04-26

Protection Motivation Theory (PMT) was developed by Rogers in 1975, to describe how individuals are motivated to react in a self-protective way towards a perceived health threat. Rogers expected the use of PMT to diversify over time, which has proved true over four decades. The purpose of this paper is to explore how PMT can be used and expanded to inform and improve public safety strategies in natural hazards. As global climate change impacts on the Australian environment, natural hazards seem to be increasing in scale and frequency, and Emergency Services' public education campaigns have necessarily escalated to keep pace with perceived public threat. Of concern, is that the awareness-preparedness gap in residents' survival plans is narrowing disproportionately slowly compared to the magnitude of resources applied to rectify this trend. Practical applications of adaptable social theory could be used to help resolve this dilemma. PMT has been used to describe human behaviour in individuals, families, and the parent-child unit. It has been applied to floods in Europe and wildfire and earthquake in the United States. This paper seeks to determine if an application of PMT can be useful for achieving other-directed human protection across a novel demographic spectrum in natural hazards, specifically, animal owners and emergency responders in bushfire emergencies. These groups could benefit from such an approach: owners to build and fortify their response- and self-efficacy, and to help translate knowledge into safer behaviour, and responders to gain a better understanding of a diverse demographic with animal ownership as its common denominator, and with whom they will be likely to engage in contemporary natural hazard management. Mutual collaboration between these groups could lead to a synergy of reciprocated response efficacy, and safer, less traumatic outcomes. Emergency services' community education programs have made significant progress over the last decade, but public safety remains suboptimal while the magnitude of the awareness-preparedness gap persists. This paper examines an expanded, other-directed application of PMT to expand and enhance safer mitigation and response behaviour strategies for communities threatened by bushfire, which may ultimately help save human life.
[Ethic review on clinical experiments of medical devices in medical institutions].

PubMed

Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

2011-07-01

Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.
Toast, Anyone? Project Teaches Electricity Basics and Math

ERIC Educational Resources Information Center

Quagliana, David F.

2010-01-01

This article describes an electrical technology experiment that shows students how to determine the cost of using an electrical appliance. The experiment also provides good math practice and teaches basic electricity terms and concepts, such as volt, ampere, watt, kilowatt, and kilowatt-hour. This experiment could be expanded to calculate the cost…
Redefining Authentic Research Experiences in Introductory Biology Laboratories and Barriers to Their Implementation

ERIC Educational Resources Information Center

Spell, Rachelle M.; Guinan, Judith A.; Miller, Kristen R.; Beck, Christopher W.

2014-01-01

Incorporating authentic research experiences in introductory biology laboratory classes would greatly expand the number of students exposed to the excitement of discovery and the rigor of the scientific process. However, the essential components of an authentic research experience and the barriers to their implementation in laboratory classes are…
Women's Experiences with Postpartum Anxiety: Expectations, Relationships, and Sociocultural Influences

ERIC Educational Resources Information Center

Wardrop, Andrea A.; Popadiuk, Natalee E.

2013-01-01

Evidence about anxiety in the postpartum is sparse and contradictory. Our research expands this knowledge by using a qualitative methodology, the Feminist Biographical Method, to explore first time mothers' experiences of postpartum anxiety. Data collection included 1.5 to 2.0 hour interviews with six women about their experiences of anxiety in…
Widening the Lens: Nonresidential College Students' Educational Experiences at an Urban Institution

ERIC Educational Resources Information Center

Passer, Marni

2012-01-01

The purpose of this study was to examine the experiences of traditional age, nonresidential students in higher education who, in contrast with their residential peers, are rarely studied in higher education research. As the population of nonresidential students expands, it becomes important to examine nonresidential students' experiences in…
Safety in the Chemical Laboratory: Learning How to Run Safer Undergraduate Laboratories.

ERIC Educational Resources Information Center

Mohrig, Jerry R.

1983-01-01

Discusses responsibilities for providing safe experiments and for teaching about safety. Provides lists of references on chemical safety and regulated/potential carcinogens. Also discusses general laboratory safety procedures including waste disposal and recycling of solvents. (JM)
Wire insulation degradation and flammability in low gravity

NASA Technical Reports Server (NTRS)

Friedman, Robert

1994-01-01

This view-graph presentation covers the following topics: an introduction to spacecraft fire safety, concerns in fire prevention in low gravity, shuttle wire insulation flammability experiment, drop tower risk-based fire safety experiment, and experimental results, conclusions, and proposed studies.
Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care

PubMed Central

Thompson, Hale M.

2016-01-01

Abstract Purpose: In 2015, the Centers for Medicare and Medicaid Services ruled that health organizations comply with additional requirements for electronic health records (EHRs), known as “Meaningful Use,” and develop the capacity to collect gender identity data. Research has established effectiveness of a two-step gender identity question to collect these data. This study examines transgender patient perspectives on the use of a two-step question and experiences with privacy and sensitive disclosures in EHRs and healthcare settings. Methods: Four focus groups (N=30) were conducted in Chicago, Illinois in 2014–2015. Participants were asked to compare two intake forms—one with a two-step question and one with a single question—and discuss experiences with gender identity disclosure, privacy, and access to care. Narratives were transcribed verbatim to identify patterns and themes; the extended case method was used and grounded the data analysis process in the concept of intersectionality. Results: Participants expressed appreciation for improved reliability and competencies that the two-part question may afford. Narratives reveal concerns related to patient privacy, safety, and access because of the contexts in which these data are collected and transmitted. Virtually all participants described situations whereby sensitive gender identity information had been involuntarily disclosed, misinterpreted, or abused, and safety and care were compromised. Conclusion: Participants recognized the potential of the two-part question as a measurement and competency tool, but anticipated new privacy violations and involuntary disclosures. Narratives indicate that effects of sensitive disclosures may vary intersectionally, whereby white participants experienced lesser harms than their immigrant, HIV-positive, and black trans feminine counterparts. Discrimination and privacy violations may occur regardless of a two-part or one-part gender identity question, but increasing these sensitive disclosures within expanding EHR infrastructures may require a range of mechanisms that have flexibility across contexts to safeguard sensitive information and access to care. PMID:28861535
Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care.

PubMed

Thompson, Hale M

2016-01-01

Purpose: In 2015, the Centers for Medicare and Medicaid Services ruled that health organizations comply with additional requirements for electronic health records (EHRs), known as "Meaningful Use," and develop the capacity to collect gender identity data. Research has established effectiveness of a two-step gender identity question to collect these data. This study examines transgender patient perspectives on the use of a two-step question and experiences with privacy and sensitive disclosures in EHRs and healthcare settings. Methods: Four focus groups ( N =30) were conducted in Chicago, Illinois in 2014-2015. Participants were asked to compare two intake forms-one with a two-step question and one with a single question-and discuss experiences with gender identity disclosure, privacy, and access to care. Narratives were transcribed verbatim to identify patterns and themes; the extended case method was used and grounded the data analysis process in the concept of intersectionality. Results: Participants expressed appreciation for improved reliability and competencies that the two-part question may afford. Narratives reveal concerns related to patient privacy, safety, and access because of the contexts in which these data are collected and transmitted. Virtually all participants described situations whereby sensitive gender identity information had been involuntarily disclosed, misinterpreted, or abused, and safety and care were compromised. Conclusion: Participants recognized the potential of the two-part question as a measurement and competency tool, but anticipated new privacy violations and involuntary disclosures. Narratives indicate that effects of sensitive disclosures may vary intersectionally, whereby white participants experienced lesser harms than their immigrant, HIV-positive, and black trans feminine counterparts. Discrimination and privacy violations may occur regardless of a two-part or one-part gender identity question, but increasing these sensitive disclosures within expanding EHR infrastructures may require a range of mechanisms that have flexibility across contexts to safeguard sensitive information and access to care.
Radiation predictions and shielding calculations for RITS-6

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

Maenchen, John Eric; O'Malley, John; Kensek, Ronald Patrick

2005-06-01

The mission of Radiographic Integrated Test Stand-6 (RITS-6) facility is to provide the underlying science and technology for pulsed-power-driven flash radiographic X-ray sources for the National Nuclear Security Administration (NNSA). Flash X-ray radiography is a penetrating diagnostic to discern the internal structure in dynamic experiments. Short (~50 nanosecond (ns) duration) bursts of very high intensity Xrays from mm-scale source sizes are required at a variety of voltages to address this mission. RITS-6 was designed and is used to both develop the accelerator technology needed for these experiments and serves as the principal test stand to develop the high intensity electronmore » beam diodes that generate the required X-ray sources. RITS is currently in operation with three induction cavities (RITS-3) with a maximum voltage output of 5.5 MV and is classified as a low hazard non-nuclear facility in accordance with CPR 400.1.1, Chapter 13, Hazards Identification/Analysis and Risk Management. The facility will be expanded from three to six cavities (RITS-6) effectively doubling the operating voltage. The increase in the operating voltage to above 10 MV has resulted in RITS-6 being classified as an accelerator facility. RITS-6 will come under DOE Order 420.2B, Safety of Accelerator Facilities. The hazards of RITS are detailed in the "Safety Assessment Document for the Radiographic Integrated Test Stand Facility." The principal non-industrial hazard is prompt x-ray radiation. As the operating voltage is increased, both the penetration power and the total amount (dose) of x-rays are increased, thereby increasing the risk to local personnel. Fixed site shielding (predominantly concrete walls and a steel/lead skyshine shield) is used to attenuate these x-rays and mitigate this risk. This SAND Report details the anticipated x-ray doses, the shielding design, and the anticipated x-ray doses external to this shielding structure both in areas where administrative access control restricts occupation and in adjacent uncontrolled areas.« less
Is the Focus of Attention in Working Memory Expanded Through Practice?

ERIC Educational Resources Information Center

Oberauer, Klaus

2006-01-01

This article reinvestigates the claim by P. Verhaeghen, J. Cerella, and C. Basak (2004) that the focus of attention in working memory can be expanded from 1 to 4 items through practice. Using a modified version of Verhaeghen et al.'s n-back paradigm, Experiments 1 and 3 show that a signature of a one-item focus, the time cost for switching between…
Fire safety practices in the Shuttle and the Space Station Freedom

NASA Technical Reports Server (NTRS)

Friedman, Robert

1993-01-01

The Shuttle reinforces its policy of fire-preventive measures with onboard smoke detectors and Halon 1301 fire extinguishers. The forthcoming Space Station Freedom will have expanded fire protection with photoelectric smoke detectors, radiation flame detectors, and both fixed and portable carbon dioxide fire extinguishers. Many design and operational issues remain to be resolved for Freedom. In particular, the fire-suppression designs must consider the problems of gas leakage in toxic concentrations, alternative systems for single-failure redundancy, and commonality with the corresponding systems of the Freedom international partners. While physical and engineering requirements remain the primary driving forces for spacecraft fire-safety technology, there are, nevertheless, needs and opportunities for the application of microgravity combustion knowledge to improve and optimize the fire-protective systems.
Spent nuclear fuel project cold vacuum drying facility operations manual

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

IRWIN, J.J.

This document provides the Operations Manual for the Cold Vacuum Drying Facility (CVDF). The Manual was developed in conjunction with HNF-SD-SNF-SAR-002, Safety Analysis Report for the Cold Vacuum Drying Facility, Phase 2, Supporting Installation of Processing Systems (Garvin 1998) and, the HNF-SD-SNF-DRD-002, 1997, Cold Vacuum Drying Facility Design Requirements, Rev. 3a. The Operations Manual contains general descriptions of all the process, safety and facility systems in the CVDF, a general CVD operations sequence, and has been developed for the SNFP Operations Organization and shall be updated, expanded, and revised in accordance with future design, construction and startup phases of themore » CVDF until the CVDF final ORR is approved.« less
Advanced propulsion engine assessment based on a cermet reactor

NASA Technical Reports Server (NTRS)

Parsley, Randy C.

1993-01-01

A preferred Pratt & Whitney conceptual Nuclear Thermal Rocket Engine (NTRE) has been designed based on the fundamental NASA priorities of safety, reliability, cost, and performance. The basic philosophy underlying the design of the XNR2000 is the utilization of the most reliable form of ultrahigh temperature nuclear fuel and development of a core configuration which is optimized for uniform power distribution, operational flexibility, power maneuverability, weight, and robustness. The P&W NTRE system employs a fast spectrum, cermet fueled reactor configured in an expander cycle to ensure maximum operational safety. The cermet fuel form provides retention of fuel and fission products as well as high strength. A high level of confidence is provided by benchmark analysis and independent evaluations.
Safety in the Chemical Laboratory: Developing Departmental Safety Procedures.

ERIC Educational Resources Information Center

Renfrew, Malcolm M., Ed.; Palladino, George F.

1980-01-01

Presents rationale and guidelines for development of Safety Standard Operating Procedures (Safety SOP) specific for local conditions. Includes an outline of a Safety SOP developed for a department primarily focused on undergraduate education with a wide variety of expertise from common laborer to PhD with 20 years experience. (Author/JN)
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...
Handbook for Public Playground Safety.

ERIC Educational Resources Information Center

Consumer Product Safety Commission, Washington, DC.

Playgrounds, being a fundamental part of the childhood experience, should be safe havens for children. This handbook includes technical safety guidelines for designing, constructing, operating, and maintaining public playgrounds. It also includes a "Public Playground Safety Checklist" to highlight some of the most important safety issues…
Treatment of cerebral vasospasm with self-expandable retrievable stents: proof of concept.

PubMed

Bhogal, Pervinder; Loh, Yince; Brouwer, Patrick; Andersson, Tommy; Söderman, Michael

2017-01-01

To report our preliminary experience with the use of stent retrievers to cause vasodilation in patients with delayed cerebral vasospasm secondary to subarachnoid hemorrhage. Four patients from two different high volume neurointerventional centers developed cerebral vasospasm following subarachnoid hemorrhage. In addition to standard techniques for the treatment of cerebral vasospasm, we used commercially available stent retrievers (Solitaire and Capture stent retrievers) to treat the vasospastic segment including M2, M1, A2, and A1. We evaluated the safety of this technique, degree of vasodilation, and longevity of the effect. Stent retrievers can be used to safely achieve cerebral vasodilation in the setting of delayed cerebral vasospasm. The effect is long-lasting (>24 hours) and, in our initial experience, carries a low morbidity. We have not experienced any complications using this technique although we have noted that the radial force was not sufficient to cause vasodilation in some instances. The vasospasm did not return in the vessel segments treated with stent angioplasty in any of these cases. In two of our cases stent angioplasty resulted in the reversal of focal neurological symptoms. Stent retrievers can provide long-lasting cerebral vasodilation in patients with delayed cerebral vasospasm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Anesthesia for subcutaneous implantable cardioverter-defibrillator implantation: Perspectives from the clinical experience of a US panel of physicians.

PubMed

Essandoh, Michael K; Mark, George E; Aasbo, Johan D; Joyner, Charles A; Sharma, Saumya; Decena, Beningo F; Bolin, Eric D; Weiss, Raul; Burke, Martin C; McClernon, Timothy R; Daoud, Emile G; Gold, Michael R

2018-05-13

Worldwide adoption of the subcutaneous implantable cardioverter-defibrillator (S-ICD) for preventing sudden cardiac death continues to increase, as longer-term evidence demonstrating the safety and efficacy of the S-ICD expands. As a relatively new technology, comprehensive anesthesia guidance for the management of patients undergoing S-ICD placement is lacking. This article presents advantages and disadvantages of different peri-procedural sedation and anesthesia options for S-ICD implants including general anesthesia, monitored anesthesia care, regional anesthesia, and nonanesthesia personnel administered sedation and analgesia. Guidance, for approaches to anesthesia care during S-ICD implantation, are presented based upon literature review and consensus of a panel of high volume S-ICD implanters, a regional anesthesiologist, and a cardiothoracic anesthesiologist with significant S-ICD experience. The panel developed suggested actions for perioperative sedation, anesthesia, surgical practices and a decision algorithm for S-ICD implantation. While S-ICD implantation currently requires higher sedation than transvenous ICD systems, the panel consensus is that general anesthesia is not required or is obligatory for the majority of patients for the experienced S-ICD implanter. The focus of the implanting physician and the anesthesia services should be to maximize patient comfort and take into consideration patient specific co-morbidities, with a low threshold to consult the anesthesiology team. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Experimental constraints on impact-induced winds

NASA Astrophysics Data System (ADS)

Quintana, Stephanie N.; Schultz, Peter H.; Horowitz, Seth S.

2018-05-01

A new class of wind streaks on Mars uniquely associated with impact craters is most clearly detected in nighttime thermal infrared imaging. Thermally bright streaks radiate from some well-preserved impact craters and are related to the impact process. Using laboratory experiments performed at the NASA Ames Vertical Gun Range, we test the hypothesis that these streaks are formed from either the winds within an air-blast or winds set up by expanding impact vapor interacting with the atmosphere. The experiments use a variety of tracers and instruments to document three interrelated processes occurring in the impact of a Pyrex projectile into an easily vaporized powdered dolomite target: (1) a surface roughening spreading outward from the impact point, (2) an expanding vapor plume, and (3) outward winds made visible by dust trails from vertically placed, dusty pipe cleaners. The clear connection between the surface roughening, vapor expansion, and outward winds implicate an expanding vapor interacting with the atmosphere as the controlling process.
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
Effects of an educational patient safety campaign on patients' safety behaviours and adverse events.

PubMed

Schwappach, David L B; Frank, Olga; Buschmann, Ute; Babst, Reto

2013-04-01

Rationale, aims and objectives The study aims to investigate the effects of a patient safety advisory on patients' risk perceptions, perceived behavioural control, performance of safety behaviours and experience of adverse incidents. Method Quasi-experimental intervention study with non-equivalent group comparison was used. Patients admitted to the surgical department of a Swiss large non-university hospital were included. Patients in the intervention group received a safety advisory at their first clinical encounter. Outcomes were assessed using a questionnaire at discharge. Odds ratios for control versus intervention group were calculated. Regression analysis was used to model the effects of the intervention and safety behaviours on the experience of safety incidents. Results Two hundred eighteen patients in the control and 202 in the intervention group completed the survey (75 and 77% response rates, respectively). Patients in the intervention group were less likely to feel poorly informed about medical errors (OR = 0.55, P = 0.043). There were 73.1% in the intervention and 84.3% in the control group who underestimated the risk for infection (OR = 0.51, CI 0.31-0.84, P = 0.009). Perceived behavioural control was lower in the control group (meanCon = 3.2, meanInt = 3.5, P = 0.010). Performance of safety-related behaviours was unaffected by the intervention. Patients in the intervention group were less likely to experience any safety-related incident or unsafe situation (OR for intervention group = 0.57, CI 0.38-0.87, P = 0.009). There were no differences in concerns for errors during hospitalization. There were 96% of patients (intervention) who would recommend other patients to read the advisory. Conclusions The results suggest that the safety advisory decreases experiences of adverse events and unsafe situations. It renders awareness and perceived behavioural control without increasing concerns for safety and can thus serve as a useful instrument for communication about safety between health care workers and patients. © 2012 Blackwell Publishing Ltd.
The role of the Therapeutic Goods Administration and the Medicine and Medical Devices Safety Authority in evaluating complementary and alternative medicines in Australia and New Zealand.

PubMed

Ghosh, Dilip; Skinner, Margot; Ferguson, Lynnette R

2006-04-03

Currently, the regulation of complementary and alternative medicines and related health claims in Australia and New Zealand is managed in a number of ways. Complementary medicines, including herbal, minerals, nutritional/dietary supplements, aromatherapy oils and homeopathic medicines are regulated under therapeutic goods/products legislation. The Therapeutic Goods Administration (TGA), a division of the Commonwealth Department of Health and Ageing is responsible for administering the provisions of the legislation in Australia. The New Zealand Medicines and Medical Devices Safety Authority (Medsafe) administers the provision of legislation in New Zealand. In December 2003 the Australian and New Zealand governments signed a Treaty to establish a single, bi-national agency to regulate therapeutic products, including medical devices prescription, over-the-counter and complementary medicines. A single agency will replace the Australian TGA and the New Zealand Medsafe. The role of the new agency will be to safeguard public health through regulation of the quality, safety and efficacy or performance of therapeutic products in both Australia and New Zealand. The major activities of the new joint Australia New Zealand therapeutic products agency are in product licensing, specifying labelling standards and setting the advertising scheme, together with determining the risk classes of medicines and creating an expanded list of ingredients permitted in Class I medicines. A new, expanded definition of complementary medicines is proposed and this definition is currently under consultation. Related Australian and New Zealand legislation is being developed to implement the joint scheme. Once this legislation is passed, the Treaty will come into force and the new joint regulatory scheme will begin. The agency is expected to commence operation no later than 1 July 2006 and will result in a single agency to regulate complementary and alternative medicines.
Annual report to Congress: Department of Energy activities relating to the Defense Nuclear Facilities Safety Board, calendar year 1998

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

NONE

1999-02-01

This is the ninth Annual Report to the Congress describing Department of Energy (Department) activities in response to formal recommendations and other interactions with the Defense Nuclear Facilities Safety Board (Board). The Board, an independent executive-branch agency established in 1988, provides advice and recommendations to the Secretary of energy regarding public health and safety issues at the Department`s defense nuclear facilities. The Board also reviews and evaluates the content and implementation of health and safety standards, as well as other requirements, relating to the design, construction, operation, and decommissioning of the Department`s defense nuclear facilities. The locations of the majormore » Department facilities are provided. During 1998, Departmental activities resulted in the proposed closure of one Board recommendation. In addition, the Department has completed all implementation plan milestones associated with four other Board recommendations. Two new Board recommendations were received and accepted by the Department in 1998, and two new implementation plans are being developed to address these recommendations. The Department has also made significant progress with a number of broad-based initiatives to improve safety. These include expanded implementation of integrated safety management at field sites, a renewed effort to increase the technical capabilities of the federal workforce, and a revised plan for stabilizing excess nuclear materials to achieve significant risk reduction.« less
Increasing Patient Safety by Closing the Sterile Production Gap-Part 2. Implementation.

PubMed

Agalloco, James P

2017-01-01

Terminal sterilization is considered the preferred means for the production of sterile drug products because it affords enhanced safety for the patient as the formulation is filled into its final container, sealed, and sterilized. Despite the obvious patient benefits, the use of terminal sterilization is artificially constrained by unreasonable expectations for the minimum time-temperature process to be used. The core misunderstanding with terminal sterilization is a fixation that destruction of a high concentration of a resistant biological indicator is required. The origin of this misconception is unclear, but it has resulted in sterilization conditions that are extremely harsh (15 min at 121 °C, of F 0 >8 min), which limit the use of terminal sterilization to extremely heat-stable formulations. These articles outline the artificial nature of the process constraints and describe a scientifically sound means to expand the use of terminal sterilization by identifying the correct process goal-the destruction of the bioburden present in the container prior to sterilization. Recognition that the true intention is bioburden destruction in routine products allows for the use of reduced conditions (lower temperatures, shorter process dwell, or both) without added patient risk. By focusing attention on the correct process target, lower time-temperature conditions can be used to expand the use of terminal sterilization to products unable to withstand the harsh conditions that have been mistakenly applied. The first article provides the background, and describes the benefits to patient, producer, and regulator. The second article includes validation and operational advice that can be used in the implementation. LAY ABSTRACT: Terminal sterilization is considered the preferred means for the production of sterile drug products because it affords enhanced safety for the patient as the formulation is filled into its final container, sealed, and sterilized. Despite the obvious patient benefits, the use of terminal sterilization is artificially constrained by unreasonable expectations for the minimum time-temperature process to be used. These articles outline the artificial nature of the process constraints and describe a scientifically sound means to expand the use of terminal sterilization by identifying the correct process goal-the destruction of the bioburden present in the container prior to sterilization. By focusing attention on the correct process target, lower time-temperature conditions can be used to expand the use of terminal sterilization to products unable to withstand the harsh conditions that have been mistakenly applied. The first article provides the background, and describes the benefits to patient, producer, and regulator. The article manuscript includes validation and operational advice that can be used in the implementation. © PDA, Inc. 2017.
Farmworkers at the border: a bilingual initiative for occupational health and safety.

PubMed

Acosta, Martha Soledad Vela; Sechrest, Lee; Chen, Mei-Kuang

2009-01-01

Bilingual and bicultural occupational health and safety interventions for Hispanic farmworkers are extremely rare and, because of language barriers and cultural differences, issues important to their health and safety on the job remain unaddressed. We designed, conducted, and assessed the first bilingual occupational health and safety education program for farmworkers attending High School Equivalency Programs (HEPs). We took an interdisciplinary participatory approach by integrating educators and researchers with a community advisory board to guide development, evaluation, and implementation of Work Safely-Trabaje con Cuidado Curriculum (Curriculum), a bilingual occupational health and safety curriculum. We created a quasi-experimental design using mixed-method evaluation (quantitative and qualitative elements) via pre- and posttest comparisons, follow-up surveys, and focus groups assessing the Curriculum effect on knowledge, safety risk perception (SRP), and safety behavior. Focus groups and follow-up surveys reflected success and acceptance of the Curriculum among participating farmworkers under the study's logic model. Completion of the Curriculum resulted in statistically significant improvements in the combined score of knowledge and SRP at the posttest (p = 0.001) and follow-up survey (p = 0.02) in the intervention group. After completing this study, the Curriculum was permanently adopted by the two high school equivalency sites involved. The participatory approach resulted in integration of community and applied research partnership. The potential to expand use of this Curriculum by other HEP sites can further assess effectiveness and external validity among underserved minority groups.
Rare Esophageal Migration of AXIOS Stent Used for Walled-off Pancreatic Necrosis Drainage

PubMed Central

Renno, Anas; Hammad, Tariq; Nawras, Ali

2017-01-01

The AXIOS stent (Boston Scientific, Marlborough, MA) is a novel lumen-apposing self-expandable metallic stent designed for enteric drainage of nonadherent lumens. Efficacy and safety of using the AXIOS stent for pancreatic fluid drainage have been consistently shown in several studies. Although it is less common with this novel stent, stent migration still may happen. We present a case of AXIOS stent migration into the esophagus. PMID:28584846
Expanding leadership capacity: educational levels for nurse leaders.

PubMed

Yoder-Wise, Patricia S; Scott, Elaine S; Sullivan, Dori Taylor

2013-06-01

A master's degree in nursing administration prepares the nurse to lead nursing and interprofessional teams, to create new and innovative approaches to improve care processes and outcomes, as well as traditional management responsibilities related to budgets, human resources, quality and safety, and a healthy work environment. Are we not at a critical juncture in our profession when we should challenge the profession to require a master's degree education for all levels of nursing administration?
Port and Waterways Safety Assessment Workshop Report, New York

DTIC Science & Technology

2008-09-01

conduct Operation Clear Channel (14) • Increase the number of small craft fueling stations outside the port area (2) • Expand VTS AOR to include the...Island (6) • Increase the number of fueling stations outside of the port area (5) • Encourage less aggressive timetables for commuter ferries (5...data available through Stevens Institute of Technology, sponsored by the State of New York • Ambrose Light being replaced with a NOAA weather
Medical Area Body Network. Final rule.

PubMed

2012-09-11

This document expands the Commission's Medical Device Radiocommunications Service (MedRadio) rules to permit the development of new Medical Body Area Network (MBAN) devices in the 2360-2400 MHz band. The MBAN technology will provide a flexible platform for the wireless networking of multiple body transmitters used for the purpose of measuring and recording physiological parameters and other patient information or for performing diagnostic or therapeutic functions, primarily in health care facilities. This platform will enhance patient safety, care and comfort by reducing the need to physically connect sensors to essential monitoring equipment by cables and wires. This decision is the latest in a series of actions to expand the spectrum available for wireless medical use. The Commission finds that the risk of increased interference is minimal and is greatly outweighed by the benefits of the MBAN rules.
Safety restraint use in Virginia : use rate trends from 1983 through 1995.

DOT National Transportation Integrated Search

1996-01-01

The purpose of this report was to take a retrospective glance at Virginia's experience in getting her citizens to use the automobile safety restraint systems available to them. In Virginia, data on safety belt and child safety seat use were collected...
Decision-Based Design of a Low Vision Aid

DTIC Science & Technology

1999-12-05

No loss ML 32 Aniridia Cloudy No Loss TT 35 Glaucoma Cloudy No Loss MM 23 Stargardt Disease Clear Loss AP 40 Congenital Retinal Malformations...brief clinical background evaluation, and a post-experiment questionnaire. The study was further expanded in scope to gather data for the VRD...Introduction and clinical evaluation 3) Experiments with red, blue and green images 4) Experiments with white images 5) Post experiment
Cognitive therapy for social anxiety disorder: the impact of the "self-focused attention and safety behaviours experiment" on the course of treatment.

PubMed

Schreiber, Franziska; Heimlich, Christiane; Schweitzer, Clea; Stangier, Ulrich

2015-03-01

Several studies have shown that cognitive therapy is an effective treatment for social anxiety disorder (SAD). However, it remains unclear which of the complex interventions are associated with an anxiety reduction during the course of treatment. The aim of this study was to examine the impact of the intervention referred to as the "self-focused attention and safety behaviours experiment" on treatment outcome. This study was part of a randomized controlled trial including 16 sessions of either individual cognitive therapy (CT) or interpersonal therapy (IPT) for SAD. Of particular importance, a concomitant time-series analysis was used to investigate the impact of the self-focused attention and safety behaviours experiment on subsequent social anxiety (1, 2, 3, and 4 weeks after the intervention) in 32 patients with SAD, who are receiving cognitive treatment. The results revealed a significant reduction of social anxiety after the self-focused attention and safety behaviours experiment during the subsequent month of treatment. The findings of the current study confirm current cognitive theories of SAD and demonstrate the importance of interventions that target self-focused attention and safety behaviour in cognitive therapy for SAD.

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